Vol 8 Issue 2 October 2020-March 2021

Abstract: Fluoxetine is the first major drug for treating up the neurological pain associated with depression since the evolution of tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) nearly 3 decades earlier. It was the one and only of its kind because of its activity along the selective serotonin reuptake inhibitor (SSRI) which was sanctioned by the United States Food and Drug Administration, offering a good efficacy and a decreased side effects comparatively to TCAs and MAOIs. However, a debate remains active regarding the true mechanism of the drug by which the medical efficacy of fluoxetine is observed, the value of fluoxetine and its related SSRIs to the profession is unquestionable. Prozac has permeated popular culture, helping to raise awareness of depression and to diminish the prevalence of long-standing stigmas associated with this illness. In this Review, we will showcase the history and importance of fluoxetine to neuroscience in general, as well as for the treatment of depression, and review the nature, pharmacology, preclinical reports, and adverse effects of fluoxetine.

Keywords: central nervous system, peripheral nervous system, tricyclic anti-depressants, serotonin-norepinephrine reuptake inhibitors.

Title: A potential impact of Fluoxetine in Neurological Pain: A review

Author: Manish Kumar, Indu Melkani, Bimlesh Kumar, Linu Dash, Anupriya, Varimadugu Bhanukirankumar Reddy, Yousif Al-Daghestani

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: WHO data shows 360 million people live with hearing loss and nearly 32 million of them are adolescents. Hearing loss and deafness in Indonesia are ranked 4th in the world and are among the highest in Southeast Asia. Hearing loss at a young age can lead to disability and reduce quality of life. Hearing loss that afflicts adolescents is associated with a modern lifestyle equipped with sophisticated technology, one of which is related to the behavior of using hearing instruments for a long time. This research objective is to provide information about the behavior of hearing tools usage and hearing disorders in PSSKPD students of the Faculty of Medicine, Udayana University 2020. This research is an observational descriptive study with cross sectional method. Sampling in this study used consecutive sampling based on inclusion and exclusion criteria in the population. Overall research respondents numbered 30 people. Characteristic the behavior of hearing tools usage in PSSKPD students of the Faculty of Medicine, Udayana University in 2020, namely the type of hearing tools is dominated by earbud canal phones (66.7%), the duration of using the device is in the range of >2 years (86.7%), with an intensity >2 hours at a time (83.3%), volume >60% (66.7%), and spending 6-7 days/week using hearing tools (53.3%). As for the description of hearing disorders, the majority of respondents did not experience hearing disorders, but it was found that 2 (6.7%) of the total respondents had been diagnosed with sensorineural deafness. The usage of hearing tools is predominantly in the form of earbud canal phones, the duration of using the device is in the range of >2 years, the intensity is >2 hours at one time, the volume is >60%, and it spends 6-7 days/week using the hearing tools. The majority of respondents did not experience hearing disorders.

Keywords: Behavior; Hearing tools; Hearing disorders.

Title: CHARACTERISTIC BEHAVIOR OF HEARING TOOLS USAGE AND HEARING DISORDERS IN COLLEGE STUDENTS BACHELOR PROGRAM OF MEDICINE AND DOCTOR PROFESSION FACULTY OF MEDICINE UDAYANA UNIVERSITY 2020

Author: Ahmad Farkhan Bin Ahmad Rashdi, I Made Wiranadha, I Ketut Suanda, I Dewa Gede Arta Eka Putra

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Neuropathic pain is pain arising from a disease or lesion that affects the somatosensory system. In Indonesia, neuropathic pain is found in 31.6% with almost 75% of cases experiencing chronic pain and disrupting the patient's daily activities and quality of life. Neuropathic pain is an important comorbid factor in impaired renal function or chronic renal failure with hemodialysis. Objective to determine the pharmacological management of overall opioids use and the use of different types of opioids including acetaminophen, anti-inflammatory drugs (NSAIDs), adjuvants, and opioids in patients with chronic kidney disease under hemodialysis.Systematic review with inclusion and exclusion criteria through search engines obtained 114 journals that were reviewed. 8 journals were used as main references in writing this review. The data obtained are in the form of qualitative and quantitative data which are then arranged systematically and according to each topic discussed so that a conclusion is obtained that represents the entire content of the review. We observed that opioids such as morphine and codeine were associated with a significantly higher risk of altered mental status in patients receiving hemodialysis. There is no evidence that at equivalent analgesic efficacy weak opioids carry a lower risk of addiction than low-dose strong opioids. Safe opioid that are recommended such as transdermal fentanyl patch, methadone, buprenorphine are opioid groups which are said to be relatively safe. Gabapentin and pregabalin are the two most common anticonvulsants used and SNRIs are renally cleared except for duloxetine. Pharmacological management of neuropathic pain in chronic kidney disease with hemodialysis that can vary between type of opioids consumed and the effectiveness of the opioids used.

Keywords: neuropathic pain, chronic kidney disease, hemodialysis.

Title: SYSTEMATIC REVIEW: PHARMACOLOGICAL MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS WITH NEUROPATHIC PAIN UNDER HAEMODIALYSIS

Author: Pratheeprao Sathianantharao, Ida Ayu Sri Wijayanti, Anna Marita Gelgel, I Made Oka Adnyana

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: The risk factor is described as something that develops the risk of breast cancer. A woman can develop breast cancer due to the various causes. It can be affected by behavior, substance or environmental condition. The purpose of this systematic review is to determine the risk factors of breast cancer. The method of writing this article is systematic review, where the articles were published from 2015 to 2020 that focused on assessing the risk factors of breast cancer. Assessment of the methodological quality of each article was carried out using PRISMA checklist. The results of the analysis of breast cancer risk factors in women are age (p value = 0.0001), family history (p value = 0.0001), age at menarche (p value = 0.036), age at menopause (p value = 0.05), age at first full term pregnancy (p value = 0.033), menopausal status (p value = 0.001), parity (p value = 0.001), breastfeeding (p value = 0.028), oral contraceptive (p value = 0.03), BMI (p value = 0.0001), active smoker (p value = 0.051), and alcohol intake (p value = 0.001). Based on the review conducted, there is a strong correlation between age, family history, age at menarche, age at menopause, age at first full term pregnancy, parity, usage of oral contraceptive, body mass index and alcohol that are very much associated as risk factors of breast cancer. However, smoking has no significant correlation to breast cancer.

Keywords: Women, Breast Cancer, Risk Factors.

Title: THE RISK FACTORS OF BREAST CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author: Nanthini Siva Kumar, Putu Anda Tusta Adiputra, I Wayan Sudarsa, I Gede Budhi Setiawan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Adverse drug reactions are common. In Indonesia, especially in Bali, there has not been a published data of knowledge and attitudes regarding drug allergy among healthcare practitioners. To determine the level of knowledge and attitudes regarding drug allergy among healthcare professionals in Public Health Centres, Denpasar, Bali, a validated questionnaire was adapted from the previous study to assess knowledge and attitudes of healthcare professionals regarding drug allergy.. The questionnaire comprised three categories of questions: (1) demographic and occupational characteristics; (2) knowledge pattern; (3) attitudes pattern. The survey conducted from 11 Public Health Centres anonymously participated in the cross-sectional study. A total of 179 / 264 of HCPs from 11 Public Health Centres in Denpasar, Bali completed the survey questionnaire, giving an overall response rate of 67.8%. Most HCPs 70.4% (126/179) had moderate knowledge regarding drug allergy. Majority were 77.8% (21/27) of doctors. Only 19.6% (35/179) of HCPs had good knowledge of drug allergy. Majority of HCPs 80.4% (144/179) were strongly agreed to receive advanced knowledge on DHRs. Most of HCPs showed moderate level of knowledge regarding drug allergy. Majority HCPs were strongly agreed to the attitudes of drug allergy statements. Advanced education became crucial to improve the knowledge of HCPs regarding drug allergy.

Keywords: Knowledge; Attitude; Drug allergy; Healthcare professionals.

Title: SURVEY OF KNOWLEDGE AND ATTITUDES OF DRUG ALLERGY AMONG HEALTHCARE PROFESSIONALS IN PUBLIC HEALTH CENTRES, DENPASAR, BALI

Author: Hemashalini Krishnan, Bagus Komang Satriyasa, Desak Ketut Ernawati, Ni Wayan Sucindra Dewi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: The relevance of glycaemic index (GI) to health is interconnected. A growing body of research over the last decades has shown that diets based on low GI can reduce the risk of developing diabetes and improve blood glucose control in people with diabetes. In this present study, the glycemic responses of 3 commercial oral nutritional supplements (Metabolic Energold (ME), Metabolic Gosure (MG) and Metabolic Basic (MB)) were assessed in 10 healthy individuals. The GI was determined based on the 50g of available carbohydrate portions in the test foods of the corresponding area following an equivalent amount of carbohydrates from the reference food (glucose).  Postprandial plasma glucose was measured at intervals for two hours after intake of the test foods. The results showed that the area under the curve of ME, 228.47 ± 93.5 was greater than MG (190.54 ± 85.1) and MB (182.97 ± 102.97). Similarly, the glycemic index of ME, 65.33 ± 22.9 was greater than MG (53.1 ± 16.5) and MB (51.0 ± 20.8). As a conclusion, ME has an intermediate GI, whilst MG and MB have low GI, which are suitable for diabetic patients to better control of glucose levels.

Keywords: oral nutritional supplements, glycemic index, diabetes formula, postprandial blood glucose.

Title: Glycemic Response to Oral Nutritional Supplements in Healthy Adults: A Single-Blind Crossover Study

Author: Alicia Wong, Wan Chien Han, Elsie Low, Chai Xiang Goh, Siew Li Ng, Lee Kuan Kwan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Maternal mortality reviews (MMR) and severe acute maternal morbidity (SAMM) and used to assess the quality of health care services. Even though admission to the intensive care unit (ICU) depends on the severity of the maternal condition and facilities, the women with severe conditions are almost always provided ICU care. Therefore, clinical and epidemiological aspects of maternal near-miss cases in the ICU will a greater picture about women with SAMM and this data can be used in planning the service provision.

Results; This hospital based,  retrospective  study  was  done  on  the  obstetrics  patients  admitted  to  ICU  between  April and  October 2014. It included 3872 deliveries with a live birth of 3949 and 108 near miss criteria in the study.  There were only 3 (0.07%) maternal deaths during the period.  The maternal near-miss incidence ratio of 27.3 per 1000 live births (LB), MMR of 75.9 per 100,000 live birth and maternal death to near-miss ratio of 1:2.78.58.3% (n=63) of them belong to age group of 20-30 years, followed by 35.2% of age over30 years and only 7 (6.5%) were of  age  less than  20 years. The mean age of the near-miss patients were 27± 5.93 years.  58.3% were multigravida (n=63) followed   by primigravida in 45 (41.7%) patients.  87 case (80.6%) were beyond 28 weeks or intrapartum period and 9 cases (8.3%) were in the postpartum period showing that late pregnancy and delivery is the riskiest period. Late pregnancy-related conditions (n=68, 62.96%) were most frequently associated with maternal near-miss cases. PPH (n=17), heart disease complicating pregnancy (n=16) and followed by medical diseases (n=13) were the causative factors in maternal near-miss cases. Among the hypertensive related complications eclampsia (n=20, 18.5%) and severe preeclampsia (n=14, 13%) were the most frequent conditions. We recorded the highest maternal near-miss ratio because of eclampsia (5.06/1000 live births) in this study. Conclusion: This study showed that PPH, heart diseases complicating pregnancy, eclampsia, and severe preeclampsia were the principal causative factors in maternal near-miss cases. An improvement in the quality of care to detest hypertensive disorders and pre-eclampsia through strengthening preventive health-care delivery and improvement in curative care delivery to provide the best care to prevent mortality.

Keywords: epidemiology, maternal mortality, Near miss cases, intensive care units.

Title: MATERNAL NEAR MISS CASES IN THE INTENSIVE CARE UNIT, TEACHING HOSPITAL BATTICALOA, SRI LANKA

Author: Markandu Thirukumar

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Pulmonary tuberculosis is the one of the main health problem among Sudanese diabetic patients who are considered as immune-compromised patients.

Objective of the study:- To evaluate cytokines IL6,IL10 and TNFα among study groups (diabetic and tuberculosis patients , non diabetic tuberculosis patients, diabetic and cardio vascular disease patients and control group of healthy individuals).

Methodology :- This study was designed as descriptive a prospective, analytical case-control study .this study was enrolled 402 individuals ,40 were diabetic  and tuberculosis patients, 41 non diabetic tuberculosis, diabetic CVD were 160 and 161 healthy control.

Five ml of blood withdraw in plain vaccutainor after informed consent from individuals whom participate in this study. Estimation of the cytokines(IL6,IL10 and TNFα) levels from all participate were done by using direct ELISA technique.

Results:- The mean levels of IL6 was recorded in 161 healthy persons 94.80pg/ml. while recorded 196.27pg/ml  in 41 tuberculosis non diabetic patients, 210.27pg/ml  in 40 tuberculosis diabetic patients and 7.90pg/ml in 160 patients tuberculosis diabetic with CVD 199.33pg/ml.

The mean levels of IL10 was recorded in 161 healthy persons mean 4.21pg/ml, while mean 8.84pg/ml in 41 TB non diabetic, mean 8.61pg/ml in 40 TB diabetic patients and 7.90pg/ml in 160 TB diabetic with CVD patients.

The mean levels of TNFα was 81.59pg/ml in 161 healthy persons, while it was 232.29pg/ml in 40 TB non diabetic patients, 261.78pg/ml in 40 TB diabetic patients and 297.42pg/ml in 160 TB diabetic with CVD.

Conclusion:- Serum levels of IL6,IL10 and TNF alpha increased in patients with no signs and symptoms of tuberculosis (latent phase). The cut off values 68pg/ml ;5.58pg/ml;279.42pg/ml for IL6, IL10 and TNF alpha respectively are diagnostic for latent tuberculosis

Where was no relationship between gender and IL6, IL10 and TNF alpha levels.

Recommendation:- All patients with complicated diabetic should be test for the latent tuberculosis in poorly controlled diabetic mellitus type Ⅱ.

Keywords: Pulmonary tuberculosis, Sudanese diabetic patients, healthy control.

Title: Cytokines levels as biomarkers for the diagnosis of latent tuberculosis among Sudanese patients with poorly controlled diabetic mellitus type Ⅱ, SUDAN 2019

Author: Wail Mohamed Alkhraj, Prof. Ahmed Kamal Bolad, Prof. Atif. Elagib, Dr. Fawzi Abdulrahim Mahgoub

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Myopia is a common eye disorder and is also one of the leading causes of blindness worldwide. A person is said to be myopic when a person cannot see objects which are at a distant. Myopia happens when light falls in front of the retina. The presence of myopia is also associated with near work activities, environmental exposure and nutritional intake. This study will research the proportion of myopia and the correlation of the associating factors and myopia in medical students in University Udayana of batch 2017. This study is an analytic study using cross sectional method. Data is obtained by using The Sydney Myopia Questionnaire and it is given out to random medical students of batch 2017 which sample who met the inclusion and exclusion criteria. The proportion of myopia among medical students’ batch 2017 of University Udayana is 70.6%. There is correlation between myopia and near work activities such as using mobile devices and reading. Environmental exposure in the terms of mainly staying indoors and indoors and outdoors. Nutritional intake in terms of consumption of fast food and vegetables have an impact on myopia. Myopia among medical students’ batch 2017 of University Udayana shows 70.6% proportion rate. There is a correlation of myopia and near work activities, environmental exposure and nutritional intake.

Keywords: myopia, refraction, near work, environmental exposure, nutritional intake.

Title: THE PROPORTION OF MYOPIA AND ITS ASSOCIATING FACTORS IN MEDICAL STUDENTS BATCH 2017 OF UNIVERSITY UDAYANA

Author: Nicole Anne Teng Ai Ming, AA Mas Putrawati Triningrat, I Wayan Eka Sutyawan, Deasy Sucicahyati Mendala

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Type 2 Diabetes Mellitus (T2DM) is an endocrinological disorder which is associated with hyperglycemia characterized by both insulin resistancy and insulin deficiency. Abnormality in lipid profile leads  to cardiovascular risks. Elevation of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and decrease in high density lipoprotein (HDL) are the characteristics of abnormality in lipid profile. Methods: This analytical research design with approach of cross sectional has been done in Non-Communicable Disease (NCD) Unit, Diabetic Clinic, Klinik  Kesihatan Kuala Lumpur from January to October 2020. Data was taken from medical records of patients and those with incomplete data were excluded from this study. Based on the findings from Klinik Kesihatan Kuala Lumpur a total of 121 samples were collected and all the samples are been used in this study for better results. Results: It is found that there is a correlation between high total cholesterol level with  high  level of HbA1c, where 91.2% of those have high level of cholesterol also have high level of HbA1c (r=0.331; p=0.001). There is significant correlation between high level of triglyceride and low level of HDL with high level of HbA1c. Around 87.3% of patients have high level of triglyceride also have a high level of HbA1c (r=0.259; p=0.014). In addition, approximately 89.7% of patients who have low level of HDL also have a high level of HbA1c (r=0.202; p=0.037). Conclusion: There is correlation between lipid profile and HbA1c in patients with T2DM

Keywords: Lipid profile, HbA1c, Type 2 Diabetes Mellitus patients, Malaysia.

Title: CORRELATION BETWEEN LIPID PROFILE AND HBA1C IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AT KLINIK KESIHATAN KUALA LUMPUR

Author: Kerthana Sunderasagar, I Nyoman Wande, Desak Gde Diah Dharma Santhi, Ni Kadek Mulyantari

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Dengue is a mosquito-borne viral infection that is still endemic in Bali. High number of dengue cases are reported annually with only limited data on dengue is available about knowledge, attitude and practices on dengue among students in Bali. The purpose of this study was to determine the differences in knowledge, attitudes, and practices on dengue prevention among medical and psychology students in Medical Faculty of Udayana, Bali. An analytic study with cross-sectional approach was conducted and 94 research sample taken by consecutive sampling technique. The results of this study showed that 62.7% of medical students and 76.7% of psychology students have good level knowledge of dengue. Also, both medical and psychology students have excellent level of attitude towards dengue prevention, 96.1% and 100% respectively. This study showed that only 19.6% of medical students and 9.3% of psychology students have good level of practice on dengue prevention. There were no significant differences on knowledge and attitude on dengue prevention between medical and psychology students. Meanwhile, it was found that there were significant differences on practice on dengue prevention between medical and psychology students in Medical Faculty of Udayana University, Bali.

Keywords: Dengue prevention; University students; Knowledge; Attitude; Practice; Bali.

Title: KNOWLEDGE, ATTITUDE AND PRACTICE ON DENGUE PREVENTION BETWEEN MEDICAL AND PSYCHOLOGY STUDENTS IN MEDICAL FACULTY OF UDAYANA UNIVERSITY, BALI

Author: Jesline Vincent, Putu Ayu Asri Damayanthi, I Kadek Swastika, I Made Sudarmaja

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Leprosy is one of the most evocative and an infectious disease known today. Leprosy is caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus which is one of the most old, terrified, and disabling diseases of mankind is on the verge of defeat. It leads to a large range of clinical symptoms, eventually resulting in mutilation and disability if left untreated. Indonesia is one of the largest country with the most number of records of this particular disease. One of the possible risk factor is poverty, although not all poor countries have high leprosy prevalence rates. Through this study we aim to determine the types of food profile consumed by the leprosy patients in RSUP Sanglah, Bali based on age, sex, and their food intake. This study is a quantitative descriptive study in design a questionnaire of their food intake in 24 hour dietary recall which was filled by 25 respondents using a cross-sectional survey. The results of this study shows patients are undernourished due to lack of proper vitamins and energy in their daily food intake. The amount of food intake of leprosy patients are insufficient for them due to poverty and lack of knowledge. Furthermore, it is concluded that more male is prone to this disease compared to women.

Keywords: leprosy patients; calorie count; food intake; RSUP Sanglah.

Title: TYPES OF FOOD PROFILE CONSUMED BY LEPROSY PATIENS IN RSUP SANGLAH, DENPASAR, BALI IN 2019

Author: Shalina Binti Mohd Hanif, I Gusti Nyoman Darmaputra, Luh Made Mas Rusyati, I Gusti Ayu Agung Praharsini

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Over a million blood units are collected from every donor every year, nevertheless, many more millions still need to be collected to meet the global demand of blood. A cross-sectional descriptive study was carried out for a period of one year aimed to assess the public knowledge, attitude, motivational factors and barriers for donating blood voluntarily in an administrative division of eastern Sri Lanka. After obtaining informed written consent, data were collected through a pilot tested, Interviewer Administered Questionnaire, frequencies, percentages and associations were assessed. A total of 405 respondents were interviewed, of which 194 (47.9%) were male and 211 (52.1%) were female. The majority (51.36%) of the respondents had adequate knowledge regarding blood donation and majority of the respondents (92.3%) answered positively as blood donation is a healthy habit. Only 33.6 % of the individuals had previous experience on voluntary blood donations. There were significant associations with the socio-demographic characteristics of gender, age, education, occupation and blood group with a p-value of less than 0.05. Nearly half of the participants (49%) had inadequate knowledge on blood donations and motivational factors such as altruism, peer pressure, media awareness had influence among more than half of them. This study revealed fear of seeing blood or feeling faint and needle pain as the barriers for voluntary blood donations among more than 55% of the participants. Attitudes related to blood donations were not significantly associated with socio-demographic characteristics but they may have contributed to the barriers of donating blood. This study identified factors influencing knowledge, attitude and motivation towards voluntary blood donations and they can be eliminated from the society through conducting series of well-planned awareness programmes.

Keywords: Motivational factors, Voluntary blood donations, Humanity.

Title: Barriers for Donating Blood Voluntarily among People aged between 18-55 Years Living in Eastern Sri Lanka

Author: Kajenthini K, Madhuwanthi L.D.M, Chandrika J.P.M, Jayarathna A.P.G.S.M, Shanmukanathan S, Sujendran S

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Before the pandemic the world was quite different as it is now and it has affected the entire economy of the world. No one has imagined that a small virus that is impossible to see it with our naked eyes has so much of capability that it can put an full stop to the entire world for about months and forced people to remain as an captive in their home itself. In all these crisis the one sector that has seen most adverse effects of covid-19 is education sector. As we can see  the entire world of education has come online from small kindergarten to higher level education it has drastically affected and the career and the mental health of the students.

Keywords: Pandemic, mental health, education system.                               

Title: Effect of the Pandemic on the students’ performance- mental health issues

Author: Nasrin khan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Low mortality rate of about 1.5% and optimism bias have changed the attitude of general public towards COVID-19. Though COVID-19 cases are increasing in India but mostly they remain in mild stage with 92.6% recovery and 1.48% mortality rate till 10^th Nov. 2020 as per WHO reports. According to another study more than 75% of patients experience mild to moderate symptoms and recover without hospitalization. Just 5% patients progress to critical stage with 2-2.5% mortality rate. COVID-19 associated coagulopathy (CAC), the main cause of mortality have been reported mainly in subgroup of patients with comorbidities like CVD, hypertension, diabetes and cancer etc.

OBJECTIVE:- Our objective is to identify the factors responsible for COVID-19 symptoms progressing to life threatening CAC and their management.

DISCUSSION:- Excessive coagulation with fibrinolytic shutdown is the hallmark of CAC. Cytokine storm induced over expression of Tissue Factor is the potential trigger for CAC. Pharmacological properties of aspirin, like anti-inflammatory and antithrombotic can be used as an evidence to hypothesize its use as a primary preventive treatment for CAC. Most of the patients are already taking aspirin for this purpose. But rising trend in aspirin resistance has made aspirin totally undependable. Omega-3 index (Omega-6/ omega-3 ratio) determines cardiovascular health. More than 8% is cardioprotective and less than 4% leads to major adverse cardiac events. Omega-3 reduces platelet aggregation, coagulation and thrombosis. High omega-6 levels cause coagulation. Omega-6 fatty acid (AA) is the substrate for the synthesis of a variety of proinflammatory/ proaggregatory molecule such as prostaglandin E₂, thromboxane A₂ (TXA₂), & leukotriene B₄.

CONCLUSION: - Low Omega-3 index (High Omega-6/ omega-3 ratio) promotes coagulopathy. This can be corrected by adequate omega-3 nutrients (EPA and DHA) supplementation. Administration of EPA & DHA helps in replacing omega 6 fatty acids (such as AA) resulting in reduction of TXA₂. Co-administration of Aspirin, EPA & DHA have shown positive results as an antiplatelet treatment. This also makes aspirin more effective by increasing its sensitivity. We hypothesize that co-adminisration of EPA + DHA + Aspirin may prove to be very useful as a primary preventive antithrombotic option in CVD patients. This can also check progression from mild COVID-19 symptoms to life threatening CAC.

Keywords: COVID-19, Aspirin, Omega-3 Fatty Acids, Coagulopathy.

Title: ASPIRIN RESISTANCE & LOW OMEGA-3 INDEX – GREATER CHANCES OF CVD MORTALITY ESPECIALLY IN COVID-19

Author: Dr. Manoj Kumar, Dr. Nishant Tyagi, Mahima Singla, Himanshu Bhatia, Aaeesha Vyas, Ved Sharma

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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