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Background: Cannabis use is becoming increasingly prevalent worldwide, yet the full spectrum of its effects largely remain unknown. Although cannabis have immunomodulatory properties, there remains a significant gap in our understanding of the potential impact of marijuana use on COVID-19 outcomes. The purpose of this study is to evaluate the effect of chronic cannabis use on severe COVID-19. Materials and Methods: National Inpatient Sample Database was used to sample individuals admitted with the diagnosis of COVID-19. Patients were divided into two groups based on cannabis use. Baseline demographics and comorbidities were collected using ICD-10 codes. Patients with missing data or age under 18 were excluded. Propensity matching using R was performed to match cannabis users to non-cannabis users 1:1 on age, race, gender, and 17 other comorbidities. The primary outcome was severe COVID-19 infection, defined as a composite of acute respiratory failure, intubation, acute respiratory distress syndrome (ARDS), or severe sepsis with multiorgan failure. Results: Out of 322,214 patients included in the study, 2,603 were cannabis users. Cannabis users were younger and had higher prevalence of tobacco use. On initial analysis, cannabis users had significantly lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. After 1:1 matching, cannabis use was associated with lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. Conclusion: Cannabis users had better outcomes and mortality compared with non-users. The beneficial effect of cannabis use may be attributed to its immunomodulatory effects.
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BACKGROUND: Device-related infective endocarditis (IE) is associated with high mortality, resulting in a growing emphasis on identifying and managing comorbidities that increase the risk of IE in these patients. Psoriasis is increasingly being recognized as having multiple cardiovascular manifestations. However, little is known about the impact of psoriasis on IE risk in patients with permanent pacemakers (PPM). Our study aimed to assess whether psoriasis is associated with an increased risk of developing IE in patients with PPM. METHODS: The National Inpatient Sample database was utilized to extract patients with PPM. The presence of psoriasis stratified patients. Demographic and comorbidity data were collected. 1:10,000 propensity matching for IE risk factors was performed to examine independent associations between psoriasis and IE. RESULTS: Of 437,793 patients, 45 had psoriasis. Psoriasis patients had higher IE rates (4.4% vs. 0.6%; P < 0.01). On multivariate analysis, psoriasis was associated with a 7.2-fold high IE risk (OR: 7.2 [1.7-30.2]; P < 0.01). Post-match analysis showed an 8.3-fold IE risk in psoriasis patients (OR: 8.3 [2.0-34.4]; P < 0.001). CONCLUSION: Psoriasis was independently associated with elevated IE risk in patients with PPM. Further studies are required to corroborate these findings, which will have implications for IE prophylaxis.
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Cigarette smoking acknowledged as the foremost contributor to preventable illnesses and deaths, has steadily risen since its inception, evolving into a global health crisis of paramount significance, particularly within the context of medical students who represent the future healthcare workforce. This study, conducted at Quaid-e-Azam Medical College, Bahawalpur, aimed to comprehensively evaluate current students' knowledge, attitudes, and practices concerning cigarette smoking. Employing a web-based cross-sectional observational descriptive study design over the study period from June 15, 2020, to August 1, 2020, a sample of 200 medical students drawn from the first to fifth year was examined using stratified sampling. Data collection involved the distribution of a meticulously designed and pre-tested questionnaire through social media platforms, encompassing inquiries about participants' biodata and research-related topics. The subsequent data analysis utilized Google Spreadsheets, Microsoft Excel, Microsoft Word, and SPSS software to calculate percentages, create graphical representations, construct tables, and apply the chi-square test. The survey findings illuminated a remarkably high level of awareness, with 99% of respondents recognizing the harmful effects of smoking, including elevated cancer risk, and 94% acknowledging its addictive nature. A substantial 93% regarded passive smoking as equally detrimental as active smoking. In comparison, 98.5% were aware of the heightened risk of respiratory illnesses in children exposed to smoking. The majority exhibited a responsible stance towards discouraging smoking, with 90.5% feeling a duty to encourage cessation and 71.5% considering maintaining good health a sufficient incentive to quit. Additionally, 97% concurred that smoking in the presence of children should be avoided. Concerning smoking cessation, 64.5% believed high taxes were effective, and 97.5% deemed public smoking bans effective measures. Notably, 74% thought professional advice had limited influence on a smoker's attitude. Active smokers constituted a mere 20% of the sample, with a mere 2% commencing smoking before age 16 and 10% succumbing to peer pressure or media influence as instigating factors. Furthermore, 13.5% reported exam-related anxiety as a trigger for smoking, and 10% admitted to smoking in the company of non-smokers. Encouragingly, 19.5% expressed a desire to quit, with 5% seeking professional guidance in their cessation attempts. In conclusion, most participants exhibited commendable knowledge and a positive attitude towards cigarette smoking, contributing to a low prevalence of tobacco consumption among them. Nevertheless, the study underscores the need for ongoing improvements through targeted educational initiatives and governmental regulations to further mitigate tobacco use among future healthcare professionals and the broader population.
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OBJECTIVES: The aim of this research was to examine the average glandular dose (AGD) of radiation among different breast compositions of glandular and adipose tissue with auto-modes of exposure factor selection in digital breast tomosynthesis. METHODS: This experimental study was carried out in the National Cancer Society, Kuala Lumpur, Malaysia, between February 2012 and February 2013 using a tomosynthesis digital mammography X-ray machine. The entrance surface air kerma and the half-value layer were determined using a 100H thermoluminescent dosimeter on 50% glandular and 50% adipose tissue (50/50) and 20% glandular and 80% adipose tissue (20/80) commercially available breast phantoms (Computerized Imaging Reference Systems, Inc., Norfolk, Virginia, USA) with auto-time, auto-filter and auto-kilovolt modes. RESULTS: The lowest AGD for the 20/80 phantom with auto-time was 2.28 milliGray (mGy) for two dimension (2D) and 2.48 mGy for three dimensional (3D) images. The lowest AGD for the 50/50 phantom with auto-time was 0.97 mGy for 2D and 1.0 mGy for 3D. CONCLUSION: The AGD values for both phantoms were lower against a high kilovolt peak and the use of auto-filter mode was more practical for quick acquisition while limiting the probability of operator error.