Current Drug Therapy - Volume 19, Issue 5, 2024

The study&'sobjectives are to highlight the significance of medical devices, investigate the prospective expansion of the Indian market, look at the legislative changes made possible by MDR 2020, and deal with the ongoing issues with cost, quality, and adverse responses. The research aims to enhance the Indian medical devices sector by offering insightful observations and suggestions. This study intends to highlight the significance of medical devices, assess the prospective growth of the Indian industry, look at the regulatory changes brought about by MDR 2020, and address the ongoing issues with cost, quality, and adverse responses. The goal of the research is to help the Indian medical devices business grow by offering helpful insights and practical suggestions. The improvement of people&'swell-being and health depends heavily on medical technologies. The usage of medical devices is expected to rise as technology develops and illnesses spread. The Indian medical device industry is expected to grow to a market value of USD 50 billion by 2025, placing it fourth in Asia. The "Atma Nibbar Bharat" strategy, which emphasizes independence, is anticipated to support the expansion of India&'smedical device industry. Before the passage of the Medications and Cosmetics Act of 1940, there were no explicit regulations controlling medical devices, which resulted in their designation as medications. The Medical Device Regulation (MDR) was initially announced in 2017, nevertheless, and went into effect in January 2018. The Indian medical device sector was greatly impacted by the change of this guideline paper into MDR 2020. For testing and altering equipment that comes within the new criteria, the amended legislation offers a wider range of options. Despite these positive adjustments, problems still exist. Significant drawbacks include unregulated pricing, difficulties with quality control, and negative responses to medical equipment. This essay covers these topics in extensive detail and includes pertinent advice. It is stated which department is in control of handling these issues. To successfully address these issues, thorough examples, case studies, and solutions are given. In conclusion, this abstract emphasizes the significance of medical devices, the market&'spotential for growth in India, MDR 2020&'slegislative adjustments, as well as the ongoing difficulties related to cost, quality, and bad responses. The essay seeks to solve these problems by providing insightful analysis and suggestions.

Drug-induced thrombocytopenia can occur in hospitalized patients and complicate their antithrombotic treatment. Several medications can associate thrombocytopenia with immune and nonimmune mechanisms. Thrombocytopenia can occur at any time from a few hours to months after a new medication initiation. In this study, we have described the case of a female patient with acute-onchronic kidney injury following a non-steroidal anti-inflammatory agent use, who developed catheterrelated thrombosis and was treated with heparin without any complication for 5 days. She was discharged after 5 days and prescribed to use apixaban 2.5 mg twice daily. However, she was readmitted after 24 hours with fatigue, petechiae, and severe thrombocytopenia (7000/mm³). The workup was negative for other reasons of thrombocytopenia. With a possible diagnosis of drug-related thrombocytopenia, apixaban was discontinued. Following the treatment with the intravenous immunoglobulin, her platelet counts increased and stabilized around 40-50,000/mm³. Anticoagulation was thus continued with adjusted doses of rivaroxaban (10-15 mg/day). 17 days after apixaban discontinuation and treatment with prednisolone, her platelet count increased to 108,000/mm3. With reference to this case, a brief review on refractory heparin-induced thrombocytopenia and the association of direct oral anticoagulants with thrombocytopenia is presented.

Background: Alcohol has been used for centuries in many different civilizations. It is a psychoactive stimulant with addictive properties. Alcohol misuse has significant negative social, economic, and health effects. Abusing alcohol can cause harm to oneself as well as to relatives, coworkers, close companions, and total strangers. Alcohol usage contributes to more than 200 diseases, accidents, and other health problems. Drinking alcohol is associated with a higher chance of developing significant non-communicable illnesses such liver cirrhosis, a number of cancers, cardiovascular diseases, as well as behavioral and mental disorders like alcoholism. Objective: Abuse of alcohol does not occur suddenly. People becoming addicted to various alcoholic beverages is a problem that results from months and years of irresponsible drinking. The process of recovering from the issue in turn includes targeted, particular methods for raising awareness of the negative effects of alcohol usage. Conclusion: Due to the heightened risks for one&'sbodily and mental health along with the social issues it generates, alcohol consumption results in these costs. We discuss the three areas of the epidemiology of alcohol's impact on health and diseases, the public health approach for treating problems related to alcohol use, and advancements in alcohol science.

The goal of this review is to explored the therapeutic application of L-Arginine (L-ARG) against various pathological illnesses, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), cardiovascular disorder, mitochondrial myopathy, encephalopathy, lactic acidosis, stroke-like episodes (MELAS), sickle cell anemia, tumour, epilepsy, erectile dysfunction therapy (ED), gestational hypertension (GH), and menopause issues. L-ARG is an important semi-essential alpha-amino acid that serves as a natural precursor for the synthesis of nitric oxide (NO). It is generally synthesized from proteinogenic amino acid proline through glutamine and glutamate. The degradation of L-ARG is a complex process due to the expression of multiple enzymes in the form of a substrate. The metabolism of L-ARG takes place in various multiple pathways, such as nitric oxide synthase, Arginine glycine amidinotransferase, and Arginine decarboxylase which results in the production of a diverse range of biochemical compounds, such as nitric oxide, polyamines, proline, glutamate, creanine, agmatine homoarginine, and urea. NO is a highly diffusible free radicle with a regulatory function in the heart and acts as an important vasodilator in intact endothelium. NO serves as an important neurotransmitter in the brain and a mediator of host defense in the immune system. L-ARG is also needed for ammonia detoxification, which is a very toxic chemical to the central nervous system. This review article focuses on the relevance of L-ARG in the prevention and treatment of a variety of illnesses.

Background: The link between autophagy and lysosomal function has been wellrecognised in recent decades; defective autophagy and lysosomal function lead to various disorders, notably Lysosomal Storage Disorders (LSDs). The malfunction of multiple mechanistic pathways influences the contribution of LSDs. Different ways are employed in such situations, but one novel approach could resolve the problem by inducing the autophagic pathway, which aids in maintaining proper autophagy and lysosomal degradation function. Methods: Autophagic Inducer functions on the activation of Transcriptional factor EB (TFEB) and its mechanism; mTOR Complex Inhibition dependently or independently may repair the malfunction of the entire mechanism. Finding a potential autophagic inducer is still a work in progress, but targeting TFEB and mTOR could redefine LSD treatment. The development of experimentally available TFEB modulators could enhance autophagic flux promote lysosomal function and increase lysosomal biogenesis and can be a promising technique for treating illnesses caused by ALP dysfunction, such as lysosomal storage disorder. Results: MTORC1 suppression causes TFEB to be transported to the nucleus and transcription of multiple genes involved in the formation of autophagosomes and lysosomes, indicating that MTORC1 has positive effects in treating lysosomal storage diseases such as Pompe disease, Batton disease, Fabry disease, etc. thus modulating autophagy attenuates the above condition. Conclusion: This review comprises autophagy and lysosome association, and their malfunction leads to various lysosomal diseases. Several natural products are also discussed, which can be possible treatment options.

"Hyaluronic acid (HA), a non-sulfated glycosaminoglycan (GAG), is a significant component of the epidermal extracellular matrix (ECM). It plays multiple roles in the inflammatory response, cell adhesion, migration, proliferation, differentiation, angiogenesis, and tissue regeneration. Due to its inherent characteristics, including non-immunoreactivity, exceptional biocompatibility, biodegradability, native biofunctionality, hydrophilicity, and non-immunoreactivity, HA has found applications in the production of wound dressings. HA's synergistic role in enhancing deeper penetration into chronic wounds and its biofunctional properties in the healing process have been harnessed. HA-based wound dressings, often incorporating biomolecules or drugs to improve the dressing's biochemical performance during wound healing, have been developed. In this review, we explore the current state of knowledge regarding hydrogels based on HA, focusing on their biofunctional properties and delivery mechanisms. We present the latest developments in the research and development of HA-based hydrogels for the treatment of skin wounds."

Background: The king of herbs, Emblica officinalis, is one of the most important herbs in Ayurveda. It contains significant amounts of Vitamin C and has been reported to have antioxidant, anticancer, antiretroviral, antidepressant, antiulcerogenic, wound healing, and many other medicinal properties. Objective: The current study is designed to investigate the aphrodisiac effects of E. officinalis seed extract on albino Wistar rats as well as its effects on stress-related sexual behaviour. Materials and Methods: The aphrodisiac effect of E. officinalis was evaluated by mating the pretreated male rats with female rats. For 30 days, test group rats (n=6) were given methanolic extracts (95%) from E. officinalis seeds (500 and 1000 mg/kg). Control rats received saline. Standard group rats received testosterone (0.5 mg/ kg, i.m). The sexual behavior study tracked Mount Latency (ML), Intromission Latency (IL), Mounting Frequency (MF), Intromission Frequency (IF), sniffing, and licking on days 0 through 30. After 30 days, rats were sacrificed, and the anabolic effect was assessed using body weight, reproductive organ weight, sperm concentration, and histopathology of the testes. The stress was induced by immobilization stress in the stress-affected alteration in the sexual behavior model, and the above procedure was repeated for evaluation. Results: The 95% methanolic extract (1000 mg/kg) of E. officinalis significantly reduced ML and IL while significantly increasing MF, IF, sniffing, licking, body weight, reproductive organ weight, and sperm concentration. Methanolic extract of E. officinalis increased sexual activities in the stress-free group and restored the stress-affected group's altered sexual behaviour. Conclusion: The current study's findings indicate that 95% methanolic extract of E. officinalis has dose-dependent aphrodisiac activity and restores sexual behavior in a stress-induced group.

Background: Tamoxifen is an effective drug for breast cancer treatment and its side effects are the production of reactive oxygen species and kidney damage. As antioxidants, vitamins E and D may help decrease kidney dysfunction. Objectives: In the present study, the protective effects of vitamins E and D on renal toxicity caused by tamoxifen in female Wistar rats were investigated. Materials and Methods: Twenty-five adult female rats weighing 180-200 were randomly divided into five groups with 5 rats. Group C, T, TE, TD, and TED were treated with olive oil, tamoxifen, tamoxifen + vitamin E, tamoxifen +vitamin D, and tamoxifen + both vitamins for four weeks. ELISA Kits measured the oxidant and antioxidant tests and TNF-α in kidney tissue. The spectrophotometric method measured urea, uric acid, and creatinine in serum and urine. Results: Tamoxifen significantly decreased the weight of rats, GPx, CAT, SOD levels and increased TNF-α, urinary creatinine level and, serum uric acid, urea levels (P < 0.05). But, treatment with vitamin D and simultaneous administration of vitamins led to a significant decrease in the level of (TNF-α) compared to the tamoxifen group (p < 0.01). Also, the histopathology results showed that the simultaneous administration of vitamins has significantly resolved the damage caused by the use of tamoxifen. Conclusion: The present study's findings showed that using vitamins E and D prevents kidney damage through antioxidant and anti-inflammatory effects. In addition, using vitamins E and D probably showed stronger synergistic effects against kidney damage.

Background: Varicose-like bulging veins that occur in the anus and lower rectum are known as hemorrhoids. Depending on their degree of prolapse, they can cause symptoms such as bleeding, discomfort, mucous discharge, perianal irritation, and burning. The aim of the study was to investigate the impact of Daflon pills on the treatment of hemorrhoids and their associated symptoms, as well as the duration of hospitalization and the likelihood of recurrence. Methods: A randomized clinical trial was used in this investigation. Patients who had been referred to the surgical clinic of the Madani Hospital in 2021 with hemorrhoid complaints were participants in a random selection process. Participants were separated into control groups (getting non-invasive regular treatments) and the intervention group after being informed and given ethical approval (Receiving Daflon 500 mg twice daily for 4 weeks). Patients' symptoms, potential sequelae, and illness recurrence were assessed in both chosen groups at each visit, and data was gathered until the desired sample size was reached. Results: This study was performed on 200 patients who received Daflon 500 mg (intervention, N = 100) or placebo (control, N = 100). The number of visits required to achieve therapeutic goals did not differ statistically significantly between the intervention and control groups (P > 0.05). The mean recovery time was 56.5 ± 12.53 days for the intervention group and 61.04 ± 13.63 days for the control group, which is considered statistically significant (P < 0.05). A total of 56 patients (28.0%) relapsed and 144 patients (72.0%) recovered. This rate in the intervention group included 78 (78.0%) recovery and 22 (22.0%) relapsed and in the control group 66 (66.0%) recovered and 34 (34.0%) relapsed, clinically it suggests that treatment Daflon can prevent relapse of the disease, although the statistical results of this study do not support this hypothesis (P = 0.059). Conclusion: The study's findings demonstrated that Daflon therapy is a superior and more effective treatment option for all grades of hemorrhoids. Moreover, the medication&'sside effects are manageable, making it a well-tolerated choice.