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  • ISSN: 2373-9363
    Xylazine and Its Speedball Combination: Induction of Apoptosis by Intrinsic and Extrinsic Pathway in Human Umbilical Vein Endothelial Cells
    Authors: L.A. Silva-Torres, C. Velez and B. Zayas
    Abstract: Emerging drugs of abuse, such as xylazine (XYL), are receiving great interest due to increasing use and the potential health toxicity effects, in the addict population. XYL is an alpha two agonist without medical applications in humans.
    The Fetal Alcohol Spectrum Disorder and Homelessness Project: Making Connections for Promising Practice
    Authors: Dorothy Badry, Christine Walsh, Meaghan Bell, Kaylee Ramage and Julia Gibbon
    Abstract: The focus of this brief paper is to describe a current research project exploring the lived experiences of individuals with Fetal Alcohol Spectrum Disorder (FASD) who are supported by the homeless-serving sector in Calgary, Alberta.
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    Research Article
    Amir Faisal Mohd Khairi*, Hejar Abdul Rahman, and Sri Ganesh Muthiah
    Introduction: Drug abuse places a heavy burden on public health systems in terms of treatment, care, prevention and their health consequences.The objective of this study was to determine risk factors associated with drug abuse among Malay males FELDA settlers in Jerantut, Pahang.
    Methods: A population based unmatched case control study was conducted in FELDA settlements in Jerantut, Pahang. Cases were defined as confirmed male drug abuser aged 18 to 60 years old. Controls defined as those who had never used any drugs in their lifetime. A total of 180 cases were selected randomly from NADA list, 180 controls were selected randomly from FELDA name list. A self-administered questionnaire was used in this study. Multiple logistic regression analysis was performed using SPSS 22.0. The final model was adjusted for age groups, marital status, education level, employment status, monthly income, smoking status, alcohol consumption, peer influence, self-esteem, family structures, family involvement in drug abuse and religiosity scale.
    Results: The response rate for case is 180 (89.1%) and 180 (90.0%) for the controls. The final model has a good fit. The highest risk of drug abuse was in age group 20 to 29 years compared to age group 40 to 49 years (aOR=6.93, 95% CI=1.61, 29.83). Those who completed only until primary school had more risk of drug abuse compared to those in tertiary level of education (aOR=11.36, 95% CI=1.78, 72.55). Cigarette smoking had higher risk of drug abuse compared to non-smoker (aOR=10.56, 95% CI=3.14, 35.56). A person who had consumed alcohol had higher risk of drug abuse compared to those who had never consumed alcohol (aOR=9.14, 95% CI=3.75, 22.27). Low self-esteem increases risk of drug abuse compared to normal self-esteem individual (aOR=7.34, 95% CI=3.66, 14.72). High resistance to peer influence was a protective factor for drug abuse (aOR=0.31, 95% CI=0.16, 0.62). Individuals with family members involved in drug abuse had higher risk of being a drug abuse compared to those who had none drug abuse in the family (aOR=4.28, 95% CI=1.80, 10.17).
    Conclusion: The risk factors associated with drug abuse are lower education level, smoking, alcohol consumption, low self-esteem, young age, and having family members involvement in drug abuse. High resistance to peer influence was a protective factor for drug abuse.
    Editorial
    Brian P. Smith* and Mark J. Seamon
    The real trouble with mass casualty events is that they are thought of as events. As if there is some beginning, middle and end that play out in a logical sequence with tidy openings and closures. Little Romeo and Juliets that fragment tragedy, making the stories more digestible.
    Review Article
    Pratima Murthy* and Shree Mishra
    While smoking prevalence is showing a decline in high income countries (HIC), smoking among pregnant women has also reduced and current prevalence in certain HIC is between 8.4 to 11.4%. In low and middle-income countries (LMIC), exposure to second-hand smoke (SHS) and the use of smokeless tobacco (SLT) are significant problems. While pooled prevalence of smokeless tobacco use across 54 LMICs was 2.6%, several countries particularly in the south Asian and West Pacific region show tobacco use prevalence higher than the pooled prevalence and rates of SLT use among pregnant women in Nepal, Bangladesh and India are 22%, 20% and 15% respectively. In many countries, pregnant women face high rates of exposure to SHS. Maternal smoking is associated with several adverse consequences for both mother and child. While a range of adverse fetal outcomes have been described, the strongest causal effects are for ectopic pregnancy and orofacial clefts. With SLT use, pre-term and small for gestation have been consistently demonstrated. Meta-analytical studies support the effectiveness of psychosocial interventions for smoking cessation. The same cannot be said of smokeless tobacco use among pregnant women in LMIC. Poverty, illiteracy, use of tobacco in the partner, poor motivation to quit, stigma are some of the common barriers to treatment in all settings, and decision not to breast-feed has been shown to be associated with a greater likelihood of relapse. There is no supporting evidence for pharmacotherapy for tobacco cessation in pregnancy and there is a growing concern of the use of E-cigarettes by pregnant women under the perceived notion that they are safer. Approaches to cessation, in addition to providing individual support, must also focus on evidence-based population strategies to reduce tobacco consumption. Asking for tobacco use and tobacco exposure, objective documentation and support to quit and to reduce SHS exposure must be offered in all maternity settings.
    Case Report
    Ashley C. Smith* and Muhammad Ghazi
    Background: Alcohol withdrawal and benzodiazepine withdrawal present in similar fashions, but can be difficult to differentiate with a muddled history of polysubstance use and psychiatric disorders especially in acute settings.
    Case presentation: We report the case of a 44-year old man with history of Bipolar disorder who presented with acute onset delirium, visual and auditory hallucinations, and autonomic instability after years of heavy alcohol and benzodiazepine use. He was unresponsive to benzodiazepine therapy, yet had profound improvement with a 7-day phenobarbital taper. Unfortunately, with completion of therapy he continued to present with intermittent episodes of agitation, delirium, and persistent hallucinations. This case outlines the necessary importance of a clear historical timeline and the variability of presentation of withdrawal when confronted with polysubstance abuse. It was eventually concluded that the etiology of presentation was attributed to alcohol withdrawal syndrome with subsequent prolonged benzodiazepine withdrawal.
    Conclusions: It remains a difficult task to correctly identify alcohol versus benzodiazepine withdrawal, especially when a prior psychiatric diagnosis could be clouding clarity of diagnosis. Importance remains on a thorough history with emphasis of timeline and detailing of drug use. Benzodiazepine withdrawal can present with various symptomatic patterns with variance in timing after discontinuation of the drug.
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