Prescription practices of physicians, quality of care, and patients' safety: A mixed methods comprehensive study.

Objectives: Amidst inconsistent prescribing patterns and potentially harmful medication errors in the field of medical practice, this study endeavored to explore the prescription practices of physicians in Rawalpindi metropolitan city in Pakistan. Methods: A mixed method study was conducted based on the analysis of 1232 prescriptions gathered from 16 pharmacies, along with in-depth interviews with 13 practicing physicians. The prescriptions were assessed for legibility, polypharmacy, patient details, history, diagnosis, and other relevant information. Data were analyzed using descriptive statistics, and the prevalence of various aspects of prescription accuracy was calculated. Thematic analysis was conducted on the qualitative data. Results: Almost half of the prescriptions were from the private general practitioners, and the rest were from hospital-based doctors and consultants. Only a small percentage of prescriptions were fully legible, and many had incomplete or missing patient information, medical history, and diagnosis. Polypharmacy was also found to be prevalent, with significant differences in prescription accuracy across different medical specialties. The absence of continuing medical education, influence of pharmaceutical industry, and overcrowded practice settings drive the doctors to prescription practices. On the user side, perception of polypharmacy, patient-physician communication, and availability and cost of medicines emerged as major themes. Conclusion: There is an obvious need to improve prescription accuracy regarding patient safety on the whole. Increased investment in health-care infrastructure, greater access to continuing medical education, and a commitment to promote evidence-based medicine could make a difference. Prescription practices must be safe, effective, and aligned with the latest advances in medical science.

Gastroprotective evaluation of Medicago sativa L. (Fabaceae) on diabetic rats.

Traditional uses for the plant Medicago sativa (M. sativa) (Alfalfa) (Family: Fabaceae) include liver protection, antioxidant activity, and the treatment of bleeding and digestive issues. This study aims to assess the effect of ethanol extract of M. sativa (EEMS) on experimental-induced ulcers in diabetic rats. By pylorus ligation and ethanol administration, gastric ulcers were induced in diabetic rats. Five groups each consisting of six rats in each model were used. All other groups except Group I were made diabetic by giving rats alloxan (140 mg/kg i.p.). Vehicles were given to Group I (normal control) and Group II (diabetes control) rats. Group III (positive control) received ranitidine 50 mg/kg, and Group IV and V received EEMS at doses of 100 and 400 mg/kg, respectively. In the pylorus ligation and ethanol-induced stomach ulcer model of rats, the findings demonstrated that EEMS (100 mg/kg) showed a decreased ulcer index of 2.01 ± 0.41 and was found statistically significant against the diabetes control group (p < 0.001) as well as, an ulcer index of 0.68 ± 0.22 by EEMS (400 mg/kg) with a significant reduction in the ulcer index (p < 0.001). EEMS (100 and 400 mg/kg) reduce free acidity by 13.16 ± 0.65 mEq/L and 9.83 ± 0.30 mEq/L, respectively. EEMS also showed a protective impact on the liver and kidneys of diabetic rats. Antihyperglycemic action was also discovered in diabetic animals. The findings of the current investigation demonstrated that ethanolic extract of M. sativa possesses anti-ulcer activity in diabetic rats. Ethanolic extract of M. sativa may be a treatment option for stomach ulcers that also have diabetes.

Federated Learning for Medical Image Analysis with Deep Neural Networks.

Medical image analysis using deep neural networks (DNN) has demonstrated state-of-the-art performance in image classification and segmentation tasks, aiding disease diagnosis. The accuracy of the DNN is largely governed by the quality and quantity of the data used to train the model. However, for the medical images, the critical security and privacy concerns regarding sharing of local medical data across medical establishments precludes exploiting the full DNN potential for clinical diagnosis. The federated learning (FL) approach enables the use of local model's parameters to train a global model, while ensuring data privacy and security. In this paper, we review the federated learning applications in medical image analysis with DNNs, highlight the security concerns, cover some efforts to improve FL model performance, and describe the challenges and future research directions.

Therapeutic management of arthritis: A review on structural and target-based approaches.

Inflammation is the natural defense mechanism against any external stimuli in the human body and it saves us from foreign entities that may alter our bodies' normal functioning. Any anomaly in this natural defense system leads to the development of different pathological conditions associated with chronic inflammation like rheumatoid arthritis, osteoarthritis, atopy, asthma, allergic rhino-conjunctivitis, coronary artery disease, cardiac arrhythmias, obesity, insulin resistance and type-2 diabetes, depression, and aging. These disorders impair the quality of life of affected people in different ways. Among these, rheumatoid arthritis and osteoarthritis are the most common chronic inflammation-associated disorders. Different therapeutic strategies are already available for the treatment of rheumatoid arthritis and osteoarthritis, but all with pros and cons. Here, we discuss the emergence of several antiarthritic analogs developed by different researchers which could provide the basis for the evolution of newer therapeutic strategies with better activity and safety profiles.

Effect of ivabradine on heart rate, functional capacity and pulmonary artery pressure in patients of COPD with cor pulmonale.

We studied the effects of heart rate reduction by ivabradine to the ongoing therapy in patients with chronic obstructive pulmonary disease (COPD) and cor pulmonale.100 patients of COPD with cor pulmonale with sinus heart rate ≥ 90 bpm were randomly assigned to either ivabradine 5 mg twice daily (50 patients) or placebo (50 patients) alongwith standard therapy. Assessment was done at baseline and after 6 months which included 6 min walk test (6MWT), dyspnea scoring by modified borg scale, Lung function test by forced expiratory volume in 1 s (FEV1) and pulmonary artery systolic pressure (PASP) by echocardiogram. The drug group showed a significant reduction in heart rate from 95.1 ± 8.2 bpm to 71.1 ± 6.2 bpm (p < 0.001). This group also showed significant improvement in 6-min walk distance and dyspnea on modified Borg scale (p < 0.001) at 6 months follow up. However no significant difference was found between both groups regarding PASP or FEV1 at 6 months.

Spammer group detection and diversification of customers' reviews.

Online reviews regarding different products or services have become the main source to determine public opinions. Consequently, manufacturers and sellers are extremely concerned with customer reviews as these have a direct impact on their businesses. Unfortunately, to gain profit or fame, spam reviews are written to promote or demote targeted products or services. This practice is known as review spamming. In recent years, Spam Review Detection problem (SRD) has gained much attention from researchers, but still there is a need to identify review spammers who often work collaboratively to promote or demote targeted products. It can severely harm the review system. This work presents the Spammer Group Detection (SGD) method which identifies suspicious spammer groups based on the similarity of all reviewer's activities considering their review time and review ratings. After removing these identified spammer groups and spam reviews, the resulting non-spam reviews are displayed using diversification technique. For the diversification, this study proposed Diversified Set of Reviews (DSR) method which selects diversified set of top-k reviews having positive, negative, and neutral reviews/feedback covering all possible product features. Experimental evaluations are conducted on Roman Urdu and English real-world review datasets. The results show that the proposed methods outperformed the existing approaches when compared in terms of accuracy.

In-vitro antifungal efficacy of tissue conditioner-chitosan composites as potential treatment therapy for denture stomatitis.

Tissue conditioners are commonly used to improve the adaptation of ill-fitting dentures. These materials are easily colonized by Candida albicans (C. albicans), resulting in "denture stomatitis". Chitosan and its derivative possess inherent antifungal activity. This study aims to formulate a chitosan-based tissue conditioner and assess its anti-fungal efficacy against C. albicans over time. A chitosan oligosaccharide (COS) was synthesized from commercially purchased chitosan and was characterized by Fourier Transform Infrared spectroscopy (FTIR) and X-ray diffraction analysis (XRD). The minimum inhibitory concentration (MIC) of COS and commercial chitosan against C. abicans was evaluated using broth micro-dilution assay (n = 3). Next, it was incorporated into tissue conditioners and two experimental groups i.e. tissue conditioner modified by chitosan (TC-CH) and tissue conditioner modified by COS (TC-COS) were prepared. The in-vitro antifungal activity of experimental group was compared with a control group (chitosan-free tissue conditioner) by counting numbers of colony forming units (CFUs) (n = 3). The antifungal potential of experimental formulations over time in a simulated oral environment was also evaluated using a spectrophotometry (n = 3). A potent in-vitro antifungal activity against C. albicans was observed. The minimum inhibitory concentration (MIC) of pure commercial chitosan and COS was 0.625 mg/ml and 0.3125 mg/ml respectively. Compared to the control group, experimental groups showed a reduction in number of CFUs of C. albicans density. Once immersed in saliva, the TC-CH retained its inhibitory effect for 24 h, while TC-COS exhibited improved inhibition until the third day, beyond which a gradual reduction in the inhibitory effect was observed. Experimental formulations showed a reduction in C. albicans density compared to the control group. Thus, a novel combination of chitosan and tissue conditioners is a promising alternative for prevention and treatment of denture stomatitis.