Prescribing Renally Inappropriate Medication to Hospitalized Geriatric Patients in Makkah, Saudi Arabia

Introduction

As a result of the physiological decline in renal function that comes with age and the common failure to recognise renal insufficiency, older adults aged 65 and above are at increased risk of receiving medications that are inappropriate for their level of renal function which in turn lead to increased risk of adverse effects. Little is known about how many older adults receive medications that are inappropriate for their level of renal function. This study aimed to determine the prevalence of renally inappropriate medications in elderly adults by reviewing patient files and evaluating the appropriateness of medication doses relative to renal function in patients aged ≥ 65 years at inpatient healthcare departments.

Methods

A retrospective cross-sectional study of patients aged ≥ 65 years was conducted, covering cases from 2015 to 2021. Patient's medical records were reviewed, their renal function and medications lists were evaluated, determined whether they had been prescribed at least one renally inappropriate medication based on drug-dosing recommendations for different degrees of renal function.

Results

A total of 317 elderly inpatients were included, 10% of whom had received inappropriate doses relative to their renal function. Glomerular filtration rate was associated with inappropriate dosing in this study. Of the patients CKD stage 5, 36.8% had at least one drug administered at an inappropriate dose, while this figure was 6.5% among the patients at CKD stage 1; this difference was statistically significant (p = 0.001).

Conclusion

A notable portion of older adults may be at risk of adverse effects due to inappropriate medication dosing related to their renal function. Further studies with large samples, drug use analyses based on comprehensive geriatric references and a prioritisation of actual outcomes over potential outcomes are needed to further determine elderly adults' exposure to inappropriate drugs.

Insight on the hepatitis B virus and host immune mechanisms in the context of occult hepatitis

Hepatitis B virus infection is the 10th leading cause of death around the world. Occult HBV infection (OBI) represents those with a viral load of < 104 IU/ml. Among permanent blood recipients, OBI appears to be the most common cause of posttransfusion hepatitis. Moreover, OBI may reduce hepatitis C virus (HCV) treatment responsiveness in people with chronic HCV infection, and OBI may become acutely reactivated when on immunosuppression or potentially contribute to chronic liver disease. Since most previous studies used either small sample sizes, diverse populations, or were cross-sectional in design, it is possible that using multiple techniques with varying sensitivity for HBV DNA measurement in the liver or serum will shed light on discrepancies in the impact of OBI in cases with chronic liver disease. The purpose of this research is to review many elements of OBI, such as its prevalence, the hepatitis B virus and host immune mechanisms, diagnostic procedures, clinical implications, therapy, and prevention strategies.

Perceptions of Saudis Toward Participating in the COVID-19 Convalescent Plasma Clinical Trial

Introduction The COVID-19 pandemic has been a major public health and economic issue worldwide. Even though vaccines have been developed to reduce the spread of the infection, treating patients remains a significant challenge. This study aims to measure the perceptions of Saudis toward participating in the COVID-19 Convalescent Plasma Clinical Trial. Method A cross-sectional study measuring the perceptions of Saudis toward participating in the COVID-19 Convalescent Plasma Clinical Trial was conducted with participants who had recovered from COVID-19. The study used an online questionnaire covering variables related to demographics, awareness, attitudes, perceptions, and plans for improvement. Results A sample of 1,051 participants participated in the questionnaire. A total of 85% had recovered from COVID-19, only 2.76% had participated in clinical trials before, and 83.44% would participate if they were advised or knew about them. The participants showed a high level of education, with 88% having obtained a degree and most used social media. The results can be biased toward the participants who get their knowledge from social media and hope to learn about things on social media. The gap in knowledge about clinical trials among the participants indicated that certain age groups could be targeted through channels where they communicate the most. Conclusion Engaging the community in clinical trials and educating others about their value by sharing experiences would help promote clinical trials and activate donations.

Li-Fraumeni syndrome in the setting of re-occurring malignancies after 27 years of remission: a case report

Multiple primary tumors are defined as multiple simultaneous (within 6 months) or heterogeneous tumors.

Case presentation

Here, the authors present the case of a 58-year-old Saudi female patient with Li-Fraumeni syndrome who has multiple primary tumors.

Clinical discussion

The surgical cytoreduction or 'debulking' technique is the main treatment option started in individuals with High Grade Serous Ovarian CanceR. This surgical strategy aims to completely remove all disseminated tumor masses that are present in the patient's peritoneal cavity on a macroscopic level.

Conclusion

In conclusion, in our case, she has developed her ovarian cancer 27 years after her breast cancer got treated. This was already stage IIIB to stage IV. If it was not for her incidental discovery of her urinary bladder cancer, which is most likely is a long-term sequel of using cyclophosphamide 27 years ago.Multiple primary tumors are defined as multiple simultaneous (within 6 months) or heterogeneous tumors. Here, the authors present the case of a 58-year-old Saudi female patient with Li-Fraumeni syndrome who has multiple primary tumors. In conclusion, in our case, she has developed her ovarian cancer 27 years after her breast cancer got treated. This was already stage IIIB to stage IV. If it was not for her incidental discovery of her urinary bladder cancer, which is most likely is a long-term sequel of using cyclophosphamide 27 years ago.