A Correlation between MRI findings in current and future Disc Herniation Grade 1- Amongst Low Back Pain Patients

Background: Magnetic resonance imaging (MRI) is a procedure used to assess the effects of a herniated disc. There is a hypothesis that there might be a correlation between MRI findings at baseline and follow-up to determine whether there is an ability to predict future progress in LBP among LBP patients with non- or mild disc prolapse (grade 1-disc herniation) with the help of MRI findings. Method: This study consisted of a total of 70 patients, all of whom gave their informed consent to participate in the study. Using the Visual Analogue Scale (VAS), patients were asked to rate how intense the back pain was and to complete the Roland Morris Disability Questionnaire for an assessment of their disability. For all patients, the spine was assessed by MRI scan. Within 1.5 years of baseline MRI scan, 39 volunteers were repeat MRI scan for LBP patients. Result: In this study, we found that age, VAS, disability index, and disc herniation were weakly correlated. Pain and disability also had a weak relation with Grade 1 (r=0.11, r=0.04). In addition, Our longitudinal study found that most of the MRI findings did not seem to be linked to future LBP - severity, whether the participant experienced LBP in the past or not (r= 0.07, p=0.8). Conclusion: it was discovered that MRI scans in both ongoing and forthcoming studies do not exhibit a statistically noteworthy association with the magnitude and position of lumbar disc herniation, pain, and disability

Community Pharmacies in the Asian Countries of Developing Health System: Formation, Regulation, and Implication

Community pharmacies (CPs) in Asian countries are often the first point of contact for patients withinthe healthcare system and their preferred place to purchase medicines. The number of CPs may vary across Asian countries, and each country has developed its own design and functioning. The regulatory environment plays a crucial role in shaping and governing CPs. The aim of this study was to conduct a comprehensive literature review in order to enhance understanding of the establishment and regulation of CPs. By undertaking this review, the researchers, policymakers, and practitioners sought to gain a deeper insight into the performance and functions of CPs and the regulatory frameworks that govern them. Moreover, this review shed light on implementation strategies, effects on patient outcomes, and the barriers and challenges associated with their establishment. A narrative literature review method was adopted with specific inclusion and exclusion criteria. Significant disparities can be observed when comparing the stated intentions of regulations with their actual implementation. Recently, there has been an inclusion of public health practices. Unfortunately, pharmacy procedures conducted in such environments have been characterized by inadequate understanding and inappropriate care. This poor performance can be attributed to employees’ focus on maximizing profits. Several shortcomings can arise, including incomplete patient history documentation, failure to refer patients who require medical attention, unauthorized dispensing of prescription-only medicines (POM), dispensing clinically inappropriate or excessive medication doses, selling incomplete antibiotic courses, and inadequate information and counseling services. Regulatory interventions can help strengthen these services

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population