Medicine Intake Research Articles

On The Design of a Novel Smart Medicine Box Towards Detecting the Medicine Expiry Date and Facilitating Medication Planning for Visually Challenged

Population growth has led to the increase of different types of medication, burden on nurses and pharmacy clerks. Studies have shown that on an average a person takes about five different types of medication for any illness. This medication has led to several other medication errors as the patient is taking wrong medicine at the wrong time in a day. This is highly prevalent in people who are older in age and for the people, who are visual impaired or challenged. These people face difficulty in checking the expiry date of the medication because of smaller text size and fonts. It is well known that consumption of an expired product is fatal. To prevent this medication error, forgetting medicine intake and consumption of expired medication; the Smart Medicine Box idea is used. It is a boxlike structure with certain compartments. The compartment has LCD screen that displays the name of the medicine stored and the date of expiration for that medicine. In addition, the box contains speaker to announce the name of the medicine and date of expiration. To assist the visually impaired to take the correct medication vibration mechanism has been set up where the compartment containing the medicine to be taken at that time vibrates indicating to the user. Image processing technique is used to process and analyse the bar code of the medication for the expiration date and the name of the medication. Ultrasonic Sensors are used to detect the pending number of pills within the compartment; a microcontroller is used to control the process. In this research effort, after a critical overview of the state-of-the-art developments in this important field we outline in detail the proposed architecture for such an efficient smart medicine box, defining its components and its preliminary UML related diagrams.

Chronic Kidney Disease of Unknown Etiology in Telangana: Is It Different?

Background Chronic kidney disease of unknown etiology (CKDu) is emerging as an important cause for CKD in various parts of the world, including India. This study was done to determine the risk factors and histology of CKDu in Telangana, a neighboring state of Andhra Pradesh that has CKDu hotspots. Materials and Methods This prospective observational study was done from March 2021 to November 2022 at a tertiary care center in Hyderabad. Patients were included as per the Indian CKDu definition. Sociodemographic data, examination, and investigations were obtained. Drinking water was analyzed. Patients with preserved kidney sizes underwent kidney biopsy. Patients were followed up with estimated glomerular filtration rate (eGFR) at 0.6 months and one year. Results A total of 75 patients were studied. Mean age was 41.72 +/- 13.59 years, where 68% were males. Groundwater was the drinking water source for 77.3%. In all, 40% had consumed alternate medicine and 46.6% patients had undergone kidney biopsy. The main findings were global glomerulosclerosis (>50%) in 54%, 31% had >50% interstitial fibrosis and tubular atrophy, 34.3% had periglomerular fibrosis, and 85.7% had interstitial inflammation. Hypertension was a significant risk factor for progression. Conclusion Our study results were like other Indian studies in terms of affecting younger male population, but differed from these studies as the majority of our patients came from nonagricultural backgrounds. Herbal medicine intake was a major risk factor. A vast majority of patients had chronic tubulointerstitial nephritis in biopsy at presentation, showing that most presented late.

Examination of factors impacting spitting or vomiting among children under 5 years of age during seasonal malaria chemoprevention: a quantitative study in Burkina Faso, Chad, Nigeria and Togo

BackgroundSince 2012, the World Health Organization has recommended seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine (SPAQ) for children aged 3–⁠59 months in regions where malaria transmission is seasonal. Full ingestion of SMC medicines without spitting or vomiting during a complete 3-day course is critical to ensure effectiveness of SMC medicines and to avoid development of antimalarial resistance. Although evidence suggests that spitting or vomiting is not rare, there is limited analytical evidence on potential factors associated with spitting or vomiting in SMC campaigns.MethodsWe utilized data from SMC coverage surveys conducted in Burkina Faso, Chad, Togo and Nigeria between 2020 and 2022. Episodes of spitting or vomiting were defined as SMC-eligible children spitting out most of the dose or vomiting the entire dose within 30 min of SPAQ administration as reported by primary caregivers. We conducted a cross-sectional study using mixed-effects logistic regression with variables including household socioeconomic variables and caregiver knowledge of SMC, to identify factors associated with spitting or vomiting.ResultsThe proportion of SMC-eligible children spitting or vomiting SPAQ doses ranged from 1.81% in Nigeria to 4.36% in Chad. The odds of spitting or vomiting were lower among children administered medicines under community distributor (CD) supervision, and whose primary caregivers had a high degree of knowledge of SMC. Spitting or vomiting were negatively associated with caregiver adherence to AQ administration and caregiver reporting of children’s adverse reactions to SMC medicines. Over half of the children experiencing a spitting or vomiting episode did not receive a replacement dose from CDs. Redosing was positively associated with caregiver educational attainment, caregiver knowledge of SMC, and directly supervised medicine administration.ConclusionsCD-supervised administration of SPAQ can strengthen community engagement strategies to enhance appropriate administration and full ingestion of SMC medicines according to the SMC delivery protocol.

Impact of platelet-rich fibrin derivatives on patient morbidity and quality of life in palatal donor sites following free gingival graft surgery: a randomized clinical trial.

Platelet concentrates are biomaterials with significant potential in tissue regeneration, functioning as scaffolds with greater leukocyte inclusion and a flexible fibrin mesh. However these concentrates have different preparation methods and biological properties. The objective of this clinical investigation was to evaluate the effects of utilizing platelet-rich fibrin (PRF) materials (L-PRF and A-PRF) as a palatal bandage following free gingival graft (FGG) on patients' morbidity and oral health-related quality of life. Thirty-nine participants received FGG to promote keratinized tissue and treat gingival recession. Participants were randomly assigned to L-PRF, A-PRF, and control groups, with 13 participants in each. They used a visual analog scale (VAS) to rate their pain, analgesic medication use, dietary changes, discomfort, and bleeding at 1-7 days, 14 days and 1 month during the healing process. Patients' quality of life was assessed using the Oral Health Impact Profile (OHIP-14) at baseline, 1-7 days, 14 days, 1 month, and 6 months. There was no difference in anxiety levels between the all groups. (p > 0.05). The control group had higher OHIP-14 total scores than the other groups, but the differences were not statistically significant, especially in the first seven days (p > 0.05). In addition, the PRF groups showed an improvement in quality of life after 14 days, 1 month, and 6 months (p < 0.05). Patients' pain and suffering decreased with healing. The control group took more postoperative analgesics than PRF groups. In addition, there was a significant decrease in patient complaints about medicine intake, bleeding, pain, perceived sensitivity, and dietary modifications in all groups during follow-up. PRF palatal bandages may improve patient's quality of life, donor site healing, postoperative pain and morbidity. This study found that preserving the palate in FGG and employing PRF materials that speed palate healing reduce discomfort and morbidity.

FACTORS ASSOCIATED WITH NON-ADHERENCE TO MEDICATION IN ELDERLY WITH HYPERTENSION

Non-adherence to medication, estimated to be approximately 10%–60%, is quite common in the elderly and is an important cause of morbidity. In this study, we aimed to determine the rates of non-adherence to antihypertensive medications and related factors in the elderly. This cross-sectional study was conducted in primary healthcare facilities in Samsun, Turkey, during May and June 2017, involving a face-to-face interview with patients. The inclusion criteria were a diagnosis of hypertension, use of antihypertensive medication for at least one year, age 65 years and older, and ability to communicate verbally. The Hypertension Medication Adherence Scale was used to assess adherence to treatment. Multivariate logistic regression analysis was used to determine the evaluated variables related to poor adherence. The mean age of the study group was 71.8 ± 6.7 years. The frequency of non-adherence to medication was 10.9%. According to the results of the logistic regression analysis, cognitive impairment, visual impairment, having no social support for medicine intake, male gender, and being single were significantly associated with non-adherence to antihypertensive medication. To improve medication adherence in primary care, simplified treatment options should be offered and a patient-oriented treatment plan should be planned.

Assess the knowledge regarding thyroid disorders among patients attending medical OPD

Background: The thyroid gland is an endocrine gland consisting of two lobes connected by an isthmus, in the neck. It is found in front of the neck below the Adams apple. Thyroid gland though a small structure on the anterior aspect of neck has many important functions to perform, failing in its duty might lead to serious consequences. Methods: A non-experimental descriptive research design was conducted to assess knowledge regarding thyroid disorders among patients attending medical OPD in a selected hospital of Dehradun at Uttarakhand. A total of 100 samples were selected through purposive sampling technique. A structured knowledge questionnaire was administered through interview technique to assess the knowledge. Results: The study showed that the mean knowledge score of patients regarding thyroid disorders was 14.04±3.755. The mean percentage was 14.04. There was significant association between social habits, suffered or suffering from thyroid disorders, family history of thyroid disorders, medical history of any medicine intake and previous knowledge regarding thyroid disorders with knowledge score. Conclusions: From the findings of the study, it was conducted that Out of 100 participants 42% had good knowledge and 7% had poor knowledge, 38% had average knowledge and 13% had very good knowledge about thyroid disorders. There is a need for educational programs to create awareness and improve knowledge regarding thyroid disorders.

Self-care strategies used by disaster responders after the 2023 earthquake in Turkey and Syria: a mixed methods study

BackgroundDisaster responders are exposed to several physical and mental health risks. This study aimed to describe self-care strategies used by disaster responders after the earthquake in Syria and eastern Turkey in February 2023.MethodsA study specific web-based questionnaire survey was used to collect quantitative and qualitative data according to a convergent mixed methods approach. Data from 252 disaster responders responding to the earthquakes in Turkey and Syria were analyzed using both descriptive and analytical statistics and summative content analysis of free-text answers. Data were collected in March to July, 2023.ResultsThe most used self-care strategies included resting, social support from colleagues in the field, extra intake of food or drink, and intake of medicines. The recovery strategies varied due to previous disaster response experience, indicating that supportive self-care strategies can be developed or learned.ConclusionGiven the extreme conditions and limited possibilities of external support, sufficient self-care is an essential competence among disaster responders. Self-care strategies can be both external processed such as intake of medicines, social support from others, and internal processes such as personal reflection. Providing oneself with self-care activities seems to be a skill developed with increasing experience supported by pre-deployment training. Therefore, to enhance resilience, self-care strategies should be encompassed in pre-disaster response training.

The trajectory of serum salicylate concentrations after ingestion of medicinal oil containing methyl salicylate

Introduction The toxicokinetics of methyl salicylate after unintentional or intentional ingestion of medicinal oil containing methyl salicylate has not been well studied. We aimed to characterize the trajectory of serum salicylate concentrations and to evaluate factors associated with the peak serum salicylate concentration and the time from ingestion to peak concentration. Methods This was a retrospective cohort study of consecutive patients reported to the Hong Kong Poison Control Centre for laboratory-confirmed methyl salicylate poisoning by all local public emergency departments between 1 July 2008 and 30 June 2023. We analyzed cases with at least three serum salicylate concentrations. Multivariable generalized linear regression was used to identify factors significantly associated with the peak serum concentration and the time from ingestion to peak concentration. Results We included 41 patients (median age 81.0 years; 32 women and nine men). The median time from ingestion to the first peak serum salicylate concentration was 5.6 h (IQR: 3.2–10.8 h). Multiple regression showed that gastric aspiration (adjusted regression coefficient [β] − 2.50; 95% CI: −3.93 to −1.08; P = 0.001) and single-dose activated charcoal (adjusted β − 1.22; 95% CI: −2.02 to −0.42; P = 0.003) were significantly associated with a lower peak concentration, after adjusting for patient age, sex, exposure due to intentional self-harm, reported ingested dose, time from ingestion to emergency department presentation, vomiting, concurrent use of aspirin (acetylsalicylic acid) and other medications that affect gastric emptying or gastric acid secretion, blood pH, serum albumin concentration, and creatinine clearance. Discussion The serum salicylate concentration did not peak as quickly as generally believed, highlighting the importance of continued monitoring. Gastric aspiration and single-dose activated charcoal may help reduce gastrointestinal absorption, but their impact on clinical outcomes remains unclear. Conclusions Given the median time of 5.6 h (IQR: 3.2–10.8 h) from ingestion to the peak salicylate concentration, gastric aspiration and single-dose activated charcoal can be considered in patients up to a few hours after medicinal oil ingestion when the airway is protected.

Adsorption of bile salts onto crystalline ritonavir particles under simulated gastrointestinal conditions

The formation of a biomolecular corona on nanoparticles in blood is a well-known phenomenon influencing in vivo performance. Analogous phenomena in other biological fluids, such as the formation of a gastrointestinal (GI) corona, remain under-investigated. The ingestion of medicines leads to the generation of drug particles in the GI fluids. Consequently, an understanding of the behavior of drug particles in the gut requires determination of the adsorption of bile components onto these drug particles. This work aims to elucidate the factors affecting adsorption of bile salts onto ritonavir (RTV) particles. Crystalline RTV particles were incubated with non-micellar or micellar bile salts and bile salt depletion from solution was measured using HPLC and small angle X-ray scattering (SAXS). HPLC results show that bile salts adsorb onto RTV particles, with greater adsorption observed for more hydrophobic bile salts, following the order sodium glycodeoxycholate (SGDC)>sodium taurodeoxycholate (STDC)>sodium glycochenodeoxycholate SGCDC>sodium glycocholate (SGC)>sodium taurocholate (STC). Increasing the ionic strength of the solution led to increased adsorption of STDC, where buffer containing 300 mM NaCl resulted in greater adsorption than 150 mM NaCl. Additionally, micellar bile salts showed greater affinity for RTV particles than unimeric bile salts. In contrast, the extent of bile salt depletion was unaltered by addition of phospholipid to form mixed micelles. SAXS analysis of mixed micelles after incubation with RTV particles confirms depletion of bile salt from the supernatant, evidenced by reduced intensity of the micellar scattering feature. In conclusion, this study investigated factors influencing bile salt adsorption onto drug particles, highlighting the need to consider adsorption of bile components in forming the GI-corona.

Complementary and Alternative Medicine use among pregnant women attending antenatal clinic: a point to ponder.

Complementary and Alternative Medicine (CAM) is a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine. Pregnant women are vulnerable to adverse effects of medicines, especially during the first trimester. Though it is advised to avoid unnecessary intake of medicine during pregnancy, CAM use is widespread. A cross-sectional questionnaire-based study was conducted on 120 pregnant women attending the antenatal clinic of a tertiary-care teaching hospital in Udaipur district of Southern Rajasthan, India. Women of age 18 years and above were surveyed between July 2022 to December 2023 by convenient sampling strategy and data were entered in a pretested and pre-validated questionnaire. The data were analyzed using descriptive statistics, the Chi-square test was applied to compare CAM use among different demographic categories and a p-value less than 0.05 was considered statistically significant. Out of 120 participants, 58 (48.33 %) were using CAM therapy. Out of 58 users, 44 (75.86 %) were using herbal & traditional medicines. Twenty (34.48 %) were using CAM for a healthy baby, 18 (31.03 %) for easy delivery and 17 (29.31 %) for boosting immunity. Forty (68.96 %) participants started CAM on the advice of a relative/friend. Fifty six (46.67 %) participants believe that CAM therapy cannot cause adverse effects on the in utero child, while 32 (26.67 %) believe that CAM and modern medicines don't interact. CAM use among pregnant women is substantial. There is a need to raise awareness among the healthcare professionals and pregnant women regarding possible adverse effects and drug-drug interactions with CAM use.

Rapid-onset methemoglobinemia from traditional-medicine-induced potassium nitrate poisoning: successful treatment with methylene blue—a case report

BackgroundPotassium nitrate poisoning is a rare but potentially serious condition that can result in methemoglobinemia and subsequent cyanosis. This case report presents a unique instance of rapid-onset methemoglobinemia resulting from the ingestion of a traditional medicine preparation containing potassium nitrate, known as “kalmi shora.”Case presentationA 14-year-old Pakistani boy reported to the emergency department with a history of sudden-onset headache, drowsiness agitation, irritability, and generalized cyanosis. Pulse oximetry showed a concerning oxygen saturation level of 58%, whereas arterial blood gas analysis revealed a normal partial pressure of oxygen (90 mmHg). The profile of abrupt onset of symptoms, generalized cyanosis, and the discrepancy between the partial pressure of oxygen and oxygen saturation readings necessitated a comprehensive assessment including inquiries into potential toxins. The peculiar appearance of the blood, resembling chocolate in color, further indicated the possibility of methemoglobinemia. The patient was successfully treated with methylene blue, leading to a prompt resolution of symptoms.ConclusionThis case highlights the significance of considering toxin exposures, such as traditional-medicine-induced poisoning, in emergency settings. The report contributes to the medical literature by highlighting the potential risks associated with traditional remedies and emphasizes the critical role of prompt diagnosis and intervention in optimizing patient outcomes. Recognition of the specific etiology of methemoglobinemia, in this case, traditional medicine ingestion, is essential for effective management in emergency medicine.

Методические аспекты использования анализа аллостатической нагрузки в оценке здоровья работающего населения в условиях воздействия производственных факторов (аналитический обзор)

Preventive medicine of pathogenetically based technologies for prenosological diagnostics of health risks at the stage of reversible physiological dysregulation is being introduced into practice as a relevant strategy for preserving population. It provides suitable conditions for timely prevention of chronic diseases and reducing risks of premature mortality among working age population. Using resources of the scientific information systems CyberLeninka, eLibrary, PubMed and Google scholar, the authors analyzed and summarized scientific literature data on methodological aspects and problems related to practical appli-cation of the concept of allostasis and allostatic load (AL) in assessing and predicting health risks for working population. The review focuses on the main causes of physiological dysregulation leading to AL formation under environmental exposures, including occupational ones; presents the most popular biomarkers of the functional state of the neuroendocrine, immune-inflammatory, cardiovascular and metabolic systems included in the sets of variables for determining the AL index. The review also provides the description of the most common algorithms for calculating the AL index used in preventive examinations of workers and highlights methodological approaches to the correction of AL values with regular intake of medicines. The sex-specific age dynamics of AL is presented; attention is drawn to the aggravating effect produced on AL by negative behavioral factors. The review shows that it is still difficult to introduce this methodology into routine practices of preventive medical examinations of working population despite the proven diagnostic and prognostic significance of the prenosological diagnosis of health disorders based on AL. This is mostly due to lack of consensus on standardized approaches to creating sets of biomarker scales and a method for calculating the AL index, as well as considering the sex factor and contribution of therapeutic effects to cumulative assessment of risks of developing physiological dysfunctions.

Methodological aspects of using allostatic load analysis in assessing health of working population exposed to adverse occupational factors (Analytical review)

Preventive medicine of pathogenetically based technologies for prenosological diagnostics of health risks at the stage of reversible physiological dysregulation is being introduced into practice as a relevant strategy for preserving population. It provides suitable conditions for timely prevention of chronic diseases and reducing risks of premature mortality among working age population. Using resources of the scientific information systems CyberLeninka, eLibrary, PubMed and Google scholar, the authors analyzed and summarized scientific literature data on methodological aspects and problems related to practical appli-cation of the concept of allostasis and allostatic load (AL) in assessing and predicting health risks for working population. The review focuses on the main causes of physiological dysregulation leading to AL formation under environmental exposures, including occupational ones; presents the most popular biomarkers of the functional state of the neuroendocrine, immune-inflammatory, cardiovascular and metabolic systems included in the sets of variables for determining the AL index. The review also provides the description of the most common algorithms for calculating the AL index used in preventive examinations of workers and highlights methodological approaches to the correction of AL values with regular intake of medicines. The sex-specific age dynamics of AL is presented; attention is drawn to the aggravating effect produced on AL by negative behavioral factors. The review shows that it is still difficult to introduce this methodology into routine practices of preventive medical examinations of working population despite the proven diagnostic and prognostic significance of the prenosological diagnosis of health disorders based on AL. This is mostly due to lack of consensus on standardized approaches to creating sets of biomarker scales and a method for calculating the AL index, as well as considering the sex factor and contribution of therapeutic effects to cumulative assessment of risks of developing physiological dysfunctions.

Assessment of heat stress contributing factors in the indoor environment among vulnerable populations in Klang Valley using principal component analysis (PCA)

Rising global temperatures can lead to heat waves, which in turn can pose health risks to the community. However, a notable gap remains in highlighting the primary contributing factors that amplify heat-health risk among vulnerable populations. This study aims to evaluate the precedence of heat stress contributing factors in urban and rural vulnerable populations living in hot and humid tropical regions. A comparative cross-sectional study was conducted, involving 108 respondents from urban and rural areas in Klang Valley, Malaysia, using a face-to-face interview and a validated questionnaire. Data was analyzed using the principal component analysis, categorizing factors into exposure, sensitivity, and adaptive capacity indicators. In urban areas, five principal components (PCs) explained 64.3% of variability, with primary factors being sensitivity (health morbidity, medicine intake, increased age), adaptive capacity (outdoor occupation type, lack of ceiling, longer residency duration), and exposure (lower ceiling height, increased building age). In rural, five PCs explained 71.5% of variability, with primary factors being exposure (lack of ceiling, high thermal conductivity roof material, increased building age, shorter residency duration), sensitivity (health morbidity, medicine intake, increased age), and adaptive capacity (female, non-smoking, higher BMI). The order of heat-health vulnerability indicators was sensitivity > adaptive capacity > exposure for urban areas, and exposure > sensitivity > adaptive capacity for rural areas. This study demonstrated a different pattern of leading contributors to heat stress between urban and rural vulnerable populations.

Smart Medi Box

This paper addresses the prevalent issue of medication mismanagement among older individuals in families, a problem observed not only in our personal context but also widespread across various demographics. Many elderly family members struggle with the complexity of multiple medications, leading to missed doses and inadvertent intake of incorrect medicines. Recognizing the urgency of this concern, we embarked on a mission to devise a solution, resulting in the conceptualization and development of a Smart Medi Box. This innovative device aims to streamline medication management by incorporating smart technology to facilitate accurate dosage scheduling and timely reminders. The impetus for this initiative stems from the staggering statistic that 16 crore (160 million) Indians rely on daily medications. Through the Smart Medi Box, we aspire to enhance medication adherence, mitigate risks associated with incorrect usage, and ultimately improve the overall well-being of individuals managing chronic illnesses. Key Words: Medication management, Smart Medi Box, adherence, medication scheduling, elderly care, health technology, chronic illnesses, reminder system, healthcare innovation, Indian population.

Mutational and Carcinogenic Potential of Amaltas Fruit Via Oxidation

Long term intake of plant-based medicines without knowing their toxicities and mutagenic potentials is common globally. Therefore, current work is an extension of cancer patient survey at Nuclear Institute of Medicine and Radiotherapy (NIMRA), for long term utilization of medicinal plant. Genotoxic potential Amaltas fruit (AF) was tested by Cicer arietinum L. and Allium cepa L plant assay. Abnormality index (A.I.), types of abnormalities and oxidative damages were the major parameters of genotoxicity. Analysis of variance (ANOVA) revealed statistically significant differences (LSD) at p≤ 0.05 for A.I. and oxidative damage in both assay plants, except negative control. Both A.I. and oxidative damages revealed incubation dependent increase. In both assay plant the major chromosomal aberration induced was fragmentation. AF induced polyploid cells, apoptotic cells and elongated cells only in Cicer arietinum L. assay. Oxidative damages in the form of nuclear membrane and cell membrane damage were observed in aberrant cells along with ghost cells. It is concluded that AF is capable to cause genotoxic effect incubation dependent manner. High rate of fragmented cells reflects its mutagenicity and carcinogenicity mediated oxidation of DNA and membranes in both assay plants. Induction of more ghost cells and less frequent apoptosis reflects activation of oncogene. Development of Pilus like projections in ghost cells depicts proliferation potential of defected cells. Prolonged utilization of AF was the cause of cancer in surveyed patients. Allium cepa L. was more sensitive as assay plant to the genotoxin. It is recommended that AF must be used occasionally.

Short-Term Supraorbital Nerve Stimulation and Pain Relief for Acute and Subacute Ophthalmic Herpetic Neuralgia: A Randomized Controlled Crossover Trial

BACKGROUND: Herpes zoster ophthalmicus (HZO) is a kind of refractory disease, and treating it is important for preventing postherpetic neuralgia (PHN). But the evidence surrounding the current treatment options for these conditions is controversial, so exploring reasonable clinical treatment strategies for HZO is necessary. Neuromodulation is an excellent modality for the treatment of various neuropathic pain conditions. This trial was designed to evaluate the effectiveness of short-term supraorbital nerve stimulation (SNS) and the supraorbital nerve block (SNB) for HZO. OBJECTIVES: To determine whether short-term SNS relieves acute and subacute ophthalmic herpetic neuralgia. STUDY DESIGN: This prospective randomized controlled crossover trial compared short-term SNS to SNB. Setting: The operating room of a pain clinic. METHODS: Patients with acute or subacute ophthalmic herpetic neuralgia were recruited. The patients were randomly assigned to receive either SNS or SNB. The primary outcome being measured was each patient’s Visual Analog Scale (VAS) score at 4 weeks. The secondary outcomes under measurement were the proportion of patients who achieved &gt;= 50% pain relief, sleep quality, medicine consumption, and adverse events. Crossover after 4 weeks was permitted, and patients were followed up to 12 weeks. RESULTS: Overall, 50 patients were included (n = 25/group). At 4 weeks, the patients who received SNS achieved greater pain relief, as indicated by their significantly different VAS scores from those of the SNB group (mean difference: -1.4 [95% CI, -2.29 to -0.51], P &lt; 0.05). Both groups showed a significant decrease in pain level from the baseline (all P &lt; 0.05). Overall, 72% and 44% of the SNS and SNB patients experienced &gt;= 50% pain relief, respectively (OR: 0.31 [95% CI, 0.09 to 0.99], P &lt; 0.05), and 68% and 32% of SNS and SNB patients, respectively, had VAS scores &lt; 3 (OR: 0.22 [95% CI, 0.07 to 0.73], P &lt; 0.05). Compared to the SNB group, the SNS group had better sleep quality, lower ophthalmic neuralgia, a lower proportion of further treatment, and lower analgesic intake. Overall, 18 patients received SNS alone, and 16 patients crossed over from SNB to SNS. The VAS scores, sleep quality, ophthalmic neuralgia, and trend of medicine intake were not significantly different between the groups (all P &gt; 0.05). No serious complications occurred. LIMITATIONS: This study was nonblind. CONCLUSIONS: Short-term SNS is effective for controlling acute or subacute ophthalmic herpetic neuralgia. Combining SNS with SNB yields no additional benefits. KEY WORDS: Herpes zoster ophthalmicus, postherpetic neuralgia, ophthalmic herpetic neuralgia, supraorbital nerve, neuromodulation, peripheral nerve stimulation, supraorbital nerve stimulation, supraorbital nerve block

Smart Medicine Remainder Box for Elderly People with IoT

This project focuses on developing a Smart Medicine Reminder Box for elderly people, leveraging IoT technology to enhance medication adherence. The system utilizes an Arduino AT Mega microcontroller to gather data from various sensors. An IR sensor is employed to detect the presence of medicine in the compartments, ensuring accurate monitoring of medicine intake. To provide timely reminders, a Real-Time Clock (RTC) module is integrated, triggering a buzzer alert when it is time for medication. The ESP8266 Wi-Fi module connects to the Blynk platform, sending alert notifications to caregivers or family members via a smartphone app. Additionally, a GSM module is included to make call alerts, ensuring critical reminders are not missed. This multi-faceted alert system is designed to support elderly individuals in maintaining their medication schedules, thereby improving health outcomes, and reducing the risk of missed doses

Association between Usage of Prophylactic AYUSH Medicines and Disease Severity in COVID-19 Patients: A Retrospective Cohort Study.

Prior vaccination is often studied for its impact on individuals' post-infection prognosis. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicines, advised by the Government of India as prophylaxis during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, were consumed by the masses in 2020. A study was therefore undertaken to observe any association between the prior usage of AYUSH prophylactic medicines and post-infection severity as reported by recovered COVID-19 individuals. This was a retrospective, multi-centre, cohort study conducted in 21 cities of India from 5th August to 30th November 2020. Data from recovered COVID-19 patients, of either sex or any age, captured information about AYUSH prophylactic medicines intake prior to infection, disease severity, symptomatology, duration of complaints, etc. The study participants were grouped into AYUSH intake and non-intake. Primary composite outcome was the disease clinical course. Secondary clinical outcomes were the rate of and time to clinical recovery. Data of 5,023 persons were analysed. Ayurveda or homeopathic prophylactic medicines were consumed by more than half of the study participants: that is, 56.85% (n = 1,556) and 56.81% (n = 1,555) respectively. The overall adjusted protective effect (PE) of AYUSH prophylactic intake against moderate/severe forms of COVID-19 disease was 56.7% (95% confidence interval [CI], 48.7 to 63.50; p < 0.001). Adjusted PE for homeopathy and Siddha was 52.9% (95% CI, 42.30 to 61.50; p < 0.001) and 59.8% (95% CI, 37.80 to 74.10; p < 0.001), respectively. A statistically significant association was found between AYUSH prophylactic medicine intake and clinical recovery more frequently by the 3rd day of illness (χ2 = 9.01; p = 0.002). Time to resolution of symptoms in the AYUSH intake group was on average 0.3 days earlier than in the non-intake group (p = 0.002). AYUSH prophylactics were associated with statistically significant levels of protection against COVID-19 disease severity. Amongst these, previous intake of homeopathy or Siddha medicines was associated with some protection against moderate/severe illness and with a somewhat quicker clinical recovery. Prospective studies with experimental research design are needed to validate the findings of this study. Clinical Trials Registry-India (CTRI/2020/08/027000).

The Prevalence of Tooth Wear and Their Associated Etiologies Among Adult Subjects Visiting Umm Al-Qura University Dental Clinic in Makkah City, Saudi Arabia.

In the past two decades, changing trends in socioeconomic status, dietary habits, and individual lifestyles of individuals have led to the emergence of tooth wear as an oral health problem. The present study aimed to investigate the prevalence and the associated etiologies of tooth wear in a convenience sample of adult patients visiting outpatient clinics of the Faculty of Dentistry at Umm Al-Qura University. This cross-sectional study was conducted on adult patients (18-40 years old) visiting outpatient clinics of the Faculty of Dentistry, Umm Al-Qura University. Two trained examiners visually assessed patients' tooth wear using Smith and Knight's Tooth Wear Index (TWI). Following the clinical examination, patients completed a self-administered questionnaire detailing risk factors such as the frequency of intake of acidic food and medicines, general health, chewing habits, dietary factors, and oral health-associated preventive behaviors. The resulting collected data were tabulated and statistically analyzed using Statistical Product and Service Solutions (SPSS, version 21; IBM SPSS Statistics for Windows, Armonk, NY). The total prevalence of tooth wear was 74%, and the recorded mean wear score (TWI) was 0.380 ± 0.386; anterior teeth exhibited greater wear than posterior teeth. Numerous associations were recorded between tooth wear and the tested variables in demographics, habits, diet, and medications, but most of them were not statistically significant. When toothbrushing habits were explored, the only factors to played a significant role in abrading the tooth structure were the type of brush bristles used (P-value = 0.026) and the frequency of brush renewal (P = 0.043). Patients who frequently ate citrus fruits and other acidic foods recorded high wear scores (0.509 ± 0.311 and 0.508 ± 0.402, respectively), although the difference was not statistically significant. When chewing occurred on both sides of the mouth, less tooth wear was recorded than if chewing was on the right or left side only (0.371 ± 0.260, 0.422 ± 0.273, and 0.520 ± 0.419, respectively). The study data support an association between tooth wear and patient occupation, use of hard-bristled and new toothbrushes, eating of citrus and other acidic food, and chewing on one side, as all of these factors increased the risk of tooth wear.