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Fulltext Comparative Assessment of Antibiotics and Probiotics: Adjuvants in Nonsurgical Periodontal Treatment for Smokers With Generalized Periodontitis

Shah S, Engineer KS, Shah R, Shah H, Gajjar S, Kumar S, et al.

Cureus, 2025 Feb;17(2):e78394.
PMID: 39902253 DOI: 10.7759/cureus.78394

Introduction Humankind is suffering from the misuse and overuse of antibiotics, leading to antibiotic resistance. At this point, probiotics, if found effective, can lead to a better future. Probiotics are nothing but a colony of living-friendly bacteria. Lactobacillus reuteri is essential for use as a probiotic among many healthy bacteria. This study aims to compare the effectiveness of probiotics in periodontal treatment. Methods One hundred smokers diagnosed with chronic generalized periodontitis were randomly assigned into two groups. Group A received a seven-day course of amoxicillin 500 mg three a day and metronidazole 500 mg twice daily, followed by 30 days of probiotics, while Group B received a placebo antibiotic for seven days and 30 days of L. reuteri probiotics (2×10⁸ CFU daily). Periodontal parameters, including plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), and bleeding on probing (BOP), were utilized to asses at baseline, month one, and month one. Baseline differences were adjusted using the generalized estimating equation (GEE) model. Results At month three, Group B (probiotics) showed a significantly lower PI (0.52±0.49 vs. 0.88±0.52, p<0.001) and a 23% greater reduction in PD (p=0.004) compared to Group A (antibiotics + probiotics). These findings highlight the effectiveness of probiotics alone in improving periodontal health in smokers. Conclusions Both groups showed equal effectiveness in improving periodontal health. Hence, probiotics should be preferred over antibiotics.
Fulltext The Effectiveness of Metronidazole as a Localized Drug Delivery System in the Treatment of Periodontal Diseases: A Narrative Review

Gandhi UH, Vyas SD, Mane V, Patel SN, Patadiya HH, Kumar S, et al.

Cureus, 2025 Mar;17(3):e80547.
PMID: 40091900 DOI: 10.7759/cureus.80547

Periodontitis is a complex, multifactorial chronic inflammatory condition that impacts the adjacent hard and soft tissues. Microorganisms, especially gram-negative anaerobic pathogens, are a causative factor for periodontal disease. Periodontitis is identified by observing deeper periodontal pockets, clinical attachment loss, and the reduction of alveolar bone, often in conjunction with these indicators. The condition can vary in severity and be classified as mild, moderate, or severe. Scaling and root planing, combined with mechanical debridement, may not adequately reduce the bacterial load; therefore, adding local or systemic antimicrobials is advised as an adjunctive treatment. Commonly utilized local drug delivery agents for patients suffering from periodontitis include tetracycline, metronidazole, minocycline, doxycycline, and chlorhexidine. This system targets the pockets and eliminates the pathogens. Metronidazole is a nitroimidazole compound used commonly against gram-negative anaerobes. Its mechanism lies in four basic steps through which bacterial cell death occurs. A 25% metronidazole gel is used widely in periodontitis patients. The effectiveness of metronidazole as a local drug delivery agent has been evaluated in numerous studies, which have shown improvements in clinical parameters. To achieve favorable clinical outcomes, the non-surgical treatment of peri-implantitis should involve the systemic or local administration of metronidazole. Thus, the role of metronidazole in the emergence of periodontal diseases and its therapeutic uses are investigated in this narrative review.
Fulltext A Narrative Review of Periodontal Vaccines: Hope or Hype?

Patel P, Patel B, Vyas SD, Patel MS, Hirani T, Haque M, et al.

Cureus, 2025 Mar;17(3):e80636.
PMID: 40091902 DOI: 10.7759/cureus.80636

Globally, periodontal diseases, mainly driven by polymicrobial biofilms, are a widespread concern of social medicine due to their considerable incidence and tie-up to systemic disorders like diabetes, cardiovascular diseases, and complications during pregnancy. Traditional treatments focus on mechanical debridement and antimicrobial therapies, but these approaches have limitations, including recurrence and antibiotic resistance. Periodontal vaccines offer a promising alternative by targeting the immunological mechanisms underlying periodontal disease. This review explores the current state of periodontal vaccine development, highlighting key antigens, vaccine delivery systems, and preclinical and clinical advancements. Special emphasis is placed on antigen selection, host variability, immune tolerance, and future directions to overcome these barriers. This article highlights the advancements and challenges in periodontal vaccine research, offering insights into the capability of immunoprophylaxis as a groundbreaking way to manage periodontal diseases.
Fulltext Impact of Artificial Intelligence on Periodontology: A Review

Patel MS, Kumar S, Patel B, Patel SN, Girdhar GA, Patadiya HH, et al.

Cureus, 2025 Mar;17(3):e81162.
PMID: 40134460 DOI: 10.7759/cureus.81162

Artificial intelligence (AI) is changing each of the healthcare fields, including periodontology, through the improvement of every diagnosis, treatment plan, and the handling of all patients. AI-driven technologies such as machine learning, deep learning, and computer vision are incorporated into radiographic analysis, automated disease detection, and prognosis prediction. These improvements effectively enable the early detection of periodontal diseases and efficient classification of disease severity. In addition, they allow for specially personalized treatment approaches. AI makes automated periodontal charting, virtual patient monitoring, and decision support systems easier, which improve clinical outcomes and patient care. Despite its immense potential, many substantial difficulties remain, such as data privacy, algorithm reliability, and the meaningful need for clinical validation. This review indicates the revolutionary function of AI in many current dental works and explores all present uses, advantages, limits, and possibilities in periodontology.
Microneedling Technique With Topical Vitamin C for Gingival Depigmentation Enhancing Gingival Aesthetics: A Longitudinal Study

Mansuri S, Hirani T, Patel JT, Patel S, Chaudhari D, Patel B, et al.

Cureus, 2025 Mar;17(3):e81338.
PMID: 40161425 DOI: 10.7759/cureus.81338

Introduction As the focus on dental aesthetics intensifies, contemporary cosmetic dentistry seeks to establish an equilibrium between teeth and gums. Gingival hyperpigmentation, resulting from excessive melanin accumulation, can impact individuals regardless of age or gender and frequently gives rise to aesthetic apprehensions. Microneedling combined with topical vitamin C is a promising new method for improving gum appearance, particularly for reducing gingival hyperpigmentation caused by excess melanin. Microneedling is less expensive, more versatile, and promotes faster healing than traditional procedures like lasers or surgery. Materials and methods A study with 10 participants at the Karnavati School of Dentistry demonstrated significant pigmentation reduction. A paste was made with powdered ascorbic acid and a liquid ampule solution and applied with a Derma Pen (Dr. Pen Ultima A1, C Cube Advanced Technologies, India), which is a rechargeable pen-like instrument with 24-36 adjustable needles (0.25 mm to 2 mm) and five-speed settings. The gadget enables multi-directional treatment, and its disposable needle tips assure clean use with several patients. Results A significant decrease in melanin pigmentation was observed across all age groups, but anatomical challenges, such as irregular gingival contours, hampered results in some cases. Conclusion Microneedling is a safe and effective option for improving gingival aesthetics. As the technique evolves, it has the potential for broader applications.
The Impact of Implant Surface Modifications on the Osseointegration Process: An Overview

Sarvaiya BB, Kumar S, Pathan MSH, Patel S, Gupta V, Haque M

Cureus, 2025 Apr;17(4):e81576.
PMID: 40177230 DOI: 10.7759/cureus.81576

Osseointegration is critical to the long-term success of endosseous dental implants. Surface factors such as roughness, topography, energy, and composition considerably impact this process. Several ways have been used to optimize surface roughness, increase surface area, and improve osseointegration. Subtractive processes such as alumina and titanium dioxide blasting, acid treatment, anodization, and laser peeling are widely utilized. Many additive techniques change implant surfaces, including plasma-sprayed hydroxyapatite, vacuum deposition, sol-gel, dip coating, electrolytic procedures, and nano-hydroxyapatite coating. Recently, biomimetic implant surfaces with calcium phosphate coatings have been created under physiological settings. These coatings can transport osteogenic agents such as bone morphogenetic proteins, growth differentiation factors, and bioactive medications, including bisphosphonates, gentamicin, and tetracycline. Advances in technology have considerably broadened the methods for surface modification of endosseous dental implants. This article provides a comprehensive overview of various surface modification techniques and current trends in oral implantology.
Fulltext Evaluation of doctors' performance as facilitators in basic medical science lecture classes in a new Malaysian medical school

Ismail S, Salam A, Alattraqchi AG, Annamalai L, Chockalingam A, Elena WP, et al.

Adv Med Educ Pract, 2015;6:231-7.
PMID: 25878516 DOI: 10.2147/AMEP.S78441

Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students' perceptions regarding lecture quality in a new medical school.
Muscle cellularity, growth performance and growth-related gene expression of juvenile climbing perch Anabas testudineus in response to different eggs incubation temperature

Ahammad AKS, Asaduzzaman M, Uddin Ahmed MB, Akter S, Islam MS, Haque MM, et al.

J Therm Biol, 2021 Feb;96:102830.
PMID: 33627269 DOI: 10.1016/j.jtherbio.2020.102830

Although indigenous climbing perch (Anabas testudineusis) is a highly valuable species, slow growth pattern during the culture period impeding its commercial success in aquaculture. In many fish species, it has been demonstrated that incubation temperature of eggs influenced the muscle development and growth rates, which persisted throughout the subsequent larval and juvenile phases. Therefore, this study aimed to investigate whether different incubation temperature of eggs prior to hatching can stimulate the muscle development, growth, and growth-related gene expression of the slow-growing indigenous species of climbing perch. The fertilized eggs of A. testudineus from an artificial breeding program were incubated under control temperature of 24 °C (IT24), 26 °C (IT26), 28 °C (IT28), and 30 °C (IT30) in 10L glass aquaria with four replicated units for each temperature treatment. After hatching, the larvae from each incubated temperature were separately reared at ambient temperature for 10 days in aquarium, 20 days in hapas, and the next 42 days in cages, totaling 72 days post-hatching (dph). The hatching rates were found significantly (P
Fulltext Favipiravir Use in COVID-19: Analysis of Suspected Adverse Drug Events Reported in the WHO Database

Kaur RJ, Charan J, Dutta S, Sharma P, Bhardwaj P, Sharma P, et al.

Infect Drug Resist, 2020;13:4427-4438.
PMID: 33364790 DOI: 10.2147/IDR.S287934

Background: COVID-19 caused by SARS-CoV-2 virus emerged as an unprecedented challenge to discover effective drugs for its prevention and cure. Hyperinflammation-induced lung damage is one of the poor prognostic indicators causing a higher rate of morbidity and mortality of COVID-19 patients. Favipiravir, an antiviral drug, is being used for COVID-19 treatment, and we currently have limited information regarding its efficacy and safety. Thus, the present study was undertaken to evaluate the adverse drug events (ADEs) reported in the WHO pharmacovigilance database.
Methods: This study analyzed all suspected ADEs related to favipiravir reported from 2015. The reports were analyzed based on age, gender, and seriousness of ADEs at the System Organ Classification (SOC) level and the individual Preferred Term (PT) level.
Results: This study is based on 194 ADEs reported from 93 patients. Most frequent ADEs suspected to be caused by the favipiravir included increased hepatic enzymes, nausea and vomiting, tachycardia, and diarrhea. Severe and fatal ADEs occurred more frequently in men and those over the age of 64 years. Blood and lymphatic disorders, cardiac disorders, hepatobiliary disorders, injury poisoning, and procedural complications were more common manifestations of severe ADEs.
Conclusion: This study revealed that favipiravir appears to be a relatively safe drug. An undiscovered anti-inflammatory activity of favipiravir may explain the improvement in critically ill patients and reduce inflammatory markers. Currently, the data is based on very few patients. A more detailed assessment of the uncommon ADEs needs to be analyzed when more information will be available.
Fulltext The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population - Public Health Implications

Rahman S, Singh K, Dhingra S, Charan J, Sharma P, Islam S, et al.

Ther Clin Risk Manag, 2020;16:1007-1022.
PMID: 33116550 DOI: 10.2147/TCRM.S272908

COVID-19 pandemic is inducing acute respiratory distress syndrome, multi-organ failure, and eventual death. Respiratory failure is the leading cause of mortality in the elderly population with pre-existing medical conditions. This group is particularly vulnerable to infections due to a declined immune system, comorbidities, geriatric syndrome, and potentially inappropriate polypharmacy. These conditions make the elderly population more susceptible to the harmful effects of medications and the deleterious consequences of infections, including MERS-CoV, SARS-CoV, and SARS-CoV-2. Chronic diseases among elderlies, including respiratory diseases, hypertension, diabetes, and coronary heart diseases, present a significant challenge for healthcare professionals. To comply with the clinical guidelines, the practitioner may prescribe a complex medication regimen that adds up to the burden of pre-existing treatment, potentially inducing adverse drug reactions and leading to harmful side-effects. Consequently, the geriatric population is at increased risk of falls, frailty, and dependence that enhances their susceptibility to morbidity and mortality due to SARS-CoV-2 respiratory syndrome, particularly interstitial pneumonia. The major challenge resides in the detection of infection that may present as atypical manifestations in this age group. Healthy aging can be possible with adequate preventive measures and appropriate medication regimen and follow-up. Adherence to the guidelines and recommendations of WHO, CDC, and other national/regional/international agencies can reduce the risks of SARS-CoV-2 infection. Better training programs are needed to enhance the skill of health care professionals and patient's caregivers. This review explains the public health implications associated with polypharmacy on the geriatric population with pre-existing co-morbidities during the COVID-19 pandemic.
Fulltext Effects of alternate nostril breathing exercise on cardiorespiratory functions in healthy young adults

Jahan I, Begum M, Akhter S, Islam MZ, Jahan N, Samad N, et al.

Ann Afr Med, 2021 7 3;20(2):69-77.
PMID: 34213471 DOI: 10.4103/aam.aam_114_20

Introduction: Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults.
Materials and Methods: This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups.
Results: Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females' PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001-0.028) and females (P < 0.001-0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males.
Conclusion: The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.
Fulltext Cognizance and utilization about breast cancer screening among the health professional female students and staffs of University Kuala Lumpur, Royal College of Medicine Perak, Malaysia

Haque AT, Mohd Hisham MA, Ahmad Adzman NA, Azudin NA, Shafri NB, Haque M

Indian J Med Paediatr Oncol, 2016 Oct-Dec;37(4):286-292.
PMID: 28144097 DOI: 10.4103/0971-5851.195752

Breast cancer (BC) is a major life-threatening problem and a global concern including Malaysia. BC is an equal threat for both developing and developed countries. The aim of this study was to determine the relationship between sociodemographic factors with knowledge, attitude, and perception on BC screening among the females of University Kuala Lumpur, Royal College of Medicine Perak (UniKL RCMP).
Quorum sensing: a new prospect for the management of antimicrobial-resistant infectious diseases

Haque M, Islam S, Sheikh MA, Dhingra S, Uwambaye P, Labricciosa FM, et al.

Expert Rev Anti Infect Ther, 2021 05;19(5):571-586.
PMID: 33131352 DOI: 10.1080/14787210.2021.1843427

INTRODUCTION: Quorum-sensing (QS) is a microbial cell-to-cell communication system that utilizes small signaling molecules to mediates interactions between cross-kingdom microorganisms, including Gram-positive and -negative microbes. QS molecules include N-acyl-homoserine-lactones (AHLs), furanosyl borate, hydroxyl-palmitic acid methylester, and methyl-dodecanoic acid. These signaling molecules maintain the symbiotic relationship between a host and the healthy microbial flora and also control various microbial virulence factors. This manuscript has been developed based on published scientific papers.
AREAS COVERED: Furanones, glycosylated chemicals, heavy metals, and nanomaterials are considered QS inhibitors (QSIs) and are therefore capable of inhibiting the microbial QS system. QSIs are currently being considered as antimicrobial therapeutic options. Currently, the low speed at which new antimicrobial agents are being developed impairs the treatment of drug-resistant infections. Therefore, QSIs are currently being studied as potential interventions targeting QS-signaling molecules and quorum quenching (QQ) enzymes to reduce microbial virulence.
EXPERT OPINION: QSIs represent a novel opportunity to combat antimicrobial resistance (AMR). However, no clinical trials have been conducted thus far assessing their efficacy. With the recent advancements in technology and the development of well-designed clinical trials aimed at targeting various components of the, QS system, these agents will undoubtedly provide a useful alternative to treat infectious diseases.
Fulltext Classic and Current Opinions in Human Organ and Tissue Transplantation

Oli AN, Babajide Rowaiye A, Adejumo SA, Anazodo FI, Ahmad R, Sinha S, et al.

Cureus, 2022 Nov;14(11):e30982.
PMID: 36337306 DOI: 10.7759/cureus.30982

Graft tolerance is a pathophysiological condition heavily reliant on the dynamic interaction of the innate and adaptive immune systems. Genetic polymorphism determines immune responses to tissue/organ transplantation, and intricate humoral and cell-mediated mechanisms control these responses. In transplantation, the clinician's goal is to achieve a delicate equilibrium between the allogeneic immune response, undesired effects of the immunosuppressive drugs, and the existing morbidities that are potentially life-threatening. Transplant immunopathology involves sensitization, effector, and apoptosis phases which recruit and engages immunological cells like natural killer cells, lymphocytes, neutrophils, and monocytes. Similarly, these cells are involved in the transfer of normal or genetically engineered T cells. Advances in tissue transplantation would involve a profound knowledge of the molecular mechanisms that underpin the respective immunopathology involved and the design of precision medicines that are safe and effective.
Fulltext Menace of antimicrobial resistance in LMICs: Current surveillance practices and control measures to tackle hostility

Sharma A, Singh A, Dar MA, Kaur RJ, Charan J, Iskandar K, et al.

J Infect Public Health, 2022 Feb;15(2):172-181.
PMID: 34972026 DOI: 10.1016/j.jiph.2021.12.008

Antimicrobial Resistance (AMR) is significant challenge humanity faces today, with many patients losing their lives every year due to AMR. It is more widespread and has shown a higher prevalence in low- and middle-income countries (LMICs) due to lack of awareness and other associated reasons. WHO has suggested some crucial guidelines and specific strategies such as antimicrobial stewardship programs taken at the institutional level to combat AMR. Creating awareness at the grassroots level can help to reduce the AMR and promote safe and effective use of antimicrobials. Control strategies in curbing AMR also comprise hygiene and sanitation as microbes travel from contaminated surroundings to the human body surface. As resistance to multiple drugs increases, vaccines can play a significant role in curbing the menace of AMR. This article summarizes the current surveillance practices and applied control measures to tackle the hostility in these countries with particular reference to the role of antimicrobial stewardship programs and the responsibilities of regulatory authorities in managing the situation.
Fulltext Key Considerations From a Health Authority Perspective When Proton Pump Inhibitors Are Used to Treat Gastroesophageal Reflux Disease (GERD) and Their Implications

Meyer JC, MacBride-Stewart S, Fadare JO, Abdulrahman Jairoun A, Haque M, Massele A, et al.

Cureus, 2022 Nov;14(11):e31918.
PMID: 36447806 DOI: 10.7759/cureus.31918

The growing prevalence of gastroesophageal reflux disease (GERD) needs to be carefully managed to relieve the symptoms and prevent complications. Complications of GERD can include erosive esophagitis, Barrett's esophagus and gastrointestinal (GI) bleeding. Proton pump inhibitors (PPIs) are typically first-line treatment for GERD alongside lifestyle changes in view of their effectiveness and cost-effectiveness. However, there are concerns with adherence to dosing regimens and recommended lifestyle changes reducing their effectiveness. There are also concerns about potential complications from chronic high-dose PPIs. These include an increased risk of chronic kidney disease, cardiovascular events and infections. Recommendations to physicians include prescribing or dispensing the lowest dose of PPI for the shortest time, with ongoing patient monitoring. Activities among community pharmacists and others have resulted in increased dispensing of PPIs without a prescription, which can be a challenge. PPIs are among the most prescribed and dispensed medicines in view of their effectiveness in managing GERD. However, there are concerns with the doses prescribed and dispensed as well as adherence to lifestyle advice. These issues and challenges need to be addressed by health authorities to maximize the role and value of PPIs.
Fulltext Alcohol and Periodontal Disease: A Narrative Review

Gandhi UH, Benjamin A, Gajjar S, Hirani T, Desai K, Suhagia BB, et al.

Cureus, 2024 Jun;16(6):e62270.
PMID: 39006719 DOI: 10.7759/cureus.62270

The scientific literature dealing with alcohol and alcoholic beverages revealed that these drinks possess an adverse impact on periodontal tissues. Additionally, other principal risk factors include tobacco, smoking, poor oral hygiene, etc. It has been observed that among chronic alcoholics, there are further issues, such as mental, social, and physical effects, that promote alcoholism. These people may have weak immunity for defense against pathogenic organisms and bacteria. Thus, chances of gingival bleeding, swollen gums, bad breath, and increased bone loss are there. Different alcoholic beverages in the market cause less salivation; these beverages contain sugars that promote acid production in the oral cavity by pathogens that demineralize the enamel and damage gum and teeth. This chronic alcohol consumption can progress into different types of oral disorders, including cancer, halitosis, and caries, and is also associated with tobacco and smoking. Chronic alcohol consumption can cause alteration of the oral microbiome and increase oral pathogens, which lead to periodontal disease and an environment of inflammation created in the body due to malnutrition, diminished immunity, altered liver condition, brain damage, and gut microbiota alteration. Heavily colored alcoholic beverages produce staining on teeth and, due to less saliva, may cause other toxic effects on the periodontium. Over-dependency on alcohol leads to necrotizing lesions such as necrotizing gingivitis, necrotizing periodontitis, and necrotizing stomatitis. These pathological impairments instigate severe damage to oral structures. Therefore, proper counseling by the attending dental surgeon and related health professionals is urgently required for the patient on the basis that the individual case needs to go away from the regular heavy consumption of alcohol.
Fulltext Utilisation, Availability and Price Changes of Medicines and Protection Equipment for COVID-19 Among Selected Regions in India: Findings and Implications

Haque M, Kumar S, Charan J, Bhatt R, Islam S, Dutta S, et al.

Front Pharmacol, 2020;11:582154.
PMID: 33628172 DOI: 10.3389/fphar.2020.582154

Background: COVID-19 has already claimed a considerable number of lives worldwide. However, there are concerns with treatment recommendations given the extent of conflicting results with suggested treatments and misinformation, some of which has resulted in increased prices and shortages alongside increasing use and prices of personal protective equipment (PPE). This is a concern in countries such as India where there have been high patient co-payments and an appreciable number of families going into poverty when members become ill. However, balanced against pricing controls. Community pharmacists play a significant role in disease management in India, and this will remain. Consequently, there is a need to review prices and availability of pertinent medicines during the early stages of the COVID-19 pandemic in India to provide future direction. Objective: Assess current utilisation and price changes as well as shortages of pertinent medicines and equipment during the early stages of the pandemic. Our Approach: Multiple approach involving a review of treatments and ongoing activities across India to reduce the spread of the virus alongside questioning pharmacies in selected cities from early March to end May 2020. Our Activities: 111 pharmacies took part, giving a response rate of 80%. Encouragingly, no change in utilisation of antimalarial medicines in 45% of pharmacies despite endorsements and for antibiotics in 57.7% of pharmacies, helped by increasing need for a prescription for dispensing. In addition, increased purchasing of PPE (over 98%). No price increases were seen for antimalarials and antibiotics in 83.8 and 91.9% of pharmacies respectively although shortages were seen for antimalarials in 70.3% of pharmacies, lower for antibiotics (9.9% of pharmacies). However, price increases were typically seen for PPE (over 90% of stores) as well as for analgesics (over 50% of pharmacies). Shortages were also seen for PPE (88.3%). Conclusion: The pandemic has impacted on utilisation and prices of pertinent medicines and PPE in India but moderated by increased scrutiny. Key stakeholder groups can play a role with enhancing evidenced-based approaches and reducing inappropriate purchasing in the future.
Fulltext Professionalism perspectives among medical students of a novel medical graduate school in Malaysia

Haque M, Zulkifli Z, Haque SZ, Kamal ZM, Salam A, Bhagat V, et al.

Adv Med Educ Pract, 2016;7:407-22.
PMID: 27524927 DOI: 10.2147/AMEP.S90737

Defining professionalism in this constantly evolving world is not easy. How do you measure degrees of benevolence and compassion? If it is so obvious to our profession, what professionalism is, then why is it so difficult to teach it to medical students and residents? Today's definition of medical professionalism is evolving - from autonomy to accountability, from expert opinion to evidence-based medicine, and from self-interest to teamwork and shared responsibility. However, medical professionalism is defined as the basis for the trust in the patient-physician relationship, caring and compassion, insight, openness, respect for patient dignity, confidentiality, autonomy, presence, altruism, and those qualities that lead to trust-competence, integrity, honesty, morality, and ethical conduct. The purpose of this study is to explore professionalism in terms of its fundamental elements among medical students of Universiti Sultan Zainal Abidin (UniSZA). This was a cross-sectional study carried out on medical students of UniSZA. The study population included preclinical and clinical medical students of UniSZA from Year I to Year V of academic session 2014/2015. The simple random sampling technique was used to select the sample. Data were collected using a validated instrument. The data were then compiled and analyzed using SPSS Version 21. Out of 165 questionnaires distributed randomly among Year I to Year V medical students of UniSZA, 144 returned, giving a response rate of 87%. Among the study participants, 38% (54) and 62% (90) were males and females, respectively. The grand total score was 170.92±19.08. A total of 166.98±20.15 and 173.49±18.09 were the total professionalism score of male and female study participants, respectively, with no statistically significant (P=0.61) differences. This study found almost similar levels of familiarity with all fundamental issues of professionalism with no statistically (P>0.05) significant differences. Medical faculty members should give more effort for the professional development of medical doctor. Henceforth, researchers believe and expect that the country will produce more rational and holistic medical doctors.
Fulltext The Role of Probiotics in the Eradication of Helicobacter pylori and Overall Impact on Management of Peptic Ulcer: A Study Involving Patients Undergoing Triple Therapy in Bangladesh

Zaman T, Haq A, Ahmad R, Sinha S, Chowdhury K, Parvin S, et al.

Cureus, 2024 Mar;16(3):e56283.
PMID: 38495972 DOI: 10.7759/cureus.56283

Background Helicobacter pylori infection has been identified to cause constantly recurring inflammation, leading to gastrointestinal tract disorders, including carcinoma. The standard triple therapy (STT), used to eradicate H. pylori, includes two antimicrobials and a proton pump inhibitor for two weeks. Other drug regimens have also been developed since H. pylori exhibits antimicrobial resistance. These regimens, including probiotics, have been shown to lower adverse drug reactions (ADR), improve drug adherence, exert bacteriostatic effect, and reduce inflammation. Objective This study intended to explore probiotic intervention for improving eradication rates and mitigating adverse effects while administrating STT. Methods This prospective study was conducted from May to December, 2021, in the Department of Gastroenterology of Ship International Hospital, Dhaka, Bangladesh, to observe the effects of probiotics inclusion along with STT on H. pylori eradication. A total of 100 patients aged ≥18 years who tested positive for H. pylori were included. The experimental group (n=50) was given STT and probiotics, and the control group (n=50) was given only STT without probiotics for 14 days. Necessary follow-up was done six weeks after treatment. An independent sample t-test, chi-square test, and multiple regression analysis were used for statistical analysis. Result The odds of getting rapid urease test (RUT) negative results from positive were 2.06 times higher (95%CI= 0.95, 3.22, p=0.054) in the experimental group. ADRs were crucially towering in the control group (p=0.045) compared to the probiotics group. The probiotics group had a lower risk of having adverse effects by 0.54 times (95%CI=0.19, 0.84, p=0.032) than the control group. Conclusion Using probiotics and STT together to eradicate H. pylori may lower ADR and improve treatment adherence. It may also help terminate H. pylori infection more effectively. More research is required as H. pylori is very contagious and can ultimately cause life-threatening gastric cancer.

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