International journal of clinical practice
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Int. J. Clin. Pract. · Aug 2021
ReviewPast, present and future perspectives of Therapeutic Drug Monitoring in India.
Therapeutic drug monitoring (TDM) is the clinical practice of performing drug assays and interpreting results to maintain constant therapeutic concentrations in patients' bloodstream. Conventional TDM was started way back in the 1960s and served to optimise pharmacotherapy by maximising therapeutic efficacy by evaluating efficacy failure and monitoring drug compliance, while minimising adverse events, in drugs with a narrow therapeutic range. Currently, the scope of TDM has been extended to additional indications which are of importance to India. ⋯ Its utility is also challenged by cost and higher reliance on conventional prescribing practices. However, the newer indications such as antimicrobial resistance, tuberculosis and HIV, with their high prevalence in developing nations, present an opportunity for the growth of TDM in these countries. Indian clinician's awareness and buoyant demands alongside expert contributions from clinical pharmacologists could widen its scope.
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Int. J. Clin. Pract. · Aug 2021
Review Meta AnalysisD-dimer levels is associated with severe COVID-19 infections: A meta-analysis.
The ongoing pandemic of COVID-19 caused by the novel coronavirus Syndrome-Coronavirus-2 (SARS-CoV-2) is an emerging, rapidly evolving situation. Excluded typical manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients also have abnormal D-dimer concentration in the serum, but the results are controversial. ⋯ Our meta-analysis showed that the severity of patients with COVID-19 significance related to D-dimer concentrations. This may be helpful for the clinic COVID-19 patients.
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Int. J. Clin. Pract. · Aug 2021
ReviewAn Updated Guide in the Management of Psoriasis for Every Practitioner.
Psoriasis is one of the most common chronic cutaneous skin disorders, having genetic and immunological components. It is currently unknown what exactly triggers it, or how far reaching are the etiological factors, although great strides have been made in uncovering the pathophysiological cascade. Presently, there is a wide diversity of treatment methods for psoriasis, yet not all are applicable for each patient. Selection of both drug and dosage depends on both the knowledge and experience of the treating dermatologist and also on the specific characteristics of each patient. Therefore, the treating physicians should be made aware of the management possibilities, their advantages and their side effects. ⋯ Current therapies are divided into topical drugs, phototherapy, systemic and biological agents. Topical therapies and phototherapy are generally the first and second line of management respectively, being typically effective in treating mild to moderate forms of psoriasis. On the other hand, the chronic moderate to severe forms usually benefit from systemic drugs, whereas biologic agents are reserved for severe or unremitting cases, especially those suffering from psoriatic arthritis. Also of importance is the understanding of the pathophysiological mechanisms in psoriasis and how the selected drugs interfere in the pathological cascade. Furthermore, physicians should be able to recommend the appropriate therapy not only for adults but also for paediatric and pregnant patients as well. In the following manuscript, we present an updated version of these management options, alongside their indications, posology and most common side effects, a guide that may be useful for every practitioner in this field.
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Int. J. Clin. Pract. · Aug 2021
ReviewPotential effects of Pomegranate (Punica granatum) on Rheumatoid arthritis: A systematic review.
Taking into account the adverse impact of the drug therapy on rheumatoid arthritis (RA), adjuvant therapies without such undesirable effects have recently gained increasing interest. Several studies have examined the potential properties of pomegranate on RA with some uncertain mechanisms suggested. This review aimed to systematically review the available evidence in this regard. ⋯ This paper gives compelling evidence regarding the efficacy of pomegranate in RA and justifies the significance of further clinical researches.
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Int. J. Clin. Pract. · Aug 2021
ReviewPotential effects of Pomegranate (Punica granatum) on Rheumatoid arthritis: A systematic review.
Taking into account the adverse impact of the drug therapy on rheumatoid arthritis (RA), adjuvant therapies without such undesirable effects have recently gained increasing interest. Several studies have examined the potential properties of pomegranate on RA with some uncertain mechanisms suggested. This review aimed to systematically review the available evidence in this regard. ⋯ This paper gives compelling evidence regarding the efficacy of pomegranate in RA and justifies the significance of further clinical researches.