Medication Adherence and Treatment Satisfaction With Lipid-Lowering Drugs Among Patients With Diabetes and Dyslipidemia.

BACKGROUND: Poor adherence to lipid-lowering drugs in diabetic patients with dyslipidemia increases has been linked with an increased cardiovascular risk. A better understanding of the determinants of adherence to lipid-lowering drugs and treatment satisfaction among people with diabetes and dyslipidemia is crucial. OBJECTIVE: We aimed to assess the prevalence of adherence to lipid-lowering drugs, identify its determinant factors, and evaluate treatment satisfaction among users of lipid-lowering drugs who have diabetes and dyslipidemia. METHODS: We surveyed 398 adult patients with diabetes and dyslipidemia, using a validated medication adherence survey (Adherence to Refills and Medications Scale) and a validated treatment satisfaction survey (Treatment Satisfaction Questionnaire for Medication, TSQM). Sociodemographic and medical history data were collected through questionnaires. RESULTS: The prevalence of poor medication adherence was 36%. Factors associated with poor adherence included adverse reactions to medications, lack of medication availability, and lack of family support. Adherent patients reported lower low-density lipoprotein-cholesterol (LDL-C) and total cholesterol levels, higher treatment satisfaction, and a higher prevalence of cardiovascular disease and comorbidities. Having a family history of dyslipidemia was negatively associated with adherence, while the number of comorbidities positively influenced it. The scores of TSQM components such as effectiveness, global satisfaction, and convenience were significantly higher in people who were adherent or achieved the LDL-C target. CONCLUSION AND RELEVANCE: Our findings highlight the need for interventions targeting several factors impacting adherence to lipid-lowering drugs in patients with diabetes and dyslipidemia. Managing adverse effects, leveraging family support, and ensuring medication access represent crucial aspects of improving adherence and potentially mitigating cardiovascular risks in this high-risk population.

A2A adenosine receptor stimulation ameliorated diabetic-induced osteoporosis in rats.

Diabetic osteoporosis is a common health problem that is associated with a disruption in bone metabolism. A2A adenosine receptor (A2AAR) signaling seems to play a critical role in bone homeostasis. This study aimed to evaluate the effect of A2AAR stimulation on the treatment of diabetic-induced osteoporosis versus insulin treatment. Forty adult male rats were allocated into control (C), untreated diabetic-induced osteoporosis (DIO), insulin-treated DIO (I-DIO), and A2AAR agonist-treated DIO (A-DIO) groups. Both insulin and A2AAR agonist treatments significantly increased serum insulin level, glutathione peroxidase (GPx) activity, bone expression of osteoprotegerin (Opg) and ß-catenin (Ctnnb1), and cortical and trabecular bone thickness, whereas they decreased serum fasting glucose, malondialdehyde (MDA), tumor necrosis factor α (TNF-α), bone expression of receptor activator of nuclear factor kappa-B ligand (Rankl), runt-related transcription factor-2 (Runx2), and sclerostin (Sost) versus the untreated DIO groups. A2AAR agonist treatment was more effective than insulin in ameliorating diabetic osteoporosis. This might be attributed to the upregulation of ß-catenin gene expression, enhancing its anabolic effect on bone, in addition to the A2AAR agonist's anti-oxidative, anti-inflammatory, and anti-diabetic effects.

Measurement of Power Frequency Current including Low- and High-Order Harmonics Using a Rogowski Coil.

The measurement of a power frequency current including low- and high-order harmonics is of great importance in calibration as well as in testing processes. Therefore, this paper presents the measurement of the power frequency current of light-emitting diode (LED) luminaires. LED luminaires were chosen as their input current includes both low- and high-order harmonics. The measurement process depends on reconstructing an LED luminaire current without using the coil parameters. Hence, the current reconstruction process is designed to be dependent on the measured characteristics of the Rogowski coil itself considering the frequency range at which the measurement process is required. An evaluation of the proposed measurement process was theoretically and experimentally carried out. A theoretical evaluation was carried out using MATALB SIMULINK software. However, the experimental evaluation was performed by building a Rogowski coil to measure the input currents of different LED luminaires having different power ratings of 300 W, 400 W, and 600 W. The currents measured using the Rogowski coil were compared with reference currents measured using a standard measurement technique. The obtained results show the efficacy of the proposed measurement method.

Nanomedicine in management of hepatocellular carcinoma: Challenges and opportunities.

Hepatocellular carcinoma is the second leading cause of cancer deaths worldwide. It is characterized by unique features that can be utilized for selective and targeted therapy, which aids in preserving healthy tissues from deteriorating effects of traditional chemotherapeutics. In this minireview, a brief overview of recent drug delivery attempts for the management of hepatocellular carcinoma with the aid of nanomedical structures is presented. The beneficial impact of nanomaterials in terms of prolonged retention in blood and target sites, controlled biodistribution and improved stability of the encapsulated payloads, will be described, together with the possibility of incorporating more than one cargo into the same nanostructure. Incorporation of stimuli-responsive components, decoration with targeting moieties and the use of molecularly targeted drugs for treatment of hepatocellular carcinoma are also highlighted.

Exploring the Quality of Life of University Students in Egypt: A Cross-Sectional Survey Using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) Assessment.

PURPOSE: To comprehensively assess the quality of life (QoL) of Egyptian university students. DESIGN: Cross-sectional online study. SETTING: Online settings of university students from August to October 2023. SUBJECTS: University students aged 18-25 from various institutions in Egypt. MEASURES: Physical, psychological, social, and environmental domains of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. Statistical analyses were performed using SPSS version 27.0. Mann-Whitney and Kruskal-Wallis tests were used to detect significant associations while Spearman correlation was used for correlation analysis. RESULTS: A total of 1930 Egyptian university students were included. Students showed outperformance in the psychological health and social relationships domains, with medians of 58 ± 20.8 and 58 ± 25, respectively, compared to physical health with a median of 46 ± 17.8 and environmental health with a median score of 16.6 ± 21.9. Non-medical students reported higher QoL scores, particularly in physical, psychological, and social domains, compared to their medical counterparts (P-values <0.001, 0.007, and 0.002, respectively). No significant differences were observed between genders in any of the domains. Academic performance satisfaction significantly correlated with higher QoL scores across all domains (P < 0.001). CONCLUSIONS: This multi-center study sheds light on diverse aspects influencing QoL of Egyptian university students. The findings underscore the importance of addressing academic stressors, promoting health behaviors, and tailoring interventions based on students' academic backgrounds with larger and more representative samples.

The clinical importance of IFN-γ and human epididymis protein 4 in Egyptian patients with epithelial ovarian cancer combined with HPV infection.

BACKGROUND: High-grade Epithelial Ovarian Cancer (HGEOC) is an aggressive disease that usually presents at an advanced stage. Thus, detecting the circulating cytokines (IFNγ and TNF-α) may serve as a biomarker to identify malignancy and manage therapeutic decisions. OBJECTIVES: Assessing the clinical importance of inflammatory mediators and tumor markers in EOC Egyptian patients compared with benign cases. Moreover, identifying the distinct inflammatory mediators in EOC patients combined with HPV infection. METHODS: This study was conducted on 61 Egyptian patients, divided into 25 patients with HGEOC, 22 patients with LGEOC, and 14 benign ovarian tumor cases. Measurements of serum HE4, CA125, CEA, and CA19-9 were determined by Roche Elecsys immunoassays. Serum levels of TNF-α and IFN-γ were measured using quantitative sandwich ELISA. Quantitative genotyping of HPV DNA types 16, 18, and 45 was assessed for the HPV DNA-positive samples. RESULTS: HPV DNA was detected in 25.53 % of malignant cases, HPV 16 was detected in 50 % of HPV-positive cases, and only 1 case of HPV 18 was detected out of 12 positive cases. The Human Epididymis protein 4 (HE4) was statistically different between patients with EOC and benign cases (p-value = 0.007) and between HPV DNA positive and HPV DNA negative cases (p-value = 0.008). The serum levels of IFN- γ were statistically different between HGEOC and LGEOC (p-value < 0.001), while the serum levels of TNF-α didn't differ statistically between the two groups. CONCLUSION: IFN-γ could be used as a biomarker to discriminate HGEOC and LGEOC. Initial evidence for the possible association between HE4 and the progression of HPV-associated EOC was speculated.

Ultrasonographic & biochemical analysis of thyroid bio-architecture for further pharmacological intervention in adult Arabian stallions & mares.

Based on the growing attention to the Arabian horses with a lack of records regarding their normal physiological parameters, which are critically vital for disease diagnosis &convenient drug administration, we give great attention to their thyroid gland normalcy. The thyroid gland is one of the key players in regulating many physiological processes. Therefore, we tackled thyroid biology & morphology in 14 Arabian stallions & 18 Arabian mares from the beginning of March to the middle of April on animals from 4 to 19 years old. First, the blood samples taken from their jugular vein were used for hematological profile, lipid profile, glucose-coagulation axis & thyroid profile. Moreover, thyroid gland dimensions & volume were estimated using ultrasonography. Noteworthy, Arabian mares have significantly higher MCH & relative eosinophils than Arabian stallions, while Arabian stallions have significantly higher glucose levels than Arabian Mares. Interestingly, this study found that Arabian horses have a high level of Total T4 & low level of platelets count compared to other horses. These results pointed to the deiodinase inhibitors as a possible target therapy for hyperthyroidism & thyroid cancer in Arabian horses, making surgery a second option. Also, these results refer to the caution required before giving Arabian horses high plasma protein bounded drugs, especially anticoagulants. Also, sonographic results showed that the left lobe is larger than the right lobe in both genders, & the lobes volume is larger in Arabian horses compared to others. These results would guide the veterinarian during diagnosis & thyroidectomy.

Predictors of Mortality in Adults With Sickle Cell Disease Admitted to the Intensive Care Unit in King Saud Medical City, Saudi Arabia.

Background Sickle cell disease (SCD) is the most common genetic blood disorder in Saudi Arabia. A limited number of studies have been conducted on SCD patients regarding their intensive care unit (ICU) admissions. We aimed to identify the cause of ICU admission in SCD patients and to identify predictors of mortality. Methodology We identified 64 patients with SCD, aged 14 years and older, who were admitted to the ICU of King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from January 1, 2017, to December 31, 2020. Results Acute chest syndrome was the most frequent primary diagnosis for ICU admission in 29 (45.3%) patients followed by vaso-occlusive crisis in 23 (35.9%) patients. Pregnancy in eight (12.5%) patients was the most prevalent co-existing condition. The median age was 29 years, with males comprising 45.3% and females comprising 54.7% of the study population. Arterial blood gas pH less than 7.2 on ICU admission (p= <0.001), hemodialysis support (p= 0.049), the use of vasopressors (p= 0.016), intubation (p= <0.001), and being intubated within the first 24 hours of ICU stay (p= 0.04) had a statistically significant association with mortality at ICU discharge out of all the variables tested. Mortality on ICU discharge was 7 (10.9%). Conclusion This was a retrospective study carried out in King Saud Medical City. Comparing the results of the study to those of similar ones conducted around the world revealed a low SCD ICU mortality rate. This low mortality may be a result of improved overall ICU care. We recommend a multi-center, prospective study in future.

Pregnant Women's Perception of Secondhand Smoke Exposure.

BACKGROUND: Birth outcomes including low birth weight, preterm birth, and delayed infant neurodevelopment are associated with secondhand smoke exposure while pregnant. The purpose of the study was to explore pregnant women's perspectives on secondhand smoke exposure to understand their experience and inform recommendations. STUDY DESIGN AND METHODS: Qualitative semistructured interviews were conducted with 15 secondhand smoke-exposed pregnant women in the United States. RESULTS: Four primary themes were identified: feeling powerless, trapped, and discomfort; enhancing women's self-advocacy and initiative; having conflicting feelings about secondhand smoke exposure; and desiring professional advice and education. Women expressed concern about prenatal secondhand smoke exposure, although they felt unable to request that people refrain from smoking in their presence or personal space. Women's strategies to minimize secondhand smoke exposure often involved their own social isolation. Women described sources of support, educational needs, and desire for practical advice in secondhand smoke avoidance. CLINICAL IMPLICATIONS: Findings underscore the role of nurses working with pregnant women living with household members who smoke to educate women about secondhand smoke risks and strategies for avoidance and to enhance women's self-confidence in advocating for themselves to reduce their exposure.

Exploitation of o-benzoyl benzoic acid as an efficient electroactive material for selective determination of Cr (III) ions in pharmaceutical samples and industrial waste water using carbon sensor.

Herein, for the first time, o-benzoyl benzoic acid has been explored as a promising electroactive material for the fabrication of sensitive, precise and accurate carbon paste electrode (CPE) for selective detection of Cr (III) ion. o-benzoyl benzoic acid (o-BBA) as a sensing material and tricresylphosphate (TCP) as a solvent mediator improved the developed sensor performance to get the Nernstian cationic slope of 20.03 ± 0.11 mV decade-1 within the concentration range of 5.0 × 10-7-1.0 × 10-1 mol L-1. The sensor displayed a fast response time of 12 s reflecting a pH independency over the pH range of 3.1-4.7. Moreover, the reaction between the sensing material and Cr (III) ion on the developed sensor surface was elucidated using the microscopic technique such as scanning electron microscope (SEM) in addition to the energy dispersive X-ray analyzer (EDX). The proposed sensor showed an adequate shelf lifetime (∼33 days). The values of potentiometric selectivity coefficient were obtained by fixed interference and separate solution methods affirming a high distinguishing power of the fabricated sensor toward Cr (III) ions over the other interfering ions. The established sensor could be utilized with a promising success for the Cr (III) ion estimation in the industrial waste water and in the pharmaceutical forms. Additionally, it has been employed as a promising indicator sensor with a superior performance for potentiometric titration of Cr (III) ion against EDTA.

Recent advances in the design of cathode materials for Li-ion batteries.

The Li-ion battery (LIB) industry has rapidly developed and dominates the market of electric vehicles and portable electronic devices. Special attention is devoted to achieving higher power and energy densities, along with enhancing safety and reducing cost. Therefore, critical insights should be made on the understanding of the behavior of the components of LIBs under working conditions in order to direct future research and development. The present review discusses the literature on the properties and limitations of different cathode materials for LIBs, including layered transition metal oxides, spinels, and polyanionic positive electrode materials, with critical insights on the structural, thermal, and electrochemical changes that take place during cycling. Besides, the strategies and techniques capable of overcoming current limitations are highlighted.

Acute Neuropsychiatric Symptoms Associated With Antibiotic Treatment of Helicobacter Pylori Infections: A Review.

Helicobacter pylori infects half the global population. Because serious complications can result from this infection, a so-called "triple therapy" is recommended: treatment with a proton-pump inhibitor and clarithromycin, along with amoxicillin or metronidazole. Although these antibiotics have been associated with neuropsychiatric symptoms, it is difficult to disentangle the effects of antibiotics from the effects of acute infections that may precipitate acute neuropsychiatric symptoms. Study of patients with chronic H. pylori infections who undergo antibiotic treatment may provide a clearer view of the associations between acute neuropsychiatric symptoms and antibiotics. The literature concerning this association in patients with H. pylori has not been reviewed. We therefore undertook a review of MEDLINE and postmarket surveillance data concerning this issue and identified 25 cases. Postmarket data indicated that gastrointestinal symptoms were the most commonly reported adverse reactions, followed by neurological adverse reactions; neuropsychiatric symptoms were less commonly reported, with variable and nonspecific terminology used to describe them. More specific, yet still variable terminology was found in the literature. Anxiety, delirium, dissociation, mania, and psychosis were reported, with approximately half of these neuropsychiatric symptoms occurring without symptoms of delirium. The use of standardized neuropsychiatric symptom rating scales and the Confusion Assessment Method for monitoring adverse reactions may improve our knowledge of neuropsychiatric symptoms and their association with antibiotics and thus mitigate underreporting. Physicians should remain alert to the possibility that neuropsychiatric symptoms may occur during antibiotic treatment of H. pylori and recognize that rapid resolution typically occurs with discontinuation of the antibiotics.