Search results for: therapeutic efficacy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3171

Search results for: therapeutic efficacy

2811 The Efficacy of Motivation Management Training for Students’ Academic Achievement and Self-Concept

Authors: Ramazan Hasanzadeh, Leyla Vatandoust

Abstract:

This study examined the efficacy of motivation management training for students’ academic achievement and self-concept. The pretest–posttest quasi-experimental study used a cluster random sampling method to select subjects for the experimental (20 subjects) and control (20 subjects) groups. posttest was conducted with both groups to determine the effect of the training. An academic achievement and academic self-concept questionnaire (grade point average requirement) was used for the pretest and posttest. The results showed that the motivation management training increased academic self-concept and academic achievement.

Keywords: motivation management, academic self-concept, academic achievement, students

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2810 Computer Assisted Strategies Help to Pharmacist

Authors: Komal Fizza

Abstract:

All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

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2809 The Influence of Psychological Capital Dimensions to Performance through OCB with Resistance to Change as Moderating Variable

Authors: Bambang Suko Priyono, Tristiana Rijanti

Abstract:

This study examines the influence of Psychological Capital Dimensions to Organizational Citizenship Behavior. There are four dimensions of Psychological Capital such as hope, optimism, resilience, and self-efficacy. It also tests the moderation effect of Resistance to Change in the relation between Psychological Capital’s dimensions and Organizational Citizenship Behavior, and the influence of Organizational Citizenship Behavior to employees’ performance. The data from the chosen 160 respondents from Public Service Institution is processed using multiple regression and interaction method. The study results in: 1) Hope positively significantly influences Organizational Citizenship Behavior, 2) Optimism positively significantly influences Organizational Citizenship Behavior, 3) Resilience positively significantly influences Organizational Citizenship Behavior, 4) Self-efficacy positively significantly influences Organizational Citizenship Behavior, 5) Resistance to change is moderating variable between hope and Organizational Citizenship Behavior, 6) Resistance to change is moderating variable between self-efficacy and Organizational Citizenship Behavior, 7) Organizational Citizenship Behavior positively significantly influences performance. On the contrary, resistance to change as a moderating variable is proven for hope and resilience.

Keywords: organizational citizenship behavior, performance, psychological capital’s dimensions, and resistance to change

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2808 Analgesic Efficacy of Opiorphin and Its Analogue

Authors: Preet Singh, Kavitha Kongara, Dave Harding, Neil Ward, Paul Chambers

Abstract:

The objective of this study was to compare the analgesic efficacy of opiorphin and its analogue with a mu-receptor agonist; morphine. Opiorphins (Gln-Arg-Phe-Ser-Arg) belong to the family of endogenous enkephalinase inhibitors, found in saliva of humans. They are inhibitors of two Zinc metal ectopeptidases (Neutral endopeptidase NEP, and amino-peptidase APN) which are responsible for the inactivation of the endogenous opioids; endorphins and enkephalins. Morphine and butorphanol exerts their analgesic effects by mimicking the actions of endorphins and enkephalins. The opiorphin analogue was synthesized based on the structure activity relationship of the amino acid sequence of opiorphin. The pharmacological profile of the analogue was tested by replacing Serine at position 4 with Proline. The hot plate and tail flick test were used to demonstrate the analgesic efficacy. There was a significant increase in the time for the tail flick response after an injection of opiorphin, which was similar to the morphine effect. There was no increase in time in the hot plate test after an injection of opiorphin. The results suggest that opiorphin works at spinal level only rather than both spinal and supraspinal. Further work is required to confirm our results. We did not find analgesic activity of the opiorphin analogue. Thus, Serine at position 4 is also important for its pharmacological action. Further work is required to illustrate the role of serine at position 4 in opiorphin.

Keywords: analgesic peptides, endogenous opioids, morphine, opiorphin

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2807 Nursing Experience of Providing Nursing Care to a Lung Transplantation Patient by Applying the Self-Efficacy Theory

Authors: Hsin-Yi Huang

Abstract:

This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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2806 Peripheral Inflammation and Neurodegeneration; A Potential for Therapeutic Intervention in Alzheimer’s Disease, Parkinson’s Disease, and Amyotrophic Lateral Sclerosis

Authors: Lourdes Hanna, Edward Poluyi, Chibuikem Ikwuegbuenyi, Eghosa Morgan, Grace Imaguezegie

Abstract:

Background: Degeneration of the central nervous system (CNS), also known as neurodegeneration, describes an age-associated progressive loss of the structure and function of neuronal materials, leading to functional and mental impairments. Main body: Neuroinflammation contributes to the continuous worsening of neurodegenerative states which are characterised by functional and mental impairments due to the progressive loss of the structure and function of neu-ronal materials. Some of the most common neurodegenerative diseases include Alzheimer’s disease (AD), Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS). Whilst neuroinflammation is a key contributor to the progression of such disease states, it is not the single cause as there are multiple factors which contribute. Theoretically, non-steroidal anti-inflammatory drugs (NSAIDs) have potential to target neuroinflammation to reduce the severity of disease states. Whilst some animal models investigating the effects of NSAIDs on the risk of neurodegenerative diseases have shown a beneficial effect, this is not the same finding. Conclusion: Further investigation using more advanced research methods is required to better understand neuroinflammatory pathways and understand if there is still a potential window for NSAID efficacy.

Keywords: intervention, central nervous system, neurodegeneration, neuroinflammation

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2805 Probiotics as Therapeutic Agents in the Treatment of Various Diseases: A Literature Review

Authors: K. B. Chathyushya, M. Shiva Prakash, R. Hemalatha

Abstract:

Introduction: Gastrointestinal (GI) tract has a number of microorganisms (microbiota) that influences the host’s health. The imbalance in the gut microbiota, which is also called as gut dysbiosis, affects human health which causes various metabolic, inflammatory, and infectious diseases. Probiotics play an important role in reinstating the gut balance. Probiotics are involved in the maintenance of healthier gut microbiota and have also been identified as effective adjuvants in insulin resistance therapies. Methods: This paper systematically reviews different randomized, controlled, blinded trials of probiotics for the treatment of various diseases along with the therapeutic or prophylactic properties of probiotic bacteria in different metabolic, inflammatory, infectious and anxiety-related disorders. Conclusion: The present review summarises that probiotics have some considerable effect in the management of various diseases, however, the benefits are strain specific, although more clinical trials are need to be carried out with different probiotic and symbiotic combinations as some probiotics have broad spectrum of benefits and few with specific activity

Keywords: life style diseases, cognition, health, gut dysbiosis, probiotics

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2804 Efficacy of Educational Program on the Performance of Internship Nursing Students Regarding Electronic Fetal Monitoring

Authors: Aida Abd El-Razek, Alyaa Salman Madian, Gamila Gaber Ayoub

Abstract:

Background: Electronic fetal monitoring is an obstetric technology that helps to record any changes in fetal heart rate and uterine activity. The aim of this study was to determine the efficacy of educational programs on the performance of internship nursing students regarding electronic fetal monitoring in obstetrics and gynecology departments. Design: A quasi-experimental research design (pre- and post-test) was used. Sample: A convenient sample of all internship nursing students (180 internship nursing students) from the Faculty of Nursing at Menoufia University during the academic year 2022-2023). The instruments of this study were a structured, self-administered interview questionnaire consisting of two parts: the socio-demographic characteristics of the study participants and an assessment of internship nursing students’ knowledge regarding electronic fetal monitoring (pre- and post-test). Observational checklist to assess internship nursing students’ performance regarding EFM. Results: There were highly statistically significant differences between the internship nurses' students’ knowledge and performance on the pretest and posttest. Conclusion: An educational program on electronic fetal monitoring carries a vital value for enhancing internship nursing students’ knowledge and performance, which ultimately leads to improved maternal and fetal outcomes. Recommendation: Regular educational programs and workshops about electronic fetal monitoring should be encouraged for all maternity nurses and internship nursing students.

Keywords: educational program, internship nursing students, performance, efficacy

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2803 Monitoring the Effect of Doxorubicin Liposomal in VX2 Tumor Using Magnetic Resonance Imaging

Authors: Ren-Jy Ben, Jo-Chi Jao, Chiu-Ya Liao, Ya-Ru Tsai, Lain-Chyr Hwang, Po-Chou Chen

Abstract:

Cancer is still one of the serious diseases threatening the lives of human beings. How to have an early diagnosis and effective treatment for tumors is a very important issue. The animal carcinoma model can provide a simulation tool for the study of pathogenesis, biological characteristics and therapeutic effects. Recently, drug delivery systems have been rapidly developed to effectively improve the therapeutic effects. Liposome plays an increasingly important role in clinical diagnosis and therapy for delivering a pharmaceutic or contrast agent to the targeted sites. Liposome can be absorbed and excreted by the human body, and is well known that no harm to the human body. This study aimed to compare the therapeutic effects between encapsulated (doxorubicin liposomal, LipoDox) and un-encapsulated (doxorubicin, Dox) anti-tumor drugs using Magnetic Resonance Imaging (MRI). Twenty-four New Zealand rabbits implanted with VX2 carcinoma at left thigh were classified into three groups: control group (untreated), Dox-treated group and LipoDox-treated group, 8 rabbits for each group. MRI scans were performed three days after tumor implantation. A 1.5T GE Signa HDxt whole body MRI scanner with a high resolution knee coil was used in this study. After a 3-plane localizer scan was performed, Three-Dimensional (3D) Fast Spin Echo (FSE) T2-Weighted Images (T2WI) was used for tumor volumetric quantification. And Two-Dimensional (2D) spoiled gradient recalled echo (SPGR) dynamic Contrast-enhanced (DCE) MRI was used for tumor perfusion evaluation. DCE-MRI was designed to acquire four baseline images, followed by contrast agent Gd-DOTA injection through the ear vein of rabbits. Afterwards, a series of 32 images were acquired to observe the signals change over time in the tumor and muscle. The MRI scanning was scheduled on a weekly basis for a period of four weeks to observe the tumor progression longitudinally. The Dox and LipoDox treatments were prescribed 3 times in the first week immediately after VX2 tumor implantation. ImageJ was used to quantitate tumor volume and time course signal enhancement on DCE images. The changes of tumor size showed that the growth of VX2 tumors was effectively inhibited for both LipoDox-treated and Dox-treated groups. Furthermore, the tumor volume of LipoDox-treated group was significantly lower than that of Dox-treated group, which implies that LipoDox has better therapeutic effect than Dox. The signal intensity of LipoDox-treated group is significantly lower than that of the other two groups, which implies that targeted therapeutic drug remained in the tumor tissue. This study provides a radiation-free and non-invasive MRI method for therapeutic monitoring of targeted liposome on an animal tumor model.

Keywords: doxorubicin, dynamic contrast-enhanced MRI, lipodox, magnetic resonance imaging, VX2 tumor model

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2802 Adverse Childhood Experiences and the Sense of Effectiveness and Coping with Emotions among Adolescents Taking Drugs

Authors: Monika Szpringer, Aneta Pawlinska

Abstract:

Adverse childhood experiences are linked to various types of health and adapt problems at different stages of life. They include various types of abuse, neglect, and dysfunctional environment. They have an unfavorable impact on the development of a child and his future functioning in society. Adolescents who were exposed to bad treatment may suffer from health problems during adulthood, like chronic diseases, psychological disorders, drug addiction, and suicide attempts. Objective: The aim of the project is to assess the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs. Material And Methods: The research was carried out in the period from March to December 2018 in Mazowieckie, Świętokrzyskie, Łódzkie, and Lubelskie Voivodship. The group consisted of 600 people aged 16-18 (M=16,58; SD=0, 78), men (63,2%) aged 16-18 (M=16,60;SD= 0,78) and women (35,5%) aged 16-18 (M16,55;SD=0,79). Participants included residents from Youth Educational Centers and Youth Sociotherapy Centers. Each participant filled in Author's Questionnaire, Adverse Childhood Questionnaire, then Courtland Emotional Control Scale-CECS and Generalized Self Efficacy Scale-GSES. Results and conclusions: The most common adverse experiences, according to teenagers, were family abuse, divorce/separation/parent's death, overuse of alcohol or drugs by an inmate, and emotional neglect. Adolescents who suffered from five to twelve adverse experiences had a higher level of depression's control. Adverse childhood experiences have an importance for the level of anger and depression's control among teenagers taking drugs. The greatest importance of the level of anger's control has emotional neglect. A higher level of emotional neglect is linked to a lower ability to control anger. The greatest importance of the level of depression's control has physical abuse and emotional neglect. The higher physical abuse during childhood, and the higher frequency of emotional neglect, the bigger the depression's control. The sense of efficacy in the group of people who suffered from one to four adverse experiences is close to the sense of efficacy that suffered people from five to twelve adverse experiences. The most important factor lowering the sense of one's efficacy was the intensification of sexual abuse. It was confirmed that the intensification and frequency of adverse childhood experiences were higher among women than men. Women also characterized lower anger control and greater depression's control. The authors’ own analyses confirmed the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs.

Keywords: adolescences, adverse childhood experiences, coping with emotions, drugs

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2801 The Effect of Second Victim-Related Distress on Work-Related Outcomes in Tertiary Care, Kelantan, Malaysia

Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

Abstract:

Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

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2800 Efficacy and User Satisfaction on the Rama-Chest Cryo Arm Innovation for Bronchoscopic Cryotherapy

Authors: Chariya Laohavich

Abstract:

At the current, the trends in the lung disease at a university hospital are the treat and diagnosis by bronchoscopy. Bronchoscopic cryotherapy is a long time procedure 1-4 hours. The cryo probe is sensitive and easy to be damaged and expensive. We have this study management for protection the cryo probe, user satisfaction and qualities work. This study conducted in 4 stages: stage 1 for a survey of problems and assessment of user’s needs; stage 2 for designing and developing the Rama-chest cryo arm for a bronchoscopy process; stage 3 for test-implementing the Rama-chest cryo arm in real situations, studying its problems and obstacles, and evaluating the user satisfaction; and stage 4 for an overall assessment and improvement. The sample used in this study consisted of a total of 15 Ramathipbodi Hospital’s Bronchoscopist and bronchoscopist’s nurse who had used the Rama-chest cryo arm for bronchoscopic cryotherapy from January to June 2016. Objective: To study efficacy and user satisfaction on the Rama-chest cryo arm innovation for bronchoscopic cryotherapy. Data were collected using a Rama-chest cryo arm satisfaction assessment form and analysed based on mean and standard deviation. Result is the Rama-chest cryo arm was an innovation that accommodated during bronchoscopic cryotherapy. The subjects rated this the cryo arm as being most satisfactory (M = 4.86 ± , SD 0.48. Therefore we have developed a cryo arm that uses local material, practical and economic. Our innovation is not only flexible and sustainable development but also lean and seamless. This produced device can be used as effectively as the imported one, and thus can be eventually substituted.

Keywords: efficacy, satisfaction, Rama-chest cryo arm, innovation, bronchoscopic cryotherapy

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2799 Nanoceutical Intervention (Nanodrug) of Neonatal Hyperbilirubinemias Compared to Conventional Phototherapy

Authors: Samir Kumar Pal

Abstract:

Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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2798 Ancelim: Health System Restoration Protocol for Cancer Patients

Authors: Mark Berry

Abstract:

A number of studies have identified several factors involved in the malignant progression of cancer cells. The Primary modulator in driving inflammation to these transformed cells has been identified as the transcription factor known as nuclear factor-κB. This essential regulator of inflammation and the development of cancer, combined with a microenvironment of inflammation and signaling molecules, plays a major role in the malignant progression of cancer, and this progression is the result of the mutagenic predisposition of persistent substances that combat infection at tumor sites and other areas of chronic inflammation. Inflammation-induced tumors, and their inflammatory cells and regulators may be the primary source of metastasis of tumor cells through angiogenesis. Previous research on cytokines and chemokines, including their downstream targets, has been the focus of the cancer/inflammation connection. The identification of the biological mechanisms of other proteins vital to the inflammation cascade and their interactions are crucial to novel and effective therapeutic protocols for the treatment of inflammation-induced cancers. The Ancelim HSRP Protocol is just such a therapeutic intervention.

Keywords: ancelim, cancer, inflammation, tumor

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2797 Efficacy of Umbilical Cord Lining Stem Cells For Wound Healing in Diabetic Murine Model

Authors: Fui Ping Lim, Wen Choong Chua, Toan Thang Phan

Abstract:

Aim: This study investigates the roles of Cord Lining Stem Cells (CLSCs) as potential therapeutic agents for diabetic wounds. Method: 20 genetically diabetic db/db mice were randomly assigned to two arms; (i) control group received placebo treatment (sham media or cells delivery material), and (ii) active comparator received CLSCs. Two full-thickness wounds, each sized 10mm X 10mm were created, one on each side of the midline on the back of the mice. Digital pictures were taken on day 1, 3, 7, 10, 14, 17, 21, 24, 28. Wound areas were analyzed with ImageJ TM software and calculated as percentage of the original wound. Time to closure was defined as the day the wound bed was completely epithelized and filled with new tissues. Results: The CLSCs-treated wounds, showed a significant increase in the percentage of wound closure and achieved 100% closure of the wound sooner than the control group by an average of 3.7 days. The mice treated with CLSCs have a shorter wound closure time (mean closure day: 19.8 days) as compared to the control group (mean closure day: 23.5 days). Conclusion: Our preliminary findings inferred that CLSCs treated wound achieved higher percentage of wound closure within a shorter duration of time.

Keywords: cord lining stem cell, diabetic wound, stem cell, wound

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2796 Therapeutic Potential of mAb KP52 in Human and Feline Cancers

Authors: Abigail Tan, Heng Liang Tan, Vanessa Ding, James Hui, Eng Hin Lee, Andre Choo

Abstract:

Introduction: Comparative oncology investigates the similarities in spontaneous carcinogenesis between humans and animals, in order to identify treatments that can benefit these patients. Companion animals (CA), like canines and felines, are of special interest when it comes to studying human cancers due to their exposure to the same environmental factors and develop tumours with similar features. The purpose of this study is to explore the cross-reactivity of monoclonal antibodies (mAbs) across cancers in humans and CA. Material and Methods: A panel of CA mAbs generated in the lab was screened on multiple human cancer cell lines through flow cytometry to identify for positive binders. Shortlisted candidates were then characterised by biochemical and functional assays e.g., antibody-drug conjugate (ADC) and western blot assays, including glycan studies. Results: Candidate mAb KP52 was generated from whole-cell immunisation using feline mammary carcinoma. KP52 showed strong positive binding to human cancer cells, such as breast cancer and ovarian cancer. Furthermore, KP52 demonstrated strong killing ( > 50%) as an ADC with Saporin as the payload. Western blot results revealed the molecular weight of the antigen targets to be approximately 45kD and 50kD under reduced conditions. Glycan studies suggest that the epitope is glycan in nature, specifically an O-linked glycan. Conclusion: Candidate mAb KP52 has a therapeutic potential as an ADC against feline mammary cancer, human ovarian cancer, human mammary cancer, human pancreatic cancer, and human gastric cancer.

Keywords: ADC, comparative oncology, mAb, therapeutic

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2795 Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of Stroke; A Systematic Review

Authors: Zahra Hassani

Abstract:

Background and Purpose: Poststroke depression (PSD) is one of the complications of a stroke that reduces the patient's chance of recovery, becomes irritable, and changes personality. Cognitive rehabilitation is one of the non-pharmacological methods that improve deficits such as attention, memory, and symptoms of depression. Therefore, the purpose of the present study is to evaluate the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke. Method: In this study, a systematic review of the databases Google Scholar, PubMed, Science Direct, Elsevier between the years 2015 and 2019 with the keywords cognitive rehabilitation therapy, post-stroke, depression Search is done. In this process, studies that examined the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke were included in the study. Results: Inclusion criteria were full-text availability, interventional study, and non-review articles. There was a significant difference between the articles in terms of the indices studied, sample number, method of implementation, and so on. A review of studies have shown that cognitive rehabilitation therapy has a significant role in reducing the symptoms of post-stroke depression. The use of these interventions is also effective in improving problem-solving skills, improving memory, and improving attention and concentration. Conclusion: This study emphasizes on the development of efficient and flexible adaptive skills through cognitive processes and its effect on reducing depression in patients after stroke.

Keywords: cognitive therapy, depression, stroke, rehabilitation

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2794 Hereditary Angioedema: Case Presentation and Review of Anaesthetic Implications

Authors: Joshua Chew, Vesa Cheng, David Thomson

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Background: Hereditary angioedema (HAE) or C1 esterase deficiency is a relatively rare entity that has a potential for significant anesthetic complications. Methods: A literature review was performed of published cases of surgery in patients with HAE. Results were limited to English language only and cases were examined for management strategies and successful prevention of acute attacks. Results: The literature revealed the successful use of C1 esterase inhibitors as the most common agent in surgical prophylaxis therapy. Other therapeutic targets described included kallikrein inhibitors and bradykinin B2 receptor antagonists. Conclusions: Therapeutic targets that exist for the management of acute attacks in HAE have been successfully employed in the setting of surgery. The data is currently limited and could not be used as a firm evidence base, but the limited outcomes seen are positive and reassuring for the prospective anesthetic management of this potentially fatal condition.

Keywords: anesthesia, C1 esterase deficiency, hereditary angioedema, surgical prophylaxis

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2793 Synthesis and Surface Engineering of Lanthanide Nanoparticles for NIR Luminescence Imaging and Photodynamic Therapy

Authors: Syue-Liang Lin, C. Allen Chang

Abstract:

Luminescence imaging is an important technique used in biomedical research and clinical diagnostic applications in recent years. Concurrently, the development of NIR luminescence probes / imaging contrast agents has helped the understanding of the structural and functional properties of cells and animals. Photodynamic therapy (PDT) is used clinically to treat a wide range of medical conditions, but the therapeutic efficacy of general PDT for deeper tumor was limited by the penetration of excitation source. The tumor targeting biomedical nanomaterials UCNP@PS (upconversion nanoparticle conjugated with photosensitizer) for photodynamic therapy and near-infrared imaging of cancer will be developed in our study. Synthesis and characterization of biomedical nanomaterials were completed in this studies. The spectrum of UCNP was characterized by photoluminescence spectroscopy and the morphology was characterized by Transmission Electron Microscope (TEM). TEM and XRD analyses indicated that these nanoparticles are about 20~50 nm with hexagonal phase. NaYF₄:Ln³⁺ (Ln= Yb, Nd, Er) upconversion nanoparticles (UCNPs) with core / shell structure, synthesized by thermal decomposition method in 300°C, have the ability to emit visible light (upconversion: 540 nm, 660 nm) and near-infrared with longer wavelength (downconversion: NIR: 980 nm, 1525 nm) by absorbing 800 nm NIR laser. The information obtained from these studies would be very useful for applications of these nanomaterials for bio-luminescence imaging and photodynamic therapy of deep tumor tissue in the future.

Keywords: Near Infrared (NIR), lanthanide, core-shell structure, upconversion, theranostics

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2792 Influence of Psychosocial Factors on Physical Activity Level among Individuals with Asthma

Authors: Awotidebe Taofeek, Oyinsuyi Oluwafunmbi

Abstract:

Psychosocial factors play a significant role in physical activity participation in diseased conditions and the general population. However, little is known about the role of exercise self-efficacy (ESE), exercise perceived barriers (EPB), and social support (SOS) in patients with asthma. This study investigated the influence of psychosocial factors on physical activity participation in patients with asthma in ile-ife. This cross-sectional study involved 130 patients with asthma. They were recruited from the Chest Clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-ife using purposive sampling technique. Ethical approval was obtained from the Ethics and Research Committee of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-ife, Nigeria. Socio-demographic characteristics of respondents were recorded. Information on ESE, EPB, and SOS were obtained using Exercise Self-Efficacy, Exercise Benefit, and Barrier and Medical Outcome Social Support Scales respectively. Physical activity level was assessed in the last 7 days using international physical activity questionnaire. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p<0.5. The mean age of the respondents was 25.15 ± 9.38, and a majority, 110 (84.60%), engaged in low physical activity, 69(53%) had low exercise self-efficacy. However, less than two-third 80 (62.20%) reported high social support, with the majority of 95 (73.10%) reported high exercise perceived barriers. The means of ESE for male and femalerespondents were 29.01 ± 20.62 and 24.35 ± 17.36, respectively. The means of SOS formale and female respondents were 49.52 ± 22.22 and 61.87 ± 22.66, respectively. Themeans of EPB for male and female respondents were 53.37 ± 10.23 and 57.43 ± 9.65, respectively. The respondents were comparable in exercise self-efficacy and physicalactivity level (p>0.05). However, there were significant differences in social support (t=-2.791; p=0.006) and exercise perceived barriers (t=-2.108, p=0.037).Theresultsshowthattherewasasignificantrelationshipbetweenexerciseperceivedbarriersandlowphysicalactivitylevel(r=-0.216;p=0.023).TherewasasignificantassociationbetweenExerciseself-efficacyandmarried individuals(OR=0.967;95%CI=0.936-0.998;p= 0.037). Similarly, However,thereweresignificantassociationsbetweensocialsupport Andagegroup35-54years(OR=1.036;95%CI=1.007-1.067;p=0.014),females(OR= 1.024;95%CI=1.006;p=0.009)andmarriedindividuals(OR=1.049;95%CI=1.020-1.079. p=0.001).Therewasasignificantassociationbetweenexerciseperceivedbarriersand females(OR=1.043;95%CI=1.002-1.085;p=0.040).However, thereweresignificant associationsbetweenexerciseperceivedbarriersandoccupationgroup;civilservants (OR=1.092;95%CI=1.009-1.182;p=0.028),retiree(OR=1.092;95%CI=1.040-1.469;p= 0.016)andstudents(OR=1.110;95%CI=1.040;p=0.002). Inconclusion,agreaterpercentageofpatientswithasthmahadlowphysicalactivityleveland it was associatedwithhighexerciseperceivedbarriers,whileexerciseself-efficacyandsocialsupportwerenot.

Keywords: asthma, psychosocial factors, physical activity, physical fitness

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2791 The Effectiveness of Using Dramatic Conventions as the Teaching Strategy on Self-Efficacy for Children With Autism Spectrum Disorder

Authors: Tso Sheng-Yang, Wang Tien-Ni

Abstract:

Introduction and Purpose: Previous researchers have documented children with ASD (Autism Spectrum Disorders) prefer to escaping internal privates and external privates when they face tough conditions they can’t control or they don’t like.Especially, when children with ASD need to learn challenging tasks, such us Chinese language, their inappropriate behaviors will occur apparently. Recently, researchers apply positive behavior support strategies for children with ASD to enhance their self-efficacy and therefore to reduce their adverse behaviors. Thus, the purpose of this research was to design a series of lecture based on art therapy and to evaluate its effectiveness on the child’s self-efficacy. Method: This research was the single-case design study that recruited a high school boy with ASD. Whole research can be separated into three conditions. First, baseline condition, before the class started and ended, the researcher collected participant’s competencies of self-efficacy every session. In intervention condition, the research used dramatic conventions to teach the child in Chinese language twice a week.When the data was stable across three documents, the period entered to the maintenance condition. In maintenance condition, the researcher only collected the score of self-efficacynot to do other interventions five times a month to represent the effectiveness of maintenance.The time and frequency of data collection among three conditions are identical. Concerning art therapy, the common approach, e.g., music, drama, or painting is to use art medium as independent variable. Due to visual cues of art medium, the ASD can be easily to gain joint attention with teachers. Besides, the ASD have difficulties in understanding abstract objectives Thus, using the drama convention is helpful for the ASD to construct the environment and understand the context of Classical Chinese. By real operation, it can improve the ASD to understand the context and construct prior knowledge. Result: Bassd on the 10-points Likert scale and research, we product following results. (a) In baseline condition, the average score of self-efficacyis 1.12 points, rangedfrom 1 to 2 points, and the level change is 0 point. (b)In intervention condition, the average score of self-efficacy is 7.66 points rangedfrom 7 to 9 points, and the level change is 1 point. (c)In maintenance condition, the average score of self-efficacy is 6.66 points rangedfrom 6 to 7 points, and the level change is 1 point. Concerning immediacy of change, between baseline and intervention conditions, the difference is 5 points. No overlaps were found between these two conditions. Conclusion: According to the result, we find that it is effective that using dramatic conventions a s teaching strategies to teach children with ASD. The result presents the score of self-efficacyimmediately enhances when the dramatic conventions commences. Thus, we suggest the teacher can use this approach and adjust, based on the student’s trait, to teach the ASD on difficult task.

Keywords: dramatic conventions, autism spectrum disorder, slef-efficacy, teaching strategy

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2790 Potential Therapeutic Effect of Obestatin in Oral Mucositis

Authors: Agnieszka Stempniewicz, Piotr Ceranowicz, Wojciech Macyk, Jakub Cieszkowski, Beata Kuśnierz-Cabała, Katarzyna Gałązka, Zygmunt Warzecha

Abstract:

Objectives: There are numerous strategies for the prevention or treatment of oral mucositis. However, their effectiveness is limited and does not correspond to expectations. Recent studies have shown that obestatin exhibits a protective effect and accelerates the healing of gastrointestinal mucosa. The aim of the present study was to examine the influence of obestatin administration on oral ulcers in rats. Methods: lingual ulcers were induced by the use of acetic acid. Rats were treated twice a day intraperitoneally with saline or obestatin(4, 8, or 16 nmol/kg/dose) for five days. The study determined: lingual mucosa morphology, cell proliferation, mucosal blood flow, and mucosal pro-inflammatory interleukin-1β level(IL-1β). Results: In animals without induction of oral ulcers, treatment with obestatin was without any effect. Obestatin administration in rats with lingual ulcers increased the healing rate of these ulcers. Obestatin given at the dose of 8 or 16 nmol/kg/dose caused the strongest and similar therapeutic effect. This result was associated with a significant increase in blood flow and cell proliferation in gingival mucosa, as well as a significant decrease in IL-1β level. Conclusions: Obestatin accelerates the healing of lingual ulcers in rats. This therapeutic effect is well-correlated with an increase in blood flow and cell proliferation in oral mucosa, as well as a decrease in pro-inflammatory IL-1β levels. Obestatin is a potentially useful candidate for the prevention and treatment of oral mucositis. Acknowledgment: Agnieszka Stempniewicz acknowledges the support of InterDokMed project no. POWR.03.02.00- 00-I013/16.

Keywords: oral mucositis, ulcers, obestatin, lingual mucosa

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2789 Exploring Nanoformulations for Therapeutic Induction of Necroptosis

Authors: Tianjiao Chu, Carla Rios Luci, Christy Maksoudian, Ara Sargsian, Bella B. Manshian, Stefaan J. Soenen

Abstract:

Nanomaterials have gained high interest in their use as potent anticancer agents. Apart from delivering chemotherapeutic agents in order to reduce off-target effects, molecular agents have also been widely explored. The advances in our understanding of cell biology and cell death mechanisms1 has generated a broad library of potential therapeutic targets by siRNA, mRNA, or pDNA complexes. In the present study, we explore the ability of pDNA-polyplexes to induce tumor-specific necroptosis. This results in a cascade of effects, where immunogenic cell death potentiates anti-tumor immune responses and results in an influx of dendritic cells and cytotoxic T cells, rendering the tumor more amenable to immune checkpoint inhibition. This study aims to explore whether the induction of necroptosis in a subpopulation of tumor cells can be used to potentiate immune checkpoint inhibition studies.

Keywords: nanoparticle, MLKL, necroptosis, immunotherapy

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2788 Contextual and Personal Factors as Predictor of Academic Resilience among Female Undergraduates in Boko Haram Neighbourhood in North-Eastern Nigeria

Authors: Ndidi Ofole

Abstract:

Ongoing Boko Haram crisis and instability in North-Eastern Nigeria has placed additional stress on academic resilience of female undergraduates who are already challenged by gender discrimination in educational opportunities. Students without resilience lack stress hardiness to cope with academic challenges. There is a limited study on academic resilience targeting this disadvantaged population in Nigeria. Consequently, survey research design was employed to investigate the contextual and personal factors that could predict academic resilience among female undergraduates in Boko Haram Neighbourhood in North-Eastern, Nigeria. Five hundred and thirty female students with age range of 18 to 24 years ( = 19.2; SD=6.9) were randomly drawn from 3 Universities in North-Eastern Nigeria. They responded to five instruments, namely; Academic Resilience scale (r=0.72); Social Support questionnaire (r=0. 64); Social Connectedness questionnaire (r=0.75); Self-Efficacy scale (r=0. 68) and Emotional Regulation questionnaire (r=78). Results showed that there was significant positive relationship between the four independent variables and academic resilience. The variables jointly contributed 5.9% variance in the prediction of academic resilience. In terms of magnitude, social support was most potent while self-efficacy was the least. It concluded that the factors considered in this study are academic resilience facilitators. The outcomes of the study have both theoretical and practical implications.

Keywords: academic resilience, emotional regulation, school connectedness, self-efficacy , social support

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2787 Integrating Non-Psychoactive Phytocannabinoids and Their Cyclodextrin Inclusion Complexes into the Treatment of Glioblastoma

Authors: Kyriaki Hatziagapiou, Konstantinos Bethanis, Olti Nikola, Elias Christoforides, Eleni Koniari, Eleni Kakouri, George Lambrou, Christina Kanaka-Gantenbein

Abstract:

Glioblastoma multiforme (GBM) remains a serious health challenge, as current therapeutic modalities continue to yield unsatisfactory results, with the average survival rarely exceeding 1-2 years. Natural compounds still provide some of the most promising approaches for discovering new drugs. The non-psychotropic cannabidiol (CBD) deriving from Cannabis sativa L. provides such promise. CBD is endowed with anticancer, antioxidant, and genoprotective properties as established in vitro and in in vivo experiments. CBD’s selectivity towards cancer cells and its safe profile suggest its usage in cancer therapies. However, the bioavailability of oral CBD is low due to poor aqueous solubility, erratic gastrointestinal absorption, and significant first-pass metabolism, hampering its therapeutic potential and resulting in a variable pharmacokinetic profile. In this context, CBD can take great advantage of nanomedicine-based formulation strategies. Cyclodextrins (CDs) are cyclic oligosaccharides used in the pharmaceutical industry to incorporate apolar molecules inside their hydrophobic cavity, increasing their stability, water solubility, and bioavailability or decreasing their side effects. CBD-inclusion complexes with CDs could be a good strategy to improve its properties, like solubility and stability to harness its full therapeutic potential. The current research aims to study the potential cytotoxic effect of CBD and CBD-CDs complexes CBD-RMβCD (randomly methylated β-cyclodextrin) and CBD-HPβCD (hydroxypropyl-b-CD) on the A172 glioblastoma cell line. CBD is diluted in 10% DMSO, and CBD/CDs solutions are prepared by mixing solid CBD, solid CDs, and dH2O. For the biological assays, A172 cells are incubated at a range of concentrations of CBD, CBD-RMβCD and CBD-HPβCD, RMβCD, and HPβCD (0,03125-4 mg/ml) at 24, 48, and 72 hours. Analysis of cell viability after incubation with the compounds is performed with Alamar Blue viability assay. CBD’s dilution to DMSO 10% was inadequate, as crystals are observed; thus cytotoxicity experiments are not assessed. CBD’s solubility is enhanced in the presence of both CDs. CBD/CDs exert significant cytotoxicity in a dose and time-dependent manner (p < 0.005 for exposed cells to any concentration at 48, 72, and 96 hours versus cells not exposed); as their concentration and time of exposure increases, the reduction of resazurin to resofurin decreases, indicating a reduction in cell viability. The cytotoxic effect is more pronounced in cells exposed to CBD-HPβCD for all concentrations and time-points. RMβCD and HPβCD at the highest concentration of 4 mg/ml also exerted antitumor action per se since manifesting cell growth inhibition. The results of our study could afford the basis of research regarding the use of natural products and their inclusion complexes as anticancer agents and the shift to targeted therapy with higher efficacy and limited toxicity. Acknowledgments: The research is partly funded by ΙΚΥ (State Scholarships Foundation) – Post-doc Scholarships-Partnership Agreement 2014-2020.

Keywords: cannabidiol, cyclodextrins, glioblastoma, hydroxypropyl-b-Cyclodextrin, randomly-methylated-β-cyclodextrin

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2786 Therapeutic Efficacy and Safety Profile of Tolvaptan Administered in Hyponatremia Patients

Authors: Sree Vennela P., V. Samyuktha Bhardwaj

Abstract:

Hyponatremia is an electrolyte disturbance in which the sodium ion concentration in the serum is lower than normal. Sodium is the dominant extracellular cation (positive ion) and cannot freely cross from the interstitial space through the cell membrane, into the cell. Its homeostasis (stability of concentration) inside the cell is vital to the normal function of any cell. Normal serum sodium levels are between 135 and 145 mEq/L. Hyponatremia is defined as a serum level of less than 135 mEq/L and is considered severe when the serum level is below 125 mEq/L. In the vast majority of cases, Hyponatremia occurs as a result of excess body water diluting the serum sodium (salt level in the blood). Hyponatremia is often a complication of other medical illnesses in which excess water accumulates in the body at a higher rate than can be excreted (for example in congestive heart failure, syndrome of inappropriate antidiuretic hormone, SIADH, or polydipsia). Sometimes it may be a result of over-hydration (drinking too much water).Lack of sodium (salt) is very rarely the cause of Hyponatremia, although it can promote Hyponatremia indirectly. In particular, sodium loss can lead to a state of volume depletion (loss of blood volume in the body), with volume depletion serving as a signal for the release of ADH (anti-diuretic hormone). As a result of ADH-stimulated water retention (too much water in the body), blood sodium becomes diluted and Hyponatremia results.

Keywords: Tolvaptan, hyponatremia, syndrome of insufficient anti diuretic hormone (SIADH), euvolemic hyponatremia

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2785 Curcumin Nanomedicine: A Breakthrough Approach for Enhanced Lung Cancer Therapy

Authors: Shiva Shakori Poshteh

Abstract:

Lung cancer is a highly prevalent and devastating disease, representing a significant global health concern with profound implications for healthcare systems and society. Its high incidence, mortality rates, and late-stage diagnosis contribute to its formidable nature. To address these challenges, nanoparticle-based drug delivery has emerged as a promising therapeutic strategy. Curcumin (CUR), a natural compound derived from turmeric, has garnered attention as a potential nanomedicine for lung cancer treatment. Nanoparticle formulations of CUR offer several advantages, including improved drug delivery efficiency, enhanced stability, controlled release kinetics, and targeted delivery to lung cancer cells. CUR exhibits a diverse array of effects on cancer cells. It induces apoptosis by upregulating pro-apoptotic proteins, such as Bax and Bak, and downregulating anti-apoptotic proteins, such as Bcl-2. Additionally, CUR inhibits cell proliferation by modulating key signaling pathways involved in cancer progression. It suppresses the PI3K/Akt pathway, crucial for cell survival and growth, and attenuates the mTOR pathway, which regulates protein synthesis and cell proliferation. CUR also interferes with the MAPK pathway, which controls cell proliferation and survival, and modulates the Wnt/β-catenin pathway, which plays a role in cell proliferation and tumor development. Moreover, CUR exhibits potent antioxidant activity, reducing oxidative stress and protecting cells from DNA damage. Utilizing CUR as a standalone treatment is limited by poor bioavailability, lack of targeting, and degradation susceptibility. Nanoparticle-based delivery systems can overcome these challenges. They enhance CUR’s bioavailability, protect it from degradation, and improve absorption. Further, Nanoparticles enable targeted delivery to lung cancer cells through surface modifications or ligand-based targeting, ensuring sustained release of CUR to prolong therapeutic effects, reduce administration frequency, and facilitate penetration through the tumor microenvironment, thereby enhancing CUR’s access to cancer cells. Thus, nanoparticle-based CUR delivery systems promise to improve lung cancer treatment outcomes. This article provides an overview of lung cancer, explores CUR nanoparticles as a treatment approach, discusses the benefits and challenges of nanoparticle-based drug delivery, and highlights prospects for CUR nanoparticles in lung cancer treatment. Future research aims to optimize these delivery systems for improved efficacy and patient prognosis in lung cancer.

Keywords: lung cancer, curcumin, nanomedicine, nanoparticle-based drug delivery

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2784 Efficacy of Self-Assessment Metacognitive Strategy on Academic Performance Among Upper Basic Students in Ankpa, Kogi State, Nigeria

Authors: Daodu Joshua Rotimi

Abstract:

This study investigated the Efficacy of Self-Assessment Metacognitive Strategy on Academic performance in Energy Concepts among Upper Basic Science Students in Ankpa, Kogi State, Nigeria. The research design adopted for the study was a Quasi-experimental control group design which employed a pretest, posttest of the experimental and control groups. The population of the study consisted of one hundred and twenty-four (124) JSSII Students; sixty-five (65) for the experimental group and (59) for the control group. The instrument used for the study was the Energy Concept Performance Test (ECPT), with a reliability coefficient of 0.80. Two research questions were answered using descriptive statistics of mean and standard deviation, while two hypotheses were tested using a t-test at P≤0.05 level of significance. The findings of the study revealed that the use of the Self-Assessment Metacognitive Strategy has a positive effect on students’ performance in energy concepts among upper Basic Science Students leading to high academic performance; also, there is no significant difference in the mean Academic Performance scores between Male and Female students taught Energy Concept using Self-Assessment Metacognitive Strategy. Based on the research findings, recommendations were made, which include that Secondary school teachers should be encouraged the use Self-Assessment Metacognitive strategy so as to make the learning process attractive, interactive and enriching to the learners.

Keywords: metacognition, self-assessment, performance, efficacy

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2783 Relationship between Dimensions of Psychological Capital and Psychological Well-Being

Authors: Touraj Hashemi, Zahara Saeidi, Paxshan H. Gader-l-Shateri

Abstract:

The present study aimed to determine the relationship between dimensions of psychological capital and psychological well-being. This research was conducted with a correlatiove method. The study population included the students of Sulaymaniyah, Garmian, and Halabja Universities in the Kurdistan region of Iraq. Therefore, using the one-stage cluster method, 300 subjects were selected and completed Riff's psychological well-being scale, and Luthans' psychological capital questionnaire. Data were analyzed using the multiple regression method. Results showed that self-efficacy, optimism, hope, and resilience had a positive relationship with psychological well-being. Hence, it can be concluded the four dimensions of psychological capital are able, in addition to modulating the effects of stress sources, to set the stage for the motivational use of life's stressors in order to develop new challenges and help the individual to continuous effort in order to develop new goals and expand happiness.

Keywords: psychological well-being, self-efficacy, optimism, hope, resilience

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2782 The Emerging Role of Cannabis as an Anti-Nociceptive Agent in the Treatment of Chronic Back Pain

Authors: Josiah Damisa, Michelle Louise Richardson, Morenike Adewuyi

Abstract:

Lower back pain is a significant cause of disability worldwide and associated with great implications in terms of the well-being of affected individuals and society as a whole due to its undeniable socio-economic impact. With its prevalence on the increase as a result of an aging global population, the need for novel forms of pain management is ever paramount. This review aims to provide further insight into current research regarding a role for the endocannabinoid signaling pathway as a target in the treatment of chronic pain, with particular emphasis on its potential use as part of the treatment of lower back pain. Potential advantages and limitations of cannabis-based medicines over other forms of analgesia currently licensed for medical use are discussed in addition to areas that require ongoing consideration and research. To evaluate the efficacy of cannabis-based medicines in chronic pain, studies pertaining to the role of medical cannabis in chronic disease were reviewed. Standard searches of PubMed, Google Scholar and Web of Science databases were undertaken with peer-reviewed journal articles reviewed based on the indication for pain management, cannabis treatment modality used and study outcomes. Multiple studies suggest an emerging role for cannabis-based medicines as therapeutic agents in the treatment of chronic back pain. A potential synergistic effect has also been purported if these medicines are co-administered with opiate analgesia due to the similarity of the opiate and endocannabinoid signaling pathways. However, whilst recent changes to legislation in the United Kingdom mean that cannabis is now licensed for medicinal use on NHS prescription for a number of chronic health conditions, concerns remain as to the efficacy and safety of cannabis-based medicines. Research is lacking into both their side effect profiles and the long-term effects of cannabis use. Legal and ethical considerations to the use of these products in standardized medical practice also persist due to the notoriety of cannabis as a drug of abuse. Despite this, cannabis is beginning to gain traction as an alternative or even complementary drug to opiates, with some preclinical studies showing opiate-sparing effects. Whilst there is a paucity of clinical trials in this field, there is scope for cannabinoids to be successful anti-nociceptive agents in managing chronic back pain. The ultimate aim would be to utilize cannabis-based medicines as alternative or complementary therapies, thereby reducing opiate over-reliance and providing hope to individuals who have exhausted all other forms of standard treatment.

Keywords: endocannabinoids, cannabis-based medicines, chronic pain, lower back pain

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