Review ArticleAhmed F*, Nazmeen A, Vekaria M, Magny S, Garimella V, Potla S, Bobba SH, Akbar UA, Fashina T, Thompson A, Enebong Nya G, Mohan K and Shahini E
Relationship between Neurodegenerative Diseases and Proton Pump Inhibitors Using Bioinformatics Read More »
Proton pump inhibitors (PPIs) are a class of drugs used for the treatment of acid-related diseases by inhibiting gastric acid secretion. Although PPIs are considered safe and clinically beneficial in the short term, mounting evidence raises safety concerns about the long-term use of PPIs. Alzheimer’s disease (AD) is the most common form and cause of dementia and one of the biggest public health challenges among neurodegenerative diseases in the elderly, with no effective treatment to date. In recent years, there have been conflicting studies in patients receiving long-term PPIs regarding the risk of dementia, and in particular, AD. Some studies showed a strong positive relationship between PPIs and their impact on dementia and AD. We performed an in-depth review and analysis of existing studies and performed some docking to investigate the interaction between PPIs and dementia, AD-associated proteins, enzymes, and receptors. This study aims to provide possible new insights about the long-term safety of PPI employment and eventual cognitive impairment leading to dementia and later AD.
Review Article
Abstract
Full TextPDF Proton pump inhibitors (PPIs) are commonly prescribed in conjunction with other drugs as a preventative measure. Their primary function is acid suppression; as such, they subsequently hold back intestinal calcium absorption. By this mechanism, chronic use of PPIs is suggested to induce osteoporosis, a condition that gradually increases bone fragility and is associated with high suffering and morbidity rates. Additionally, PPI administration amongst elderly patients for more than one year has been shown to have an increased risk for hip fractures. This current review consists of literature searches from PubMed and the National Library of Medicine (USA). It analyzes factors such as age, race, gender, menopausal status, lifestyle, medical conditions, and polypharmacy, which may induce osteoporosis, and explores the mechanism of how PPIs may trigger osteoporosis development and/or progression. Clinicians should be cautious of severe osteoporosis as a potential consequence of PPI use, and be aware that it can be mitigated by the appropriate selection of pharmacological therapies and modalities.
Research Article
Abstract
Full TextPDF Background: Various irrigating solutions have been used during pulpectomy and root canal procedures. However, each one of them has its own demerits. As a result, there is a quest for novel bioactive materials that are safer and biodegradable.
Aim: To evaluate and compare the antimicrobial efficacy of pomegranate, tulsi, garlic, and liquorice as a root canal irrigant against Enterococcus faecalis.
Methodology: 0.2% chlorhexidine, pomegranate, tulsi, garlic, and liquorice extracts with different concentrations of 5%, 25%, 50%, 100% and fresh stains of Enterococcus faecalis (ATCC 29212) were used. The agar well diffusion method was performed to evaluate and compare the antibacterial efficiency of all the groups.
Results: The results were tabulated and statistically analyzed using analysis of variance (ANOVA). The mean zone of inhibition was highest for Group A (0.2% chlorhexidine), i.e., 18.36 mm, followed by Group E (liquorice extract), i.e., 17.40 mm, Group C (tulsi extract), i.e., 16.43 mm, and Group B (pomegranate extract), i.e., 14.55 mm.
Conclusion: All four herbal products (pomegranate, tulsi, liquorice, and garlic) possess antimicrobial activity against Enterococcus faecalis, with liquorice and tulsi extract having maximum effect, followed by pomegranate and garlic extract having minimum antimicrobial activity.
Research Article
Abstract
Full TextPDF Background: Hemoglobinopathies are chronic diseases that significantly burden patients both in their daily lives and in the long term. The purpose of the research is to contribute to the understanding of patients’ experiences, needs and perceptions regarding the medical services provided. The research aims to highlight the positive and negative dimensions of healthcare, as well as to enhance self-efficacy in medication use and empower patients to use medications appropriately.
Methods: The research is based on a sample of 130 patients with diagnosed hemoglobinopathy, coming from three different hospitals in Greece. Data were collected through a structured questionnaire, which includes four main sections: satisfaction with healthcare (PSQ-18), self-efficacy in medication use (SEAMS), quality of life (QOL10), and demographic/clinical data of the participants.
Results: The research findings indicate that quality of Life (overall) presents a negative correlation (r = -0.358, p < 0.001), indicating that higher levels of self-efficacy in medication use may be associated with lower perceived quality of life. Also, general Quality of Life is negatively correlated (r = -0.372, p < 0.001), possibly indicating that self-efficacy in medication use affects the overall sense of well-being and health. Overall, self-efficacy does not appear to be significantly related to any of the Satisfaction subscales. Self-Efficacy in Medication Use and Overall Satisfaction with Overall Satisfaction, Self-Efficacy in Medication Use shows a non-significant correlation (r = -0.019, p = 0.827).
Conclusion: The findings show a strong association of quality of life with self-efficacy in the use of medication.
Review Article
Abstract
Full TextPDF Heart failure (HF) and type 2 diabetes mellitus (T2DM) frequently coexist, substantially increasing cardiovascular (CV) risk and mortality. Sodium-glucose co-transporter 2 inhibitors (SGLT2is) have revolutionized the management of T2DM and HF by demonstrating CV and renal protective effects beyond glucose lowering. Among these, sotagliflozin, a dual SGLT1/SGLT2 inhibitor, offers additional metabolic benefits via gastrointestinal glucose modulation. This review comprehensively integrates findings from 27 studies analyzing sotagliflozin and SGLT2is in HF and diabetes.
The SOLOIST-WHF trial demonstrated sotagliflozin’s efficacy in reducing CV death, HF hospitalizations, and urgent HF visits in T2DM patients following HF exacerbation. Meta-analyses confirmed reductions in major adverse cardiovascular events (MACE), all-cause mortality, and HF hospitalization. Sotagliflozin’s dual mechanism further improves postprandial glycemic control, elevates GLP-1/GIP secretion, and may enhance myocardial efficiency, particularly in heart failure with preserved ejection fraction (HFpEF). Sotagliflozin also demonstrated safety and efficacy in type 1 diabetes mellitus (T1DM), reducing insulin needs and glucose variability.
Safety profiles align with SGLT2is, generally, but with additional gastrointestinal side effects from SGLT1 inhibition. Cost-effectiveness models project an incremental cost-effectiveness ratio (ICER) of ~$45,596/QALY. Real-world eligibility studies suggest broad applicability of sotagliflozin in HF patients. Early initiation post-HF hospitalization offers rapid clinical benefit, while renoprotection remains robust even in advanced chronic kidney disease (CKD).
This review highlights sotagliflozin’s unique dual mechanism, early benefits, and broad applicability, positioning it as a promising option for HF patients with diabetes.
Case Report
Abstract
Full TextPDF Pilonidal sinus is a common disease of the sacrococcygeal region. The pilonidal sinus of the umbilicus is not frequently reported in the literature. The disease having an atypical presentation is often misdiagnosed. The presenting symptoms include pain and discharge. There is no consensus regarding the treatment hence, both conservative treatment and surgery have been suggested for the management of the disease. We present a case of umbilical pilonidal sinus (UPS), which was managed surgically after the conservative trial of management had failed. We have also discussed the current review of literature regarding the management of this rare clinical disorder.
Research Article
Abstract
Full TextPDF Background: All over the world, hundreds of millions of population suffer from common bacterial infections of the urinary tract every year. An increased risk of death, morbidity, and increased healthcare expenses in the critical care unit is linked to catheter-associated urinary tract infections (CAUTIs), which occur when bacteria enter the urinary tract through a urinary catheter. Since urinary catheterization is linked to urinary tract infections (UTIs), which are among the most common infections in healthcare settings and account for almost 30% of intensive care unit (ICU) reports, there is a significant opportunity for prevention.
Methods: An institutional-based cross-sectional study design is applied to determine the prevalence and associated factors of healthcare-associated urinary tract infections (HAUTIs) among selected adult patients accounting for 391 that were admitted to ICU in the two years at Addis Ababa Public Governmental Hospital, Addis Ababa, Ethiopia, from June–December 2020. Data was manually checked and entered into EpiData Manager version 4.6.1, and statistical analyses were performed using the SPSS version 23 software program. The strength of the association between dependent and independent variables is assessed using crude odds ratio (COR) and adjusted odds ratio (AOR) with a confidence interval (CI) of 95%. Variables with a value of P < 0.25 on bivariate analysis were directly forwarded to be analyzed by multivariable analysis. The goodness of the FIT test was also computed for logistic regression using the Hosmer-Lemeshow test, resulting in (sig = 0.073); finally, having P-values < 0.05 is considered statistically significant.
Results: The study finds that the prevalence of HAUTI among ICU admitted patients was 91 (23.3%) 95% CI; (19.2-27.4), while the length of stay, having tracheostomy, patients on mechanical ventilation, and taking proton pump inhibitor (PPI) drugs were associated with HAUTI in the study area.
Conclusion: HAUTI is a highly emerging clinical condition among ICU-admitted patients in the study areas.
Case Report
Abstract
Full TextPDF Dupilumab is an interleukin 4 (IL-4) receptor α-antagonist that inhibits IL-4 and IL-13 signaling through blockade of the shared IL-4αR subunit. Blockade of IL-4/13 is effective in reducing Th2-oriented response including the release of proinflammatory cytokines, chemokines, and IgE. These mechanisms are mediators in the pathogenesis of atopic dermatitis (AD), food allergy, allergic rhinitis (AR) with and without polyposis, and asthma. We report the clinical case of a patient in whom the Th2-mediated inflammatory substrate is evident in comorbid allergic manifestations and shows a good response after treatment with dupilumab for moderate AD.
Case Report
Abstract
Full TextPDF Essential thrombocythemia (ET) is a rare chronic myeloproliferative disorder characterized by significant thrombocytosis. The ocular manifestations reported during ET are rare and are mainly represented by occlusion of the central retinal vein. We present the case of a 67 years old patient who was referred for an acute visual loss in the right eye, without associated pain or redness, and whose clinical examination on the admission found vitreous hemorrhage of the right eye, associated with microhyphema and ocular hypertonia. The pre-therapeutic biological assessment revealed hyperplateletosis at 1,146,000/mm3, without associated myelemia. The patient was treated with general and topical hypotonizing treatment, and was referred after the normalization of his intraocular pressure (IOP) to hematology for further management. The assessments carried out were in favor of ET and cytoreductive treatment was initiated. Ophthalmological involvement during ET is rare. This is the first case of spontaneous vitreous hemorrhage as an ocular complication of ET.
Review Article
Abstract
Full TextPDF Background: Cancer represents a public health problem worldwide. Cancer incidence rates were estimated worldwide by the GLOBOCAN 2020 study. Cancer statistics in Libya indicate an increasing disease burden. However, comprehensive epidemiological data in Libya is sparse or non-existent.
Objective: To describe and discuss cancer incidence in Libya based on GLOBOCAN Libya 2020 estimates.
Methods: A descriptive review of published visualized cancer data through the Global Cancer Observatory (GCO), a web-based platform that provides interactive features and presents comprehensive global cancer statistics.
Results: According to GLOBOCAN 2020 findings, the estimated number of new cancer cases in Libya in 2020 was 7,661, including cases of both sexes. Of these, 3,913 were women and 3,748 were men. The most common malignancies in Libyan men occur in the lungs at 21.3%, followed by colon cancer at 11.3%, prostate cancer at 10.7%, bladder cancer at 10%, and leukemia at 4.4%. The most common cancers among Libyan women were breast cancer at 31.4%, followed by colon cancer at 12.3%, cervical cancer at 6.1%, thyroid cancer at 4.8%, and leukemia at 4.3%. Lung cancer accounted for a significant number of cases in Libya, of which 770 (16.2%) died, followed by breast cancer with 459 (9.7%).
Conclusion: The GLOBOCAN findings have provided useful indicators of cancer incidence in Libya, although some limitations were noted due to the weakness of national cancer registrations. Healthcare policies are needed for the management and control of the more prevalent and pressing cancers in Libyan society.
