Combination therapy is expected to play an important role for the treatment of Alzheimer’s disease (AD). In October 2018, the European Union-North American Clinical Trials in Alzheimer’s Disease Task Force (EU/US CTAD Task Force) met to discuss scientific, regulatory, and logistical challenges to the development of combination therapy for AD and current efforts to address these challenges. Task Force members unanimously agreed that successful treatment of AD will likely require combination therapy approaches that target multiple mechanisms and pathways. They further agreed on the need for global collaboration and sharing of data and resources to accelerate development of such approaches.

Chronic obstructive pulmonary disease is a very common disease often punctuated by intermittent episodes of exacerbation. These exacerbations affect the natural history of the disease, accelerating a decline in lung function. They affect the individual in many ways and affect the health service caring for these patients. The definition of exacerbation varies and lacks clarity. The definitions used most are either symptom based, for example, breathlessness, sputum production and sputum purulence, or event driven, for example, an event causing a patient to seek healthcare input or change to medications. In this article, we discuss the importance of exacerbations, the clinical definitions, clinical trial definitions, physiological and biomarker evidence of exacerbations and the challenges associated with each of these. Application of a practical definition would aid in our clinical management of patients with chronic obstructive pulmonary disease and facilitate developments in future therapeutic advances through clinical trials.

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Background: Despite the benefit of lifestyle changes, there is no standard treatment for Fibrotic NASH. However the concept of reversibility of liver fibrosis and cirrhosis with various natural biologically active compounds and antioxidant micro-nutrients is not new. Aim: The aim of this study was to compare effectiveness of Viusid ® (a nutritional supplement) and Vitamin E in reducing steatosis and liver fibrosis score in patients with fibrotic NASH. Methods: 52 patients diagnosed with nondiabetic and noncirrhotic NASH on liver fibroscan were divided into 2 groups randomly and given Viusid ® 3 sachets daily to 25 patients or Vitamin E 800 IU daily to 27 patients along with a hypocaloric diet and exercise for 3 months. Results: After 3 months treatment with Viusid ® , as compared with Vitamin E, was associated with a significant reduction of both mean steatosis score (CAP value reduces from 286±16.3 to 208±18.5 dB/m in Viusid ® group vs. from 278±14.4 to 253±12.1 dB/m in Vitamin E group; p<0.00001) and fibrosis score (E value reduces from 6.8±0.5 to 5.1±0.7 kPa in Viusid ® group vs. from 6.9±0.5 to 6.5±0.4 kPa in Vitamin E group; p<0.00001).

Background: The Whipple operation treats pancreatic, bile duct, and intestinal malignancies. ERAS® usage in the Whipple surgery is seldom documented. So, this study examined how the ERAS® regimen affected postoperative complications in Whipple patients. Method: From January 2017 to December 2022, 97 patients were admitted to the general surgery department at Hayatabad Medical Complex, Peshawar, Pakistan, a tertiary care hospital. This study recruited Whipple patients. The prospective group was treated with ERAS methods, whereas the control group was handled using the non-ERAS treatment (Jan 2017–Dec 2018). The Whipple technique was performed on 18-year-olds with pancreatic, duodenum, and bile duct cancer. The present study's primary outcomes were CDC grading, surgical complications, 30-day readmission rate, 30-day re-operation for any reason, and hospital stay. SPSS 26.0 examined data. Results: This study has 97 patients. Both groups had equal comorbidities. The ERAS® technique minimized postoperative complications, as seen by the considerable drop in CDC grading (p = 0.003). Non-ERAS® patients had increased mortality (2 vs. 8). ERAS® also decreased stay duration (p = 0.001). ERAS® patients also had a lower readmission rate (p = 0.001). Conclusion: The Whipple procedure's ERAS® protocol has lowered postoperative complications, duration of stay, and readmission rates.