Role of Stem Cells in Orthopaedic Surgery: Theoretical Survey

This study aims at analyzing the Stem cell application is a burgeoning field of medicine that is likely to influence the future of orthopaedic surgery. Stem cells are associated with great promise and great controversy. For the orthopaedic surgeon, stem cells may change the way that orthopaedic surgery is practiced and the overall approach of the treatment of musculoskeletal disease. Stem cells may change the field of orthopaedics from a field dominated by surgical replacements and reconstructions to a field of regeneration and prevention. This review will introduce the basic concepts of stem cells pertinent to the orthopaedic surgeon and proceed with a more in depth discussion of current developments in the study of stem cells in orthopaedic surgery. Keywords: Stem cell, orthopaedic, surgery

Oral semaglutide adequate glycaemia control with safe cardiovascular ‎profile

BackgroundType 2 diabetes is a chronic and progressive disease that ‎associated with series complication such as major adverse ‎cardiovascular events. Adequate glycaemic control proven ‎to reduce this risk. Orally administered semaglutide ‎promising medication in managing patient with type 2 ‎diabetes.‎AimsTo assess the cardiovascular safety and efficacy of semaglutide, a recently approved glucagon-like peptide 1 receptor agonist (GLP-1 RA) for type 2 diabetes.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were ‎systematically search for relevant articles. The terms‎ diabetes‎, Glucagon-like peptide, semaglutide‎ were used. Out of hundred twenty-two records, only ‎four fulfilled ‎the inclusion criteria.Results Four placebo-controlled studies with oral semaglutide ‎were included. Single study concern about the cardiovascular safety of oral semaglutide ‎and showed that, ‎compared with placebo, semaglutide ‎ was not associated ‎with increased in the cardiovascular events. On the other ‎hand, the remaining trials shown that, semaglutide ‎ can ‎effectively control the blood glucose as evident by ‎reduction in HA1c.ConclusionOral semaglutide can effectively and safely lower blood glucose without increase in the major adverse ‎cardiovascular events‎‎ (MACE).

Comparing the effectiveness of corticosteroid and surgery in managing chronic subdural hematoma: A systematic review and meta-analysis

Background: The optimal treatment for Chronic Subdural Hematoma (CSDH), corticosteroids or surgery, remains controversial. This meta-analysis compares the efficacy and safety of these interventions. Methods: We searched four databases until July 2023 for relevant studies. Data extraction was independently performed by two authors. Risk ratios (RR) with a 95% confidence interval (CI) were calculated for dichotomous outcomes and mean difference (MD) with a 95% CI for continuous outcomes. Results: Six studies involving 804 patients were included. Dexamethasone showed non-inferiority to surgery for good neurological outcomes (pooled RR = 1.02, 95% CI [0.95, 1.09], P = 0.60). No significant differences were found in mortality, recurrence rate, and hospital stay length between the two groups. Conclusion: Our analysis indicated that there was no statistically significant difference in terms of good neurological outcomes, length of hospital stay, mortality, and recurrence rate between the surgical interventions and dexamethasone. However, we noticed only clinical and numerical differences between the surgical interventions and dexamethasone regarding length of hospital stay, mortality, and recurrence rate. On the other hand, dexamethasone was associated with statistically higher complications compared to surgery. However, we should treat these results with caution as the only included RCT reported a high recurrence rate with dexamethasone indicating that surgery may be the first-line treatment for patients with CSDH

Pediatric intussusception due to basidiobolomycosis: a case report and literature review

Abstract Background Pediatric gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum, an environmental saprophyte found worldwide. Typically, basidiobolomycosis presents as a subcutaneous infection or soft tissue tumor-like lesion, and rarely involves the gastrointestinal tract. Gastrointestinal basidiobolomycosis is most common in young infants. It has no definitive clinical presentation, and almost all cases are misdiagnosed during the initial presentation. Case presentation We report the case of a 4-year-old Saudi boy who presented to the emergency department with abdominal pain, nausea, vomiting, and weight loss. Ultrasonography revealed a target sign. Based on the ultrasonography findings, surgery was performed, which revealed the presence of intussusception. Eventually, the patient was diagnosed with intussusception secondary to intra-abdominal basidiobolomycosis based on the histological findings. The patient was readmitted and intravenous voriconazole therapy was initiated. One week after the second admission, the patient developed abdominal pain, nausea, vomiting, inability to hold down food, and constipation. Computed tomography of the abdomen was suggestive of small bowel obstruction, which was managed conservatively. The patient responded well and was subsequently discharged with a prescription of oral voriconazole. Conclusions This case reveals that gastrointestinal basidiobolomycosis can cause intussusception. This report will inform clinicians of the importance of considering gastrointestinal basidiobolomycosis in the differential diagnosis of chronic abdominal pain in children, even in the absence of fever or a clinically obvious abdominal mass, especially in countries such as Saudi Arabia, where cases have been reported

Efficacy of Different Doses of Daprodustat for Anemic Non-dialysis Patients with Chronic Kidney Disease: A Systematic Review and Network Meta-Analysis

(1) Background: Anemia affects about 40% of patients with chronic kidney disease (CKD). Daprodustat improves serum hemoglobin in anemic patients by inhibiting prolyl hydroxylase of hypoxia-inducible factor. We conducted a network meta-analysis to investigate the direct and indirect effects of different doses of daprodustat compared to each other and erythropoietin and placebo. (2) Methods: We searched PubMed, Cochrane Library, Web of Science, and Scopus, for randomized clinical trials (RCTs) reporting data about different doses of daprodustat for anemia in nondialysis of CKDs. (3) Results: We eventually included five RCTs with a total sample size of 4566 patients. We found that the higher the dose of daprodustat, the greater the change in serum total iron binding capacity (TIBC), hemoglobin, and ferritin from baseline. Compared to placebo, daprodustat 25–30 mg was associated with the highest significant increase in serum hemoglobin (MD = 3.27, 95% CI = [1.89; 4.65]), a decrease in serum ferritin (MD = −241.77, 95% CI = [−365.45; −118.09]) and increase in serum TIBC (MD = 18.52, 95% CI = [12.17; 24.87]). (4) Conclusion: Higher daprodustat doses were associated with a higher impact on efficacy outcomes as serum total iron-binding capacity (TIBC), hemoglobin, and ferritin. However, data about the safety profile of different doses of daprodustat is still missing

Tailoring antidepressant therapy based on genetic profiles: Review

Background: Depression is a substantial public health concern that impacts millions of individuals globally. The wide range of symptoms and manifestations of depression emphasizes the need of tailoring treatment methods to each individual, which includes adapting antidepressant prescriptions accordingly. Genetic factors contribute to depression and its association with other psychiatric and non-psychiatric illnesses, highlighting the need of a thorough assessment that encompasses psychopathology, physical health, and genetic variables. Aim of Work: This research aims to highlight the significance of customized therapy in the management of depression, taking into account hereditary variables, metabolic abnormalities, and inflammatory indicators. The research also seeks to emphasize the potential use of genotyping in directing the selection of antidepressants and making dose changes for people with altered metabolism. Methods: The research entails examining previously published works on the genetic factors related to depression, the influence of inflammatory and metabolic abnormalities in its development, and the possible advantages of genotyping in the treatment of antidepressants. The research also examines the incorporation of genetic information, such as the tendency to develop cardio-metabolic illnesses due to several genes, together with non-genetic risk factors to improve treatment results.&nbsp

New anticoagulant therapies in atrial fibrillation: Clinical outcomes

Background: Global observational studies are revealing a lack of agreement between recommendations and actual clinical practice when it comes to the dosages of direct oral anticoagulant drugs (DOACs). Aim of Work: This review provides a concise and critical assessment of the use of Direct Oral Anticoagulants (DOACs) in real-world clinical setting. Methods: This study was conducted using the PubMed (MEDLINE) and Medscape databases for the search. Results: Analysis of data from 75 trials revealed that the majority of patients who were administered DOACs for stroke prevention in atrial fibrillation were given dosages that aligned with the recommended recommendations. Nevertheless, a considerable proportion of patients were given dosages that were not approved for their specific condition (ranging from 25% to 50% in the majority of the assessed trials). Overdosing on DOACs was linked to higher rates of death from any cause and more severe bleeding episodes. Underdosing, on the other hand, was connected with higher rates of hospitalization for cardiovascular issues. Specifically, with apixaban, underdosing was linked to a nearly five times higher risk of stroke.&nbsp

Pharmaceutical compounding: Techniques and applications

Pharmaceutical compounding is a vital practice in pharmacy that involves the customization of medications to meet individual patient needs. This article explores various compounding techniques and their applications across different fields of healthcare. It delves into mixing, grinding, molding, and other compounding methods used to create customized dosage forms. Furthermore, it discusses the role of compounding in specialty areas such as hormone replacement therapy, dermatology, pain management, pediatrics, geriatrics, and veterinary medicine. Additionally, it highlights the importance of quality control measures, regulatory compliance, and emerging trends such as 3D printing and personalized medicine in shaping the future of pharmaceutical compounding

Smart pills: the future of adherence monitoring

Background: The precise assessment and monitoring of patient medication adherence is a worldwide concern due to the lack of universally accepted methodologies for accurately measuring adherence. There has been recent focus on using technology to monitor medication adherence, since they allow for continuous surveillance of an individual's behavior in taking their prescription. Nevertheless, the existing technologies for monitoring medication adherence range in terms of their technological characteristics and techniques of data collection, resulting in variations in their individual benefits and constraints. There is a dearth of suitable criteria to guide the evaluation of medication adherence monitoring devices for optimum uptake and utilization. Aim of Work: The objective of this research is to conduct a narrative evaluation of existing technologies for monitoring medication adherence and to suggest a set of criteria for assessing these technologies, which will aid in the development and implementation of such technologies. Methods: Using the terms medication adherence, measuring technology, and monitoring technology, a literature search was carried out on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (2010-present). The selection concentrated on research concerning the technology used to monitor medication adherence, as well as its development and use

The role of pharmacists in healthcare delivery

Pharmacists play a multifaceted role in healthcare delivery, contributing significantly to patient care, medication management, and public health initiatives. This paper explores the diverse responsibilities and contributions of pharmacists within healthcare teams, highlighting their expertise in medication therapy management, preventive care, chronic disease management, and medication access and adherence. Through collaborative practice models, patient education initiatives, and innovative interventions, pharmacists play an integral role in promoting optimal health outcomes and improving the quality, safety, and effectiveness of healthcare delivery