National Journal of Health Sciences最新文献

{"title":"Role of the Gut Microbiome in the Pathophysiology and Treatment of Type 2 Diabetes Mellitus: A Mini Review","authors":"Anika Zainab, Arpit Mago, A. Mehmood, Mohamed S. Riad, S. Sonavane","doi":"10.21089/njhs.62.0075","DOIUrl":"https://doi.org/10.21089/njhs.62.0075","url":null,"abstract":"Abstract: Introduction: Diabetes mellitus type 2 is a chronic metabolic condition characterized by insulin resistance along with inadequate circulating insulin in the blood. It has been observed that the changes in the complex habitat composed of trillions of bacteria can cause metabolic disturbances. Previous studies have explained the phenomenon of dysbiosis which leads to the development and progression of diabetes mellitus type 2. It has been reported that there are altered gut microbiota levels present in patients with type 2 diabetes mellitus. Main Body: Gut microbiota and its metabolites are involved in the pathogenesis of multiple metabolic diseases including type 2 diabetes mellitus therefore, intestinal microbiota may be one of the crucial medicinal targets for the disease. Studies have shown that diabetes can be managed effectively by altering the human gut microbiome. This review presents three therapeutic options which can be used to alter the gut microbiome. The therapeutic options are; fecal microbial transplant, use of probiotics and cinnamon. These interventions have proven to increase richness and diversity of gut microbiota. A vast number of studies support the beneficial effects of probiotics in treating type 2 diabetes due to its oxidative stress inhibiting properties. Cinnamon has shown similar benefits owing to its anti-inflammatory and anti-oxidative nature. An adequate number of animal studies and few human studies have reported improvement in insulin sensitivity in fecal microbial transplant recipients. Conclusion: Consumption of probiotics and cinnamon have shown potential benefits in the treatment and prevention of type 2 diabetes mellitus. Fecal microbiota transplant has been shown to improve insulin sensitivity along with other impaired characteristics for example HbA1c found in diabetics. It can be suggested that microbiota-based interventions can be used for the prevention and treatment of type 2 diabetes mellitus. Further studies are necessary to explore the mechanisms by which these treatment options provide potential beneficial effects in T2DM patients. Keywords: Gut microbiome, Gut microbiota, Gut flora, Type 2 diabetes mellitus, Fecal microbial transplant, Probiotics.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127010021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Management of Metastatic Spinal Cord Compression","authors":"Muhammad Muaz Abbasi, Sheikh Muhammad Ebad Ali, Badar Saheto, Sumbal Zaidi","doi":"10.21089/njhs.62.0046","DOIUrl":"https://doi.org/10.21089/njhs.62.0046","url":null,"abstract":"Metastatic Spinal Cord Compression (MSCC) is one of the major forms of oncological emergencies. Other common emergency scenarios seen in cancer patients include Neutropenic Sepsis, Hypercalcemia and Superior Vena Cava Obstruction (SVCO). During this brief discussion of MSCC we will be going over the red flag symptoms a patient may present with common malignancies. We shall go through the points that are associated with and the multidisciplinary management of MSCC. A patient presenting to the emergency room with symptoms including recent onset back pain [1, 2], in the extremes of age (i.e. <20 or >55), with a history of weight loss, pyrexia, night sweats, sensory loss, leg weakness, constant pain at night and at rest and/or complains of urinary retention, fecal incontinence should have MSCC considered in differential diagnosis and appropriate work up should be considered.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"43 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116729271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Drug Interaction between Non-Steroidal Anti-Inflammatory and Angiotensin Receptor Blocker","authors":"Mahreen Muzammil, S. Hussain","doi":"10.21089/njhs.62.0088","DOIUrl":"https://doi.org/10.21089/njhs.62.0088","url":null,"abstract":"Abstract: Objective: In pharmacotherapy, factors such as mode of administration, dose, and contraindications play a significant part in determining the optimal pharmacotherapeutic strategy. A drug’s ability to influence the safety or efficacy of another drug (drug-drug interaction) is another factor to consider when choosing the best pharmacotherapy [1]. When multiple medications are prescribed at the same time, they may interact [2]. Drug-drug interactions (DDIs) can have a variety of outcomes, and adverse DDIs might result in patient death or drug withdrawal. Drug interactions can alter the pharmacokinetics and/or harmacodynamics of a drug which may leads to therapeutic failure or any adverse drug event. Co-administration of naproxen with losartan will decrease the action of losartan which is an anti-hypertensive agent leads to uncontrolled hypertension. NSAIDs inhibit prostaglandin thus antagonise effect of converting enzyme inhibitors. Losartan is angiotensin receptor blocker, whose natriuretic effects decreased by naproxen. Keywords: Drug-drug interaction, Pharmacotherapy, Tertiary care hospital, Naproxen, Losartan, Clinical pharmacy","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115195406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Fibrosis in Chronic Hepatitis C by Mean Platelet Volume and Platelet to Lymphocyte Ratio","authors":"Mehmet Ali Kosekli","doi":"10.21089/njhs.62.0048","DOIUrl":"https://doi.org/10.21089/njhs.62.0048","url":null,"abstract":"Abstract: Introduction: Hepatitis C is a chronic inflammatory condition that associated with fibrosis. Novel inflammatory markers have been suggested to be related inflammatory condition. Therefore, we aimed to investigate hemogram derived indices, such as, Mean Platelet Volume (MPV) and Platelet to Lymphocyte ratio (PLR) in hepatitis C subjects and to compare those in healthy controls. Materials and Methods: In present retrospective study, 17 HCV patients having mild fibrosis, 23 patients having advanced fibrosis and 68 control subjects were included whom visited outpatient clinics of our institution between 1.10. 2017 and 30.11.2019. Hemogram indices and laboratory characteristics were compared. Results: Median MPV values of the advanced fibrosis patients [8.3 (6.5-14) fL] was significantly higher than that of the mild fibrosis patients [7.9 (6.5-11.1) fL] (p=0.002) and control subjects [7.2 (4.6-10.7) fL] p<0.001) whereas MPV values of mild and advanced fibrosis patients were similar (p=0.750). Median PLR values of the mild fibrosis, advanced fibrosis and control groups were 103 (58-223) %, 86 (45-358) %, and 77 (64-96) %, respectively (p=0.010). A ROC analysis revealed that a MPV value greater than 7.3 fL determines advanced fibrosis with 76% sensitivity and 59% specificity. A PLR greater than 92% determines advanced fibrosis with 73% sensitivity and 64% specificity. Conclusion: We suggest that elevated PLR and MPV could predict of advanced fibrosis in chronic hepatitis C. Keywords: Hepatitis C, Fibrosis, Platelet to lymphocyte ratio, Mean platelet volume, Hemogram indices, Liver cirrhosis.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"584 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134459667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Interesting Acute Renal Failure Case which Developed in a Patient with Chronic Kidney Disease","authors":"Elif Basaran, Burcin Meryem Atak Tel, O. Kurtkulagi, G. Kahveci, Elif Boduc Bulunmaz, S. Bilgin, T. Duman, M. Demirkol, G. Aktas","doi":"10.21089/njhs.62.0086","DOIUrl":"https://doi.org/10.21089/njhs.62.0086","url":null,"abstract":"Abstract: Chronic Kidney Disease (CKD) is defined as a chronic and progressive deterioration in kidney functions such as, balancing fluid-solute equilibrium and metabolic-endocrine effects as a result of a decrease in glomerular filtration rate. In present case, we aimed to report an acute renal failure case in an elderly man with CKD. A sixty two year old man presented with dyspnea, leg swelling and loss of appetite for two weeks. He is diagnosed with acute exacerbation of CKD caused by infected diabetic foot ulcer. He responded well to antibiotic and diuretic treatment. Management of acute exacerbation of kidney failure in patients with CKD requires a systematic approach and elimination of underlying causes. Careful treatment usually results in restoration of kidney function to the pre-exacerbation stage. Keywords: Chronic kidney disease, Diabetic foot ulcer, Diuretic, Antibiotic, Kidney function, Glomerular filtration rate.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123407642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothyroidism is Strongly Correlated with Mean Platelet Volume and Red Cell Distribution Width","authors":"S. Bilgin, Burcin Meryem Atak Tel, G. Kahveci, T. Duman, O. Kurtkulagi, Semanur Yurum, Asli Erturk, Buse Balci, G. Aktas","doi":"10.21089/njhs.61.0007","DOIUrl":"https://doi.org/10.21089/njhs.61.0007","url":null,"abstract":"Abstract: Objective: Hypothyroidism is characterized with insufficient production and release of thyroid hormones, and cause a variety symptoms including cold intolerance, constipation, deceleration in movement, and hair loss. It is associated with increased inflammatory burden. Therefore, we aimed to observe red cell distribution width (RDW) and mean platelet volume (MPV) levels, novel predictors of inflammation, in patients with hypothyroidism and to compare to those in healthy subjects. Materials and Methods: The subjects with hypothyroidism that show up in internal medicine outpatient clinics of Abant Izzet Baysal University Hospital between January 2020 and January 2021 were enrolled to the retrospective study. Healthy volunteers were enrolled as control subjects. MPV and RDW of the study groups were compared. Results: The median RDW level of hypothyroid and control groups were 13.3 (10-20.7) % and 15.3 (11.8-21.3) %, respectively (p<0.001). The median MPV level of hypothyroid and control groups were 10.2 (6.4-12.4) fL and 8.1 (5.4-11.5) fL, respectively (p<0.001). MPV levels greater than 9.47 fL have 80% sensitivity and 72% specificity in predicting hypothyroidism (AUC: 0.66 [95% CI: 0.58-0.74]; p<0.001). RDW levels greater than 13.4% have 80% sensitivity and 50% specificity in predicting hypothyroidism (AUC: 0.67 [0.82 [95% CI: 0.59-0.75]; p<0.001). Conclusion: We suggest that elevated MPV and reduced RDW levels should alert physicians for hypothyroidism in otherwise healthy subjects. Keywords: Hypothyroidism, Red cell distribution width, Mean platelet volume, Inflammation, Thyroid hormones, Predictor, Retrospective study.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130662447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covid-19 Vaccination: A Bird’s Eye View","authors":"T. Shamsi, M. Imam","doi":"10.21089/njhs.61.0001","DOIUrl":"https://doi.org/10.21089/njhs.61.0001","url":null,"abstract":"Covid-19 pandemic plagued this world since the beginning of 2020 AD. It is caused by a new positive-strand RNA virus of coronaviridae family [1]. It causes Coronavirus disease 2019 (hence the name COVID-19). It is a contagious disease predominantly causes severe acute respiratory syndrome, hence the name SARS-CoV-2. It started from Wuhan, China, in December 2019. Since then, it has spread globally. It is reported to be a new virus therefore it’s properties, pathogenesis, virulence, immunogenicity, variants, and how will host body will react to this virus was unknown. Despite of 22 months since this virus started to spread worldwide, researchers and clinicians continued to learn about it on daily basis. Newer information about it poured in daily in scientific journals as well as in print / electronic media. Mostly, newer information continued to negate earlier information. Social media disinformation continued to confuse the masses.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132368871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interim-Guidelines for COVID-19 Vaccination in Hematological Malignancies and Hematopoietic Stem Cell Transplant Recipients","authors":"Raheel Iftikhar, U. Zaidi","doi":"10.21089/njhs.61.0038","DOIUrl":"https://doi.org/10.21089/njhs.61.0038","url":null,"abstract":"Abstract: Objective: Hematologic malignancies such as Acute Leukemias, Myelodysplastic Syndromes (MDS), Myeloproliferative Neoplasms (MPNs), Lymphomas and Multiple Myeloma (MM) can be treated with chemotherapy, Hematopoietic Stem Cell Transplant (HSCT) or Chimeric Antigen Receptor T-cell (CAR-T) therapies with either a curative intent or to prolong survival. The hematologic malignancy itself or the anti-cancer therapies can result in long-term immunodeficiency; COVID-19 infection in this population is associated with a significantly higher risk of hospitalization and death [1]. Given lack of available data on COVID-19 vaccination from Pakistan, this guidance is based on the review of safety and efficacy of FDA and CDC approved vaccines for the prevention of COVID-19 disease and recommendations of European Society for Blood and Marrow Transplant (EBMT), American Society for Transplantation and Cellular Therapies (ASTCT) and British Society of Hematology (BSH) for the use of COVID vaccination in HSCT recipients and those with hematological malignancies. The American Society of Hematology (ASH), EBMT, ASTCT and BSH recommends the desired access to vaccines for this highly susceptible group along with care takers, family members, and domestic& everyday contacts when vaccine supply is available. Keywords: COVID-19 vaccination, Hematological malignancies, Hematopoietic stem cell transplant, mRNA vaccine, Acute leukemia, Chemotherapy.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"148 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121816350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olanzapine in Chemotherapy Induced Nausea and Vomiting","authors":"S. S. Hussain, F. Rahman, Sarmad Iqbal","doi":"10.21089/njhs.61.0026","DOIUrl":"https://doi.org/10.21089/njhs.61.0026","url":null,"abstract":"Abstract: Objective: Patients diagnosed with cancer and undergoing chemotherapeutic regimen often anticipate many negative effects of the therapy. Chemotherapy induced nausea and vomiting is of their principal concerns which remains one of the most unpleasant, distressing and feared adverse effect. The management of chemotherapy induced nausea and vomiting has always been a challenge for high and moderate emetogenic chemotherapeutic agent. D2-receptor antagonists were the first agents to produce antiemetic effect. Then 5-HT3 receptor antagonist and NK1 receptor antagonist were developed which proved to possess higher selective antiemetic effect compared to D2 receptor antagonist. This review includes the clinical advancements of an atypical antipsychotic agent olanzapine and its role in chemotherapy induced nausea and vomiting. Olanzapine is traditionally used to treat schizophrenia and manic disorder. But recent clinical studies have illustrated its additional therapeutic effect as an antiemetic agent. This advancement may prove to have beneficial effect in managing chemotherapy induced nausea and vomiting and providing a better quality of life to patient being treated with different chemotherapeutic agents. Keywords: Anti-emetic, CINV, Chemotherapy, Anti-psychotic, Emetogenicity, Clinical Trial.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122619452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Attitude towards Infection Prevention at a Newly Established Hospital","authors":"Haya Ul Mujtaba, N. Anwar, N. Fatima, S. Mukry, Aisha Jamal, Qurat-ul-ain Rizvi, T. Shamsi","doi":"10.21089/njhs.61.0011","DOIUrl":"https://doi.org/10.21089/njhs.61.0011","url":null,"abstract":"Abstract: Objective: Health care associated infections are those infections that patients acquire in hospitals during their treatment and health care workers are important source for it. The study was designed to evaluate the knowledge and attitude of Health care workers towards infection control. Materials & Methods: A cross sectional study conducted from December 2019 to February 2020 at NIBD & BMT. Approval was taken from NIBD Research Committee. A pre-designed questionnaire was given to staff that had given informed consent. The questionnaire was composed of two parts. The first part comprised of sociodemographic information and the second part comprising 37 questions of knowledge and 11 question of attitude. Data was analyzed by SPSS version 23. Frequencies and percentages were calculated for categorical variables and mean for quantitative data. Chi-square test was used for association with level of significance as P-value <0.05. Results: A total of 82 health care professionals were interviewed. Out of which 49(60%) were male. The mean age of participants was 28.87 ± 6.4 years. Majority of staff had graduate or above graduate education 40(49%). The overall mean knowledge score was found below average with mean of 18.3±12.3. The mean knowledge scores between age groups (p=0.786), gender (p=0.760) and department (p=0.360) were not found significant. Knowledge score was significantly different among educations level (p= <0.001). 71% were found to have good attitude. Educational status was associated with attitude (p<0.001). Conclusion: Our findings revealed below average knowledge however, attitude was found satisfactory. It is the need of time to organize training and educational sessions in order to minimize the rate of infection for the betterment of health care professionals and patients. Keywords: Healthcare associated infection, Infection control, Knowledge and practices, Attitude towards infection control, Healthcare workers, Pakistan.","PeriodicalId":441304,"journal":{"name":"National Journal of Health Sciences","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125491970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}