Biomedical Sciences and Clinical Medicine

Association Between Polypharmacy and Frailty in Elderly Patients Receiving Care at a Public Hospital in South India

2025-05-13T10:41:28+07:00

Objective This study analyses the impact of polypharmacy on frailty among the elderly patients visiting the public sector hospitals. The present study was done to assess the frailty status of the elderly patients and to see whether the individuals with polypharmacy exhibited more frailty when compared to those without polypharmacy.

Methods This is a case-control study that included 488 participants age 60 years and above who visited the general medicine department of Public Hospital Ooty, India. Polypharmacy was defined as the concomitant use of 5 or more medications. Frailty status of the participants was assessed using the Tilburg Frailty Indicator.

Results Polypharmacy was found to be present in 34.42% of cases. The prevalence of frailty was significantly higher in the polypharmacy group, affecting 41.07% of the study participants. Finally, three variables emerged as influential predictors of polypharmacy namely, 3 or more diseases (AOR 6.303, Cl 4.009-9.911, p < 0.0001), unsatisfied sleep status (AOR 1.669, Cl 1.068-2.606, p = 0.01), and people taking frailty causing drugs (AOR 4.328, Cl 2.628-7.128, p = 0.003). Additionally, there was a moderate relationship between modified lifestyle (smoking, alcohol consumption) and polypharmacy.

Conclusions The results suggest that polypharmacy is linked with frailty among the elderly population, highlighting the importance of clinician awareness of these factors.

Prevalence of Alcohol and Drugs in Fatal Road Traffic Injuries (RTIs) in a Thai Population Between 2018 and 2023

2025-09-26T09:55:54+07:00

Objective To determine and compare the prevalence of alcohol, drugs of abuse and medicines in fatal road traffic injuries (RTIs) in Thailand from 2018 through 2023.

Methods A retrospective study was conducted of fatal RTI cases sent for autopsy at the Department of Forensic Medicine, Siriraj Hospital, Mahidol University from 2018 through 2023. Subject data, including sex, age, type of RTI case, blood alcohol concentration (BAC), and urine drug profile, were collected. Descriptive statistics, Chi-square tests, Mann–Whitney U tests, and Kruskal–Wallis H tests were performed as appropriate.

Results From 2018 through 2023 a total of 1,979 fatal RTI cases were included in this study. Of those cases, 1,649 were male (83.3%) and the mean subject age was 37.3 years. The yearly prevalence of driving under the influence (DUI) of alcohol (BAC > 50 mg/dL) during the study period was between 45.80% and 53.40% with the exception of 2022, which showed a significant increase at 57.10% (p < 0.05). The prevalence of drugs in 2023 was 21.00%, a significant difference compared with the prevalence in 2018 of 13.70% (p < 0.05). The prevalence of cannabis use showed an increasing trend, with a statistically significant increase in 2023 (p < 0.05). The preva-lence of multiple drug use also significantly increased over the study period, particularly in 2023 (p < 0.05).

Conclusions The prevalence of drugs of abuse and medication in fatal RTI cases markedly increased over the study period, particularly in 2023. There was a significant increase in cannabis use and poly-drug use in fatal RTI cases over the period, especially in 2023.

Biochemical and Genetic Determinants of Early Cardiovascular and Hepatic Dysfunction: A Focus on ADIPOQ Expression

2025-09-23T12:19:10+07:00

Objective Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) frequently coexist due to common metabolic dysfunctions such as insulin resistance, chronic inflammation, and dyslipidemia. Adipo-nectin, encoded by the ADIPOQ gene, is an anti-inflammatory adipokine vital for glucose and lipid regulation. Reduced adiponectin levels and certain ADIPOQ gene variants (e.g., rs266729, rs2241766) have been linked to both NAFLD and CVD progression. This study aims to evaluate the association between ADIPOQ gene expression and early biochemical markers of hepatic and cardiovascular dysfunction.

Methods A case-control study (n = 300) was conducted in Thiruvananthapuram, Kerala, India (2022-2024), analyzing blood samples for fasting blood sugar (FBS), lipid profile, malondialdehyde (MDA), interleukin-6 (IL-6), and ADIPOQ expression (RT-PCR). Statistical analyses included receiver operating characteristic (ROC) curves and quantile regression using Stata 17.0.

Results Cases exhibited significantly elevated FBS, triglycerides (TG), low-density lipoprotein (LDL), MDA, and IL-6, along with reduced high- density lipoprotein (HDL) and adiponectin levels (p < 0.05). ADIPOQ gene expression was markedly downregulated, particularly in individuals with both NAFLD and CVD. A positive correlation was observed between ADIPOQ expression and HDL, and a negative correlation with IL-6. Reduced ADIPOQ expression showed an association with risk in unadjusted analysis, but this association was not statistically significant after adjustment (OR = 0.0220). Nevertheless, ROC analysis indicated potential diagnostic utility.

Conclusions Reduced ADIPOQ expression is significantly associated with early metabolic and inflammatory markers in NAFLD and CVD. These findings highlight the potential utility of ADIPOQ as a biomarker for early detection and targeted prevention strategies in at-risk populations.

Antimutagenic Potential of Piper sarmentosum Leaf Extracts: Insights from Culinary Preparation

2025-10-20T10:05:32+07:00

Objective Piper sarmentosum Roxb., a traditional vegetable in Lanna and Thai cuisine, is valued for its flavor but its health-promoting properties after cooking remain unclear. This study investigated the phytochemical profiles, antioxidant capacity, and mutagenicity of its leaf extracts prepared to mimic typical culinary practices.

Methods Three P. sarmentosum extracts were prepared: an ethanolic extract of uncooked leaves (PEE), a hot water extract simulating curry broth (PHWE), and an ethanolic extract of boiled leaf residues representing the cooked leaves in curry (PREE). Their chemical composition, antioxidant activity, and antimutagenic effects were evaluated.

Results The extracts showed distinct phytochemical patterns. PEE and PREE were rich in phenolics and flavonoids, yielding strong antioxidant activity in ABTS and FRAP assays. PHWE contained higher levels of condensed tannins, reflecting the extraction of water-soluble compounds. None of the extracts showed mutagenicity in the Salmonella assay. Notably, PEE and PREE displayed significant antimutagenic activity against aflatoxin B1 (AFB₁) in Salmonella typhimurium strains TA98 and TA100 with metabolic activation.

Conclusions P. sarmentosum leaves retain considerable antioxidant and antimutagenic potential after cooking, highlighting their value as a safe and functional food ingredient with potential health benefits.