Home diagnostic tests in the state of Qatar: a snapshot of public views, level of awareness and use

Background In Qatar, home diagnostic tests are available over the counter in community pharmacies. While possibly beneficial, these tests have the potential for harm if they are used in the absence of pharmacist counseling. Objectives To determine the public views, level of awareness and use of home diagnostic tests and to evaluate the extent of community pharmacists?? involvement in educating the public about these tests in Qatar. Setting Qatar??s Supreme Council of Health lists 245 community pharmacies in Qatar. Ten community pharmacies were randomly selected from the list as study sites. Method The investigators visited selected pharmacies on different weekdays and at different times of the day. Members of the public who appeared to be over 16?years of age and able to communicate in English or Arabic were randomly approached, provided with the study objectives, and requested to participate. Those who offered oral consent were anonymously interviewed using a multipart survey. Main outcome measures Measures include the public awareness and use of home diagnostic tests and the extent of community pharmacist involvement in educating the public about these tests. Results During the 5-month study period, 297 patients answered the survey (60?% response rate). Most respondents were aware of at least one home diagnostic test (98?%). The top four home diagnostic tests that the respondents had ever heard of included: thermometers (91?%), blood pressure monitors (91?%), blood sugar tests (86?%) and regular pregnancy tests (72?%). Seventy-one percent of respondents had performed at least one home diagnostic test. When asked about the factors that influenced their choice of the home diagnostic tests, the pharmacist was only cited by 7?% of respondents. The majority of respondents (>80?%) agreed that using a home diagnostic test is convenient, comfortable and helps them in early diagnosis and treatment of healthcare conditions. Only 31?% agreed that the pharmacist offered sufficient information on what to do in case the test result turns to be positive. The study results suggest that generally, the public has good attitudes and awareness of home diagnostic tests. However, the results indicate that Qatar community pharmacists are not sufficiently involved in public education about home diagnostic tests. Pharmacists should take a more active role in counseling the public on the proper use of these tests.     

Effect of small bowel resection on the intestinal surface acid microclimate in the rat

The effect of extensive (65%) proximal and middle small bowel resection on the intestinal surface acid microclimate (ISAM) of the remaining ileum in the rat was examined and the results were compared to those of sham-operated rats. ISAM pH measurements were performed in vivo using a pH microelectrode; incubation was performed in Krebs-Ringer phosphate buffer (pH 7.40 +/- 0.02). In the resected rats, ISAM pH of 6.03 +/- 0.07 and 7.22 +/- 0.03 were recorded in the proximal and distal part of the remaining ileum, respectively. In the sham-operated rats, ISAM pH of 6.04 +/- 0.07, 6.98 +/- 0.03 and 7.28 +/- 0.02 were recorded in the proximal jejunum and in the proximal and distal part of the corresponding ileal segment. ISAM pH was significantly lower (p less than 0.01) in the proximal part of the remaining ileum of the resected rats as compared to the corresponding part in the sham-operated rats but was similar in distal ileum. In fact, the ISAM pH of the proximal part of the remaining ileum of resected rats was as acidic as that of the jejunum of the sham-operated rats. These results clearly demonstrate that adaptation in the ISAM occurs in the remaining ileum following extensive resection of proximal and middle small intestine.     

The Various Applications of 3D Printing in Cardiovascular Diseases

Purpose of Review

To highlight the various applications of 3D printing in cardiovascular disease and discuss its limitations and future direction.

Recent Findings

Use of handheld 3D printed models of cardiovascular structures has emerged as a facile modality in procedural and surgical planning as well as education and communication.

Summary

Three-dimensional (3D) printing is a novel imaging modality which involves creating patient-specific models of cardiovascular structures. As percutaneous and surgical therapies evolve, spatial recognition of complex cardiovascular anatomic relationships by cardiologists and cardiovascular surgeons is imperative. Handheld 3D printed models of cardiovascular structures provide a facile and intuitive road map for procedural and surgical planning, complementing conventional imaging modalities. Moreover, 3D printed models are efficacious educational and communication tools. This review highlights the various applications of 3D printing in cardiovascular diseases and discusses its limitations and future directions.

     

Ligands for peroxisome proliferator-activated receptorγ and retinoic acid receptor inhibit growth and induce apoptosis of human breast cancer cells in vitro and in BNX mice

Induction of differentiation and apoptosis in cancer cells through ligands of nuclear hormone receptors (NHRs) is a novel and promising approach to cancer therapy. All-trans-retinoic acid (ATRA), an RA receptor-specific NHR ligand, is now used for selective cancers. The NHR, peroxisome proliferator-activated receptor γ (PPARγ) is expressed in breast cancer cells. Activation of PPARγ through a synthetic ligand, troglitazone (TGZ), and other PPARγ-activators cause inhibition of proliferation and lipid accumulation in cultured breast cancer cells. TGZ (10⁻⁵ M, 4 days) reversibly inhibits clonal growth of MCF7 breast cancer cells and the combination of TGZ (10⁻⁵ M) and ATRA (10⁻⁶ M, 4 days) synergistically and irreversibly inhibits growth and induces apoptosis of MCF7 cells, associated with a dramatic decrease of their bcl-2 protein levels. Similar effects are noted with in vitro cultured breast cancer tissues from patients, but not with normal breast epithelial cells. The observed apoptosis mediated by TGZ and ATRA may be related to the striking down-regulation of bcl-2, because forced over-expression of bcl-2 in MCF7 cells cultured with TGZ and ATRA blocks their cell death. TGZ significantly inhibits MCF7 tumor growth in triple immunodeficient mice. Combined administration of TGZ and ATRA causes prominent apoptosis and fibrosis of these tumors without toxic effects on the mice. Taken together, this combination may provide a novel, nontoxic and selective therapy for human breast cancers.     

Gastrointestinal perforation secondary to COVID-19: Case reports and literature review

Introduction:Corona virus disease-2019 (COVID-19) presents primarily with respiratory symptoms. However, extra respiratory manifestations are being frequently recognized including gastrointestinal involvement. The most common gastrointestinal symptoms are nausea, vomiting, diarrhoea and abdominal pain. Gastrointestinal perforation in association with COVID-19 is rarely reported in the literature.Patient concerns and diagnosis:In this series, we are reporting 3 cases with different presentations of gastrointestinal perforation in the setting of COVID-19. Two patients were admitted with critical COVID-19 pneumonia, both required intensive care, intubation and mechanical ventilation. The first one was an elderly gentleman who had difficult weaning from mechanical ventilation and required tracheostomy. During his stay in intensive care unit, he developed Candidemia without clear source. After transfer to the ward, he developed lower gastrointestinal bleeding and found by imaging to have sealed perforated cecal mass with radiological signs of peritonitis. The second one was an obese young gentleman who was found incidentally to have air under diaphragm. Computed tomography showed severe pneumoperitoneum with cecal and gastric wall perforation. The third case was an elderly gentleman who presented with severe COVID-19 pneumonia along with symptoms and signs of acute abdomen who was confirmed by imaging to have sigmoid diverticulitis with perforation and abscess collection.Interventions:The first 2 cases were treated conservatively. The third one was treated surgically.Outcome:Our cases had a variable hospital course but fortunately all were discharged in a good clinical condition.Conclusion:Our aim from this series is to highlight this fatal complication to clinicians in order to enrich our understanding of this pandemic and as a result improve patients’ outcome.