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The discovery of different antimicrobial agents has revolutionized the treatment against a variety of infections for many decades, but the emergence of antimicrobial resistance require rigorous measures, even amid the coronavirus disease 2019 (COVID-19) pandemic. This retrospective study aimed to examine the consumption of antibiotics in patients with COVID-19 admitted into the five hospitals in the province of Punjab, Pakistan. We collected data on the consumption of antibiotics, classified using the World Health Organization (WHO) AWaRe (Access, Watch, and Reserve), within two months-August and September, 2020, and the corresponding months in 2019. Consumption of antibiotics was presented as daily define dose (DDD) per 100 occupied bed-days. Eight different classes of antibiotics were prescribed to patients with COVID-19 without culture tests being performed, with the prescribing of antibiotics of the Watch category was especially prevalent. The consumption of antibiotics was higher during the COVID-19 pandemic compared to the pre-pandemic period the consumption of azithromycin increased from 11.5 DDDs per 100 occupied bed-days in 2019 to 17.0 DDDs per 100 occupied bed-days in 2020, while the consumption of ceftriaxone increased from 20.2 DDDs per 100 occupied bed-days in 2019 to 25.1 DDDs per 100 occupied bed-days in 2020. The current study revealed non-evidence-based utilization of antibiotics among patients with COVID-19 admitted into the hospitals in Pakistan. Evidently, the current COVID-19 pandemic is a public health threat of notable dimensions which has compromised the ongoing antimicrobial stewardship program, potentially leading to the emergence of antimicrobial resistance among pathogens.
Contemporary energy research is becoming more interdisciplinary through the involvement of technical, economic, and social aspects that must be addressed simultaneously. Within such interdisciplinary energy research, the novel domain of energy informatics plays an important role, as it involves different disciplines addressing the socio-techno-economic challenges of sustainable energy and power systems in a holistic manner. The objective of this paper is to draw an overview of the novel domain of energy informatics by addressing the educational opportunities as well as related challenges in light of current trends and the future direction of research and industrial innovation. In this study we discuss the energy informatics domain in a way that goes beyond a purely scientific research perspective. This paper widens the analyses by including reflections on current and future didactic approaches with industrial innovation and research as a background. This paper provides key recommendations for the content ofstinguishing features.Developed by Siegfried ("Zig") Engelmann and colleagues, direct instruction (DI) has been recognized as an effective and replicable teaching model for decades. Although rooted in many principles of learning that behavior analysts utilize in daily practice, DI is not a common a component of behavior analytic services for learners with autism spectrum disorder (ASD). This may be attributed to behavior analysts' unfamiliarity with research evaluating the efficacy of DI with learners with ASD. This article synthesizes findings across studies evaluating DI with learners with ASD. The review addresses the contributions of the studies to date and identifies additional areas of research that may lead to more learners with ASD benefitting from DI.Background Down's syndrome (DS) is the most common chromosomal abnormality globally. Ireland has one of the highest rates of DS in the western world with an incidence of 1444 live births. Congenital heart disease (CHD) and pulmonary hypertension (PH) are the commonest morbidities affecting the cardiovascular system in DS. PH is associated with significant morbidity and an increase risk of mortality. The impact of the diagnosis of DS, the presence of CHD and the associated PH on myocardial function during transition and over the first 2 years of age in this population is not well defined and warrants further study. In particular, serial measurements of pulmonary pressures in this population over the first week of age are lacking. This study aims to characterise myocardial function and pulmonary haemodynamics in infants with Down syndrome during the transitional period (over the first week of age) and throughout the first two years of age. Methods A prospective, observational study utilising novel echocardiography techniques to assess myocardial function and pulmonary haemodynamics over the first two years of age in infants with Down Syndrome. A population of healthy infants without CHD or a diagnosis of DS will be recruited as controls. This study will be conducted across the three Dublin maternity units. Discussion In total, 70 babies with DS have been enrolled into this study with 292 echocardiograms performed to date. Further evaluation of cardiac performance in DS infants with and without CHD may yield more insight into the pathophysiology of cardiac dysfunction and pulmonary hypertension that are recognised features in these patients. This could aid in our ability to monitor and treat patients, as well as improve our ability to predict outcomes.
The aim was to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on access to health care among patients with scleroderma and to analyse the economic and psychosocial impacts and the infection prevention measures taken by them during the pandemic.
A 25-item questionnaire designed to assess the components of the objectives was tele-administered between October 2020 and January 2021 to the patients enrolled in the Indian Progressive Systemic Sclerosis Registry.
Of the 428 patients in the registry, 336 took part in the study. A scheduled outpatient visit was missed by 310 (92.3%) patients, and 75 (22.3%) skipped prescription drugs. During the pandemic, 75 (22.3%) had a family member lose a job. Financial difficulties were reported by 155 (46.1%), with 116 (34.5%) patients having to spend an additional INR 4000 (2000-10 000) [USD 54.9 (27.0-137.4)] to continue treatment. Although 35 patients (10.4%) had at least one symptom suggestive of COVID-19, infection was confirmed in only 4. selleckchem None of them needed hospitalization or had adverse outcomes.
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