Knowledge about the Management of Anti-Epileptic Drug Treatment among General Practitioners in Brazzaville, Congo

Background: Epilepsy is a chronic brain disorder. It often leads to disabilities and handicaps. In Africa, epilepsy is almost exclusively treated by general practitioners (GPs) because of a shortage of epilepsy specialists. It is therefore important to know the level of knowledge about epilepsy among GPs in order to improve their skills. Objectives: To assess the level of knowledge about the management of anti-epileptic drug treatment among GPs in Brazzaville;to investigate the relationship between demographic factors and GPs’ knowledge. Methods: This was a cross-sectional analytical study. It was conducted from 20 July to 1 September 2021. It focused on GPs working in public hospitals and private care centers in Brazzaville. Information on treatment aspects was collected through a standardized 11-item questionnaire. Results: Among the 137 participants, there were 84 (61.3%) men and 53 (38.7%) women. Of these participants, 36 (26.3%) were trained in Congo versus 101 (73.7%) in other countries. Only 21 (15.3%) GPs had good knowledge about the management of anti-epileptic drug treatment. The overall average knowledge score among GPs was low (31.4%). No significant associations were found between low and good levels of knowledge and gender (OR = 1.03;95% CI = 0.40 - 2.68;p = 1.000), age groups (OR 0.05), training country (OR = 0.62;95% CI = 0.19 - 1.98;p = 0.591), practice hospital (OR = 0.40;95% CI = 0.05 - 3.20;p = 0.695) and duration of professional experience (OR 0.05). Conclusion: The study population has insufficient knowledge about the management of anti-epileptic drug treatment. Demographic factors have no impact on GPs’ knowledge. Epilepsy education programs are needed to improve GPs’ knowledge and skills.

Drug treatment of functional dyspepsia

有在药治疗以后的机能性消化不良的病人的征兆的改进经常在不超过 60% 病人不完全、获得。因为机能性消化不良是异构的疾病，这是可能的。尽管大进展与罗马的一致定义被完成了我和 II 标准，仍然关于机能性消化不良的定义有一些方面要求澄清。罗马标准明确地认识到腹上部的疼痛或不快 must 是在作为受不了机能性消化不良标记的病人的占优势的抱怨。然而，这个严格的定义能在每天主要的照顾创造问题临床的实践，有机能性消化不良的病人在此与多重症状介绍。在开始药治疗前，向病人提供疾病过程和安慰的解释被建议。彻底的体格检查和实验室数据和内视镜检查法的明智的使用也被显示。一般来说，基于他们的主要症状与机能性消化不良对待病人的途径实际、有效。通常，病人们应该与如果占优势的症状是腹上部的，使用质子泵禁止者的镇压治疗伤害的酸或胃的食道的倒流症状被对待。尽管在机能性消化不良的 Helicobacter pylori (H pylori ) 的角色继续是争论的一件事，最近的数据显示有在有机能性消化不良的病人的 H pylori 的根除的谦虚却清楚的利益。另外， H pylori 是胃的致癌物，如果发现，它应该被消除。尽管为有 FD 的病人没有特定的食谱，在健康锻练和吃的习惯指导病人可能是有用的。

Drug treatment of male fertility disorders

Drug treatment remains an active domain in the therapy of male fertility disorders. Although there are only a fewconditions that allow causal treatment, rational approaches are possible in many cases. Best results are obtained in casesrequiring an anti-inflammatory treatment and in patients with an impaired sperm transport. High-dosage administrationof FSH is a promising new development, aimed particularly at improving the disturbed sperm structures. A careful di-agnostic work-up with elucidation of the underlying disease is essential to achieve a successful therapy.

Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

Epidemiological Investigation of Brucellosis Spondylitis and Optimal Selection of Clinical Drug Compatibility, Treatment Course and Treatment Plan

Background: Brucellosis is a zoonotic endemic disease, the main source of infection is infected cattle, sheep, pigs and their products. In recent years, the global incidence of brucellosis spondylitis has increased year by year, and it has spread from pastoral areas to semi-agricultural and semi-pastoral areas, agricultural areas and cities. It has changed from a mainly occupational disease to a mainly food-borne disease, and it is also a zoonotic specific spinal infectious disease that WHO and governments around the world pay great attention to. Due to the low cure rate and high recurrence rate of traditional drug therapy regimen. Therefore, to carry out epidemiological investigation and Related research on clinical drug therapy of brucellosis spondylitis has practical significance for improving diagnosis rate, cure rate and reducing recurrence rate. Objective: To analyze the epidemiological characteristics of Brucellosis spondylitis and explore the choice of drugs and the best drug treatment plan, so as to provide scientific basis for improving the prevention and control of the disease and treatment effect. Methods: Clinical epidemiodogical materials were collected from 113 patients with brucellar spondylitis. All these patients were divided into 5 different groups according to 5 kinds of drugs adopted respectively, and then the patients were given different course of treatment. Results: In the 113 patients, brucellar spondylitis morbility of female patients were higher than that of male ones, and the morbility of Bashang were higher than that of Baxia. These patients were infected mainly through browsing and breeding beasts. Lumbars were the major focus of infection. It was very comnlon that two adjacent lumbars were involved in concurrently. L4 was the most common infection location and its demolishment was most serious. The curative effect of group treated with doxycycline was better than that of group treated without doxycycline. If the course of treatment Was increased, the curative effect Was not increased obviously. Conclusions: There are characteristic features in clinical epidemiology of brucell spondylitis. Doxycycline + Rifampicin + Sulfamethoxazole was used as the preferred antibiotic. Using antibiotics adequately and jointly by two courses of treatment for a long time is the most reasonable way to treat the disease and prevent the disease from recurrence.

Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus

Type 2 diabetes mellitus （T2DM） is one of the common endocrinology diseases that greatly affects the health care sector and economy. Application of hypoglycemic drugs has its own drawbacks and the use of non-drug therapy on treating T2DM has drawn much attention recently. This paper reviewed the research development of the non-pharmacological interventions on T2DM in recent years, including dietary therapy, exercise therapy, psychotherapy, acupuncture and moxibustion therapies and so on. The authors mentioned the problems in the research of non-drug treatment for blood glucose control of T2DM and put forward new ideas for the research in the future. Further well-designed trials with large sample size and long-term follow-up are needed to confirm current conclusions.

The Assessment of the Clinical Effect of the Drug Compatibility and Course of Treatment to the Brucellar Spondylitis

Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.

Incidence of Interpersonal Violence among Individuals with Drug Addiction Receiving Compulsory Treatment: A Survey at Two Drug Detention Centers in Hunan, China

Drug dependence is a serious global health problem.To assist individuals with drug addiction,China alone has established 678 Compulsory Detoxification Detention Centers （CDDCs） that treat over300,000i ndividuals who are required by national law to receive compulsory treatment;because community-based outpatient treatment failed.

Optimizing hepatitis C virus treatment through pharmacist interventions: Identification and management of drug-drug interactions

AIM To quantify drug-drug-interactions(DDIs) encountered in patients prescribed hepatitis C virus(HCV) treatment, the interventions made, and the time spent in this process.METHODS As standard of care, a clinical pharmacist screened for DDIs in patients prescribed direct acting antiviral(DAA) HCV treatment between November 2013 and July 2015 at the University of Colorado Hepatology Clinic. HCV regimens prescribed included ledipasvir/sofosbuvir(LDV/SOF), paritaprevir/ritonavir/ombitasvir/dasabuvir(OBV/PTV/r + DSV), simeprevir/sofosbuvir (SIM/SOF), and sofosbuvir/ribavirin (SOF/RBV). This retrospective analysis reviewed the work completed by the clinical pharmacist in order to measure the aims identified for the study. The number and type of DDIs identified were summarized with descriptive statistics.RESULTS Six hundred and sixty four patients(83.4% Caucasian, 57% male, average 56.7 years old) were identified; 369 for LDV/SOF, 48 for OBV/PTV/r + DSV, 114 for SIM/SOF, and 133 for SOF/RBV. Fifty-one point five per cent of patients were cirrhotic. Overall, 5217 medications were reviewed (7.86 medications per patient) and 781 interactions identified (1.18 interactions per patient). The number of interactions were fewest for SOF/RBV (0.17 interactions per patient) and highest for OBV/PTV/r + DSV (2.48 interactions per patient). LDV/SOF and SIM/SOF had similar number of interactions (1.28 and 1.48 interactions per patient, respectively). Gastric acid modifiers and vitamin/herbal supplements commonly caused interactions with LDV/SOF. Hypertensive agents, analgesics, and psychiatric medications frequently caused interactions with OBV/PTV/r + DSV and SIM/SOF. To manage these interactions, the pharmacists most often recommended discontinuing the medication (28.9%), increasing monitoring for toxicities (24.1%), or separating administration times (18.2%). The pharmacist chart review for each patient usually took approximately 30 min, with additional time for more complex patients. CONCLUSION DDIs are common with HCV medications and management can require medication adjustments and increased monitoring. An interdisciplinary team including a clinical pharmacist can optimize patient care.

Molecular diagnosis and treatment of drug-resistant hepatitis B virus

Oral antiviral agents have been developed in the last two decades for the treatment of chronic hepatitis B(CHB).However,antiviral resistance remains an important challenge for long-term CHB therapy.All of the clinically available oral antiviral agents are nucleoside or nucleotide analogues that target the activity of viral reverse transcriptase(RT),and all are reported to have resistant mutations.Since the hepatitis B virus(HBV)RT,like other viral polymerases,lacks proofreading activity,the emergence of drug-resistance occurs readily under selective pressure from the administration of antiviral agents.The molecular diagnosis of drug-resistant HBV is based on sequence variations,and current diagnostic methods include sequencing,restriction fragment polymorphism analysis,and hybridization.Here,we will discuss the currently available molecular diagnosis tools,in vitro phenotypic assays for validation of drug-resistant HBV,and treatment options for drug-resistant HBV.

A model for retention and continuity of care and treatment for opioid dependent injection drug users in the Russian Federation

Health and Development Foundation has worked collaboratively with the Government of the Russian Federation to develop and implement a model program of retention and continuity of care for opioid dependence and HIV infection. The model utilizes the Narcology Detoxification Service, State AIDS Centers, Non Government Organization (NGO) managed narcology treatment and rehabilitation centers, NGO outreach programs and the community. The model program was developed and implemented as a pilot demonstration project to provide essential health services to injection drug users and retain them in care. The interventions developed and implemented comprised HIV Testing and Counseling, HIV/AIDS Narcology Post-Graduate Curriculum, Peer Support Groups (Buffer groups), Narcological Follow-up Phone Monitoring, Women’s Narcological Services and Short Messaging Services for Injection Drug Users. These services and interventions promoted the integration and utilization of HIV/AIDS health services and narcological services to form an evidence-based health service delivery model providing essential services to people who inject drugs and people living with HIV/AIDS in the Russian Federation.

Duration of dual antiplatelet treatment in the era of next generation drug-eluting stents

Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high risk of bleeding.Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo,especially following next-generation DES implantation,for cost-effectiveness.However,the clinical results are inconsistent and the data regarding next-generation DESs limited.In this report,recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized.

The Effectiveness of Surgical Methods of Treatment of Pulmonary Tuberculosis for Patients with Multidrug Resistant at Adequate Chemotherapy (Retrospective, Case Control, Comparative Research)

In this article, there are given results of comparative studying of efficiency of surgical and conservative treatment of 277 patients with multidrug resistant tuberculosis. The effectiveness of the surgical treatment of the main group of patients against the background of chemotherapy with anti-TB chemotherapy with the drugs of the reserve line has been compared with two control groups: Group I—Surgical intervention was implemented with drugs of the first line, Group II—Chemotherapy was conducted with anti-TB drugs of the second line without surgical intervention. Treatment outcomes in three groups were stated after cohort investigation, and following results were obtained: Effectiveness of surgical treatment of patients of the main group with MDR TB treated with anti-TB drugs of the second line constituted 98.0% versus 53.7% in the Group II. Effectiveness of conservative treatment of patients in III (control) Group constituted 74.4%. Analysis of results obtained showed that the outcomes in the main group after regimen completed were higher by 1.8 times than in patients operated against the background of treatment with the drugs of the first line and by 1.3 times higher than effectiveness in patients in the Group III (P < 0.01). Effectiveness of the treatment in the Group II was obtained through implementation of collapse-surgical interventions. In this article, the statistical program STAT 10 was applied.

Study of the Duration of Treatment in Drug Prescriptions Received in Pharmacies in Dakar

The prescription must include the name of the drugs or products prescribed, dosage form, dosage, directions for use and duration of treatment. However, sometimes errors can occur that can have consequences for the health of patients. Our study concerns the use of medical prescriptions received in pharmacies in the Dakar department. The survey was conducted in 90 pharmacies in these communes, which represent one third of the 270 pharmacies in the department of Dakar. This allowed us to study 2700 prescriptions. The study took place from 1 December 2016 to 30 June 2017, i.e. over a period of 7 months. Our results show that neurologists and urologists have a longer average treatment time than other specialists, with an average of 120 days and 90 days of treatment respectively. Then, the specialists who take a long time the drug represent more than 27%, and require renewal of the drug. In 63.90% of the cases, no notification on the duration of treatment was given by the prescriber. Only 5.39% were only given the mention “to be renewed”. At the end of our analysis, we can say that the prescription must be perfectly legible to avoid confusion by the patient or the pharmacist. The pharmacist then participates in the therapeutic education of the patient and thus helps him/her to live better with his/her disease. Therefore, socio-professional health associations and organisations must provide more continuous training on prescribing to ensure good compliance and above all avoid people buying medicines in the parallel circuit in order to better control health expenditure.

Work as An Effective Intervention Strategy and Rehabilitation Treatment Program for People Who Abuse Drugs And Alcohol

Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify!they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be exqlored and tested for effectiveness, and applied.

The Effectiveness of Mindfulness Therapy in Controlling under Treatment Addicts’ Drug Cravings

The present study aimed to examine the effectiveness of mindfulness therapy in controlling under treatment addicts’ drug cravings. This was a quasi-experimental study with pretest and posttest. The sample of this study included 30 under treatment male addicts whom were selected through applying random sampling method and were placed in two groups, experimental and control. After holding a preliminary session aiming at aiding the experimental group to become familiar with the procedure, 8 sessions of the mindfulness-based therapy were administered. Assessment tools were Craving Beliefs Questionnaire (CBQ) and the Depression Anxiety Stress Scale (DASS-21). After calculating mean and standard deviation, the obtained data were analyzed using covariance. The results indicated that the mindfulness therapy was significantly effective in controlling drug cravings, decreasing stress, anxiety, and depression of under treatment addicts (p < 0.05).

Natural Tubular Halloysite as Drug Carrier: Effect of Organosilane Modification and Thermal Treatment

Naturally occurring tubular halloysite is a potential drug carrier because of the significant deposit, unique mesoscopic (2-50 nm) or even macroscopic (>50 nm) lumen, and excellent biocompatibility. The drugs loaded on halloysite exhibited slow release under the diffusion limitation by the halloysite nanotube. However, due to the weak interaction between halloysite and guest, the loading capacity of halloysite was relatively low. This drawback severely limits the application of halloysite as carrier in pharmaceutics. In this study, the performance of halloysite as carrier for ibuprofen (IBU) loading was investigated for the first time. The effects of 3-aminopropyltriethoxysilane (APTES) modification and thermal treatment of halloysite on the loading and release of IBU were also studied. The purified halloysites were heated at 120 ℃ and 400 ℃ (labeled as Hal/120 and Hal/400), and then modified with APTES (labeled as Hal/120-A and Hal/400-A). The loading of IBU was achieved by soaking method (labeled as IBU-Hal/120, IBU-Hal/400, IBU-Hal/120-A, and IBU-Hal/400-A.). The in vitro drug delivery assays were performed in phosphate buffer solution. IBU was loaded mainly into the lumen and partially on the external surface of halloysite. The order of IBU contents was as follows: IBU-Hal/400-A (14.8wt%) > IBU-Hal/120-A (12.7wt%) > IBU-Hal/400 (11.8wt%) > IBU-Hal/120 (11.7wt%). The IBU was initially anchored to the surface hydroxyl groups of halloysite by hydrogen bonding, followed by further bonding of IBU with the anchored IBU to form hydrogen-bonded aggregates. The APTES modification of halloysite promoted the loading of IBU by introducing a strong affinity through electrostatic attraction between the introduced aminopropyl groups of APTES and the carboxyl groups of IBU. Thermal treatment at 400°C did not destroy the tubular morphology or the crystal structure of halloysite and had little effect on IBU loading in unmodified halloysite. However, thermal treatment by reducing water content in halloysite restricted the grafting of APTES in the lumen space, and further increased IBU loading. All IBU-loaded samples exhibit a burst release with a following slow release. However, owing to the strong electrostatic attraction in modified samples, the burst release was much more suppressed and the release rate was also lower than that in unmodified ones. The in vitro release profiles of the IBU-loaded samples were well fitted with the modified Korsmeyer-Peppas model. The IBU release mechanism of the unmodified samples was Fickian diffusion; however it was non-Fickian diffusion for the modified samples. The findings are of significance for broadening the use of halloysite as carrier for drugs and other active molecules in the pharmaceutical, pesticides, and coating industries.

CLINICAL OBSERVATION ON THE TREATMENT OF APOPLEXY BY ACUPUNCTURE COMBINED WITH DRUGS

Apoplexy involves cerebrovascular accident, such as cerebral hemorrhage, cerebralthrombosis, cerebral infarction, subarachaoid hemorrhage, etc. and its sequelae in modern medicine. The author treated 81 cases of apoplexy using acupuncture combined with drugs. AIn0ng them, 36cases were male, accounting for 44%; 45 cases female, accounting for 56 %. The oldest was 82 yearsold, and youngest 28 years old. The shortest course of disease was one day, and the longest over 3years The treatment results show that 60 cases were cured, accounting for 74. 07%; 16 casesmarkedly effect, acc0unting for 19. 75 %; 3 cases improved, accounting for 3. 7 %; 2 cases ineffective,accounting for 2. 48 %. The total effect rate was 97. 52 %.

The Impact of Matrix Treatment (Family Training) in Reducing the Amount of Drug Consumption in Heroin and Crack Addicts

The purpose of this study is to investigate the impact of family training based on matrix model in reducing the amount of drug consumption by heroin and crack addicts. The subjects were referral to Karaj Clinic, Karaj City, Iran, for crack abuse in 2013. In order to select participants convenience sampling was been used and totally 45 patients were selected (15 heroin addict, 15 crack addict, and 15 with combination of heroin and crack addiction) and put into two groups of experimental and control groups randomly. For collecting the data, Addiction Severity Index questionnaire was used. Descriptive and inferential statistics were used through one-way analysis of covariance for data analyzing. The results indicated that there was statistical difference between the experimental and control group with consumption of heroin and crack in family status, mental and substance use and also it has been shown that the experimental group with heroine consumption achieved better performance compared with the control group in the amount of consumption.