Drug reprofiling history and potential therapies against Parkinson's disease.

Given the high whittling down rates, high costs, and moderate pace of new medication, revelation, and improvement, repurposing "old" drugs to treat typical and uncommon illnesses is progressively becoming an appealing proposition. Drug repurposing is the way toward utilizing existing medications in treating diseases other than the purposes they were initially designed for. Faced with scientific and economic challenges, the prospect of discovering new medication indications is enticing to the pharmaceutical sector. Medication repurposing can be used at various stages of drug development, although it has shown to be most promising when the drug has previously been tested for safety. We describe strategies of drug repurposing for Parkinson's disease, which is a neurodegenerative condition that primarily affects dopaminergic neurons in the substantia nigra. We also discuss the obstacles faced by the repurposing community and suggest new approaches to solve these challenges so that medicine repurposing can reach its full potential.

Bicarbonate Therapy in Renally Compromised Critically Ill Patients with Metabolic Acidosis: Study of Clinical Outcomes and Mortality Rate.

BACKGROUND: Metabolic acidosis is the most frequent medical condition occurring in critically ill renally compromised patients. This study was aimed to determine clinical outcomes of bicarbonate therapy in renally compromised critically ill patients having metabolic acidosis. METHODS: A prospective longitudinal cohort study was undertaken in three military hospitals in Rawalpindi, Pakistan. All patients fulfilling the inclusion criteria who were admitted to the ICU of any of the three study hospitals from July 2019 to March 2020 were studied for clinical outcomes of bicarbonate therapy using an evidence-based clinical checklist. Outcome measures include changes in blood pH, serum potassium, and sodium levels, blood pressure and weight, along with other clinically significant laboratory parameters. RESULTS: Eighty-one patients fulfilling the inclusion criteria were evaluated. The mean age of the patients was 55.61±19.5 years, while the mean weight was 63.43±14.19 Kg. A mortality rate of 45.7% was observed. Disease-related complications including hypoxia, cardiac failure, multiple organ failure, elevated blood pressure, and ischemic heart disease (IHD) were found to be associated with a higher mortality rate (P<0.005). Whereas using Fisher's exact test, concomitant administration of sodium chloride, along with bicarbonate therapy was associated with a low mortality rate and had no significant impact on sodium loading or weight gain. Moreover, various drug-drug interactions were found to be associated with a higher mortality rate (P<0.05). CONCLUSION: Bicarbonate therapy was not found to affect the mortality rate in critically ill renally compromised patients with metabolic acidosis.

Evaluation of myocardial injury patterns and ST changes among critical and non-critical patients with coronavirus-19 disease.

Novel coronavirus disease (COVID-19) has led to a major public health crisis globally. Currently, myocardial damage is speculated to be associated with COVID-19, which can be seen as one of the main causes of death of patients with COVID-19. We therefore, aim to investigate the effects of COVID-19 disease on myocardial injury in hospitalized patients who have been tested positive for COVID-19 pneumonia in this study. A prospective study was conducted among 201 patients with COVID-19 in the Pakistan Military Hospital from April 1 to August 31, 2020, including non-critical cases and critical cases. COVID-19 patients were stratified as critical and non-critical according to the signs and symptoms severity; with those requiring intensive care and invasive mechanical ventilation as critical, and those did not requiring invasive mechanical ventilation as non-critical. A total of 201 COVID-19 patients with critical and non-critical categories presented with myocardial injury. All patients with myocardial injury had an elevation in CKMB and Troponin-I levels. Of these patients, 43.7% presented with new electrocardiography (ECG) changes, and ST depression was typically observed in 36.3% patients. In addition, 18.7% patients presented with abnormal echocardiography findings, with right ventricular dilatation and dysfunction commonly seen among critical group patients. Results analyzed by a logistic regression model showing COVID-19 direct contribution to myocardial injury in these patients. COVID-19 disease directly leads to cardiovascular damage among critical and non-critical patients. Myocardial injury is associated not only with abnormal ECG changes but also with myocardial dysfunction on echocardiography and more commonly observed among critical patients.