COMPARING THE EFFECT OF SECOND-GENERATION ANTIPSYCHOTICS VERSUS SELECTIVE SEROTONIN REUPTAKE INHIBITORS IN REFRACTORY OBSESSIVE-COMPULSIVE DISORDER: A SYSTEMATIC REVIEW OF THE PAST, PRESENT, AND FUTURE CLINICAL TRIALS

Objective: In this concise and systematic review, the trend of using major medication modalities prescribed for refractory obsessive-compulsive disorder (OCD), including serotonin-specific reuptake inhibitors (SSRIs) and second-generation antipsychotics (SGAs) are discussed.Methods: We systematically searched PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) systematically using Mesh terms. OCDis extremely disabling and associated with considerable depression and other serious psychiatric illnesses.Results: Through databases, we found 78 randomized clinical trials (RCTs), which included selective SSRI compared with routine drug therapy or placebo. Out of these 78 studies, 62 studies were conducted on adult patients with OCD, comprising 7920 cases. While only 16 RCTs were performed on children and adolescents with OCD, including 1313 people. We found 24 clinical trial studies related to SGAs, of which were conducted on adult patients with OCD, including 992 cases.Conclusion: As our data showed among the SSRIs, fluvoxamine has been particularly well studied and used in RCTs in both children and adolescents with OCD. According to the summary of our review, it will be better when therapists use SGAs in the early treatment programs of refractory OCD. Thus, considering our reviewed, it seems that the first choice of early treatment programs of refractory OCD is fluvoxamine in combination with quetiapine or aripiprazole.Keywords: Obsessive-compulsive disorder, Refractory, Second-generation antipsychotic drugs, Selective serotonin reuptake inhibitors.Â

Estimating Case Fatality and Case Recovery Rates of COVID-19: is this the right thing to do?

Introduction: Case fatality rates (CFRs) and case recovery rates (CRRs) are frequently used to define health consequences related to specific disease epidemics, including the COVID-19 pandemic. This study aimed to compare various methods and models for calculating CFR and CRR related to COVID-19 based on the global and national data available as of April 2020.Methods: This analytical epidemiologic study was conducted based on detailed data from 210 countries and territories worldwide in April 2020. We used three different formulas to measure CFR and CRR, considering all possible scenarios.Results: We included information for 72 countries with more than 1,000 cases of COVID-19. Overall, using first, second, and third estimation models, the CFR were 6.22%, 21.20%, and 8.67%, respectively; similarly, the CRR was estimated as 23.21%, 78.86%, 32.23%, respectively. We have shown that CFRs vary so much spatially and depend on the estimation method and timing of case reports, likely resulting in overestimation.Conclusion: Even with the more precise method of CFRs estimation, the value is overestimated. Case fatality and recovery rates should not be the only measures used to evaluate disease severity, and the better assessment measures need to be developed as indicators of countries’ performance during COVID-19 pandemic

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Purpose ― We performed a meta-analysis of all eligible case-control studies published to date, to assess the association of salivary ferritin and iron with hematological disorders. Methods ― We conducted Medline/PubMed and Scopus searches for papers published from January 1, 1980, through January 1, 2013. Data were merged the summary mean difference were estimated using either a random-effects model or a fixed-effects model. Results ― There were 3 studies including 196 cases and 70 controls. There was a statistically significant difference in the salivary ferritin and iron between hematological diseases and control groups, and the summary estimate of mean difference was 1.37 (95%CI: 0.01–2.74) and 2.23 (0.92–3.54) in salivary ferritin and iron, respectively. The stratification showed the same statistically significant differences in the salivary ferritin between Iron deficiency anemia (IDA) with thalassemia intermedia (TI), and IDA with thalassemia major (TM) groups. Besides, the stratification showed that there were statistically significant differences in the salivary iron between IDA with TM groups, while no statistically significant difference was observed between IDA with TI. Conclusion ― Saliva ferritin iron and ferritin increase significantly in patients with thalassemia compared to IDA. Salivary ferritin and iron can be used as a diagnostic marker and new discriminating indices routinely to differentiate IDA from thalassemia, especially thalassemia trait; furthermore, their easy applicability, safe, relatively simple, and noninvasive procedure may be an important advantage compared to blood sample collection. Consequently, it could be promising to develop a simplified testing and differentiating procedure, which could reach many clinical decision-makers as a diagnostic potential

SARS-Cov2-Induced Cytokine Storm and Schizophrenia, Could There be a Connection?

Today, a new coronavirus (2019-nCoV, later named SARS-CoV-2) has become known as a pandemic with over 3,949,200 cases and 271,782 deaths. It has been considered that most of the deaths in infected patients stem from comorbidity conditions. Therefore, understanding at-risk populations are currently under the focus of investigations. This object has highly driven attention to put patients with a higher potential of death related to SARS-CoV2 infection at priority. For instance, this can happen in Schizophrenia owing to ambiguous immunology attributes, including elevated levels of pro-inflammatory cytokines and stress-related immune disability. Given that, the hyper-inflammatory responses are the significant cause of the pathophysiology of the SARS-CoV2-related mortality. Moreover, SARS-CoV2 can prompt the risk of developing Schizophrenia in the future. This review punctuates that prenatal/perinatal infection could be associated with increased Schizophrenia risk; on the flip side, the potential risk of ongoing medication can worsen mentally disabled patients, and healthy people are at risk

Multiple unite sustained released floating of sodium diclofenac: Formulation and evaluation using factorial design

The aim of this study was prepare and evaluate floating granules of sodium diclofenac with lipid excipient for prolonged gastric residence and reduced dose regimen. Floating granules prepared by extruder-spheronization technique. Compritol and gelucire as lipid excipient, HPMC as retardant and tween 80 as emulsifier were used. The effect of drug/lipid, drug/HPMC, drug amount, percentage of tween and type of lipid on floating ability, morphology and dissolution parameters were evaluated by factorial design. Results showed floating ability of granules was influenced by proportion of drug/lipid, drug/HPMC and percentage of tween. Floating property of Compritol was more than gelucire and provided good floating particles. Compritol granules provided suitable sustained release pattern in the manner that increase in D/L reduced D8 and MDT and increase in %T increased MDT. Higuchi model was the best fitted for dissolution data of granules prepared by Compritol and gelucire. In conclusion, Compritol provided more suitable floating ability and sustained release property.Keywords: Sodium diclofenac; Floating granules; Gastric residence time; Extruder-spheronizatio

The Impact of Human Cystic Echinococcosis in the Central Asian Region, 1990-2019

Objective: This research aims to update knowledge on the regional and national sickness burden attributable to cystic echinococcosis (CE) from 1990 to 2019, as well as epidemiology and disease control, with a particular emphasis on the People’s Central Asian Regions. Methods: We calculated the morbidity, mortality, and disability-adjusted life years at the global, regional, and national levels for CE in all central Asian countries from 1990 to 2019, and we analyzed the association between GDP per capita and the disease burden of CE. Results: In 2019, the three greatest numbers of CE cases were recorded in Kazakhstan [23986; 95% uncertainty interval (UI); 19796; 28908]; Uzbekistan (41079; 18351; 76048); and Tajikistan (10887; 4891; 20170) among all 9 countries. The three countries with the greatest ASIR of CE were estimated to be Kazakhstan (127.56; 95% UI: 105.34-153.8), Uzbekistan (123.53; 95% UI: 58.65-219.16), and Tajikistan (121.88; 58.57-213.93). Kyrgyzstan, Tajikistan, and Uzbekistan had the biggest increases (125%, 97%, and 83%, respectively) in the number of incident cases of CE, whereas Georgia, Kazakhstan, and Armenia saw the largest decreases (45%, 8%, and 3%, respectively). Conclusion: To reduce the illness burden caused by CE, our findings may help public health professionals and policymakers design cost-benefit initiatives. To lessen the impact of CE on society, it is suggested that more money be given to the region’s most endemic nations. Echinococcosis, cystic, negative health effects, life-years lost due to disability, rate of occurrence as a function of age, rate of death as a function of age