Archive Volume 116, Issue 1, January 2023

(1)

Submit Paper (https://ijrp.org/paper-submit) | Check Paper Status (https://ijrp.org/check-status) |

Download Certi�cate (https://ijrp.org/check-status) | FAQ (https://ijrp.org/faq) | Archive (https://ijrp.org/archive) | Join as an Editor-Reviewer (https://ijrp.org/join) | Login (https://ijrp.org/login)

Search Here...

(https://ijrp.org/ )



(2)

Join as an Editor / Reviewer (https://ijrp.org/join)

Archive Volume 116, Issue 1, January 2023

DDeepprreessssiioonn aanndd AAnnxxiieettyy aammoonngg EEllddeerrllyy dduurriinngg CCOOVVIIDD--1199 PPaannddeemmiicc:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr-- ddeettaaiill//44335533))

PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 1-7

DDOOII::10.47119/IJRP1001161120234391 (https://doi.org/10.47119/IJRP1001161120234391) , VViieewwss::6677 ,

DDoowwnnllooaadd::3355

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//ff11bbccaa33eedd55ccbb5566ff33aa99ff88aa2255eecc99bb88aa77443388//11))

FFoorrmm DDeepprriivvaattiioonn MMyyooppiiaa ((FFDDMM)) EEffffeecctt iinn SScclleerraa LLaayyeerr ooff AAnniimmaall MMooddeell:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr-- ddeettaaiill//44335566))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//33aa2299aa9999ddeeaa00bbddeebbdd5500aacc33bb0044bb9911004400dd11//22))

EEffffeecctt ooff JJoobb SSeeccuurriittyy oonn EEmmppllooyyeeee PPeerrffoorrmmaannccee iinn BBeerrggeerr CCoonnssttrruuccttiioonn CCoommppaannyy iinn NNiiggeerriiaa ((hhttttppss::////iijjrrpp..oorrgg //ppaappeerr--ddeettaaiill//44221199))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//119988ddaa11ee003333dd4433ff5533226611224433881111aaaaffcc00ccee//11))

SSttuuddyy ooff TThhee UUssee ooff AAnnttiibbiioottiiccss iinn MMeenniinnggooeenncceepphhaalliittiiss PPaattiieennttss aatt DDrr.. SSooeettoommoo HHoossppiittaall iinn 22001199——22002200 ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44225577))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//33113311cc8822112299eebb33ee44ff11771166cc33665588cc770055aa44ee//22))

AA LLiitteerraattuurree RReevviieeww ooff AAddvvaanncceedd MMaatteerrnnaall AAggee iinn PPrreeggnnaanntt WWoommeenn wwiitthh CCOOVVIIDD--1199 ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill //44226688))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//ff2211dd00bbff8811eedd11445511eebbeeffee88cc554433cc66ddbb44dd44//33))

TT22DDMM PPaattiieennttss AAddhheerreennccee TToowwaarrddss OOAADD MMeeddiiccaattiioonn:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44229900)) PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 43-52

(https://ijrp.org/ )



(3)

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//ff55000011cc66229955ffff4400ddcc44bbbbee77eeaa22ddff336600ccffaa//44))

RRiisskk FFaaccttoorrss ffoorr CCaarrppaall TTuunnnneell SSyynnddrroommee ((CCTTSS)) ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44229977)) PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 53-57

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//bb115555aa9966007700ffcc99bb337788669966bbddee6666aadddd6688ccff//22))

SSttrreessss LLeevveellss iinn MMeeddiiccaall SSttuuddeennttss ooff AAiirrllaannggggaa UUnniivveerrssiittyy CCllaassss ooff 22002200 ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44229999)) PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 58-62

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//44775555ee77bb0077bbcc0066ccdd55bbffddff66118888225599bb33773377//33))

MMaannaaggeemmeenntt ooff DDyyssppeeppssiiaa:: AA BBrriieeff OOvveerrvviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44330022)) PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 63-68

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//bb88dddd3355bb1199888899ff11550088ccaa992288eeeeaa5511aa556699ee//22))

IInnttrroodduuccttiioonn aanndd TTrriiaallss ooff EEccoo--eennzzyymmee aass aa HHoouusseehhoolldd WWaassttee MMaannaaggeemmeenntt SSoolluuttiioonn aatt DDuukkuuhhddeemmppookk VViillllaaggee,, WWuulluuhhaann DDiissttrriicctt,, JJeemmbbeerr RReeggeennccyy,, IInnddoonneessiiaa ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44332211))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//99558877aaffdd8855993311ee110099eebb7700ddffffaabb7799cc7744dd66//22))

TTHHEE AASSSSOOCCIIAATTIIOONN BBEETTWWEEEENN BB--RRAAFF VV660000EE GGEENNEE MMUUTTAATTIIOONN WWIITTHH AAGGEE,, GGRRAADDIINNGG,, AANNDD CCLLIINNIICCAALL RREESSPPOONNSSEE IINN CCOOLLOORREECCTTAALL CCAANNCCEERR AATT TTHHEE CCEENNTTEERR GGEENNEERRAALL HHOOSSPPIITTAALL ((RRSSUUPP)) PPRROOFF.. DDrr.. II GGOOEESSTTII NNGGOOEERRAAHH GGDDEE NNGGOOEERRAAHH IINN BBAALLII ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44332233))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//cc11aa9922aaaa2288aa55bb7744661199ff22bb114433113366bb22dd224444//33))

FFaaccttoorrss AAssssoocciiaatteedd TToowwaarrddss MMaallnnuuttrriittiioonn iinn LLiivveerr CCiirrrrhhoossiiss PPaattiieenntt:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr-- ddeettaaiill//44332288))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//770044ff88ddee44cccc22eeaa11eedd117788117744ffffddccff22ee55bb88//22))

PPssyycchhoollooggiiccaall SSttrreessss aass aa RRiisskk FFaaccttoorr ffoorr LLooww BBaacckk PPaaiinn:: aa RReevviieeww AArrttiiccllee ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44332299))

(https://ijrp.org/ )



(4)

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//ee66bb77ffbbcc88ccaa222244aa22ff22eeaa881100ccaa4433dd1144ffdd77//33))

TThhee FFuuttuurree PPeerrssppeeccttiivvee ooff GGuutt MMiiccrroobbiioottaa aanndd AAuuttooiimmmmuunnee TThhyyrrooiidd DDiisseeaassee ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44333300)) PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 93-97

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//22ffdd440022004411882200ddcc55006699ee5577003399ffdd33dddd114455//44))

BBoonnee MMiinneerraall DDeennssiittyy ((BBMMDD)) ooff SSyysstteemmiicc LLuuppuuss EErryytthheemmaattoossuuss ((SSLLEE)) PPaattiieennttss aanndd iittss RRiisskk ooff OOsstteeooppoorroossiiss:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44333311))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//9955008844999911eedd99335533ffcc11ee44337744008899004488bbaaccff//22))

TThhee RReellaattiioonnsshhiipp bbeettwweeeenn AABBOO BBlloooodd GGrroouupp aanndd TThhee SSeevveerriittyy ooff CCOOVVIIDD--1199 aatt UUnniivveerrssiittaass AAiirrllaannggggaa HHoossppiittaall ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44333355))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//9966ffcc77994411bb00660099554400ff8800660055aa664466ffee77332255//33))

EEffffeecctt ooff CCoommbbiinnaattiioonn LLooww VVoollttaaggee EElleeccttrriicciittyy aanndd MMeerrooppeenneemm ttoo KKiillll AAcciinneettoobbaacctteerr bbaauummaannnniiii ((hhttttppss::////iijjrrpp..oorrgg //ppaappeerr--ddeettaaiill//44333366))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//008844eeff2222bbcc447766ddddbbaa44ccbb9911bbdd220088eeaaee1144aa//33))

TThhee EEffffeeccttss ooff MMeettffoorrmmiinn oonn SSttrrookkee PPaattiieennttss OOuuttccoommeess:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44334422)) PPuubblliisshheedd OOnnlliinnee:: 02 January 2023 PPaaggeess:: 115-117

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//4400aadd33aaaacc99cc886666cccc66aa77448866dd88ee00ddee9911665566//22))

EEmmppoowweerriinngg CCaaddrreess iinn SSttuunnttiinngg PPrreevveennttiioonn tthhrroouugghh TTrraaiinniinngg oonn MMaakkiinngg WWeeaanniinngg FFoooodd iiccee ccrreeaamm bbaasseedd YYeellllooww PPuummppkkiinn iinn SSuummbbeerreejjoo AAmmbbuulluu JJeemmbbeerr ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44335500))

(https://ijrp.org/ )



(5)

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//77dd66ee2277dd44ff6633cc77005522ee0055ddffeebb11eeaaff88dd55ff22//11))

SSoocciioo--PPssyycchhoollooggiiccaall HHeeaalltthh aanndd SSttrreessss MMaannaaggeemmeenntt ooff TTeeaacchheerrss aammiiddsstt PPaannddeemmiicc:: BBaassiiss ffoorr CCooppiinngg DDeevveellooppmmeenntt PPrrooggrraamm ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44335522))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//558866ccff887766cccc0044ff9977bb77ff22775511dd44ff557777ff889900//22))

TTeeaacchheerrss'' AAttttiittuuddee TToowwaarrddss IInncclluussiivvee EEdduuccaattiioonn ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44335577)) PPuubblliisshheedd OOnnlliinnee:: 06 January 2023 PPaaggeess:: 134-150

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//55662255cc44ffcc66aa22ff33bb00bb99990099bbeeeeccccff993344335599//33))

EEaarrllyy SSeeppssiiss RReeccooggnniittiioonn iinn PPeeddiiaattrriiccss:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44335588)) PPuubblliisshheedd OOnnlliinnee:: 06 January 2023 PPaaggeess:: 151-155

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//00ee776699bbdd77bb00aa55002299ccff666655335500225500116677aa44ee//22))

TThheeoorreettiiccaall mmooddeellss ffoorr eelleeccttrroopphhoottooccaattaallyyssiiss pprroocceessss ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44336644)) PPuubblliisshheedd OOnnlliinnee:: 06 January 2023 PPaaggeess:: 156-163

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//33aa55aa227799aa22880022ffccbb885599778888eeff9922eebb6611ff99bb//22))

CCAARRDDIIAACC CCAACCHHEEXXIIAA AANNDD CCLLIINNIICCAALL OOUUTTCCOOMMEE OOFF CCHHRROONNIICC HHEEAARRTT FFAAIILLUURREE DDUUEE TTOO RRHHEEUUMMAATTIICC HHEEAARRTT DDIISSEEAASSEE ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44336666))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//5544dd88ffbbccffbbccddff44bb990011dddd1177885511882277aaaa119900//22))

LLOONNEELLIINNEESSSS IINN TTHHEE EELLDDEERRLLYY IINN NNUURRSSIINNGG HHOOMMEESS:: AA CCAASSEE SSTTUUDDYY OOFF UUNNDDEERRSSTTAANNDDIINNGG TTHHEE PPHHEENNOOMMEENNOONN OOFF LLOONNEELLIINNEESSSS ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//33668833))

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//aa7733990055aaee77bbee1144ee77225511ff22ff99bb008866994477bb99dd//22))

TTHHEE CCOORRRREELLAATTIIOONN BBEETTWWEEEENN LLIIFFEESSTTYYLLEE AANNDD MMEENNOOPPAAUUSSAALL SSYYMMPPTTOOMMSS AAMMOONNGG WWOOMMEENN IINN TTHHRREEEE BBIIGG CCIITTIIEESS OOFF IINNDDOONNEESSIIAA ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44331100))

(https://ijrp.org/ )



(6)

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//cc11aa993322bbaaff7755dd6622aa115599448877bb11ff6655227700cc77bb//44))

RRiisskk FFaaccttoorrss ooff CChhoolleelliitthhiiaassiiss:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44331166)) PPuubblliisshheedd OOnnlliinnee:: 06 January 2023 PPaaggeess:: 185-195

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//00aa44bb7711bbccee224433ddbb00ee0077889922aa1199cc9911aa3311ffff//33))

JJeerraallddiinnee AApppprrooaacchh oonn BBrraaiillllee RReeaaddiinngg SSkkiillllss ooff VViissuuaallllyy IImmppaarriieedd PPuuppiillss ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44335555)) PPuubblliisshheedd OOnnlliinnee:: 09 January 2023 PPaaggeess:: 196-202

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//3388ee5522ddaa88ee88bb55ee11002299ff3333dd668855bbff22661122ddaa//66))

OObbeessiittyy aanndd PPrreeeeccllaammppssiiaa:: AA LLiitteerraattuurree RReevviieeww ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44336622)) PPuubblliisshheedd OOnnlliinnee:: 09 January 2023 PPaaggeess:: 203-209

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//220033eedd4444ccccbbffdd22ffffddcc33eeff22cc33cc55668833995533cc//22))

IInncclluussiivvee EEdduuccaattiioonn PPrraaccttiicceess aatt GGeenneerraall SSaannttooss CCiittyy SSPPEEDD IInntteeggrraatteedd SScchhooooll ((hhttttppss::////iijjrrpp..oorrgg//ppaappeerr--ddeettaaiill//44331177)) PPuubblliisshheedd OOnnlliinnee:: 09 January 2023 PPaaggeess:: 210-221

 DDoowwnnllooaadd PPDDFF ((hhttttppss::////iijjrrpp..oorrgg//��lleePPeerrmmiissssiioonn//��lleeDDoowwnnllaaoodd//44//2244cc229999225566ee77cccc66007788ee88bb557777aa22559955cc22ffcc//44))

2 (https://ijrp.org/archive/116/30) >> (https://ijrp.org/archive/116/30)

 editor.ijrp@gmail.com, editor@ijrp.org (mailto:editor.ijrp@gmail.com, editor@ijrp.org)

 H- 280, 14 Atish Deepankar Rd, Dhaka 1219, Bangladesh Quick Contact

Important Links 11

(https://ijrp.org/ )



(7)

Join as an Editor / Reviewer (https://ijrp.org/join) Submit Paper (https://ijrp.org/paper-submit) Check Paper Status (https://ijrp.org/check-status)

Archive (https://ijrp.org/archive)

Download template (https://ijrp.org/download-template) Feedback (https://ijrp.org/feedback)

Important Links

Get in touch & be the �rst one . Subscribe to our newsletter

youremail@domain.com SUBSCRIBE

(https://ijrp.org/ )



(8)

Submit Paper (https://ijrp.org/paper-submit) | Check Paper Status (https://ijrp.org/check-status) |

Download Certi�cate (https://ijrp.org/check-status) | FAQ (https://ijrp.org/faq) | Archive (https://ijrp.org/archive) | Join as an Editor-Reviewer (https://ijrp.org/join) | Login (https://ijrp.org/login)

Search Here...

Medicine, Health & Food

Home (https://ijrp.org/) Journal List (https://ijrp.org/journallist) MMeeddiicciinnee,, HHeeaalltthh && FFoooodd

Medicine, Health & Food

Home (https://ijrp.org/) / Journal List (https://ijrp.org/journallist)

/ Medicine, Health & Food (https://ijrp.org/paper/Medicine--Health---Food/3/home) / EEddiittoorr

Editorial Board (24)

BBeehhzzaadd ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//BBeehhzzaadd//223300)) Shahroud University of Medical Sciences, Iran Assistant Professor

DDrr SSOONNAALLII CCHHAATTUURRVVEEDDII ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//DDrr--SSOONNAALLII--CCHHAATTUURRVVEEDDII//223399)) UNIVERSITY OF CALIFORNIA- San Francisco, USA

Postdoctoral Researcher USA



(https://ijrp.org/ )



(9)

DDrr.. EEssttaarrii MMaammiiddaallaa,, PPhh..DD,, PPDDFF ((UUSSAA)) ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//DDrr..--EEssttaarrii--MMaammiiddaallaa-- PPhh..DD----PPDDFF----UUSSAA--//224400)) Metabolic Disorders & Infectious Diseases Research Lab, USA

Assistant Professo India

MMaahhaavviirr SSiinngghh ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//MMaahhaavviirr--SSiinngghh//224411)) CSIR-National Physical Laboratory, New Delh, India

Sr. Principal Scientist & Head, India

DDrr.. SSiimmoonn OObbwwaatthhoo ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//DDrr..--SSiimmoonn--OObbwwaatthhoo//224444)) AFRICA NAZARENE UNIVERSITY

Director of Postgraduate Programs

RRiiffkkyy AA..LL..MM ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//RRiiffkkyy--AA..LL..MM//5544)) Eastern University, Sri Lanka

Lecturer Sri Lanka

JJiibbaann SShhrreesstthhaa ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//JJiibbaann--SShhrreesstthhaa//224455)) Nepal Agricultural Research Council

Scientist (Plant Breeding & Genetics)

MMdd.. SSaaiiffuull IIssllaamm ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//MMdd..--SSaaiiffuull--IIssllaamm//4499)) Daffodil International University

Software Engineer Bangladesh

KKAAVVYYAACCHHAANNDD YYAALLAAMMUUDDII ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//KKAAVVYYAACCHHAANNDD--YYAALLAAMMUUDDII//11115555)) Q1HOSPITALS-HEALTHCITY-VIZAG-ANDHRAPRADESH

CONSULTANT PHYSICIAN AND DIABETOLOGIST India

DDrr.. SS.. AAzzhhaagguu MMaaddhhaavvaann ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//DDrr..--SS..--AAzzhhaagguu--MMaaddhhaavvaann//11550044)) A. V. V. M. Sri Pushpam College (Autonomous), Poondi, Thanjavur Dt, Pin -613504 Current affairs Ph.D., Completed Lock down period

India

SSaaddeekkuurr RRaahhmmaann ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//SSaaddeekkuurr--RRaahhmmaann//11666655)) IJRP

(https://ijrp.org/ )



(10)

Editor

NNiihhaadd KKhhaallaawwee TTeekkttooookk ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//NNiihhaadd--KKhhaallaawwee--TTeekkttooookk//996655)) MIDDLE TECHNICAL UNIVERSITY

Middle Technical University Co Iraq

KKHHIINN TTHHAANNDDAARR AAUUNNGG ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//KKHHIINN--TTHHAANNDDAARR--AAUUNNGG//11883377)) International Islamic University, Malaysia(IIUM)

lecturer Malaysia

DDrr OOwwaaiiss YYoouussuuff ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//DDrr--OOwwaaiiss--YYoouussuuff//11667777)) Integral University

Assistant Professor India

SSaannjjaayy PPaannddeeyy ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//SSaannjjaayy--PPaannddeeyy//33227755)) Albert Einstein college of medicine

Research Fellow USA

KKUUMMAARR AAVVIINNAASSHH CCHHAANNDDRRAA ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//KKUUMMAARR--AAVVIINNAASSHH--CCHHAANNDDRRAA//22007799)) Dr. A.P.J.A.K. WOMEN'S INSTITUTE OF TECHNOLOGY

ASSISTANT PROFESSOR India

AASSHHWWIINN SSIINNGGHH CCHHOOUUHHAANN ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//AASSHHWWIINN--SSIINNGGHH--CCHHOOUUHHAANN//33775500)) Jai narain vyas university jodhpur rajasthan

Assistant Professor ( Pharmacology) India

HHeebbaa MMuuwwaaffaaqq AAttttaasshh ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//HHeebbaa--MMuuwwaaffaaqq--AAttttaasshh//44114433)) University of Mosul/ Pharmacy College

Pharmacist Iraq

RRuuddaaiinnaa IIssmmaaiill OOssmmaann AAhhmmeedd ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//RRuuddaaiinnaa--IIssmmaaiill--OOssmmaann--AAhhmmeedd//44336644)) Napata College

Medical Researcher and Teaching Assistant Sudan

(https://ijrp.org/ )



(11)

SShheerryyll JJ.. CCoonnttrreerraass ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//SShheerryyll--JJ..--CCoonnttrreerraass//44551199)) Antonio A. Maceda Integrated School (JHS)

Head Teacher III Philippines

DDrr.. IIssiiaakkaa SSaannnnii OOlluuwwaasseegguunn ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//DDrr..--IIssiiaakkaa--SSaannnnii--OOlluuwwaasseegguunn//44884466)) Makkah Specialist Eye Hospital Bauchi

Kobi street, Bauchi Nigeria

SSUULLEEIIMMAANN IIBBRRAAHHIIMM KKAARRAAYYEE ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//SSUULLEEIIMMAANN--IIBBRRAAHHIIMM--KKAARRAAYYEE//55442277)) Federal College of Agricultural Produce Technology, Kano.

Junior Director CTA Nigeria

LLuummaa MM.. AAll--OObbaaiiddyy ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//LLuummaa--MM..--AAll--OObbaaiiddyy//55552200)) University of Mosul

Lecturer at University of Mosul Iraq

EEVVIIYYAATTII AAIINNII MMUURRIIAANNAA ((hhttttppss::////iijjrrpp..oorrgg//uusseerr//EEVVIIYYAATTII--AAIINNII--MMUURRIIAANNAA//55994433)) Universitas Gadjah Mada

Master of Applied Midwifery Indonesia

 editor.ijrp@gmail.com, editor@ijrp.org (mailto:editor.ijrp@gmail.com, editor@ijrp.org)

 H- 280, 14 Atish Deepankar Rd, Dhaka 1219, Bangladesh Quick Contact

Join as an Editor / Reviewer (https://ijrp.org/join) Submit Paper (https://ijrp.org/paper-submit) Check Paper Status (https://ijrp.org/check-status) Important Links

Important Links

(https://ijrp.org/ )



(12)

Archive (https://ijrp.org/archive)

Download template (https://ijrp.org/download-template) Feedback (https://ijrp.org/feedback)

Get in touch & be the �rst one . Subscribe to our newsletter

youremail@domain.com SUBSCRIBE

(https://ijrp.org/ )



(13)

The Effects of Metformin on Stroke Patients Outcomes: A Literature Review

Yohana Zenitha Triyanti

^a

, Paulus Sugianto

^b*

*paulus.sugianto@fk.unair.ac.id

a Medical Programme, Faculty of Medicine, Airlangga University, Surabaya, Indonesia

b Neurology Department, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Abstract

Diabetes might produce pathological changes to blood vessels in several locations, and if the brain's blood arteries are directly affected, it can lead to strokes. Moreover, stroke survivors having uncontrolled glucose levels had a greater fatality rate and poorer outcomes following the event. Therapeutic interventions for ischemic stroke remain limited; thus, it is vital to create novel therapeutic drugs or combination treatments. Metformin is a widespread biguanide medication owing to its safety and low cost, especially for the treatment of diabetes. Metformin's anti-inflammatory properties protect the brain from ischemia/reperfusion-induced injury. In clinical populations, chronic metformin use is linked to a reduced risk of stroke and cardiovascular mortality.

Keywords: Metformin, Stroke, Diabetes Mellitus

Introduction

Stroke is the third main reason of mortality and disability in the globe. Stroke causes roughly 4.4 million deaths annually worldwide [1]. Diabetes is a prevalent stroke-related risk factor. People with this condition have a significant chance of developing hemorrhagic changes [2]. Diabetes mellitus is predicted to affect about 30%

of stroke patients. Metformin is the first therapy of choice for type two diabetes. More than 100 million diabetes people worldwide are administered this medication yearly [3]. Metformin is an anti-diabetic oral medicine that reduces the occurrence of ischemia in diabetic patients. Several molecular mechanisms, such as oxidative stress, activation of endothelial nitric oxide synthase, stimulation of revascularization and neurogenesis, autophagy, and apoptosis, were involved in the neuroprotective function for metformin in the majority of investigations involving animals with middle cerebral artery occlusion (MCAO)-induced cerebral ischemia. However, therapy with metformin in experimental strokes had inconclusive results when compared to the preventive effects of stroke models [5]. Consequently, the purpose of this paper is to explore the use of metformin as an additional treatment for stroke.

115

www.ijrp.org IJRP 2023, 116(1), 115-117; doi:.10.47119/IJRP1001161120234383

(14)

Methods

This research is a literature review conducted as secondary research. According to the MeSH term, a literature search was carried out on PubMed utilizing keywords such as stroke, metformin, and diabetes mellitus.

The research designs included randomized controlled trials, observational studies, and experimental studies, and the literature was selected according to publication year (2012-2022).

Results

Metformin is an in vivo and in vitro AMPK activator [6]. AMPK is the primary detector and controller of cellular energy homeostasis. AMPK is stimulated once AMP/ATP ratios are sufficient and AMP attaches to AMPK complex components [7]. Metformin functions by inhibiting the respiratory chain in order to raise the AMP:ATP ratio, so activating AMPK. Live kinase B (LKB) influences this activation [8]. It has been shown that activation of AMPK protects against ischemic injury by stimulating nuclear erythroid factor 2-related antioxidant pathways (Nrf2) or blocking NF-B cascades to prevent post-ischemic nerve inflammation [9]. In addition, metformin has a neuroprotective impact by blocking the mitochondrial I respiratory chain complex, which has been discovered to enhance the intracellular calcium absorption as well as inhibit the entrance of the permeability transition pore in mitochondria [10]. In post-stroke patients, metformin is not only useful for preventing immediate infarction, but also for encouraging long-term functional recovery. Its been observed that intraperitoneal therapies of metformin soon after an experimental stroke dramatically decreased acute infarction in rodents and stroke-induced increases in blood glucose [11]. Metformin is claimed to aggravate the severity of a stroke, while having certain properties that promote stroke recovery. Acute activation of AMPK at the neuron level generates negative consequences with an increase in the extent of cerebral infarction compared to chronic therapy for at least 2 to 3 weeks prior to ischemia [12].

The period of metformin administration and the dosage of metformin may account for varying study outcomes [13]. An experimental stroke research demonstrated that acute metformin administration for three days prior to an experimental stroke significantly worsened infarct damage 24 hours after MCAO. In contrast, chronic metformin therapy for three weeks prior to experimental stroke reduces acute infarction 24 hours after MCAO [5]. Patients with type 2 diabetes mellitus who took metformin consistently well before onset of stroke and afterwards hospitalization seemed to have excellent treatment benefit at 90 days, whereas participants who underwent metformin just before the onset of stroke or just after hospitalization did not demonstrate useful outcomes [14]. Metformin administered intravenously to the brain after a stroke worsens acute ischaemia by stimulating cerebral AMPK [11].

In the MCAO model, dosages of metformin varied from 10 mg/kg/day to 500 mg/kg/day of diverse delivery methods (gavage and intraperitoneal) in several investigations [15]. After 24 hours after pMCAO, it has been shown that pretreatment with a single dosage of metformin 10 mg/kg/day dramatically lowers infarct volume and neurological impairments [16]. In contrast, a high dosage of metformin might result in an excessive activation of AMPK, resulting in protracted astrocytic glycolysis and increasing acidosis [5].

116

www.ijrp.org Yohana Zenitha Triyanti / International Journal of Research Publications (IJRP.ORG)

(15)

Conclusion

Metformin treatment has the potential to promote stroke recovery. It is determined mostly by dose, duration of therapy, and mode of administration. Metformin has a favorable impact on stroke when taken continuously and persistently, however acute metformin treatment, particularly before to stroke, has dose- dependent effects on acute infarction. Regarding the appropriate therapeutic dosage, the use of metformin as an adjuvant treatment for stroke warrants more investigation.

Acknowledgement

None of the authors have any conflict of interest regarding the contents of this article

References

[1] V. L. Feigin et al., “World Stroke Organization (WSO): Global Stroke Fact Sheet 2022,”

https://doi.org/10.1177/17474930211065917, vol. 17, no. 1, pp. 18–29, Jan. 2022, doi: 10.1177/17474930211065917.

[2] I. Idris, G. A. Thomson, and J. C. Sharma, “Diabetes mellitus and stroke,” Int J Clin Pract, vol. 60, no. 1, pp. 48–56, Jan. 2006, doi: 10.1111/J.1368-5031.2006.00682.X.

[3] G. Rena, E. R. Pearson, and K. Sakamoto, “Molecular mechanism of action of metformin: old or new insights?,” Diabetologia, vol. 56, no. 9, pp. 1898–1906, Sep. 2013, doi: 10.1007/S00125-013-2991-0.

[4] I. Arbeláez-Quintero and M. Palacios, “To Use or Not to Use Metformin in Cerebral Ischemia: A Review of the Application of Metformin in Stroke Rodents,” Stroke Res Treat, vol. 2017, 2017, doi: 10.1155/2017/9756429.

[5] J. Li, S. E. Benashski, V. R. Venna, and L. D. McCullough, “Effects of Metformin in Experimental Stroke,” Stroke; a journal of cerebral circulation, vol. 41, no. 11, p. 2645, Nov. 2010, doi: 10.1161/STROKEAHA.110.589697.

[6] H. A. Halpin, M. M. Morales-Suárez-Varela, and J. M. Martin-Moreno, “Chronic disease prevention and the new public health,”

Public Health Rev, vol. 32, no. 1, pp. 120–154, Jun. 2010, doi: 10.1007/BF03391595/METRICS.

[7] D. G. Hardie, F. A. Ross, and S. A. Hawley, “AMPK: a nutrient and energy sensor that maintains energy homeostasis,” Nat Rev Mol Cell Biol, vol. 13, no. 4, pp. 251–262, Apr. 2012, doi: 10.1038/NRM3311.

[8] R. J. Shaw et al., “The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin,” Science, vol.

310, no. 5754, pp. 1642–1646, Dec. 2005, doi: 10.1126/SCIENCE.1120781.

[9] G. Ashabi, L. Khalaj, F. Khodagholi, M. Goudarzvand, and A. Sarkaki, “Pre-treatment with metformin activates Nrf2 antioxidant pathways and inhibits inflammatory responses through induction of AMPK after transient global cerebral ischemia,” Metab Brain Dis, vol. 30, no. 3, pp. 747–754, Jun. 2015, doi: 10.1007/S11011-014-9632-2.

[10] K. Skemiene, E. Rekuviene, A. Jekabsone, P. Cizas, R. Morkuniene, and V. Borutaite, “Comparison of Effects of Metformin, Phenformin, and Inhibitors of Mitochondrial Complex I on Mitochondrial Permeability Transition and Ischemic Brain Injury,”

Biomolecules, vol. 10, no. 10, pp. 1–17, Oct. 2020, doi: 10.3390/BIOM10101400.

[11] S. Harada, W. Fujita-Hamabe, and S. Tokuyama, “Retraction notice to ‘The importance of regulation of blood glucose levels through activation of peripheral 5’-AMP-activated protein kinase on ischemic neuronal damage’ [Brain Res 1351 (2010) 254-263],”

Brain Res, vol. 1758, May 2021, doi: 10.1016/J.BRAINRES.2021.147363.

[12] I. Arbeláez-Quintero and M. Palacios, “To Use or Not to Use Metformin in Cerebral Ischemia: A Review of the Application of Metformin in Stroke Rodents,” Stroke Res Treat, vol. 2017, 2017, doi: 10.1155/2017/9756429.

[13] T. Leech, N. Chattipakorn, and S. C. Chattipakorn, “The beneficial roles of metformin on the brain with cerebral ischaemia/reperfusion injury,” Pharmacol Res, vol. 146, Aug. 2019, doi: 10.1016/J.PHRS.2019.104261.

[14] Y. Jian et al., “Metformin treatment and acute ischemic stroke outcomes in patients with type 2 diabetes: a retrospective cohort study,” Neurological Sciences, vol. 1, pp. 1–9, Nov. 2022, doi: 10.1007/S10072-022-06491-0/FIGURES/2.

[15] K. P. Mansoorali, T. Prakash, D. Kotresha, K. Prabhu, and N. Rama Rao, “Cerebroprotective effect of Eclipta alba against global model of cerebral ischemia induced oxidative stress in rats,” Phytomedicine, vol. 19, no. 12, pp. 1108–1116, Sep. 2012, doi:

10.1016/j.phymed.2012.07.004.

[16] T. Jiang et al., “Acute metformin preconditioning confers neuroprotection against focal cerebral ischaemia by pre-activation of AMPK-dependent autophagy,” Br J Pharmacol, vol. 171, no. 13, pp. 3146–3157, 2014, doi: 10.1111/BPH.12655.

117

www.ijrp.org Yohana Zenitha Triyanti / International Journal of Research Publications (IJRP.ORG)