Validation of the Arabic Version of Medication Regimen Complexity Index Among Older Patients - Validation of the “MRCI-Arabic”

The medication regimen complexity index is widely used in clinical practice and many studies, to assess the complexity of medication regimens. The goal of this study is to validate the medication regimen complexity index-Arabic (MRCI-Arabic) version among older patients. Methods: This methodologic study was conducted in older patients (≥ 65 years old) who were native Arabic speakers at a community pharmacy located in Istanbul, Turkey. After the translation and cultural adaptation process finished, medication regimens of 30 patients were evaluated for test-retest reliability three weeks apart by the rater who was a native Arabic speaker. The inter-rater correlation was calculated in study population (n =100). The link between the number of medications and the score of medication regimen complexity was used to assess convergent validity. The difference in the score of pharmaceutical regimen complexity in stratified age groups was used to examine discriminant validity. Results: The inter-rater and test-retest reliability of the MRCI-Arabic total scale and its subsection were extremely high (Spearman’s rho ranged from 0.996 to 1; p <0.001). There was a strong and positive correlation between the total MRCI-Arabic score and the number of medications (r = 0.830; p < 0.001), the number of chronic diseases (r = 0.641; p < 0.001). Conclusion: The Arabic validation of the MRCI is a validated tool that can be used by native Arabic-speaking healthcare professionals to determine the complexity of their patients’ medication regimens

Physiological and psychological determinants of long-term diet-induced type 2 diabetes (T2DM) remission:A narrative review

Type 2 diabetes mellitus (T2DM) is a highly prevalent metabolic disease, causing a heavy burden on healthcare systems worldwide, with related complications and anti-diabetes drug prescriptions. Recently, it was demonstrated that T2DM can be put into remission via significant weight loss using low-carbohydrate diets (LCDs) and very low-energy diets (VLEDs) in individuals with overweight and obesity. Clinical trials demonstrated remission rates of 25–77%, and metabolic improvements such as improved blood lipid profile and blood pressure were observed. In contrast, clinical trials showed that remission rate declines with time, concurrent with weight gain, or diminished weight loss. This review aims to discuss existing literature regarding underlying determinants of long-term remission of T2DM including metabolic adaptations to weight loss (e.g., role of gastrointestinal hormones), type of dietary intervention (i.e., LCDs or VLEDs), maintaining beta (β)-cell function, early glycemic control, and psychosocial factors. This narrative review is significant because determining the factors that are associated with challenges in maintaining long-term remission may help in designing sustainable interventions for type 2 diabetes remission.</p

The role of antioxidant activity in the prevention and treatment of infertility caused by cisplatin in rats

Kurt, Nezahat/0000-0002-1685-5332; AKSOY, Ayse Nur/0000-0002-3793-9797; AKSOY, Mehmet/0000-0003-0867-8660WOS: 000350267200009PubMed: 25632879Background/Aims:To investigate the importance of antioxidant activity in infertility caused by cisplatin in rats. Methods: Rats in cisplatin control (CG), Vitamin E+cisplatin (ECG), Vitamin C + cisplatin (CCG), Hippophae rhamnoides extract (HRE) + cisplatin (HRECG), and thiamine pyrophosphate (TPP) + cisplatin (TPPCG) groups were injected intraperitoneally (ip) with (100 mg/kg) Vitamin E, Vitamin C, HRE, and TPP, respectively. One hour later, ip cisplatin was administered (5 mg/kg), and then antioxidant medications were continued for 10 days. Cisplatin + Vitamin E (CEG-1), cisplatin + Vitamin C (CCG-1), cisplatin + HRE (CHREG-1), and cisplatin + TPP (TPPCG-1) rats received cisplatin (5 mg/kg, ip) and were kept for 10 days. At the end of that period, rats received antioxidant medications for 10 days. (n = 12, for each group). Six rats from each group were sacrificed. Ovaries were removed to measure malondialdehyde, total glutathione, glutathione S-transferase, and glutathione reductase levels. the remaining rats were kept in a suitable laboratory environment. Results: Cisplatin-induced oxidative stress was best prevented by HRE, Vitamin E, Vitamin C, and TPP, in that order. However, infertility caused by cisplatin was only prevented and treated by TPP. Conclusion: Oxidative stress is not a major component in the pathogenesis of cisplatin-associated infertility. (C) 2015 S. Karger AG, Base

Evaluation of the mobile phone electromagnetic radiation on serum iron parameters in rats

Background: Electromagnetic fields (EMF) created by mobile phones during communication have harmful effects on different organs.Objectives: It was aimed to investigate the effects of an EMF created by a mobile phone on serum iron level, ferritin, unsaturated iron binding capacity and total iron binding capacity within a rat experiment model.Methods: A total of 32 male Wistar albino rats were randomly divided into the control, sham, mobile phone speech (2h/day) and stand by (12 h/day) groups. The speech and stand by groups were subjected to the EMF for a total of 10 weeks.Results: No statistically significant difference was observed between the serum iron and ferritin values of the rats in the speech and stand by groups than the control and sham groups (p&gt;0.05). The unsaturated iron binding capacity and total iron capacity values of the rats in the speech and stand by groups were significantly lower in comparison to the control group (p&lt;0.01).Conclusion: It was found that exposure to EMF created by mobile phones affected unsaturated iron binding capacity and total iron binding capacity negatively.Keywords: cellular phone, electromagnetic fields, ferritin, serum iro

Diyabetik hastaların eğitim ihtiyaçlarının değerlendirilmesi

Objective: Our study aimed to assess the role of pre-graduate pharmacy students’ participation in a diabetic education program on improving diabetic self-care. Material and Method: This study included both a cross-sectional and a longitudinal follow-up. Altinbas University fifth-year pharmacy students gathered relevant information from diabetic patients that visited community pharmacies, under the supervision of their instructor pharmacist. The participants filled out the diabetic self-care scale on their first visit before they were given the education. Patients refilled the same self-care questionnaire after three months. Statistical package for the social science (SPSS) 26 was used for all statistical analysis. Result and Discussion: The study comprised 86 diabetic patients. The second questionnaire results showed significant improvement in all patients. The total diabetic self-care scale scores were improved remarkably after the training session. HbA1c and BMI values decreased significantly. An educational program can improve diabetic self-care and diabetic outcomes. Active participation of final year pharmacy students in patient care can also improve pharmacists' participation and contribution to patient care delivery.Amaç: Çalışmamız, son sınıf eczacılık öğrencilerinin diyabetik bir eğitim programına katılımlarının diyabetik öz bakımın iyileştirilmesindeki rolünü değerlendirmeyi amaçlamıştır. Gereç ve Yöntem: Bu çalışma hem kesitsel hem de boylamsal bir takip içermektedir. Altınbaş Üniversitesi eczacılık beşinci sınıf öğrencileri, serbest eczaneleri ziyaret eden diyabet hastalarının gerekli bilgilerini sorumlu eczacılarının gözetiminde topladı. Katılımcılar diyabetik öz bakım ölçeğini doldurduktan sonra kendilerine eğitim verildi. Hastalar aynı öz bakım anketini üç ay sonra tekrar doldurdu. Tüm istatistiksel analizler için sosyal bilimler için istatistiksel paket (SPSS) 26 kullanıldı. Sonuç ve Tartışma: Çalışmaya 86 diyabetik hasta dahil edildi. İkinci anket sonuçları tüm hastalarda anlamlı iyileşme gösterdi. Toplam diyabetik öz bakım ölçeği puanları, eğitim seansından sonra önemli ölçüde iyileşti. HbA1c ve BMI değerlerinde anlamlı azalma oldu. Bir eğitim programı diyabetik öz bakımı ve diyabetik sonuçları iyileştirebilir. Eczacılık son sınıf öğrencilerinin hasta bakımına aktif katılımı, eczacıların hasta bakımı sunumuna katılımını ve katkısını da artırabilir

A Nonsurgical Approach to Treatment of High-Angle Class II Malocclusion

The bite opening effects of orthodontic appliances often cause a downward and backward mandibular rotation that only exacerbates the malocclusion. Successful orthodontic treatment of a high angle, Class II, Division 1 malocclusion requires careful consideration of the vertical dimension during treatment planning. This case report shows an individualized treatment approach to a patient with high angle Class II malocclusion

Investigation of ceftazidime-avibactam susceptibility in clinical isolates of gram-negative bacteria

Background/aim: Our study investigated the susceptibility rate of ceftazidime-avibactam and the risk factors associated with its resistance by analyzing gram-negative bacteria isolated from various patient samples. Materials and methods: Between March and November 2020, 1119 gram-negative bacteria strains were isolated from patient samples in Acıbadem Healthcare Group hospitals; ceftazidime-avibactam susceptibility results were evaluated using a 10/4µg (Oxoid, UK) disc and evaluated according to Eucast 2020 recommendations. Patient and isolate characteristics that could be risk factors were retrospectively investigated and statistically analyzed using SPSS 25.0. Results: Male patients made up 52% (n = 581) of the study’s total patient population, and they averaged 55.5 ± 24.9 years old. Of 1119 gram-negative strains culture and antibiogram, 1023 (91.4%) were sensitive to ceftazidime-avibactam. An increased risk of resistance was observed with female gender (OR = 2.29; CI 95% [1.45–3.61]; p < 0.05), Pseudomonas aeruginosa (OR = 1.67, CI 95% [1.03–2.7]; p < 0.05), the presence of multidrug-resistance (MDR) (OR = 4.07, CI 95% [2.47–6.7]; p < 0.05) pandrug-resistance (PDR) (OR = 12, (CI) 95% [9.9–14.7] ]; p < 0.05) and admission to intensive care unit (ICU) (OR = 1.89, CI 95% [1.22–2.93]; p < 0.05). Conclusion: The resistance rate of ceftazidime-avibactam was found to be 8.6%, and it was thought that resistant strains produced metallo-ß-lactamase (MBL) type carbapenemase. Risk factors were female gender, Pseudomonas aeruginosa, MDR, PDR, and admission to ICU. Therefore, studying the ceftazidime-avibactam susceptibility test together with gram-negative bacteria identification, especially in groups at risk for resistance, is one of the important factors that can positively affect the success of treatment

Elektif sezaryen ameliyatı geçiren primipar ve multipar hastaların anestezi tekniği tercihlerinin karşılaştırılması

Amaç: Bu çalışmanın amacı, iki aşamalı anket formu kullanarak, elektif sezaryen operasyonu planlanan primipar ve multipar hastaların anestezi yöntemi tercihlerinin karşılaştırılmasıdır. Ayrıca, hastaların anestezi yöntemi tercihini etkileyen faktörlerin tespit edilmesi planlandı. Gereç ve Yöntem: Miad gebeliği olan, elektif sezaryen operasyonu planlanan 100 primipar ve 100 multipar hasta olmak üzere 200 hasta çalışmaya dahil edildi. Hastalardan iki aşamalı anket formununu doldurmaları istendi. Anket formu doldurulduktan sonra bir anestezi uzmanı tarafından anestezi yöntemleri hakkında sözel olarak bilgilendirme yapıldı. Sözel bilgilendirme sonrası hastalara tercih ettikleri anestezi yöntemini değiştirmek isteyip istemedikleri soruldu. Hastaların demografik-obstetrik bilgileri ile anket sorularına verdikleri cevaplar kaydedildi ve veriler uygun istatistiksel testler kullanılarak analiz edildi. Bulgular: Multipar hastalarının 98’i (%98) ve primipar hastalarının 65'i (%65) anestezi tekniği hakkında bilgili sahibiydi (p &lt;0.001). Bilgi sahibi olan katılımcıların çoğunluğu (n=59,% 36.19) en fazla bilgiyi anestezi doktorlarından aldıklarını ifade etti. Primipar hastaların 21’i (%21), multipar hastaların 9’u (%9) başlangıçta bölgesel anesteziyi reddetti. Anestezi uzmanı tarafından yapılan sözel bilgilendirme sonrası bölgesel anesteziyi reddeden pimipar hastalardan 9'u (%42.8) tercihini bölgesel anestezi yöntemi olarak değiştirdi. Sonuç: Multipar hastalar bölgesel anestezi yöntemini primipar hastalara göre daha yüksek oranda tercih etmektedir. Anestezi doktoru tarafından anestezi tekniği ile ilgili ayrıntılı sözel bilgilendirme yapılması hastaların bölgesel anestezi tercihini artırabilir

Effect of intensive insulin therapy on systemic nitric oxide levels and adenosine deaminase activity in secondary sulfonylurea failure

Uvod: Vjerojatno je da upala, oksidativni stres i apoptoza imaju ulogu u sekundarnom neuspjehu liječenja sulfonilurejom, koji se povezuje s propadanjem beta-stanica i njihovom smanjenom funkcijom. Dušikov oksid (NO) stimulira otpuštanje inzulina, ima proupalne, apoptotičke učinke te djeluje kao slobodni radikal. Adenozin-deaminaza (ADA) regulira koncentraciju adenozina, koja utječe na otpuštanje inzulina i glukagona te na periferni metabolizam glukoze. Cilj ovoga istraživanja bio je ispitati aktivnost ADA i koncentraciju NO kao potencijalne posrednike intenzivne inzulinske terapije kod bolesnika sa sekundarnim neuspjehom liječenja sulfonilurejom. Materijali i metode: U istraživanje su bila uključena 24 bolesnika sa šećernom bolešću tipa 2 i sekundarnim neuspjehom liječenja sulfonilurejom. Koncentracije NO u serumu i aktivnosti ADA određene su u uzorcima krvi uzetim prije liječenja, nakon trodnevne inzulinske infuzije i nakon šestomjesečne višestruke supkutane primjene inzulina. Aktivnost ADA određena je metodom prema Giustiu. Koncentracija NO izmjerena je kolometrijskom metodom prema Griessu. Rezultati: Kod sekundarnog neuspjeha liječenja sulfonilurejom, bazalna je aktivnost ADA (17,0 [14,6-21,7] U/L) bila statistički značajno niža nego aktivnost ADA izmjerena trećeg dana (20,5 [16,2-23,4] U/L; P = 0,018) i u šestom mjesecu (21,2 [16,6-22,5] U/L; P = 0,010). Između vrijednosti NO određenih na početku (18,8 [11,6-28,4] μmol/L), trećeg dana (17,8 [9,7-33,6] μmol/L; P = 0,966) i u šestom mjesecu (21,7 [16,0-33,9] μmol/L; P = 0,230) nije bilo statistički značajne razlike. Zaključak: Prema našem je istraživanju aktivnost ADA bila povećana u objema fazama, ranoj i kasnoj fazi intenzivne inzulinske terapije kod sekundarnog neuspjeha liječenja sulfonilurejom. O ulozi NO kod pogoršanja funkcije beta-stanica nismo puno saznali na razini perferne krvi.Background: Inflammation, oxidative stress and apoptosis are suggested to take part in secondary sulfonylurea failure associated with β cell destruction and impaired β cell function. Nitric oxide (NO) stimulates insulin release, has proinflammatory, apoptotic and free radical effects. Adenosine deaminase (ADA) exerts control on adenosine levels, which affects insulin and glucagon release and peripheral glucose metabolism. In this study, we aimed to investigate ADA activity and NO levels as potential mediators of intensive insulin treatment in patients with secondary sulfonylurea failure. Materials and methods: Twenty-four patients with type 2 diabetes mellitus and secondary sulfonylurea failure were enrolled in the study. Serum NO levels and ADA activity were determined in blood samples obtained prior to treatment, after three-day insulin infusion and after six-month multiple subcutaneous insulin administration. ADA activities were estimated by the method of Giusti. Nitric oxide levels were measured with colorimetric assay by the method of Griess reaction. Results: In secondary sulfonylurea failure, baseline ADA activity (17.0 [14.6-21.7] U/L) was significantly lower than ADA activity measured on day 3 (20.5 [16.2-23.4] U/L; P = 0.018) and at 6 months (21.2 [16.6-22.5] U/L; P = 0.010). There was no statistically significant difference between NO levels determined before (18.8 [11.6-28.4] μmol/L), on day 3 (17.8 [9.7-33.6] μmol/L) and at 6 months (21.7 [16.0-33.9] μmol/L; P = 0.966 and P = 0.230, respectively). Conclusions: According to our study, ADA activity is increased both in the early and late periods of intensive insulin therapy in secondary sulfonylurea failure. The role of NO in amelioration of β cell function is not supported at the level of peripheral blood