Case Report: Successful Use of Minoxidil to Promote Facial Hair Growth in an Adolescent Transgender Male

Increasing numbers of trans and gender diverse young people are presenting to health services seeking gender-affirming medical care. While testosterone therapy in transgender males is generally effective in inducing masculinization, some adolescents encounter barriers to accessing such treatment or may not wish to experience all the changes that usually accompany testosterone. Here, we describe the case of a 17 year old trans male who presented with gender dysphoria but was initially unable to start testosterone therapy. Due to a desire for facial hair, he was therefore treated with topical minoxidil, an easily accessible, over-the-counter medication that has been used to treat androgenic alopecia for several decades. In this case, minoxidil was applied regularly to the lower face and, after three months of treatment, he developed obvious pigmented facial hair that was sufficient to help him avoid being misgendered. The only reported side effect was excessive skin dryness. Unexpectedly, despite no direct application to other areas, there was also an increase in pigmented body hair, suggestive of systemic absorption and effect. Given its long-standing use and safety record in the management of alopecia, minoxidil might thus represent a useful treatment option for trans males who desire an increase in facial hair.

Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic

Introduction On February 26th 2020, a high alert was issued in Sweden in response to the diagnosis of the first few coronavirus disease 2019 (COVID-19) cases in the country. Subsequently, a decreased supply of essential goods, including medical products, was anticipated. We aimed to explore the weekly patterns of prescription dispensing and over-the-counter (OTC) medication sales in Sweden in 2020 compared with previous years, to assess the influence of the government restrictions on medication sales, and to assess whether there is evidence of medication stockpiling in the population. Methods Aggregated data on the weekly volume of defined daily doses (DDDs) of prescription medication dispensed and OTC sales from 2015 to 2020 were examined. From 2015–2019 data, the predicted weekly volume of DDDs for 2020 was estimated and compared to the observed volume for each ATC anatomical main group and therapeutic subgroup. Results From mid-February to mid-March 2020, there were increases in the weekly volumes of dispensed medication, peaking in the second week of March with a 46% increase in the observed versus predicted number of DDDs dispensed (16,440 vs 11,260 DDDs per 1000 inhabitants). A similar pattern was found in all age groups, in both sexes, and across metropolitan and non-metropolitan regions. In the same week in March, there was a 96% increase in the volume of OTC sold (2,504 vs 1,277 DDDs per 1000 inhabitants), specifically in ATC therapeutic subgroups including vitamins, antipyretics, painkillers, and nasal, throat, cough and cold preparations. Conclusion Beginning in mid-February 2020, there were significant changes in the volume of prescription medication dispensed and OTC drugs sold. The weekly volume of DDDs quickly decreased following recommendations from public authorities. Overall, our findings suggest stockpiling behavior over a surge in new users of medication.

Melatonin as a Novel Supplement to COVID 19 Therapies

The COVID-19 disease continues its rampage on the human population all over the world. The pathogenesis mechanisms involve various inflammatory and altered immune responses and oxidative processes, leading to complications like cytokines storm and death in vulnerable cases. Therefore, in this review, we summarize current evidence on melatonin therapy for viral infections with focus on possible underlying mechanisms of melatonin actions. Since this pandemic crisis elapses time, researchers worldwide are busy trying new solutions to overcome the heavy toll of the COVID-19 illness morbidity and mortality. One such drug with growing recognition is melatonin. Melatonin is a well-known anti-inflammatory and antioxidant molecule which helps in promoting adaptive immunity. Melatonin improves sleep and anxiety and also can prevent fibrosis. It is a readily available over-the-counter medication that can be manufactured easily in bulk, hence inexpensive to a patient from a developing nation like India. It can be orally administered and has a wide margin of safety. This article reviews the various facets, merits, demerits, and rationale of the re-use use of molecule melatonin, which is yet to be recognized.

Diabetic Muscle Infarction: Resolution of Rare Microangiopathy with Over-The-Counter Medication

Diabetic muscle infarction (DMI) is a rare complication of poorly controlled type 1 and type 2 diabetes seen mostly in those who have already experienced microvascular complications. Currently, the incidence and prevalence of DMI are difficult to conclude, and there is no clear algorithm or standard of care in managing this condition. Pathogenesis of the microangiopathy of DMI remains unclear. A major finding in this investigation of DMI emphasizes that, within 2–17 weeks, patients who initiate low-dose acetylsalicylic acid, bed rest, and close outpatient follow-up see significant size reduction of lower extremity mass and complete resolution of pain without being subjected to invasive muscle biopsy.

Acetaminophen Potentiates Fear Processing: A Comparison Between Ancestral and Modern Threats

The painkilling medication acetaminophen produces a variety of unintended psychological effects. In particular, it has been shown to diminish varied forms of psychological distress by attenuating neural activity in the cerebral cortex and enhancing the signaling of serotonin. As a result, this over-the-counter medication appears to dampen overall affective processing and has been termed “an all-purpose emotion reliever.” However, this drug may not necessarily modify all emotions in the same manner. Specifically, fear processing occurs rapidly within the amygdala and is governed by serotonin. Thus, by blunting cortical activity and facilitating serotonergic action, acetaminophen could in fact potentiate reactions to threatening stimuli. This study intersects with the fields of evolutionary psychology and psychopharmacology by investigating whether acetaminophen modulates responses to fear-inducing stimuli that vary in ancestral relevance. We hypothesized that the more subcortical and prewired mechanisms controlling responses to recurring ancestral threats (snakes and spiders) would be more affected by this drug compared to learned threats of modern environments (handguns and hypodermic needles). In a double-blind placebo-controlled design (N = 94), acetaminophen significantly enhanced participants’ evaluations and emotional reactions to threatening stimuli. In addition, ancestral threats were rated as both significantly more negative and emotionally arousing compared to modern threats. Contrary to our predictions, however, acetaminophen altered affective responses to ancestral and modern threats in a highly similar manner. We conclude that acetaminophen does not blunt overall affective processing, and call for further evolutionary-based research examining the various psychoactive effects of this commonly consumed over-the-counter painkiller.

Can Cannabidiol Affect the Efficacy of Chemotherapy and Epigenetic Treatments in Cancer?

The success of cannabinoids with chronic neuropathic pain and anxiety has been demonstrated in a multitude of studies. With the high availability of a non-intoxicating compound, cannabidiol (CBD), an over-the-counter medication, has generated heightened interest in its use in the field of oncology. This review focuses on the widespread therapeutic potential of CBD with regard to enhanced wound healing, lowered toxicity profiles of chemotherapeutics, and augmented antitumorigenic effects. The current literature is sparse with regard to determining the clinically relevant concentrations of CBD given the biphasic nature of the compound’s response. Therefore, there is an imminent need for further dose-finding studies in order to determine the optimal dose of CBD for both intermittent and regular users. We address the potential influence of regular or occasional CBD usage on therapeutic outcomes in ovarian cancer patients. Additionally, as the development of chemoresistance in ovarian cancer results in treatment failure, the potential for CBD to augment the efficacy of conventional chemotherapeutic and epigenetic drugs is a topic of significant importance. Our review is focused on the widespread therapeutic potential of CBD and whether or not a synergistic role exists in combination with epigenetic and classic chemotherapy medications.