The Use of Plants, Nanotechnology and Surfactants in Lindane Remediation: A Mini Review

Lindane is an organochlorine chemical and an isomer of hexachlorocyclohexane that has been used both as an agricultural insecticide and as a pharmaceutical treatment for lice and scabies. Lindane accumulates in the agricultural soil and plants thereby causing environmental and health deteriorative effects. A lot of soil remediation methods used are highly expensive and require a lot of expertise. Phytoremediation (rhizofiltration, phytostabilization), which involve the use of the plant to stabilize or remove environmental toxicants is presently much in use because of its cost-effectiveness and ecological friendliness. Adsorption has emerged as the most efficient, easy, and promising nanotechnology method of wastewater treatment out of the several approaches now employed. Recently, biosurfactants are used for the production of nanoparticles which will be further applied in the area of pesticide remediation. The use of phytoremediation is the most important fully green approach as no new chemicals are added to the polluted soil. Other emerging technologies where phytoremediation might not be applicable especially groundwater has begun to evaluate the use of green nanobiotechnology.

Evaluation of osteopathic manipulative treatment in pain reduction in pregnant women during third trimester and postpartum: Review Article

The female body undergoes physiological changes during pregnancy that often lead to low back pain (LBP). To assess a non-pharmaceutical treatment option for LBP, a literature review was conducted comparing research trials using Osteopathic Manipulative Treatment (OMT) and its effect on LBP experienced in the third trimester and postpartum. Research studies using the Visual Analog Scale (VAS) to rate pain were used and the effects of OMT was analyzed. It was found that, compared to usual treatment for LBP, OMT provided significant relief of pain for patients. While research conducted in pregnant populations is limited, further research is required to assess OMT technique models on individuals and the effect on pain throughout pregnancy through the postpartum period.

Associations between maternal characteristics and pharmaceutical treatment of gestational diabetes: an analysis of the UK Born in Bradford (BiB) cohort study

ObjectivesTo identify the maternal characteristics associated with pharmaceutical treatment of gestational diabetes mellitus (GDM).DesignProspective birth cohort study.SettingBradford, UK.Participants762 women from the Born in Bradford (BiB) cohort who were treated for GDM in a singleton pregnancy. BiB cohort participants were recruited from 2007 to 2010. All women booked for delivery were screened for GDM between 26 and 28 weeks of gestation using a 75 g 2-hour oral glucose tolerance test (OGTT).Outcome measureGDM treatment type: lifestyle changes advice (lifestyle changes), lifestyle changes advice with supplementary insulin (insulin) and lifestyle changes advice with supplementary metformin (metformin).Results244 (32%) women were prescribed lifestyle changes advice alone while 518 (68%) were offered supplemental pharmaceutical treatment. The odds of receiving pharmaceutical treatment relative to lifestyle changes advice alone were increased for mothers who were obese (OR 4.6, 95% CI 2.8 to 7.5), those who smoked (OR 2.6, 95% CI 1.2 to 5.5) and had higher fasting glucose levels at OGTT (OR 2.1, 95% CI 1.6 to 2.7). The odds of being prescribed pharmaceutical treatment rather than lifestyle changes advice were lower for Pakistani women (OR 0.7, 95% CI 0.4 to 1.0)) than White British women. Relative to insulin treatment, metformin was more likely to be offered to obese women than normal weight women (relative risk ratio, RRR 3.2, 95% CI 1.3 to 7.8) and less likely to be prescribed to women with higher fasting glucose concentrations at OGTT (RRR 0.3, 95% CI 0.2 to 0.6).ConclusionsIn the BiB cohort, GDM pharmaceutical treatment tended to be prescribed to women who were obese, White British, who smoked and had more severe hyperglycaemia. The characteristics of metformin-treated mothers differed from those of insulin-treated mothers as they were more likely to be obese but had lower glucose concentrations at diagnosis.

Guideline adherence among prehospital emergency nurses when caring for patients with chest pain: a prospective cohort study

Background The emergency medical services (EMS) use guidelines to describe optimal patient care for a wide range of clinical conditions and symptoms. The intent is to guide personnel to provide patient care in line with best practice. The aim of this study is to describe adherence to such guidelines among prehospital emergency nurses (PENs) when caring for patients with chest pain. Objective To describe guideline adherence among PENs when caring for patients with chest pain. To investigate whether guideline adherence is associated with patient age, sex or final diagnosis of acute myocardial infarction on hospital discharge. Methods Guideline adherence in terms of patient examination and pharmaceutical treatment was analysed in a cohort of 2092 EMS missions carried out in 2018 in Region Halland, Sweden. Multivariate regression was used to describe how guideline adherence is associated with patient age, sex and diagnosis on hospital discharge. Results Guideline adherence was high regarding examination of vital signs (93%) and electrocardiogram (ECG) registration (96%) but lower in terms of pharmaceutical treatment (ranging from 28 to 90%). Adherence was increased in cases in which the patient ended up with acute myocardial infarction (AMI) as diagnosis on discharge. Patients with AMI were given acetylsalicylic acid by PENs in 50% of cases. Women were less likely than men to receive treatment with acetylsalicylic acid and oxycodone. Conclusions Guideline adherence among PENs when caring for patients with chest pain is satisfactory in terms vital signs and ECG registration. Regarding pharmaceutical treatment guideline adherence is defective. Improved adherence is mainly associated with male sex in patients and a diagnosis of AMI on hospital discharge. Defective adherence excludes measures known to improve patients’ prognoses such as treatment with acetylsalicylic acid.

Pharmaceutical treatment of primary open angle glaucoma

Background: Glaucoma is a progressive, irreversible optic neuropathy that results in serious vision loss and blindness. This review aimed to summarize key concepts of primary open angle glaucoma (POAG) pharmaceutical treatment trials over the last decade. Methods: We searched PubMed/MEDLINE and clinicaltrials.gov from January 1, 2010, to August 31, 2020, using the key words “POAG” and “Ocular topical therapeutics”. This search yielded 77 and 120 papers, respectively. Results: Thirty-three records were compatible with our inclusion criteria. Pharmaceutical treatment is a common intervention in POAG for lowering IOP. Prostaglandin (PG) analogues are most commonly recommended as initial medical therapy, which are administrated either as a monotherapy or in combination with other IOP-lowering classes of medications. Alternative therapies, such as ?-blockers, ?-2 adrenergic receptor agonists, and topical carbonic anhydrase inhibitors, have been used in combination or as a monotherapy. Rho-kinase inhibitors, such as netarsudil 0.02%, AR-13324 0.02%, and ripasudil are new IOP-lowering medications. Despite IOP reduction, there is a significant number of patients with POAG that may experience disease progression, and the risk of blindness over the long term is considerable. Conclusions: Clinical trials have indicated that pharmaceutical treatment of POAG is effective and safe. In addition, the new novel Rho-kinase inhibitors have shown significant IOP reduction. The new fixed combinations have also yielded significant reductions in IOP. POAG is a cause of irreversible vision loss, if not diagnosed and treated early. The condition is likely to progress in a significant number of patients, with a considerable risk of blindness in the long-term. How to cite this article: Al-Namaeh M. Pharmaceutical treatment of primary open angle glaucoma. Med Hypothesis Discov Innov Optom. 2021 Spring; 2(1): 8-17. DOI: https://doi.org/10.51329/mehdioptometry120

Best of Science and Nature - Alternative Approaches to Prevent and Treat Type 2 Diabetes

The results indicate that OGB alone or together with Metformin works significantly faster in lowering glucose and to a healthy level without side effects when compared to clinical findings with current pharmaceutical treatment options, which take 3 months to 6 months to show clinically meaningful results. OGB’s speed of action also suggests that it works more holistically to address the various cellular disease onset mechanisms at the same time. The learning’s also suggest that the select polyphenols and magnesium in OGB may safely and more effectively supplement and or potentially replace T2DM pharmaceutical medications.

P654 Prevalence of Inflammatory Bowel Disease in young Greek Army male recruits from 2006 to 2018: a thirteen-year retrospective study from a tertiary center

Background Prevalence and incidence of Inflammatory Bowel Diseases (IBD), vary among different countries. Data regarding prevalence of IBD in Greece are limited or outdated. Methods We studied retrospectively, using the official Hospital electronic-form database, medical records of IBD patients from a population of 551,808 Greek Army candidates for recruitment in a thirteen-year period from 2006 to 2018. Study population consisted of males aged 18 to 37 from Northwest, Central Greece (including Athens) and South Aegean Islands. Age, disease distribution, surgery and pharmaceutical treatment at the time of patients’ admission were recorded. Results Prevalence of IBD among male recruits during the studied period was 0.15% (n=839 patients), (95% confidence interval = 0.14% to 0.16%). Out of them, 448 (53.4%) had Crohn’s Disease (CD) and 391 (46.6%) Ulcerative Colitis (UC). Figures 1 & 2 illustrate the percentages of pharmaceutical treatment for CD and UC respectively, while figures 3 & 4 their distribution and fluctuation during the studied period for CD and UC respectively . Concerning CD cases, monotherapy with biologics was the most commonly used pharmaceutical choice (32.1%) with Infliximab being the predominant one (60% of them), though azathioprine had been used more often than any other isolated drug agent (27%). Interestingly, 21% of CD patients received 5-ASA as monotherapy, mainly in cases of mild CD colitis or terminal ileitis. Among UC patients, mesalamine was the most often prescribed treatment (64.2%), while biological drugs and combination therapy were not so widely administered as in CD (ratio 1:2). During the recorded period for CD patients we noticed that: i) there was a reducing trend in azathioprine prescription, ii) adalimumab presented to be an increasing predilection iii) infliximab’s use was maintained at the same level all these years. Among UC cases, mesalamine was constantly the first choice, while adalimumab was not so widely administered as in CD. A distinct reduction in steroid use was noted from 2006 to 2018, coming alongside with biologics establishment. Additionally, 8% of CD and 2.8% of UC patients had undergone a surgery due to disease complications. This low proportion could be explained by the relatively young age of the study population. Conclusion Prevalence of IBD in Greek recruits was 0.15% with a slight CD predominance. This is the first Greek epidemiological study that recorded also the provided treatment at the time of patient’s admission giving useful information upon IBD epidemiological profile in a wide region of our country and contributing to quantification of public health burden of those diseases in Greece.

Protein Substitute Requirements of Patients with Phenylketonuria on BH4 Treatment: A Systematic Review and Meta-Analysis

The traditional treatment for phenylketonuria (PKU) is a phenylalanine (Phe)-restricted diet, supplemented with a Phe-free/low-Phe protein substitute. Pharmaceutical treatment with synthetic tetrahydrobiopterin (BH4), an enzyme cofactor, allows a patient subgroup to relax their diet. However, dietary protocols guiding the adjustments of protein equivalent intake from protein substitute with BH4 treatment are lacking. We systematically reviewed protein substitute usage with long-term BH4 therapy. Electronic databases were searched for articles published between January 2000 and March 2020. Eighteen studies (306 PKU patients) were eligible. Meta-analyses demonstrated a significant increase in Phe and natural protein intakes and a significant decrease in protein equivalent intake from protein substitute with cofactor therapy. Protein substitute could be discontinued in 51% of responsive patients, but was still required in 49%, despite improvement in Phe tolerance. Normal growth was maintained, but micronutrient deficiency was observed with BH4 treatment. A systematic protocol to increase natural protein intake while reducing protein substitute dose should be followed to ensure protein and micronutrient requirements are met and sustained. We propose recommendations to guide healthcare professionals when adjusting dietary prescriptions of PKU patients on BH4. Studies investigating new therapeutic options in PKU should systematically collect data on protein substitute and natural protein intakes, as well as other nutritional factors.