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Objectives To display virtual pharmaceutical care programs implemented by pharmacists across the world. Accordingly, a search in PubMed, Scopus and Embase with keywords such as ''Pharmacist', 'Pharmaceutical care', 'Virtual platform' and its associated medical subject headings retrieved appropriate articles. The quality of each filtered article were assessed with the Critical Appraisal Skills Program checklist. Key findings A total of 2 14 841 articles were identified through database screening and 16 articles were extracted and finalized. Twelve papers presented different forms of electronic medical record-based virtual pharmacy systems that had significantly contributed to patient care;minimizing medication errors, rectifying adverse events, modifying drug administration patterns to reduce the fatality of drug-drug interaction and further promoting medication counselling. Nevertheless, few studies had social media platforms for providing clinical pharmacy services that depicted good patient satisfaction. Additionally, we were also able to portray community pharmacies that transformed themselves to provide better and easily accessible pharmaceutical care to their society. There are limited numbers of peer-reviewed articles on pharmacist-operated virtual systems. However, owing to the benefits imparted to patient safety and care by the virtual pharmacy in the era of pandemic, it is highly recommended that more pharmacy professionals contribute and implement such programs in their settings. Prospero Registration ID CRD42022307175.
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Aim: To assess the neurological and mental health responses to pandemic Covid-19. Study design: Cohort study Place and duration of study: Department of Medicine, Chandka Medical College Hospital Larkana and Department of Medicine, Khairpur Medical College Hospital Khairpur Mir's from 1st October 2021 to 31st March 2022. Methodology: Two hundred patients who suffered Covid-19 infection and 200 who had any other life event except Covid-19 were enrolled. All patients who were above 18 years of age and were positive for Covid-19 through reverse transcriptase PCR were included in the study.Global Psych trauma Screening was done by enlisting twenty-two items which assessed trauma related symptoms while five items only assessed the factors increasing risks. Result(s): There were 112 (56%) females and 88 (44%) males in Covid-19 patients and 150 (75%) females and 50 (25%) males in non-Covid patients. The mean age of the Covid-19 patients was 49.65+/-15.5 year while of non Covid patients was 39.02+/-12.01 years. A significant increase in post-traumatic stress disorder (PTSD) cases probability was noted in the Covid-19 cases than non Covid-19 related events. Neurological responses showed that patients who had suffered from Covid 19 infections had a generalized weakness with hyposmia formation. Conclusion(s): Covid-19 is related with high level of depression, anxiety, hyposmia and other mental and neurological responses. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Aim: The world is affected by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) pandemic. This virus has emerged as a human pathogen that can cause symptoms ranging from fever to Pneumonia, but it remains asymptomatic or mild. To better understand the virus's ongoing spread, identify those who have been infected, and track the immune response, accurate and robust immunological monitoring and SARS-CoV-2 detection assays are needed. Methods: The estimation of serology tests to assess the presence of antibodies to SARS-CoV-2 in COVID-19 patients at Asian Institute of Medical Sciences (AIMS) and Isra University & hospital. 1229 patients were selected including males and females with the age being 25 to 65 years living in the territories from 1st August to 30th November 2020. The anti-SARS-CoV-2 test was performed by an electrochemiluminescence immunoassay analyzer. Results: Out of 1229 participants 206 (17%) were positive with COVID-19, and 1023 (83%) were negative. The results further revealed that a higher percentage of positive COVID-19 were detected in males in all age groups as compared to females, and most of them are affected at age of 46-65 years male 40 (24.69%) and female 14(17.5%). Conclusion: The seroprevalence of SARS-COV-2 antibodies has increased in the old age population, which may aid in determining the true number of infected cases. Although the current study is based on a small sample of participants, the findings suggest a study with a larger population to implement stronger and targeted interventions.
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Aims: To assess medical students' perception of online teaching to suggest transforming the future curriculum in low-economic countries. Study Design: Cross-sectional online interview study. Place and Duration of Study: A team of collaborators interviewed final year medical and dental students of Pakistan from 07/08/2020 till 17/09/2020. Methodology: A questionnaire was developed based on open and close-ended questions in Google forms;focusing on institutional preparedness, views on online education, the institute's closure and COVID-19, and long-term effects of closure of the institute. Independent fellow researchers systematically analyzed the unaltered transcripts of the responses, and themes were then identified and coded to conclude the results. SPSS version 23 used for analysis. As this study was based on final year students. Results: In response to an invitation email, 2442/2661 (91.77%) students voluntarily participate in this qualitative study. Most participants were females (1614, 66.10%). Closing down institutes was directly linked to a lack of motivation and feel of helplessness. As most showed dissatisfaction with online teaching compounded by psychological effects, students feared losing clinical skills and life during the pandemic. Conclusion: The psychological impact of the crisis led to resistance to accepting the change for a better outcome. Incorporating telemedicine, different interactive learning style to online teaching, and resilience training would result in fruitful outcomes. Developed countries may also guide build infrastructure in developing countries to develop a more robust online teaching methodology in the long-run.
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Background:AML is predominantly a disease of the elderly, yet outcomes remain dismal, particularly for relapsed/refractory (R/R) AML patients (pts). Gemtuzumab Ozogamicin (GO) is a monoclonal antibody targeting CD33-commonly expressed on AML blasts, and, critically, AML stem cells (LSC)-linked to the cytotoxin calicheamicin. GO resistance mechanisms include (i) decreased/aberrant blast CD33 expression, (ii) p-glycoprotein export of calicheamicin, and (iii) apoptosis resistance due to deficient activation of mitochondrial outer membrane permeabilization, a process highly dependent on BCL-2 expression. GO-induced apoptosis depends on the pro-apoptotic proteins Bax and Bak and is inhibited by overexpression of the anti-apoptotic proteins BCL-2 or BCL-XL. Venetoclax (VEN) is a BH3 mimetic, binding BCL-2, dislodging its binding to Bak/Bax, and thus facilitating apoptosis. LSC overexpress BCL-2, however VEN monotherapy is not effective in AML, as resistance develops rapidly. Hypothesis: VEN targeting of BCL-2 proteins that protect LSC from GO-induced apoptosis will synergistically increase GO efficacy. Correlative studies include pre-treatment AML blast BH3 profiling, CD33 expression (including sequencing for isoforms), and BCL-2, BCL-XL, and MCL-1 protein levels;MRD measurement at post-therapy time points using digital drop PCR technology;and quality of life assessments (EORTC QLQ-C30, FACT-Fatigue) MethodsThis is a single arm, open-label, multi-center (BTCRC), dose-escalation phase Ib study of combination of VEN and GO in R/R AML pts (18-75y), using a 3+3 design. Major eligibility: ECOG 0-2, adequate organ function, CD33+ in ≥ 20% AML blasts, ≤ 3 lines of prior therapy, and no prior use of GO or VEN, previous VOD, BMT within 2 months, CNS disease, or history of HIV. Induction: 3-day VEN ramp-up to the target dose of 200 (cohort i), 400 (ii), or 600 (iii) mg daily x 28 d, with GO 3mg/m2 infused days 1, 4, and 7. If CR/CRi achieved, pts proceed to BMT if applicable, otherwise, if in CR/CRi (provided ANC > 1000, plts > 100K) or PR (regardless of counts), they are consolidated with VEN at the prescribed dose x 28d and GO 3mg/m2 on days 1 and 4 (Cycle 2). If BMT not applicable, and pt remaining in CR/CRi or PR (as above), then proceed to VEN alone as Maintenance in cycles 3+ until progression or toxicity. The primary endpoint is MTD of VEN with GO. Secondary endpoints include ORR, antileukemic activity, characterization of AEs, and estimates of RFS, EFS, and OS. Progress: This study is currently open to its second dosing cohort and has enrolled 5 pts to date. No dose-limiting toxicities have been encountered. However, the COVID-19 pandemic has had a negative impact on enrollment, which is expected to improve as vaccinations expand. ClinicalTrials.gov NCT04070768.