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The recent pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of Coronavirus Disease 2019 (COVID-19) has introduced itself into the human population in the 21st century after the coronavirus diseases SARS-CoV and Middle East respiratory syndrome (MERS-CoV). Major investigations are underway worldwide in the search for pharmaceutical interventions for COVID-19 and many agents are administered in off-label routes. Several cases are under study to check or restrict clinical manifestations of COVID-19. According to the fact that the efficacy of some micro-nutrients like vitamins is proven to treat or prevent infectious diseases because of their antimicrobial and immunomodulatory activity, the potential role of vitamins in the COVID-19 treatment or prevention must be considered. [ABSTRACT FROM AUTHOR]

The article focuses on concerns raised about the China Tongxinluo Study for Myocardial Protection in Patients With Acute Myocardial Infarction (CTS-AMI) due to the absence of patient risk stratification, despite its significant findings on Tongxinluo's clinical outcomes in acute ST-segment.

The article focuses on the efficacy of orforglipron in achieving significant weight reduction in adults with obesity, while also addressing safety concerns related to a potential increased risk of thyroid cancers associated with glucagon-like peptide-1 (GLP-1) receptor agonists.

Because of the key role blood viscosity plays in the regulation of blood pressure (BP) and the hemorheological effects of pentoxifylline (PTX), this study was conducted to evaluate whether PTX can reduce BP when added to captopril in patients with stage 1 hypertension. In this randomized clinical trial 62 patients with stage 1 hypertension were entered. The intervention group (n = 30) received 1200 mg PTX in 3 divided doses plus 25 mg captopril 3 times a day, whereas the control group (n = 32) received only 75 mg captopril in 3 divided doses. Measurements of BP were done at baseline and in the first and second months after entering the study. Major adverse cardiac events during this period were recorded. When the systolic BP levels in the intervention and the control groups were compared, no significant differences at baseline (150.4 ± 6.03 versus 150.4 ± 6.2, P =.98) or first (138.4 ± 9.4 versus 142.3 ± 5.6, P =.08) or second (134.6 ± 8.9 versus 137.4 ± 6.0, P =.20) month of the study were noted. Similarly no significant difference was observed in the diastolic BP at baseline (91.7 ± 3.9 versus 92.0 ± 3.7, P =.84) or first (85.5 ± 5.1 versus 86.9 ± 3.8, P =.27) or second (82.6 ± 5.7 versus 84.0 ± 3.5, P =.31) month. Based on the results of present study, adding PTX as a hemorheological agent to captopril could not significantly reduce blood pressure in the patients with stage 1 hypertension. [ABSTRACT FROM AUTHOR]

Background and Objectives: Hypertension is one of the main risk factors of cardiovascular diseases and associated with mortality and morbidity all over the world. This study was designed to evaluate the rate of blood pressure (BP) control and its associated risk factors in Tabriz University of Medical Sciences. Material and Methods: This cross-sectional prospective study was conducted for a ten-month period in patients with hypertension and concomitant cardiovascular disease. The BP of participants was measured by the cardiologist. Demographic information, drug and medical history, lab data, smoking, use of opium or alcohol or amphetamine were recorded in a data collecting form. The Spearman and logistic regression analysis were performed to access the association of study risk factors and control of hypertension. Results: Totally, 314 patients were entered to the study. The mean age of patients was 62.7±12.2. 139 (44.3%) of the patients were female and 175 (55.7%) were males. The mean systolic BP of patients was 131.6 ± 2 and diastolic BP was 78.3 ± 12.9 mmHg. Approximately, half of patients had an uncontrolled BP (n=114, 45.9%). The most common drug regimen is associated with dual therapy in 152 cases (48.4%). The ACEI/ARBs and beta-blockers were the most commonly used drugs. There were significant association between not-controlling BP and age (r=0.29, p=0.022) and diabetes (r=0.273, p=0.024). Conclusion: The results showed that BP in about half of patients was not in goal and this observation was seen more commonly in older and diabetic patients. This study raises the concern about the control of hypertension among health care providers and patients. [ABSTRACT FROM AUTHOR]

Purpose: Medication errors (MEs) are a leading cause of morbidity and mortality, yet they have remained as confusing and underappreciated concept. The complex pharmacotherapy in hospitalized patients necessitates continued report and surveillance of MEs as well as persistent pharmaceutical care. This study evaluated the frequency, types, clinical significance, and costs of MEs in internal medicine wards. Methods: In this 8-month prospective and cross-sectional study, an attending clinical pharmacist visited the patients during each physician's ward round at the morning. All MEs including prescription, transcription, and administration errors were detected, recorded, and subsequently appropriate corrective interventions were proposed during these rounds. The changes in the medications' cost after implementing clinical pharmacist's interventions were compared to the calculated medications' cost, assuming that the MEs would not have been detected by clinical pharmacist and continued up to discharge time of the patients. Results: 89% of the patients experienced at least one ME during their hospitalization. A mean of 2.6 errors per patient or 0.2 errors per ordered medication occurred in this study. More than 70% of MEs happened at the prescription stage by treating physicians. The most prevalent prescription errors were inappropriate drug selection, unauthorized drugs and untreated indication. The highest MEs occurred on cardiovascular agents followed by antibiotics, and vitamins, minerals, and electrolytes. The net effect of clinical pharmacist's contributions in medication therapy management was to decline medications' costs by 33.9%. Conclusion: The role of clinical pharmacy services in detection, prevention and reducing the cost of MEs is of paramount importance to internal medicine wards. [ABSTRACT FROM AUTHOR]

High plasma level of P-selectin is associated with the development of venous thromboembolism (VTE). Furthermore, supplementation of vitamin D could decrease thrombotic events. Hence, this study was designed to examine whether the administration of vitamin D can influence the plasma level of P-selectin in patients with VTE. In the randomized controlled trial, 60 patients with confirmed acute deep vein thrombosis and/or pulmonary embolism (PE) were randomized into the intervention (n = 20) and control (n = 40) groups. The intervention arm was given an intramuscular single dose of 300 000 IU vitamin D3. Plasma level of 25-hydroxy vitamin D, P-selectin, and high-sensitive C-reactive protein (hs-CRP) was measured at baseline and 4 weeks after. The plasma level of P-selectin (95% confidence interval = −5.99 to −1.63, P = .022) and hs-CRP (P = .024) significantly declined in vitamin D-treated group, while only hs-CRP was significantly decreased in the control group (P = .011). However, the magnitude of these reductions was not statistically significant. This study could not support the potential benefit of the high-dose vitamin D on plasma level of P-selectin and hs-CRP in patients with VTE. [ABSTRACT FROM AUTHOR]

Anemia of chronic diseases (ACD) is a common problem in patients with infectious diseases and can influence the quality of life and patients> survival. Despite the clinical importance of ACD, data are still lacking regarding this problem in the infectious diseases. This study aimed to evaluate the prevalence, related factors, outcome and approaches to anemia in the infectious diseases ward. This retrospective study was performed to review the medical records of patients admitted to the infectious diseases department of Imam Khomeini hospital during a two-year period between 2009 and 2011. A standard protocol was developed to evaluate anemia. Patients' demographic data approaches to manage anemia and routine laboratory tests were recorded and compared with the protocol. Totally, 1,120 medical records were reviewed. ACD was recognized in 705 patients (63%). Only 5.1% of diagnostic and 8.7% of treatment approaches was based on the protocol. The majority of patients (89.4%) were received inappropriate treatment regarding. Mortality rate of patients with ACD was 3.4%. Moreover, a significant correlation between anemia and mortality was detected (r = 0.131; p = 0.026). A statistically significant correlation was also identified between patients' Hgb and ESR, CRP, reasons of admission, number of medications, and underlying diseases. In conclusion, results of this study suggested that ACD is a common problem in infectious diseases patients and significantly associated with patients' mortality. Moreover, the majority of studied patients were not received an appropriate diagnostic and treatment approach which arises more concerns regarding the management of ACD in infectious diseases setting. [ABSTRACT FROM AUTHOR]

Low plasma level of vitamin D is linked to the increased risk of cardiovascular diseases such as hypertension, diabetes, dyslipidemia and peripheral vascular diseases. Vitamin D deficiency is a worldwide problem that involves Iranian population. To the best of our knowledge, this was the first investigation on venous thromboembolism (VTE) subjects that assessed the correlation of vitamin D level with plasma P-selectin, hs-CRP, and risk factors of thrombosis. In this prospective pilot study, patients with diagnosis of acute deep vein thrombosis and/ or pulmonary embolism were enrolled. All patients' clinical data, demographics and risk factors of thrombosis were evaluated. Plasma level of P-selectin and hs-CRP were measured by ELISA method. Radio immune assay method was used to determine plasma level of 25-hydroxy vitamin D (25(OH) D). In this study, 60 subjects were included. The mean ± SD plasma 25-hydroxy vitamin D level (25(OH) D) of participants was 21.4 ± 14.6 ng/mL. The vitamin D deficiency was detected in 60% of patients. No significant relation was found between the plasma 25(OH)D level and P-selectin and hs-CRP. In multiple regression analysis, there was a significant relationship between the level of 25(OH)D and the patients' age (beta = 0.452; p = 0.001), diabetes (beta = 0.280; p = 0.036) and positive family history of cardiovascular diseases (beta = 0.373; p = 0.003). Vitamin D deficiency is a frequent problem in Iranian VTE patients. Moreover, Plasma level of vitamin D is not associated with P-selectin and hs-CRP in VTE patients. [ABSTRACT FROM AUTHOR]

Background: Isotretinoin (13-cis retinoic acid) is used for treatment of nodular cystic acne unresponsive to conventional therapy. It is an expensive, potent teratogenic drug with serious adverse drug reaction (ADRs). Recently, use of this drug has increased in Iran. To date, there are no published data about the use of isotretinoin in Iran; therefore, this study aims to assess its use in this country. Methods: This was a prospective, drug utilization evaluation (DUE) study conducted in an institutional community pharmacy affiliated with Tehran University of Medical Sciences (TUMS). Drug prescription, administration, and evaluation of appropriateness were recorded and compared with standard protocols. Collected data were analyzed by SPSS software. Results: A total of 274 outpatients treated with isotretinoin enrolled in the study. Of these, 51.3% were prescribed isotretinoin under the usual recommended daily doses of 0.5mg/kg/day. Data also indicated that 33.5% of the patients were given total doses of less than 100 mg/kg (72.4 ± 17.2 mg/kg) and 12.2% received more than 150 mg/kg. With regards to the teratogenic effects of isotretinoin, only 6.8% of couples simultaneously used two methods of contraception (P = 0.001 ). In addition, we detected improper use of isotretinoin for mild and moderate acne in about 20% of cases. Conclusion: The most important finding of this study is that the doses of isotretinoin are incorrect in many cases. Incorrect dosages would decrease drug efficacy and increase the risk of relapse. In addition, patients have not been adequately counseled about isotretinoin's teratogenicity and the seriousness of its adverse effects. [ABSTRACT FROM AUTHOR]

Background and Aims: Adverse drug reactions (ADRs) are one of the major leading causes of death in the world. This study was designed and conducted because of the importance of adverse events in the cancer treatment setting and regarding this issue there is no study exploring adverse reactions of acute hematologic malignancy chemotherapy in Iranian population. Methods: This was a prospective, cross-sectional study performed at hematology-oncology and bone marrow transplantation research center. The inclusion criteria were all patients with acute hematologic malignancies such as ALL and AML, which were admitted over an 8 months period and were >15 years old age. Each ADR was categorized based on the WHO system organ classification. Results and Conclusion: The total number of detected ADRs was 310 in total of 105 patients. Eight patients (7.6 %) experienced only one ADR, eleven patients (10.5%) experienced two ADRs and eighty-six of them (82%) experienced more than two ADRs. there was a significant relationship between the number of ADRs and type of hematologic malignancy. In this regard, the patients with AML malignancy showed more number of ADRs than with ALL malignancy (p<0.05) The Gastro-intestinal system disorders were the most common affected system-organ by chemotherapy regimens (33.5%). We suggest more well designed studies to determine the relation between the number of ADRs and study factors. [ABSTRACT FROM AUTHOR]

Since there is no specific recommendation of sodium‐glucose cotransporter‐2 (SGLT‐2) inhibitors in acute myocardial infarction (MI), this systematic review and meta‐analysis was performed to address this lack of evidence. Scopus, Embase, PubMed, Web of Sciences, and Cochrane Library were searched from inception until May 30, 2024. We used both random and fixed‐effects models for data analyses. Odds ratio (OR) and standard means difference (SMD) were performed for binary and continuous variables, respectively. Nine studies including five randomized clinical trials (RCTs) and four observational studies including 15,595 individuals with acute MI were entered. Overall, SGLT‐2 inhibitors are significantly associated with a reduction of hospitalization for heart failure (OR, 0.78; 95% CI, 0.63 to 0.97; P =  .02; I2 = 0%) and all‐cause mortality (OR, 0.55; 95% CI, 0.38 to 0.81; P =  .002; I2 = 0%) based on the RCTs and observational studies, respectively. SGLT‐2 inhibitors also significantly improved the left ventricular ejection fraction (SMD, 0.36; 95% CI, 0.02 to 0.70; P =  .04; I2 = 62%) among RCTs. Further evaluation of these drugs also revealed an acceptable safety profile without any major adverse events. In conclusion, although SGLT‐2 inhibitors may have some clinical benefits among acute MI individuals, further RCTs are still needed to provide robust evidence regarding the use of SGLT‐2 inhibitors in this setting. [ABSTRACT FROM AUTHOR]

Background: The effects of sodium–glucose cotransporter-2 (SGLT-2) inhibitors on ischemia reperfusion injury (IRI) is a novel concept and only limited number of animals studies have yet been investigated. We aimed to perform a systematic review of literature to explore the clinical studies which investigated the effects of SGLT-2 inhibitors on myocardial IRI setting.Methods: We searched MEDLINE, Embase, and Cochrane Library from inception until December 7th, 2023. ClinicalTrials.gov was also explored for ongoing studies. Two authors independently conducted the literature search, examined the studies, and evaluated the eligibility criteria. Any disagreements or uncertainties were resolved by the corresponding author. The search strategy followed the PICO process (Population, Intervention, Comparison, and Outcome) and Emtree was used to select relevant keywords.Results: Of 220 articles identified from the literature research, five articles were included in the study, of which three studies lately were retracted. The remaining studies included 1229 participants, with 209 receiving SGLT-2 inhibitors and 1090 not receiving them. All of the participants were diabetic patients admitted with acute myocardial infarction (AMI), undergoing percutaneous coronary intervention (PCI). The results demonstrated that the use of SGLT-2 inhibitors is associated with lower troponin levels, and higher rates of ST resolution. The results of the studies also showed smaller infarct sizes, lower inflammatory biomarkers and improved left ventricular function at discharge among SGLT-2 inhibitor users.Conclusion: In line with in vivo and ex vivo findings, the results of this systematic review supported benefits of SGLT-2 inhibitors in IRI through reducing infarct size and inflammatory biomarkers. However, further clinical trials are warranted to provide robust evidence. [ABSTRACT FROM AUTHOR]

Background: According to many studies, vitamin D deficiency has been linked to cardiovascular diseases (CV). Other than maintaining skeletal health, vitamin D has been shown to decrease the risk of developing CV disease such as hypertension, coronary artery disease (CAD) and thromboembolism. Materials and Methods: To perform a comprehensive review of the current literature on vitamin D and CV disease, we searched the online database, including PUBMED, Scopus, and Google Scholar until data inception January 2016. The search term included "vitamin D", "blood pressure", "hypertension", "coronary artery disease "and "thrombosis". We only included human studies that were published in English. Results: A majority of data indicate that there is no relationship between vitamin D and hypertension, but the association of vitamin Dwith thrombosis is yet to be determined. Vitamin D is a fair predictor of adverse outcomes in coronary artery disease (CAD), which highlights it for future studies. Conclusion: According to research, there is a high prevalence of vitamin D deficiency among patients with CV diseases, which needs to be diagnosed and treated. [ABSTRACT FROM AUTHOR]

By triggering immune responses in malignancies that have generally been linked to poor outcomes, immunotherapy has recently shown effectiveness. On the other hand, tumors provide an environment for cells that influence the body's immunity against cancer. Malignant cells also express large amounts of soluble or membrane-bound ligands and immunosuppressive receptors. In this regard, the combination of oncolytic viruses with pro-inflammatory or inflammatory cytokines, including IL-2, can be a potential therapy for some malignancies. Indeed, oncolytic viruses cause the death of cancerous cells and destroy the tumor microenvironment. They result in the local release of threat signals and antigens associated with tumors. As a result, it causes lymphocyte activity and the accumulation of antigenpresenting cells which causes them to accumulate in the tumor environment and release cytokines and chemokines. In this study, we reviewed the functions of IL-2 as a crucial type of inflammatory cytokine in triggering immune responses, as well as the effect of its release and increased expression following combination therapy with oncolytic viruses in the process of malignant progression, as an essential therapeutic approach that should be taken into consideration going forward., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

According to studies, a significant association exists between the low levels of vitamin D and cardiovascular diseases such as myocardial infarction (MI). In a prospective case control study, 88 patients with acute coronary syndrome (ACS) including ST elevation myocardial infarction (STEMI) and Non-STEMI were enrolled. The plasma level of 25-hydroxy vitamin D [25(OH) D] was obtained at the time of acute MI. To assess the association between study variables logistic regression analysis was done. The overall rate of vitamin D deficiency was documented in 59.1% with the significantly higher prevalence rate in STEMI group (77.5% versus 43.7%; p = 0.001). In STEMI group, the plasma level of 25(OH) vitamin D was significantly lower than non-STEMI group (13.5 ± 7.7 versus 24.3 ± 14.9; p = 0.001). Vitamin D deficiency was the main predictor in occurring the ST elevation type of MI (Odd ratio: 8.1, 95% CI: 2.3 - 28.2; p = 0.001). The results of the present study demonstrated a higher prevalence of vitamin D deficiency among ACS patients. Furthermore, vitamin D deficiency was responsible for occurring ST elevation type of MI among ACS patients. Large studies are needed to confirm these findings.

Acute myocardial infarction (AMI) is one of the main leading causes of mortality and morbidity. Despite the progress in the treatment of AMI, streptokinase is still being used in many countries. Because of the critical condition of patients with AMI and complications of streptokinase therapy, this study was performed to evaluate the pattern of adverse drug reaction (ADRs) induced by streptokinase and its associated risk factors in patients with acute ST elevation MI. A prospective cross-sectional study in a 14-month period was done at the university affiliated referral cardiovascular center. The Naranjo probability scale and Food and drug administration (FDA) criteria for severity of ADRs were performed for assessing the ADRs. The linear and logistic regression tests were used to evaluate the correlation between ADRs and study risk factors. During the study period, 217 patients who received streptokinase were entered. The majority of patients (n = 191) experienced at least one ADR. Six patients died in-hospital mainly because of cardiac causes. The history of drug allergy was the main predictor in occurring of ADRs (Odds ratio: 3.26; 95% CI: 1.48-457.6; p =0.026). The most serious ADR was hemorrhagic stroke with a 1.4% incidence. Hypotension was one of the most occurred ADR (n = 75). Anaphylactic shock was not detected in this study. In summary, our study showed that the history of drug allergy is the main predictor in occurring of ADRs by streptokinase. Furthermore, streptokinase therapy was associated with a higher rate of hemorrhagic stroke in Iranian population.

Objective: Current literature indicates that the presence of clinical pharmacists in hospitals results in improved patient care, rational drug therapy, and treatment costs. This study assessed the clinical pharmacy services in the intensive care unit (ICU) of a tertiary hospital at Tabriz University of Medical Sciences, Iran., Methods: During a 9-month cross-sectional study (2014-2015), the clinical pharmacy interventions in 27 sessions and educational activities for patients and health-care professionals were randomly assessed based on the Australian guideline and standard of practice for clinical pharmacy. The interventions of clinical pharmacist were evaluated in terms of their clinical importance., Findings: In this study, a total of 832 interventions on 242 patients were performed by the clinical pharmacist, and approximately 93.6% of the interventions were approved by the attending physician. Most interventions concerned adding a new medication to a drug regimen or switching to a needed new medication. Each patient received an average of three interventions. The clinical pharmacist provided drug information to employees and medical staff in 108 of the total 832 interventions (13%). Medical residents who were surveyed indicated that the quality of education, research, and patient care was improved by the attendance of a clinical pharmacist., Conclusion: The results of this study show that the collaboration of a clinical pharmacist with the medical staff of an ICU can improve pharmacotherapy approach and increase the quality of education., Competing Interests: There are no conflicts of interest.