High-risk hypertension patients are more susceptible to cardiovascular disease, stroke, and mortality. Monotherapy and triple combination drug therapy are two different approaches to treating hypertension. Monotherapy involves using a single medication to manage hypertension, whereas triple combination therapy involves the simultaneous use of three different antihypertensive medications from different drug classes. Making a fast switch from monotherapy to combination medication is one method to regulate blood pressure (BP) better. It is widely recognized that a significant proportion of individuals with hypertension require combination therapy to manage their condition effectively. This review aims to evaluate the mortality rates across monotherapy and triple combination drug therapy in high-risk hypertension patients. A systematic literature review was conducted across multiple scientific literature repositories. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines for systematic reviews and meta-analyses. Based on the end outcome of each published journal on the effectiveness of triple combination drug therapy as a treatment option for high-risk hypertension patients, there was a notable difference in overall survival, mortality rates, BP reduction, and adherence datasets. Triple combination drug use correlated with increased timeframes for multiple patient survival parameters within the articles shortlisted in this investigation. However, it is crucial for healthcare providers to weigh the risks and benefits of triple combination drug therapy when deciding which treatment approach is best for their patients.
This paper explores the neuropsychiatric consequences of SARS-CoV-2 (COVID-19) infection, specifically the use of intravenous immunoglobulin (IVIG) therapy in treating central nervous system (CNS) symptoms associated with COVID-19. The authors searched PubMed and Google Scholar using the keywords "IVIG" and "covid-19 neuropsychiatric symptoms" to find five articles, including three case reports, a retrospective study, and a prospective study, that detail the experiences of individuals with persistent neuropsychiatric symptoms after contracting COVID-19. The neuropsychiatric symptoms reported in the analyzed studies include sleep disturbance, exhaustion, cognitive decline, anxiety, and others. Common treatments for post-COVID neuropsychiatric symptoms include medications, cognitive behavioral therapy, and lifestyle modifications. IVIG therapy to manage CNS symptoms of COVID-19 has shown mixed results in studies, with some showing positive effects while others remain inconclusive. Further research is needed to understand this therapy's potential benefits and limitations fully.
There is a developing trend of using wearable electronic devices as health aides, spurred on by telecommunication companies as fitness devices and marketed as such. They have been shown to count steps, pulse, and record arrhythmias, doubling as communication devices and prompting healthcare providers in some instances. We sought to determine if there was a direct correlation between device use and increased physical activity as recommended by the World Health Organization, or if this physical activity increase was only marginal at best. In addition, we sought to investigate if there were additional benefits to using these devices besides increased self-awareness of health. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Keywords for searching articles centered around cardiovascular disease, wearable electronic devices, and their synonyms. Most of the data were obtained from PubMed, although other contributing databases were used, including ResearchGate, Science.gov, ScienceDirect, and PubMed Medical Subject Headings database. Only full-text articles were used. We identified 62 articles that met our search criteria but narrowed them down to 19 following qualitative assessment. Increased physical activity was found to be the one parameter that stood out by way of benefit from the device. Other findings, such as reduced waist circumference, obesity, glycated hemoglobin, and lipid levels, shared mixed results. At this time, we do not have a definition of what duration of device use is deemed standard for health. We have no consensus on which devices are superior healthwise. Our study, however, indicates that these devices, used with adequate health professional supervision, have a role to play in motivation and increased physical activity, enough to cause impactful gains in cardiovascular health.
Multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR TB) is a global concern, with 450,000 new cases and 191,000 deaths in 2021. TB and chronic kidney disease (CKD) have been associated since 1974, with suggested explanations such as oxidative stress, malnutrition, dysfunction in vitamin D metabolism, and a compromised cell-mediated immune response. End-stage renal failure patients are more likely to acquire drug resistance due to poor adherence, adverse drug reactions, and inappropriate dose adjustment. We then aim to evaluate the therapeutic outcome of multidrug-resistant TB of the lungs in patients who require hemodialysis in terms of successful treatment (cured and treatment completed) and the associated factors for a favorable outcome. Our secondary goal is to identify unfavorable treatment outcomes (treatment failed, patient died, or patient lost to follow-up) and the underlying associated factors. We conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Guidelines for this systematic review. We included adults (>19 years old) with chronic kidney disease who needed hemodialysis and had microbiologically confirmed multidrug-resistant pulmonary TB, excluding patients who had a renal allograft transplant, were on peritoneal dialysis, had extrapulmonary TB, were children and pregnant patients. We searched PubMed, MEDLINE, PubMed Central, ScienceDirect, Public Library of Science (PLOS), and Google Scholar. Keywords were combined with the Boolean "AND" operator to gather results as well as the medical subject heading (MeSH) search strategy. After screening study articles by reading their titles and abstracts, the following tools were used to assess the risk of bias: the Newcastle-Ottawa scale for observational studies, the Assessment of Multiple Systematic Reviews (AMSTAR) checklist for systematic reviews, and the Joanna Briggs Institute (JBI) assessment tool for case reports. Primary and secondary outcomes were assessed, and a conclusion was made. We gathered 21,570 studies from the databases between 2013 and 2023, with 30,062 total participants. There were eight eligible studies for review. Patients with CKD, particularly those on dialysis, are at increased risk of TB due to a combination of factors that contribute to immunosuppression. TB reactivation is common in chronic renal failure patients. Diagnostic samples such as sputum and pleural fluid had lower sensitivity rates compared to tissue samples, which led to delays in diagnosis and treatment and, most importantly, contributed to drug resistance. All new dialysis patients should undergo interferon-gamma release assay testing. TB-infected patients with severe renal disease (eGFR 30 ml/min) had increased morbidity and mortality; however, the use of directly observed treatment, short-course (DOTS), and renal-dose adjustment of anti-TB medications significantly reduced these risks. Drug-induced hepatitis and cutaneous reactions were common adverse effects of anti-TB medications. A therapeutic drug monitorin...
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