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Background: Cardiovascular disease is the leading cause of death and disability worldwide. It is a general term used to describe a group of disorders that affect the heart or blood vessels. This study aimed to evaluate the prevalence and predictors of polypharmacy in patients with heart failure. Methods: We conducted a cross-sectional study in a tertiary hospital in Saudi Arabia. Data was extracted from an electronic database between January 2019, and December 2022. The study included all adult patients with heart failure who visited outpatient clinics; individuals with cancer were excluded. The outcome variable in our study was "polypharmacy" which was defined as the use of eight or more medications. Descriptive analysis was performed using frequencies and percentages for categorical variables. In addition, Multivariate logistic regression was used to assess the covariates associated with polypharmacy. Results: A total of 331 patients with heart failure were included in this study. The prevalence of polypharmacy among our HF population was 39.88 %. Most participants were male (60.73 %), and 60 years or older (68 %). The most frequently used medications were beta-blockers (67.98 %) and diuretics (58.31 %), whereas the least frequently used medications were hydralazine and histamine H2 blockers (5.74, and 3.02 %, respectively). Polypharmacy was likely to be a non-significantly higher in individuals aged between 60 and 69 years (adjusted odds ratio (AOR) = 1.52; 95 % confidence interval (CI) 0.78-2.98) and suffering from hypertension (AOR = 1.48; 95 % CI 0.83-2.64). However, patients with heart failure and diabetes mellitus had a significant six-fold higher of polypharmacy than those without diabetes mellitus (AOR = 6.55; 95 % CI 3.71-11.56). Conclusion: Patients with heart failure often use multiple medications. Patients with heart failure together with diabetes have a higher risk of polypharmacy. Therefore, healthcare professionals should manage polypharmacy to improve the outcomes in patients with heart failure.
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Background: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia type. Patients with AF are often administered anticoagulants to reduce the risk of ischemic stroke due to an irregular heartbeat. We evaluated the efficacy and safety of edoxaban versus warfarin in patients with nonvalvular AF by conducting an updated meta-analysis of real-world studies. Methods: In this comprehensive meta-analysis, we searched two databases, PubMed and EMBASE, and included retrospective cohort observational studies that compared edoxaban with warfarin in patients with nonvalvular AF from 1 January 2009, to 30 September 2023. The effectiveness and safety outcomes were ischemic stroke and major bleeding, respectively. In the final analysis, six retrospective observational studies involving 87,236 patients treated with warfarin and 40,933 patients treated with edoxaban were included. To analyze the data, we used a random-effects model to calculate the hazard ratio (HR). Results: Patients treated with edoxaban had a significantly lower risk of ischemic stroke [hazard ratio (HR) = 0.66; 95% confidence interval (CI) = 0.61-0.70; p < 0.0001] and major bleeding (HR = 0.58; 95% CI = 0.49-0.69; p < 0.0001) than those treated with warfarin. The sensitivity analysis results for ischemic stroke and major bleeding were as follows: HR = 0.66; 95% CI = 0.61-0.70; p < 0.0001 and HR = 0.58; 95% CI = 0.49-0.69; p < 0.0001, respectively. Conclusion: Our findings revealed that edoxaban performed better than warfarin against major bleeding and ischemic stroke.
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AIM: The aim of this study was to know self-medication practices among the population of Riyadh region for oral health issues. METHODOLOGY: A questionnaire consisting of demographic self-practice of medication for oral health problems and knowledge about self-medication practices was sent through Google forms and it was in Arabic and English languages. The link of the questionnaire was sent through social and requested to send the link to their friends and relatives. RESULTS: About 50.4% of study participants were having self-practice of medication for oral health problems. Self-practice of medication for oral health issues was statistically significant according to age gender and education (P < 0.05). Toothache (62.4%) is the main problem triggering self-medication and lack of time (44.6%) is the main reason for self-medication. Pain killer (68.8%) was the main medication and antibiotics were used by 2.2% of subjects. CONCLUSION: Self-medication practice is prevalent in the world and hence, education regarding its consequences and adverse effects for the general public is mandatory.
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COVID-19 has emerged as the world's biggest challenge that has not only threatened human lives but also had an immense impact on the economy, safety and religious practices. The situation has worsened due to the lack of proper guidelines for fighting the sudden unexpected outbreaks. The world was not prepared for this situation. This review highlights some important steps the Middle East countries is taking and their impact on controlling the COVID-19 outbreak. We also discuss some hypothetical predictions for the coming months.
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AIM: This study aimed to retrospectively compare the survival outcomes over two years between teeth with proximal dental caries that were restored with stainless-steel crowns to those that were pulpotomized and then restored with a stainless-steel crown in patients who were rehabilitated under general anesthesia. Participants and Methods. The records of 131 patients aged between two to six years who had stainless-steel crowns placed under general anesthesia and had two-year follow-up were screened. 340 teeth with moderate proximal caries on the radiograph (D2) were included in the study. Of these, 164 teeth were treated with a pulpotomy and stainless-steel crown, while 176 teeth were crowned without a pulpotomy. The type of each tooth was compared using the Chi-squared test and Kaplan-Meier survival analysis, and curves were plotted based on the two-year outcomes. RESULTS: Treatment: the sample comprised 59 males (mean age 4.73 years, SD ± 1.4 years) and 72 females (mean age 5.2 years, SD ± 2.0 years). The Kaplan-Meier regression model showed no significant difference in survival outcomes between teeth that had been pulpotomized and those that had not (p = 0.283). CONCLUSION: Within the limitations of the current study, we can conclude that performing a pulpotomy does not influence the survival outcome of mild/moderate proximal caries restored with stainless-steel crowns under general anesthesia.
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BACKGROUND: Transcranial direct current stimulation (tDCS) is a neuromodulation tool used to modify the cognitive function in subjects. There is a paucity of data on tDCS' effect on cognitive function during Ramadan fasting. This paper aims to assess the effect of tDCS of three brain areas, including the right dorsolateral prefrontal cortex (DLPFC), posterior parietal cortex (PPC), and cerebellum on cognitive function, and obtain safety data in healthy adults during Ramadan fasting. METHODS AND MATERIAL: A total of 42 healthy, right-handed participants were randomly assigned to one of the 6 stimulation groups: active (anodal)-tDCS of right DLPFC, PPC, and cerebellum; or sham for DLPFC, PPC, and cerebellum after 8 h of fasting for Ramadan. Safety data and cognitive function, such as attention-switching tasks (AST), were obtained by employing the Cambridge Neuropsychological Test Automated Battery (CANTAB) before and after each tDCS session. The cognitive function outcome variables were the response time and the percentage of correct answers in AST. For sham stimulation, the placement of the electrodes was the same as for the active stimulation. RESULTS: An improvement in performance time in attention tasks was observed; however, it did not reach a significant level after anodal stimulation of the DLPFC, PPC, and cerebellum. Overall, there were no statistically significant differences between the active and sham tDCS groups in cognitive function. There were no significant side effects of tDCS during fasting for any group. CONCLUSIONS: Our data suggest that there are variable effects of tDCS on attention tasks during Ramadan fasting. TDCS appears to be safe, well-tolerated and adhered to the international standard of safety in the local population during Ramadan fasting. Further large sample size studies should be conducted to validate the current study findings and reach better conclusions.