Medicine articles list

Metronidazole-induced neurotoxicity is a rising challenge in managing susceptible infections. The mechanisms involved in metronidazole-induced neurotoxicity are not fully unraveled. This study aimed to explore the effect of metronidazole on iron homeostasis in SH-SY5Y neuroblastoma cells. Confluent SH-SY5Y neuroblastoma cells were treated with different concentrations of 1.0, 10, 25, 50, 100, and 250 µM of metronidazole only or in combination with 20 µM iron. DMSO or culture media was used as control. Viability and ferritin assays were conducted on the treated cells. The treatments were for 24 hours, 48 hours, and 72 hours, respectively. In the viability assay, doses of metronidazole reduced the viability of SH-SY5Y neuroblastoma cells in a time and concentration-dependent manner. After 24-hour treatment, 250 µM metronidazole significantly reduced cell viability while 50 µM, 100 µM and 250 µM metronidazole reduced considerably viability only after 48-hour and 72-hour compared with control. Different doses of metronidazole 50 µM, 100 µM, and 250 µM in 20 µM iron reduced viability in a time-dependent manner in all the test periods. Metronidazole also induced a time- and concentration-dependent increase (p<0.05) in cellular iron uptake in the 48-hour and 72-hour treated cells in concentrations above 25 µM metronidazole. It is concluded that metronidazole induces a time and concentration-dependent iron overload and consequent cell death in SH-SY5Y neuroblastoma cells and this may contribute to the mechanism of metronidazole-induced neurotoxicity.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Administering medication to children at home presents substantial challenges for caregivers. Errors in dosage, timing, or administration method could be harmful. A key contributor to such errors is inadequate knowledge of pediatric medication. The objective of this study was to explore how parents in Libya administer oral medications to their children and the self-care therapies they use for them. A cross-sectional study was conducted using an online self-designed questionnaire consisting of yes/no and multiple-response questions. The sample size was 523 parents with valid questionnaires. Inclusion criteria were being a parent of children aged six months to 10 years and consent to participate. The data were analyzed by the Chi-square test was employed to examine associations between demographic characteristics and parental behaviors and techniques of medication administration. One-third of parents used inappropriate tools to administer liquid medications to their children. When children resisted medication, 49.3% of parents insisted on administering it, 10.7% mixed it with milk or other drink, 5.2% mixed it with food, and 9.2% dissolved solid forms in water or another drink. Additionally, 9.4% of parents admitted to giving doses higher than prescribed, trying to achieve rapid recovery. Furthermore, 82.0% of the parents engaged in self-medication of children, mostly with antipyretics (86.4%) but also with antibiotics (2.5%). We concluded that knowledge of the correct practices for administering oral medication to children was inadequate. It is suggested to develop educational programs for parents on correct practices.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The global endeavor to develop and deploy COVID-19 vaccines has underscored both significant scientific progress and enduring disparities in worldwide access. This analysis examines regional vaccine distribution patterns across World Health Organization (WHO) regions—Africa, the Americas, Eastern Mediterranean, Europe, and Western Pacific—revealing substantial variations in vaccine types and manufacturer contributions. Data indicate that the Americas and Europe demonstrate a broad vaccine portfolio, with prominent contributions from major international pharmaceutical companies alongside regionally developed vaccines. Conversely, African, Eastern Mediterranean, and Western Pacific regions show considerable reliance on vaccines from Asian (notably China and India) and Russian manufacturers, in addition to Western products. This distribution highlights the influence of geographical proximity to manufacturing centers, regional alliances, and local production capabilities (e.g., CIGB and Finlay in the Americas, COVIran Barakat in the Eastern Mediterranean, and various Chinese products in the Western Pacific) on vaccine availability. Predominant vaccines by country count include Pfizer-BioNTech's Comirnaty, AstraZeneca's Vaxzevria, Janssen's Ad26.COV2-S, Moderna's Spikevax, Beijing CNBG's BBIBP-CorV, and SII's Covishield. The observed regional variations in vaccine types and supply chains carry implications for comparative effectiveness research, the understanding of differential immune responses, and the evaluation of pandemic control strategies. Furthermore, inconsistencies in global data reporting and product nomenclature present challenges for comprehensive analysis. The findings emphasize the importance of diversified supply chains, the growing role of regional manufacturing in enhancing global health security, and the need for standardized global data for a more profound understanding of vaccine equity and efficacy to inform future pandemic responses.

Mostafa Eissa

Epithelial cells, lining the skin and internal organs, play a crucial role as protective barriers and regulators of substance transport. Traditionally, these cells were not considered to employ electrical signaling for communication. However, recent investigations have unveiled that epithelial cells generate slow electrical signals, termed the "silent scream," in response to injury, thus challenging conventional views of intercellular communication. A recent experimental investigation provided compelling evidence for this phenomenon, demonstrating the ability of these cells to transmit electrical signals over considerable distances within the epithelium. The research utilized microelectrode array chips to precisely detect subtle electrical events in keratinocytes and Madin-Darby Canine Kidney (MDCK) cells, revealing spiking activity characterized by slow propagation speeds, distinct from the rapid action potentials of neurons. The mechanisms underlying this novel signaling are explored, focusing on the involvement of mechanosensitive ion channels, calcium signaling, and Adenosine triphosphate (ATP) release. Calcium ions, well-established intracellular messengers, appear to play a central role in this biological phenomenon. Integrating this newly discovered communication mode into the existing understanding of skin cell biology reveals a more intricate picture of how skin senses and responds to its environment. The implications of this finding extend to various facets of skin physiology and pathology, including wound healing, inflammation, and skin aging. In wound healing, where endogenous electric fields guide cell migration and promote repair, this unique type of electrical signaling potentially plays a crucial part. Furthermore, aberrant electrical signaling might contribute to chronic inflammatory conditions, and age-related changes in this signaling could underlie the functional decline observed in aged skin. The potential for other environmental stressors to trigger the epithelial-generated electric signals also warrants investigation. The exploration concludes by discussing potential technological applications, such as bioelectric sensors and enhanced wound healing therapies, and future research directions aimed at further elucidating the molecular mechanisms and functional roles of this non-excitable cell electrophysiology.

Mostafa Eissa

Introduction: Mental health disparities are deeply entrenched within the fabric of societal inequalities, shaped by structural factors that perpetuate intergenerational cycles of disadvantage. Addressing these disparities is crucial for promoting social justice and improving public health outcomes. Aim: This paper aims to synthesize high-quality evidence to elucidate the causal relationships between social determinants and mental health outcomes. It prioritizes pervasive social determinants that influence major mental disorders across the life course and outlines preventive strategies to mitigate these effects. Methodology: A comprehensive literature review was conducted, focusing on publications from the Global North from 2014 to 2024, to explore the influence of social determinants on mental health. Keywords such as "social determinants," "mental health outcomes," "preventive strategies," and "vulnerable populations" guided the search across databases like PubMed and Google Scholar. Results: The review highlights significant associations between mental health and social determinants such as socioeconomic status, racial and ethnic marginalization, and exposure to adverse environments. It underscores the heightened vulnerability of marginalized groups, including refugees, LGBTQ+ individuals, and those living in poverty. The paper introduces a preventive framework to guide primary prevention efforts and reviews both primary and secondary strategies to improve mental health equity. Conclusion: Strategic interventions aimed at the root social causes of mental health disparities can substantially enhance public mental health. This paper provides seven strategic recommendations focused on social justice, offering a roadmap for researchers, policymakers, and public health professionals to address these pressing issues.

Dr K C Yadav

Recent reports showed an association between bariatric surgery and the development of acute pancreatitis. This report presents a case of acute pancreatitis following a laparoscopic sleeve gastrectomy (LSG) in a 24-year-old Indian female patient, who presented to the Emergency Department at Hamad General Hospital, Qatar, with severe epigastric pain and persistent vomiting 13 days after LSG. She was diagnosed with acute pancreatitis based on a high level of lipase greater than three times the upper limit of normal, and a computed tomography scan of the abdomen, which was consistent with acute pancreatitis. The patient was treated conservatively with a significant improvement in her symptoms and laboratory tests throughout her admission and consequently was discharged.

Karishma

Iatrogenic splenic infarction is a rare clinical entity that can result from various abdominal surgical and invasive procedures. We report a case of iatrogenic splenic infarction in a 29-year-old female who presented with hemoptysis and was found to have pulmonary sequestration. During the embolization of the anomalous artery supplying the pulmonary sequestration, she developed severe pain and was found to have a splenic infarction, caused by a part of the coil that dislodged during the procedure. The patient showed good response to conservative management and was discharged in good condition.

Karishma

A 33-year-old young male patient with a history of uncontrolled hypertension was referred to my clinic due to a 2-week fever, generalized body aches, shortness of breath, and easy fatigue. Clinical examination showed a toxic dyspneic patient, but conscious and well-oriented. His blood pressure was 170/100 mm Hg, pulse 90 beat/min, respiratory rate 15/min, and the temperature was 38.6°C. Cardiac examination showed a harsh systolic murmur at the mitral area radiating to the axilla. Abdomen examination revealed moderate splenomegaly and mild hepatomegaly. The rest of the examination was unremarkable.

Karishma

A 22-year-old Indonesian woman was admitted through the emergency department with a 10-day history of  fever associated with chills. Other medical history was unremarkable. On examination, she appeared ill; BP 95/60 mmHg, pulse 105/min, and temperature 39.5°C. Abdominal examination showed splenomegaly; examination of the heart, lungs, and nervous system was unremarkable.

Karishma

Medical science has grown tremendously at a rapid rate over the recent past. This is especially true in the fields of diagnostics and therapeutics encompassing various diseases of all the systems of the human body including psychosomatic disorders. During the past three to four decades, precision in diagnostics has enormously improved due to invention of multiple imaging modalities such as computerized tomography (CT) scan, magnetic resonance imaging (MRI) scan, positron emission tomography scan, ultrasound scanguided studies, CT-guided diagnostic procedures, Doppler studies, arteriography, CT angiography, advanced needle biopsy procedures, histochemistry studies, tumor marker studies, as well as in the ongoing improvements in all diagnostic and therapeutic branches. The surgical advancements due to increasing use of key-hole surgery using scopes such as arthroscope, laparoscope, colonoscope, and bronchoscope have revolutionized the surgical treatments and made surgery safer, less time-consuming, less costly, and less risky with reduced post-operative morbidity. Cardiac catheterization, percutaneous cardiac angiography, angioplasty, and vascular surgery have made the procedures/ surgeries related to the heart and major vessels, much simpler, faster, and safer minimizing the need for big infrastructures or large operative teams.

Karishma

Celiac disease (CeD) is a complex disorder characterized by gastrointestinal (GI) symptoms as well as extraintestinal manifestations, sometimes difficult to diagnose. Commonly referred to as a childhood disease, adult CeD is a well-known entity that should be included in the differential diagnosis of chronic diarrhea or malabsorption syndrome. The pathogenesis involves a genetically mediated autoimmune pathway. In individuals with genetic susceptibility, the mucosa of the small intestine is damaged in response to foods containing gluten. The clinical presentation is variable and ranges from typical GI symptoms to extra-intestinal and systemic manifestations. Clinical improvement and restoration of the intestinal mucosa occur simply by eliminating gluten from the diet. We reported a case of CeD in a young man after 6 years of iron deficiency anemia (IDA), without asserting a clear etiology during this time. In our country, the search for CeD in patients with IDA is usually forgotten and we hereby put it in the spotlight.

Karishma