Avicenna - Volume 2024, Issue 2

Objective: The objective of this study was to assess the effects of COVID-19 safety measures on outcomes in patients receiving warfarin for cardiac indications at the Heart Hospital’s anticoagulation clinic, Hamad Medical Corporation.

Methods: Two cohort surveys were studied: pre-COVID-19 (December 1, 2018, to February 28, 2019) and post-COVID-19 (April 1, 2020, to June 20, 2020). Collected data included demographics, chronic conditions, warfarin indications, clinic visits, and safety and efficacy outcomes. Thrombotic events and bleeding events were tracked in order to assess the safety of the anticoagulant clinic’s adopted procedures during the COVID-19 pandemic.

Results: Patients who visited the clinic for 3 months before the pandemic were included in the pre-COVID-19 group, while those who visited at the peak of the pandemic in 2020 were included in the post-COVID-19 group. During the pandemic, significant reductions in thrombotic and bleeding events were noted, with a noteworthy increase in time in the therapeutic range. Notable findings included decreased ischemic strokes (13 to 1 case, p-value = 0.022) and reduced major bleeding (9 to 4 cases, p-value < 0.001). Time in the therapeutic range improved from 60% ± 20% to 64% ± 20% (p-value < 0.001). Clinic visits decreased during the pandemic but significantly increased afterward.

Conclusion: COVID-19 safety measures at the anticoagulation clinic were safe and highly effective in optimizing therapy. Larger studies across multiple centers are recommended to further assess the broader safety and efficacy. The study emphasizes the ongoing need for improvements in anticoagulation management during and beyond the pandemic, potentially reshaping future care.

Background: The inability of depressed patients to acknowledge their health status and their resistance to conventional treatments have made depression a global health concern. However, dietary integration of nutraceuticals may be more effective than normal pharmaceutical administration in the treatment and management of depression.

Aim: The aim of this study was to determine the possible role of bioactive components of selected seed oils in the management of depression and the enhancement of testosterone synthesis and secretion in experimental animals.

Methods: Seed oils of Cucumeropsis mannii, Cucurbita moschata, and Sesamum indicum from the farms of the University of Port Harcourt were analyzed for their bioactive compounds using GC–MS. The oils were then administered at different concentrations to adult male Wistar rats and their antidepression parameters, cholesterol, and testosterone concentrations were determined.

Results: Except for noxiptiline in C. moschata seed oil, all seed oils contained saturated and unsaturated lipids, and 9,12-octadecadienoic acid (Z,Z) was the most predominant with percentage concentrations of 71.865, 86.164, and 86.184 in C. mannii, C. moschata, and S. indicum seed oils, respectively. The lowest stress-induced hyperthermia of 0.08 ± 0.00°C was observed at week 3 in animals administered 15.0 ml/kg body weight (BW) of C. moschata seed oil, while the highest swimming, struggling/climbing and lowest immobility times of 5.31 ± 0.40, 8.30 ± 1.25, and 1.40 ± 0.05 min for 10.0, 15.0, and 15.0 ml/kg BW were observed at week 4 in animals administered C. moschata seed oil. Cholesterol and testosterone concentrations were highest at weeks 1 and 4 in animals administered 15.0 ml/kg BW of water and C. moschata seed oil, with values of 3.70 ± 0.20 ml/dL and 8.35 ± 1.26 nmol/L, respectively.

Conclusion: The reduction in depression markers and increase in testosterone levels by C. moschata seed oil are undoubtedly attributed to its noxiptiline content.

Background: The procurement of medicines places a heavy burden on the healthcare budget. The emergence of generic medicines as a low-cost alternative to the more expensive branded drugs has been of considerable help to developing countries such as Mauritius. However, the negative perception of the quality and efficacy of generic medicines has always been a controversial topic.

Objective: This study focused on understanding patients’ perceptions towards the generic drugs available in the public healthcare sector.

Methods: A questionnaire assessing various aspects such as knowledge about generics, beliefs about safety and efficacy of generic drugs, and lack of communication and education about generic medicines was administered to 395 respondents.

Results: A vast majority of the participants (74%) were unaware that the drugs available in public hospitals are generics. Although the respondents believed (76%) that generics were cheaper than branded drugs, they were unaware of the similarity in the composition of generics and branded drugs (55%). Statistically significant relationships were found between demographic factors such as gender, education, and knowledge of generic drugs. Respondents also noted a difference between medicines purchased from private pharmacies and those purchased from public pharmacies. The need to sensitize patient awareness of generic drugs was also identified.

Conclusion: This study was successful in analyzing the factors influencing the knowledge about generic drugs, analyzing the beliefs about safety and efficacy, the perception towards generic medicines in the public and private sectors. Strategies need to be developed to inform healthcare professionals and patients about generic drugs and their potential benefits. However, strict guidelines should be introduced to control the quality, efficacy, and safety of generic drugs before use to increase patient confidence.

Background: COVID-19 is associated with a hypercoagulable state leading to an increased risk of thrombotic events. Although anticoagulation therapy is widely used, the optimal dosing strategy remains uncertain.

Objective: The aim of this study was to evaluate the impact of therapeutic versus prophylactic anticoagulation on outcomes in critically ill COVID-19 patients.

Methods: A retrospective cohort study was conducted on 315 critically ill COVID-19 patients. Patients were divided into two groups based on their anticoagulation regimen: therapeutic dose and prophylactic dose. The primary outcome was in-hospital mortality, while secondary outcomes included major bleeding events, thromboembolic events, and mechanical ventilation requirements.

Results: No significant difference in mortality was observed between the therapeutic and prophylactic anticoagulation groups. Additionally, there were no significant differences in secondary outcomes.

Conclusion: Our findings suggest that therapeutic anticoagulation may not provide a significant survival benefit compared to prophylactic anticoagulation in critically ill COVID-19 patients. To optimize patient outcomes, a more tailored approach to anticoagulation may be necessary, taking into account individual patient factors and risk assessment. Further prospective studies are needed to definitively establish the optimal anticoagulation strategy, especially in the context of evolving treatment modalities and vaccinations.