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Multiple, hard, flesh-to-pink papules, plaques, and nodules, often seen on the extensor surfaces of the limbs, are characteristic of prurigo nodularis, a persistent skin condition. The itchy lesions may strike people of any age. It often occurs in tandem with another condition that causes constant itching, such atopic dermatitis or another dermatosis. The clinical symptoms are the primary indicators. However, there may be numerous instances when lichen simplex chronic us and hypertrophic lichen planus are indistinguishable from a clinical standpoint. Therefore, it is crucial to confirm the diagnosis by dermoscopy and histology. Many other therapy strategies are being used, including those using powerful antipruritics, immunomodulators, and neuromodulators. After a diagnosis has been made, treatment might take a long time, thus patient education and counseling are crucial to ensuring they stick with the plan. A subset of chronic prurigo, prurigo nodularis (PN) manifests as hyperkeratotic, very itchy papules and nodules that are often seen in a symmetrical pattern. PN develops with persistent pruritus in the setting of a wide variety of dermatological, systemic, neurological, or mental disorders. Although the specific pathophysiology of PN is not well understood, chronic scratching may be a primary cause. Topical steroids, capsaicin, calcineurin inhibitors, ultraviolet (UV) treatment, systemic injection of gabapentinoids, -opioid receptor antagonists, antidepressants, and immunosuppressants are the current gold standard in treating PN. Clinical trials are being conducted on cutting-edge therapeutic modalities such blockers of neurokinin-1, opioid, and interleukin-31 receptors.

Background: Oral medication for patients with type 2 diabetes mellitus plays an important role in diabetes care and is associated with high levels of self-care and self-management behavior. Barriers to adherence can include complex treatment regimens, often associated with multiple long-term therapies, side effects from medications, and inadequate, incomprehensible, or confusing information or instructions from the healthcare provider. Multidisciplinary approaches can support successful adherence and enable more effective management of diabetes care. One The aim was to analyze the effectiveness of pharmaceutical interventions to improve adherence to therapy in type 2 diabetes mellitus. Study quality was assessed using the Cochrane Risk of Bias Tool. Two studies investigating primarily educational interventions showed a significant improvement in therapy adherence. In addition, the quality of the included studies was poor. Conclusion: Although pharmaceutical interventions could potentially improve medication adherence in type 2 diabetes mellitus, high-quality studies are needed to assess their effectiveness Keywords: Oral medication, type 2 diabetes, long-term therapies, side effects, healthcare provider. Title: Improving Adherence in Patients with Type 2 Diabetes: A Scientific Review of Randomized Controlled Trials Author: Ahmed Saud Aldalbahi, Lamyaa Mohammed Alsouyd, Abdullah Alaaaldin Mohammed Matter, Mohammed Khalid Alrabiah, Maryam Saleh Fallatah International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 11, Issue 1, April 2023 - September 2023 Page No: 147-153 Research Publish Journals Website: www.researchpublish.com Published Date: 17-July-2023 DOI: https://doi.org/10.5281/zenodo.8155159 Paper Download Link (Source) https://www.researchpublish.com/papers/improving-adherence-in-patients-with-type-2-diabetes-a-scientific-review-of-randomized-controlled-trials, International Journal of Healthcare Sciences, ISSN 2348-5728 (Online), Research Publish Journals, Website: www.researchpublish.com

IntroductionGrowing data support the safe and efficacious use of ablative radiotherapy in the setting of liver metastases, with some studies suggesting that patients with metastatic breast cancer (MBCa) do better than patients with metastases from other cancers. This study aims to retrospectively review clinical outcomes of patients with MBCa following liver radiotherapy (RT).Materials and MethodsPatients with MBCa who received liver hypo fractionated ablative RT between 2004 – 2020 were classified according to metastatic classification and treatment intent (i.e., oligo-metastatic (OM) or oligo-progressive (OP)). Demographics, disease characteristics and treatment characteristics were collated. Primary outcome was local control (LC) of treated metastases. Secondary outcomes included overall survival (OS), progression-free survival (PFS), and time to next line systemic therapy (ST), analyzed by univariate (UVA) and multi-variable analysis (MVA).ResultsThirty MBCa patients with 50 liver metastases treated with 5 – 10 fraction ablative intent RT were identified for analysis. Median follow-up was 14.6 months (range 0.9 - 156.2 months). Mean age was 55.6 years (range 32.1 - 79.3 years); 53% were ER+/HER2-ve and 33% HER2+ve. Class of metastatic disease was described as – induced (12 patients, 40%), repeat (15 patients, 50%) and de novo (3 patients, 10%) (1 synchronous, 2 metachronous). Indication of treatment was OP (73%) and OM (27%). Median size of treated liver metastases (LM) was 3.1 cm (range 1cm – 8.8 cm) and the median dose delivered was 40Gy (range 30Gy-60Gy). 1 and 3-year LC rates were 100%. Median OS was 57.7-months with size of treated liver metastases predictive of overall survival (HR 1.35, p=0.023) on UVA. Median time to progression post treatment was 4.8 months (0.8 – 114.7). Patients with induced OMD had a significantly higher rate of progression (HR 4.77, p=0.01) on UVA compared to others, which trended to significance on MVA (HR 3.23, p=0.051).ConclusionHypo-fractionated ablative liver RT in patients with MBCa provides safe, tolerable treatment with excellent LC. Further studies assessing the impact, ideal sequencing, and indications of RT in each metastatic class in MBCa are required.

Salicylic acid (SA) acts as a signaling molecule and plays an important role in various physiological and biochemical processes in plants. The aim of the present study was to evaluate the role of SA in the enhancement of lead (Pb) tolerance in wheat (Triticum aestivum) plants. When 2–3 true leaves had appeared, treatments were applied to the plants. The treatments were as follows: (i) no addition of SA and Pb (control), (ii) 2 µM SA + 0 mM Pb, (iii) 8 µM SA + 0 mM Pb, (iv) 0 mM SA + 2 mM Pb, (v) 2 µM SA + 2 mM Pb, and (vi) 8 µM SA + 2 mM Pb. One-way analysis of variances (ANOVA) was used to compare the means, and Duncan’s multiple-range test (DMRT) was used to determine significant (P < 0.05) differences among the individual means of treatments. Exposure of Pb severely affected wheat plants by reducing plant height, fresh and dry weight, photosynthetic pigments (Chl a and b, Chl a:b) and carbonic anhydrase enzyme activity, and by enhancing Chl degradation, electrolyte leakage (EL), malondialdehyde accumulation. Also, Pb treatment increased the accumulations of proline and total soluble carbohydrates (TSC) and activities of antioxidant enzymes [superoxide dismustase (SOD), catalase (CAT), and peroxidase (POD)]. However, application of SA induced biosynthesis of pigments by suppressing Chl degradation, and EL and malondialdehyde accumulation. Furthermore, SA treatments further enhanced the production of proline and TSC, and the activities of SOD, CAT, and POD. SA directly or indirectly improved physiological processes, which helped wheat plants to overcome the oxidative damage induced by Pb toxicity. Also, this study reveals that exogenous application of SA is beneficial for plant growth and development of wheat plants by suppressing ill effects of heavy metal stress. Therefore, this study opens up the hidden role of SA in tolerance of plants to heavy metal toxicity to explore its new regulatory role and defensive mechanism at physiological and molecular levels. Also, exogenous application of SA could be beneficial for sustainable agriculture.

Background and objectivesThe prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections has been steadily increasing. These infections are considered to be either hospital-acquired MRSA (HA-MRSA) or community-acquired MRSA (CA-MRSA). Children are at higher risk of infection than adults. HA-MRSA has been reported to have more serious outcomes than CA-MRSA. However, there are not enough studies in Saudi Arabia to study the characteristics of HA-MRSA in children. We aim to describe the characteristics of HA-MRSA infection, including risk factors, culture site, clinical manifestations, complications, and outcomes among pediatric patients in a tertiary care hospital in Riyadh, Saudi Arabia.Design and settingsThis is a retrospective chart review study. It was conducted in King Abdulaziz medical city in Riyadh.Patients and methodsThe study included all patients 14 years of age or younger who were culture-positive from any site in the body during the period from January 1, 2009 to December 31, 2011. The time of culture compared to admission time was used to differentiate between CA-MRSA (within 72 h of admission) and HA-MRSA (more than 72 h after admission). The final sample size was 39 patients.ResultsWe found HA-MRSA to be more common in males and those with risk factors such as previous surgery and previous hospitalization. Patients had a high Pediatric intensive care unit (PICU) admission rate and were commonly septic with positive blood cultures. Seventy-four percent of patients fully recovered, 10% recovered with complications and 15% died.ConclusionHA-MRSA is an infection that can cause serious complications and a high rate of PICU admissions. Clinical manifestations such as shock are associated with higher mortality and morbidity rates. Special care should be given to those admitted to PICU, as they have high rates of mortality and morbidity.

Background and objectives The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections has been steadily increasing. These infections are considered to be either hospital-acquired MRSA (HA-MRSA) or community-acquired MRSA (CA-MRSA). Children are at higher risk of infection than adults. HA-MRSA has been reported to have more serious outcomes than CA-MRSA. However, there are not enough studies in Saudi Arabia to study the characteristics of HA-MRSA in children. We aim to describe the characteristics of HA-MRSA infection, including risk factors, culture site, clinical manifestations, complications, and outcomes among pediatric patients in a tertiary care hospital in Riyadh, Saudi Arabia. Design and settings This is a retrospective chart review study. It was conducted in King Abdulaziz medical city in Riyadh. Patients and methods The study included all patients 14 years of age or younger who were culture-positive from any site in the body during the period from January 1, 2009 to December 31, 2011. The time of culture compared to admission time was used to differentiate between CA-MRSA (within 72 h of admission) and HA-MRSA (more than 72 h after admission). The final sample size was 39 patients. Results We found HA-MRSA to be more common in males and those with risk factors such as previous surgery and previous hospitalization. Patients had a high Pediatric intensive care unit (PICU) admission rate and were commonly septic with positive blood cultures. Seventy-four percent of patients fully recovered, 10% recovered with complications and 15% died. Conclusion HA-MRSA is an infection that can cause serious complications and a high rate of PICU admissions. Clinical manifestations such as shock are associated with higher mortality and morbidity rates. Special care should be given to those admitted to PICU, as they have high rates of mortality and morbidity.