scholarly journals Dynamics of age characteristics and prevalence of concomitant cardiovascular and non-sardiovascular diseases in patients hospitalized with COVID-19 during epidemic wave: data from TARGET-VIP registry

2022 ◽  
Vol 20 (8) ◽  
pp. 3106
Author(s):  
M. M. Lukyanov ◽  
S. Yu. Martsevich ◽  
A. A. Pulin ◽  
N. P. Kutishenko ◽  
E. Yu. Andreenko ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Chronic Diseases ◽  
Pronounced Increase ◽  
Prognostic Assessment ◽  
National Medical ◽  
Digestive Diseases ◽  
Rate Of Increase ◽  
Patients With Diabetes ◽  
The Difference ◽  
Epidemic Wave

Aim. According to hospital-based registry, to evaluate the age characteristics and prevalence of concomitant cardiovascular and non-сardiovascular diseases in patients hospitalized with COVID-19 during epidemic wave.Material and methods. The TARGET-VIP register included 1130 patients aged 57,5+12,8 years (men, 51,2%) hospitalized at the Pirogov National Medical and Surgical Center from April 6, 2020 to June 22, 2020 with COVID-19. Cardiovascular diseases (CVDs) were diagnosed in 51,6% of patients, non-сardiovascular chronic diseases — in 48,6%, while CVDs and/or non-сardiovascular chronic diseases — in 65,8% of patients.Results. The average age of patients significantly increased by an average of 0,77 years per week (p<0,001), while the difference between the 1st week (52,8 years) and 11th week (62,2 years) was 9,4 years; the proportion of men did not change significantly. The proportion of patients with CVDs increased significantly — from 34,2% to 66,7%, on average by 3,7% per week (p<0,001; Incidence Risk Ratio (IRR)=1,037; 95% confidence interval (CI), 1,017-1,058), with chronic non-cardiovascular diseases — from 32,5% to 43,2%, on average by 2,5% per week (p<0,001; IRR=1,025; 95% CI, 1,002-1,049), as well as those with CVDs and/or chronic non-cardiovascular diseases — from 47,5% to 75,3%, on average by 3,2% per week (p<0,001; IRR=1,032; 95% CI, 1,017-1,048). Over the entire period, the proportion of people with hypertension (HTN) was 47,0%, with coronary artery disease (CAD) — 15,4%, with heart failure (HF) — 4,0%, and with atrial fibrillation (AF) — 10,1%. The proportion of patients with HTN increased by 9,5% (p<0,001; OR=1,095; 95% CI, 1,047-1,144), with СAD — by 9,4% (p=0,01; OR=1,094; 95% CI, 1,022-1,172) and with AF — by 9,4% (p<0,001; OR=1,094; 95% CI, 1,023-1,170) per week. The proportion of patients with diabetes was 16,5%, with respiratory diseases — 11,4%, with chronic kidney disease (CKD) — 12,6%, with digestive diseases — 22,5%, with obesity — 6,1%. During the epidemic wave, the most pronounced increase in the proportion of patients with CKD was by 6,2% (p=0,036; OR=1,062; 95% CI, 1,004-1,124) and with digestive diseases — by 6,0% (p=0,01; OR=1,060; 95% CI, 1,014-1,109) per week.Conclusion. According to the 11-week TARGET-VIP registry, the age of patients increased by 9,4 years, CVD cases — by 1,9 times (mainly HTN, CAD, AF), and chronic non­сardiovascular pathology — by 1,3 times (mainly CKD and digestive diseases). These trends in hospital practice corresponded to a weekly increase in the proportion of patients with a higher risk of fatal and non-fatal complications, which is the basis for further research in order to develop a system for a comprehensive prognostic assessment of the degree and rate of increase in the load on hospitals during COVID-19 epidemic wave.

Apolipoprotein(a), Fibrinopeptide A and Carotid Atherosclerosis in Middle-Aged Men

1994 ◽  
Vol 72 (04) ◽  
pp. 563-566 ◽  
Author(s):  
Tuomo Rankinen ◽  
Sari Väisänen ◽  
Michele Mercuri ◽  
Rainer Rauramaa
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Bifurcation ◽  
Carotid Intima Media Thickness ◽  
Fibrinopeptide A ◽  
Carotid Imt ◽  
Apolipoprotein A ◽  
The Difference

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.

Primary prevention and screening of cardiovascular diseases in patients with diabetes

Medic ro ◽  
2018 ◽  
Vol 3 (123) ◽  
pp. 48
Author(s):  
Lucia Cojocaru ◽  
Sergiu Chirila ◽  
Luminiţa Matei
Keyword(s):  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Patients With Diabetes

Evaluation of Salivary Antioxidants and Oxidative Stress Markers in Type 2 Diabetes Mellitus: A Retrospective Cohort Study

2020 ◽  
Vol 20 (4) ◽  
pp. 584-590 ◽  
Author(s):  
Shima Fathi ◽  
Shiva Borzouei ◽  
Mohammad Taghi Goodarzi ◽  
Jalal Poorolajal ◽  
Fatemeh Ahmadi-Motamayel
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Control Group ◽  
Oxidative Stress Markers ◽  
Stress Markers ◽  
Type 2 Dm ◽  
Patients With Diabetes ◽  
The Difference ◽  
And Oxidative Stress

Background: Diabetes Mellitus (DM) is a progressive metabolic disorder. Objective: The aim of this study was to investigate the relationship between antioxidant and oxidative stress markers in the saliva of patients with type 2 DM and a healthy control group. Methods: In this study, 20 patients with diabetes and 20 healthy individuals were evaluated. Salivary antioxidants markers consisted of total antioxidant capacity (TAC), uric acid (UA), peroxidase and catalase. Oxidative stress markers included total oxidant status (TOS), malondealdehyde (MDA) and total thiol (SH). Sialochemical analysis was performed with spectrophotometric assay. All the statistical analyses were conducted using STATA software. Results: TAC decreased significantly in patients with diabetes. Although salivary UA and peroxidase were lower in patients with diabetes compared to the control group, the difference was not significant. Salivary catalase in patients with diabetes was significantly lower than that in the control group. MDA and TOS exhibited significantly higher levels in type 2 DM. SH levels were slightly higher in DM. Conclusions: According to the results of the present study, there were some changes in the salivary levels of some antioxidants and oxidative stress markers in patients with type 2 DM and could be measured as an indicator of serum changes..

scholarly journals Prognostic Assessment of the Performance Parameters for the Industrial Diesel Engines Operated with Microalgae Oil

2021 ◽  
Vol 13 (11) ◽  
pp. 6482
Author(s):  
Sergejus Lebedevas ◽  
Laurencas Raslavičius
Keyword(s):  
Energy Efficiency ◽  
Diesel Engine ◽  
High Speed ◽  
Performance Parameters ◽  
Prognostic Assessment ◽  
High Speed Diesel ◽  
Microalgae Oil ◽  
The Difference ◽  
Smoke Opacity ◽  
Efficiency Indicators

A study conducted on the high-speed diesel engine (bore/stroke: 79.5/95.5 mm; 66 kW) running with microalgae oil (MAO100) and diesel fuel (D100) showed that, based on Wibe parameters (m and φz), the difference in numerical values of combustion characteristics was ~10% and, in turn, resulted in close energy efficiency indicators (ηi) for both fuels and the possibility to enhance the NOx-smoke opacity trade-off. A comparative analysis by mathematical modeling of energy and traction characteristics for the universal multi-purpose diesel engine CAT 3512B HB-SC (1200 kW, 1800 min−1) confirmed the earlier assumption: at the regimes of external speed characteristics, the difference in Pme and ηi for MAO100 and D100 did not exceeded 0.7–2.0% and 2–4%, respectively. With the refinement and development of the interim concept, the model led to the prognostic evaluation of the suitability of MAO100 as fuel for the FPT Industrial Cursor 13 engine (353 kW, 6-cylinders, common-rail) family. For the selected value of the indicated efficiency ηi = 0.48–0.49, two different combinations of φz and m parameters (φz = 60–70 degCA, m = 0.5 and φz = 60 degCA, m = 1) may be practically realized to achieve the desirable level of maximum combustion pressure Pmax = 130–150 bar (at α~2.0). When switching from diesel to MAO100, it is expected that the ηi will drop by 2–3%, however, an existing reserve in Pmax that comprises 5–7% will open up room for further optimization of energy efficiency and emission indicators.

scholarly journals Nutrition as a Key Modifiable Factor for Periodontitis and Main Chronic Diseases

2021 ◽  
Vol 10 (2) ◽  
pp. 197
Author(s):  
Prescilla Martinon ◽  
Laurie Fraticelli ◽  
Agnes Giboreau ◽  
Claude Dussart ◽  
Denis Bourgeois ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Chronic Diseases ◽  
Periodontal Diseases ◽  
Saturated Fat ◽  
Warning Signal ◽  
Dietary Quality ◽  
Omega 3 ◽  
Periodontal Health ◽  
High Fiber ◽  
Increased Risk

Nutrition is recognized as an essential component in the prevention of a number of chronic diseases, including periodontal disease. Based on these considerations, a better understanding is required regarding how the diet, and more particularly the intake of macronutrients and micronutrients, could impact the potential relationship between nutrition and periodontal diseases, periodontal diseases and chronic diseases, nutrition and chronic diseases. To overcome this complexity, an up-to-date literature review on the nutriments related to periodontal and chronic diseases was performed. High-sugar, high-saturated fat, low-polyols, low-fiber and low-polyunsaturated-fat intake causes an increased risk of periodontal diseases. This pattern of nutrients is classically found in the Western diet, which is considered as an ‘unhealthy’ diet that causes cardiovascular diseases, diabetes and cancers. Conversely, low-sugar, high-fiber and high-omega-6-to-omega-3 fatty acid ratio intake reduces the risk of periodontal diseases. The Mediterranean, DASH, vegetarian and Okinawa diets that correspond to these nutritional intakes are considered as ‘healthy’ diets, reducing this risk of cardiovascular diseases, diabetes and cancers. The role of micronutrients, such as vitamin D, E, K and magnesium, remains unclear, while others, such as vitamin A, B, C, calcium, zinc and polyphenols have been shown to prevent PDs. Some evidence suggests that probiotics and prebiotics could promote periodontal health. Periodontal and chronic diseases share, with a time delay, nutrition as a risk factor. Thus, any change in periodontal health should be considered as a warning signal to control the dietary quality of patients and thus reduce the risk of developing chronic diseases later on.

Grazing behaviour and pattern of intake of dairy cows grazing kikuyu (Pennisetum clandestinum) grass pastures in relation to sward height and length of grazing session

2009 ◽  
Vol 49 (3) ◽  
pp. 233 ◽  
Author(s):  
R. C. Dobos ◽  
W. J. Fulkerson ◽  
K. Sinclair ◽  
G. N. Hinch
Keyword(s):  
Dairy Cows ◽  
Grazing Management ◽  
Feeding Strategies ◽  
Intake Rate ◽  
Pennisetum Clandestinum ◽  
Sward Height ◽  
Rate Of Increase ◽  
Grazing Period ◽  
The Difference ◽  
Strip Grazing

To investigate how grazing time, herbage dry matter intake (DMI) and intake rate (IR) are influenced by intensive grazing management, dairy cows strip-grazing subtropical grass pastures (Pennisetum clandestinum) at two compressed sward heights (10 and 13 cm) and at five grazing durations (1, 2, 4, 8 and 15 h) and replicated over 3 days were studied. The study was conducted in summer and the cows were observed every 20 min from 1600 to 0700 hours to calculate the time spent (min/h) grazing, ruminating and resting. Total time spent grazing was 45 min longer for cows grazing the 13-cm sward than for those grazing the 10-cm sward over the 15-h grazing period. The rate of increase in grazing time was 0.64 h/h grazing duration up to 4 h after introduction to fresh pasture. IR of cows grazing the 13-cm sward was significantly higher than those grazing the 10-cm sward (0.17 v. 0.12 kg DM/min spent grazing). The difference in IRs between sward height treatments resulted from the higher DMI in the 13-cm sward within the first 4 h of grazing compared with the 10-cm sward, although following the first 4-h grazing period IR was similar for both sward heights. Grazing time increased with sward height up to a maximum of 4 h after introduction to fresh pasture and had also maximised herbage DMI by this time. These results have important practical implications for dairy cow grazing management systems because they show that dairy managers could remove cows after 4 h with little compromise in production and will help in developing optimum supplementary feeding strategies when pasture availability limits DMI.

scholarly journals THU0236 EFFICACY AND SAFETY OF NON-MITOGENIC ANTICD3 ANTIBODY ADMINISTRATION IN THE TREATMENT OF LUPUS-PRONE MICE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 345.1-345
Author(s):  
M. Morita ◽  
S. Masuyama ◽  
M. Mizui ◽  
Y. Isaka
Keyword(s):  
T Cells ◽  
Antibody Titer ◽  
Cell Function ◽  
Cell Subpopulation ◽  
Target Cells ◽  
Therapeutic Effects ◽  
Autoantibody Production ◽  
Rate Of Increase ◽  
Dsdna Antibody ◽  
The Difference

Background:Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by the production of autoantibody and systemic tissue damages including glomerulonephritis. Immune responses mediated by autoreactive T-cells, as well as by autoantibody, is involved in the development and progression of end-organ damages1. Biologic agents which manipulate T-cell function such as CTLA4-Ig and anti-CD40L have been revisited and tried to treat human SLE, however, both of them failed to demonstrate efficacy.A mouse specific anti-CD3ε mAb, clone 145-2C11 (2C11) is known to be immunosuppressive by down-modulation of TCR and depletion of T-cells2. Administration of Fc-deleted 145-2C11 F(ab’)2to lupus-prone mice was reported to reduce lymphadenopathy and prolong survival, but had no significant effect on anti-DNA antibody titer3. The mechanisms by which 2C11 ameliorates lupus are still unclear.In this study, we used non-mitogenic Fc-modified silent 145-2c11 (2C11S), which disables interaction between target cells and Fc receptor-bearing cells, abolishes antibody directed cytotoxicity, and has longer half-life than F(ab’)2. 2C11S is expected to exert its effect in safe and stable as compared with functional parent-2C11 (2C11P) antibody.Objectives:The purpose of our study is to clarify the difference between 2C11S and 2C11P and to examine their therapeutic effects against murine lupus-prone (NZB/W F1) mice.Methods:20 μg of 2C11P (absolute antibody), 2C11S (absolute antibody), or isotype control immunoglobulin G1 κ (IC)(BioLegend) were administered intraperitoneally to C57BL6 mice. The difference of their action on T-cells were evaluated in a time series from peripheral blood. Plasma cytokine levels were measured within 24 hours after antibody administration.In NZB/W F1 mice from weeks 10 or 20, 2C11P, 2C11S, and IC were administered (100 μg / week, 4 times, intraperitoneally). Plasma anti-dsDNA antibody titer, spleen and kidney blood cell subpopulation, and histology of renal tissue were evaluated before and/or after treatment.Results:Duration of reduced TCR expression in 2C11S group was approximately twice as long as that in 2C11P group, and the levels of plasma TNF-α was not increased in 2C11S group while significant increase was observed in 2C11P group (IC; mean 48.3 ± SD 16.7 pg/ml, 2C11S; 57.9 ± 6.12, 2C11P; 168 ± 50.6, IC VS 2C11S; p>0.99, IC VS 2C11P; p=0.03, ANOVA).In NZB/W F1 mice, the number of follicular helper T (Tfh) cells in spleen significantly decreased in 2C11S group (IC; median 9.0*104[interquartile range 8.5*104], 2C11S; 1.8*104[1.0*104], 2C11P; 1.0*105[9.4*104], IC VS 2C11S; p=0.03, IC VS 2C11P; p>0.99, Kruskal-Wallis). The number of germinal center B (GCB) cells in spleen also decreased in 2C11S group (IC; 1.2*105[1.7*105], 2C11S; 9.0*103[2.3*104], 2C11P; 8.0*104[2.3*105], IC VS 2C11S; p=0.03, IC VS 2C11P; p>0.99). The number of infiltrating CD4+T-cells in kidney significantly reduced in 2C11S group (IC; 3.4*103[1.0*104], 2C11S; 6.4*102[8.8*102], 2C11P; 1.2*103[4.4*103], IC VS 2C11S; p=0.048, IC VS 2C11P; p=0.23). In addition, the rate of increase in anti-dsDNA IgG titers significantly decreased in 2C11S group (IC; 2.3 [1.3], 2C11S; 0.9 [1.0], 2C11P; 1.3 [1.4], IC VS 2C11S; p=0.03, IC VS 2C11P; p=0.24). Finally, glomerular hypercellularity was markedly alleviated only in 2C11S group (IC; 4.4*10 [8.4], 2C11S; 3.8*10 [1.1], 2C11P; 3.9*10 [8.2], IC VS 2C11S; p=0.02, IC VS 2C11P; p=0.57).Conclusion:2C11S did not induce cytokine release with maintaining longer effect on TCR down-modulation. 2C11S reduced autoantibody production by suppressing GCB differentiation, possibly through down-regulation of Tfh cell number. Consequently, 2C11S ameliorated lupus nephritis. On the other hand, 2C11P did not show therapeutic effect.References:[1]George C Tsokos. et al. Nat. Rev. Rheum (2016) 12: 716-730.[2]Kuhn C. et al. Immunotherapy (2016) 8: 889-906.[3]Henrickson M. et al. Arthritis Rheum (1994) 37: 587-589.Disclosure of Interests: :None declared

PENGARUH BUERGER ALLEN EXERCISE TERHADAP NILAI ANKLE BRACHIAL INDEX PADA PASIEN DIABETES MELITUS

2021 ◽  
Vol 4 (1) ◽  
pp. 90-94
Author(s):  
Pratiwi Christa Simarmata ◽  
Sari Desi Esta Ulina Sitepu ◽  
Abdi Lestari Sitepu ◽  
Ruttama Hutauruk ◽  
Rita Ayu Butar-butar
Keyword(s):  
Diabetes Mellitus ◽  
Exercise Intervention ◽  
Ankle Brachial Index ◽  
Endocrine System ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
Flexion Extension ◽  
Patients With Diabetes ◽  
Quasi Experimental ◽  
The Difference

Diabetes mellitus is a disorder of the endocrine system characterized by increased levels of glucose in the blood. The purpose of this study was to assess the effect of Buerger's Allen exercise on the value of the ankle brachial index (ABI) in patients with diabetes mellitus. The research design was a quasi-experimental pretest and posttest without a control. The study was conducted from March to May 2021 at Grandmed Lubuk Pakam Hospital with 48 respondents, with consecutive sampling technique. Data were analyzed using the Wilcoxon test. The Buergers Allen exercise intervention was performed twice a day, for three weeks. The procedure is performed by lifting the lower extremities up at an angle of 45-90 degrees for 2-3 minutes, then the patient sits at the bedside with the legs hanging down, accompanied by flexion, extension, pronation and supination movements for 5-10 minutes, and the patient lies down. with both feet resting for 10 minutes. There was a significant effect between the mean ABI value before intervention 0.83 and after intervention 0.95, p=0.00. The difference in mean ABI p=0.000, p<0.05. The results of the study concluded that there was an effect of buerger allen exercise on the ABI value before and after the intervention where the ABI value was getting better. It is recommended for nurses to make Buergers Allen exercise one of the independent nursing interventions in providing nursing care to patients with diabetes mellitus.

Various glycolysis inhibitor-containing tubes for glucose measurement cannot be used interchangeably due to clinically unacceptable biases between them

2018 ◽  
Vol 56 (2) ◽  
pp. 236-241 ◽  
Author(s):  
Andrea Saracevic ◽  
Lora Dukic ◽  
Gordana Juricic ◽  
Lara Milevoj Kopcinovic ◽  
Gorana Mirosevic ◽  
...  
Keyword(s):  
Plasma Sample ◽  
Glucose Measurement ◽  
Friedman Test ◽  
Potassium Oxalate ◽  
Citrate Buffer ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Heparin Plasma ◽  
Glycolysis Inhibitor ◽  
The Difference

Abstract Background: The aim of our study was to determine the difference between glucose concentration measured 30 min after venipuncture in ice-chilled heparin plasma sample and all currently available citrate buffer-containing tubes (Greiner Glucomedics, Greiner FC Mix and Sarstedt GlucoEXACT) and still widely used sodium fluoride/potassium oxalate (NaF/Kox) tubes from Greiner. Methods: Blood was collected from 20 healthy volunteers and 20 patients with diabetes into LiH, NaF/KOx, Glucomedics, FC mix and GlucoEXACT tubes. Glucose was measured within 30 min from blood sampling in duplicate on the Architect c8000 analyzer. Mean biases between all tube types were calculated and compared to the recommended criteria (1.95%). Additionally, glucose concentrations measured in all five tube types were compared using the Friedman test. Results: In the entire studied population, glucose concentrations measured in Glucomedics, FC mix and GlucoEXACT were higher (7.3%, 3.2% and 2.0%, respectively) than in the ice-chilled LiH tubes. When all glycolysis inhibitor-containing tubes were compared, Glucomedics tubes significantly differed from GlucoEXACT and FC mix tubes (biases −4.9% and 4.0%, respectively). In addition, there was a significant difference between the NaF/KOx tube and Glucomedics, as well as FC mix tubes (biases 7.1% and 3.0%, respectively). Conclusions: Glucose concentrations measured in recommended ice-chilled lithium heparin- and citrate buffer-containing tubes are not comparable. Significant biases exist between various glycolysis inhibitor-containing tubes; therefore, they cannot be used interchangeably.

scholarly journals Patterns of medication use and adherence to medications among residents in the elderly homes

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Magda AlGameel
Keyword(s):  
Side Effects ◽  
Patient Education ◽  
Chronic Diseases ◽  
Kidney Diseases ◽  
Medication Use ◽  
The Elderly ◽  
Current Therapy ◽  
Creative Commons ◽  
National Medical ◽  
Liver And Kidney

Objective: To evaluate health care related to medication regimens among institutionalized elders in Damanhour, Beheira Governate, Egypt. Methods: A prospective, multi-centered, observational study was conducted in the two elderly residential homes in Damanhour between March and May 2017. A questionnaire was developed and validated to test for elderly socio-economic, chronic diseases, current therapy adherence, vaccination history and patient education. Descriptive and quantitative analysis were performed. Results: sixty-three elderly residents were included in the study. The sample showed broad socioeconomic variability posing a true reflection of Egyptian population. 63.5% had no hearing problems, 31.7% had proper vision and 57% could move with no help. More than three quarters had chronic diseases of which 58.7% were previously hospitalized. The most prevalent diseases were hypertension, diabetes and arthritis 46%, 41.3%, 26.9% respectively. Only 7.9% and 4.7% showed chronic liver and kidney diseases, respectively and less than 10% suffered from respiratory related diseases. No alcohol drinker, 25.3% were smokers and 58.7% drank caffeine. Only 25.3% of residents showed full adherence to their medication pattern. Approximately 80% of residents never received proper patient education. Forty-three residents did not know the indication of their medications and 92% ignored its side effects. Conclusion: Absence of proper medical care exposure for the elderly residents was reflected in their low medication adherence, adverse side effects and hospitalization. We suggest extension of the national medical insurance system to include larger number of elderly population. To monitor the care given concerning medication, a daily resident gerontological nurse needs to be assigned, visits by clinical pharmacists weekly or bi-weekly from the nearby governmental hospital can improve improper medication. doi: https://doi.org/10.12669/pjms.36.4.1923 How to cite this:Algameel M. Patterns of Medication use and adherence to medications among residents in the elderly homes. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1923 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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