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1.
Med J Malaysia ; 79(1): 74-79, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38287761

RESUMO

INTRODUCTION: Salmonella typhi could infect the intestinal tract and the bloodstream or invade body organs and secrete endotoxins. It is endemic in developing countries. It is increasingly evolving antimicrobial resistance to several commonly used antimicrobial agents. MATERIALS AND METHODS: A cross-sectional study was done at Iraqi Communicable Disease Control Center, where all confirmed cases of Salmonella typhi are reported, for a period 2019-2021. All demographic, epidemiological and clinical characteristics of patients, comorbidities, type of samples, distribution of S. typhi by age and gender, time distribution in each year and profile of bacterial resistance and sensitivity to antibiotics were gathered and analysed. RESULTS: Most samples were taken from blood. The mean age of cases during 2019, 2020 and 2021 was 18.7 ± 6.5, 17.7 ± 14.1 and 17.3 ± 12.8. Males constituted 56.7%, 58.5% and 39.8%, respectively. Some cases had comorbidities. Most cases had headache and fever. Some of them had nausea, diarrhoea, vomiting and epigastric pain. The age and sex were significantly associated with years of reporting. The most months of case reporting were June-July (2019 and 2021), Jan. -Feb. (2020). There was an obvious increase in S. typhi resistance to ceftriaxone (92.2%, 86.1%, 88.8%) and ampicillin (77.1%, 76.9%, 81.27%). There was a gradual increase in sensitivity to tetracycline (83.1%, 88.1%, 94%), cotrimoxazole (86.7%, 86.1%, 92.2%), ciprofloxacin (78.3%, 90.1%, 87.8%) and cefixime (77.7%, 72.3%, 72.7%). CONCLUSIONS: There was a sharp rise in resistance rates of the S. typhi in Iraq (during 2019-2021) to ceftriaxone and ampicillin, while there were highest sensitivity rates to imipenem, aztreonam and chloramphenicol. The following recommendations were made: (1) Improvement of general hygiene and food safety measures. (2) Emphasis on vaccination and surveillance of Salmonella infection. (3) Rational use of appropriate antibiotics through implementation of treatment guidelines. (5) Educate communities and travelers about the risks of S. typhi and its preventive measures.


Assuntos
Febre Tifoide , Masculino , Humanos , Febre Tifoide/tratamento farmacológico , Febre Tifoide/epidemiologia , Febre Tifoide/microbiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Iraque/epidemiologia , Estudos Transversais , Prevalência , Farmacorresistência Bacteriana , Testes de Sensibilidade Microbiana , Salmonella typhi , Ampicilina/uso terapêutico
2.
J Chem Phys ; 149(16): 164710, 2018 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-30384711

RESUMO

We present an extended metal-coordinated structure obtained by deposition of trimesic acid (TMA) onto the Ag(111) surface under ultra-high vacuum conditions followed by annealing to 510 K. Scanning tunneling microscopy and density functional theory calculations reveal the structure to consist of metal clusters containing seven Ag atoms each, coordinated by six dehydrogenated TMA molecules. The molecules are asymmetrically arranged, resulting in a chiral structure. The calculations confirm that this structure has a lower free energy under the experimental conditions than the hydrogen-bonded structures observed after annealing at lower temperatures. We show that the formation of such large metal clusters is possible due to the low adatom formation energy on silver and the relatively strong Ag-O bond in combination with a good lattice match between the structure and the Ag surface.

3.
Int J Health Plann Manage ; 33(2): e464-e473, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29380909

RESUMO

BACKGROUND: The shortage of nursing staff is a national and international issue. Inadequate number of hospital nurse staff leads to poor health care services. Yet the effects of patient-centeredness between the relationships of nursing shortage on the quality of care (QC) and patient safety (PS) have not been explored. The aim of this study was to examine the mediating effects of patient-centeredness on the relationship of nursing shortage on the QC and PS in the Medical and Surgical Wards, in Malaysian private hospitals. METHOD: A descriptive, cross-sectional study was carried out on 12 private hospitals. Data was gathered, through a self- administered questionnaire, from 652 nurses, with a 61.8% response rate. Stratified simple random sampling was used to allow all nurses to participate in the study. Hayes PROCESS macro-regression analyses were conducted to explore the mediating effects of patient-centeredness on the relationships of hospital nurse staffing on the QC and PS. RESULTS: Patient-centeredness mediated the relationships of hospital nurse staffing on both the QC (F = 52.73 and P = 0.000) and PS (F = 31.56 and P = 0.000). CONCLUSION: Patient-centeredness helps to mitigate the negative associations of nursing shortage on the outcomes of care. The study provides a guide for hospital managers, leaders, decision-makers, risk managers, and policymakers to maintain adequate staffing level and instill the culture of patient-centeredness in order to deliver high quality and safer care.


Assuntos
Recursos Humanos de Enfermagem Hospitalar/provisão & distribuição , Avaliação de Resultados em Cuidados de Saúde , Assistência Centrada no Paciente , Adulto , Estudos Transversais , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Análise de Regressão , Adulto Jovem
4.
Ann Ig ; 30(2): 162-172, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29465153

RESUMO

BACKGROUND: Ships have long been sites for outbreaks of infectious diseases, particularly gastrointestinal diseases. The ship environment has the potential to facilitate the spread of such diseases, infecting susceptible cohorts of embarked passengers and crew. Gastrointestinal disorders among seafarers are fairly common and usually represent the first or second cause of requests for medical assistance aboard ships in international waters. STUDY DESIGN: The purpose of this study was to evaluate food safety and the level of knowledge among food service personnel on board merchant ships, where food handlers could be a cause of health problems for all crew members. METHODS: An anonymous self-administered questionnaire containing specific questions about food hygiene and safety knowledge was administered. RESULTS: The overall score of correct answers for the food safety aspects tested was 51.77 (SD 3.87) out of 76 points, corresponding to 68.12% of questions answered correctly. Food workers who followed a training course showed higher mean knowledge score (p < 0.05) compared to not-trained workers. The most relevant significant differences (p < 0.05) were noticeable in the personal hygiene, cross-contamination, safe storage, and knowledge of foodborne pathogens sections. CONCLUSION: Food services staff on board cargo ships should be adequately trained and should understand basic and fundamental aspects of food hygiene, related pathologies and sanitation, as they are responsible for the health and wellbeing of many seafarers.


Assuntos
Inocuidade dos Alimentos , Serviços de Alimentação , Conhecimentos, Atitudes e Prática em Saúde , Navios , Adulto , Feminino , Humanos , Higiene , Masculino , Pessoa de Meia-Idade , Autorrelato , Adulto Jovem
5.
Magn Reson Med ; 71(2): 783-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23441013

RESUMO

PURPOSE: To demonstrate the feasibility of direct virtual coil (DVC) in the setting of 4D dynamic imaging used in multiple clinical applications. THEORY AND METHODS: Three dynamic imaging applications were chosen: pulmonary perfusion, liver perfusion, and peripheral MR angiography (MRA), with 18, 11, and 10 subjects, respectively. After view-sharing, the k-space data were reconstructed twice: once with channel-by-channel (CBC) followed by sum-of-squares coil combination and once with DVC. Images reconstructed using CBC and DVC were compared and scored based on overall image quality by two experienced radiologists using a five-point scale. RESULTS: The CBC and DVC showed similar image quality in image domain. Time course measurements also showed good agreement in the temporal domain. CBC and DVC images were scored as equivalent for all pulmonary perfusion cases, all liver perfusion cases, and four of the 10 peripheral MRA cases. For the remaining six peripheral MRA cases, DVC were scored as slightly better (not clinically significant) than the CBC images by Radiologist A and as equivalent by Radiologist B. CONCLUSION: For dynamic contrast-enhanced MR applications, it is clinically feasible to reduce image reconstruction time while maintaining image quality and time course measurement using the DVC technique.


Assuntos
Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Armazenamento e Recuperação da Informação/métodos , Angiografia por Ressonância Magnética/métodos , Interface Usuário-Computador , Algoritmos , Estudos de Viabilidade , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
6.
Avicenna J Med Biotechnol ; 16(3): 187-192, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39132632

RESUMO

Background: Brucellosis vaccines are designed to induce cellular immunity. An effective brucellosis vaccine could induce both cellular and humoral immunity. Serum Bactericidal Assay (SBA) is an important method for determining vaccine humoral immunity. This study is the first to observe humoral immunity in brucellosis by SBA. Methods: Extracted Brucella abortus (B. abortus) Lipopolysaccharide (LPS) and Outer Membrane Proteins (OMPs) were injected into rabbits. Group 1 was injected with 25 µg of LPS, Group 2 was injected with 50 µg of OMPs, and Group 3 was injected with 1 ml of combined vaccine, 3 times every 2 weeks. The groups were challenged with B. abortus 544 in the second injection. Sera were separated 2 weeks after the last injection. SBA was performed, and each well was streak-cultured into a plate of Brucella agar. A colony count was done for each plate. Results: Results have shown, the third injection of the combined vaccine had the highest titer of 1 64 , and the efficacy of the vaccine was 87.71%. Conclusion: As a conclusion, the results of this study showed that LPS and OMP's from B. abortus can provide acceptable immunity.

7.
Tex Heart Inst J ; 51(1)2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38686681

RESUMO

BACKGROUND: Atrial tachyarrhythmias are common and difficult to treat in adults with congenital heart disease. Dronedarone has proven effective in patients without congenital heart disease, but data are limited about its use in adults with congenital heart disease of moderate to great complexity. METHODS: A single-center, retrospective chart review of 21 adults with congenital heart disease of moderate to great complexity who were treated with dronedarone for atrial tachyarrhythmias was performed. RESULTS: The median (IQR) age at dronedarone initiation was 35 (27.5-39) years. Eleven patients (52%) were male. Ten patients (48%) had New York Heart Association class I disease, 10 (48%) had class II disease, and 1 (5%) had class III disease. Ejection fraction at initiation was greater than 55% in 11 patients (52%), 35% to 55% in 9 patients (43%), and less than 35% in 1 patient (5%). Prior treatments included ß-blockers (71%), sotalol (38%), amiodarone (24%), digoxin (24%), and catheter ablation (38%). Rhythm control was complete in 5 patients (24%), partial in 6 (29%), and inadequate in 10 (48%). Two patients (10%) experienced adverse events, including nausea in 1 (5%) and cardiac arrest in 1 (5%), which occurred 48 months after initiation of treatment. There were no deaths during the follow-up period. The median (IQR) follow-up time for patients with complete or partial rhythm control was 20 (1-54) months. CONCLUSION: Dronedarone can be effective for adult patients with congenital heart disease and atrial arrhythmias for whom more established therapies have failed, and with close monitoring it can be safely tolerated.


Assuntos
Antiarrítmicos , Dronedarona , Cardiopatias Congênitas , Humanos , Dronedarona/uso terapêutico , Dronedarona/efeitos adversos , Masculino , Estudos Retrospectivos , Feminino , Adulto , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/fisiopatologia , Antiarrítmicos/uso terapêutico , Antiarrítmicos/efeitos adversos , Resultado do Tratamento , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/complicações , Amiodarona/uso terapêutico , Amiodarona/efeitos adversos , Amiodarona/análogos & derivados , Fatores de Tempo
8.
J Pathol Inform ; 15: 100357, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38420608

RESUMO

Computational Pathology (CPath) is an interdisciplinary science that augments developments of computational approaches to analyze and model medical histopathology images. The main objective for CPath is to develop infrastructure and workflows of digital diagnostics as an assistive CAD system for clinical pathology, facilitating transformational changes in the diagnosis and treatment of cancer that are mainly address by CPath tools. With evergrowing developments in deep learning and computer vision algorithms, and the ease of the data flow from digital pathology, currently CPath is witnessing a paradigm shift. Despite the sheer volume of engineering and scientific works being introduced for cancer image analysis, there is still a considerable gap of adopting and integrating these algorithms in clinical practice. This raises a significant question regarding the direction and trends that are undertaken in CPath. In this article we provide a comprehensive review of more than 800 papers to address the challenges faced in problem design all-the-way to the application and implementation viewpoints. We have catalogued each paper into a model-card by examining the key works and challenges faced to layout the current landscape in CPath. We hope this helps the community to locate relevant works and facilitate understanding of the field's future directions. In a nutshell, we oversee the CPath developments in cycle of stages which are required to be cohesively linked together to address the challenges associated with such multidisciplinary science. We overview this cycle from different perspectives of data-centric, model-centric, and application-centric problems. We finally sketch remaining challenges and provide directions for future technical developments and clinical integration of CPath. For updated information on this survey review paper and accessing to the original model cards repository, please refer to GitHub. Updated version of this draft can also be found from arXiv.

9.
Malays Orthop J ; 17(2): 35-42, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37583520

RESUMO

Introduction: To investigate the use of a tubular retractor to provide access to the craniovertebral junction (CVJ) sparing the soft palate with the aim of reducing complications associated with traditional transoral approach but yet allowing adequate decompression of the CVJ. Materials and methods: Twelve consecutive patients with severe myelopathy (JOA-score less than 11) from ventral CVJ compression were operated between 2014-2020 using a tubular retractor assisted transoral decompression. Results: All patients improved neurologically statistically (p=0.02). There were no posterior pharynx wound infections or rhinolalia. There was one case with incomplete removal of the lateral wall of odontoid and one incidental durotomy. Conclusions: A Tubular retractor provides adequate access for decompression of the ventral compression of CVJ. As the tubular retractor pushed away the uvula, soft palate and pillars of the tonsils as it docked on the posterior pharyngeal wall, the traditional complications associated with traditional transoral procedures is completely avoided.

10.
Front Mol Neurosci ; 16: 1069375, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36846569

RESUMO

Introduction: Genome-wide association studies have discovered common polymorphisms in regions associated with schizophrenia. No genome-wide analyses have been performed in Saudi schizophrenia subjects. Methods: Genome-wide genotyping data from 136 Saudi schizophrenia cases and 97 Saudi controls in addition to 4,625 American were examined for copy number variants (CNVs). A hidden Markov model approach was used to call CNVs. Results: CNVs in schizophrenia cases were twice as large on average than CNVs in controls (p = 0.04). The analyses focused on extremely large >250 kilobases CNVs or homozygous deletions of any size. One extremely large deletion was noted in a single case (16.5 megabases on chromosome 10). Two cases had an 814 kb duplication of chromosome 7 spanning a cluster of genes, including circadian-related loci, and two other cases had 277 kb deletions of chromosome 9 encompassing an olfactory receptors gene family. CNVs were also seen in loci previously associated with schizophrenia, namely a 16p11 proximal duplication and two 22q11.2 deletions. Discussion: Runs of homozygosity (ROHs) were analyzed across the genome to investigate correlation with schizophrenia risk. While rates and sizes of these ROHs were similar in cases and controls, we identified 10 regions where multiple cases had ROHs and controls did not.

11.
Cureus ; 15(12): e50479, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38107214

RESUMO

Objective The incidence of peritonitis secondary to viscus perforation will be examined to determine the most common sites of perforation and associated comorbidities. Methods This is a retrospective observational study based on data collected from the King Fahad Hospital of the University (KFUH). This research targeted patients who had viscus organ perforation and the relation of peritonitis secondary to it. The sample was taken from patients under the care of the General Surgery Department from the first of Feb 2016 to the 12th of Sep 2022. The final sample consisted of 450 patients. The method of diagnosis of peritonitis was mainly clinical, and the surgical approach was either through an exploratory laparotomy or a diagnostic laparoscopy. Incidental findings of viscus organ perforation were noted in addition to certain postoperative complications (e.g., adhesions) and hospital stay. Results Analysis of the results showed a significant relation (p<0.001) between viscus organ perforation and peritonitis. The most common comorbidities associated with secondary peritonitis were hypertension (12, 24.5%), diabetes mellitus (10, 20.4%), any abdominal mass (3, 6.1%), and inflammatory bowel disease (1, 2%). However, a chi-square analysis has shown no significant association between peritonitis and the targeted associated comorbidities. Conclusion Perforation of the small intestine carries the biggest association with peritonitis incidence, in addition to comorbidities such as hypertension and diabetes mellitus. Further study to establish the value of these factors might contribute to decreasing the morbidity and mortality of secondary peritonitis.

12.
J Family Community Med ; 30(4): 267-272, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38044971

RESUMO

BACKGROUND: Diabetic nephropathy (DN) is a complication of chronic hyperglycemia associated with diabetes mellitus (DM). Several studies have demonstrated the positive impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on kidney outcomes. The objective of the study was to evaluate the effects of dapagliflozin, an SGLT2 inhibitor, on kidney outcomes in Saudi patients with type 2 DM. MATERIALS AND METHODS: Study included all Saudi patients with type 2 DM who visited our center from August 1, 2021, to July 31, 2022, and had been on dapagliflozin for at least 3 months. Data was abstracted through chart review for all patients included in the study. Paired t-test or Wilcoxon signed-rank test were used to compare the results before and after treatment for continuous variables and the McNemar test was used to compare the results for categorical data. RESULTS: Study included 184 Saudi patients with type 2 diabetes with a mean age of 61.32 years (SD=9.37). Dapagliflozin 10 mg/day significantly reduced hemoglobin A1C (HbA1C) from a mean (SD) of 9.00 to 8.40 (P < 0.001). Among a subgroup of patients with significant proteinuria (n = 83), dapagliflozin significantly reduced ACR from a median of 93.1 to 64.9 mg/g (P = 0.001). Following treatment, the estimated glomerular filtration rate improved from a mean of 69.83 to 71.68 mL/min and the mean arterial pressure (MAP) fell from 90.03 to 89.06 mmHg, both were not statistically significant. Despite a statistically insignificant increase in the episodes of urinary tract infections (UTIs), the hospitalization rate declined. No episodes of amputations or ketoacidosis occurred during the study period. CONCLUSION: SGLT2 inhibitors had beneficial effects among Saudi patients with type 2 diabetes by improving diabetic control and lowering proteinuria. Dapagliflozin did not result in significant harm, including UTIs, amputations, and ketoacidosis.

13.
Cureus ; 15(11): e48279, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38058323

RESUMO

Cardiovascular disease (CVD) is a critical public health issue in Saudi Arabia, where it is the leading cause of death. The economic burden of CVD in the country is expected to triple by 2035, reaching $9.8 billion. This paper provides an overview of CVD in Saudi Arabia and its risk factors, impact on healthcare, and effects on patients' quality of life. The review emphasizes the potential of cardiac rehabilitation (CR) programs in addressing the CVD epidemic. CR programs have been shown to reduce morbidity, mortality, and hospital readmissions while improving patients' cardiovascular health and overall well-being. However, these programs are underutilized and inaccessible in Saudi Arabia. The paper highlights the urgent need for CR programs in the country and suggests key strategies for implementation. These include increasing patient referrals, tailoring programs to individual needs, enhancing patient education, and making CR accessible through home-based options. Fostering multidisciplinary collaboration and developing tailored guidelines for Arab countries can further enhance the impact of CR programs. In conclusion, this review underscores the vital importance of comprehensive CR programs in Saudi Arabia to combat the rising CVD burden, improve patient quality of life, and align with the goals of the Saudi 2030 Vision for a healthier society.

14.
Acta Virol ; 55(4): 353-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22149501

RESUMO

A growing body of evidence suggests that host genetic factors play an important role both in susceptibility to human immunodeficiency virus 1 (HIV-1) infection and in progression to AIDS. Interleukin 18 (IL-18) is a pleiotropic proinflammatory cytokine that serves as an important regulator of immune responses. It plays a key role in induction of both Th1 and Th2 cytokines and, thereby, modulates their immune responses. Single nucleotide polymorphisms in the IL-18 gene promoter region may lead to an altered transcriptional activity and IL-18 production, and so this may account for individuals' variation to the risk of HIV-1 infection. With this perspective, the -137G/C polymorphism in the promoter region of the IL-18 gene was studied in 500 patients with HIV-1/AIDS and an equal number of sex and age matched healthy controls using sequence specific polymerase chain reaction analysis. We did not observe any significant association of the heterozygous G/C genotype with the risk of HIV-1-infection/AIDS. However, statistically significant associations of the G allele and homozygous G/G genotype of -137 G/C polymorphism of IL-18 promoter with increased risk of HIV-1/AIDS were identified. The data of the present study suggest that IL-18 -137 G allele and G/G genotype seem to be involved in the pathogenesis of HIV-1 infection among North Indians.


Assuntos
Síndrome da Imunodeficiência Adquirida/genética , Predisposição Genética para Doença , Infecções por HIV/genética , Interleucina-18/genética , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas/genética , População Branca/genética , Síndrome da Imunodeficiência Adquirida/etnologia , Síndrome da Imunodeficiência Adquirida/imunologia , Síndrome da Imunodeficiência Adquirida/virologia , Adulto , Estudos de Casos e Controles , Progressão da Doença , Feminino , Frequência do Gene , Infecções por HIV/etnologia , Infecções por HIV/imunologia , Infecções por HIV/virologia , HIV-1/patogenicidade , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Análise de Sequência de DNA
15.
Ann R Coll Surg Engl ; 103(9): 651-655, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34412537

RESUMO

INTRODUCTION: Careful identification and management of inguinal nerves during inguinal hernia repair is important to avoid iatrogenic injury. Documentation of this practice may inform postoperative clinical management. We set out to investigate how often surgeons identify inguinal nerves and document findings and management in their operation notes. METHODS: We carried out a retrospective review of operation notes at a single district general hospital. We analysed operation notes for documentation of identification and intraoperative management (preservation or sacrifice) of the inguinal nerves (iliohypogastric, ilioinguinal, genital branch of genitofemoral nerve). We collected data on the baseline characteristics of the patients, hernia characteristics and primary operating surgeons for subgroup analysis. RESULTS: A total of 100 patients were included in the analysis. Identification of any inguinal nerves (generic 'nerve') was documented in 17% of operation notes. Documentation in the operation notes of named individual nerves was limited. No documentation of intraoperative management of inguinal nerves was found in 83% of operation notes. Preservation of the inguinal nerves (generic 'nerve') was recorded in 8% and sacrifice recorded in 9% of cases. Subgroup analysis revealed similar incidence of documentation of identification and management of inguinal nerves across grades of primary surgeon, with overall incidence low for all grades. CONCLUSION: This study reveals a lack of appreciation of the importance of documenting identification and management of inguinal nerves in operation notes. Further consideration of the potential implications of poor documentation would be beneficial to improve standards.


Assuntos
Documentação , Virilha/inervação , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Canal Inguinal/diagnóstico por imagem , Cuidados Intraoperatórios/métodos , Complicações Intraoperatórias/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Ann R Coll Surg Engl ; 103(1): 5-9, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32981334

RESUMO

INTRODUCTION: Chronic groin pain following inguinal hernia surgery is a common and potentially debilitating complication, and yet patients are infrequently informed of this risk. This leaves surgeons open to negligence claims, especially given recent changes to case law, which for the first time highlighted the need for a more patient-centred approach to risk disclosure. We investigated how these changes have influenced our consenting practice with respect to the disclosure of this risk. METHODS: We compared how often surgeons discussed the risk of chronic groin pain with adults undergoing elective open unilateral inguinal hernia mesh repairs in 2019 and 2009. The first 50 patients in each of these two years were retrospectively compared. Discussions during the initial consultation and on the day of surgery were assessed by reviewing clinic letters, medical notes and consent forms. FINDINGS: The risk of chronic pain was discussed with significantly more patients in 2019 than in 2009 (96% v 54%, p<0.0001). Most of these discussions occurred on the day of surgery (92% v 54%, p<0.0001). Only a few patients had these discussions during their initial consultation (18% v 4%, p<0.025). CONCLUSIONS: Discussing the risk of chronic groin pain has improved significantly over the past 10 years. However, these discussions occur mostly on the day of surgery, which gives patients very little time to weigh up the risk. This potentially invalidates the consent they give for surgery. Patients should be given an opportunity to discuss their operative risks in advance of their operation.


Assuntos
Dor Crônica/epidemiologia , Revelação/tendências , Herniorrafia/efeitos adversos , Consentimento Livre e Esclarecido/normas , Dor Pós-Operatória/epidemiologia , Padrões de Prática Médica/tendências , Idoso , Dor Crônica/etiologia , Revelação/normas , Feminino , Virilha , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Relações Médico-Paciente , Padrões de Prática Médica/normas , Estudos Retrospectivos , Fatores de Tempo
17.
Materials (Basel) ; 14(14)2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34300691

RESUMO

Cutting tool wear reduces the quality of the product in production processes. The optimization of both the machining parameters and tool life reliability is an increasing research trend to save manufacturing resources. In the present work, we introduced a computational approach in estimating the tool wear in the turning process using artificial intelligence. Support vector machines (SVM) for regression with Bayesian optimization is used to determine the tool wear based on various machining parameters. A coated insert carbide tool 2025 was utilized in turning tests of 709M40 alloy steel. Experimental data were collected for three machining parameters like feed rate, depth of cut, and cutting speed, while the parameter of tool wear was calculated with a scanning electron microscope (SEM). The SVM model was trained on 162 experimental data points and the trained model was then used to estimate the experimental testing data points to determine the model performance. The proposed SVM model with Bayesian optimization achieved a superior accuracy in estimation of the tool wear with a mean absolute percentage error (MAPE) of 6.13% and root mean square error (RMSE) of 2.29%. The results suggest the feasibility of adopting artificial intelligence methods in estimating the machining parameters to reduce the time and costs of manufacturing processes and contribute toward greater sustainability.

18.
S Afr Med J ; 111(2): 100-105, 2021 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-33944717

RESUMO

The COVID-19 pandemic has resulted in many hospitals severely limiting or denying parents access to their hospitalised children. This article provides guidance for hospital managers, healthcare staff, district-level managers and provincial managers on parental access to hospitalised children during a pandemic such as COVID-19. It: (i) summarises legal and ethical issues around parental visitation rights; (ii) highlights four guiding principles; (iii) provides 10 practical recommendations to facilitate safe parental access to hospitalised children; (iv) highlights additional considerations if the mother is COVID-19-positive; and (v) provides considerations for fathers. In summary, it is a child's right to have access to his or her parents during hospitalisation, and parents should have access to their hospitalised children; during an infectious disease pandemic such as COVID-19, there is a responsibility to ensure that parental visitation is implemented in a reasonable and safe manner. Separation should only occur in exceptional circumstances, e.g. if adequate in-hospital facilities do not exist to jointly accommodate the parent/caregiver and the newborn/infant/child. Both parents should be allowed access to hospitalised children, under strict infection prevention and control (IPC) measures and with implementation of non-pharmaceutical interventions (NPIs), including handwashing/sanitisation, face masks and physical distancing. Newborns/infants and their parents/caregivers have a reasonably high likelihood of having similar COVID-19 status, and should be managed as a dyad rather than as individuals. Every hospital should provide lodger/boarder facilities for mothers who are COVID-19-positive, COVID-19-negative or persons under investigation (PUI), separately, with stringent IPC measures and NPIs. If facilities are limited, breastfeeding mothers should be prioritised, in the following order: (i) COVID-19-negative; (ii) COVID-19 PUI; and (iii) COVID-19-positive. Breastfeeding, or breastmilk feeding, should be promoted, supported and protected, and skin-to-skin care of newborns with the mother/caregiver (with IPC measures) should be discussed and practised as far as possible. Surgical masks should be provided to all parents/caregivers and replaced daily throughout the hospital stay. Parents should be referred to social services and local community resources to ensure that multidisciplinary support is provided. Hospitals should develop individual-level policies and share these with staff and parents. Additionally, hospitals should ideally track the effect of parental visitation rights on hospital-based COVID-19 outbreaks, the mental health of hospitalised children, and their rate of recovery.


Assuntos
Saúde da Criança/normas , Criança Hospitalizada/estatística & dados numéricos , Hospitais/normas , Controle de Infecções/normas , Isolamento de Pacientes/normas , Visitas a Pacientes/estatística & dados numéricos , COVID-19 , Criança , Feminino , Humanos , Recém-Nascido , África do Sul
19.
Saudi J Biol Sci ; 28(10): 5526-5537, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34588862

RESUMO

Superoxide Dismutase SODs are defense associated proteins that detoxify ROS and primarily serve as scavengers. They have been described in numerous plant species, but their in-depth characterization in Brassica rapa has not been reported. Therefore, the present investigation on genome wide study of SOD gene family was conducted to identify BrSOD genes, their domain-based organization, gene structure analysis, phylogenetic analysis, intron-exon structure of genes and expression analysis. The sequence characterization of Super oxide dismutase gene family in Brassica rapa, their syntenic associateship of conserved motifs and phylogenetic correlationship, prediction of cis-elements and determing the expression analysis in distinct tissues namely plant callus, root, stem, leaf, flower, and silique under abiotic conditions have been analysed using different software's. The study on SOD gene family identified 17 BrSOD genes which were grouped into eight BrCu-ZnSODs and nine BrFe-MnSODs domain-based organization. Furthermore, the conserved character of BrSODs were confirmed by intron-exon organisation, motif arrangements and domain architectural investigations. Expression analysis using RNA Sequence data of different developmental stages proclaimed that genes were manifested in all six tissues with an exception of BrCu-ZnSOD3, which was not manifested in roots; however, whose transcript was detected in all other tested tissues. The study has genome wide insight into the occurrence and functional specifications of BrSOD gene family in Brassica rapa that can be potentially utilized in breeding program for resilience to climate change and abiotic stresses tolerance Brassica variety.

20.
J Family Community Med ; 28(1): 28-34, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33679186

RESUMO

BACKGROUND: The purpose of this study was to determine the prevalence of anxiety, depression, and obsessive-compulsive disorder (OCD) and assess their severity in both male and female secondary school students. MATERIALS AND METHODS: This cross-sectional study was conducted among secondary school students in Al Hasa region. A sample of student was selected using multi-stage sampling technique. Data were collected using valid self administered questionnaires (Patient Health Questionnaire 9, Anxiety Disorder 7, and Yale-Brown Obsessive-Compulsive scale). Study was approved by institutional ethical review committee, and informed consent was obtained from each participant. SPSS used for data entry and analysis. Chi-square test was used to test for statistical significance. RESULTS: A total of 1783 of students, 930 males and 853 females, were enrolled in the study. The prevalence of depression, anxiety, and OCD was 76.2%, 49.9%, and 61.6%, respectively. Most of the diagnosed students had mild forms of the diseases, fewer had moderate form, and very few had severe forms. The most significant risk factor was gender, but other risk factors were significant for some of the diseases. CONCLUSION: The prevalence of the three diseases is high and significantly associated with gender. Further work is needed to evaluate this high prevalence and assess the severity of the diseases and other risk factors.

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