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Objectives We did this study intending to compare the efficacy of rosuvastatin 5 mg and 10 mg in patients of type 2 diabetes mellitus with dyslipidemia by validating their effect on lipid profile and the side effects. Methodology This study was carried out at the outpatient department of a tertiary care hospital in Multan. Three hundred patients of both genders were included. The research approach employed a parallel-controlled, randomized study. After taking relevant history and physical examination, each patient's fasting venous blood samples were taken and sent to the institutional laboratory to analyze glycated hemoglobin (HbA1c), baseline lipid levels for cholesterol, triglycerides, low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and high-density lipoprotein (HDL). Patients were divided into two groups based on the drug administered. One group was prescribed rosuvastatin 5 mg, and the other group was prescribed rosuvastatin 10 mg. Patients were followed up after six months to record the latest lipid profile. Data analysis was done through SPSS version 24. Results Patients in the two groups had similar lipid levels to start with. After six months of therapy, total serum cholesterol, triglycerides, and LDL-C were reduced to statistically significant levels in group two compared to group one. However, both groups showed a similar increase in serum levels of HDL-C. Patients treated with 10 mg rosuvastatin showed a slight decrease in BMI. Nine patients treated with 10 mg rosuvastatin reported myalgias compared to only one patient treated with a dose of 5 mg (p less then 0.005). Conclusion Our study concludes that both 5 mg and 10 mg of rosuvastatin exhibit the antihyperlipidemic effect, but high doses are associated with more side effects. Therefore, physicians should be aware of dose titration related to statins as it will ultimately lead to reduced cardiovascular mortality.The development of the Prescription Drug Monitoring Program (PDMP) led to an innovation in the healthcare organization system (HCOs). The PDMP system has been utilized in different states at various organizational levels in an effort to achieve improved health outcomes, reduce the number of prescription drug overdoses, and lighten the economic burden that follows. However, during the implementation of PDMP, there were several barriers and limitations that were discovered. Those barriers impeded the process of utilization of PDMP, such as the complex user interface and lack of training for healthcare providers. The purpose of this paper was to examine the advances and limitations in the utilization and implementation of PDMP in the US healthcare industry and develop strategies for effective use of PDMP in West Virginia. The qualitative part of this paper was a literature review. The paper referred to several peer-reviewed studies and research articles from several reliable resources, which were reached by databases or Google Scholar. A total of 44 articles were reviewed for this study. The implementation of the PDMP was influenced by benefits and barriers. This article reviewed several studies in general that demonstrated positive outcomes from the implementation of PDMP, including a reduced number of prescription drug overdoses, coordinated care for patients, and improved health outcomes. However, the barriers and limitations were not neglected, which mainly include integration of PDMP into the electronic health record (EHR) system, lack of training for the providers, and lack of basic standards for the use of PDMP. Although the new health reforms encouraged the adaption of PDMP among providers, data reporting and data interpretation still remain major concerns for assessing the health outcomes of PDMP implementation.

Neurofibromatosis type 1 (NF1) is an inherited neuroectodermal abnormality with multisystem effects, which can have heavy psychological and physical burdens, especially in countries like India, wherein skin disease is significantly stigmatized. This study was performed to understand the clinical and epidemiological trends of NF1 at a tertiary care center in India and evaluate the association between clinical severity and quality of life in these patients.

We conducted a cross-sectional study of 40 patients with NF1 over a period of two years at a tertiary hospital in western India. After obtaining consent, demographic and clinical information was collected from the patients and recorded in a pre-designed proforma. Quality of life was assessed by a validated Dermatology Life Quality Index (DLQI) questionnaire in languages understood by the patients and subsequently analyzed.

This study included 40 patients at a mean age of 28.6 years, with a slight male predominance. The most frequently occurring lesions were café-au-lait macules, followed by neurofibromas and intertriginous freckling. The mean DLQI score was 12.35, implying a large effect on most patients' lives. Questions related to self-consciousness, embarrassment, and the influence of skin lesions on clothing choices had the highest scores, indicating a significant effect on social perception.

NF1 has a profound impact on a patient's quality of life, as evidenced by the high DLQI scores in our patient cohort. The early identification and management of such patients can help prevent further deterioration of their quality of life.

NF1 has a profound impact on a patient's quality of life, as evidenced by the high DLQI scores in our patient cohort. The early identification and management of such patients can help prevent further deterioration of their quality of life.Cerebral venous sinus thrombosis (CVST) is a rare type of cerebrovascular disease that affects mainly young to middle-aged adults. The main clinical presentation of CVST includes progressive headache, focal neurological deficit, disturbance of conscious level, and epileptic seizures, which can occur early or late in the disease process. Generalized seizure has been recognised as the most common seizure subtype among patients with CVST and epileptic seizures. Epilepsia partialis continua (EPC), a subclass of focal motor status epilepticus, has rarely been reported as the initial presenting feature of CVST. Here, an encounter of CVST with an isolated initial presentation of EPC involving the right hand is presented. The initial discordant clinical and radiological findings prompted further investigations that revealed patchy venous infarction along the precentral gyrus that attributed to the occurrence of EPC.Background Pakistan reported more than a million cases during the coronavirus disease 2019 (COVID-19) pandemic, shuffling the already resource-constrained health system that is known for its high vulnerability and lack of adaption. Objective To find out the level of preparedness of public hospitals for the novel COVID-19 pandemic in Lahore district. Methods A descriptive cross-sectional study was conducted from April to July 2021 among all 18 public hospitals under Specialized Health Care and Medical Education (SHC&ME) in Lahore by administering World Health Organization (WHO) and SHC&ME modified and pre-tested interviewer based and observation checklist. The level of preparedness was assessed for 11 domains, and each domain was scored as a dichotomous variable (Yes and No). Hospital preparedness was labeled as 'acceptable,' 'insufficient,' and 'unacceptable.' Descriptive statistics were run by using SPSS version 26 (IBM Corp., Armonk, NY), and data are presented in the form of tables and bar graphs. Results Out of 18 hospitals, only three (17%) had an acceptable level of preparedness for COVID-19 (>70%). An unacceptable level of preparedness ( less then 35%) was seen in one hospital (5%). Fourteen hospitals (78%) were insufficiently prepared (35-70%). Conclusion The study highlights the suboptimal preparedness in 83% of the public hospitals with a consistent pattern of deficiencies in surge capacity, logistics and resource management, essential services, including diagnostics, infection prevention, and control.

COVID-19 poses a significantly more serious threat to adults aged 65 and above, with a higher mortality rate. This study aims to describe the outcome of COVID-19 patients in the elderly and very elderly population admitted to a tertiary care Portuguese hospital.The authors defined the elderly population (65 to 79 years) and the very elderly population (≥ 80 years).

We conducted aretrospectiveobservationalsingle center study in the internal medicine ward of a tertiary hospital from November1,2020 toJanuary31,2021.All COVID-19 patients aged over 65 years were enrolled.

Of the 824 patients with SARS-CoV-2 infection, 586 (71%) were aged above 65 years.Of them, 61.7% were very elderly and 32.9% were elderly. The hospital recorded 53 (27.5%) deaths in the elderly group and 182 (46.3%) in the over-80 group. In the elderly population, only 32 patients had critical illness compared to the 79 in the very elderly group. In addition to respiratory complications, acute kidney failure and liver dysfunction were notede groups despite their current widespread usage in COVID-19 treatment worldwide.A 79-year-old female complained of a one-month history of imbalance and headache. selleck chemical Brain MRI showed an irregular rim enhancing solid and cystic mass centered in the superomedial left cerebellar hemisphere. Resection of the lesion was recommended; however, the patient opted to undergo the procedure the following month because of the nearby Christmas holidays. When the patient returned 30 days later, a new brain MRI showed an enlargement of the cerebellar mass, extending to the brainstem and infiltrating the left brachium pontis, left posterior aspect of the tegmentum of the pons, and posterolateral medulla oblongata. Subtotal resection was performed without complications, and pathology was compatible with a primary cerebellar glioblastoma negative for IDH1/2 gene mutation. Because of the poor prognosis, the patient and her family members opted for hospice treatment, with the patient dying three weeks later. This case illustrates that cerebellar glioblastoma can rapidly infiltrate the brainstem.A 29-year-old patient presented to the hospital with worsening generalized rash for the last two days from a mental health facility. The patient was commenced on lamotrigine two weeks earlier, and he developed fever and generalized macular rash on his body. His blood tests showed deranged liver function tests (LFTs) and clotting with raised eosinophil count, and he was treated for lamotrigine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. The patient was commenced on prednisolone 50 mg once daily with a proton pump inhibitor cover, and lamotrigine was suspended on advice from Dermatology. The patient showed improvement after 3-4 days of treatment. His skin biopsy showed prominent suppurative granulomatous folliculitis, mild perivascular chronic inflammation, and red blood cell extravasation, including the rare eosinophil. He was weaned off from prednisolone by 5 mg weekly and had complete resolution of symptoms.Scombroid is a foodborne illness that results from eating improperly handled fish. Due to a disruption in the cold chain, these fish have high histamine levels. As a result, scombroid presents with allergy-like symptoms but is not really an allergy per se. Cases have been reported in many countries. Here, we report two cases of a 48 and 17-year-old father and son in Singapore who developed symptoms suggestive of scombroid after eating tuna imported from Vietnam delivered by an internationally known supply company. The diagnosis was confirmed by elevated histamine levels measured in the culprit fish product. We discuss the pathophysiology, signs, symptoms, and management of scombroid.