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ginseng against COVID-19 mediated thrombosis, the coagulation pathway and platelet aggregation. Additionally, we aimed to investigate the roles of P. ginseng against COVID-19 with the involvement of platelet-leukocyte aggregates in relation to immunity-related responses in COVID-19.
Clinical reasoning skills are a core competency that must be taught at all levels of health-care education. In the last decade, several health professional education curricula in Ethiopia have been redesigned with the goal of improving student competence in key health-care delivery skills. Despite the fact that some academic programs followed the conventional educational strategy, a significant number of academic programs adopted a new educational strategy for curriculum development Student-centered, Problem-based, Integrated, Community-based, Elective, and Systematic (SPICES) model. More empirical evidence, however, is required to determine whether the new curricular approach is effective in improving students' clinical reasoning. The purpose of this study is to determine whether the new educational strategy for curriculum development improves the clinical reasoning ability of midwifery students when compared to a peer institution that follows a traditional curriculum.
A comparative cross-sectional studyills of Midwifery students in managing PPH.
Our study found that the new SPICES model curricular approach is promising in fostering the development of clinical reasoning skills of Midwifery students in managing PPH.
Large-scale natural disasters have an enormous physical and mental impact, immediately after they occur, on people living near the central disaster areas. It is known that, in the early stages, a seismic disaster triggers high rates of symptoms for insomnia, depression, and anxiety. However, little information is available about their medium- to long-term clinical outcomes. In this study, we conducted a repeated cross-sectional nationwide questionnaire survey to clarify changes in the prevalence of insomnia and its background factors after the Great East Japan Earthquake, a huge earthquake with a moment magnitude of 9.0 that occurred on March 11, 2011.
We conducted a repeated cross-sectional survey in November 2009 (pre-earthquake, 1224 participants), July 2011 (4 months post-earthquake, 1259 participants), and August 2012 (18 months post-earthquake, 1289 participants) using stratified random sampling from 157 Japanese sites.
Compared to 2009, the prevalence of insomnia statistically increased nationwider, individuals with insomnia were more likely to experience psychological distress after the earthquake that continued until 2012.
This study demonstrated that the prevalence of insomnia was significantly higher after the earthquake. Moreover, individuals with insomnia were more likely to experience psychological distress after the earthquake that continued until 2012.
HIV clients' mistrust in providers' handling of their medical information can be a reason for them not to utilize services. Compromised confidentiality of HIV clients can affect the entire community, as other people may become reluctant to seek HIV testing and counseling. In Ethiopia, there are few data on perceived breaches of confidentiality among HIV/AIDS clients. Thus, this study aimed to assess perceived breaches of confidentiality and associated factors among people living with HIV (PLHIV) on anti-retroviral therapy (ART) at Nekemte Specialized Hospital, Western Ethiopia.
A facility-based cross-sectional study was conducted among 423 HIV/AIDS clients at Nekemte Specialized Hospital from January 15 to February 20, 2021. Data were collected by an investigator-administered questionnaire. Collected data were entered into EpiData version 3.1, and Stata version 14.0 was used for analysis. Bivariable and multivariable logistic regression analyses were performed. VH298 Variables with a
-value of <0.2 in the e on the type of care and information they want need to be strengthened in order to reduce breaches of confidentiality.
One in four HIV/AIDS clients reported experiencing perceived breaches of confidentiality. Thus, early ART initiation, further HIV serostatus disclosure, and encouraging patients to decide on the type of care and information they want need to be strengthened in order to reduce breaches of confidentiality.
There are currently no methods for the treatment of reversible drug-resistant EGFR-TKI lung cancer in the clinical setting, and thus, the patients finally return to the currently used drugs. This study aimed to compare the efficacy of chemotherapy alone and gefitinib combined with chemotherapy in the treatment of non-small cell lung cancer (NSCLC) patients in advanced stage with the mutation of epidermal growth factor receptor (EGFR).
A retrospective analysis was carried out on 120 patients with advanced EGFRm+ NSCLC who were divided into the control group (CG, received chemotherapy alone) or the observation group (OG, received chemotherapy and gefitinib) according to the treatment methods.
Comparison of the objective response rates (ORRs) showed no statistical significant difference between OG (36.92%) and CG (29.09%, P > 0.05), whereas in OG, disease control rate (DCR) was significantly increased in comparison with CG (P < 0.05). The medians of progression-free survival (PFS) and overall survival (OS) in OG were 8.0 months and 24.0 months, respectively, which were longer than 5.0 months and 18.0 months in CG (P = 0.031). The univariate analysis revealed that clinical stage of tumor (HR = 1.590, 95% CI 1.097-2.343) was the prognostic factor for advanced lung cancer. Multi-factor Cox regression analysis revealed that clinical analysis was an independent prognostic factor (HR = 1.701, 95% CI 1.099-2.632).
In PFS patients, the OS rate was significantly improved, which was worth for clinical use.
In PFS patients, the OS rate was significantly improved, which was worth for clinical use.
The triglyceride-glucose (TyG) index, a widely accessible measure, has been a surrogate indicator of peripheral insulin resistance, and its clinical importance continues to grow in East Asia. We hypothesized that the TyG index is relevant to subclinical white matter hypersensitivities (WMHs) of presumed vascular origin among community-dwelling Koreans.
We investigated the relationship between the TyG index and WMHs on brain magnetic resonance imaging scans in 2417 Koreans over 45 years of age without a history of cancer, stroke, or ischemic heart disease. The study population was divided into four groups according to the TyG index quartiles. Using multiple logistic regression analysis, we assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for WMHs across the TyG index quartiles.
The prevalence of WMHs was significantly higher in the fourth TyG index quartile, with an overall rate of 9.3%. After adjusting for potential confounding variables, the ORs of WMHs for the TyG index quartiles were 1.00, 1.47 (95% CI, 0.91-2.40), 1.76 (95% CI, 1.05-2.97), and 6.79 (95% CI, 3.85-1.54), respectively.
We found that higher TyG index values were associated with the brain's WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.
We found that higher TyG index values were associated with the brain's WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.
Acute pancreatitis (AP) is a multifactorial disease that is associated with substantial morbidity and mortality. Thrombosis and inflammation are involved in the development and progression of AP.
To develop and validate a novel and simple scoring system for predicting 28-day adverse outcomes in AP patients based on a thrombotic and an inflammatory biomarker.
A single-center, retrospective cohort study was used to establish the new scoring system (thrombo-inflammatory prognostic score; TIPS), and another study was used to verify it. The study end points were 28-day mortality, requirement for mechanical ventilation (MV), persistent organ failure (POF), and admission to the intensive care unit (AICU). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the TIPS. The performance of the TIPS was compared with that of conventional predictive scoring systems. Logistic regression models were used to investigate the relationship between the TIPS and the different end points.
Among 440 patients with AP in the derivation group, 27 patients died within the 28-day follow-up period. Prothrombin time (PT) and interleukin-6 (IL-6) were used to calculate the TIPS. The TIPS (AUC=0.843) showed a performance comparable to that of the more established APACHE II (AUC=0.841), SOFA (AUC=0.797), BISAP (AUC=0.762), and Balthazar CT (AUC=0.655) in predicting 28-day mortality in AP. The 28-day mortality and the incidence of MV, POF, and AICU were significantly higher among patients with a higher TIPS (
<0.001). The results of logistic regression analyses indicated that the TIPS was independently associated with the risks of 28-day mortality, AICU, MV and POF.
The TIPS can enable prediction of 28-day adverse clinical outcomes with AP patients in the ED.
The TIPS can enable prediction of 28-day adverse clinical outcomes with AP patients in the ED.Asthma is a chronic respiratory disease characterized by chronic airway inflammation and airflow obstruction. Up to ten percent of asthmatics have severe asthma, and many remain uncontrolled despite optimal medical management. With our increased understanding of the heterogeneity of asthma and its complex pathophysiology, several biomarkers have been developed and in the recent past, several biologic therapies for severe asthma have been developed and are now in widespread use. Although these biological agents have shown great benefit in treating severe asthma, not all patients respond equally well, and some do not derive any benefit. As much of the current literature of these medications have not assessed biomarkers or have used different cutoffs, it is often challenging to decide the best medication for an individual patient. Here, we review common asthma subtypes, current available biologic therapies for asthma, the clinical application of currently available type 2 biomarkers, as well as summarizing the evidence on how patient characteristics and biomarkers can help with choosing the optimal biologic for a patient that has the highest likelihood of success.
Diabetes is a documented risk factor for peripheral neuropathy. It was reported that associated hypertension could increase this risk. The present study aimed to assess the effect of hypertension and diabetes on median nerve using high-resolution ultrasound.
The study includes 50 hypertensive patients (HTN group), 50 diabetic patients (DM group), 50 patients with coexisting diabetes and hypertension (HTN + DM group) and 50 healthy controls. Median nerve affection in the studied groups was studied by vibration perception thresholds (VPT). The median nerve cross-sectional area was determined at the nerve cross-sectional area of the median nerve at the carpal tunnel by high-resolution ultrasound. Clinical symptoms were assessed using Toronto Clinical Severity Score (TCSS).
There was significantly higher median nerve CSA in all patient groups in comparison to controls. HTN + DM group had significantly higher median nerve CSA when compared with DM group. Patients with peripheral neuropathy in HTN + DM and DM groups had significantly higher median nerve CSA than patients without.
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