Effect of levothyroxine plus liothyronine combination therapy on hypothyroid patients quality of life

BackgroundLiothyronine combination with Levothyroxine(T4-T3) has been tried to improve the quality of life among hypothyroid patients on levothyroxine immunotherapy and normal thyroxine stimulating hormone levels. However, the efficacy of such a combination is unknown. The current review aimed to assess the effects of T4-T3 combination therapy on quality of life.AimsThe current review aimed to compare levothyroxine mono-therapy versus T4-T3 combination therapy on quality of life among hypothyroid patients.Methods The Pub Med and Google Scholar databases were systematically searched for relevant articles. Articles published in the English language from the first available article up to March 2020 were approached. The terms hypothyroidism, levothyroxine, and liothyronine were used. Out of hundred and eight articles retrieved, only six fulfilled the inclusion and exclusion criteria.Results In majority of randomized control trials (4 out of 6 RCTs), T4/T3combination therapy fail to show superiority over the standard levothyroxine mono-therapy.ConclusionLevothyroxine remain the standard of care in hypothyroid patient

Anaemia characteristic in end stage renal disease patients receiving haemodialysis at King Salman armed forced hospital in Tabuk, Saudi Arabia

BackgroundChronic kidney disease (CKD) is a disease associated with high rate of morbidity and mortality mainly due to cardiovascular disease. Anaemia is the most common haematological abnormality in end stage renal disease.AimsThe current Study aimed to determine the laboratory characteristic and management of anaemia among haemodialysis patients.Methods A cross sectional study conducted among 112 adult patients with the diagnosis of end stage renal disease (ESRD) on haemodialysis at King Salman Armed Forced Hospital in Tabuk, Saudi Arabia, data were collected by a pre-tested data collection sheet.Results There were 112 patients with a mean age of 43 years. The mean haemoglobin value was 10.5g/dL, which was lower than the target haemoglobin range recommended by Kidney Disease Outcomes Quality Initiative (KDOQI). Twenty- eight patients (25 per cent) had haemoglobin values between 11.0 and 12.0g/dL. Only seven patients (6.3 per cent) exceeded the recommended range (>12g/dL) and seventy- seven (68.7 per cent) had less than recommended range. The majority of patients had been receiving haemodialysis for two or more years. The most common primary cause of end stage renal failure was diabetic nephropathy. Hypertension was the most common co-morbidity, followed by diabetes, and ischemic heart disease.ConclusionPatients with end stage renal disease at a high risk for anaemia which should be investigated for correctable causes such as Iron-deficiency before initiating erythropoietin replacement therapy

Budesonide as a first line therapy in autoimmune hepatitis: A systematic review

BackgroundAutoimmune hepatitis (AIH) Is a chronic liver disease with female predominance. Treatment of this condition required usually a long-term corticosteroid therapy.AimsCurrent review aimed to summarize the efficacy of budesonide as a first line treatment in AIH.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were ‎systematically search for relevant articles. The terms ‎ ‎‎autoimmune hepatitis, budesonide, prednisolone and ‎azathioprine ‎were used. out of hundred ‎and six, only ‎five fulfilled ‎the inclusion criteria. Results Out of 106 articles, only 5 included in this review. All patients included in current review were steroid naive. Budesonide in dose of 3 mg trice a day was the used in 2 out of 5 studies both document complete platelet response in 50–80 per cent. Azathioprine was added to budesonide in 3 out of 5 studies, 60 per cent of the budesonide treated patient had a complete platelet response versus 30–40 per cent of prednisolone treated group.ConclusionIn non-cirrhotic AIH patients, budesonide was as effective as prednisolone with fewer steroid related side effects.

Role of adjuvant metformin therapy on HA1C in type 1 diabetes

BackgroundAdequate glycaemic control ‎is a protective strategy against ‎diabetic complication that achieved manly with insulin therapy, ‎‎studies have shown that type 1 diabetic patients had ‎a reduced insulin sensitivity, on view of this fact, ‎‎metformin as an insulin sensitizing agent was used in ‎trials as an adjuvant medication to the insulin. AimsCurrent study aimed to summarize the benefit of adjuvant metformin on HA1C in type 1 diabetes on glycaemic control.Methods A systematic electronic search was conducted including ‎the Pub Med, Google ‎Scholar, and EBSCO using the ‎‎following terms in different combinations: metformin, diabetes, ‎HA1c, and C- peptide. Out of two hundred and four articles, only ‎six were included.Results Six randomized control trials were identified, aimed to investigate the role of adjuvant metformin on glycaemic control in type 1 diabetes patients. Metformin in dose ranging between 1–2g per day were used for at least three months. Significant HA1c reduction was shown in two out of six trials.ConclusionAdministering adjunctive metformin therapy in type ‎‎1 ‎diabetic patients ‎associated with modest reduction in ‎HA1c, improve insulin resistance as indicated ‎by reduce ‎daily insulin ‎requirement.

Vitamin D supplementation as a fall prevention method: A systematic review

BackgroundFalls are ‎common occurrences events leading to ‎remarkable morbidity and ‎mortality. Vitamin D supplementation is often recommended to prevent falls, although vitamin D trials‎ conclude contradictory results.AimsThis review aimed to summarize the available RCTs that studied the effect of ‎vitamin ‎D administered on falls in older adults.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were systematically search for relevant articles. The terms ‎ vitamin D, falls, ergocalciferols, 25-hydroxy vitamin D, and ‎‎1, ‎‎25-dihydroxy vitamin D‎ were used. out of Three hundred and four, only ‎eleven fulfilled ‎the inclusion criteria.Results In the majority of the randomized control trial, vitamin D supplementation provides protection against falls among the elderly population.ConclusionThe majority of the studies concluded that vitamin D alone or ‎in ‎combination with calcium was a ‎successful fall ‎reduction method among the ‎elderly

Chlorhexidine versus Povidone-Iodine for the prevention of ‎Surgical Site ‎Infections: A review.‎

BackgroundSurgical Site Infections (SSIs) are the third most frequently reported health care-associated ‎infection‎ and it remain a major clinical problem despite improvements in prevention, as they ‎are associated with ‎significant mortality and morbidity. Prevention strategies for SSIs are based ‎on reducing the risk of infection by bacteria, So many antiseptic agents are ‎used, the most ‎common one are Chlorhexidine and Povidone-Iodine.‎AimsTo discuss the ‎findings of RCTs that compare Chlorhexidine versus Povidone-Iodine in the prevention of ‎Surgical ‎Site ‎Infections (SSIs).‎Methods This systematic review was carried out, including PubMed, Google Scholar, and EBSCO that ‎examining randomized trials of Chlorhexidine and Povidone-Iodine to summarize the major ‎RCT that compare Chlorhexidine versus Povidone-Iodine in the prevention of Surgical Site ‎Infections (SSIs).‎Results The review included six randomized studies that compare between Chlorhexidine and Povidone-‎Iodine for the prevention of SSIs. The findings showed that many studies prefer using ‎Chlorhexidine over Povidine-Iodine to reduce SSIs, few studies prefer using PVI as antiseptic ‎and other studies reported that there is no significant difference between both. ConclusionMajority of results prefer using Chlorhexidine than Povidone-Iodine‎ as antiseptics but ‎there were few findings prefer ‎PVI and other studies reported that there was no significant ‎difference between using them as ‎antiseptics.

Comparison of total endoscopic thyroidectomy with conventional open thyroidectomy for treatment of papillary thyroid cancer

BackgroundRecent advance of endoscopic techniques has allowed surgeons to perform thyroidectomy via an incision placement at hidden places which lead to better cosmetic acceptability compared with conventional open thyroidectomy.AimsThis study was conducted to summarize the current evidence that compare open thyroidectomy with endoscopic ‎thyroidectomy in treatment of papillary thyroid cancer‎.‎Methods An electronic literature review, including PubMed, Google Scholar, and EBSCO that examining randomized trials of endoscopic thyroidectomy (ET), conventional open thyroidectomy (COT), and management of papillary thyroid carcinoma was carried out.Results The review included 8 randomized studies that compare total endoscopic thyroidectomy versus conventional open thyroidectomy in treatment of papillary thyroid cancer. The findings showed endoscopic thyroidectomy had statically significant cosmetic appearance, less amount of blood loss and occurrence of transient hypocalcaemia than conventional open thyroidectomy in form of cosmetic outcome, amount lower blood loss.ConclusionThe current review showed that, ET has a better cosmetic outcome and lower blood loss compared with COT. While COT was associated with significantly low operation time, hospital stay, drainage time, amount of drainage fluid and transient recurrent laryngeal nerve (RLN) palsy

Role of Nemolizumab and Omalizumab in management of atopic dermatitis: A review

BackgroundNemolizumab (CIM331) is a monoclonal antibody that binds the IL-31 receptor α component. This inhibits IL-31 from acting on neurons that constrains the initialization of the sense of pruritus in cases of atopic dermatitis.AimsTo summarize the results of reported studies evaluating the role of nemolizumab and omalizumab in management of atopic dermatitis.Methods This is a systematic review was carried out, including PubMed, Google Scholar, and EBSCO that examining randomized controlled trials, observational, and experimental studies which study role of nemolizumab in management of atopic dermatitis.Results The review included 8 randomized studies reported efficacy of both nemolizumab and omalizumab for management of atopic dermatitis.ConclusionOther studies with large numbers of patients with AD are necessary to define the adverse effects of both drugs in the treatment of AD

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).

Efficacy of tranexamic acid administration in traumatic brain injury patients: A review

BackgroundAnti-fibrinolytic medications decrease traumatic intracranial haemorrhage (ICH). Tranexamic acid (TXA) is an anti-fibrinolytic, which recently has shown effectiveness in management of traumatic haemorrhage‎.AimsTo summarize the randomized control trials (RCTs) that evaluate the efficacy of tranexamic acid administration in traumatic brain ‎injury (TBI) patients‎.‎Methods An electronic literature review, including PubMed, Google Scholar, and EBSCO that examining RCTs, observational, and experimental studies which study the efficacy of TXA administration in (TBI) patients.ResultsThe current review included 7 randomized studies reported the efficacy of TXA in management of TBI. TXA limit secondary brain injury by preventing the expansion of ICH. Administration of TXA exhibited a tendency to decrease head trauma-related mortality.ConclusionTXA significantly lower the risk of ICU expansion m and prevent brain injury related deaths