RESUMEN

BACKGROUND: Catatonia is a psychomotor syndrome characterized by numerous clinical features, a few being stupors which is the most common sign, posturing, forced grasping, echopraxia, etc. There have been cases documented in the literature of Catatonia occurring with COVID-19. This article will focus on the complete and brief overview of catatonia observed in patients with COVID-19 infection. METHODS: We outline the evidence of the pathophysiology of COVID-19 in the CNS system, the effect of the virus in inducing catatonia, and its outcome. The literature used in the article is mostly case reports from different parts of the world thus; we have generalized our review taking into consideration multiple factors. RESULTS: In patients with COVID-19, neuropsychiatric manifestations are very commonly appreciated. Catatonia has been documented in many patients along with respiratory symptoms such as fever, shortness of breath, and cough. There are multiple etiologies associated with this presentation which have been discussed in detail in this article. In many patients, there was no history of any psychiatric illness. The timing of presenting with catatonic features was also different for different individuals. CONCLUSIONS: COVID-19 has been believed to contribute to the presentation of catatonia. There is no specific timeline between the onset of symptoms and the presence of COVID-19 infection. However, coronavirus can be responsible in a few ways for inducing catatonia in patients with or without any previous psychiatric illness. Therefore, COVID-19 should be considered as one of the major factors in this complex psychiatric disease, catatonia.

Asunto(s)

RESUMEN

Recently, the Japanese government has announced the national objective of turning the economy of Japan carbon-neutral by 2050. This declaration has therefore enhanced the imperativeness of replacing the use of unclean energy with cleaner alternatives so that the carbon-neutrality agenda can be attained in due course. Against this backdrop, this study aims to assess whether enhancing government investments in research and development for developing clean energy can help Japan curb its carbon dioxide emission figures. In addition, the analysis also controls for the environmental effects of clean electricity output, economic growth, international trade, financial globalization, and urbanization on Japan's carbon dioxide emission figures. The cointegration test results confirm long-run relationships between all these variables. Besides, the regression results showed that scaling-up research and development-related investments for clean energy development reduces carbon dioxide emissions only in the long run. Similar emission-inhibiting impacts are also evidenced to be associated with greater output of clean energy-fired electricity. Moreover, it is also observed that higher clean energy development-related investments play a mediating role in amplifying the carbon dioxide emission-reducing effects of clean electricity generation in the long run. In addition, economic growth is seen to dampen environmental quality by triggering higher emissions of carbon dioxide both in the short and long run. Simultaneously, enhancing openness to international trade and greater urbanization is found to boost the carbon dioxide emission figures of Japan. However, an influx of foreign direct investments is not observed to influence carbon dioxide emissions in Japan, neither in the short run nor in the long run. Accordingly, concerning the achievement of carbon neutrality goal by 2050, these findings emphasize the importance of boosting clean energy development-related investments, increasing clean electricity output, greening economic activities, reducing the trade of unclean commodities, adopting environmentally sustainable urbanization policies, and facilitating the influx of clean foreign direct investments within the Japanese economy.

Asunto(s)

RESUMEN

OBJECTIVE: The aim of the study was to examine the prescription pattern of antihypertensive drugs used in a secondary care hospital in the United Arab Emirates (UAE). METHODS: It was a prospective, observational study carried out in 588 adult hypertensive patients presenting to medicine outpatient and inpatient departments of Dibba Hospital, Fujairah, UAE. The study was conducted for a period of 6 months from December 2017 to May 2018. Demographic and clinical data were collected from electronic patient case records and documented. Prescriptions were studied overall for drug use details and for specific types of antihypertensive drugs. The World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose methodology was further used to calculate utilization. Statistical analysis of data was performed using Statistical Package for the Social Sciences 24.0. FINDINGS: Of the 588 study participants, majority of the patients were on two-drug combination antihypertensive therapy (n = 210, 35.5%) followed by monotherapy (n = 188, 32.1%) and three-drug combination (n = 136, 23.1%). Calcium channel blockers were the most frequently (51%) prescribed class both in monotherapy and in combination therapy while angiotensin receptor blockers and angiotensin-converting enzyme inhibitors (55.9%) were the most preferred agents for monotherapy. Among individual antihypertensive drugs, amlodipine was prescribed the most (266 prescriptions), irrespective of monotherapy or combination therapy. CONCLUSION: Our study represents the current prescribing trends of antihypertensive drugs in a secondary care hospital in the UAE. The use of antihypertensive drugs largely conforms to international guidelines, but still, there is room for improvement in terms of rational drug utilization.