Articles

Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally grounded contexts. To explore the lived experiences of Filipino adults taking antihypertensive medication. A qualitative study grounded in Heideggerian interpretive phenomenology was conducted. Ten Filipino adults diagnosed with hypertension were purposively recruited from outpatient clinics in Manila, Philippines. In-depth semi-structured interviews were transcribed verbatim and analyzed using the six-step IPA framework. Analysis revealed six interconnected themes describing how participants interpreted and sustained medication use: (1) Diagnosis as Disruption; (2) Medication as Protection and Responsibility; (3) The Paradox of the Silent Illness; (4) Everyday Barriers to Sustained Treatment; (5) Constructing Routine and Adaptive Self-Management; and (6) Family as Anchor within Cultural Contexts. These themes reflected emotional adjustment, symptom-driven adherence, financial and work-related barriers, adaptive coping strategies, and strong family-centered motivation. Medication-taking was experienced as an ongoing negotiation shaped by bodily cues, daily demands, and relational obligations. Conclusion: Antihypertensive medication use is shaped by relational, cultural, and socioeconomic contexts, underscoring the need for family-inclusive and culturally responsive hypertension care.

<b>Background:</b> Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. <b>Methods:</b> A retrospective descriptive study was conducted including all TB cases reported between 2020 and 2024. Data from the National Tuberculosis Program were analyzed for demographic characteristics, clinical form, bacteriological confirmation, comorbidities, and treatment outcomes. <b>Results:</b> Of 1,335 TB cases, 352 (26.4%) occurred in individuals aged ≥65 years. Pulmonary TB accounted for 80.7% of cases. Men represented 63.4% of patients, and 56.8% lived in urban areas. Bacteriological confirmation was achieved in 82% of pulmonary cases, and treatment success exceeded 85%. Diabetes mellitus (26.5%) and arterial hypertension (31%) were the most common comorbidities. An increase in TB cases was observed in the post-COVID-19 period. A significant association was found between age and clinical form of TB (p < 0.001). <b>Conclusions:</b> Elderly individuals constitute a substantial proportion of TB cases and frequently present with chronic comorbidities. Despite diagnostic challenges, favorable treatment outcomes were achieved, highlighting the need for integrated and early management strategies in this population.

This paper describes the current status of research on disease distress in elderly type 2 diabetic patients at home and abroad, with a view to developing targeted interventions for diabetic patients, improving self-management behavioral ability and quality of life in elderly type 2 diabetic patients, and improving patients' glycemic control.

<b>Background: </b>Dysphagia is a common functional impairment in elderly populations, often leading to severe complications such as malnutrition and aspiration pneumonia, significantly increasing healthcare burdens. Currently, effective prognostic assessment tools are lacking. The absolute lymphocyte count (ALC), a biomarker reflecting immune-nutritional status, has potential predictive value in this context, though its role in dysphagia prognosis remains unclear. <b>Methods: </b>This retrospective cohort study included 253 dysphagic patients who received percutaneous endoscopic gastrostomy (PEG) or total parenteral nutrition (TPN) between 2014 and 2017. Five patients with missing ALC were excluded. Cox regression models assessed the association between ALC and mortality. ALC was analyzed as both continuous variable (using restriocted cubic splines) and categorical tertiles, with additional threshold analyses to assess non-linearity. Kaplan–Meier survival curves and subgroup analyses were also performed. <b>Results: </b>Lower ALC was associated with poorer nutritional status, higher inflammatory markers, and greater comorbidity burden. Higher ALC was independently associated with reduced mortality (adjusted HR: 0.60; 95% CI: 0.44–0.83; <i>p</i> = 0.002). Patients in the highest tertile had significantly better survival than those in the lowest (HR: 0.37; 95% CI: 0.23–0.59; <i>P</i> < 0.001). A non-linear threshold effect was identified at ALC = 1.899×10<SUP>9</SUP>/L (<i>p</i> for non-linearity = 0.009). Kaplan–Meier analysis confirmed improved survival with higher ALC (<i>p</i> < 0.0001). Subgroup analyses showed the protective effect of higher ALC was consistent across age, sex, BMI, PEG use, and comorbidity strata, with no significant interactions. <b>Conclusions: </b>ALC is an independent, non-linear predictor of mortality in older dysphagic patients and may aid clinical risk stratification across diverse patient subgroups.

Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.

Drug shortages represent a significant and growing challenge within the pharmaceutical supply chain, with profound implications for patient care, public health, and healthcare costs. This manuscript provides a comprehensive examination of the causes and impacts of drug shortages, highlighting the multifaceted nature of this issue. Key factors contributing to shortages include manufacturing complications, limited availability of active pharmaceutical ingredients (APIs), market dynamics that discourage the production of less profitable medications, and regulatory challenges that slow down the approval process for new manufacturing capacities. The consequences of these shortages are far-reaching. Patients often face treatment delays, which can lead to adverse health outcomes, increased hospitalization rates, and even mortality. Healthcare providers experience heightened operational costs as they seek alternative therapies and manage complications resulting from inadequate treatment. Furthermore, the frequent occurrence of drug shortages erodes public trust in both the healthcare system and the pharmaceutical industry, leading to decreased patient adherence to prescribed therapies. To mitigate the impacts of drug shortages, this manuscript proposes several strategic solutions, including enhanced communication among stakeholders, diversification of supply sources, increased regulatory flexibility, and collaborative approaches between public and private sectors. Additionally, raising awareness among healthcare providers and patients regarding the causes and potential alternatives can empower stakeholders to navigate shortages effectively. Ultimately, addressing drug shortages necessitates a proactive and coordinated effort from all participants in the pharmaceutical supply chain. By implementing these strategies, stakeholders can enhance the resilience of the supply chain, ensuring that essential medications remain accessible and that patient care is not compromised. The findings of this manuscript underscore the urgent need for ongoing vigilance and collaborative action to tackle the challenges posed by drug shortages, safeguarding public health and improving healthcare outcomes globally.

Myeloproliferative neoplasms (MPNs) are hematological disorders affecting myeloid stem cells. They are classified as Philadelphia (Ph) chromosome positive-chronic myeloid leukemia, and Ph-negative polycythemia vera, essential thrombocythemia, primary myelofibrosis, chronic neutrophilic leukemia, chronic eosinophilic leukemia, juvenile myelomonocytic leukemia, and MPN unclassifiable. This review is mainly focused on the Ph-negative MPNs namely, PV, ET, and PMF. These affect both males and females with a slight male predominance, with patients mainly presenting in the seventh decade. Patients often present with thrombotic events resulting in complications that lower survival rates. The major driver mutations that have been identified in MPNs are <i>JAK2 </i>Exon 14, <i>JAK2 </i>Exon 12, <i>MPL </i>Exon 10, and<i> CALR </i>Exon 9. The importance of these driver mutations gives due recognition to their inclusion into the 2022 diagnostic criteria of the MPN WHO Classification. However, other non-driver mutations have also been reported, especially in triple-negative cases. These mutations lead to downstream constitutive activation of the JAK/STAT signaling pathway, as well as the MAPK, and PI3K/Akt pathways. Insights into the molecular pathogenesis of MPN and its association with <i>JAK2</i>, <i>CALR</i>, and <i>MPL</i> mutations have identified JAK2 as a rational therapeutic target. Thus, as an approach to MPN therapy, JAK2 inhibitors, such as ruxolitinib, have been shown to effectively inhibit JAK2, and are currently in clinical trials in combination with other drug classes. This review comprehensively examines the molecular markers of the main Ph-negative MPNs, as well as diagnosis and treatment options.

The Gambia uses the Primary Health Care model with no trauma response system. Trauma patients are transferred through multiple levels of health care facilities before definitive care hospitals. This study was conducted to identify predictors of injury factors associated with transfer. In this study, we examined characteristics of transferred patients compared to those directly admitted in definitive care hospitals. The study was conducted in two major trauma hospitals in The Gambia. 251 road traffic injury (RTI) patients were either transferred (84%) from lower-level health centers or directly admitted (16%) to one of the study hospitals. Transferred patients were more likely to have been pedestrian/bicyclists (aOR = 1.81; 95% CI = 0.86 – 3.80). Administration of antibiotics was significantly associated with direct admit than transferred patients (aOR = 6.84; 95% CI = 2.38 – 19.68). Transferred patients were more likely to receive intravenous fluid compared to direct admits (aOR = 0.03; 95% CI = 0.01 – 0.08). The study results have implications for policies and planning in the healthcare setting in The Gambia and other LMICs with similar settings. Based on the findings of this study, it is essential that hospital management teams adapt to increasing reliance of RTI patients on lower-level healthcare facilities. The study results suggest increased burden on lower-level health care facilities. Efforts and resources should focus more on supporting lower-level facilities.

Delirium is a major complication most commonly observed in patients with advanced cancer. However, despite its prevalence, the early diagnosis, management, and prevention of this condition have not seen significant progress. Aim of this research is to provide insights into the prevalence of delirium, the optimization of interventions for managing delirium symptoms, their effectiveness and the impact of underlying factors on the reversibility of delirium in advanced cancer patients receiving palliative care. The review involved systematic searches of relevant databases including MEDLINE, CINAHL, ProQuest Nursing and Allied Health, and PsychInfo using refined search terms. Eight publications out of 614 studies originally searched were selected and critically reviewed. Their quality was assessed using Joanna Briggs Institute's Critical Appraisal Tool for Case Series. Data abstraction and content analysis were performed to synthesize the findings. Delirium is prevalent among advanced cancer patients in palliative care, with rates ranging from 10.3% to 24.1%. Pharmacotherapy and non-pharmacological interventions showed effectiveness in reducing delirium symptoms. Delirium was found to be reversible through palliative care interventions, antipsychotic medications, and exercise therapy. Effective delirium management is crucial in improving the quality of life of cancer patients. This review emphasizes the importance of subtype-specific treatments, standardized guidelines, and long-term follow-up studies. Implementing evidence-based individualized approaches to delirium management can optimize treatment efficacy and clinical outcomes in patients as well as improve the quality of care. Tailored interventions, standardized protocols, and further research are hereby recommended.

<b>Introduction:</b> Cerebral venous thrombosis is a rare type of stroke caused by partial or complete occlusion of cerebral venous sinuses. Current guidelines recommend the administration of Low Molecular Weight Heparin (LMWH) during the acute phase and oral Vitamin K antagonists (VKAs) such as warfarin for 3-12 months. Direct Oral Anticoagulants (DOACs) are an attractive alternative to VKAs as therapy for CVT, for its safety and efficacy as anticoagulation therapy for deep venous thrombosis or pulmonary embolism. <b>Method:</b> This systematic review is written based on PRISMA guidelines with electronic search performed on various databases for journals published from June 1, 2018 to June 1, 2023. <b>Results:</b> We found four studies fulfilling the inclusion criteria, with four randomized controlled studies presenting 179 CVT patients treated with DOAC and 150 patients treated with standard therapy. DOACs used in reviewed studies are Dabigatran and Rivaroxaban. <b>Discussion:</b> Administration of DOACs as anticoagulation therapy in patients with CVT presents better recanalization rate with no significant differences in efficacy compared with VKAs, along with a better safety profile through similar mortality rate across two groups. <b>Conclusion:</b> DOACs as long-term anticoagulation therapy in patients with CVT has better efficacy along with a similar safety profile compared to VKA.

Background:</b> The World Health Organization (WHO) has declared COVID-19 a public health emergency of international concern. In this context, effective and affordable diagnostic procedures are essential for identifying and managing cases. Complete blood counts (CBC) are among the most common and readily available diagnostic tests. The current study aimed to evaluate the efficacy of CBC in diagnosing COVID-19 and identifying cases. <b>Patients and Methods:</b> A case-control study was conducted on 173 patients at Ain Shams University Hospitals over a period of three months. Patients were allocated into two groups according to COVID-19 PCR results: Group 1 included patients with COVID-19 positive PCR, and Group 2 included patients with COVID-19 negative PCR. <b>Results:</b> The study found that differential CBC had significant value in diagnosing COVID-19 disease. Many COVID-19 patients had lymphopenia and leucopenia compared to non-COVID-19 suspected patients. The low values of leukocytes, neutrophils, lymphocytes, and eosinophils with a CBC test were found to be valuable in the initial diagnosis of COVID-19. <b>Conclusion:</b> The definitive diagnosis of COVID-19 requires RT-PCR analysis, which is time-consuming and less accessible. Thus, the initial diagnosis and treatment of patients may be delayed. This study suggests that CBC, which is easily available and affordable, can be valuable in the early identification of COVID-19 cases, allowing for prompt treatment and management.

<b>Background</b>: <i>Pseudomonas aeruginosa </i>(<i>P</i><i>.</i><i> aeruginosa</i>)<i> </i>is one of the most common pathogens in hospital-acquired pneumonia (HAP) including ventilator-associated pneumonia (VAP). Recently, ceftolozane/tazobactam (CTLZ/TAZ) has been used to treat pneumonia due to<i> P</i><i>.</i><i> aeruginosa</i>. <b>Case series</b>: Two cases of <i>P</i><i>.</i><i> aerugi</i><i>n</i><i>osa</i> pneumonia treated by CTLZ/TAZ that had been initially treated by piperacillin/tazobactam (PIPC/TAZ) are presented. (Case 1): A 76-year-old man who underwent esophagectomy developed severe pneumonia caused by <i>P</i><i>.</i><i> aeruginosa </i>infection and received oxygen by high-flow nasal canula. PIPC/TAZ was started, and he improved 10 days later. PIPC/TAZ was switched to sulbactam/ampicillin, but on day 14, his respiratory condition worsened, and septic shock developed. <i>P</i><i>.</i><i> aeruginosa</i> was isolated from his blood, and CTLZ/TAZ was started because the isolated <i>P</i><i>.</i><i> aeruginosa</i> showed resistance to PIPC/TAZ. Although he recovered on Day 28, and CTLZ/TAZ was switched to levofloxacin, his condition worsened again, and<i> P</i><i>.</i><i> aeruginosa </i>resistant to CTLZ/TAZ was isolated from his blood on day 32. Finally, he died of septicemia and renal failure. (Case 2) A 51-year-old woman who underwent surgery for a brain tumor developed VAP due to<i> P</i><i>.</i><i> aeruginosa </i>and was treated by PIPC/TAZ. Her pneumonia improved, but pneumothorax developed, and she was therefore switched to CTLZ/TAZ on day 7. Her pneumonia improved smoothly without bacteremia 10 days later. <b>Conclusions:</b> These data and cases suggest that CTLZ/TAZ was effective for severe <i>P</i><i>.</i><i> aeruginosa</i> pneumonia although the isolated <i>P</i><i>.</i><i> aeruginosa</i> was resistant to PIPC/TAZ. However, the duration of CTLZ/TAZ administration may need to be considered for pneumonia cases with bacteremia due to <i>P</i><i>.</i><i> aeruginosa</i>.

<b>Background</b>: By rediscovering the medical field spiritual foundation, clinicians sought to balance their care and realize that spirituality is frequently associated with healthcare, thus one’s spiritual beliefs influence patients' decisions between aggressive care and complementary therapies in oncology care. <b>Aim:</b> This study investigates clinicians’ experiences and perceptions of spirituality in oncology care that clinicians can utilize to improve cancer and spiritual care provision. <b>Methods:</b> A thematic, qualitative synthesis. <b>Results:</b> Four main themes emerged from the synthesis of the 11 included studies that can steer future framework and policies to make clinicians more inept in providing care to address spiritual well-being of the patients and their family from a clinician's point of view of spirituality: “Maintaining Hope and Spiritual Wellness, Clinician’s Sensitivity to Cancer Patients, Provision of Culturally Respectful Spiritual Care, and Education in Providing Spiritual Care”. <b>Conclusion:</b> Cancer patients, cancer survivors, and clinicians’ quality of life is correlated with measures of spirituality and spiritual well-being. Spirituality also fulfill these oncologic patients has been linked to improved emotional and spiritual adjustment. <b>Implications:</b> Clinicians with different proficiencies, novice or expert, develop a strong spiritual belief can also be a strength when it comes to caring for those terminally ill patients, to be able to aid them in their sufferings. Amidst the challenges of spiritual care, these clinicians provide a patient strategy approach that is holistic to the care.

<b>Background:</b> Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients<b>. Objectives:</b><b> </b>The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. <b>Materials and Methods:</b> The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. <b>Results:</b> The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs &#x26; platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (<i>P<0.01</i>) decrease, and MCV was a significant (<i>P<0.01</i>) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (<i>P<0.05</i>) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (<i>P<0.01</i>) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (<i>P<0.01</i>) positive correlation was recorded between uric acid with platelets count. A significant (<i>P<0.05</i>) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (<i>P<0.01</i>), creatinine, and uric acid, and Hb (<i>P<0.05</i>). A significant (<i>P<0.01</i>) negative correlation was observed between blood groups with serum uric acid. A significant (<i>P<0.01</i>) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (<i>P<0.05</i>) negative correlation was recorded between durations of hemodialysis with body weight, and MCHC. <b>Conclusion</b>: It can be concluded that a higher prevalence of moderate, normocytic hypochromic anemia among hemodialysis patients. Also, results showed a significant variation in hematological parameters among the anemic hemodialysis patients. So, hemodialysis patients advice to examine the hematological parameters and treated from anemia if detected.

<b>Background:</b> Sexuality is considered to be one of the most significant markers of quality of life. This is due to the fact that sexuality is linked to ideas, feelings, behaviors, social integration, and therefore, a person's physical and mental health and well-being but with patients who have gynecologic cancers, there are significant challenges when it comes to matters of sexuality and intimacy. <b>Aim:</b> To find out how gynecological cancer affects women's sexual experiences and how they express sexuality in the context of their sickness <b>Design:</b> A qualitative synthesis, thematic approach <b>Result:</b> Nineteen (19) eligible studies centered with gynecologic cancers on sexual functioning were included with two (2) main themes emerged: (1) Issues with Sexual Experiences and (2) Physical and Emotional Burden. Many individuals were found to have one or more sexual dysfunctions, which commonly caused distress. <b>Conclusion:</b> Changes in the women’s quality of life in the sexual aspect due to their disease takes a toll not just on the physical but in other facets as well. Better knowledge and patient-centered approaches would improve gynecologic cancer patients' capacity to cope in terms of sexual functioning. <b>Implications:</b> Healthcare professionals such as oncology nurses and doctors should better understand ways to address the sexual problems of their patients following the myriad of events following their diagnosis and treatment of their gynecologic cancers.

Exercise is an important factor of rehabilitation in heart failure patients, improving several indicators of disease prognosis and functional capacity. The aim of the present study was to examine the effect of a cardiorespiratory rehabilitation program on the physical and mental fatigue, general health and anxiety in patients suffering from heart failure. Thirty-one patients with heart failure [(M±SD) age: 67.59±7.60 years] participated in a cardiorespiratory rehabilitation program. The program included aerobic exercise on cycle ergometers and muscle strengthening for 3 months (12 weeks), 3 times/week. Before and after the program, patients' fatigue, general and mental health were assessed using the following self-reported questionnaires: a) Fatigue Assessment Scale (FAS), b) Goldberg's General Health Questionnaire (GHQ-28) and c) Spielberger's Anxiety Questionnaire. Data analysis showed a statistically significant tendency of reduction in social dysfunction (from 1.99±0.42 to 1.75±0.45, p=0.05), while anxiety (from 27.10±7.61 to 26.40±4.35) showed no change (p>0.05).Also, evaluating the changes in the health level after attending the program, there was a trend of improvement in physical activity and functioning with the appearance of fewer physical symptoms (from 1.38±0.43 to 1.24±0.31, p=0,13). These results show that exercise can contribute to increasing the general well-being of these patients and reducing feelings of helplessness, making them able to cope with their daily activities and tasks.

<b>Background: </b>In December 2019, a cluster of patients with unexplained viral pneumonia was identified in Wuhan, China. Since March 11^th 2020 the WHO declared COVID 19 as a pandemic with rising number of cases all over the world. <b>Aim of the work: </b>The aim of the study was to measure the percentages of possible, probable and provisionally excluded cases among the first 500 attendants of the triage of Ain Shams University Hospital and describe their epidemiological and clinical characteristics. <b>Patients and Methods: </b>This was a retrospective descriptive case series study including the first 500 patients attending the triage of Ain Shams University Hospitals from March 29th to May 31st. A constructed questionnaire in the form of a scoring system was used and data was collected through interviewing the patients after appropriate consent. <b>Results: </b>As regard the scoring system, 72.2% of patients had new onset of cough or old worsened cough in the previous 3 days, 59.2% had sore throat and 59% had dyspnea. Out of the 500 cases 33.2% were probable, 38.2% were possible and 28.2% were provisionally excluded. <b>Conclusion: </b>COVID-19 pneumonia usually occurred at an age younger than 47 years and it was more predominant in the male gender. The most common initial clinical presentations were new dry cough or chronic cough with worsening over the last 3 days, sore throat and/or runny nose and fever. Thirty-eight percent were classified as possible COVID-19 cases, and 33% were classified as probable.

NSAIDs are aberrantly used for pain management but pain and discomforts exerted from viral infections like COVID-19, Dengue, and Chikungunya should strictly be treated according to clinical guidelines and weighing risk-benefits, among such patients.

<b>Background:</b> Neck pain is one of the most common reasons patients seek treatment in the hospital. The causes of neck pain vary widely, trigger misdiagnosis, and often result in mistreatment. Misdiagnoses and mistreatment-related neck pain diagnoses are often associated with a diagnosis of cervical herniated disc. The implication of the misdiagnosis is the use of excessive investigations and inappropriate therapy. This review aims to determine the causes of neck pain often obtained in daily practice and how to diagnose and treat it. <b>Method:</b> Search relevant articles on clinical diagnosis of neck pain with the keywords neck pain diagnostic therapy using Medline and PubMed databases. <b>Results:</b> Neck pain can be in the form of axial pain, which is mostly related to disorders of the joints and muscles of the neck, or in the form of pain in the roots and spinal cord. Investigations and therapy must be related to the clinical diagnosis of neck pain experienced by patients with a history of neck pain. <b>Conclusion:</b> Neck pain is one of the most common complaints encountered in outpatient department settings, associated with reduced quality of life. Patients may come with differing degrees of pain, various symptoms, and aetiologies making it quite challenging to treat them into complete remission. Despite being frequently encountered, some patients with neck pain are underdiagnosed and undertreated due to failure to understand the clinical symptoms before deciding possible aetiologies.