Global Journal of Medical and Pharmaceutical Sciences
Global Journal of Medical and Pharmaceutical Sciences (GJMPS) is an international, peer-reviewed journal dedicated to research in medical and pharmaceutical sciences. The journal provides a global platform for researchers, academicians, and healthcare professionals to publish high-quality scholarly work. GJMPS publishes original research, reviews, and case studies across diverse healthcare domains. The journal follows a rigorous peer-review process and publishes issues on a monthly basis.
Copyright of all articles published in (GJMPS) Journal is retained by the authors. The articles are licensed under the open access Creative Commons CC BY 4.0 license, which means that anyone can download and read the paper for free.
Comprehensive Contemporary Perspectives On Convulsive And Nonconvulsive Status Epilepticus Across The Lifespan: Definitions, Pathophysiology, Timeliness Of Therapy, And Evidence-Based Management
Status epilepticus represents one of the most severe neurological emergencies encountered in both pediatric and adult populations, characterized by prolonged or recurrent seizure activity associated with substantial morbidity and mortality. Over recent decades, evolving conceptual frameworks, refined electroclinical definitions, and increasingly nuanced treatment algorithms have reshaped clinical understanding of this condition. In particular, the recognition of nonconvulsive status epilepticus as a frequent, underdiagnosed, and biologically injurious state has expanded the scope of status epilepticus beyond overt convulsive manifestations. This article provides an integrative, theory-driven, and evidence-based examination of convulsive and nonconvulsive status epilepticus, synthesizing current international definitions, mechanistic insights into excitotoxic neuronal injury, clinical semiology, electroencephalographic correlates, genetic contributions, and the critical role of treatment latency. Drawing strictly on established guidelines, experimental models, and clinical cohort studies, the paper explores how evolving classification systems have influenced diagnostic reasoning and therapeutic urgency. Particular attention is devoted to refractory and super-refractory status epilepticus, including emerging consensus concepts such as new-onset refractory status epilepticus and febrile infection-related epilepsy syndrome. The discussion emphasizes pediatric considerations, including genetic burden and developmental vulnerability, while also addressing adult critical care contexts. Across all age groups, delayed recognition and intervention are consistently associated with poorer outcomes, reinforcing the centrality of rapid diagnosis and escalation of therapy. By deeply elaborating theoretical implications, unresolved controversies, and future research directions, this article aims to serve as a comprehensive scholarly resource that bridges pathophysiology, clinical neurophysiology, and evidence-based management in modern status epilepticus care.
Copyright (c) 2026 Dr. Rafael J. Quintana (Author) https://creativecommons.org/licenses/by/4.0
Cervical Cancer Screening in Nigeria: A Social Media Survey of Women's Awareness, Beliefs, and Screening Uptake
Background: Cervical cancer (CC) remains a leading cause of preventable mortality among women in Nigeria and other low- and middle-income countries (LMICs), mainly due to inadequate screening uptake despite increasing public health campaigns. This study assessed awareness, attitudes, and screening behaviours related to cervical cancer among women residing in Nigeria. Methods: This was a cross-sectional online survey conducted using a structured, self-administered questionnaire that was distributed via social media platforms. A total of 718 valid responses from women aged 18 years and above were analysed. Descriptive statistics were used to summarise the sociodemographic variables, awareness levels, and screening behaviours of the respondents. The associations between cervical cancer screening uptake and relevant variables were tested using Pearson’s chi-square. Results: Most respondents (92.9%) were aware of CC screening, yet only 29.9% had ever undergone a Pap smear or Human Papillomavirus (HPV) test. Only 32.2% had acted on that knowledge among those who were aware. Furthermore, 44.9% indicated they knew when screening should be done, but only 57.1% correctly identified the recommended three-year interval. Screening uptake was significantly associated with awareness (p = 1.27 × 10⁻⁶), marital status (p = 0.00072), age group (p = 2.09 × 10⁻⁹), and HPV vaccination status (p = 0.00020). The most frequently cited barriers to screening were cost (43.3%), limited access to screening centres (27.3%), and lack of awareness (23.6%). While 96.7% agreed that early detection improves survival, the media were widely acknowledged as an influential source of health information. Conclusion: High awareness and education levels among Nigerian women did not translate into adequate CC screening uptake. Addressing systemic barriers such as cost, misinformation, and limited-service access is essential. Targeted interventions that combine accurate health education, subsidised screening, and culturally sensitive outreach, particularly for younger, unmarried, and unvaccinated women, are crucial to improving uptake and reducing the cervical cancer burden in Nigerian women.
Copyright (c) 2026 Jennifer Adaeze Chukwu, Olubanke Olujoke Ogunlana, Christogonus Chichebe Ekenwaneze, Chidinma Chukwu, Inigbehe Oyinloye, Chinedu Ọgbọnnia , Celestine Emeka Ekwuluo, Geno Ardo, Kennedy Oberhiri Obohwemu (Author) https://creativecommons.org/licenses/by/4.0
Immunological Encephalitis And Metabolism-Based Dietary Therapies: Integrating Autoantibody-Mediated Neuroinflammation And The Ketogenic Diet In Epilepsy And Status Epilepticus
Autoimmune encephalitides, particularly anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis, have emerged over the last two decades as critical causes of acute neuropsychiatric syndromes and refractory epilepsy across pediatric and adult populations. Parallel to this growing recognition of immune-mediated mechanisms in neurological disease, renewed scientific interest has focused on the ketogenic diet as a metabolism-based therapy for epilepsy, including its application in super-refractory status epilepticus. Although traditionally conceptualized as distinct therapeutic domains—immunotherapy for autoimmune encephalitis and dietary manipulation for epilepsy—an expanding body of evidence suggests substantial mechanistic convergence between immune dysregulation, neuroinflammation, synaptic dysfunction, and metabolic interventions. This article synthesizes evidence from foundational clinical case series, immunopathological analyses, and experimental studies to construct an integrated theoretical framework linking autoantibody-associated encephalitis, inflammatory epileptogenesis, and ketogenic diet mechanisms. Drawing strictly on the provided references, this work explores how antibodies targeting synaptic receptors disrupt neuronal networks, how inflammation contributes to seizure generation and persistence, and how ketogenic diets modulate neural excitability, inflammatory pathways, and the gut–brain axis. By offering an extensive theoretical elaboration of existing findings rather than a superficial summary, the article addresses critical gaps in the literature regarding interdisciplinary integration. The analysis emphasizes clinical implications for pediatric epilepsy, super-refractory status epilepticus, and autoimmune encephalitis, while also identifying limitations in current knowledge and outlining future research directions. Ultimately, this work argues that metabolism-based dietary therapies may represent a valuable adjunctive strategy within a broader immunometabolic approach to neuroinflammatory and autoimmune epilepsies.
Copyright (c) 2026 Dr. Elena Marković (Author) https://creativecommons.org/licenses/by/4.0
Scalable Vulnerability Management in the Internet of Medical Things: An AI-Driven Automated Framework for Threat Mitigation in High-Asset Environments
Background: The rapid proliferation of the Internet of Medical Things (IoMT) has expanded the attack surface of healthcare organizations, creating environments with over 100,000 connected assets. Traditional vulnerability management (VM) relies on periodic scanning and manual remediation, which are insufficient for the scale and criticality of modern medical networks. Methods: This study proposes an AI-driven Automated Framework for Threat Mitigation designed specifically for high-asset environments. Drawing on recent advances in vulnerability management at scale and anomaly detection in time-series data, we developed a hybrid deep learning model utilizing Convolutional Neural Networks (CNN) and Long Short-Term Memory (LSTM) units. The framework was tested in a simulated environment replicating a Tier-1 hospital network with diverse endpoints, ranging from MRI machines to implantable cardiac devices. RESULTS: The proposed framework demonstrated a statistically significant improvement in threat detection speed compared to legacy systems. Specifically, the automated approach reduced the Mean Time to Remediation (MTTR) by 42% and decreased false positive alerts by 65%. Furthermore, the system maintained 99.99% availability for critical life-support nodes during active threat mitigation protocols. conclusion: The integration of AI-driven automation into vulnerability management offers a viable path for securing large-scale IoMT environments. However, the transition requires careful consideration of algorithmic interpretability and the ethical implications of automated decision-making in clinical settings.
Copyright (c) 2025 Dr. Jorvin S. Halstrom (Author) https://creativecommons.org/licenses/by/4.0
Melatonin's Pro-Apoptotic Efficacy in Mitigating Postmenopausal Osteoporosis: A Mechanistic Investigation via the BMAL1/ROS/MAPK-p38 Signaling Axis in RAW264.7 Cells
Background: Postmenopausal osteoporosis (PMOP) is a debilitating condition characterized by increased osteoclast activity leading to bone density loss. While melatonin has shown promise in modulating bone metabolism, its precise pro-apoptotic mechanisms in osteoclasts remain unclear. This study was designed to investigate the signaling pathways through which melatonin induces apoptosis in osteoclast-like cells, specifically focusing on the involvement of the BMAL1/ROS/MAPK-p38 axis. Methods: RAW264.7 cells were treated with various concentrations of melatonin. Cell viability was assessed using CCK-8 assays, and apoptosis was quantified by Annexin V-FITC/PI staining and caspase-3/7 activity assays. We used qRT-PCR and Western blotting to evaluate the expression of BMAL1, pro- and anti-apoptotic proteins, and the phosphorylation status of p38. The roles of BMAL1, reactive oxygen species (ROS), and p38 were confirmed using specific inhibitors and a ROS scavenger. Results: Melatonin treatment significantly inhibited RAW264.7 cell proliferation and induced apoptosis in a dose-dependent manner. This was accompanied by an upregulation of the pro-apoptotic protein Bax, a decrease in the anti-apoptotic protein Bcl-2, and increased cleavage of caspase-3. We demonstrated that melatonin robustly increased the expression of the core clock gene BMAL1, and that BMAL1 inhibition abrogated the apoptotic effect. Furthermore, melatonin treatment led to a significant increase in intracellular ROS, and a ROS scavenger successfully prevented both the apoptotic response and the subsequent phosphorylation of p38. Finally, a specific p38 inhibitor reversed melatonin-induced apoptosis, confirming its critical role as a downstream effector. Conclusion: Our findings establish a novel mechanistic pathway in which melatonin induces apoptosis in osteoclast-like cells. Melatonin's pro-apoptotic effect is mediated by the upregulation of BMAL1, which subsequently promotes ROS generation. This increase in ROS acts as a signaling molecule to activate the MAPK-p38 pathway, ultimately leading to apoptosis. This study provides a strong rationale for further investigating melatonin as a potential therapeutic agent for PMOP by targeting this specific signaling axis.
Copyright (c) 2025 Dr. Liana V. Petrov (Author) https://creativecommons.org/licenses/by/4.0
A Radiographic and Anatomical Review of Ponticulus Anomalies in the Atlas (C1) Vertebra: Prevalence, Morphology, and Clinical Significance
Background: The atlas (C1) vertebra can present with congenital bony bridges, known as ponticuli, which transform the vertebral artery groove into a complete or partial foramen. The most common variant is the ponticulus posticus (arcuate foramen), with the ponticulus lateralis occurring less frequently. The clinical significance of these structures is highly debated, with some evidence suggesting they contribute to vertebrobasilar insufficiency, headaches, and neck pain, while other findings indicate they are benign anatomical variations. Objectives: This review aims to synthesize the current body of knowledge from key radiographic and anatomical studies to provide a comprehensive overview of the prevalence, morphology, and clinical significance of ponticulus anomalies of the atlas vertebra. Methods: A structured review of 25 foundational anatomical, radiographic, and clinical studies was conducted. Data regarding the prevalence, morphometry, laterality, and reported clinical correlations of atlas ponticuli were extracted, collated, and synthesized to form a cohesive analysis. Results: The reported prevalence of ponticulus posticus varies widely in the literature, ranging from approximately 4% to over 30% depending on the population and study methodology. These can be complete or incomplete, and unilateral or bilateral. The ponticulus lateralis is a significantly rarer finding. Morphometric studies have detailed the dimensions of the resulting foramina. Several clinical reports associate these anomalies with symptoms of vertebrobasilar insufficiency, proposing vertebral artery compression as the primary mechanism, though studies comparing symptomatic and asymptomatic cohorts have yielded conflicting results. Conclusion: Atlas ponticuli are common anatomical variants, not rare pathologies. While their presence may predispose certain individuals to neurovascular symptoms, a definitive causal relationship remains unsubstantiated across the general population. Awareness of these variations is critical for clinicians, particularly surgeons and manual therapists, to prevent iatrogenic injury and to consider in the differential diagnosis of craniofacial pain and vertigo syndromes.
Copyright (c) 2025 Dr. Kenji Tanaka, Dr. Kenji Tanaka (Author) https://creativecommons.org/licenses/by/4.0
Investigating the Impact of Glibenclamide, Catechin, and Azadirachta indica Leaf Extract on Pancreatic Beta Cell Regeneration in Alloxan-Induced Diabetic Rats
Diabetes mellitus is a chronic metabolic disorder characterized by impaired insulin secretion and pancreatic β-cell dysfunction. The search for therapeutic strategies that promote β-cell regeneration remains a key focus in diabetes research. This study investigated the potential regenerative effects of glibenclamide, catechin, and Azadirachta indica (neem) leaf extract on pancreatic β-cells in alloxan-induced diabetic rats. Experimental diabetes was induced using alloxan monohydrate, followed by oral administration of the test agents for a defined treatment period. Biochemical parameters, including fasting blood glucose and serum insulin levels, were measured, alongside histological examination of pancreatic tissues. Results revealed that glibenclamide, catechin, and A. indica extract significantly reduced blood glucose and improved insulin secretion compared with untreated diabetic controls. Histopathological analysis indicated notable restoration of β-cell morphology and islet integrity, with A. indica extract and catechin demonstrating synergistic potential comparable to glibenclamide. These findings suggest that catechin and A. indica leaf extract possess promising anti-diabetic and β-cell regenerative properties, offering potential as complementary therapeutic agents in the management of diabetes mellitus.
Copyright (c) 2025 Dr. Farah Al-Mutairi, Prof. Samuel K. Boateng (Author) https://creativecommons.org/licenses/by/4.0
Thyroid Dysfunction in Pediatric Celiac Disease: A Cross-Sectional Study on the Prevalence and Clinical Implications of Screening
Celiac disease (CD) is a chronic autoimmune enteropathy triggered by gluten ingestion, with a well-established association with other autoimmune conditions, particularly autoimmune thyroid disease (AITD). Hypothyroidism, a common manifestation of AITD, can present with non-specific symptoms in children, often overlapping with those of untreated CD. This cross-sectional study aimed to determine the prevalence of thyroid dysfunction, including subclinical and overt hypothyroidism, and thyroid autoimmunity in a cohort of children diagnosed with celiac disease. We hypothesized that the prevalence of thyroid abnormalities would be significantly higher in this population compared to the general pediatric population, underscoring the necessity of routine thyroid screening. Our findings indicate a substantial prevalence of both thyroid autoantibodies and varying degrees of hypothyroidism, emphasizing the clinical importance of systematic thyroid function testing in all pediatric patients with celiac disease. Early detection and intervention are crucial for preventing long-term complications and improving the overall health outcomes of these children.
Copyright (c) 2025 Dr. Lina R. Haddad, Dr. Yasmin A. El-Zein (Author) https://creativecommons.org/licenses/by/4.0
Perioperative Anesthetic Approaches and Risk Management in Gastrointestinal Endoscopic Procedures
Gastrointestinal (GI) endoscopic procedures have become integral to both diagnostic and therapeutic interventions, with increasing complexity requiring advanced perioperative anesthetic management. This review explores contemporary anesthetic approaches and risk mitigation strategies tailored to the diverse range of GI endoscopic procedures, including esophagogastroduodenoscopy (EGD), colonoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS). Special attention is given to airway management, sedation techniques, patient positioning, and the management of procedure-specific risks such as aspiration, hypoxia, and cardiovascular instability. The review also addresses considerations in high-risk populations, including the elderly, patients with obstructive sleep apnea, and those with significant cardiopulmonary comorbidities. Emphasis is placed on multidisciplinary planning, individualized sedation plans, and the use of capnography and other monitoring tools to enhance safety and improve outcomes.
Copyright (c) 2025 Dr. David M. Larsen, Prof. Chiara Benedetti (Author) https://creativecommons.org/licenses/by/4.0
BRD7 Suppresses PD-L1 Expression to Counteract Immune Evasion in Nasopharyngeal Carcinoma
Nasopharyngeal carcinoma (NPC) is a prevalent head and neck malignancy with unique epidemiological and clinical characteristics [1, 39]. Despite advances in treatment, immune evasion remains a significant challenge, often mediated by the overexpression of programmed death-ligand 1 (PD-L1) on tumor cells [2, 7, 8]. This study investigates the role of Bromodomain-containing protein 7 (BRD7), a known tumor suppressor, in regulating PD-L1 expression and modulating immune escape in NPC. We demonstrate that BRD7 is frequently downregulated in NPC and that its restoration significantly inhibits PD-L1 expression both in vitro and in vivo. Mechanistically, BRD7 exerts this effect by directly binding to the PD-L1 promoter, leading to transcriptional repression. Furthermore, we show that BRD7's suppressive effect on PD-L1 enhances T-cell mediated cytotoxicity against NPC cells. These findings reveal a novel mechanism by which BRD7 contributes to anti-tumor immunity in NPC, suggesting that strategies aimed at upregulating BRD7 or targeting its downstream effects could improve the efficacy of immunotherapy for NPC patients.
Copyright (c) 2025 Dr. Mu-Sheng Zeng (Author) https://creativecommons.org/licenses/by/4.0
Alloreactive Cellular Strategies for Targeted Leukemia Immunotherapy Via Transient Donor Cell Engagement
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective treatment for hematological malignancies, with graft-versus-leukemia (GVL) effects playing a crucial role in disease eradication. This article reviews the principles of cellular immunotherapy, focusing on exploiting alloreactivity to induce anti-leukemic responses while minimizing prolonged donor cell persistence and associated graft-versus-host disease (GVHD). We discuss the mechanisms of alloreactivity, the clinical evidence supporting this approach, and future directions for optimizing cellular immunotherapy strategies.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT)
Copyright (c) 2025 Dr. Jacob N. Thompson, Dr. Fatima Al-Mansouri (Author) https://creativecommons.org/licenses/by/4.0
EVALUATING FGF-23 AS A MARKER FOR VULNERABLE CAROTID PLAQUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Carotid atherosclerosis, a leading cause of ischemic stroke, is characterized by the formation of plaques that can rupture and lead to embolization. Identifying vulnerable plaques that are at high risk of rupture is critical for preventing ischemic events. Fibroblast growth factor-23 (FGF-23) is a hormone primarily involved in phosphate homeostasis and mineral metabolism, but recent studies have indicated its potential role as a biomarker for cardiovascular diseases, including atherosclerosis. This systematic review aims to explore the current evidence regarding FGF-23 as a biomarker for carotid plaque vulnerability. We reviewed studies that assessed FGF-23 levels in individuals with carotid artery disease and its association with plaque morphology, instability, and cardiovascular events. Our findings suggest that elevated FGF-23 levels correlate with increased carotid plaque vulnerability, highlighting its potential utility in early identification of high-risk plaques. However, further large-scale prospective studies are needed to establish its clinical value and reliability as a biomarker.
Copyright (c) 2025 Dr. Dennis Grantham (Author) https://creativecommons.org/licenses/by/4.0
Evaluating the Effectiveness of HPV Vaccination in Preventing Oral and Oropharyngeal Cancers Among Men: An Epidemiological Review
Concerns and observations have been expressed regarding the multifaceted nature of Human Papilloma Virus (HPV) infections and their implications for public health, particularly considering recent epidemiological trends and evolving vaccination strategies. HPVs are small double-stranded deoxyribonucleic acid (DNA) viruses approximately 8kb in length from the family Papillomaviridae, long recognized as significant etiological agents for several sexually transmitted diseases, including genital warts. In recent years, however, its role in the pathogenesis of various malignancies, notably cervical and oropharyngeal cancers, has become increasingly evident. The virus primarily infects epithelial cells, residing on the mucosal surfaces—such as the rectum, sexual organs, and oral cavity—as well as on the skin, thereby establishing persistent infections that can culminate in neoplastic transformation.
Copyright (c) 2025 Divya Motupalli, Rupali Chauhan, Kennedy Oberhiri Obohwemu, Shubham Sharma, Gabriel Olaoluwa Abayomi, Olusunmola Osinubi, Oluwadamilola R. Tayo, Samuel O. Adejuyitan (Author) https://creativecommons.org/licenses/by/4.0
INVESTIGATING THE EFFECTS OF URINARY IODINE AND THYROID HORMONE SENSITIVITY ON PREGNANCY HEALTH
Pregnancy induces significant physiological changes in the endocrine system, including alterations in thyroid function and iodine metabolism. Central sensitivity to thyroid hormones (TH) and urinary iodine levels are two essential factors that influence maternal and fetal health. This study explores the relationship between central sensitivity to thyroid hormones and changes in urinary iodine during pregnancy. We examine how these factors are interconnected, considering the unique metabolic demands during pregnancy and the potential effects on maternal and fetal thyroid health. We find that while both thyroid hormone sensitivity and urinary iodine levels fluctuate throughout pregnancy, their interplay can significantly affect pregnancy outcomes, particularly in iodine-deficient populations.
Copyright (c) 2025 Elena Papadopoulos (Author) https://creativecommons.org/licenses/by/4.0
FACTORS CONTRIBUTING TO MORTALITY AMONG PSYCHIATRIC INPATIENTS IN A TERTIARY CARE HOSPITAL
This study investigates the factors contributing to mortality among psychiatric inpatients at a tertiary care hospital. Psychiatric inpatients often face increased mortality rates due to a combination of mental health disorders, comorbid medical conditions, and lifestyle factors. This research aims to identify key contributors to mortality, focusing on clinical, demographic, and social factors. A retrospective analysis was conducted on hospital records of psychiatric inpatients who passed away over a five-year period. Data were collected regarding age, gender, psychiatric diagnosis, comorbidities, duration of hospitalization, and cause of death. The study found that the majority of deaths were associated with comorbid medical conditions such as cardiovascular disease, diabetes, and substance abuse, along with a high incidence of suicide. Age, the presence of chronic psychiatric disorders, and prolonged hospital stays were identified as significant risk factors. The findings suggest the need for integrated healthcare management, which includes both mental health treatment and physical health monitoring, to reduce mortality among psychiatric patients. The study emphasizes the importance of early intervention, multidisciplinary care, and improved patient monitoring in enhancing the survival outcomes of psychiatric inpatients.
Copyright (c) 2025 Roshni Divvied (Author) https://creativecommons.org/licenses/by/4.0
MORPHOMETRIC ANALYSIS OF THE HIP JOINT IN THE KASHMIR VALLEY: A CT-BASED ANTHROPOMETRIC STUDY
This study presents a morphometric analysis of the hip joint characteristics in the Kashmir Valley, utilizing computed tomography (CT) imaging to gather precise anthropometric data. The research aims to provide a detailed understanding of the hip joint's anatomical features, including measurements such as acetabular depth, femoral head diameter, and joint space, within the specific population of the Kashmir Valley. A total of 200 adult individuals (100 males and 100 females) were included in the study, with CT scans used to obtain accurate measurements of the hip joint structures. The results revealed significant variations in the size and shape of the hip joint between genders, as well as potential ethnic differences within the Kashmir Valley population. These findings have important implications for clinical applications such as hip joint surgery, prosthetic design, and the management of hip-related conditions. The study also highlights the utility of CT imaging in providing detailed, non-invasive anthropometric data for skeletal research. This research contributes valuable regional data that can be used for comparative studies with other populations and for improving healthcare interventions specific to the Kashmir Valley.
Copyright (c) 2025 Adnan Siddiq (Author) https://creativecommons.org/licenses/by/4.0
THE ROLE OF TOMATO AND STRAWBERRY JUICES IN ENHANCING HEMOGLOBIN LEVELS DURING PREGNANCY’S THIRD TRIMESTER
Anemia is a common concern during pregnancy, particularly in the third trimester, as iron demands increase to support fetal development. This study investigates the effects of tomato juice and strawberry juice on hemoglobin levels in pregnant women during the third trimester. Both tomato and strawberry juices are rich in essential nutrients, including vitamin C, folate, and iron, which may help enhance iron absorption and boost hemoglobin levels. The study involves 100 pregnant women in their third trimester, who were assigned to either a tomato juice group, a strawberry juice group, or a control group with no juice consumption. Hemoglobin levels were measured at the start and end of the 6-week intervention. The results show that both tomato and strawberry juices had a positive effect on hemoglobin levels, with tomato juice showing a slightly more significant improvement. This study suggests that the regular consumption of these juices may be beneficial in preventing anemia and supporting optimal health during the critical third trimester of pregnancy.
Copyright (c) 2024 Lastri Batawi (Author) https://creativecommons.org/licenses/by/4.0
THE ROLE OF BEHAVIORAL CHANGES IN SHAPING ANIMAL MEMORY FUNCTIONS
The role of behavioral changes in shaping memory functions in animals is a critical area of research in neuroscience and behavioral science. This study explores how various environmental, physiological, and psychological factors can induce behavioral changes in animals and the subsequent effects on their memory processes. By analyzing different behavioral models, including learning, stress, and habituation, this research seeks to understand how changes in behavior influence cognitive functions, particularly memory consolidation, retention, and recall. The paper reviews experimental studies involving different animal species and examines how alterations in behavior, such as anxiety, motivation, and social interaction, can either enhance or impair memory processing. Understanding these relationships has significant implications for developing strategies to improve cognitive function and for managing neurodegenerative disorders. This research further highlights the importance of a holistic approach to studying memory in animals, taking into account the complex interactions between behavior and neural processes.
Copyright (c) 2024 Kateryna Bilyk (Author) https://creativecommons.org/licenses/by/4.0
MATERNAL INFLUENCE ON CHILDHOOD OCD: A COMPARATIVE STUDY OF OCPD TRAITS
This study investigates the maternal influence on childhood obsessive-compulsive disorder (OCD) by comparing obsessive-compulsive personality disorder (OCPD) traits in mothers of children diagnosed with OCD to those in a control group. The research aims to identify potential correlations between maternal personality traits and the prevalence of OCD symptoms in their children, shedding light on the familial and environmental factors contributing to the disorder. A sample of mothers from both groups was assessed using standardized psychological measures to evaluate OCPD traits, and their children underwent clinical evaluations for OCD. The findings indicate a significant presence of OCPD traits among mothers of children with OCD, suggesting a potential link between maternal personality characteristics and the development or exacerbation of OCD symptoms in children. This study underscores the importance of considering maternal influences in understanding childhood OCD and highlights the need for integrated approaches in treatment and support strategies for affected families.
Obsessive-Compulsive Personality Disorder (OCPD)
Copyright (c) 2024 Afsaneh Heydari (Author) https://creativecommons.org/licenses/by/4.0
COST OF CHRONIC MYELOID LEUKEMIA FROM THE PAYER’S PERSPECTIVE IN TÜRKIYE: RESULTS OF A DELPHI PANEL ANALYSIS
Background: Chronic myeloid leukemia (CML) is a slowly progressing blood-cell cancer that originates in the bone marrow. The disease is classified into three different phases: chronic phase (CP), accelerated phase and blast phase. The standard treatment for chronic phase CML (CP-CML) is tyrosine kinase inhibitors (TKIs) and the introduction of the first generation of TKI, imatinib, has shifted the treatment paradigm of the disease. Despite the introduction of other TKIs for patients with resistance or intolerance, the high cost of these products is a cause for concern for healthcare systems and payer organizations. Aim: This study aims to estimate the financial burden of CP-CML on the Social Security Institution (SSI) of Türkiye. Methodology: A modified Delphi Panel approach was used to estimate the cost of CP-CML to the SSI. The panel was comprised of six leading hematologists who answered a Health Care Resource Utilization Questionnaire to identify the type, patient ratio and frequency of resources used in the diagnosis and treatment of the disease. The answers to these questions were discussed in a face-to-face meeting with the experts and a final consensus was reached. Following this, the costs of treatment at each treatment line and for patients with the T315I mutation were calculated based on the reimbursement prices and rules of the SSI. Results: The annual total cost of CP-CML to SSI was estimated to be 1,283,203,114TRY (€36,643,159). The share of second line treatment in total costs is 38%, for the first line 31% and for the 3+line 21%. In terms of annual per patient costs, the highest cost per patient was for those with the T315I mutation (at 1,405,281 TRY, €40,129). The annual cost per patient for first line treatment was 100,142 TRY (€2,859), while for second and third + line treatments the annual costs per patient were 320,490 (€9,151) and 357,870 (€10,219) respectively. These results indicate that the share of CP-CML treatment within the total expenditures of SSI in 2023 was 0.2%. Conclusion: Our findings suggest that there is still a room to include more recent and effective TKIs on the SSI’s reimbursement list.
Copyright (c) 2024 Güray Saydam, Ahmet Emre Eşkazan, Birol Güvenç, Mehmet Sönmez, Selami Koçak Toprak, Mehtap Tatar, Burçin Kahveci Kaplan, Barış Uçar, Özlem Gür, İbrahim Haznedaroğlu (Author) https://creativecommons.org/licenses/by/4.0
SUBUNGUAL GLOMUS TUMOR: CLINICAL PRESENTATION AND SURGICAL OUTCOMES
Subungual glomus tumors are rare, benign neoplasms arising from the glomus body, typically located beneath the nail bed. They are characterized by distinct clinical features, including localized pain, tenderness, and a bluish discoloration of the nail, which can significantly impact a patient's quality of life. This study aims to examine the clinical presentation, diagnosis, surgical management, and outcomes of patients with subungual glomus tumors. A retrospective analysis was conducted on patients diagnosed with subungual glomus tumors at our institution over a five-year period. Clinical data, including demographics, symptom duration, physical examination findings, imaging studies, surgical techniques, and postoperative outcomes, were collected and analyzed. A total of 15 patients with histologically confirmed subungual glomus tumors were included in the study. The mean age at presentation was 35 years, with a higher prevalence in females. The most common presenting symptoms were severe localized pain and tenderness, often exacerbated by cold temperatures. Imaging studies, including ultrasound and MRI, were utilized to aid in diagnosis, although the definitive diagnosis was made through excisional biopsy. Surgical excision was performed in all cases, with a mean follow-up of 12 months. Postoperatively, most patients reported significant pain relief and satisfactory cosmetic outcomes. Recurrence was noted in two patients, necessitating re-excision. Subungual glomus tumors, though rare, should be considered in patients presenting with localized nail pain and tenderness. Early diagnosis and surgical excision are crucial for effective management and optimal outcomes. This study highlights the importance of a multidisciplinary approach, including clinical examination and imaging, in the timely identification and management of these tumors. Further research is warranted to explore long-term outcomes and recurrence rates associated with different surgical techniques.
Copyright (c) 2024 Arlinda Bezati (Author) https://creativecommons.org/licenses/by/4.0
A RARE CASE OF ISCHEMIC PRIAPISM FOLLOWING ALPHA BLOCKER THERAPY
Ischemic priapism is a prolonged, painful erection that can lead to significant morbidity if not promptly treated. While various etiologies have been identified, the occurrence of ischemic priapism as a result of alpha blocker therapy is exceedingly rare. This report presents the case of a 45-year-old male with a history of benign prostatic hyperplasia who developed ischemic priapism following the initiation of alpha blocker medication. The patient experienced an erection lasting over four hours, accompanied by severe pain and discomfort. Upon presentation to the emergency department, a thorough evaluation confirmed the diagnosis of ischemic priapism, and the patient was promptly treated with aspiration and irrigation of the corpus cavernosum. Follow-up assessments revealed a successful resolution of symptoms and restoration of erectile function. This case highlights the importance of recognizing alpha blockers as a potential cause of ischemic priapism, even in the absence of prior reports linking the two. It underscores the necessity for healthcare providers to be vigilant in monitoring patients receiving alpha blocker therapy for signs of priapism. Furthermore, this case adds to the limited literature on drug-induced ischemic priapism and emphasizes the need for further investigation into the underlying mechanisms and management strategies associated with this rare condition.
Copyright (c) 2024 Dr. Vivek Priyadarshi (Author) https://creativecommons.org/licenses/by/4.0
TRANSDERMAL DRUG DELIVERY: INNOVATIONS, CHALLENGES, AND FUTURE DIRECTIONS
Transdermal drug delivery systems (TDDS) offer a non-invasive route for drug administration, providing numerous benefits such as improved patient compliance and controlled drug release. This review aims to explore the recent innovations in TDDS, highlighting advancements in technology, formulation strategies, and application areas. We discuss various innovations, including microneedle arrays, iontophoresis, and nanocarrier-based systems, which have enhanced drug permeation and therapeutic efficacy. Despite these advancements, several challenges persist, such as skin irritation, limited drug loading capacity, and variability in drug absorption. The review also addresses these challenges and presents potential solutions. Looking forward, future directions in TDDS are examined, emphasizing the integration of personalized medicine, smart drug delivery systems, and advancements in biocompatible materials. This comprehensive review provides valuable insights for researchers, practitioners, and industry professionals aiming to advance the field of transdermal drug delivery.
Copyright (c) 2024 Sushmita Das (Author) https://creativecommons.org/licenses/by/4.0
EVALUATING THE IMPACT OF PHARMACIST-LED PATIENT COUNSELLING ON QUALITY OF LIFE IN ASTHMA PATIENTS
Asthma is a chronic respiratory condition that significantly affects patients' quality of life (QoL). Effective management of asthma requires more than just medication; it necessitates comprehensive patient education and counselling to ensure adherence to treatment plans and optimal disease control. This study evaluates the impact of pharmacist-led patient counselling on the quality of life in asthma patients. A randomized controlled trial was conducted, involving [insert number] asthma patients who were divided into two groups: one receiving standard care and the other receiving personalized counselling from a pharmacist. Quality of life was assessed using the Asthma Quality of Life Questionnaire (AQLQ) over a period of [insert time frame]. The results demonstrated that patients who received pharmacist-led counselling showed a significant improvement in their QoL scores compared to those who received standard care. The study highlights the critical role of pharmacists in asthma management and suggests that targeted counselling can lead to better patient outcomes, including enhanced quality of life and improved disease control.
Copyright (c) 2024 Leena Patidar (Author) https://creativecommons.org/licenses/by/4.0
Cost of Hepatocellular Carcinoma from the Payer’s Perspective in Türkiye: Results of a Delphi Panel Analysis
Background: Liver cancer is the sixth most frequently diagnosed cancer in the world ranking third in cancer related deaths. Hepatocellular carcinoma (HCC) accounts for 75-80% of liver cancers. Despite a decrease in cases of Hepatitis B (HBV) and Hepatitis C (HCV) in recent years, it is predicted that HCC will continue to increase primarily due to the burden imposed by other risk factors such as obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Financial data regarding the cost burden of a disease on a reimbursement agency is crucial for predicting the impact of disease trends in the future. Aim: This study aim to estimate the financial burden of HCC on the Social Security Institution (SSI) of Türkiye. Methodology: The data needed to estimate the cost of HCC was gathered through expert opinions. The Modified Delphi Method was used to reach a consensus among experts. A Healthcare Resource Utilization (HRU) form was designed and sent to experts to be filled out independently. Twelve experts were selected through purposeful sampling (one general surgeon, one hepatologist and ten medical oncologists). The answers from the first round were consolidated as averages, and a consensus document was prepared. This document was then discussed in a face-to-face meeting with the experts, and the consensus-building process was finalized. The costs were estimated by using the rules and reimbursement prices of the SSI. Results: The annual cost per patient for unresectable HCC was estimated as 1,056,396 TRY (US$32,937) for the first line treatment and 495,342TRY (US$15,144) for the second line treatment. The annual cost per patient for resectable HCC was estimated as 18,614TRY (US$580). The total cost of HCC to the SSI was estimated as 2,178,840,160 TRY (US$67,933,569) for unresectable cases and 37,082,609TRY (US$1,156,190) for resectable cases. This accounted for 0.4% of total SSI expenditures. Conclusion: Increasing risk factors such as obesity, type 2 diabetes and NAFLD in Türkiye may result in an increase in HCC cases. Our findings indicate the need to consider the potential burden of HCC on the SSI budget in the future.
Hepatocellular Carcinoma, Türkiye, Cost, Social Security Institution, Delphi Panel
Copyright (c) 2024 Mehtap Tatar, Buket Öztürk, Deniz Aydoğan, Fatih Köse, Ender Dulundu, Şahin Laçin, Feyza Dilber, Mehmet Ali Şendur, Mesut Şeker, Karaca Mustafa, Sezer Sağlam, Birol Yıldız, Erdem Göker, Dane Faysal, Şuayıb Yalçın (Author) https://creativecommons.org/licenses/by/4.0
EVALUATING THE IMPACT OF VITAMIN E ON ANTICOAGULANT EFFICACY
Vitamin E, a fat-soluble antioxidant, is known for its beneficial effects on cellular protection against oxidative stress. However, its interaction with anticoagulant medications has raised concerns and interest within the medical community. This study aims to evaluate the impact of Vitamin E on anticoagulant efficacy, focusing on the potential alterations in the therapeutic outcomes and safety profiles of commonly used anticoagulants such as warfarin and direct oral anticoagulants (DOACs). The anticoagulant response is a critical factor in managing conditions like atrial fibrillation, deep vein thrombosis, and pulmonary embolism. Warfarin, a vitamin K antagonist, has been a cornerstone in anticoagulation therapy but requires careful monitoring due to its narrow therapeutic index and interaction with various dietary and pharmacological agents. The newer class of DOACs, including drugs like dabigatran, rivaroxaban, and apixaban, offers more predictable pharmacokinetics and less frequent monitoring but remains susceptible to interactions affecting their efficacy and safety. This study investigates the hypothesis that high doses of Vitamin E may enhance the anticoagulant effects, potentially leading to an increased risk of bleeding complications. The interaction is hypothesized to occur through several mechanisms, including the inhibition of vitamin K-dependent clotting factors and potentiation of the anticoagulant drugs' effects. To test this hypothesis, a cohort of patients on stable anticoagulation therapy with either warfarin or DOACs was selected. The study involved a controlled administration of Vitamin E supplements at varying doses. Patients were monitored for changes in key indicators such as International Normalized Ratio (INR) for those on warfarin and specific coagulation assays for those on DOACs. Additionally, bleeding events and other adverse effects were meticulously recorded. Preliminary findings indicate a dose-dependent interaction between Vitamin E and warfarin, evidenced by significant alterations in INR levels. Patients receiving higher doses of Vitamin E exhibited prolonged INR, necessitating adjustments in warfarin dosage to maintain therapeutic ranges. This potentiation effect aligns with the proposed mechanism of Vitamin E interfering with vitamin K metabolism, thereby amplifying warfarin's anticoagulant action. Interestingly, the interaction with DOACs presented a more complex picture. While some patients showed increased sensitivity to DOACs, others did not exhibit significant changes, suggesting that the interaction might be influenced by individual patient factors such as genetic variations in drug metabolism and baseline antioxidant status. The safety analysis revealed an increased incidence of minor bleeding events in the group receiving high doses of Vitamin E, particularly among warfarin users. Major bleeding events were rare but notable, reinforcing the need for cautious administration of Vitamin E in patients on anticoagulation therapy. These findings underscore the importance of personalized medicine approaches in managing anticoagulant therapies, taking into account the potential for nutrient-drug interactions. This study contributes to the growing body of evidence on the complex interplay between dietary supplements and pharmacotherapy. The results highlight the need for healthcare providers to carefully evaluate and monitor patients who may be using Vitamin E supplements concurrently with anticoagulant medications. Recommendations for clinical practice include routine assessment of supplement use in patients prescribed anticoagulants and considering potential dose adjustments to mitigate the risk of adverse bleeding events.
Copyright (c) 2024 Melanie Balval (Author) https://creativecommons.org/licenses/by/4.0
DEVELOPMENT AND ASSESSMENT OF SUSTAINED RELEASE SOLID DISPERSION OF GLIMEPIRIDE
Glimepiride is a third-generation sulfonylurea used in the management of type 2 diabetes mellitus. Despite its efficacy, glimepiride's therapeutic application is limited by its poor water solubility and short biological half-life, necessitating frequent dosing to maintain effective plasma concentrations. To overcome these challenges, the development of a sustained release formulation through solid dispersion techniques presents a promising strategy. Objective: This study aims to formulate and evaluate a sustained release solid dispersion of glimepiride to enhance its solubility, bioavailability, and therapeutic efficacy, while reducing dosing frequency. Solid dispersions of glimepiride were prepared using various hydrophilic carriers, including polyethylene glycol (PEG), polyvinylpyrrolidone (PVP), and hydroxypropyl methylcellulose (HPMC), via solvent evaporation and melting techniques. Different ratios of drug to carrier were tested to identify the optimal formulation. The prepared solid dispersions were characterized using Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), and X- Ray Diffraction (XRD) to assess drug-polymer interactions, thermal properties, and crystallinity changes. The optimal solid dispersion was incorporated into sustained release matrix tablets using direct compression. Various excipients such as hydroxypropyl methylcellulose (HPMC K15M), ethyl cellulose, and carbopol were utilized to achieve sustained release profiles. Tablet formulations were evaluated for physical properties including hardness, friability, and uniformity of weight. Dissolution tests were conducted using USP Type II dissolution apparatus in phosphate buffer (pH 7.4) to simulate intestinal conditions. The release profiles were analyzed using mathematical models (zero-order, first-order, Higuchi, and Korsmeyer-Peppas) to determine the kinetics and mechanism of drug release. The FTIR and DSC analyses confirmed the absence of significant drug-polymer interactions, indicating chemical stability. XRD patterns revealed a reduction in the crystallinity of glimepiride in the solid dispersions, suggesting enhanced solubility. Among the carriers tested, HPMC-based solid dispersions exhibited the highest solubility enhancement. The sustained release tablets showed satisfactory physical properties, with hardness and friability within acceptable limits. The in vitro dissolution studies demonstrated a controlled and sustained release of glimepiride over 24 hours. The release kinetics followed the Higuchi model, indicating diffusion-controlled release. The optimized formulation achieved a significant improvement in the dissolution rate compared to pure glimepiride, with approximately 80% drug release at 24 hours, demonstrating its potential for sustained therapeutic effect.
Copyright (c) 2024 Madhuri Pagariya (Author) https://creativecommons.org/licenses/by/4.0
IMPACT OF OCCUPATIONAL EXPOSURE ON PERIODONTAL HEALTH AND ANTIOXIDANT LEVELS AMONG DIESEL GENERATOR WORKERS
Occupational exposure to diesel generator emissions poses significant health risks, including potential impacts on periodontal health and antioxidant levels. This study aims to assess the periodontal health status and antioxidant levels among diesel generator workers compared to a control group with no such exposure. A cross-sectional analysis was conducted involving 100 diesel generator workers and 100 control subjects. Periodontal health was evaluated using clinical parameters such as plaque index, gingival index, probing depth, and clinical attachment loss. Antioxidant levels were measured using blood samples to assess total antioxidant capacity (TAC) and specific antioxidants like superoxide dismutase (SOD) and glutathione peroxidase (GPx).
Copyright (c) 2024 Kasim Leafed (Author) https://creativecommons.org/licenses/by/4.0
RELATIONSHIP BETWEEN FINGERPRINT PATTERNS AND BLOOD GROUPS IN LIBYAN STUDENTS: A COMPARATIVE STUDY
This study investigates the relationship between fingerprint patterns and blood groups among Libyan students, aiming to identify potential correlations that may exist between these two phenotypic traits. Fingerprint patterns were analyzed using standard classification methods, while blood group determination followed established laboratory protocols. Statistical analysis was employed to assess any significant associations between specific fingerprint types (arches, loops, whorls) and blood group categories (A, B, AB, O). Results indicate intriguing patterns of correlation, suggesting potential implications for forensic and genetic research. The findings underscore the relevance of fingerprint and blood group analysis in understanding genetic diversity and phenotypic variability within the Libyan student population.
Copyright (c) 2024 Abdallah Bashir (Author) https://creativecommons.org/licenses/by/4.0
EVALUATING HEALTHCARE PROFESSIONALS' ATTITUDES AND KNOWLEDGE ON PHARMACEUTICAL CARE SERVICES AT ADAMA HOSPITAL MEDICAL COLLEGE, EAST SHOA, ETHIOPIA
This study evaluates the attitudes and knowledge of healthcare professionals regarding pharmaceutical care services at Adama Hospital Medical College in East Shoa, Adama, Ethiopia. Through a comprehensive survey involving physicians, nurses, and pharmacists, the research aims to identify the level of understanding and perception of pharmaceutical care's role in patient management. The findings reveal significant gaps and strengths in current knowledge, highlighting areas for targeted educational interventions and policy enhancements. By understanding these attitudes and knowledge bases, the study provides insights into improving interdisciplinary collaboration and optimizing patient care outcomes.
Copyright (c) 2024 Amhara Berhanu (Author) https://creativecommons.org/licenses/by/4.0