Tag: nevin manimala

Altern Ther Health Med. 2023 Sep 15:AT9043. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the use of antimicrobial drugs in patients during the COVID-19 pandemic.

METHODS: We searched for literature about antimicrobial treatment in COVID-19 patients through the Cochrane Library, Embase, PubMed, the Chinese biomedical literature database, CNKI, the Chinese journal full-text database, Wanfang, and Vipu. The quality evaluation of the literature was performed by Jadad’s quality score.

RESULTS: A total of three articles reported on ivermectin treatment in patients with COVID-19, and the Meta-analysis showed no clinical and statistical heterogeneity among the studies (I2 = 15%, P = .31), a fixed effect model was used to incorporate effect sizes. The clinical effect of the observed group was not different from the control group (P = .16). None of the three ivermectin articles with clinical effect as the effect indicator showed a significant difference (P > .05), suggesting no publication bias. A total of four publications reported the treatment with azithromycin in patients with COVID-19, and the Meta-analysis showed no clinical and statistical heterogeneity between the studies (I2 = 0%, P = .88), using a fixed-effect model to incorporate the effect sizes. The clinical effect of the observed group was not different from the control group (P = .57). None of the four azithromycin articles with a clinical effect as the effect index was statistically significant (P > .05), suggesting no publication bias.

CONCLUSION: During the COVID-19 pandemic, the patient’s use of antibiotics does not significantly improve clinical efficacy, so antibiotic use is recommended only for patients with complicated bacterial infections.

PMID:37708540

Altern Ther Health Med. 2023 Sep 15:AT8421. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigated the effectiveness of a technique for eliminating cloudiness and managing liver function in treating liver fibrosis/cirrhosis associated with the Hepatitis B virus (HBV).

METHODS: From January 2022 to January 2023, the researchers’ hospital treated 200 patients with HBV-related liver fibrosis/cirrhosis. These patients constituted two groups for the study: the control group, consisting of 100 cases who received routine treatment, and a study group, consisting of 56 cases who received treatment with a combination of turbidity removal and liver regulation, in addition to the standard treatment given to the control group. The researchers then compared factors such as liver function, level of liver fibrosis, liver stiffness measurement (LSM), and renal function between the two groups. Additionally, the researchers assessed the effectiveness of those treatments and any adverse reactions that may have occurred.

RESULTS: The study group demonstrated significantly higher clinical effectiveness than the control group after undergoing treatment, with statistical significance (P < .05). Post-treatment, both groups experienced lower GGT, ALT, and AST levels than their pre-treatment levels. Additionally, the study group had higher AIB levels than their pre-treatment levels. There was a statistically significant difference between the study and control groups regarding these biomarkers (P < .05), as the study group exhibited lower GGT, ALT, AST, TBIL levels and higher AIB levels. Furthermore, both groups displayed decreased HA, IV-C, PC III, and LN levels post-treatment compared to their pre-treatment values. The study group had significantly lower HA, IV-C, PC III, and LN concentrations than the control group (P < .05). Regarding LSM measurements after treatment for both groups, while there was a decrease in LSM values from their respective pre-treatment readings for each group, no significant difference was observed between them (P < .05). Moreover, the incidence of adverse reactions experienced by individuals in the study group following treatment was significantly lower than that of individuals in the control group (P < .05).

CONCLUSION: Treatment based on removing turbidity and regulating the liver can effectively relieve the clinical symptoms of patients with HBV-related liver fibrosis/cirrhosis, promote the liver function to return to normal, relieve the degree of liver fibrosis, and reduce the LSM value. The curative effect is significant and worthy of clinical application.

PMID:37708539

Altern Ther Health Med. 2023 Sep 15:AT8221. Online ahead of print.

ABSTRACT

OBJECTIVE: The present investigation aims to conduct a comprehensive examination of the infection prevention and control efforts in hospitals of Xinjiang Production and Construction Corps designated for COVID-19 treatment.

METHODS: By searching the Cochrane Library, PubMed, Embase, Chinese Academic Journal, Full Text Database, Chinese Biomedical Literature Database (CBM), VIP Chinese Scientific, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database (CECDB), and using Review Manager 5.2 software, the quality assessment, data extraction, and meta-analysis were carried out for the included literature.

RESULTS: Between both the experimental and the control groups, there was a statistically significant difference in the level of public awareness of COVID-19 prevention and control [OR = 1.61, 95% confidence interval (CI) (1.31, 1.99), P < .00001, I2 = 32%, Z = 4]; public concern about COVID-19 prevention and control [OR = 1.56, 95% CI (1.28, 1.90), P < .0001, I2 = 0%, Z = 4.35]; public anxiety on COVID-19 prevention and control [OR = 1.67, 95% CI (1.37, 2.03), P < .00001, I2 = 32%, Z = 5.13].

CONCLUSION: Chinese prophylaxis and controlling measures for COVID-19 are mainly to protect vulnerable populations, cut off transmission routes, and control the source of infection. Therefore, we must also do our best to prevent and control novel coronavirus pneumonia to protect our health and reduce the burden on our country.

PMID:37708537

J Speech Lang Hear Res. 2023 Sep 14:1-21. doi: 10.1044/2023_JSLHR-22-00742. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to examine quality of life (QOL) and its relation to language skills in children with developmental language disorder (DLD). This was examined by comparing QOL to a control group of children with typical development (TD), as well as children with cochlear implants (CIs), who potentially struggle with language for language, although for a different reason than children with DLD.

METHOD: Two groups of children, a group with TD (n = 29) and a group of children with CIs (n = 29), were matched to the DLD group (n = 29) on chronological age, gender, nonverbal IQ, and parental educational level through a propensity matching procedure. A third group consisting of children with CIs was also matched to the DLD group but additionally matched on language abilities. QOL scores were compared across groups, and the association between language skills and QOL was examined in the DLD group.

RESULT: The DLD group was reported by parents to have statistically significantly poorer QOL scores than peers with TD or CIs. When controlling for language skills, either statistically or through an additional CI group matched on language abilities, there were no statistically significant differences in QOL scores across groups. In the DLD group, language skills explained 16% of the variation in QOL.

CONCLUSION: DLD is associated with the children’s overall QOL, and the degree of reduced QOL relates to the severity of the language impairment.

PMID:37708514 | DOI:10.1044/2023_JSLHR-22-00742

Obstet Gynecol. 2023 Sep 14. doi: 10.1097/AOG.0000000000005368. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether a community-informed, language-concordant postpartum video education campaign, developed with community input, improves patients’ knowledge of warning signs for postpartum maternal mortality (infection, hemorrhage, hypertensive disorders, and postpartum depression) compared with routine discharge procedures.

METHODS: A single-center, investigator-blinded, parallel-group randomized controlled trial of postpartum individuals who delivered at a large, urban, tertiary care hospital. Eligible participants were enrolled and completed a baseline knowledge questionnaire. After delivery, they were randomized to routine discharge education (control) or routine education plus video education (intervention). After discharge education, patient knowledge was again assessed in both groups before participants left the hospital. The primary outcome was the percentage of participants who showed improvement in their knowledge, measured by the number of correct questionnaire responses after education compared with their baseline, assessed as a binary outcome. A sample size of 150 (75 per group) was planned to detect a 25% absolute increase in the frequency of the primary outcome.

RESULTS: From July to August 2022, 296 participants were screened and 200 were randomized (100 per group). Eighty-two percent of participants had college or graduate education, and 71.5% had commercial insurance. There was no significant difference in baseline characteristics. There was no statistically significant difference in the percentage of participants who improved their scores between the baseline and posteducation questionnaires (64.5% vs 50.0%, P=.09). However, the median posteducation questionnaire total score was significantly higher in the video education group (14 [interquartile range 12-15] vs 13 [interquartile range 12-14], P=.003). In addition, they more frequently reported that video education was “very helpful” (83.9% vs 72.5%, P=.23) and that they were “very satisfied” with their education (86.1% vs 75.5%, P=.29).

CONCLUSION: Enhanced postpartum education through a novel video did not result in a statistically significant difference in frequency of improved score on the posteducation questionnaires but was associated with increased satisfaction with care.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT05159726.

PMID:37708502 | DOI:10.1097/AOG.0000000000005368

Epidemiology. 2023 Sep 12. doi: 10.1097/EDE.0000000000001664. Online ahead of print.

ABSTRACT

The analysis of time series studies linking daily counts of a health indicator with environmental variables (e.g., mortality or hospital admissions with air pollution concentrations or temperature; or motor vehicle crashes with temperature) is usually conducted with Poisson regression models controlling for long-term and seasonal trends using temporal strata. When the study includes multiple zones, analysts usually apply a two-stage approach: first, each zone is analyzed separately, and the resulting zone-specific estimates are then combined using meta-analysis. This approach allows zone-specific control for trends. A one-stage approach uses spatio-temporal strata and could be seen as a particular case of the case-time series framework recently proposed. However, the number of strata can escalate very rapidly in a long time series with many zones. A computationally efficient alternative is to fit a conditional Poisson regression model, avoiding the estimation of the nuisance strata. To allow for zone-specific effects, we propose a conditional Poisson regression model with a random slope, although available frequentist software does not implement this model. Here, we implement our approach in the Bayesian paradigm, which also facilitates the inclusion of spatial patterns in the effect of interest. We also provide a possible extension to deal with overdispersed data. We first introduce the equations of the framework and then illustrate their application to data from a previously published study on the effects of temperature on the risk of motor vehicle crashes. We provide R code and a semi-synthetic dataset to reproduce all analyses presented.

PMID:37708493 | DOI:10.1097/EDE.0000000000001664

Epidemiology. 2023 Sep 4. doi: 10.1097/EDE.0000000000001670. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying community characteristics associated with firearm assault could facilitate prevention. We investigated the effect of community firearm dealer and alcohol outlet densities on individual risk of firearm assault injury.

METHODS: In this density-sampled case-control study of Californians, January 2005 – September 2015, cases comprised all residents with a fatal or nonfatal firearm assault injury. We sampled controls monthly from the state population, 4:1 with cases. Exposures were monthly densities of county-level pawn and non-pawn firearm dealers and ZIP code-level off-premises alcohol outlets and bars and pubs (“bars/pubs”). We used case-control-weighted g-computation to estimate risk differences (RD) statewide and among younger Black men, comparing observed exposure densities to hypothetical interventions setting these densities to low. We estimated additive interactions between firearm and alcohol retailer density. Secondary analyses examined interventions targeted to high exposure density or outcome burden areas.

RESULTS: There were 67,850 cases and 268,122 controls. Observed (vs. low) densities of pawn firearm dealers and off-premises alcohol outlets were individually associated with elevated monthly risk of firearm assault per 100,000 people (RDpawn dealers: 0.06, 95% CI: 0.05, 0.08; RDoff-premises outlets: 0.01, 95% CI: 0.01, 0.03), but non-pawn firearm dealer and bar/pub density were not; models targeting only areas with the highest outcome burden were similar. Among younger Black men, estimates were larger. There was no interaction between firearm and alcohol retailer density.

CONCLUSIONS: Our results are consistent with the hypothesis that limiting pawn firearm dealer and off-premises alcohol outlet densities can reduce interpersonal firearm violence.

PMID:37708491 | DOI:10.1097/EDE.0000000000001670

N Z Med J. 2023 Sep 15;136(1582):64-86.

ABSTRACT

AIMS: Routinely collected health data can provide rich information for research and epidemiological monitoring of different diseases, but using the data presents many challenges. This study aims to explore the attitudes and preferences of people aged 55 and over regarding the use of their de-identified health data, and their concerns and comfort in different scenarios.

METHODS: An anonymous online survey was conducted with people aged 55 and over currently engaged with health services in a New Zealand health district during June-October 2022. The survey could be completed online or by telephone and was available in eight languages.

RESULTS: Seventy-nine percent of respondents knew that their health information was currently being used in the ways described in the scenarios, and between 80-87% felt comfortable or very comfortable with their data being used as described in the scenarios. In contrast, 4% (n=9) felt “uncomfortable” or “very uncomfortable” across all of the scenarios. Participants expressed concerns about data accuracy, privacy and confidentiality, security, transparency of use, consent, feedback and the risk of data being sold to commercial companies. Some participants identified situations where permission should be required to link data, including being used by people other than health professionals, containing sensitive health issues, or being used for commercial purposes.

CONCLUSION: This study finds general support from patients for the use of their routinely collected data for secondary purposes as long as its use will benefit the population from which the data are taken. It also highlights the necessity of including the perspectives of different cultures in the collection, storage, use and analysis of health information, particularly concerning Māori cultural considerations.

PMID:37708487

N Z Med J. 2023 Sep 15;136(1582):14-27.

ABSTRACT

AIMS: Non-traumatic dental presentations (NTDPs) commonly present to emergency departments (EDs) and may receive orthopantomograms (OPGs, plain X-rays), opiates and antibiotics. “Choosing Wisely” is an international healthcare campaign that aims to reduce unnecessary and low-value patient care. This study aims to identify low-value management of NTDPs.

METHODS: Presentations to the Christchurch Hospital ED with dental pain or dental abscess in 2020 were included. Data collected included patient demographics, management and discharge medications. Descriptive statistics were calculated.

RESULTS: There were 931 NTDPs during the study period, with over-representation of young adults, Māori, Pacific Peoples and those living in high-deprivation areas. Of these, 343 (37%) received an OPG, of which 24% (83) were considered low value. Of patients managed by ED staff who were not referred to specialist dental services, 258 (42%) were prescribed antibiotics, of whom only half had facial swelling, and 71% received a script for analgesia, of which 78% included an opiate. Seventy-three percent of patients presented outside of normal working hours. Fewer than one in five NTDPs received definitive treatment.

CONCLUSIONS: NTDPs may receive non-optimal management in EDs. Continuing to care for NTDPs in this environment may add to increased healthcare costs, access block and poor opioid and antimicrobial stewardship.

PMID:37708483

JCO Oncol Pract. 2023 Sep 14:OP2300242. doi: 10.1200/OP.23.00242. Online ahead of print.

ABSTRACT

PURPOSE: Prime childbearing years occur during medical training and early career, leaving physicians with tough choices between family planning and career growth. Restrictive workplace parental leave (PL) policies may negatively affect physician well-being. We evaluate existing PL and lactation policies, as well as return-to-work experiences, among oncology trainees and early-career faculty.

METHODS: An anonymous 43-question cross-sectional survey was distributed via e-mail and social media channels between May and June 2021 to oncology trainees and physicians within 5 years of terminal training in the United States. The survey was administered through SurveyMonkey. Descriptive statistics were used to analyze data. Two hundred seventy-five participants were recruited via social media and outreach to program directors and coordinators in adult hematology/oncology and radiation oncology program directors.

RESULTS: The average duration of PL was <6 weeks for most participants. Among those who used PL, 50% felt pressured to work while on PL, 60% felt guilty asking coworkers for help, and 79% were overwhelmed with demands of work and home, whereas only 27% had resources available at workplace to assist with transition back to work. Among those who breastfed at return to work, 31% did not have access to a lactation room, 56% did not have adequate pumping breaks, and 66% did not have pumping breaks mandated in contract.

CONCLUSION: Our findings underline the immense magnitude of problems surrounding inadequate PL and support for lactating mothers among trainees and early-career physicians in oncology subspecialities. Policies and practices around PL and lactation should be restructured to meet the needs of the evolving oncology workforce.

PMID:37708434 | DOI:10.1200/OP.23.00242