Canadian Journal of Medicine,
2022, Volume 4, Issue 2, Pages 38-41
DOI:
10.33844/cjm.2022.6020
Uncertainty about the future, fear of losing a loved one, and countless lockdowns and social distancing restrictions have created great stress for almost everyone during the COVID-19 pandemic. As a result, the wellbeing of individuals has been negatively impacted. Maintaining stable wellbeing is important as is an avoidance of excessive alcohol use, as both factors can potentially harm individual health and lead to death. However, an increase in alcohol purchases and alcohol consumption has been noted globally during the COVID-19 pandemic. Thus, this article explores the possible connections between affected wellbeing and alcohol usage during the COVID-19 pandemic.
Canadian Journal of Medicine,
2022, Volume 4, Issue 2, Pages 42-50
DOI:
10.33844/cjm.2022.6021
Myocarditis, or inflammation of the muscle layer in the heart wall, is caused by several factors including viral infection. Although the literature briefly alludes to a method of viral entry into cardiomyocytes, this work provides further detail into subsequent novel mechanisms leading to the development of myocarditis following infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The keywords "COVID-19”, “SARS-CoV-2”, “Myocarditis”, “viruses”, and “human” were used to run searches on OVID Medline, as well as Google Scholar. Resulting papers were subject to further analysis. SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) receptor which is found on type 2 pneumocytes and cardiomyocytes. Infection of cardiomyocytes can overregulate the immune response resulting in a cytokine storm: an uncontrolled increase of proinflammatory cytokines, as is commonly seen in respiratory infections. Cytokines can enter established biological pathways, creating positive feedback, which causes increased inflammation leading to myocarditis. SARS-CoV-2 viral envelope (E) proteins present an alternate association with myocarditis. Less severe myocarditis manifests common symptoms, and detecting it before it worsens may be difficult. Understanding the pathogenesis of myocarditis in COVID-19 could help find and implement preventative measures during future treatment.
Canadian Journal of Medicine,
2022, Volume 4, Issue 2, Pages 51-54
DOI:
10.33844/cjm.2022.6022
As life expectancy continues to increase, it is critical to investigate ways to age successfully physically, mentally, and socially. Senior citizens (65 years and older) tend to struggle with lower mental health and wellbeing and suffer higher incidences of loneliness compared to the younger population. As a result, the COVID-19 pandemic has put them at higher risk, not only of contracting the virus, but also of experiencing feelings of loneliness and depression. Music participation, specifically music therapy, has been known to be an effective tool to promote wellbeing and mental health, especially among the elderly. Thus, this article investigates the changes in mental health and wellbeing among elderly people when participating in music to explore the importance of conducting virtual music participation programs during the COVID-19 pandemic.
Canadian Journal of Medicine,
2022, Volume 4, Issue 2, Pages 55-62
DOI:
10.33844/cjm.2022.6023
Thyrotoxic Periodic Paralysis (TPP) is an acute potentially lethal emergency in patients with hyperthyroidism who present with sudden muscle weakness and hypokalemia. It is commonly precipitated by high carbohydrate or high salt content meals, strenuous exercise, stress, trauma, glucocorticoids, epinephrine, alcohol, or respiratory infections. COVID-19 infection or vaccination may represent a novel trigger for TPP. Furthermore, COVID-19 infection or vaccination may incite inflammatory processes leading to thyrotoxicosis, which can manifest as TPP. While COVID-19 causing subacute thyroiditis, euthyroid sick syndrome, Hashimoto’s disease, or Graves’ disease have been well documented in the literature; there have only been six case reports of post-COVID-19 TPP. Notably, all cases thus far have been restricted to male patients, and there is paucity of literature from North America. The purpose of this paper is to outline the first case of post-COVID-19 TPP in a female patient, who presented to the emergency department with acute paralysis and severe hypokalemia (2.2 mmol/L) three months after COVID-19 infection. Investigations in the emergency department showed thyrotoxicosis. She was treated with potassium replacement, which improved her paralysis. Subsequent investigations revealed severe hyperthyroidism from Graves’ disease, which is currently managed with metoprolol and methimazole. Her hyperthyroidism improved without recurrent hypokalemia or paralysis. In addition, we outline the epidemiology, pathophysiology, precipitants, and management of TPP, with a particular focus on COVID-19 infection or vaccination precipitating TPP. We discuss post-COVID-19 TPP cases thus far described in the literature. Knowing that North American COVID-19 infection waves lagged Asia, we could anticipate additional future TPP cases.
Canadian Journal of Medicine,
2022, Volume 4, Issue 2, Pages 63-68
DOI:
10.33844/cjm.2022.6024
The case follows the treatment of a woman from age 73 to age 83 who was bipolar and who also had Chronic Kidney Disease (CKD). During the study, the eGFR dropped from 43 to below 20. Initially the treatment was fairly standard but highlighted the difficulty of knowing when to reduce the lithium dose before undesired mood changes occurred. In phase 2 of the treatment, the usual monthly blood serum test is combined with a new concept of a monthly running average eGFR to decide when to reduce the lithium dose. A new way of administering lithium was created which was used when the patient’s daily dose of lithium reached 300mg a day. In place of a fixed daily dose of lithium, a fixed average daily dose of lithium over a short cyclic pattern was used. The daily dose varies within the repeatable cycle but is smoothed out by the long half-life of lithium. The new method allows for the reduction of the lithium dose by small amounts, less than the minimum strength 150mg capsule used in North America or the 100mg tablet used in Europe. The method has been successfully used for several years with the patient’s moods stable and lithium toxicity avoided. The patient is currently on an average daily dose of 187mg a day with an eGFR less than 20.
Canadian Journal of Medicine,
2022, Volume 4, Issue 2, Pages 69-74
DOI:
10.33844/cjm.2022.6025
In 2019, Shulman et al. [1] summarized the known lithium therapeutic ranges for Old Age Bipolar Patients (OABP). For patients over 60, the range is 0.4-0.8 mmol/L, and for those over 80, 0.4-0.7 mmol/L. For younger patients, the standard region is 0.6-1.2 mmol/L. The current research leaves three disconnected therapeutic ranges. A unifying theory is developed explaining the therapeutic range of lithium for all ages. It explains why the changes in the therapeutic range happen and exactly how the upper limits change on a year by year basis instead of by decades. It also explains why and when the standard therapeutic range should be abandoned. In developing the theory, only information about the changes with age in the eGFR is used; when applied to lithium, the theory explains why the therapeutic regions for over sixty and over eighty exist. The known ranges were discovered using empirical evidence. The theory gives a more precise start for those regions as well as how to move smoothly through them. It applies for bipolar patients who do not have chronic kidney disease and shows that a new therapeutic region for those over 90 needs to be created. Table 1 is developed using the new theory to give the upper limit, the midpoint, and the twenty-fifth percentile up from the minimum level of the therapeutic range for each year from age fifty to one hundred. This table enables doctors to keep the patient’s serum level where they want it as the patient ages.
Canadian Journal of Medicine,
2021, Volume 3, Issue Issue 3, Pages 121-143
DOI:
10.33844/cjm.2021.60511
COVID-19 management still lacks a protocol of proven efficacy, and we present a novel COVID-19 immunomodulatory protocol based on our early pioneering article, re-purposing nitazoxanide/azithromycin combination for early COVID-19 diseases. Our findings were followed by two articles to justify the addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin. Furthermore, another recent article of ours illustrated the potential immunomodulatory mechanisms by which all the drugs used in this manuscript might be beneficial for COVID-19 patients. We presented a case series of 34 confirmed and highly suspected COVID-19 patients. It is noteworthy that 13 PCR-confirmed COVID-19 patients were included while the others were diagnosed by other measures and all cases were managed by telemedicine. The patients included adult males and females as well as children. All patients have received a short 5-day-regimen of NSAIDs / nitazoxanide/ azithromycin +/- cefoperazone either in full or in part. The primary endpoint of this protocol was a full relief of all debilitating COVID-19 clinical manifestations, and it was fully achieved within two weeks. Most of the patients who were treated early have fully recovered during their described five days; the leucocytic/lymphocytic counts were significantly improved for those with prior abnormalities. Neither significant adverse effects nor post/para COVID-19 syndrome was reported. In conclusion, we present a pioneering 5-day protocol for the safe and effective treatment of COVID-19 using economic FDA-approved immunomodulatory drugs. We recommend conducting double-blind, randomized clinical trials with sufficient strength at the earliest opportunity.
Canadian Journal of Medicine,
2021, Volume 3, Issue 1, Pages 10-35
DOI:
10.33844/cjm.2021.60499
The current pandemic of COVID-19 is considered a worldwide threat to public health caused
by a novel type of coronaviridae family called SARS-CoV-2. Owing to the urge of finding a
treatment for this virulent virus, many aspects of drug development are swept aside. This
review aimed to clarify the double-edged sword of drug repurposing in COVID-19 via
summarizing the available treatment options and promising candidates for COVID-19 based
on drug repurposing preclinical studies and in-silico approach. Different drugs target SARS
CoV-2 main structures under clinical investigation; some showed limited efficacy and severe
side effects, while others can be promising solutions. Some drugs suppress the cytokine storm
and modulate immune response during viral infection, including anti-interleukin and
glucocorticoids. Antiparasitic agents are repurposed for SARS-CoV-2 infection management.
Various vaccines and monoclonal antibodies are designed against SARS-CoV-2 and are being
evaluated in different preclinical and clinical stages. However, none of them is approved yet.
Convalescent Plasma Transfusion is a promising strategy against SARS-CoV-2 infection,
where impressive results are reported in clinical trials, requiring more validation. Furthermore,
anticoagulant therapy exhibited better disease outcomes in patients admitted to the ICU.
Finally, in-silico studies suggested several potential compounds or FDA-approved drugs
targeting various viral structure subunits. In conclusion, although many clinical trials were
launched to examine potential therapies based on drug repurposing for COVID-19, there is no
definitive treatment till now. Moreover, computational approaches identified several
compounds and FDA-approved drugs with potential inhibitory effects.
Canadian Journal of Medicine,
2020, Volume 2, Issue 1, Pages 13-16
DOI:
10.33844/cjm.2020.60494
Spread of COVID-19 in all of the world caused the warning alert from WHO. It began from China and was the reason of many death through the world since 2019 December. Elders and people with previous diseases such as IgA deficiency [IgAD] are more susceptible to get COVID family. Also, higher level of IgA can combat with infectious disease.
Canadian Journal of Medicine,
2021, Volume 3, Issue 1, Pages 36-44
DOI:
10.33844/cjm.2021.60500
In clinical, sciences expectation of heart malady is one of the foremost troublesome
undertakings. Nowadays, coronary illness may be a significant reason for bleakness and
mortality in present-day society. Coronary illness could be a term that doles intent on countless
ailments identified with the heart. Clinical determination is incredibly a big, however entangled
errand that must be performed precisely, effectively, and unequivocally. Although huge
advancement has been imagined within the finding and treatment of coronary illness, further
examination is required. The accessibility of enormous measures of clinical information
prompts the requirement for amazing information examination instruments to get rid
of valuable information. Coronary illness determination is one in all the applications where
information mining and AI instruments have demonstrated victories. This study used the
machine learning algorithms KNN, Naïve Bayes, Random forest, Logistic regression, Support
vector machine, J48, and Decision tree by WEKA software to spot which method provides
maximum performance and accuracy. Using these algorithms with WEKA software, we made
an ensemble (Vote) hybrid model by combining individual methods. Our research aims to
access the effectiveness of various machine learning algorithms to diagnose the center disease
and find the feasible algorithm, which is that the best for a heart condition
Canadian Journal of Medicine,
2021, Volume 3, Issue Issue 2, Pages 67-76
DOI:
10.33844/cjm.2021.60506
Mentha arvensis is an essential aromatic, energizer restorative, and medicinal plant in the mint family Lamiaceae. Mentha arvensis is found in rugged areas or cold climates of India. Herein, we studied the presence of different dynamic metabolites like- Flavonoids, Saponins, Tannins, terpenoids, steroids, Carb, anthraquinones, Heart glycosides, and alkaloid. In the given study, the phytochemical and antimicrobial action of leaves concentrates on pudina (Mentha arvensis L.). The broth dilution method has been used to check the antimicrobial activity of Mentha arvensis. In vitro antimicrobial movement was studied against pathogenic microbes such as Escherichia coli, Staphylococcus aureus, Streptococcus Pyogenes, Pseudomonas aeruginosa, Candida albicans, Aspergillus Niger, Aspergillus clavatus by agar well dispersion method. When used on bacterial colonies and fungal colonies, the separated extract showed the maximum zone of inhibition against Staphylococcus aureus, Escherichia coli, Streptococcus Pyogenes, Pseudomonas aeruginosa, Candida albicans, Aspergillus Niger, Aspergillus clavatus over the control. The maximum zone of inhibition was found in Methanolic extracts against Pseudomonas aeruginosa and Aspergillus clavatus over the control. Thus, the present approach can be useful to find new bioactive segments to improve new drugs. Our findings showed that the Mentha arvensis plant gives 25- 100 MIC (ug/ml) to inhibit the growth of the mentioned microorganisms. Thus, it can be used as a strong antimicrobial agent against pathogens, mainly Aspergillus Clavatus.
Canadian Journal of Medicine,
2020, Volume 2, Issue 1, Pages 13-16
DOI:
10.33844/cjm.2020.60494
Spread of COVID-19 in all of the world caused the warning alert from WHO. It began from China and was the reason of many death through the world since 2019 December. Elders and people with previous diseases such as IgA deficiency [IgAD] are more susceptible to get COVID family. Also, higher level of IgA can combat with infectious disease.
Canadian Journal of Medicine,
2021, Volume 3, Issue Issue 2, Pages 67-76
DOI:
10.33844/cjm.2021.60506
Mentha arvensis is an essential aromatic, energizer restorative, and medicinal plant in the mint family Lamiaceae. Mentha arvensis is found in rugged areas or cold climates of India. Herein, we studied the presence of different dynamic metabolites like- Flavonoids, Saponins, Tannins, terpenoids, steroids, Carb, anthraquinones, Heart glycosides, and alkaloid. In the given study, the phytochemical and antimicrobial action of leaves concentrates on pudina (Mentha arvensis L.). The broth dilution method has been used to check the antimicrobial activity of Mentha arvensis. In vitro antimicrobial movement was studied against pathogenic microbes such as Escherichia coli, Staphylococcus aureus, Streptococcus Pyogenes, Pseudomonas aeruginosa, Candida albicans, Aspergillus Niger, Aspergillus clavatus by agar well dispersion method. When used on bacterial colonies and fungal colonies, the separated extract showed the maximum zone of inhibition against Staphylococcus aureus, Escherichia coli, Streptococcus Pyogenes, Pseudomonas aeruginosa, Candida albicans, Aspergillus Niger, Aspergillus clavatus over the control. The maximum zone of inhibition was found in Methanolic extracts against Pseudomonas aeruginosa and Aspergillus clavatus over the control. Thus, the present approach can be useful to find new bioactive segments to improve new drugs. Our findings showed that the Mentha arvensis plant gives 25- 100 MIC (ug/ml) to inhibit the growth of the mentioned microorganisms. Thus, it can be used as a strong antimicrobial agent against pathogens, mainly Aspergillus Clavatus.
Canadian Journal of Medicine,
2020, Volume 2, Issue 1, Pages 23-32
DOI:
10.33844/cjm.2020.60496
Urticaria is a common disease characterised by transient erythematous, oedematous, pruritic
wheals in the dermis due to the release of various inflammatory mediators from mast cells.
There was previously limited evidence on the effectiveness of hydroxychloroquine (HCQ) in
the literature but there is now emerging evidence that warrants further investigation. This
review aims to appraise the current literature and propose contemporary evidence
recommendations for hydroxychloroquine treatment of patients with urticaria by performing
a systematic review. The MEDLINE, Embase and Cochrane databases were searched from
inception to 12 June 2020 in accordance with the PRISMA guidelines. We also examined the
reference lists of the retrieved studies. Texts were reviewed independently by two authors.
The risk of bias and quality of the studies was assessed using the Critical Appraisal Skills
Programme for systematic reviews. A total of 7 studies were included, involving 211 pooled
trial participants. There was moderate-quality evidence from two RCTs that revealed the
effectiveness of HCQ in the subjective improvement of urticarial symptoms. Two case reports
and one case series also demonstrated the therapeutic benefit of HCQ for urticaria. There was
considerable heterogeneity of outcome variables and trial designs which did not permit a meta
analysis of the results. The limited available evidence reveals that HCQ is effective for the
resolution of urticaria. Further multi-centred, placebo-controlled, RCTs are required in order
to reveal the relative effectiveness of HCQ in comparison to current second-line treatment
modalities
Canadian Journal of Medicine,
2021, Volume 3, Issue 4, Pages 176-178
DOI:
10.33844/cjm.2021.60602
Coronavirus disease (COVID-19) is an ongoing global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many systematic reviews and meta-analyses discussed the correlation of COVID-19 with a different disease. Given the urgent need for data, some meta-analyses containing datasets included many manuscripts, but their providence was not clearly reported. The possible overlap between some of the studies included in the analyses is a significant issue for conducting systematic reviews during the COVID-19 pandemic.
Canadian Journal of Medicine,
2021, Volume 3, Issue 1, Pages 10-35
DOI:
10.33844/cjm.2021.60499
The current pandemic of COVID-19 is considered a worldwide threat to public health caused
by a novel type of coronaviridae family called SARS-CoV-2. Owing to the urge of finding a
treatment for this virulent virus, many aspects of drug development are swept aside. This
review aimed to clarify the double-edged sword of drug repurposing in COVID-19 via
summarizing the available treatment options and promising candidates for COVID-19 based
on drug repurposing preclinical studies and in-silico approach. Different drugs target SARS
CoV-2 main structures under clinical investigation; some showed limited efficacy and severe
side effects, while others can be promising solutions. Some drugs suppress the cytokine storm
and modulate immune response during viral infection, including anti-interleukin and
glucocorticoids. Antiparasitic agents are repurposed for SARS-CoV-2 infection management.
Various vaccines and monoclonal antibodies are designed against SARS-CoV-2 and are being
evaluated in different preclinical and clinical stages. However, none of them is approved yet.
Convalescent Plasma Transfusion is a promising strategy against SARS-CoV-2 infection,
where impressive results are reported in clinical trials, requiring more validation. Furthermore,
anticoagulant therapy exhibited better disease outcomes in patients admitted to the ICU.
Finally, in-silico studies suggested several potential compounds or FDA-approved drugs
targeting various viral structure subunits. In conclusion, although many clinical trials were
launched to examine potential therapies based on drug repurposing for COVID-19, there is no
definitive treatment till now. Moreover, computational approaches identified several
compounds and FDA-approved drugs with potential inhibitory effects.
Publisher: Canadian Institute For Knowledge Development
Email: EditorialOffice.CJM@cikd.ca
Editor-in-chief: Alipasha Meysamie
Print ISSN: 2564-0127
Online ISSN: 2564-0135
