Leukocyte elastase is a marker of inflammation. Previously, a relationship was found between the severity of mental disorders in patients and elastase-like activity of blood plasma. The effect of various neurotropic drugs on leukocyte elastase activity was analyzed in an in vitro experiment. We revealed an inhibitory effect of the benzodiazepine tranquilizers diazepam and bromodihydrochlorophenylbenzodiazepine and immunomodulators aminodihydrophthalazinedione and diclofenac on the plasma elastase-like activity of healthy donors and pure human neutrophil elastase. The antipsychotics chlorpromazine and alimemazine, as well as the nootropic vinpocetine increased elastase-like activity in a dose-dependent manner. The activating effect of chlorpromazine and vinpocetine, but not alimemazine, was reproduced in neutrophil elastase. We hypothesized that these drugs can affect the development of inflammatory reactions in the complex therapy of mental disorders.

The current meta-analysis searched the literature connected to different tranquilizers used to treat elderly people and assessed it in terms of dose, types of outcomes and adverse effects, to determine a safe and acceptable tranquilizer and its optimal dose. A systematic literature review was undertaken for randomized controlled trials, case-control, retrospective and prospective studies on the use of tranquilizers in elderly patients, using PubMed, Ebsco, SCOPUS and Web of Science. PICOS criteria were used to select studies, and pertinent event data was collected. This meta-analysis includes 16 randomized control trials spanning the years 2000 to 2022, using the data from 2224 patients. The trials that were included used various tranquilizers such as diazepam, alprazolam, temazepam and lorazepam, and indicated high treatment efficacy and low adverse effects. With a p-value of 0.853 for Egger\'s test and 0.13 for Begg\'s test, the current meta-analysis shows a minimal probability of publication bias. A recent meta-analysis supports the use of tranquilizers in older people to treat sleeplessness, epilepsy or anxiety, but only at modest doses, because large doses are harmful and produce numerous withdrawal symptoms.

The present study aimed to determine the relationship of non-modifiable (rheumatoid arthritis, thyroid diseases, and arterial hypertension) and modifiable risk factors (diuretics, antidepressants, or anxiolytics tranquilizers) with the different Dry Eye Disease (DED) diagnostics in a sample adjusted by antihistamines intake.
A total of 400 participants were included in a cross-sectional study. Before a dry eye examination, participants completed an online self-administered OSDI questionnaire with six additional questions about possible DED risk factors. The Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS-II) diagnostic criteria of DED was used. Based on signs and/or symptoms, participants were divided into 4 groups: No DED, Pre-clinical DED, Predisposition to DED and DED. Since the symptom scores would have been altered by the use of antihistamines, the analysis of each outcome was adjusted for this factor, where those participants were assumed to be symptomatic.
Multivariable logistic regression found thyroid disease as a possible risk factor for DED (OR 4.53, 95 % CI 1.04-19.73; Fisher\'s exact, p = 0.044; Crameŕs V = 0.140, p = 0.024). No association was found between the studied parameters and Pre-clinical DED (Fisher\'s exact, all p ≥ 0.398; Crameŕs V, all p ≥ 0.242) or Predisposition to DED (Fisher\'s exact, all p ≥ 0.065; Crameŕs V, all p ≥ 0.031).
Participants with thyroid disease were more likely to develop DED, therefore, thyroid disease could be a risk factor for DED.

BACKGROUND: Drug abuse is a global challenge with harmful effects on health, wealth and wellbeing of nations. University students report more habitual use of marijuana, cocaine, hallucinogens and illicit drugs than noncollege students report.
OBJECTIVE: To identify the prevalence of tobacco use, alcohol and drug abuse and to identify some factors associated with drug abuse.
METHODS: A cross-sectional study recruiting 2552 students from all faculties hosted by Kafr El-Sheikh University during the academic year 2018-2019. Data were collected using a structured self-administered questionnaire.
RESULTS: The prevalence of current drug abuse was 8.9% for cigarette smoking, followed by tranquilizers (4.3%), hashish (3.6%), alcohol (2.7%), bhang (1.4%) and tramadol (1.0%). Men reported significantly greater use of cigarettes, alcohol, tramadol, hashish and bhang than women. Students of practical colleges were found to smoke cigarettes and abuse hashish significantly more than their peers in other colleges. Risk factors associated with drug abuse were mainly related to gender and college type.
CONCLUSIONS: There is a need to design and implement programmes to raise awareness and provide supportive services for prevention and management of drug abuse among university students tailored according to their needs.
تعاطي مواد الإدمان في صفوف طلاب الجامعات في مصر: معدل الانتشار والعوامل المرتبطة به.
إبراهيم كباش، عمر زيدان، شيماء سعيد.
UNASSIGNED: يعد تعاطي المخدرات تحديًا عالميًا له آثار ضارة على صحة وثروة ورفاهية الدول. أبلغ طلاب الجامعات عن تعاطي الماريجوانا والكوكايين والمهلوسات والمخدرات بشكل اعتيادي أكثر مما أفاد به الطلاب غير الجامعيين.
UNASSIGNED: هدفت هذه الدراسة إلى تحديد معدل انتشار التدخين وتعاطي الكحول ومواد الإدمان، وتحديد بعض العوامل المرتبطة بتعاطي مواد الإدمان.
UNASSIGNED: أجريت دراسة مقطعية ضمت 2552 طالبًا من جميع الكليات الموجودة في جامعة كفر الشيخ خلال العام الدراسي 2018-2019. كما جُعت البيانات من خلال استبيان منظَّم ذاتي التعبئة.
UNASSIGNED: كانت المهدئات أكثر المواد تعاطيًا (8.7٪)، يليها الكحول (6.7٪)، ثم الحشيش (6.6٪)، ثم القنب (3.0٪)، ثم الترامادول (2.4٪). كما بلغ معدل انتشار مواد الإدمان في الوقت الحالي 8.9٪ لتدخين السجائر، يليه المهدئات (4.3٪)، ثم الحشيش (3.6٪)، ثم الكحول (2.7٪)، ثم القنب (1.4٪)، ثم الترامادول (1.0٪). وكان تعاطي الرجال للسجائر والكحول والترامادول والحشيش والقنب أكبر بكثير من النساء. وتبين أن طلاب الكليات يدخنون السجائر ويتعاطون الحشيش أكبر بكثير من أقرانهم في الكليات الأخرى. وكانت عوامل الخطر المرتبطة بتعاطي المخدرات تتصل أساسًا بالجنس ونوع الكلية.
UNASSIGNED: هناك حاجة إلى تصميم وتنفيذ برامج لزيادة الوعي وتوفير الخدمات الداعمة من أجل الوقاية من تعاطي المخدرات ومعالجتها بين أوساط طلاب الجامعات، وتكون مصممة وفقًا لاحتياجاتهم.
Abus de substances psychoactives parmi les étudiants universitaires en Égypte : prévalence et corrélats.
BACKGROUND: L\'abus de drogues est un défi mondial qui a des effets néfastes sur la santé, la richesse et le bien-être des nations. Les étudiants universitaires déclarent consommer plus souvent de la marijuana, de la cocaïne, des hallucinogènes et des drogues illicites que les étudiants non universitaires.
OBJECTIVE: Déterminer la prévalence de la consommation de tabac, d\'alcool et de l\'abus de drogues et cerner certains facteurs associés à ce dernier.
UNASSIGNED: Une étude transversale a recruté 2552 étudiants de toutes les facultés à l\'Université de Kafr El- Sheikh (Égypte) pendant l\'année universitaire 2018-2019. Les données ont été recueillies au moyen d\'autoquestionnaires structurés.
UNASSIGNED: La prévalence de l\'abus de drogues au moment de l\'étude était de 8,9 % pour le tabagisme par cigarettes, suivi par les tranquillisants (4,3 %), le haschisch (3,6 %), l\'alcool (2,7 %), le bhang (1,4 %) et le tramadol (1,0 %). Les hommes ont déclaré une consommation de cigarettes, d\'alcool, de tramadol, de haschisch et de bhang significativement plus élevée que les femmes. Il a été constaté que les étudiants des facultés d\'études pratiques fumaient des cigarettes et consommaient du haschisch beaucoup plus que leurs camarades des autres facultés. Les facteurs de risque associés à l\'abus de drogues étaient principalement liés au genre et au type d\'université.
CONCLUSIONS: Il est nécessaire de concevoir et de mettre en oeuvre des programmes de sensibilisation et de fournir aux étudiants des services d\'appui adaptés à leurs besoins en matière de prévention et de prise en charge de l\'abus de drogues.

Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach\'s alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach\'s alpha = 0.79) and Attitudes towards healthcare providers (Cronbach\'s alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.

Tranquilizer misuse represents a growing international public health problem with heavy social and economic consequences. We aimed to identify the psychosocial determinants of this misuse practice, focusing on modifiable factors including knowledge and attitudes towards these medications.
A prospective cohort study involving 847 adults accompanying children in primary care clinics was carried out in Spain. A validated Knowledge, Attitudes and Practices (KAP) questionnaire on tranquilizer use was self-administered at baseline, and then participants were followed-up bimonthly. A misuse event was defined as unprescribed intake of tranquilizers, storing/sharing leftovers of tranquilizers, and/or not adhering to the prescribed treatment period, timing or dosage. Poisson regression models were applied to estimate adjusted Incidence Rate Ratios (IRRs) of misuse and their 95 % Confidence Intervals (CIs).
Individuals\' personal attitudes towards tranquilizers and treating physicians are strongly associated with the misuse of these drugs. These attitudes include: individuals\' acceptance of taking tranquilizers to improve sleeping [IRR: 5.10 (95 %CI: 2.74-9.48)], to work better [IRR: 2.04 (95 %CI: 1.05-3.99)], or for recreational purposes [IRR: 1.85 (95 %CI: 1.04-3.32)]; willingness to prolong the course of tranquilizer treatment without medical consultation [IRR: 2.45 (95 %CI: 1.46-4.13)]; agreeing on storing tranquilizers for possible future need [IRR: 5.07 (95 %CI: 2.73-9.40)]; and untrusting the physician\'s decision about tranquilizer prescription [IRR: 1.92 (95 %CI: 1.12-3.30)]. The level of knowledge is marginally associated with tranquilizer misuse.
There is a strong association between individuals\' attitudes towards tranquilizers and the misuse practices of these drugs. Educational interventional studies could help reduce the incidence of tranquilizer misuse.

UNASSIGNED: To measure the association between knowledge, attitudes and practices of personal misuse of tranquilizers among parents of schoolchildren in Beirut (Lebanon).
UNASSIGNED: We carried out a cross-sectional study in 1396 adults recruited from parents of students of eleven public and private schools, from primary schools to high schools, using a Knowledge, Attitude and Practices (KAP) questionnaire of personal use of tranquilizers.
UNASSIGNED: We assessed five patterns of tranquilizers\' misuse: unprescribed use, shortened treatment, stored leftovers, doubled forgotten doses or taken when remembered, changed dose without medical recommendation, and a sixth composite outcome: \'any misuse\'.
UNASSIGNED: Sixty-three (62.2%) of 91 parents who used tranquilizers reported at least one misuse pattern. Higher odds of \'any misuse\' were observed among parents who reported taking tranquilizers to sleep better, to enjoy themselves with their families or to work better [2.35 ≤ adjusted interquartile odds ratio (aIqOR) ≤ 1.99]. Storing tranquilizers for future need was strongly associated with misuse [aIqOR: 5.00 (95% CI: 3.30, 7.59)]. Greater awareness about hazards of tranquilizers and the importance of therapeutic compliance was associated with lower odds of specific misuse patterns (0.50 ≤ aIqOR ≤ 0.72).
UNASSIGNED: Poor knowledge and medically disapproved attitudes increase the likelihood of practices of tranquilizer misuse.

Tranquilizer misuse is insufficiently acknowledged as a public health problem despite its alarming consequences. Instruments to measure psychosocial factors related to tranquilizer misuse are lacking. We aimed to develop and validate a Knowledge, Attitude and Practice questionnaire of tranquilizer misuse by adults in Spain.
The questionnaire was designed after an extensive literature review and several meetings with experts. We assessed face and content validity, and pilot tested the questionnaire. We examined its reliability by test-retest analysis in a sample of 145 adults. We distributed the questionnaire to 879 individuals, tested the construct validity through Confirmatory Factor Analysis (CFA), measured its overall reliability and determined its acceptability.
The Item Content Validity Index (I-CVI from 0.78 to 1.00), the Scale Content Validity Index, using the averaging method (S-CVI/Ave = 0.95) and the fact that the modified Kappa statistic for each of the Knowledge, Attitude and Practice items was equal to I-CVI demonstrated the content validity of the questionnaire. The Intra-Class Correlation coefficients for Knowledge and Attitude items were > 0.5, establishing their reliability. The Knowledge and Attitude construct was modeled using CFA and the model showed a good fit, thus establishing its validity. The overall reliability of the construct was revealed by Cronbach՚s alpha values > 0.6. The questionnaire was highly accepted (response rate = 95 % and item non-response ≤ 4%).
The validity of the developed questionnaire was established. Its availability will stimulate the initiation of research on tranquilizer misuse and will consequently help in designing related public health interventions.

This paper examines the epidemiology of extra-medical use of prescription medications for sleep among a nationally representative sample of U.S. adults.
We analyzed data from the 2015-2018 National Surveys on Drug Use and Health. The sample includes 3410 U.S. adults who reported extra-medical use of prescription medications for sleep. Multinomial logistic regression models identified correlates of type of drug used [i.e., sedatives and/or tranquilizers-only (ST-only), prescription pain relievers-only (PPR-only), or sedatives, tranquilizers, and prescription pain relievers (ST + PPR)], and logistic regression models identified correlates of reasons for extra-medical use (i.e., sleep-only vs. sleep and recreational).
About 60% (95%CI = 58.9, 63.5) of the sample reported extra-medical use of ST-only, followed by PPR-only (29.9%, 95%CI = 27.5, 32.5), and ST + PPR (8.9%, 95%CI = 7.7, 10.4). Recreational use was reported by 28.4% (95% CI = 26.5, 30.4) of the sample. The odds of extra-medical use of PPR-only (aRRR = 3.1, 95%CI = 2.1, 4.5) and ST + PPR (aRRR = 1.9, 95%CI = 1.2, 3.1) as opposed to ST-only, were greater among Non-Hispanic Blacks than Non-Hispanic Whites. Compared to non-alcohol users, those with a past-12 months diagnosis of alcohol use disorder were more likely to use ST + PPR rather than ST-only (aIRR = 2.0, 95%CI = 1.1, 3.7). Non-Hispanic Blacks (aOR = 0.6, 95%CI = 0.4, 08) and individuals living in rural areas (aOR = 0.5, 95%CI = 0.3, 09) were less likely to report extra-medical use of prescription medications for recreational reasons than Non-Hispanic Whites and those residing in large metropolitan areas, respectively.
Extra-medical use of PPR-only and ST + PPR as an aid to sleep, is prevalent among Non-Hispanic Blacks, young adults, and those residing in rural areas. Most individuals reported that extra-medical use of prescription medications was primarily motivated by sleep reasons, rather than by sleep and recreational reasons. Potential interventions include access to sleep treatments, education on the effectiveness and risk associated with extra-medical use and co-use of prescription medications for sleep, and research on sleep-related disparities.

Background and Objectives: Prior research has identified that sources of prescription drugs for misuse vary based on educational attainment, which is important as certain sources are associated with adverse outcomes. The current research addressed limitations of the extant literature by creating distinct categories of push factors for high school dropout (e.g., negative school performance/experiences), pull factors for high school dropout (e.g., starting a family or getting a job), and high school graduates who did not attend college.Methods: Using data from the 2009-2014 National Survey on Drug Use and Health, prevalence of sources were estimated and design-based multivariable logistic regression investigated the association between sources and educational attainment. Additionally, multivariable logistic regression assessed the associations between sources and adverse outcomes (i.e., substance use, substance use disorders, and mental health) separately for each educational category.Results: College respondents were more likely to report \"physician\" and free from \"friend/relative\" and less likely to report \"purchased\" as sources. For most educational categories, \"purchasing\" prescription drugs was associated with adverse outcomes. Additionally, \"theft/fake\" prescription emerged as a source associated with adverse outcomes for college respondents, while \"friend/relative\" was associated with adverse outcomes for high school graduates that did not go on to college.Conclusions: This research has important clinical implications as it identified young adults with a college education as being less likely to obtain prescription drugs from sources known to be associated with adverse outcomes. It also highlighted how associations between sources and adverse outcomes vary based on educational attainment.