Routine Medication Research Articles

Recovery rate and predictors among children aged 6–59 months with severe acute malnutrition in Addis Ababa, Ethiopia: a retrospective follow-up study

IntroductionSevere acute malnutrition (SAM) is a critical public health concern in Ethiopia, contributing to high morbidity and mortality rates among children. Despite the improvement in hospital coverage and the development of standardized WHO treatment guidelines, recent reviews indicated a wide range in recovery rates (34%–88%) due to several context-specific factors. Understanding the factors influencing the recovery time can help inform targeted interventions and improve the overall management of SAM cases. Therefore, this study aimed to assess the time to recovery and predictors of children aged 6–59 months with severe acute malnutrition in Addis Ababa, Ethiopia, in 2023.MethodsAn institutional-based retrospective follow-up study was conducted among children aged 6–59 months who were admitted to Tirunesh Beijing Hospital (TBH), Addis Ababa, Ethiopia, from July 2019 to June 2023. The Kaplan–Meir estimate and survival curve were used to compare the time to recovery using a log-rank test among different characteristics. A Cox proportional hazard regression analysis model was used to identify significant predictors of time to recovery. Finally, a p-value of <0.05 was used to declare a significant association.ResultsThe median survival time to recovery was 17 (95% CI: 16.39–17.60) days, and the incidence rate of recovery from SAM was 37.8 per 1,000 child days. Moreover, exclusive breastfeeding [adjusted hazard ratio (aHR): 1.97, 95% CI: 1.45–2.68], amoxicillin provision (aHR = 1.62, 95% CI: 1.11–2.35), and deworming (aHR = 2.14, 95% CI: 1.48–3.09) were protective factors. However, complications at admission (aHR = 0.41, 95% CI: 0.23–0.73) and diarrhea during admission (aHR = 0.64, 95% CI: 0.45–0.91) were identified as risk factors of recovery from SAM.ConclusionThe time to recovery among the current study participants was low compared with the sphere standard. Besides, exclusive breastfeeding, complications at admission, diarrhea, amoxicillin provision, and deworming were independent predictors. Therefore, appropriate provision of routine medication and early management of medical comorbidity as per the national SAM management protocol can reduce the mortality of children with severe acute malnutrition significantly.

Central Venous Catheter Use in Burn Patients: Complications and Preventive Measures

Summary: The use of a central venous catheter (CVC) is essential in the management of burn patients, especially due to the difficulty of venous access, the length of hospitalization, and the need for routine fluid replenishment and medication administration, particularly antibiotics. Aim of the study: The aim of this study is to identify the rate of complications associated with central venous catheters in the context of burn patients to discuss its indications and the benefit/risk ratio. Methods: This descriptive retrospective study was conducted in the Plastic Surgery Department of CHU Mohamed VI in Marrakech, involving patients who received a central venous catheter during their admission to the burn unit from March 2023 to March 2024. Data collection included basic demographic data, comorbidities, burn mechanism, burn depth, percentage of burned body surface area (BSA), central catheter location (subclavian, femoral, jugular), the site (healthy/burned), the duration of catheter placement, complications (infection and venous thrombosis), detection of germs during culture, and the length of hospital stay. Results: Infection and venous thrombosis were identified as the most frequent complications of CVC use. Further research is needed to evaluate the role of regular CVC changes (every 10 to 15 days after insertion) in preventing infections and to establish a clear anticoagulation protocol for preventing deep vein thrombosis (DVT). Conclusion: While CVCs can be a valuable resource in the treatment of burn patients, they are associated with significant risks, some of which may be life-threatening. The duration of CVC placement should be minimized, and blood cultures (preferably from the CVC tip) should be systematically sent after 10 days or at the first suspicion of complications to reduce the incidence and severity of CVC-related infections.

Protective Effect of Allergen Immunotherapy in Patients With Allergic Rhinitis and Asthma Against COVID-19 Infection: Observational, Nationwide, and Multicenter Study.

Allergic diseases are associated with an increased susceptibility to respiratory tract infections. Although allergen immunotherapy (AIT) alters the course of allergies, there is limited evidence from clinical practice demonstrating its ability to enhance the host defense against pathogens. The aim of this study was to investigate the protective effect of AIT against viral infection in patients with allergic rhinitis (AR) and allergic asthma (AS) based on clinical evidence. A multicenter, questionnaire-based survey was conducted during a tremendous surge in COVID-19 cases between February 10, 2023, and March 15, 2023, in 81 centers across China recruiting healthy volunteers and patients with AR and AS to investigate the clinical outcomes of COVID-19 infection. Of 10,151 participants recruited in the survey, 3654 patients and 2192 healthy volunteers who tested positive for COVID-19 were included in this analysis after screening. Overall, no significant differences in COVID-19 outcomes were observed between patients and healthy volunteers. An additional 451 patients were excluded due to their use of biologics as the sole add-on treatment, leaving 3203 patients in the further analysis. Of them, 1752 were undergoing routine medication treatment (RMT; the RMT group), whereas 1057 and 394 were receiving AIT and a combination of AIT and omalizumab (OMA) as adjunct therapies to RMT, respectively (AIT+RMT and AIT+OMA+RMT groups). The AIT group showed milder COVID-19 symptoms, shorter recovery periods, and a lower likelihood of hospitalization or emergency department visits than the RMT group (all P<.05). After adjusting for confounding factors, including demographic characteristics and COVID-19 vaccination, AIT remained a significant protective factor associated with shorter recovery time (adjusted odds ratio [OR] 0.62, 95% CI 0.52-0.75; adjusted P<.001) and a lower incidence of hospitalization or emergency department visits (adjusted OR 0.73, 95% CI 0.54-0.98; adjusted P=.03). Furthermore, the AIT+OMA+RMT group showed greater protection with a shorter recovery time (adjusted OR 0.51, 95% CI 0.34-0.74; adjusted P<.001) than the AIT+RMT group. Our multicenter observational study provides valuable clinical evidence supporting the protective effect of AIT against COVID-19 infection in patients with AR and AS.

Effects of probiotic and vitamin D co-supplementation on clinical symptoms, mental health, and inflammation in adult patients with migraine headache: a randomized, triple-blinded, placebo-controlled trial

BackgroundMigraine headache is a major public health problem. Routine medications for migraine treatment are not useful in treating all patients and may have some side effects. The present study aimed to investigate the effect of vitamin D and probiotic co-supplementation on clinical characteristics of migraine, daily functioning, mental health outcomes, and serum levels of high-sensitivity C-reactive protein (hs-CRP).MethodsIn this randomized, triple-blinded, placebo-controlled trial, patients aged 18 to 55 years diagnosed with migraine based on the International Classification of Headache Disorders-3 (ICHD-3) were randomized to either vitamin D (50,000 IU every 2 weeks) plus probiotic (4.5 × 1011 CFU per day) or placebo for 12 weeks. The Headache Impact Test (HIT-6) and Depression, Anxiety, and Stress Scale (DASS) questionnaires were administered to patients at baseline and after 12 weeks. In addition, the frequency, duration, and severity of migraine headaches per month were assessed using a self-administered 30-day headache diary at baseline and the end of the intervention. Anthropometric indices, blood pressure, and serum levels of 25-hydroxy vitamin D and hs-CRP were also examined at first and the end of the study.ResultsSeventy-two migraine patients with a mean age of 37.46 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 8.32 years were included in this trial. Probiotic and vitamin D co-supplementation compared to placebo resulted in a significant increase in serum levels of vitamin D (+ 12.86 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 1.64 vs. + 1.12 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.80 ng/mL, P < 0.001). The between-group analysis in the adjusted model showed a significantly greater reduction in migraine headache frequency (− 3.17 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.84 vs. − 1.25 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.34; P = 0.031) and severity (− 1.55 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.35 vs. + 0.67 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.29; P = 0.017) in the probiotic and vitamin D group than the placebo group. No significant difference was found between the two arms of the intervention regarding the change in headache duration, hs-CRP, scores of DASS, and HIT-6 questionnaires (P > 0.05).ConclusionsThis trial showed that probiotic and vitamin D co-supplementation for 12 weeks has beneficial effects on migraine headache characteristics. Further research is needed to confirm this finding.

Gastric adenocarcinoma due to H. Pylori infection on patient with chronic kidney disease on hemodialysis

A 53-year-old Male was admitted to our emergency department presenting with severe anemia (Hb 6.9 gr/dl) with a history of chronic kidney disease on routine hemodialysis twice a week and insulin-dependent type 2 diabetes. He was diagnosed with gastric adenocarcinoma after biopsy sample acquired from endoscopy confirmed by pathologist. The patient also has a positive HPSA test result. He was given rapid insulin 3 times daily and long-acting insulin once daily, continued routine hemodialysis and planned to do partial gastrectomy after recommended serum-creatinine level and minimum hemoglobin level are reached. We will take into consideration the routine use of anti-platelets and anti-coagulants during hemodialysis and how it will affect our decision to do surgery. Currently the patient still discusses the option of surgery even though it has been suggested by the digestive surgeon. In conclusion, we are discussing the difficulties of managing patient with gastric adenocarcinoma caused by H. pylori infection with chronic kidney disease and diabetes as the aggravating factors, including the use of routine medication and managing the blood sugar.

The Efficacy of the Cognitive Exercise Therapy Approach by Telerehabilitation in People Living with HIV: Preliminary Results.

The Cognitive Exercise Therapy Approach, referred to as BETY, is a biopsychosocial model that has demonstrated effectiveness in improving the quality of life among various patient populations with chronic diseases. This study aimed to determine the efficacy of BETY combined with telerehabilitation for people living with HIV (PLWH). Fifty PLWH who were virologically suppressed receiving follow-up and treatment at Şanlıurfa Training and Research Hospital were included in this study. Patients were divided into the telerehabilitation group (TG) and the control group (CG). In addition to routine treatments, the TG underwent group rehabilitation exercises via Zoom application for 60 minutes three times a week for 12 weeks (a total of 36 sessions) under the supervision of a physiotherapist, following the principles of BETY. The CG received no intervention and continued with routine medication treatments. Before and after the exercise therapy, the BETY Scale (BETY-BQ), Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Clinical Frailty Scale, and Frail Scale were administered to both the TG and the CG. The responses to the scales were compared between the two groups after the 12-week period. The preliminary results included data from 10 patients in the TG and 15 patients in the CG who completed the 12-week treatment. In the TG, significant differences were observed in the SF-36 pain subscale and the BETY total score, while in the CG, significant differences were found in the SF-36 emotional role functioning and vitality subscales (p<0.05). In the TG, negative values were observed in all BETY-BQ subscales, indicating improvement in all parameters. Additionally, the mean value of the SF-36 pain subscale increased from 79 before treatment to 91.5 after treatment. Our preliminary results indicate that the BETY method applied by telerehabilitation may be effective in reducing pain and improving biopsychosocial conditions in PLWH. Telerehabilitation with cognitive exercise therapy can provide an alternative treatment option by complementing routine therapies and offering the opportunity to participate anonymously in group therapies in PLWH.

Management of Corneal Ulcers using Autologous Serum, Platelet Rich Plasma and Processed Human Amniotic Membrane in Dogs

Background: In dogs the corneal ulcers are one of the major ophthalmic emergencies and can cure with routine medications, but in delay presentation will become challenge for veterinarians. In such cases advanced therapeutic management such as serum, platelet reach plasma and corneal grafts are needed for favorable outcome. Methods: The present study was conducted on 24 dogs (29 eyes) with corneal ulcer categorized as a superficial (Group-I, n=15), deep corneal ulcers (Group-II, n=8) and descemetocele (Group-III, n=6) which were treated with autologous serum, Platelet Rich Plasma and Processed decellularized human amniotic membrane grafting, respectively. All the affected eyes were given routine topical medications with eye drops Moxifloxacin, Flurbiprofen q.i.d till healing, 1% Atropine sulphate b.i.d for 5 days and Oral Doxycycline was given @ 5 mg/kg b.i.d for 10 days. Result: The group-I (n=11, 15 eyes) treated with autologous serum eight to ten times-a-day as per severity with routine medication. Two dogs with entropion which was corrected first. The eyes gained vision within 10th-15th days. Developed complications managed medicinally till complete recovery. The group-II (n=7, 8 eyes) treated with platelet rich plasma drops five to seven times-a-day with routine medication. 75% eyes recovered up to 45th day. Developed complication were managed medicinally till complete recovery. The group-III (n=5, 6 eyes) treated with Decellularized Processed Human Amniotic Membrane Graft. 4 eyes gained complete transparency on 28th day of therapy while in 2 eyes developed complication were managed medicinally.

Electronic medical information and analytical system (EMIAS) as a tool for the new level of understanding and diagnosis of medication adherence in patients with myocardial infarction in primary care practice in Moscow

Introduction. The global community is increasingly using patients' prescription claims data as a dominant method for assessing medication adherence, which encouraged us to conduct this study.Aim. To adapt the existing international experience of using digital technologies to measure medication adherence to the routine practice of domestic health care at the outpatient level.Methods. We conducted a retrospective study of adherence to statin therapy in patients with myocardial infarction (MI) at a large primary care clinic in Moscow, which included 2 stages: 1st stage — compilation of international experience on medication adherence studies using pharmacy dispensing records; 2nd stage — testing the method of electronic prescription refill record to measure adherence. We calculated the proportion of days covered (PDC) by statin therapy over a 12‑month period following MI. Data on demography, anamnesis, lipid profile, and statin prescriptions were obtained from the electronic medical records of patients with acute MI from January 1 — December 31, 2022. A total of 109 patients were included according to the prespecified selection criteria.Results. An analysis of international experience demonstrated that the pharmacy dispensing record method has become widespread in recent decades in foreign countries and has established itself as an objective, noninvasive, and inexpensive method for measuring medication adherence. The study of adherence to statin therapy in post-MI patients using the electronic prescription refill record method revealed a mean PDC = 63.0±29.7 %. Optimal adherence (PDC≥80 %) throughout the 12‑month follow-up period was noted in 38 % of patients. When PDC was calculated separately for the 1st and 2nd half year, it was found that the proportion of patients with optimal adherence decreased by 17.6 % (p=0.04). Adherence correlated with the efficacy of statin therapy — a more pronounced reduction of LDL–C was observed in patients with PDC≥80 % compared with those who were insufficiently adherent (–1.47±1.09 vs –0.96±1.16 mmol/L; p=0.043).Conclusion. This study demonstrated the efficiency and information value of an electronic prescription refill record system for domestic primary care. After operational tuning, the proposed method can be integrated into EMIAS for routine medication adherence assessment.

Effects of video-based cervical stabilization home exercises in patients with rheumatoid arthritis: arandomized controlled pilot study.

This study aimed to examine the effects of aremote video-based cervical stabilization exercise program on cervical proprioception, functional status, and disease-related quality of life in patients with rheumatoid arthritis (RA). Patients with RA were evaluated regarding cervical joint positioning error, cervical region functional status (Neck Disability Index), general functional status (Health Assessment Questionnaire), and disease-related quality of life (Rheumatoid Arthritis Quality of Life Scale). Patients were randomized to exercise (n = 14, 10female) and control (n = 12, 9female) groups. Patients in the exercise group performed avideo-based home exercise program consisting of progressive cervical stabilization exercises three times aweek for sixweeks in addition to their routine medication. The patients in the control group continued their routine medication only. Evaluations were repeated in both groups in the seventh week following the baseline evaluation. Groups were similar at baseline (p > 0.05). Patients in both groups had low disease activity (DAS-28 CRP ≤ 3.2). The remote video-based exercise program led to significant improvements in cervical proprioception, functional status, and disease-related quality of life (p < 0.05). No significant changes were detected in any parameters in the control group (p > 0.05). Obtained changes were superior in the exercise group compared to the control group (d > 1.00, p < 0.05). Cervical stabilization exercises may increase cervical proprioception, improve functional status, and enhance disease-related quality of life in patients with RA when administered as aremote program. https://clinicaltrials.gov/study/NCT04948775 , NCT04948775.

Exploring The Contours: Navigating Cannabis Use Among Older Adults

Cannabis has been employed medicinally throughout history, with recent renewed interest for use due to media awareness and medical marijuana legislation. The geriatric population, identified as those 65 years of age and older, is increasingly using cannabis-derived products, has a higher likelihood of having multiple comorbidities, and is subject to polypharmacy. These individuals are at increased risk of psychiatric and other medical adverse events due to their decreased physical and cognitive reserve and changes in their physicality. Recreational use of cannabis in this population has not been well studied, but medical marijuana use has been investigated more frequently. Increased nonmedical use increases the risk of adverse health consequences. Heavy regular use can lead to cannabis use disorder (CUD), which is formerly known as cannabis abuse and dependence, and may also lead to impaired social functioning and psychiatric comorbidity. The pattern of patients admitted to hospitals has dramatically changed recently, with an increased number of elderly patients being frequently admitted. As such, due to the ease of accessing CBD, this vulnerable cohort is seen more frequently in the hospital, and we need to be more vigilant and inquire about cannabis use as we do, asking about routine medications and over-the-counter supplements. In the U.S., marijuana laws have been changing rapidly, and Americans increasingly favor legalizing cannabis for medical and recreational uses. Policymakers should ensure that training on cannabis screening and interventions for CUD are provided to clinicians to equip them better to monitor and treat patients with cannabis-related problems.

Provider perspectives on screening and treatment for opioid use disorder and mental health in HIV care: A qualitative study.

HIV, opioid use disorder (OUD), and mental health challenges share multiple syndemic risk factors. Each can be effectively treated with routine outpatient appointments, medication management, and psychosocial support, leading implementers to consider integrated screening and treatment for OUD and mental health in HIV care. Provider perspectives are crucial to understanding barriers and strategies for treatment integration. We conducted in-depth qualitative interviews with 21 HIV treatment providers and social services providers (12 individual interviews and 1 group interview with 9 participants) to understand the current landscape, goals, and priorities for integrated OUD, mental health, and HIV care. Providers were purposively recruited from known clinics in Mecklenburg County, North Carolina, U.S.A. Data were analyzed using applied thematic analysis in the NVivo 12 software program and evaluated for inter-coder agreement. Participants viewed substance use and mental health challenges as prominent barriers to engagement in HIV care. However, few organizations have integrated structured screening for substance use and mental health into their standard of care. Even fewer screen for opioid use. Although medication assisted treatment (MAT) is effective for mitigating OUD, providers struggle to connect patients with MAT due to limited referral options, social barriers such as housing and food insecurity, overburdened staff, stigma, and lack of provider training. Providers believed there would be clear benefit to integrating OUD and mental health treatment in HIV care but lacked resources for implementation. Integration of screening and treatment for substance use and mental health in HIV care could mitigate many current barriers to treatment for all three conditions. Efforts are needed to train HIV providers to provide MAT, expand resources, and implement best practices.

A machine learning-based prediction model for gout in hyperuricemics: a nationwide cohort study.

To develop a machine learning-based prediction model for identifying hyperuricemic participants at risk of developing gout. A retrospective nationwide Israeli cohort study used the Clalit Health Insurance database of 473 124 individuals to identify adults 18 years or older with at least two serum urate measurements exceeding 6.8 mg/dl between January 2007 and December 2022. Patients with a prior gout diagnosis or on gout medications were excluded. Patients' demographic characteristics, community and hospital diagnoses, routine medication prescriptions and laboratory results were used to train a risk prediction model. A machine learning model, XGBoost, was developed to predict the risk of gout. Feature selection methods were used to identify relevant variables. The model's performance was evaluated using the receiver operating characteristic area under the curve (ROC AUC) and precision-recall AUC. The primary outcome was the diagnosis of gout among hyperuricemic patients. Among the 301 385 participants with hyperuricemia included in the analysis, 15 055 (5%) were diagnosed with gout. The XGBoost model had a ROC-AUC of 0.781 (95% CI 0.78-0.784) and precision-recall AUC of 0.208 (95% CI 0.195-0.22). The most significant variables associated with gout diagnosis were serum uric acid levels, age, hyperlipidemia, non-steroidal anti-inflammatory drugs and diuretic purchases. A compact model using only these five variables yielded a ROC-AUC of 0.714 (95% CI 0.706-0.723) and a negative predictive value (NPV) of 95%. The findings of this cohort study suggest that a machine learning-based prediction model had relatively good performance and high NPV for identifying hyperuricemic participants at risk of developing gout.

Emergency department discharge practices for children with acute wheeze and asthma: a survey of discharge practice and review of safety netting instructions in the UK and Ireland

ObjectiveRecovery from acute wheeze and asthma attacks should be supported with safety netting, including treatment advice. We evaluated emergency department (ED) discharge practices for acute childhood wheeze/asthma attacks to describe...

Prescribing practices in the treatment of wasting: secondary analysis from a randomised trial

IntroductionCurrent guidelines for the outpatient treatment of severe acute malnutrition (SAM) recommend the provision of routine medications to all children at admission and prescribed medications as clinically indicated thereafter. The...

Evaluating MediBetter: A Mobile Application for Health Monitoring and Medication Management.

This study introduces MediBetter, a mobile application designed to empower patients undergoing routine medication in health monitoring and medication adherence. It is a mobile application designed to serve as a supportive health technology for patients to monitor their health status and manage their routine medication. It offers three main features: text-based daily self health report, AI-based summarization of the health report, and medication taking reminder. To evaluate the quality of generated summaries generated by both the user and AI (ChatGPT), we conducted human expert evaluation process. Furthermore, we also evaluated the usefulness of existing features in the app. The experiment results show that ChatGPT-generated summaries outperformed user-generated ones, demonstrating superior informativeness, coherence, fluency, consistency, and contradiction handling. Participants found the app's features highly useful for health monitoring and medication adherence, with strong agreement on their utility.

Exploring Gut Microbiota Alterations with Trimethoprim-Sulfamethoxazole and Dexamethasone in a Humanized Microbiome Mouse Model.

Along with the standard therapies for glioblastoma, patients are commonly prescribed trimethoprim-sulfamethoxazole (TMP-SMX) and dexamethasone for preventing infections and reducing cerebral edema, respectively. Because the gut microbiota impacts the efficacy of cancer therapies, it is important to understand how these medications impact the gut microbiota of patients. Using mice that have been colonized with human microbiota, this study sought to examine how TMP-SMX and dexamethasone affect the gut microbiome. Two lines of humanized microbiota (HuM) Rag1-/- mice, HuM1Rag and HuM2Rag, were treated with either TMP-SMX or dexamethasone via oral gavage once a day for a week. Fecal samples were collected pre-treatment (pre-txt), one week after treatment initiation (1 wk post txt), and three weeks post-treatment (3 wk post txt), and bacterial DNA was analyzed using 16S rRNA-sequencing. The HuM1Rag mice treated with TMP-SMX had significant shifts in alpha diversity, beta diversity, and functional pathways at all time points, whereas in the HuM2Rag mice, it resulted in minimal changes in the microbiome. Likewise, dexamethasone treatment resulted in significant changes in the microbiome of the HuM1Rag mice, whereas the microbiome of the HuM2Rag mice was mostly unaffected. The results of our study show that routine medications used during glioblastoma treatment can perturb gut microbiota, with some microbiome compositions being more sensitive than others, and these treatments could potentially affect the overall efficacy of standard-of-care therapy.

Chinese medicine Jianpi Antai formula improves pregnancy outcomes of in vitro fertilization-embryo transfer in infertile women.

To evaluate the efficacy and safety of Chinese medicine Jianpi Antai formula in infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET). A total of 300 infertile women who underwent 2 frozen embryo transfer procedures at the Reproductive Medicine Center, Sir Run Run Shaw Hospital were included in the study. The participants were randomly divided into study group and control group. The study group received routine medication plus the Jianpi Antai formula during the period of embryo transfer, while the control group received routine medication only. The general condition, embryo implantation rate, clinical pregnancy rate, live birth rate, and the blood routine and liver and kidney function were evaluated and compared between two groups. There were 277 cases who completed the study, including 134 in the study group and 143 in the control group. The embryo implantation rate (68.7% vs. 55.9%), the clinical pregnancy rate (56.7% vs. 44.8%) and the live birth rate (50.7% vs. 37.8%) in the study group were all higher than those in the control group (all P<0.05). Subgroup analysis revealed that in patients of advanced age (≥35 years) and those with decreased ovarian reserve function (anti-Müllerian hormone <1.68 ng/mL), the embryo implantation rate, clinical pregnancy rate, and live birth rate in the study group were all higher than those in the control group (all P<0.05). During the follow-up period, there were no abnormalities in the basic vital signs of both groups, and no adverse events were reported. Jianpi Antai formula can safely improve the embryo implantation rate in infertile women undergoing IVF-ET, reduce the embryo miscarriage rate, increase the live birth rate as well as improve the clinical outcomes.

Impact of Deep Breathing, Murottal, and Hypertension Exercises on Headache Management in Hypertensive Individuals

Hypertension, characterized by an abnormal increase in blood pressure, often triggers headaches at the back of the head and neck due to vascular disturbances. This study explores the effectiveness of a holistic non-pharmacological intervention—comprising Deep Breathing Relaxation Technique, Qur'anic recitation (murottal), and Hypertension Exercise—to alleviate these headaches in hypertensive patients at Mekarjaya Community Health Center, Indonesia. Employing a quantitative approach, the research utilized a Quasi-Experimental Design with a Pretest and Posttest Control Group. The intervention group underwent IMAS therapy, an integrated approach combining the three techniques, while the control group continued only with routine medication. Conducted in December 2022 with 16 participants in each group, results from both Dependent and Independent T-tests (p &lt; 0.05) confirmed the significant effect of the interventions. This study not only underscores the potential of such integrative therapies in managing hypertension-related headaches but also contributes to broader health care practices by offering a viable alternative to conventional medication. The findings align with and extend existing research on relaxation therapies for hypertension, suggesting substantial benefits in patient well-being and symptom management.

Intestinal Parasitic Infection in Children and Adolescents With Ocular Diseases: The Prevalence, Spectrum, and Effect of Lockdown During the COVID-19 Pandemic.

People with visual impairments and blindness face challenges in performing regular tasks such as maintaining proper sanitation, which makes them vulnerable to intestinal parasitic infections. This study aims to examine the prevalence and distribution of intestinal parasitic infections in children and adolescents with ocular diseases and to assess if the lockdown during the COVID-19 pandemic affected these rates. This retrospective, hospital record-based study was conducted among children and adolescents attending the Regional Institute of Ophthalmology in Kolkata, India. It involved routine stool examinations as part of their treatment during 2019-2020. Early morning stool specimens were collected and brought to the institute laboratory in containers. Stools were examined under a microscope for cysts, ova, parasites, and adult worms. Findings were recorded in the laboratory record book. These data were then extracted into a spreadsheet and analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York). The prevalence of intestinal parasitic infections was 8.59% (59 out of 687 patients). Among those 59 positive cases, Ascaris lumbricoides, Giardia lamblia, Entamoeba histolytica, Trichuris trichiura, Taenia spp., Enterobius vermicularis, and Isospora belli were detected in 27 (45.8%), 15 (25.4%), 8 (13.6%), 6 (10.2%), 3 (5.1%), 2 (3.4%), and 1 (1.7%) patients, respectively. The positivity rate of stool samples was higher from September and thereafter from January to March. The sample positivity rate was higher post-pandemic and lockdown, but not statistically significant (11.5% vs. 5.3%; χ²=4.044, df=1, p=0.44). Ascaris lumbricoides was the most commonly observed intestinal parasite in children and adolescents with ocular disease in our setting. Seasonal variation was noted with higher case positivity at the end of the rainy season and thereafter in winter. Therefore, we propose to strengthen the routine deworming program during this period in Eastern India. Higher sample positivity after the pandemic may be attributed to school closures during the lockdown period, which might have caused some children to miss their routine deworming medication.

Distress and Coping Strategy among Indonesian Men with Type-2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) can have a notable impact on the psychological and physical well-being of individuals, which, in turn, affects the management of the condition. Both men and women experience stress and adopt distinct coping strategies. However, research focusing specifically on T2DM in men is still limited. Purpose: The present study aimed to investigate the distress and coping strategies adopted by outpatient men with T2DM in Malang, East Java, Indonesia.Methods: This study employed a qualitative research design and conducted in-depth interviews with 24 outpatient men with T2DM. The interview guidelines were formulated using the Bahasa Indonesia version of the Diabetes Distress Scale (DDS17) questionnaire, which includes four domains: physician distress, emotional burden, regimen distress, and interpersonal distress. Thematic analysis was performed to analyze the results gathered during the research and compile them into a final report. Results: The study revealed that individuals diagnosed with T2DM experienced a range of emotional and practical difficulties, including feelings of fear, anxiety, and a lack of understanding. Disease burden, a lack of understanding of healthcare services, difficulties managing their diet, routine medication, financial concerns, and fatigue also contributed to the distress. To cope with distress, the informants identified eight distinct coping strategies. Among these, the most effective was receiving support from family members. Additionally, acceptance of the condition, self-management, a positive attitude, understanding of the illness, participation in the diabetes community, spiritual solace, and gaining further knowledge of T2DM were also identified. Conclusion: The findings of this research indicate that men experience eight distinct types of stress and utilize comparable coping strategies associated with T2DM. Emotional distress represents the predominant pressure, while family support constitutes the primary coping strategy. These results are important for nurses and other healthcare professionals in supporting patients.