Managing polypharmacies in a community pharmacy involves proactively identifying and addressing unnecessary or potentially harmful medications while optimizing medication regimens for individual patients. The process includes medication reviews, patient education, and collaboration with other healthcare professionals.
Here’s a more detailed look at how community pharmacists can effectively manage polypharmacy:

 

1. Medication Reviews and Reconciliation:
Medication Therapy Reviews (MTRs):
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Pharmacists thoroughly review a patient’s medication list, including prescription, over-the-counter, and herbal medications.
Medication Reconciliation:
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The process involves comparing a patient’s medication list to the one documented in their electronic health record (EHR), identifying discrepancies, and ensuring accuracy.
Personal Medication Records (PMRs):
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Encouraging patients to maintain and update their PMR helps them track their medications and share this information with their healthcare providers.

2. Identifying and Addressing Polypharmacy:
Beers Criteria:
Pharmacists can use the Beers Criteria, a list of potentially inappropriate medications for older adults, as a guide to identify medicines that may not be appropriate for a patient’s specific needs.
Drug-Drug and Drug-Disease Interactions:
MTRs help identify potential interactions between medications and between medications and the patient’s existing health conditions.
Deprescribing:
Pharmacists can help identify and recommend discontinuing unnecessary medications, ensuring a clear indication for each remaining medication.

3. Patient Education and Empowerment:
Adherence Counselling:
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Providing education on how to take medications correctly, including timing, dosage, and storage, can improve adherence and reduce the risk of polypharmacy-related problems.
Shared Decision-Making:
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Involving patients and their carers in the decision-making process regarding their medication regimen can increase their understanding and engagement in their care.
Action Plans:
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Pharmacists can create action plans with clear steps for patients to follow to address medication-related problems.

4. Collaboration and Communication:
Team Approach:
Collaborating with physicians, nurses, and other healthcare professionals can provide a holistic approach to managing polypharmacy.
Care Transitions:
Pharmacists play a crucial role in medication reconciliation and communication during care transitions, such as when a patient moves from an inpatient setting to an outpatient setting.
Communication with Providers:
Pharmacists can communicate findings from MTRs and provide recommendations to prescribers, ensuring appropriate prescribing and medication adjustments.

5. Ongoing Monitoring and Evaluation:
Regular Reviews:
Pharmacists should regularly review patients’ medication regimens to assess their effectiveness and safety.
Monitoring for Adverse Drug Events:
Pharmacists should be vigilant in monitoring for adverse drug reactions and drug interactions.
Adjustments:
Based on ongoing monitoring, pharmacists can recommend adjustments to the medication regimen to optimize therapeutic outcomes.
By implementing these strategies, community pharmacists can make a significant impact in managing polypharmacy, improving patient safety, and enhancing overall healthcare outcome

Believe it or not, Viagra (sildenafil) is one of the most popular medications in the U.S. The blue, diamond-shaped pill is known for its ability to help men fight back against erectile dysfunction (ED). However, Viagra’s popularity doesn’t mean the medication is always self-explanatory.

If you’re using this medication for the first time, here’s how to take Viagra for the best results.

What is Viagra?
Viagra is a prescription medication commonly used to treat ED, a condition that affects over 150 million people worldwide. While the brand-name prescription comes in a blue tablet form, generic sildenafil is a white tablet. Viagra and its generics are prescribed as 25 mg, 50 mg, and 100 mg tablets.

Sildenafil can also treat pulmonary arterial hypertension, a type of lung high blood pressure. However, only Revatio-equivalent sildenafil is FDA-approved for this particular condition.

Getting ahead of potential problems: Here are some of the most notable Viagra side effects, from headaches to vision changes — and how to manage them:

Is Viagra right for you? Several health conditions and interacting medications can make taking Viagra especially risky. Check to find out if these scenarios apply to you.
Get your questions answered: Are you curious about the duration of Viagra’s stay in your system? Read more to find out — plus answers to several other frequently asked questions.
How does Viagra work to treat ED?
When you’re aroused, your body releases nitric oxide down below. This compound is a molecule that triggers the events responsible for an erection. But an enzyme (protein) called phosphodiesterase type 5 (PDE5) breaks down certain messengers involved in this process, preventing the desired effect.

While there are several reasons why someone may have difficulty getting or maintaining an erection, PDE5 inhibitors that block this enzyme, such as Viagra, are often used as a remedy.

Viagra and other PDE5 inhibitors, such as Cialis (tadalafil) and vardenafil, help relax muscles and arteries inside the penis. This process helps more blood reach the penis. When aroused, the combination of relaxation and increased blood flow helps fill the penis with blood. That’s how you’re able to achieve an erection.

How to take Viagra for the best results
Here are a few tips on how to take Viagra safely and effectively.

The standard recommended Viagra dosage for treating ED is 50 mg. But your prescriber could recommend taking anywhere from 25 mg to 100 mg per dose, depending on how you respond.

You should only take Viagra once a day. This implies that if you plan to engage in sexual activity more than once throughout the day, you should avoid taking a pill every time. And if you take a pill and it doesn’t work for you, donot take another one. Exceeding the recommended Viagra dosage can put you at risk for serious side effects.

Because Viagra can also affect other parts of the body, such as the heart and lungs, it’s important to stick to the dose and instructions your prescriber provides. And if your prescribed Viagra dose isn’t working for you, they may make adjustments to find one that works.

Take it on an empty stomach
You can take Viagra with or without food, but it works best on an empty stomach. So, to maximize its effects, try to take it separately from meals.

But if you eat beforehand, avoid taking it with a high-fat meal. Eating fatty foods can slow down the absorption of the medication and prolong the time it takes for Viagra to start working.

Know the potential side effects of Viagra
The most common Viagra side effects include:

Flushing
Indigestion or heartburn
Headache
Insomnia
Changes in vision
Nosebleeds
Nasal congestion
More serious side effects are also possible. Viagra and other ED medications can rarely cause dangerously long-lasting erections. An erection lasting longer than 4 hours is known as priapism. If left untreated, this condition can cause permanent damage to the tissue that helps you become erect. We will delve deeper into this topic in a later section.

Who Shouldn’t Take Viagra? Advice for Older Adults, People with Heart Problems, and More

Viagra and Alcohol: Can You Take Erectile Dysfunction Medications and Drink?

Viagra: Uses, Side Effects, Dosage, & More
What’s more, your prescriber may warn you not to use Viagra if you have certain heart conditions or take blood pressure medications that relax your blood vessels, including nitrates like isosorbide, dinitrate, or nitroglycerin. Such caution is due to the increased risk of heart attack or dangerously low blood pressure.

How long does it take Viagra to work?
After taking Viagra, the medication quickly enters your system. Viagra should start working within an hour. But this timeframe can vary for different people. You can take it anywhere from 30 minutes to 4 hours before sexual activity to see how it affects you.

You may be wondering if there are ways to help Viagra work even faster, such as chewing or crushing the tablet and dissolving it under your tongue. However, this is not the intended method of action. Viagra should be swallowed whole.

How long does Viagra last?
The effects of Viagra usually last 4 to 8 hours. The specific time frame Viagra lasts depends on the person and the dose you take. In fact, some people may experience more than one erection during this time.

But just because Viagra lasts 8 hours doesn’t mean your erection should. If your erection lasts more than 4 hours — even if it is not painful — seek medical help right away. Treat priapism immediately to prevent potential long-term damage.

If you have sickle cell anaemia, multiple myeloma, leukaemia, or certain penile deformities (such as Peyronie’s disease), you’re more likely to have a prolonged erection.

Does Viagra make you last longer?
Not typically. Just as there are several reasons why someone experiences ED, the same goes for premature ejaculation. And while medications like Viagra can help your erection stay firm, it usually aren’t the first choice for preventing ejaculation.

However, the two issues often happen together. Your prescriber may recommend taking Viagra to help address ED. As a result of treatment, you may see some improvement with how long you last.

If you’re still not lasting as long as you’d like during sex, your prescriber may have you try behavioural methods (e.g., practising ejaculation control), counselling, or other medications — such as numbing creams or antidepressants — to help.

The bottom line
Viagra (sildenafil) can be an effective option to help you achieve and maintain an erection. To get the best results, take Viagra on an empty stomach at least an hour before sexual activity, and follow the instructions from your prescriber. If your erection lasts over 4 hours, get medical attention right away to avoid possible long-term damage.

References
Brody, S., et.al. (2015). Erectile dysfunction and premature ejaculation: interrelationships and psychosexual factors. The Journal of Sexual Medicine.

Davies, K. P. (2015). Development and therapeutic applications of nitric oxide-releasing materials to treat erectile dysfunction. This study was published in Future Science OA, a journal that focuses on innovative scientific research.

Building a global pharmacy brand is a multifaceted endeavor that requires strategic planning, market understanding, and effective execution. Here are some key steps to consider:

1. Market Research and Analysis
Identify Target Markets: Determine which countries or regions demand the highest pharmaceutical products and services.
Understand Regulations: Research the regulatory requirements for pharmaceuticals in each target market, including licensing, import/export laws, and health regulations.
Competitor Analysis: Analyze existing pharmacy brands in the target markets to understand their strengths, weaknesses, and market positioning.

2. Brand Development
Brand Identity: Develop a strong brand identity that includes a memorable name, logo, and tagline. Ensure that the brand resonates with the target audience and reflects the values of trust, reliability, and quality.
Brand Positioning: Position your brand as a leader in the pharmaceutical industry by highlighting unique selling points such as innovative products, superior customer service, and competitive pricing.

3. Product Portfolio
Diverse Range of Products: Offer a wide range of pharmaceutical products, including prescription medications, over-the-counter drugs, health supplements, and wellness products.
Quality Assurance: Ensure that all products meet high-quality standards and are sourced from reputable manufacturers.

4. Distribution Channels
Online Presence: Develop a robust e-commerce platform to reach customers globally. Invest in digital marketing strategies to drive traffic to your online store.
Physical Stores: Establish physical pharmacy locations in key markets. Consider partnerships with local pharmacies to expand your reach.
Supply Chain Management: Optimize your supply chain to ensure timely delivery of products and maintain inventory levels.

5. Marketing and Promotion
Digital Marketing: Utilize social media, search engine optimization (SEO), and pay-per-click (PPC) advertising to promote your brand online.
Content Marketing: Create valuable content such as health blogs, product reviews, and educational videos to engage and inform your audience.
Local Marketing: Tailor marketing campaigns to suit the cultural and social norms of each target market.

6. Customer Service
24/7 Support: Offer round-the-clock customer support to address queries and concerns.
Loyalty Programs: Implement loyalty programs to reward repeat customers and encourage brand loyalty.
Feedback Mechanism: Establish a system for collecting and analyzing customer feedback to continuously improve your products and services.

7. Compliance and Ethics
Regulatory Compliance: Ensure that your operations comply with all local and international regulations.
Ethical Practices: Maintain high ethical standards in all business practices, including marketing, sales, and customer interactions.

8. Partnerships and Collaborations
Healthcare Providers: Collaborate with healthcare providers, hospitals, and clinics to expand your reach and credibility. Pharmaceutical Companies: Partner with pharmaceutical manufacturers to ensure a steady supply of high-quality products.

9. Innovation and Technology
Telemedicine: Integrate telemedicine services to provide remote consultations and prescriptions.
AI and Data Analytics: Utilize AI and data analytics to optimize operations, predict market trends, and personalize customer experiences.

10. Monitoring and Evaluation
Performance Metrics: Establish key performance indicators (KPIs) to monitor the success of your strategies.
Continuous Improvement: Regularly review and refine your strategies based on performance data and market feedback.

To keep your health in check during Easter, focus on balanced eating, physical activity, and moderation of treats while prioritizing rest and mindful practices.

Here’s a more detailed breakdown:
1. Balanced Eating:
Healthy Breakfast: Start the day with a protein-rich breakfast to help control appetite and prevent overeating later.
Snack Wisely: Choose healthy snacks like fruits, vegetables, and whole-grain crackers instead of sugary treats.
Portion Control: Be mindful of portion sizes, especially when indulging in Easter treats.
Incorporate Nutritious Meals: Focus on lean proteins, whole grains, and plenty of vegetables in your meals.
Hydrate: Drink plenty of water throughout the day to stay hydrated, especially since sugary treats can dehydrate you.

2. Get Active:
Physical Activity: Make time for exercise, such as a walk, bike ride, or playing outdoor games with family.
Easter Egg Hunt: Turn the Easter egg hunt into a fun, active event for all ages.
Family Activities: Organize family activities that encourage movement, like a game of tag or a hike.

3. Moderation and Mindful Practices:
Moderation of Treats: Enjoy Easter treats in moderation and be mindful of sugar intake.
Mindful Eating: Pay attention to your hunger cues and eat without distractions.
Make time for self-care: Prioritize sleep, relaxation, and mindful activities to manage stress and maintain well-being. Change your thoughts around food: Don’t view treats as “good” or “bad,” but as a part of a balanced lifestyle.

4. Tips for Specific Easter Foods:
Chocolate: Enjoy chocolate in moderation, and consider choosing dark chocolate, which has more antioxidants.
Hot Cross Buns: Enjoy hot cross buns in moderation, as they are often high in sugar and refined flour.
Deviled Eggs: Make a healthier version by using Greek yogurt instead of mayonnaise.

5. Additional Tips:
Prioritize Sleep: Aim for 7-9 hours of quality sleep per night.
Control Stress: Find healthy ways to manage stress, such as meditation, yoga, or spending time in nature.
Enjoy the Celebration: Focus on the joy and connection with family and friends rather than just the food.
Plan Ahead: Plan healthy meals and snacks to avoid impulsive choices.

The future pharmacy will be characterized by a blend of digital technology, personalized care, and expanded roles for pharmacists. It will move beyond traditional dispensing to encompass clinical services and health and wellness information. This vision includes greater automation, AI-driven analytics, and the use of digital health tools to empower patients and improve healthcare outcomes.

Here’s a more detailed look at key aspects:

1. Digital Transformation and Enhanced Accessibility:
Telehealth and Online Platforms:
Online consultations and digital health tools will provide convenient access to healthcare professionals and medication management support.
Omnichannel Engagement:
Pharmacies will offer a seamless experience across digital and physical channels, including home delivery, same-day delivery, and on-demand pharmacist support.
Automation and AI:
AI-driven analytics can identify potential medication issues, predict risks, and support pharmacists in managing complex therapies.

2. Expanded Role of Pharmacists:
Healthcare Providers:
Pharmacists will be recognized as healthcare providers, able to diagnose and treat minor acute illnesses, manage chronic conditions, and provide preventative care.
Clinical Services:
Pharmacies will offer a wider range of clinical services, including immunizations, medication counseling, and even prescribing medications.
Specialty Care:
Pharmacists will play a vital role in specialty areas like oncology and cell and gene therapy, leveraging their expertise in pharmacotherapy.

3. Personalized and Patient-Centric Care:
Data-Driven Insights:
Integration of patient data from various sources, including wearable devices and electronic medical records, will enable personalized treatment plans and proactive care management.
Digital Therapeutics and Personalized Health Advice:
Pharmacists will help patients identify and utilize digital health tools, including digital therapeutics, for their specific needs.
Focus on Patient Experience:
Pharmacies will strive to create a more personalized and convenient experience for patients, whether it’s through online platforms, same-day delivery, or in-store services.

4. Opportunities and Challenges:
Opportunities:
Increased access to care, improved patient outcomes, and a more efficient healthcare system.
Challenges:
Regulatory barriers, reimbursement issues, and the need for collaboration and interoperability among different healthcare providers and systems.

5. Key Themes:
Patient-centered care: Focusing on individual patient needs and preferences.
Data-driven decision-making: Leveraging data insights to improve care and outcomes.
Collaboration and integration: Working with other healthcare professionals and systems to provide seamless care.
Accessibility and convenience: Making care more accessible and convenient for patients.

To manage period cramps, consider using heat therapy, such as a heating pad or hot bath; over-the-counter pain relievers, such as NSAIDs (ibuprofen or naproxen); gentle exercise; and relaxation techniques, like yoga or meditation. Additionally, staying hydrated and managing stress can help alleviate symptoms.

Here’s a more detailed look at these strategies:

1. Heat Therapy:
Heating Pad: According to the Cleveland Clinic, applying a heating pad or hot water bottle to your lower abdomen can help relax tense muscles and reduce pain.
Hot Bath: Soaking in a warm bath can also soothe muscles and reduce pain.

2. Pain Relievers: NSAIDs
Non-steroidal anti-inflammatory drugs, like ibuprofen (Advil) or naproxen (Aleve), are effective at reducing prostaglandins (hormones that cause contractions and pain).
Acetaminophen:
While not as effective for reducing inflammation as NSAIDs, acetaminophen (Tylenol) can still provide pain relief.

3. Exercise and Relaxation:
Gentle Exercise:
Motrin says light to moderate exercise, like walking or yoga, can help release endorphins (natural pain relievers) and reduce pain.
Yoga and Meditation:
Relaxation techniques, such as yoga and meditation, can help reduce stress and tension, which can worsen menstrual pain.

4. Other Helpful Tips:
Stay Hydrated:
Drinking plenty of fluids can help prevent dehydration, which can contribute to muscle cramps.
Manage Stress:
Stress can exacerbate menstrual pain, so finding healthy ways to manage it, like deep breathing or spending time in nature, can be beneficial.
Consider Dietary Changes:
Limiting processed foods, sugar, and caffeine and focusing on a diet rich in fruits, vegetables, and healthy fats may help reduce inflammation and cramping.

5. When to Seek Medical Advice:
If your cramps are severe, interfere with your daily life, or are accompanied by other symptoms like heavy bleeding, severe nausea, or fever, it’s important to see a doctor.
A doctor can help rule out underlying medical conditions and recommend appropriate treatment options, such as hormonal birth control or other medications.

AI in healthcare is transforming diagnostics, treatments, and patient care by analyzing medical data, automating tasks, and aiding in research, potentially leading to earlier disease detection, personalized medicine, and improved efficiency.

Here’s a more detailed look at AI’s impact on healthcare:

1. Enhanced Diagnostics and Treatment:
Image Analysis:
AI algorithms can analyze medical images (X-rays, MRIs, CT scans) to identify diseases and abnormalities with greater accuracy and speed than human experts.
Personalized Medicine:
AI can analyze patient data (genetic information, medical history) to personalize treatment plans and predict patient responses to therapies.
Early Disease Detection:
AI can help identify diseases at earlier stages, when treatment is often more effective.
Drug Discovery and Development:
AI can accelerate drug discovery and development by analyzing vast amounts of data to identify potential drug candidates and predict their effectiveness.

2. Automation and Efficiency:
Administrative Tasks:
AI can automate routine administrative tasks, such as scheduling appointments, managing patient records, and processing insurance claims, freeing up healthcare professionals to focus on patient care.
Robotic Surgery:
AI-powered robotic surgery systems can assist surgeons with complex procedures, improving precision and reducing surgical errors.
Remote Monitoring:
AI-powered wearable devices and sensors can monitor patients remotely, allowing healthcare providers to detect early warning signs of illness and intervene promptly.

3. Research and Development:
Data Analysis:
AI can analyze large datasets to identify patterns and trends, helping researchers to understand diseases and develop new treatments.
Clinical Trials:
AI can help optimize clinical trials by identifying suitable patients, predicting trial outcomes, and accelerating the recruitment process.

4. Challenges and Considerations:
Data Privacy and Security:
Protecting patient data and ensuring the security of AI systems are crucial concerns.
Ethical Considerations:
AI in healthcare raises ethical questions about bias, fairness, and accountability.
Regulatory Compliance:
AI systems used in healthcare must comply with relevant regulations and standards.
Public Trust:
Ensuring public trust in AI-powered healthcare solutions is essential for their successful implementation.
Job Displacement:
Some healthcare jobs may be impacted by automation, requiring healthcare professionals to adapt to new roles and responsibilities.

DOWN SYNDROME: HOW YOU CAN HELP INCREASE THE LIFE EXPECTANCY OF THOSE AFFECTED.

According to the National Down Syndrome Society, the life expectancy of people with down syndrome in 1983 was reported to be 25 years. In recent years, individuals with DS have been known to live into their sixties. Down syndrome occurs because of an extra copy of chromosome 21 which leads to developmental delays, mental and physical challenges. The disorder cannot be prevented and is not caused by what a parent did or didn’t do. However, with a great support system, individuals with DS lead a long, happy, and fulfilled life.

Why is a strong support system advocated?

In recent years, individuals with Down syndrome have showcased remarkable abilities, prompting a shift in societal perceptions and acceptance of their roles within the community. Research indicates that these individuals tend to meet the elevated expectations set by their families and society when they receive sufficient support and encouragement. Rusell O’Grady, McDonald’s employee for 32 years, exemplifies an individual with Down syndrome who led a joyful life, spreading smiles each day despite his challenges. For children born with Down Syndrome, early intervention services like Physical therapy, occupational therapy, and speech/feeding therapy can help boost their development. A great support from the family makes living to their fullest potential possible. In addition, DS comes with several health challenges including heart defects, hearing and vision problems, thyroid disorders, Alzheimer’s disease, and immune system deficiencies. Studies show that approximately 40% to 50% of children with DS are born with congenital heart defects (CHD). But with regular medical check-ups, early interventions, and lifelong healthcare support, the quality of life of these individuals can be improved.

How can we support people with DS to improve their Life Expectancy?
1. Promotion of Early and Regular Healthcare:
DS comes with multiple health challenges necessitating proactive medical intervention and routine medical checkups. This enhances early development and ensures better health outcomes over time. If you find yourself in the same space with someone with DS, encourage them to go for regular screenings/ medical checkups as this aids early diagnosis and treatment. With early screenings and routine checkups, heart defects, hearing, and vision issues, coupled with hypothyroidism can be detected and managed, preventing future complications. In addition, timely intervention helps to maximize a child’s potential, which improves their independence and social inclusion.

2. Enhancing Cognitive and Emotional Well-being
Targeted support aimed at improving cognitive and emotional well-being help individuals with DS help reach their full potential and lead healthier, happier lives. For instance, speech therapy, occupational therapy, and specialized education improves memory, problem solving and language skills. Employing visual aids, along with repeated exposure and interactive tasks, significantly aids in information processing capabilities. Also, with counseling, support from peer groups, and mindfulness exercises, individuals with DS can manage stress and emotional distress effectively. Providing the right support leads to improved independence, better mental health, and longevity.

3. Strengthening Community Support and Inclusion
Building community support and fostering inclusion are essential for enhancing the quality of life, health outcomes, and life expectancy for individuals with Down syndrome. An inclusive community that fosters acceptance, accessibility, and equal opportunities cultivates an atmosphere in which individuals with Down syndrome can thrive and reach their maximum potential. Schools and workplaces should endeavor to provide an inclusive environment as this would not only build their self-esteem but improve confidence as well. Fostering a more inclusive society benefits everyone involved. It not only aids individuals with Down syndrome but also enriches the entire community by encouraging diversity, empathy, and a collective spirit.

In accordance with the 2025 World Down Syndrome theme, “Improve Our Support Systems,” lets us collaborate to enhance the support provided to individuals with Down syndrome, enabling them to lead healthier, happier, and more fulfilling lives.

There is a lot of belief that glaucoma is the cause of every blindness. But the fact is that if you have been diagnosed with glaucoma, you can still maintain functional vision throughout your life.

What is glaucoma?
Glaucoma is an eye condition that progressively impairs vision by inflicting harm on the optic nerve. In a healthy eye, fluid drainage occurs through the drainage angle as more aqueous humor flows in, keeping the eye pressure stable. In glaucoma, the function of the drainage angle is impaired leading to a fluid build up, which in turn increases the eye pressure (called the intraocular pressure). According to the American Academy of Ophthalmology, “Glaucoma is a leading cause of blindness for people over 60 years old. But blindness from glaucoma can often be prevented with early treatment”. The National Eye Institute also states that vision loss from glaucoma can be averted with early prevention and treatment.

What are the two major types of Glaucoma?
Primary open angle glaucoma (POAG)- This is the most prevalent type of glaucoma. Here, there is an elevated resistance to the normal flow of aqueous humor, which causes a rise in intraocular pressure. In the initial phases, symptoms are usually absent, highlighting the importance of early detection. In fact, POAG does not cause any eye pain. However, as the disease progresses over time, it can result in vision loss and blindness if not treated. Clinical trial evidence shows that reducing intraocular pressure effectively halts the progression of the disease in both its early and advanced stages.

Primary closed angle glaucoma (PACG) – In PACG, angle closure is the primary concern, while elevated intraocular pressure (IOP) results from the angle closure. The most common mechanism here is pupillary block. This happens when the aqueous humor is unable to move freely from the posterior chamber, located behind the iris, to the anterior chamber, situated in front of the iris, because the lens is too close to the back surface of the iris. This variation in pressure leads to a forward displacement of the peripheral iris, thereby blocking the trabecular meshwork and contributing to an increase in intraocular pressure (IOP). Recent research studies has shown that the angle closure process can be halted in the early stages preventing PACG.

What are the contributing factors to vision loss in glaucoma?
There are factors that promote vision loss in glaucoma. And without the knowledge of these factors and what to do to forestall them, you will be caught unawares by this “silent thief of sight’. That is to say that if patients with Glaucoma are not diagnosed early, these factors progress over time leading to irreversible blindness. Some of the factors include;

1. Elevated intraocular pressure: This is a significant risk factor for glaucoma. Higher IOP in patients can lead to damage to the optic nerve, which is crucial for vision. Increased IOP has been attributed to higher disease risk by 10%. However, this factor can be modified and according to a series of randomized trials, treatments focused on decreasing baseline intraocular pressure (IOP) can be successful in preventing the development and progression of open-angle glaucoma (POAG). It is important to note that exercise like heavy weightlifting, intense resistance training, or activities that involve breath-holding (Valsalva maneuver) should be avoided if you’ve been diagnosed with IOP. This is because research studies have shown that it causes transient surges in intraocular pressure (IOP).

2. Age- The occurrence of open-angle glaucoma rises with advancing age. Studies show that among Americans aged 73 to 74 years, the prevalence rate stands at 3.4%, and rises to 9.4% for individuals over the age of 75. There is a correlation between older age and a higher degree of optic nerve damage, as well as an accelerated rate of glaucoma advancement. The aging process is believed to heighten the susceptibility of the optic nerve to damage associated with intraocular pressure (IOP). Hence, older patients need enhanced intraocular pressure management to avert the progression of the disease.

3. Optic Nerve Properties: The anatomy of the optic nerve can vary, and factors such as the cup-to-disc (CDR) ratio may indicate a greater likelihood of damage and visual deterioration. The CDR is the relationship between the size of the optic cup (which is the depression found in the optic nerve) and the size of the optic disc (the area through which the optic nerve enters the eye). A CDR of 0.6 or higher raises suspicion for glaucoma, though it does not confirm the diagnosis.

4. Genetic Factors: A family history of glaucoma increases the risk of the disease. Genetic factors like mutation in specific genes play an important role in the development and progression of glaucoma through various pathogenic mechanisms. For instance, the MYOC (myocilin) gene mutations contribute to roughly 8-36% of juvenile open-angle glaucoma (JOAG) and about 2-4% of adult-onset primary open-angle glaucoma (POAG). This prevalence differs based on the ethnicity of the population examined.

5. Thinner Central Cornea: There is a significant association between central cornea thickness and risk of developing glaucoma. A reduced cornea thickness has been linked to a heightened risk of disease progression. For every 40 micrometer reduction in central corneal thickness (CCT),the probability of disease progression rises with an odds ratio (OR) of 1.45. This suggests that corneas of reduced thickness are associated with an increased risk of developing glaucoma.

Why is early detection/prevention encouraged?

Glaucoma is asymptomatic in its early stages which makes it challenging to be diagnosed clinically. It frequently goes undetected until significant vision impairment has taken place. Early detection of glaucoma reduces visual impairment and blindness, while also being an effective means of reducing costs. Efficient methods of glaucoma screening are therefore warranted for early detection of disease. Routine eye examinations are essential, particularly for individuals who are at an elevated risk, such as older adults and individuals with a familial predisposition to glaucoma. These assessments facilitate the early identification of increased IOP, angle closure or other concerning indicators that could result in any type of glaucoma.
For individuals identified as having primary angle closure suspects (PACS), advancements in treatment like the laser peripheral iridotomy and/or iridoplasty, are proving effective to open the angle or halt the angle closure process in primary angle-closure glaucoma. Hence, with early detection, PACG may be preventable in the early stages. For the management of IOP, more effective and better tolerated drugs are being developed. In 2023, the FDA approved iDose TR (Glaukos), a travopost implant designed to effectively reduce intraocular pressure (IOP) in patients suffering from open-angle glaucoma. This has been reported to reduce ocular pressure by 6-7 mmHg. Also, there are ongoing advancements in the creation of new treatments designed to directly target and preserve the retinal ganglion cells that suffer damage due to glaucoma.
Ultimately, with regular eye examinations, glaucomatic symptoms can be identified and treated preventing disease progression and averting blindless.

Spina bifida is a birth defect where the spinal cord and spine don’t close completely during pregnancy, potentially causing a range of symptoms and requiring medical interventions.
Here’s a more detailed overview of spina bifida:

What it is:
Neural Tube Defect:
Spina bifida is a type of neural tube defect, meaning the neural tube (which develops into the brain and spinal cord) doesn’t close properly during early pregnancy.
Varies in Severity:
The condition can range from mild to severe, depending on the location and extent of the spinal defect.

Types:
Spina Bifida Occulta: A mild form where the spinal cord and nerves are in their normal place, but there’s a gap in the vertebrae, often without visible signs.
Meningocele: A sac containing spinal fluid protrudes through the gap in the spine, but the spinal cord remains inside the spinal canal.
Myelomeningocele: The most severe form, where a sac containing spinal fluid, meninges, and part of the spinal cord protrudes through the opening in the spine and skin.
Causes and Risk Factors:

Early Pregnancy:
Spina bifida develops during the first few weeks of pregnancy when the neural tube is forming.
Folic Acid Deficiency:
Lack of folic acid (vitamin B9) before and during early pregnancy is a significant risk factor.
Other Factors:
The exact causes are not fully understood, but other factors may include genetics, certain medications, and maternal health conditions.

Symptoms:
Visible Signs:
Depending on the type of spina bifida, there may be a visible sac on the back, a tuft of hair, a birthmark, or a dimple.
Neurological Problems:
Some individuals with spina bifida may experience weakness, loss of sensation, or paralysis in their legs and feet.
Other Complications:
Bowel and bladder control problems, hydrocephalus (excess fluid in the brain), and scoliosis (curvature of the spine) are also possible.

Treatment and Management:
Surgery:
Surgery is often needed to close the opening in the spine and prevent further complications.
Ongoing Care:
Individuals with spina bifida may require ongoing medical care, including physical therapy, occupational therapy, and other therapies to address specific needs.
Mobility Aids:
Depending on the severity of the condition, individuals may need mobility aids like braces, crutches, or wheelchairs.

Managing Complications:
Treatment focuses on managing complications such as hydrocephalus, bowel and bladder problems, and other health issues.
Living with Spina Bifida:
Long-Term Care:
Spina bifida is a chronic condition that requires ongoing management and support.
Specialized Services:
Individuals with spina bifida may benefit from specialized services and support groups.
Advocacy and Support:
Organizations like the Spina Bifida Association offer resources and support for families and individuals affected by spina bifida.