Impact Of Drug Therapy Research Articles

Impact of Drug Therapy on Visual Acuity in Diabetic Retinopathy among Adults in Saudi Arabia: A Cross-sectional Analysis

Abstract Introduction: Diabetes mellitus, a global health concern, is increasingly prevalent and leads to various complications, notably diabetic retinopathy (DR), a major cause of visual impairment. This study aims to investigate the impact of pharmacological treatments on visual outcomes in DR patients, focusing on the Saudi Arabian population. Methods: This cross-sectional study was conducted in various healthcare centres across Saudi Arabia, enrolling 2233 DR patients aged 20 years and above. The methodology involved stratified random sampling to ensure diverse demographic representation. Data collection encompassed interviews, medical record analysis and standardised assessments, focusing on pharmacological treatment types, treatment duration, visual acuity outcomes and the presence of other diabetic complications. Statistical analysis was conducted using SPSS software version 28. Results: The study revealed that patients on oral medications, especially metformin, reported higher perceived improvements in visual acuity (53.9%) compared to those on anti-vascular endothelial growth factor treatments. A significant correlation was found between the duration of pharmacological treatment and the severity of DR. Furthermore, age and duration of diabetes were identified as influential factors in visual acuity outcomes. The study also noted that combination treatments did not significantly worsen visual acuity. Conclusion: This study underscores the importance of personalised pharmacological treatment strategies in managing DR in Saudi Arabia. Future research should focus on longitudinal studies to further explore the long-term impacts of these treatments. The study’s insights are crucial for optimising patient care and improving visual outcomes in DR patients.

A Prospective Observational Study on Assessment of Prescribing Pattern and Effectiveness of Psychotropic Medication on Schizophrenia in a Tertiary Care Hospital

Abstract: Aim: Schizophrenia is a chronic mental disorder that is related to poor physical health, early death and severe functional impairment. Schizophrenia is a worldwide condition that affects 1% of the population. It refers to a category of symptoms that involve disorganized and bizarre thinking, delusions, hallucinations, inappropriate affect and poor psychosocial functioning. Aim/Background: The main aim of the study is to assess the prescribing pattern and effectiveness of psychotropic medication on schizophrenia. Materials and Methods: Patient data was collected using data collection form which included the demographic details, mental status examination, diagnosis and medications. Assessment of prescription pattern was done by analyzing the prescription of 30 patients. Effectiveness was evaluated using PANSS SCALE. Results: A total of 30 patients with schizophrenia were studied. Anti-psychotics were prescribed to 27 (90%) of the patients. Anti-depressants were prescribed to 5 (16.7%) patients. Mood stabilizers were prescribed to 2 (6.7%) patients. Tranquilizers/hypnotics were prescribed to 8 (26.7%) patients. Anti- cholinergic were prescribed to 11 (36.7%) patients. Other psychiatry drugs were prescribed to 4 (13.3%) patients. There was a significant reduction in PANSS score before and after treatment. This shows that psychotropic medication are effective in treating patients with schizophrenia. Conclusion: The present study concludes that antipsychotics are the most prescribed drugs in schizophrenia followed by anticholinergic. Psychotropic medications are effective in treating schizophrenia as it was proved by PANSS score analysis. The study report also showed that the impact of drug therapy was more effective in males than in females as it shows a significant improvement in the symptoms of schizophrenia. Keywords: Effectiveness, Prescription pattern, Gender, Polypharmacy, PANSS and Schizophrenia.

The impact of drug therapy on minor oral surgery procedures

Some advanced and slightly more invasive treatments require the use of certain drugs before, during and after the treatment like local anesthetics, vasoconstrictors, anxiolytics, analgesics and antibiotics. All of these can possibly interact with medications a patient is already taking and can also interfere with the current dental treatment and create complications. This article aims to provide necessary information about commonly encountered systemic diseases and associated treating medications, their mechanism of action, possible complications and their management. CPD/Clinical Relevance: This article discusses drugs that are used for treating various systemic conditions, but can have a harmful effect on minor oral surgery procedures.

What is the impact of drug therapy with antiresorptive agents on the success of dental implants? a literature review

Objective: To review the current literature and provide the latest information on anti-resorptive agent-induced osteonecrosis of the jaw (ARONJ), including our basic and clinical research findings, as well as discuss the risks of developing osteonecrosis in patients undergoing dental implant surgery in use of anti-resorptive drugs (ARDs). Methods: A literature review was performed using articles published in indexed journals based on Pubmed, Web of Science, Embase and Scopus databases. Results: Our results show that the placement of dental implants in patients treated with ARDs should be carefully evaluated, these patients are not free from complications and, therefore, the risk assessment should be done individually, as one of the most serious complications, although rare, is the ARONJ. Conclusion: Thus, all patients treated with this type of drug should be informed about the risk of implant loss or the possibility of osteonecrosis, being necessary to inform about the increased risk also patients who already have osteointegrated implants and will start therapy with bisphosphonates (BPT). And, in addition, establishing a relationship and collaboration between doctor, dentist and patient is essential for the good prognosis of these cases.

Effects of zoledronic acid on bone structure and organization of nanocomposites in rats with obesity and limited mobility

Abstract Background: Some investigations show that obesity is associated with increase in bone mass due to excessive mechanical exertion. However, these data are contradictory as loss of mineral density of bone tissue and, respectively, the risk of fractures in this population group is higher. The aim of the research was to investigate impact of drug therapy with zoledronic acid on nanostructure of bones in rats with limited mobility and high-calorie diet. Methods: Rats (n = 56) were distributed into three groups: control (n = 18) – standard vivarium conditions, І experimental group (n = 18) – rats, which were on a high-calorie diet with limited mobility (HCD+LM), ІІ experimental group (n = 18) – HCD+LM+zoledronic acid. Zoledronic acid was injected at the dose 0.025 mg/kg intramuscularly every four weeks for six months. X-ray structure analysis, scanning electron microscopy and atomic absorption spectrometry were used for investigation of ultrastructure and quantitative assessment of mineral component loss in the femoral neck. Results: Obesity and limited mobility reduced the level of the mineral component in the femoral neck (−31.5%) compared with control. It is significant that zoledronic acid did not permit decrease in mineral component of the bone throughout the entire experiment compared with group I (+41.8%), and all parameters were higher than in control group (+15%). Conclusions: Obesity and limited mobility negatively affect mineral bone mass. Zoledronic acid induces increase in the mineral component as a result of remodeling inhibition under conditions of obesity and limited mobility modeling.

Modeling and simulations of CoViD-19 molecular mechanism induced by cytokines storm during SARS-CoV2 infection

It is highly desired to explore the interventions of COVID-19 for early treatment strategies. Such interventions are still under consideration. A model is benchmarked research and comprises target cells, virus infected cells, immune cells, pro-inflammatory cytokines, and, anti-inflammatory cytokine. The interaction of the drug with the inflammatory sub-system is analyzed with the aid of kinetic modeling. The impact of drug therapy on the immune cells is modelled and the computational framework is verified with the aid of numerical simulations. The work includes a significant hypothesis that quantifies the complex dynamics of the infection, by relating it to the effect of the inflammatory syndrome generated by IL-6. In this paper we use the cancer immunoediting process: a dynamic process initiated by cancer cells in response to immune surveillance of the immune system that it can be conceptualized by an alternating movement that balances immune protection with immune evasion. The mechanisms of resistance to immunotherapy seem to broadly overlap with those used by cancers as they undergo immunoediting to evade detection by the immune system. In this process the immune system can both constrain and promote tumour development, which proceeds through three phases termed: (i) Elimination, (ii) Equilibrium, and, (iii) Escape [1]. We can also apply these concepts to viral infection, which, although it is not exactly “immunoediting”, has many points in common and helps to understand how it expands into an “untreated” host and can help in understanding the SARS-CoV2 virus infection and treatment model.

Impact of drug therapy on the risk of death in patients with coronary heart disease (according to the data of registry of cardiovascular diseases, RECVASA)

The aim of the study was to evaluate the effect of the drug therapy assigned at the index visit on the risk of fatal outcome in outpatients with coronary heart disease within 24 months from the index visit, based on the data of registry of cardiovascular diseases (RECVASA). Follow-up feedback was 97.4%, the survival rate - 90.6%. The study found that the prescribing of angiotensin-converting enzyme (ACE) inhibitors or ACE inhibitors/angiotensin receptor blockers II (ARB) was associated with reduction of all-cause mortality by 1.6 times (p=0.016) and 2.0 times (p=0.006), respectively, statins - by 1.6 times (p=0.038). The risk of death from cardiovascular causes in the case of prescribing of ACE inhibitors or ACE inhibitors/ARBs decreased by 2.1 times (p=0.0008) and 2.3 times (p=0.0008), respectively, statins - by 1,7 times (p=0.048).

Impact of drug therapy on brachioradial pruritus.

Few studies have described therapeutic options in brachioradial pruritus. We describe a cross-sectional study of brachioradial pruritus patients treated in an outpatient unit. We reviewed medical records and interviewed brachioradial pruritus patients without indication for decompressive surgery, in order to access the perceptions of intensity of pruritus prior to treatment and response to therapy. We found that antidepressants and anticonvulsants were the most frequently prescribed drugs. Best reductions in pruritus were associated with its highest intensities prior to treatment, and with longer periods of therapy.

Влияние лекарственной терапии, назначенной по поводу ишемической болезни сердца, на риск смертельного исхода у амбулаторных пациентов, по данным РЕгистра КардиоВАскулярных ЗАболеваний (РЕКВАЗА)

Влияние лекарственной терапии, назначенной по поводу ишемической болезни сердца, на риск смертельного исхода у амбулаторных пациентов, по данным РЕгистра КардиоВАскулярных ЗАболеваний (РЕКВАЗА)

SYSTEMIC OSTEOPOROSIS AND PSORIATIC ARTHRITIS: CURRENT UNDERSTANDING OF THE PROBLEM

The review deals with the problem of generalized osteoporosis (OP) in psoriatic arthritis (PsA). Works published in the past 15 years were sought in the Medline using the keywords «psoriatic arthritis», «osteoporosis», and «osteoporosisassociated fractures» (fragility fractures, low-energy fractures, and osteoporotic fractures). The paper includes the data of studies on the frequency of OP and fractures, the risk factors of OP, and the impact of drug therapy on bone status in patients with PsA.

Impact of drug therapy on long-term prognosis in patients with ischemic chronic heart failure with preserved ejection fraction and renal dysfunction

Despite the achievements of recent decades, chronic heart failure (CHF) is one of the most widespread and steadily progressive disease which accompanied by high mortality. Aim. To investigate the effect of combined drug therapy for long-term prognosis in patients with ischemic heart failure with reduced ejection fraction of left ventricle and renal dysfunction. Materials and methods. The study involved 140 patients (114 (81.4%) men) with ischemic chronic heart failure; average age was 60 [54.5-68] years. Therapy included: ACE inhibitors/ARBs (90%), beta blockers (94.3%), diuretics (87.8%), statins (84.3%), mineralocorticoid receptor antagonists (75%), antiplatelet agents (70.7%), calcium antagonists (14.3%), amiodarone (18.6%), ivabradin (15%). The cumulative survival curves were constructed by the Kaplan-Meier method using and groups were compared with the log-rank test. Results. In our study it has been established that statins inclusion in the therapy of patients with ischemic heart failure with reduced ejection fraction of left ventricle and renal dysfunction reduces the risk of cumulative endpoint by 51% (hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.26 -0.91, p=0.02), prescription of trimetazidine - by 43% (HR 0.57, 95% CI 0.34-0.95, p=0.03), nitrates - by 47% (HR 0.53; 95% CI 0.31-0.89, p=0.01). Inclusion of mineralocorticoid receptor antagonists increased number of cardiovascular events during three years of monitoring (HR 1.88, 95% CI 1.21-2.94, p=0.005). Inclusion of aspirin reduced the risk of SCD by 75% (HR 0.25, 95% CI 0.12-0.53, p=0.0004). Inclusion of nitrates by 55% (HR 0.45, 95% CI 0.23-0.89, p=0.02) and statins by 68% (HR 0.32, 95% CI 0.14-0.72; p=0.006) reduced hospitalization. Conclusion. Based on three-year monitoring results of ischemic heart failure patients with reduced ejection fraction and renal dysfunction it has been found that the inclusion of statins, nitrates, trimetazidine to standard therapy was associated with reduced risk of cumulative endpoint and hospitalization caused by heart failure decompensation.

Impact of drug therapy on long-term prognosis in patients with ischemic chronic heart failure with reduced ejection fraction and renal dysfunction

Impact of drug therapy on long-term prognosis in patients with ischemic chronic heart failure with reduced ejection fraction and renal dysfunction

Hypothalamic energy metabolism is impaired by doxorubicin independently of inflammation in non-tumour-bearing rats.

We sought to explore the effects of doxorubicin on inflammatory profiles and energy metabolism in the hypothalamus of rats. To investigate these effects, we formed two groups: a control (C) group and a Doxorubicin (DOXO) group. Sixteen rats were randomly assigned to either the control (C) or DOXO groups. The hypothalamus was collected. The levels of interleukin (IL)-1β, IL-6, IL-10, TNF-α and energy metabolism (malate dehydrogenase, complex I and III activities) were analysed in the hypothalamus. The DOXO group exhibited a decreased body weight (p < 0.01). Hypothalamic malate dehydrogenase activity was reduced when compared with control (p < 0.05). In addition, pro-inflammatory cytokine levels were unchanged. Therefore, our results demonstrate that doxorubicin leads to an impairment of \hypothalamic energy metabolism, but do not affect the inflammatory pathway. SIGNIFICANCE PARAGRAPH: The hypothalamus is a central organ that regulates a great number of functions, such as food intake, temperature and energy expenditure, among others. Doxorubicin can lead to deep anorexia and metabolic chaos; thus, we observed the effect of this chemotherapeutic drug on the inflammation and metabolism in rats after the administration of doxorubicin in order to understand the central effect in the hypothalamus. Drug treatment by doxorubicin is used as a cancer therapy; however the use of this drug may cause harmful alterations to the metabolism. Thus, further investigations are needed on the impact of drug therapy over the long term.

Impact of drug therapy and surgery on quality of life in Crohn's disease: a systematic review.

Crohn's disease is associated with substantially impaired health-related quality of life (HRQoL). Even in the absence of active disease, patients with Crohn's disease report lower HRQoL, poorer function, and greater concerns, than those without disease. Achievement of disease remission in Crohn's disease, whether by pharmacological or surgical means, is associated with improved HRQoL, although the durability of the improvement seen after intestinal resection is uncertain because of the high rate of postoperative disease recurrence. This review focuses on the available literature on HRQoL in patients with Crohn's disease with an emphasis on the effects of intestinal resection and immunomodulatory therapy.

Modeling tissue- and mutation- specific electrophysiological effects in the long QT syndrome: role of the Purkinje fiber.

Congenital long QT syndrome is a heritable family of arrhythmias caused by mutations in 13 genes encoding ion channel complex proteins. Mounting evidence has implicated the Purkinje fiber network in the genesis of ventricular arrhythmias. In this study, we explore the hypothesis that long QT mutations can demonstrate different phenotypes depending on the tissue type of expression. Using computational models of the human ventricular myocyte and the Purkinje fiber cell, the biophysical alteration in channel function in LQT1, LQT2, LQT3, and LQT7 are modeled. We identified that the plateau potential was important in LQT1 and LQT2, in which mutation led to minimal action potential prolongation in Purkinje fiber cells. The phenotype of LQT3 mutation was dependent on the biophysical alteration induced as well as tissue type. The canonical ΔKPQ mutation causes severe action potential prolongation in both tissue types. For LQT3 mutation F1473C, characterized by shifted channel availability, a more severe phenotype was seen in Purkinje fiber cells with action potential prolongation and early afterdepolarizations. The LQT3 mutation S1904L demonstrated striking effects on action potential duration restitution and more severe action potential prolongation in Purkinje fiber cells at higher heart rates. Voltage clamp simulations highlight the mechanism of effect of these mutations in different tissue types, and impact of drug therapy is explored. We conclude that arrhythmia formation in long QT syndrome may depend not only on the basis of mutation and biophysical alteration, but also upon tissue of expression. The Purkinje fiber network may represent an important therapeutic target in the management of patients with heritable channelopathies.

Radiation-Associated Kidney Injury

The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients.

Outcomes in Adolescents with Postural Orthostatic Tachycardia Syndrome Treated with Midodrine and β‐Blockers

Postural orthostatic tachycardia syndrome (POTS) is associated with debilitating fatigue, dizziness, and discomfort in previously healthy adolescents. The effects of medical therapy have not been well studied in this patient population. This study assessed the relative efficacy and impact of drug therapy on the functioning and quality of life in adolescents with POTS. A retrospective, single center, chart review analysis with a follow-up written survey was conducted on a group of 121 adolescents who had undergone autonomic reflex screening at the Mayo Clinic from 2002 to 2005 as part of an evaluation for possible POTS. Of 121 surveys sent, 47 adolescents returned a completed survey. In this cohort of patients, the two most commonly prescribed drug therapies were midodrine (n = 13) and beta-blockers (n = 14). Patients in the midodrine group were comparable to patients in the beta-blocker group in gender, age, pretreatment postural heart rate changes, and months from initial evaluation to survey completion. More patients treated with a beta-blocker reported improvement after visiting Mayo Clinic (100% vs 62%, P = 0.016) and more attributed their progress to medication (63.6% vs 36.4%, P = 0.011) than did those treated with midodrine. Treatment with both midodrine and beta-blockers was associated with overall improvement in POTS patients' general health; however, adolescents taking beta-blockers were more likely than those taking midodrine to credit the role of medications in their improvement.

Assessing the effect of fibromyalgia on patients’sexual activity

AIMS: The primary aim of this study was to investigate whether a questionnaire developed for patients with rheumatoid arthritis (RA) could also be used with patients who have fibromyalgia. A secondary aim was to assess the impact of fibromyalgia on sexuality. METHOD: In the first of two phases the face and content validity of a sexuality questionnaire already being used in patients with RA were assessed in a qualitative, audio-taped, interview study of five patients with fibromyalgia. The second phase consisted of a self-report questionnaire distributed to 60 patients with fibromyalgia. FINDINGS: The interview data confirmed that the content of the RA sexuality questionnaire was relevant to patients with fibromyalgia. A total of 43 (72%) questionnaires were returned and, of these, 41 (95%) were usable. Patients reported that fibromyalgia had altered their sexual relationship. They cited pain, stiffness, fatigue, reduced sexual drive and the impact of drug therapy as the main reasons. CONCLUSION: The symptoms associated with fibromyalgia had a negative effect on sexual enjoyment. The questionnaire appears to be useful in addressing sexuality in patients with fibromyalgia.

Assessing the effect of fibromyalgia on patients’ sexual activity

The primary aim of this study was to investigate whether a questionnaire developed for patients with rheumatoid arthritis (RA) could also be used with patients who have fibromyalgia. A secondary aim was to assess the impact of fibromyalgia on sexuality. In the first of two phases the face and content validity of a sexuality questionnaire already being used in patients with RA were assessed in a qualitative, audio-taped, interview study of five patients with fibromyalgia. The second phase consisted of a self-report questionnaire distributed to 60 patients with fibromyalgia. The interview data confirmed that the content of the RA sexuality questionnaire was relevant to patients with fibromyalgia. A total of 43 (72%) questionnaires were returned and, of these, 41 (95%) were usable. Patients reported that fibromyalgia had altered their sexual relationship. They cited pain, stiffness, fatigue, reduced sexual drive and the impact of drug therapy as the main reasons. The symptoms associated with fibromyalgia had a negative effect on sexual enjoyment. The questionnaire appears to be useful in addressing sexuality in patients with fibromyalgia.

Impact of Drug Therapy, Radiation Dose, and Dose Rate on Renal Toxicity Following Bone Marrow Transplantation

To demonstrate a radiation dose response and to determine the dosimetric and chemotherapeutic factors that influence the incidence of late renal toxicity following total body irradiation (TBI). A comprehensive retrospective review was performed of articles reporting late renal toxicity, along with renal dose, fractionation, dose rate, chemotherapy regimens, and potential nephrotoxic agents. In the final analysis, 12 articles (n = 1,108 patients), consisting of 24 distinct TBI/chemotherapy conditioning regimens were included. Regimens were divided into three subgroups: adults (age > or =18 years), children (age <18 years), and mixed population (both adults and children). Multivariate logistic regression was performed to identify dosimetric and chemotherapeutic factors significantly associated with late renal complications. Individual analysis was performed on each population subgroup. For the purely adult population, the only significant variable was total dose. For the mixed population, the significant variables included total dose, dose rate, and the use of fludarabine. For the pediatric population, only the use of cyclosporin or teniposide was significant; no dose response was noted. A logistic model was generated with the exclusion of the pediatric population because of its lack of dose response. This model yielded the following significant variables: total dose, dose rate, and number of fractions. A dose response for renal damage after TBI was identified. Fractionation and low dose rates are factors to consider when delivering TBI to patients undergoing bone marrow transplantation. Drug therapy also has a major impact on kidney function and can modify the dose-response function.