Role of L- glutamine and crizanlizumab in sickle cell anaemia painful crisis reduction

BackgroundPatients with sickle cell disease, frequently ‎ suffer from intense painful episodes. Till recently hydroxyurea was the only available medical therapy that approved for reduction of painful episodes.AimsTo summarize the available data from randomized controlled trials that aim to evaluate the efficacy of newly approved L-‎glutamine‎ (alters redox state of red blood cells ‎‎[RBCs]) ‎and ‎crizanlizumab (‎(anti-P-selectin)‎)‎ ‎on vaso-occlusive episodes in Sickle cell disease ‎ patients.Methods PubMed, ‎Google Scholar, and EBSCO ‎ databases were ‎‎systematically search for relevant articles. The terms ‎ ‎ ‎ L-glutamine, sickle cell disease, sickle cell ‎anaemia,‎ ‎‎crizanlizumab ‎and vaso-occlusive episodes‎ were used.Results Out of Four-hundred seventy-two records, only three fulfilled the inclusion criteria. Two trials were aimed to evaluate the efficacy of L-glutamine therapy on the frequency of painful crises in sickle cell anaemia patients. Both studies showed that L-glutamine therapy significantly reduce the frequency of VOEs. Only one trial examined the ability of crizanlizumab on VOEs reduction, and showed crizanlizumab successful reduce the occurrence of VOEs.‎ConclusionNewer agent ‎with different mechanism of action, such as ‎L-glutamine, ‎and crizanlizumab may consider if ‎hydroxyurea not effective or not ‎tolerable

PLGA-Based Nanomedicine: History of Advancement and Development in Clinical Applications of Multiple Diseases

Research on the use of biodegradable polymers for drug delivery has been ongoing since they were first used as bioresorbable surgical devices in the 1980s. For tissue engineering and drug delivery, biodegradable polymer poly-lactic-co-glycolic acid (PLGA) has shown enormous promise among all biomaterials. PLGA are a family of FDA-approved biodegradable polymers that are physically strong and highly biocompatible and have been extensively studied as delivery vehicles of drugs, proteins, and macromolecules such as DNA and RNA. PLGA has a wide range of erosion times and mechanical properties that can be modified. Many innovative platforms have been widely studied and created for the development of methods for the controlled delivery of PLGA. In this paper, the various manufacturing processes and characteristics that impact their breakdown and drug release are explored in depth. Besides different PLGA-based nanoparticles, preclinical and clinical applications for different diseases and the PLGA platform types and their scale-up issues will be discussed

Use of High-Flow Nasal Cannulas in Saudi’s Neonatal Level III Intensive Care Units: A Nationwide Questionnaire Study

Objective . To describe heated humidified high-flow nasal cannulas (HHHFNC) utilization in level III neonatal intensive care units (NICUs) in Saudi Arabia. Methods . A prospective cross-sectional study using an electronic web-based questionnaire. The survey targeted level III NICUs hospitals using HHHFNCs, covering HHHFNC availability, protocols, patient characteristics, and indications. It also collected opinions on the benefits of HHHFNCs compared to nasal continuous positive airway pressure (nCPAP). Results . Out of 47 government-level III neonatal intensive care units, 35 (74%) responded to the survey. Among the included units, 46% had guidelines for HHHFNC use. Additionally, 51% reported using HHHFNC in infants of all gestational ages. The primary indication for HHHFNC use was weaning off nCPAP (34%), with 60% of the respondents noting its advantages for kangaroo care and breastfeeding. Conclusion . HHHFNC are increasingly prevalent in NICUs in Saudi Arabia. However, there remain no clear policies or guidelines regarding their use in preterm infants

Burnout, Resilience, Supervisory Support, and Quitting Intention among Healthcare Professionals in Saudi Arabia: A National Cross-Sectional Survey

Although personal resilience and supervisory support are known to reduce the impact of burnout and quitting intention, there is limited data available to explore these relationships among healthcare professionals (HCPs) in Saudi Arabia. This study aimed to assess the prevalence of burnout and explore its association with resilience, supervisory support, and intention to quit among Saudi Arabian HCPs. Methods: A cross-sectional survey was distributed to a convenience sample of HCPs between April and November 2022. Participants responded to socio-demographic questions, the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)), the Connor-Davidson resilience scale 10 (CD-RISC 10), and the Perceived of Supervisor Support Scale (PSS). Descriptive, inferential, correlation, and logistic regression tests were performed for data analyses. Results: Of the 1174 HCPs included in the analysis, 77% were presented with high burnout levels: 58% with emotional exhaustion (EE), 72% with depersonalization (DP), and 66% with low personal accomplishment (PA). Females were associated with increased odds of burnout (OR: 1.47; 95% CI: 1.04–2.06) compared to males. Burnout and its subscales were associated with higher intention to leave practice, with 33% of HCPs considering quitting their jobs. Furthermore, HCPs reported a low resilience score overall, and negative correlations were found between EE (r = −0.21; p < 0.001) and DP (r = −0.12; p < 0.01), and positive correlation with low PA (r = 0.38; p < 0.001). In addition, most HCPs perceived supervisory support as low, and it is associated with increased burnout and quitting intention. Conclusion: Burnout is common among HCPs across all clinical settings and is associated with higher intention to quit and low resilience and supervisory support. Workplace management should provide a supportive workplace to reduce burnout symptoms and promote resiliency