ENHANCED EXTERNAL COUNTERPULSATION EFFECTIVENESS ON CLINICAL PARAMETERS IN DIABETIC AND NON-DIABETIC CORONARY HEART DISEASE PATIENTS

Objectives: The objectives of the study were to assess the effectiveness of enhanced external counterpulsation (EECP) treatment on clinical profile comprising physiological, biochemical, and clinical symptoms of diabetic and non-diabetic coronary heart disease (CHD) patients.Methods: A pretest–posttest designed prospective study with 163 diabetic and non-diabetic CHD patients enrolled in Science and Art of Living Heart Center (SAAOL), New Delhi, India. Angina severity was assessed using Canadian Cardiovascular Society (CCS) angina classification scale and dyspnea status was assessed using medical research council (MRC) scale. The study subjects were followed up for 12 months. Statistical analysis was done using the SPSS v21 software. Descriptive analysis with sample t-test for two independent groups and paired sample t-test for EECP effectiveness within the group was done.Results: A minute difference in body mass index mean (30.1±5.86–29.9±5.62 vs. 27.5±4.17–27.16±3.88) was observed in diabetic and non-diabetic CHD patients, but that was not statistically significant. A significant drop out in blood sugar fasting (166.7±41.9–150.1±23.7), blood sugar postprandial (204.7±64.4–173.2±41.2), and glycosylated hemoglobin (7.9±0.8 to 7.5±0.6) was also observed in diabetic CHD patients from baseline to 12th month after completion of EECP treatment with significant p<0.001, that may be due to EECP treatment. CCS angina classification score and MRC dyspnea score also significantly improved after EECP treatment.Conclusion: EECP treatment may improve clinical symptoms of CHD and lower the blood glucose level in diabetic CHD patients. This treatment may be effective for CHD patients with diabetes mellitus

Effectiveness of enhanced external counter pulsation on clinical profile and health-related quality of life in patients with coronary heart disease: a systematic review

Introduction. Enhanced External Counter Pulsation (EECP) is a non-invasive United States Food and DrugAdministration (FDA) approved outpatient treatment option for the complex problem of angina, a commonsymptom of coronary heart disease. A systematic review of the literature searched to assess the effect of EECPon the clinical profile that comprised physiological measurements, biochemical assessments, cardiac clinicalsymptoms, physical functional status, and Health-Related Quality of Life (HRQoL) in Coronary Heart Disease(CHD) patients. Material and methods. Total 258 EECP research articles from the early stage of EECP development to tilldate screened. Out of 258 EECP articles, total 60 articles (53 EECP articles for clinical profile and 7 article forHRQoL matched the inclusion criteria and other (n = 198) articles excluded due to irrelevant to study objectives. Results. All enrolled studies showed a significant improvement in angina pectoris and HRQoL with reductionof nitroglycerine use and exercise tolerance. There are several gaps in research has been found for furtherresearch to evaluate the EECP effectiveness on Body Mass Index (BMI), Heart Rate, Cholesterol, Triglyceride,High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), HbA1C, SpO2, Vo2max level with a comparativeassessment of cardiac and non-cardiac metabolic markers including blood glucose. Conclusions. There is further need of multi-centric randomize controlled trial studies to evaluate the effectof EECP on obese, diabetic, hypertension and other metabolic disease patients and more research required forfurther modifications in EECP device to cure, prevent and treat chronic diseases by the non-invasive procedure

Removing the Roadblocks in Equitable Global Access to COVID-19 Vaccine through IPR Waiver

In October 2020, South Africa and India proposed a plan to protect developing nations' interests and ensure a seamless supply of COVID-19 vaccinations. While rich countries have made rapid progress with their immunization programmes, many poor and underdeveloped countries have been left behind to fend for themselves due to patent protection. With the frightening rate at which COVID-19 cases have been emerging, the global population requires immediate and equitable access to life-saving vaccines. In this paper a methodological systematic review of IPR waiver related journal papers and newsletters published from 2019-2021 was performed. Search was conducted through significant scientific databases for relevant publications for this systematic review. This paper discusses to waive IPR in the COVID-19 pandemic, which has received both criticism and praise. Some opponents oppose the IPR waiver because it eliminates rewards for pharmaceutical corporations' R & D efforts. Vaccine development necessitates specialized requirements which cost a lot of money. Along with this, pharmaceutical corporations will be hesitant to take the lead in the future if a situation similar to COVID-19 arises. However, those in favour believe that an IPR waiver can reduce the barriers to countries producing their own vaccines, particularly for the lowest-income nations. Whether the reasoning is correct or incorrect, the timely & equitable distribution of COVID-19 immunizations is critical to the abolition of this pandemic

A SYSTEMATIC REVIEW OF RISK FACTORS OF ADVERSE DRUG REACTIONS IN HOSPITALIZED PATIENTS

Background: Adverse drug reactions (ADRs) pose both financial and health encumbrances for patients. Although prevalence and risk factors associated with ADRs have been published in many studies, most of them lack the statistical evidence for predictors. The aim of this study was to review the published literature to determine the risk factors in the adult and elderly population for ADRs. An electronic search of articles published in English language in databases such as Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Scopus, and Google Scholar was conducted in between January 2001 and April 2018. The search terms used were: ADRs,†drug-related problems,†risk factors,†general adult population,†elderly patients,†and hospital admission.†For inclusion in the review, studies had to include an explicit definition of what was considered an ADR and/or an explicit assessment of causality, as well as a clear description of the method used for ADR identification. Polypharmacy was the major risk factor of ADR followed by comorbidities and length of hospital stay

Tumor Necrosis Factor-α Regulates Distinct Molecular Pathways and Gene Networks in Cultured Skeletal Muscle Cells

Skeletal muscle wasting is a debilitating consequence of large number of disease states and conditions. Tumor necrosis factor-α (TNF-α) is one of the most important muscle-wasting cytokine, elevated levels of which cause significant muscular abnormalities. However, the underpinning molecular mechanisms by which TNF-α causes skeletal muscle wasting are less well-understood.We have used microarray, quantitative real-time PCR (QRT-PCR), Western blot, and bioinformatics tools to study the effects of TNF-α on various molecular pathways and gene networks in C2C12 cells (a mouse myoblastic cell line). Microarray analyses of C2C12 myotubes treated with TNF-α (10 ng/ml) for 18h showed differential expression of a number of genes involved in distinct molecular pathways. The genes involved in nuclear factor-kappa B (NF-kappaB) signaling, 26s proteasome pathway, Notch1 signaling, and chemokine networks are the most important ones affected by TNF-α. The expression of some of the genes in microarray dataset showed good correlation in independent QRT-PCR and Western blot assays. Analysis of TNF-treated myotubes showed that TNF-α augments the activity of both canonical and alternative NF-κB signaling pathways in myotubes. Bioinformatics analyses of microarray dataset revealed that TNF-α affects the activity of several important pathways including those involved in oxidative stress, hepatic fibrosis, mitochondrial dysfunction, cholesterol biosynthesis, and TGF-β signaling. Furthermore, TNF-α was found to affect the gene networks related to drug metabolism, cell cycle, cancer, neurological disease, organismal injury, and abnormalities in myotubes.TNF-α regulates the expression of multiple genes involved in various toxic pathways which may be responsible for TNF-induced muscle loss in catabolic conditions. Our study suggests that TNF-α activates both canonical and alternative NF-κB signaling pathways in a time-dependent manner in skeletal muscle cells. The study provides novel insight into the mechanisms of action of TNF-α in skeletal muscle cells

1H NMR-Based Metabolic Signatures in the Liver and Brain in a Rat Model of Hepatic Encephalopathy

Hepatic encephalopathy (HE) is a debilitating neuropsychiatric complication associated with acute and chronic liver failure. It is characterized by diverse symptoms with variable severity that includes cognitive and motor deficits. The aim of the study is to assess metabolic alterations in the brain and liver using nuclear magnetic resonance (NMR) spectroscopy and subsequent multivariate analyses to characterize metabolic signatures associated with HE. HE was developed by bile duct ligation (BDL) that resulted in hepatic dysfunctions and cirrhosis as shown by liver function tests. Metabolic profiles from control and BDL rats indicated increased levels of lactate, branched-chain amino acids (BCAAs), glutamate, and choline in the liver, whereas levels of glucose, phenylalanine, and pyridoxine were decreased. In brain, the levels of lactate, acetate, succinate, citrate, and malate were increased, while glucose, creatine, isoleucine, leucine, and proline levels were decreased. Furthermore, neurotransmitters such as glutamate and GABA were increased, whereas choline and myo-inositol were decreased. The alterations in neurotransmitter levels resulted in cognitive and motor defects in BDL rats. A significant correlation was found among alterations in NAA/choline, choline/creatine, and NAA/creatine with behavioral deficits. Thus, the data suggests impairment in metabolic pathways such as the tricarboxylic acid (TCA) cycle, glycolysis, and ketogenesis in the liver and brain of animals with HE. The study highlights that metabolic signatures could be potential markers to monitor HE progression and to assess therapeutic interventions

Role of Serine/Threonine Kinase 11 (STK11) or liver kinase B1 (LKB1) Gene in Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome (PJS) is a well-described inherited syndrome, characterized by the development of gastrointestinal polyps and characteristic mucocutaneous freckling. PJS is an autosomal prevailing disease, due to genetic mutation on chromosome 19p, manifested by restricted mucocutaneous melanosis in association with gastrointestinal (GI) polyposis. The gene for PJS has recently been shown to be a serine/threonine kinase, known as LKB1 or STK11, which maps to chromosome subband 19p13.3. This gene has a putative coding region of 1302 bp, divided into nine exons, and acts as a tumor suppressor in the hamartomatous polyps of PJS patients and in the other neoplasms that develop in PJS patients. It is probable that these neoplasms develop from hamartomas, but it remains possible that the LKB1 or STK11 locus plays a role in a different genetic pathway of tumor growth in the cancers of PJS patients. This article focuses on the role of LKB1 or STK11 gene expression in PJS and related cancers

Advances in pulmonary drug delivery targeting microbial biofilms in respiratory diseases

The increasing burden of respiratory diseases caused by microbial infections poses an immense threat to global health. This review focuses on the various types of biofilms that affect the respiratory system and cause pulmonary infections, specifically bacterial biofilms. The article also sheds light on the current strategies employed for the treatment of such pulmonary infection-causing biofilms. The potential of nanocarriers as an effective treatment modality for pulmonary infections is discussed, along with the challenges faced during treatment and the measures that may be implemented to overcome these. Understanding the primary approaches of treatment against biofilm infection and applications of drug-delivery systems that employ nanoparticle-based approaches in the disruption of biofilms are of utmost interest which may guide scientists to explore the vistas of biofilm research while determining suitable treatment modalities for pulmonary respiratory infections. </jats:p

Nanoparticulate RNA delivery systems in cancer

Background: Drug delivery system is a common practice in cancer treatment. RNA interference-mediated post-transcriptional gene silencing holds promise as an approach to knockdown in the expression of target genes responsible for cancer cell growth and metastasis. RNA interference (RNAi) can be achieved by delivering small interfering RNA (siRNA) and short hairpin RNA (shRNA) to target cells. Since neither interfering RNAs can be delivered in naked form due to poor stability, an efficient delivery system is required that protects, guides, and delivers the siRNA and shRNA to target cells as part of cancer therapy (chemotherapy). Recent findings: In this review, a discussion is presented about the different types of drug delivery system used to deliver siRNA and shRNA, together with an overview of the potential benefits associated with this sophisticated biomolecular therapy. Improved understanding of the different approaches used in nanoparticle (NP) fabrication, along with an enhanced appreciation of the biochemical properties of siRNA/shRNA, will assist in developing improved drug delivery strategies in basic and clinical research. Conclusion: These novel delivery techniques are able to solve the problems that form an inevitable part of delivering genes in more efficient manner and as part of more effective treatment protocols. The present review concludes that the nanoparticulate RNA delivery system has great possibility for cancer treatment along with several other proposed methods. Several NPs or nanocarriers are already in use, but the methods proposed here could fulfill the missing gap in cancer research. It is the future technology, which unravels the mystery of resolving genomic diseases that is, especially genomic instability and its signaling cascades

Sleep disturbances in cancer patients: Underrecognized and undertreated

Sleep-related complaints are extremely common in patients with cancer but often are not recognized, and even if they are, they are seldom treated. Recognizing insomnia in cancer patients is imperative, as appropriate treatment can improve quality of life