Clinical Journal for Medicine, Health and Pharmacy
Clinical Journal for Medicine, Health and Pharmacy (ISSN-3049-1282) Journal was established in November 2023. The journal is a peer-reviewed publication from India that is released on basis of 4 issues per year. The publication's primary objective is to publish original research articles and reviews in the fields of Medicine, Health and Pharmacy. We will prioritize articles of current interest and newer research topics. Publisher name: Clinical Forum for Intellectuals in Medical & Health ISSN: 3049-1282 Frequency: Quarterly (4 issues per year) Language of publication: English Domains: Medical sciences (Medicine, Pharmacy, Health) Year of Starting: November, 2023 Mode of Publication: Online Only
Clinical Forum for Intellectuals in Medical & Health
Evaluation of Adherence to Prescribed Medications Among Older Adults with Cognitive Impairment
Medication adherence is a significant difficulty in treating elderly patients, yet they are underrepresented in studies. The researchers conducted a systematic study targeting older patients to evaluate the factors contributing to non-adherence in this demographic. The research examined several electronic databases for research detailing the causes of medication non-adherence among individuals aged 75 and older. The findings were not confined to illnesses, medical settings, or geographical regions. The quality of qualifying studies was evaluated using the Newcastle-Ottawa Index. A narrative review of the results was conducted. Twenty-five publications were considered, all situated in community settings. Regular medication evaluations and understanding the rationale behind the medicine were favorably correlated with compliance. Factors linked to inadequate adherence included multimorbidity, cognitive decline, intricate regimens involving several prescribing doctors, and issues related to medication storage or composition. The results indicate that treatments to enhance adherence should concentrate on medication reviews designed to simplify regimes and educate patients on their medical care. Populations exhibiting insufficient compliance that might get the most out of such a paradigm include those with numerous illnesses and cognitive impairments.
Prescribed Medications, Older Adults, Cognitive Impairment, Health
Copyright (c) 2025 Clinical Journal for Medicine, Health and Pharmacy
Drug-Drug Interaction Risk in Polypharmacy: A Case Study-Based Approach in Elderly Care
Despite the implications for patient safety and the increased occurrence among older patients, prior research has not examined Drug-Drug Interactions (DDIs) concerning the medical treatment of senior mental patients. To detect possible DDI and polypharmacy (PP) in prescriptions for elderly inpatients with mental illnesses and to analyze relevant characteristics. The present retrospective cross-sectional research examined the medical records of 94 hospitalized individuals over 60 years old diagnosed with mental illnesses and given various drugs. Drug medications were verified at admission, at the midpoint, and during the final prescription review. Multivariable logistic regression (LR) assessment evaluated variables related to the incidence of DDIs. The theoretical prevalence of DDI was 68.1% at enrollment, 75.6% halfway through hospitalization, and 81.2% at the final prescription. Most of the prescription medications were medicines affecting the neurological system. A significant proportion of severe and potentially prohibited DDIs occurred. Individuals aged 60 to 70 years, those using cardiac and pulmonary treatments, and the total number of prescriptions substantially contributed to DDI. Understanding the aspects related to DDI among individuals with mental illnesses might enhance the efficacy and safety of nursing treatment
Drug-Drug Interaction, Polypharmacy, Elderly Care, Health
Pharmacokinetic Modeling of Drug Absorption in Elderly using a Two-Compartment Algorithm
Physiological changes with age profoundly affect drug absorption, distribution, metabolism, and excretion in the elderly population. This paper describes a pharmacokinetic model based on a two-compartment algorithm for defining the drug absorption kinetics in older people. The model encompasses key variables associated with aging, including diminished gastrointestinal motility, altered plasma protein binding, and reduced hepatic and renal clearance. Parameters were fit on clinical pharmacokinetic information for geriatric drugs of frequent prescription. The two-compartment model accurately mimics the central and peripheral distribution of the drug, enabling a precise study of the absorption phase and systemic availability. Simulation by the model indicates a delayed time to absorption and a delay in peak plasma concentration in the elderly population compared with young subjects. Sensitivity analysis confirms that even minimal variations in the rate constants of absorption or clearance values may considerably influence therapeutic performance. These results emphasize the importance of adjusting doses by age and advocate the use of compartmental models to improve the design of more effective and safer pharmacotherapy for the elderly. The model is a valuable tool for geriatric drug discovery and clinical optimal dosing.
Pharmacokinetics, Two-Compartment Model, Drug Absorption, Elderly, Geriatric Pharmacology, Bioavailability, Dose Optimization.
Pharmacokinetics of Antihypertensive Drugs in Geriatric Patients: A Systematic Review
Hypertension (HT) is a prevalent comorbidity that facilitates the onset of several cardiovascular illnesses in aged individuals. HT has been linked to cognitive deterioration (CD) and alzheimer. Cognitive Impairment (CI) results in heightened morbidity and death in older people with HT. Prior research examining the relationship among blood pressure (BP), BP variability (BPV), HT medication use, and the risk of dementia in senior hypertensive individuals has shown conflicting results. Considering the worldwide prevalence of high BP, the aging demographic, and the diminished quality of life linked to dementia, an increased awareness of the relationship between HT and dementia is essential. This review synthesizes the preclinical data and clinical studies about the relationship between BP management, variability, antihypertensive (AH) medication use, and CI performance. The research specifically focused on the distinctions among groups of HT medications. The study determined that the relationship between BP and the risk of memory loss is non-linear and age-dependent. Intensive BP regulation is often not advised, especially for older people. Elevated BP variability and the features of orthostatic HT in older people heighten the risk of mental deterioration. The existing data does not indicate that any one class of AH drugs is more effective than others in avoiding dementia in older people with HT.
Antihypertensive Drugs, Geriatric Patients, Review, Hypertension
Measurement of Pain Response in Geriatric Dentistry using the COMFORT Behavioral Algorithm
Geriatric dentistry is strongly encouraged to assess pain accurately in patients with compromised cognition, difficulties in communication, and sensory changes commonly associated with the elderly. Based on this, this paper proposes an AI system that utilizes the COMFORT Behavioral Algorithm, initially developed for assessing pain in non-verbal pediatric patients, to quantify pain in elderly patients undergoing dental treatment. A real-time observational system tracked facial, postural, and vocal cues, processing them to identify behavioral traits such as alertness, calmness, muscle tone, and facial tension. They were weighed and normalized into a COMFORT Score, and a logistic regression model predicted the probability of pain occurrence. Clinician feedback in real-time and automatic pain scoring were enabled through the system architecture. Results in 60 patients indicated that facial tension and muscle tone were the most predictive indicators of pain, and the model was found to be highly consistent with human expert ratings, with an RMSE of 0.41. This research supports the viability of AI-facilitated behavioral scoring to enhance evaluation and treatment of pain in non-verbal elderly populations.
Geriatric dentistry, Pain Assessment, Comfort Behavioral Algorithm, Artificial Intelligence, Facial Analysis, Logistic Regression, Non-Verbal Patients.
Prevalence and Impact of Polypharmacy in Elderly Patients with Chronic Conditions
The prolonged use of several drugs in older individuals with chronic conditions presents significant medication-related issues, severely diminishing their quality of life. The cost of drugs significantly influences patients' perceptions, actions, and illness outcomes regarding their treatment. It alleviates the cost of medicines for patients. The medication concerns provide a fresh viewpoint. This research sought to use the form of the Clinical Life with Medicines Questionnaire-3 (CLMQ3) to assess the medication burden among older patients with chronic illnesses and to analyze the demographic features of sub-populations experiencing a high medication burden. The survey was administered to senior patients aged 60 years and older with chronic diseases taking five or more medications. CLMQ3 ratings and area scores were analyzed for the features of the elderly individuals using descriptive data and statistical tests. A total of 435 answers were evaluated, with individuals aged 60 to 90 years, yielding an average lifespan of 74.6 years. Most respondents were female and had a middle school education. 55.2% of those surveyed resided solely with a spouse, 15.1% cohabited with parents and kids, and 11.4% lived isolated. Regression analysis revealed that elevated CLMQ3 scores correlated with those possessing a poor educational background, aged 60-68 years, via ≥ 11 medications, administering medications ≥ 3 times daily, earning a monthly salary ($) ≤ 3500, and incurring greater monthly out-of-pocket pharmaceutical expenses ($) ≥ 350 (p < 0.02). The burden was influenced mainly by financial constraints, apprehensions about medications, and a deficiency of autonomy in managing medication regimens. This research provides early data indicating that older patients who suffer from chronic illnesses should be mindful of the financial burden of various drugs, as this mitigates drug-related issues; middle-aged individuals experience a greater medication load. Healthcare practitioners must prioritize the assessment and identification of these individuals and develop appropriate intervention techniques to guarantee regular use and continuous administration of medications for older adults with polypharmacy.
Polypharmacy, Elderly Patients, Chronic Conditions, Medication.
Evaluation of Toothbrushing Techniques Using the Modified Bass Technique Algorithm
To prevent gum disease, periodontal disease, and tooth decay, it is essential to maintain good oral hygiene. There are several ways to brush your teeth, but the Modified Bass Technique (MBT) is widely regarded as the gold standard for removing plaque from the gum line and beyond. However, people still struggle to execute it consistently due to its complexity. To compare the efficacy of MBT with that of conventional brushing techniques, this research proposes a combined clinical and algorithmic methodology. Fifty preclinical dentistry students were separated into two groups: one that received MBT and another that received a control. After 28 days, the students included in the trial were followed up. After completing structured training, participants in the MBT group underwent clinical evaluations, as well as assessments utilizing a rule-based approach that incorporated video analysis and a Random Forest classifier. The results demonstrated that the MBT group experienced significantly lower ratings for plaque and gingival bleeding (p < 0.01), especially in areas between the two joints. Scores for method adherence reported by the algorithmic evaluation were consistent with those of clinical examiners. To improve oral hygiene practices and provide objective assessment models for brushing technique quality, these findings advocate the use of structured MBT training and algorithmic feedback.
Modified Bass Technique, Toothbrushing Evaluation, Oral Hygiene, Dental Plaque, Algorithmic Assessment, Random Forest Classifier, Gingival Health.
Sleep Quality and Mental Health Correlation in Institutionalized Older Adults
Sleeping difficulties often occur in the senior population. A primary sleeping disorder arises from the physiological deterioration associated with age; conversely, subsequent sleeping issues stem from several factors related to physical and mental health. The current study seeks to elucidate the relationship between sleeping habits and mental wellness in aging, focusing on how various factors typically linked to sleep, such as cognitive and physiological elements, as well as medications for sleep, forecast low levels of sleep across multiple phases of life. The researchers performed many analyses (ANOVAs, Pearson correlations, and linear declines) to evaluate the study's hypotheses. Among a cohort of 180 respondents (comprising old, middle-aged, and young people), 143 people exhibiting poor sleeping habits were identified. Distinct prognostic patterns appeared among the three groups. The use of sleeping medicine linked to deteriorated sleeping circumstances is anticipated by inadequate sleeping quality in older people and by depression in young individuals. Conversely, worsening sleeping quality is forecasted by sadness in middle-aged individuals. This investigation is the first to analyze the characteristics of insufficient sleep in aging, contrasting with previous research that concentrated on changing from excellent to poor sleeping duration and varying sleeping habits over the lifetime. This data needs to be evaluated from a preventative standpoint.
Sleep Quality, Mental Health, Older Adults, Aging.
Dosage Adjustment in Polypharmacy Management using Age Specific PK Simulation Algorithms
Polypharmacy in older people is an important clinical issue with drug pharmacokinetic changes associated with aging that enhance the risk of adverse drug effects and loss of therapeutic efficacy. In this hypothesis, a model-informed precision dosing (MIPD) approach is assumed, utilizing age-scaled pharmacokinetic (PK) simulation algorithms to personalize drug therapy in the management of polypharmacy. Clinical information was collected from older people and used to estimate crucial PK parameters such as clearance and volume of distribution. Simulations were run to predict patient-specific drug concentration-time profiles for five drugs of frequent use. Dosage adjustment was then suggested based on simulated systemic exposure (AUC and Cmax) and confirmed against the observed results. The outcomes showed that more than 70% of the patients needed dose adjustment, especially for kidney-excreting or minimally clear drugs. A large number of patients achieved therapeutic targets after adjustments with simulation, validating the model's utility. These results promise well for future age-adjusted PK modeling to reduce drug toxicity and maximize the safety and efficacy of treatment in multimorbid elderly patients.
Polypharmacy, Geriatric Pharmacotherapy, Age-Specific Pharmacokinetics, Model-Informed Precision Dosing (MIPD), Pharmacokinetic Simulation, Dosage Optimization, Clinical Decision Support Systems.
Role of Physical Activity in Reducing the Risk of Multimorbidity Among the Elderly
Engagement in physical activity has shown positive impacts on the health of those with chronic illnesses. Information on the correlation between multimorbidity (MM) and exercise is scarce. To examine the correlation between chronic diseases, MM, and inadequate physical activity amongst older persons, categorized by sex. This research is a cross-sectional, population-based, and household-based analysis from the Ageing Cohort research wave. The deficiency of exercise (results) was determined using the extended form of the International Physical Activity Survey (≤ 150 min/week). Eleven expressed chronic illnesses were discovered. MM was characterized by the quantity of chronic diseases present (none, 2 or 3, or four or more). The adjustment factors were age, education, relationship status, revenue, smoking habits, alcohol intake, and cognitive function. Each chronic illness was controlled for the others. Relationships were evaluated via logistic regression analysis (both crude and modified). Of the 1200 individuals under 64, women (55.0%) were more likely to be inadequately active than males (40.1%). In the modified study, those exhibiting signs of depression, both women and men, as well as males with diabetes, had a higher likelihood of being inadequately active compared to those without such symptoms. Women with MM had a higher likelihood of inadequate physical activity, with the impact being most pronounced for four or more disorders. This research demonstrates that the relationships were exclusive to sex. Feelings of depression and MM correlated with inadequate exercise in women, while diabetes was linked to a lack of exercise in males.
Physical Activity, Multimorbidity, Elderly People, Risk.
Assessment of Oral Health in Geriatric Patients Using the OHAT Evaluation Framework
The growing geriatric population worldwide poses a significant challenge in administering appropriate oral care. The present study evaluated the oral health status of geriatric patients using the Oral Health Assessment Tool (OHAT), a standardized evaluation tool used to measure several parameters of oral health in the elderly. The investigation was among geriatric populations living in community and institutional settings. With the OHAT model, assessments were conducted on lips, tongue, gums and tissues, saliva, natural teeth, dentures, oral cleanliness, and dental pain using a systematic approach. The research aimed to determine common oral conditions, their correlation with systemic diseases, and whether regular oral examinations were still an effective practice in managing the elderly. The results reveal a high incidence of oral issues, including dry mouth, gum inflammation, and poor denture hygiene, necessitating targeted interventions. Furthermore, the research highlights the need for routine adoption of OHAT screening as a standard protocol in geriatric care to ensure early diagnosis and improve overall quality of life. The results advocate for greater training of carers and oral health services in all aged care centers. Overall, this research emphasizes the whole-person, preventive care of older adults' oral health.
Oral Health, Geriatric Patients, OHAT, Dental Assessment, Elderly Care, Preventive Dentistry, Oral Hygiene.
Functional Oral Assessment in Long Term Care Facilities Using the CIRS Stratification Algorithm
According to the American Dental Association, functional oral health is important to the well-being and quality of life of people living in long-term care (LTC) settings. Nevertheless, standardized assessment tools to measure and manage oral function among LTC residents have yet to be appropriately developed. This study examined the feasibility of using the Cumulative Illness Rating Scale (CIRS) stratification algorithm to provide functional oral health assessment for this population. We aimed to utilize the CIRS medical complexity data, in conjunction with functional measures of oral health, including the ability to masticate, swallow, and wear dentures, to identify residents at a higher risk of oral dysfunction, thereby prioritizing the provision of dental care. To examine both 'traditional' oral health assessments and the CIRS stratification approach, a cohort of LTC residents was recruited. As expected, we found that those with higher CIRS scores correlated with impaired oral function, indicating CIRS algorithm merits use for predicting oral health decline. By doing so, resource allocation for oral health care across the spectrum of LTC will be more focused and efficient for this medically complex population. The CIRS algorithm can be incorporated into the evaluation process and integrated into existing assessment protocols for the purpose of improving oral health outcomes, mitigating complications of malnutrition and/or aspiration, and ultimately improving the quality of life for institutionalized older adults. Future research should investigate the validity and reliability of this approach in other healthcare settings and with diverse populations.
Functional Oral Assessment, Long-Term Care, CIRS (Cumulative Illness Rating Scale), Stratification Algorithm, Oral Health, Geriatric Dentistry, Risk Identification.
Drug Interaction Profiling in Aging Populations Using Compartmental Pharmacology Models
Older people often have chronic illnesses and take multiple medications, which makes them more at risk of experiencing harmful impacts from drug interactions. This research examines the profiling of drug interactions in elderly patients using compartmental pharmacology models, which simulate the ADME (absorption, distribution, metabolism, and excretion) processes of drugs within the body. The study employed a multi-compartmental approach to capture age-related changes, such as decreased hepatic clearance, altered renal function, and shifts in body composition, that affect drug distribution and pharmacokinetics. Key pharmacokinetic parameters were obtained from clinical metrics, and simulations were conducted to analyze drug-drug interactions (DDIs) in commonly prescribed classes, including antihypertensives, antidiabetics, and central nervous system (CNS)-active drugs. Model outcomes revealed that aging significantly prolongs drug half-life and alters peak plasma concentrations, heightening the risks of toxicity and subtherapeutic attenuation. Furthermore, interaction profiles exhibited both synergistic and antagonistic effects based on the drug combinations and physiological conditions. The research underscores the importance of compartmental models for predicting geriatric specific DDIs and advocates for their use in personalized medicine aimed at improving prescribing safety. Incorporating pharmacological modeling alongside clinical perspectives provides a foundational framework for evaluating drug interactions among the aging population, improving therapeutic strategies, and reducing unintentional adverse drug reactions.
Drug Interaction, Profiling, Aging Populations, Compartmental Models, Pharmacokinetics, Pharmacology, Simulation.
Salivary Flow Measurement for Xerostomia Diagnosis Using a Schirmer Based Algorithm
Xerostomia, or dry mouth, is a condition that can result from various medical conditions, certain medications, or even radiation therapy, often to the detriment of the patient's oral and overall health. For effective intervention in xerostomia to occur, a timely and accurate diagnosis is necessary. The study examined a new approach to measuring salivary flow rate that employs a Schirmer-based method, which comes from ophthalmology and the measurement of tear production. Through oral modification of the Schirmer strip, we describe a standardized method for estimating the rate of salivary secretion using calibrated absorption with time. Some variables take into account the length of strip saturation, time interval, patient symptoms, and others, for the quantitative measurement of salivary gland function. In a validation study involving subjects with and without xerostomia, the Schirmer-based method for estimating salivary flow rate was found to have high sensitivity and specificity when compared to formal sialometry. The technique is easy, inexpensive, and does not require a single physical space; therefore, it can be performed from the patient's bedside or remotely, making it practical in low-resource environments. The application of algorithmic assessment also enhances the accuracy and reliability of the diagnosis. This represents a significant advance in terms of a straightforward tool for initial and ongoing measurement of xerostomia, as it is likely to help enhance patient care through more timely interventions. Ongoing research aims to refine the algorithm and demonstrate its applicability in various population groups and clinical settings.
Salivary Flow, Measurement, Xerostomia, Diagnosis, Schirmer Strip, Algorithm, Non Invasive.
Frailty, Nutrition, and Cognitive Decline: A Cross-Sectional Study in Geriatric Populations
The human population is now aging at an accelerated rate. This results in increased dependence rates and necessitates the adaptation of health and social services to accommodate the aging population. This population has acquired frailty (FR) as one of its modifications. It is characterized as a clinically identifiable condition associated with the aging of many bodily functions, resulting in vulnerability. The genesis of FR seems multifaceted, with its pathophysiology shaped by the interplay of several variables. The research identifies four primary pathways that induce FR: atherosclerosis, sarcopenia, Cognitive Decline (CD), and malnutrition, together with their associated metabolic changes. Malnutrition correlates with cognitive impairment and functional decline; yet, it is recognized that insufficient food intake contributes to CD. Nutritional variables that affect vascular risk factors might impact the decline of dementia in people with cognitive FR. This study seeks to elucidate the dietary aspects investigated so far that contribute to the onset of FR, particularly CD.
Frailty, Nutrition, Cognitive Decline, Geriatric Populations
Risk Evaluation of Dental Erosion Using the Basic Erosive Wear Examination Scoring Method
Dental erosion — defined as the progressive loss of hard dental tissue due to chemical wear, excluding bacterial involvement — has recently become a significant concern in oral health. The Basic Erosive Wear Examination (BEWE) scoring system provides clinicians with a systematic and practical method to assess the extent and pattern of erosive tooth wear in clinical settings. The purpose of this study was to evaluate dental erosion risk using the BEWE index method among patients with varying dietary habits, oral hygiene practices, and systemic health conditions. A thorough clinical examination was conducted for all individuals, and they were classified according to their BEWE scores, which determined the level of erosion severity and risk level. The results demonstrated a strong relationship between high acid dietary consumption, brushing common mistakes, and high BEWE scores. The erosion risk was significantly related to GERD and eating disorder patients, who had higher erosion levels than those with other aetiologies. BEWE was beneficial in early detection, enabling clinicians to make a timely diagnosis and implement effective preventive and therapeutic modalities. This work reinforces the importance of routinely assessing erosive wear and promoting BEWE as a practical and evidence-based diagnostic method for understanding the progression of dental erosion. When BEWE is incorporated into the routine dental examination, it may improve early intervention, reduce long-term adverse health consequences, and promote individualized education and management of patients to control erosion progression.
Dental Erosion, Risk Evaluation, BEWE, Tooth Wear, Oral Health, Erosive Lesions, Clinical Assessment.
Effectiveness of Tele-Dentistry in Managing Oral Health of the Elderly in Rural Areas
A significant prevalence of unaddressed oral health requirements is prevalent among the older population. In an aging society severely impacted by the coronavirus, a global epidemic, formulating novel ways to improve overall and oral health is essential for fostering healthy aging. This systematic study aims to evaluate the viability of Teledentistry (TD) in community or home settings for elderly individuals. A thorough and organized investigation was conducted across key digital libraries for papers published in English: PubMed, Cochrane Libraries, Web of Science, Scopus, etc. Thirteen articles were discovered using a search of databases employing various keyword permutations. Of the 12 publications, eight abstracts were evaluated for alignment with the study's objective, and the complete texts were obtained. After abstract evaluations, seven papers were chosen for further examination. Out of them, six were evaluated for qualification. Four papers focused on assessing the experiences of clients and healthcare practitioners regarding TD, three investigations provided a cost evaluation and overview of TD in nursing homes, and two studies examined TD's potential benefits and accuracy for diagnosing dental pathological conditions. Integrating TD in aged-care institutions and home-assistance services is a practical solution for managing oral care for those unable to access dental services.
Tele-Dentistry, Oral Health, Rural Areas, Elderly People.
Impact of Salivary Biomarkers on Early Detection of Periodontitis in Geriatric Patients
The study aimed to assess the accuracy of salivary matrix metalloproteinases (MMPs)-8 and -9, as well as tissue inhibition of MMP (TIMP)-1, in the diagnosis of periodontal disease and in discriminating between stages S1 to S3 of the condition. This research was a case-control study, including those with healthy periodontia and those with stages S1 through S3. Saliva was collected; next was the clinical data collection, including medical attachment degree, probe pocket dimension, and plaque measure. Radiograph evaluation of the alveolar bone levels confirmed the medical diagnosis. An enzyme-linked immunosorbent assay was used to evaluate salivary indicators. Enrolled as a comparison were 45 persons total—15 from each phase—and 18 healthy people. All salivary and medical marker concentrations were significantly higher in those with periodontitis than in the control group. With an accuracy range of 0.98 to 1.000, these markers also showed high diagnostic precision in differentiating S1 periodontal from the controls. Including S1 gingivitis, this study found that salivary markers showed notable diagnostic accuracy in separating periodontally healthy from periodontally diseased. TIMP1 differentiates S1 from S3.
Salivary, Biomarkers, Periodontitis, Geriatric Patients.
Oral Sedation Monitoring in Elderly Dental Patients Using the Ramsay Sedation Scale
Oral sedatives are frequently used in geriatric dentistry for relaxation, patient cooperation, procedural concerns, and for potential medically compromised elderly patients requiring more complex dental procedures. Elderly patients are at greater risk for sedation complications due to physiological changes related to aging, pre-existing comorbidities, and polypharmacy. Monitoring sedation can help manage unexpected sedation levels and also identify potential safety concerns. The Ramsay Sedation Scale (RSS) is a reliable and straightforward clinical guide that provides a standard assessment and documentation of sedation levels in real-time. This study investigates RSS as a tool for applied sedation monitoring in the context of oral sedation for elderly dental patients. For our research, we identified elderly patients aged 65 years and older who were undergoing dental treatment with oral sedatives. Participants were followed using RSS scale modifications at regular intervals, both preoperatively, intraoperatively, and postoperatively. We assessed the depth of sedation of the participants, adverse events related to sedation, and the satisfaction of the clinician utilizing RSS. The study's findings indicated that RSS is capable of providing consistent and easily understandable assessments that correlate with clinical observations. The majority of patients achieved moderate sedation (RSS 3–4), which enabled successful treatment while ensuring patient safety. The use of RSS enabled the recognition of oversedation more quickly, allowing for faster intervention and treatment. Practitioners reported greater confidence in managing sedation issues and in interprofessional communication within healthcare teams. In summary, the Ramsay Sedation Scale is an appropriate non-invasive for monitoring oral sedation in elderly dental patients, representing enhanced safety and control in geriatric dentistry for sedation practices.
Oral Sedation, Monitoring, Elderly, Dental Patients, Ramsay Sedation Scale, Geriatric Dentistry, Sedation Assessment.
Comparative Evaluation of Remineralizing Agents on Early Enamel Lesions in Older Adults
This research evaluated and contrasted the efficacy of three distinct remineralizing treatments (Tricalcium phosphate (TCP) paste, Fluoride coating, and Nano-hydroxyapatite gel) with the instrument. The current clinical investigation was conducted on the first 90 carious lesions identified using caries diagnosis guidelines, followed by a baseline recording with the instrument. The chosen initial severe lesions were randomized and categorized into three categories based on treatment methods, with 30 lesions in each category, with the following remineralizing drivers: category A, group B (fluoride varnishes), and category C (nano-hydroxyapatite gels). The remineralizing chemicals were administered for four minutes biweekly for four weeks. During five weeks, the DIAGNO-dent ratings of primary carious lesions were documented to assess the impact of restoring medications. A paired t-test was employed to compare foundation data and follow-up ratings. A one-way Analysis of Variance (ANOVA) was performed to analyze results between all three categories. Post-Hoc Tukey testing was conducted to assess the substantial distinction among every category. Significant variations were seen between the three categories at follow-up (p = 0.001). Within every category, there was an essential difference between baseline and final follow-up grades (p = 0.000 for the three categories). Comparative analyses between each pair of groupings revealed a substantial difference in follow-up records among nano-hydroxyapatite and varnish with fluoride concerning pit and fissure cavities, with nano-hydroxyapatite demonstrating superior efficacy.
Remineralizing Agents, Enamel Lesions, Older Adults, Review.
Comparative Study of The Safety and Efficacy of Different Anticoagulation Regimens in Patients with Atrial Fibrillation Undergoing Coronary Artery Bypass Grafting
Atrial fibrillation (AF) is common in patients after coronary artery bypass grafting (CABG), and anticoagulant treatment is crucial to avoiding thromboembolic consequences. to assess the efficacy and safety of several anticoagulation therapies, such as warfarin, low molecular weight heparin (LMWH), unfractionated heparin (UFH), and novel oral anticoagulants (NOACs), in AF patients undergoing CABG. Patients with AF receiving CABG at a tertiary care facility were included in this retrospective cohort research. Based on their anticoagulant protocol, the patients were split up into four groups. The groups were compared for safety outcomes (thromboembolic events, bleeding complications) and efficacy outcomes (myocardial infarction, stroke, and mortality). The study involved 100 patients in total. The findings demonstrated that, in comparison to warfarin, NOACs were linked to a decreased risk of bleeding problems (p<0.01). The safety profiles of UFH and LMWH were comparable. The four groups' efficacy results were comparable. According to this study, NOACs might be a safer option for AF patients having CABG than warfarin. To validate these results and assess the cost-effectiveness of various anticoagulation regimens, more research is required.
Coronary Artery Bypass Grafting, Atrial Fibrillation, and Quality Enhancement.
Copyright (c) 2024 Clinical Journal for Medicine, Health and Pharmacy
Investigating the Role of MicroRNAs in The Pathogenesis and Progression of Hepatocellular Carcinoma
The primary regulators of the cellular pathways implicated in virus-induced pathogenesis include a variety of host factors, including proteins and microRNAs (miRNAs). Numerous secretory chemicals that are secreted from virus-infected cells aid in cell-to-cell communication and foster a microenvironment that promotes cellular pathogenesis, both of which advance the course of the disease. One of the main parts of secretive substances is exosomes. They are the small extracellular vesicles, secreted out by the cells and have a significant role in cell-to-cell signaling. They typically represent the state of the cell and are made up of several host components such as cellular proteins, lncRNAs, mRNAs, and miRNA. Exosomes, which are vesicles that originate inside cells as multivesicular bodies and are ejected from the cell upon fusion with the cell membrane, will exhibit any changes in the composition of the cell. All things considered, the work shows that exosome proteins and miRNA may play a part in host response and viral tactics, which may together accelerate the course of the disease and provide new targets for potential treatment.
Microrna, Hepatocellular Carcinoma, Pathogenesis, Biomarker, Therapeutic Target.
Clinical and Histopathological Analysis of the Efficacy of Immunotherapy in Treating Advanced Melanoma
There are few choices for treating advanced melanoma, which is a terrible disease. Although immunotherapy has shown promise as a treatment, further research is needed to determine its safety and effectiveness in treating metastatic melanoma. to examine the histopathological alterations linked to immunotherapy treatment, as well as the clinical effectiveness and safety of immunotherapy in the treatment of advanced melanoma. An analysis of a retrospective cohort of adult patients at a tertiary care cancer center who received immunotherapy for advanced melanoma. To assess treatment outcomes and look at the connection between tumor immune microenvironment and clinical outcomes, clinical and histological data will be gathered and examined. In addition to identifying potential indicators for treatment response, this study attempts to shed light on the safety and effectiveness of immunotherapy in the treatment of advanced melanoma. The results of this study will help create individualized treatment plans for individuals with advanced melanoma.
Advanced Melanoma, Histopathological, Biomarkers.
Pharmacist-Led Medication Therapy Management: A Review of Its Effectiveness in Improving Patient Outcomes
Cardiologists at the HF facility got exhaustive prescription survey notes as a component of the HF drug specialist medicine audit administration. 64 mediation patients who had a drug specialist prescription survey and 64 control patients who didn't got an earlier drug specialist audit had their graphs looked into reflectively. The quantity of DRPs found per patient in the mediation bunch fourteen days following the drug specialist prescription audit was the principal result, and it was contrasted with the number found per patient in the benchmark group. Following the scientific expert mediation, the mean DRPs per patient in the mediation bunch dropped from 2.80 to 1.95. The mean DRPs for every patient in the control and mediation bunches were 2.55 DRPs per patient versus 1.95 DRPs per patient, separately, with a genuinely massive distinction (P = 0.016). Drug adherence (78%), renal meds (67%), hypertension (58%), and cardiovascular breakdown DRPs (55%) had the best endorsement rates.High-influence DRP ideas made up the larger part in both the mediation (87%) and control gatherings (87%) gatherings.
Medication, Drug-related Problems, Pharmaceutical.
Synthesis and Characterization of Novel Nanoparticles for Targeted Cancer Therapy
The use of nanoparticles in carrier-drug systems improves tumour inhibition and lowers drug-related side effects, according to recent studies on silver nanoparticles. The fusion of conventional medicine with nanotechnology presents an opportunity to create novel antimicrobial agents concurrently. This work aimed to identify the pro-apoptotic properties, anticancer, and antibacterial properties of silver nanoparticles (AgNPs) and AgNPs-Car, the latter of which were loaded with carboplatin. DLS, EDX-STEM, and FTIR analysis were used to conduct characterisation studies of the synthesised nanoparticles. The outcomes showed that AgNPs-Car effectively targeted C6 glioma cells by encouraging medication entrance into the cell. Additionally, the toxicity was minimal and the anticancer efficacy against MCF-7 and A549 cells was strong. Silver nanoparticles are the favoured material because of their superior quality and ability to improve medication delivery. Consequently, it is a promising field of study for the focused combat of cancer cells and harmful microbes. Silver nanoparticles are the favoured material because of their superior quality and ability to improve medication delivery. Consequently, it is a promising field of study for the focused combat of cancer cells and harmful microbes.
Cancer, Nanomedicine, Targeted Nanoparticles.
Pharmacist-Delivered Interventions on Pain Management: Review and Cluster-Randomized Trial
Pharmacists have played a vital role in the oversight of chronic pain, guaranteeing the optimal use of medication. There is variability in the therapies administered by pharmacists and their effects. Six Internet sources were examined from the start to July 2024 for English-language literature investigating the pharmacist's role in chronic discomfort treatment interventions. Research examining the impact of pharmacist interventions, individually or as part of collaborative groups, on chronic pain treatment was considered. This review encompassed fourteen research with 2400 individuals. Six research studies included randomized controlled experiments, while the others were qualitative research studies in which pharmacists delivered interventions independently or in conjunction with other healthcare providers. The pharmacist predominantly conducted drug evaluations as their primary treatment. The pooled study revealed that pharmacist-delivered therapies decreased pain intensities in people with chronic pain. Pharmacist-delivered opiate management was successful; nevertheless, the intervention's effects on physical well-being, depressive disorders, anxiety, and quality of life yielded mixed findings. The action taken by the pharmacist incurred more costs than the standard therapy. Pharmacists play a significant role in chronic pain treatment by assuring the optimal administration of medication, which leads to decreased pain severity. Additional research with a robust design is required to assess the effects of pharmacist-delivered interventions, either independently or within an integrated group, on economic advantages and other medical results.
Pharmacist, Interventions, Pain Management, Review.
A Systematic Review and Meta-Analysis of Tuberculosis Patients: Perspectives of Pharmacists Towards Sustainability
In resource-constrained environments, national Tuberculosis (TB) control programs heavily rely on foreign funding, jeopardizing program viability. An acknowledged necessity exists for formulating recommendations about the sustainable programming of existing TB control activities. This study aimed to investigate public pharmacists' views on the sustainability of TB control strategies at the leading medical level. Utilizing interpretative epistemology, comprehensive online conversations were performed with ten healthcare pharmacists experienced in resource planning for the TB control strategy. Thematic content evaluation was used as the analytical strategy for the textual material. Three topics were inductively extracted from the thematic review: community participation, participation of stakeholders, and optimal utilization of the Primary Healthcare (PHC) network. Community engagement was a crucial factor in maintaining TB control measures. This was ascribed to the characteristics of the illness and the prevailing health-seeking behavior. Stakeholder participation was linked to financing agreements among public and private entities and deemed crucial for integrating new projects into the established framework. Adequate primary healthcare infrastructure is essential for maintaining present TB control activities at the primary healthcare level. Creating a conducive working atmosphere through legislation, optimizing the use of existing assets, broadening the network of suppliers, implementing inclusive preparation, enhancing investment in research, and promoting affordable screening are essential for continuing TB control programs.
Tuberculosis, Meta-Analysis, Pharmacist, Sustainability.
The Mechanism of Drug – Drug Interactions: A Systematic Review
When the pharmacological or therapeutic effects of one drug are changed by the presence of another, this is known as a drug-to-drug interaction (DDI). Because they affect the effectiveness and safety of pharmacological therapy, these interactions are crucial factors to take into account in clinical practice. To maximise treatment benefits and reduce side effects, it is crucial to comprehend the mechanisms behind these interactions. In polypharmacy circumstances, such as in elderly individuals or those with chronic disorders like cancer and cardiovascular diseases, drug-drug interactions were most common. The review highlights the significance of pharmacogenomics and personalised medicine in identifying patients at higher risk of drug-metabolizing enzyme-related infections (DDIs). The major mechanisms of drug-drug interactions (DDIs) are the subject of this study, which focusses on pharmacokinetic, pharmacodynamic, and combination pathways. This review aims to provide insights into the clinical importance of DDIs and suggestions on how to manage them successfully in practice by summarising the available research.
Drug to Drug Interactions, Pharmacological Therapies, Pharmacokinetic, Pharmacodynamic Pathways.
Exploring Barriers to Medication Adherence Among Patients with Chronic Diseases
An concerning rise in the prevalence of chronic illnesses worldwide has coincided with rising life expectancy and global population ageing. Physical or mental disorders that endure longer than a year and necessitate continuous care are typically classified as chronic diseases. They jeopardise people's ability to perform both physically and socially, their quality of life in relation to their health, and the long-term financial viability of healthcare systems. Chronic diseases are currently a public health concern due to their extraordinary global prevalence in various populations. Medication adherence is the act of taking medication as prescribed by a medical professional. In order to increase medication adherence, a socio-ecological model was applied to this study, which identifies multilayer elements pertaining to medication adherence obstacles in chronic disease and furnishes data for the development of scientific health communication interventional techniques. Suboptimal drug adherence and discontinuations of therapy remain the most frequent reasons why various diseases are poorly managed in the population. The primary problem is that doctors don't have enough time or resources to identify patients who don't comply to their treatment plans. The purpose of this study was to investigate medication adherence difficulties in individuals with long-term illnesses.
Medication Adherence, Socio-Ecological Model, Barriers of Medicaion Adherence.
The Role of Pharmacists in Optimizing Medication Regimens for Patients with Polypharmacy
In order to maximise pharmaceutical regimens, reduce polypharmacy risks, and enhance patient outcomes, clinical chemists are in a unique position. Various facets of medication management fall under your purview, such as treatment, medication monitoring, and medication reconciliation. Clinical chemists and healthcare professionals work together to optimise prescription regimens, identify potential drug interactions, and customise treatment programs to meet the needs of each patient through collaborative practice agreements and interdisciplinary teamwork. Thus, there is compelling evidence to support the use of chemists in the provision of geriatric care to lessen polypharmacy and its clinical consequences, including hospitalisations, urgent or emergency room visits, medication errors, non-adherence, and adverse drug reactions. Due to the high rate of ADR recurrence, patients and the general public must bear a heavy financial burden and extended hospital stays. All social health professionals must collaborate to create clear and unambiguous evidence and, when necessary, report adverse drug reactions to pertinent intra-company, regional, or national surveillance authorities in order to lessen the impact and consequences of adverse drug reactions related to fear, mortality, and costs. To raise the frequency of adverse drug responses to medications, several nations have put in place pharmacovigilance programs. Voluntary ADR Reporting Systems (SADRRS) have also been expanded and implemented in a number of nations.
Clinical Pharmacists, Medication Regimens, Drug Therapy, ADR Reporting System.