The association between marital status and treatment initiation in lung cancer: A systematic review and meta-analysis of observational studies.

Lung cancer is associated with high mortality, and significant health burden. Marital status has been associated with lung cancer survival. This systematic review and meta-analysis set out to investigate the association between marital status and treatment receipt in lung cancer. The search was conducted across three databases: Medline (OVID), Embase and CINAHL, from inception to June 2022. Retrospective or prospective observational studies that quantified treatment receipt by marital status were eligible for inclusion. Study quality was assessed via a modified checklist for retrospective databased-based studies. Meta-analysis using a random effects model was undertaken by chemotherapy, radiotherapy, surgery, and any treatment relative to married or not married. Pooled unadjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for each type of treatment. 837 papers were screened and 18 met the inclusion criteria with eight being eligible for inclusion in the meta-analysis. Studies were excluded from meta-analysis due to overlap in the data reported in papers; the mean quality score of the 18 included papers was 12/17. Being married was associated with increased odds of overall treatment OR 1.43 (95 % CI 1.14-1.79; I2 = 82 %; Tau2 = 0.07; six studies) and also increased receipt of: chemotherapy 1.40 (95 % CI 1.35-1.44; I2 = 82 %; Tau2 = 0.00); radiotherapy 1.29 (95 % CI 0.96-1.75; I2 = 100 %; Tau2= 0.09; four studies) and surgery (95 % CI 1.31-1.52; I2 = 86 %; Tau2 = 0.00; five studies). The results indicate that those who are married are more likely to receive treatment for lung cancer compared to those who are not married. This requires further investigation to better understand the explanations behind this finding and how we can work to combat this inequality.

Which ICU patients need stress ulcer prophylaxis?

Critically ill patients are at an increased risk for developing stress ulcers of the mucosa of the upper gastrointestinal (GI) tract. Bleeding from stress ulcers was previously associated with a longer stay in the intensive care unit and an increased risk of death. Thus, most patients admitted to the intensive care unit receive stress ulcer prophylaxis. However, there is a growing concern that acid-suppression drugs may be associated with increased frequency of nosocomial pneumonia and Clostridioides difficile infection. In this article, the authors address controversies regarding stress ulcer prophylaxis in critically ill patients and provide guidance for its appropriate use in this setting.

Assessment of the knowledge and practice toward male's participation during their wives' prenatal and postnatal care at King Saudi Medical City, Riyadh: KSA.

Background: Access to skilled health care services during pregnancy, childbirth, and postnatal period for obstetric care is one of the strongest determinants of maternal and newborn health outcomes. The main objective of the present study is to assess the knowledge and practice toward male's participation during their wives' prenatal and postnatal care at King Saud Medical City. Methods: We conducted a single center, a quantitative, cross-sectional study based on a personal-interviewed structured questionnaire in 2019 adopting a stratified random sampling technique. Married men above 18 years with at least one child were interviewed using a structured questionnaire. Results: The knowledge level was positive and moderately correlated with the practice on prenatal and postnatal care r = +0.641(P = 0.000) and was statistically significant. There was a significant difference between pregnancy intention and level of education (P = 0.000). The score of knowledge and practice increased with the increase in the number of children. Conclusion: Socioeconomic factor was the major determinant for men's knowledge and practice in maternal and newborn health services. In the future, studies with a large sample size are required to increase men's awareness regarding MNH issues, but should not be limited to this.

Inhibitory effect of Allium sativum and Zingiber officinale extracts on clinically important drug resistant pathogenic bacteria.

BACKGROUND: Herbs and spices are very important and useful as therapeutic agent against many pathological infections. Increasing multidrug resistance of pathogens forces to find alternative compounds for treatment of infectious diseases. METHODS: In the present study the antimicrobial potency of garlic and ginger has been investigated against eight local clinical bacterial isolates. Three types of extracts of each garlic and ginger including aqueous extract, methanol extract and ethanol extract had been assayed separately against drug resistant Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, Klebsiella pneumoniae, Shigella sonnei, Staphylococcusepidermidis and Salmonella typhi. The antibacterial activity was determined by disc diffusion method. RESULTS: All tested bacterial strains were most susceptible to the garlic aqueous extract and showed poor susceptibility to the ginger aqueous extract. The (minimum inhibitory concentration) MIC of different bacterial species varied from 0.05 mg/ml to 1.0 mg/ml. CONCLUSION: In the light of several socioeconomic factors of Pakistan mainly poverty and poor hygienic condition, present study encourages the use of spices as alternative or supplementary medicine to reduce the burden of high cost, side effects and progressively increasing drug resistance of pathogens.

Is glycemic control in patients with type-2 diabetes in Rawalpindi improving?

BACKGROUND: Glycaemic control is critical for managing diabetes and related complications. Considering high prevalence of Diabetes in Pakistan, our study aimed to assess the status of glycaemic control in Type-II Diabetics by measurement of HbA1c from 2005-2007 at Rawalpindi. We also evaluated changes in its trends in relation with sex and age. METHODS: It was a retrospective analysis of data from Clinical Pathology Laboratory, Army Medical College, Rawalpindi during 2005-2007. A total of 2875 patients, aged 24-70 years, taking oral hypoglycaemic agents, were included. HbA1c was measured by using Human kit. International Diabetes Federation guidelines, < or = 6.5%, 6.6%-8.4% and > or = 8.5% were used to classify patients into good, fair and poor control categories. RESULTS: The number of patients (n = 2875) tested for HbA1c increased from 904,974 to 997 during 2005-2007. The patients had an age of 48 +/- 13 years and comprised of 54% males and 46% females. Improvement in patient's glycaemic control among the three categories during 2005 to 2007 was as follows: good (41% vs 47%), fair (38% vs 40%) and poor (21% vs 13%) respectively. The average HbA1c values improved from 7.25 % in 2005 to 6.69% in 2007 (p < 0.05). Overall, males (45%) and youngest age group (53%) patients had good diabetic control. CONCLUSION: Glycaemic control improved in diabetic patients from 41% to 47% during 2005-2007 at Rawalpindi. Males, especially the youngest patients comprised majority of good control population. For effective disease management and optimal HbA1c values, a combined effort by the patient and physician is required.