Pub Date : 2021-03-15DOI: 10.31829/2641-7456/ahs2021-5(1)-01510.31829/
Objective: Is to to assess the efficacy and safety of vaginal misoprostol plus isosorbide mononitrate versus misoprostol in termination of anembryonic pregnancy. Setting: Department of Obstetrics and Gynecology, Woman’s Health Hospital, Assiut University. Methods: 108 women scheduled for termination of anembryonic pregnancy were recruited were assigned randomly to vaginal misoprostol 800 g plus isosorbide mononitrate 40 mg or vaginal misoprostol 800 g plus placebo .The efficacy of the medication was evaluated by predetermined outcome variables for Successful expulsion of gestational sac in both groups and need for surgical interference.
{"title":"Misoprostol plus Isosorbide Mononitrate versus Misoprostol for Termination of Anembryonic Pregnancy","authors":"","doi":"10.31829/2641-7456/ahs2021-5(1)-01510.31829/","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2021-5(1)-01510.31829/","url":null,"abstract":"Objective: Is to to assess the efficacy and safety of vaginal misoprostol plus isosorbide mononitrate versus misoprostol in termination of anembryonic pregnancy. Setting: Department of Obstetrics and Gynecology, Woman’s Health Hospital, Assiut University. \u0000Methods: 108 women scheduled for termination of anembryonic pregnancy were recruited were assigned randomly to vaginal misoprostol 800 g plus isosorbide mononitrate 40 mg or vaginal misoprostol 800 g plus placebo .The efficacy of the medication was evaluated by predetermined outcome variables for Successful expulsion of gestational sac in both groups and need for surgical interference.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116263517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-01DOI: 10.31829/2641-7456/ahs2021-5(1)-013
In March 2020, the World Health Organization considered coronavirus disease-2019 (COVID-19) as a worldwide pandemic.1 The provision of a continuous supply of safe blood and blood components is an essential issue especially in low resource countries as Egypt with a high rate of obstetric hemorrhage.2 However, there are situations in which either the supply of blood may be affected, or the safety of the blood supply may be compromised as in the event of COVID-19 pandemic.3
{"title":"COVID-19 Pandemic and Blood Donation Services: Perspective of Low-Resource Country 10.31829/2641-7456/ahs2021-5(1)-013","authors":"","doi":"10.31829/2641-7456/ahs2021-5(1)-013","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2021-5(1)-013","url":null,"abstract":"In March 2020, the World Health Organization considered coronavirus disease-2019 (COVID-19) as a worldwide pandemic.1 The provision of a continuous supply of safe blood and blood components is an essential issue especially in low resource countries as Egypt with a high rate of obstetric hemorrhage.2 However, there are situations in which either the supply of blood may be affected, or the safety of the blood supply may be compromised as in the event of COVID-19 pandemic.3","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"407 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116071077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-09DOI: 10.31829/2641-7456/ahs2021-5(1)-004
Igor K
Our assessment of various events and phenomena depends, first of all, on our baggage of acquired knowledge, established stereotypes and worldviews. It is this kind of bias that affects the definition of our goals, decisions and specific actions, which often go against the observed facts and lose sight of important features of the object being studied. The way experts perceive the current COVID-19 pandemic is one typical example of such a biased interpretation. The basis of the clinical picture of coronavirus infection is a lesion of the lung tissue, which, according to clinical and radiological and pathoanatomical data, is defined as viral inflammation and corresponds to the nosology "acute pneumonia" (AP)(1-4). According to the modern concept of AP, the only and main cause of this disease is considered to be its causative agent. This view of the nature of the AP is generally consistent with current events. Indeed, coronavirus infection causes inflammation of the lung tissue. At the same time, the usual treatment of AP with etiotropic drugs is unattainable in coronavirus infection due to the lack of such drugs.
{"title":"Look at the COVID-19 Pandemic with an Open Mind","authors":"Igor K","doi":"10.31829/2641-7456/ahs2021-5(1)-004","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2021-5(1)-004","url":null,"abstract":"Our assessment of various events and phenomena depends, first of all, on our baggage of acquired knowledge, established stereotypes and worldviews. It is this kind of bias that affects the definition of our goals, decisions and specific actions, which often go against the observed facts and lose sight of important features of the object being studied. \u0000\u0000The way experts perceive the current COVID-19 pandemic is one typical example of such a biased interpretation. The basis of the clinical picture of coronavirus infection is a lesion of the lung tissue, which, according to clinical and radiological and pathoanatomical data, is defined as viral inflammation and corresponds to the nosology \"acute pneumonia\" (AP)(1-4). According to the modern concept of AP, the only and main cause of this disease is considered to be its causative agent. This view of the nature of the AP is generally consistent with current events. Indeed, coronavirus infection causes inflammation of the lung tissue. At the same time, the usual treatment of AP with etiotropic drugs is unattainable in coronavirus infection due to the lack of such drugs.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127478260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-08DOI: 10.31829/2641-7456/ahs2021-5(1)-003
The World Health Organization announced that Coronavirus disease-2019 (COVID-19) officially a pandemic after its detection in Wuhan, China. From a religious point of view, most churches announced a suspension of all liturgical activities. Church practices have been altered in an effort to contain the virus. In this article we will enumerate the lessons applied from Christianity to behave in such pandemics. Introduction On March 11, 2020, the World Health Organization announced that the COVID-19 officially a pandemic after barreling through 114 countries in three months and infecting over three million people [1]. It's comprehensible that people tend to use religion to deal with a crisis or explain the tragedy by reference to an Act of God and seeking a church to receive spiritual support and healing during such traumatic events. Nonetheless, all over the world, liturgical services are being suspended [2]. Several million worshipers have been deprived of the existential comfort of attending religious rituals in a moment of critical vagueness and confusion.
{"title":"Mercy Not Sacrifice: Lessons from Christianity for COVID-19 Pandemic","authors":"","doi":"10.31829/2641-7456/ahs2021-5(1)-003","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2021-5(1)-003","url":null,"abstract":"The World Health Organization announced that Coronavirus disease-2019 (COVID-19) officially a pandemic after its detection in Wuhan, China. From a religious point of view, most churches announced a suspension of all liturgical activities. Church practices have been altered in an effort to contain the virus. In this article we will enumerate the lessons applied from Christianity to behave in such pandemics. \u0000\u0000Introduction \u0000On March 11, 2020, the World Health Organization announced that the COVID-19 officially a pandemic after barreling through 114 countries in three months and infecting over three million people [1]. It's comprehensible that people tend to use religion to deal with a crisis or explain the tragedy by reference to an Act of God and seeking a church to receive spiritual support and healing during such traumatic events. Nonetheless, all over the world, liturgical services are being suspended [2]. Several million worshipers have been deprived of the existential comfort of attending religious rituals in a moment of critical vagueness and confusion.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126567989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-28DOI: 10.31829/2641-7456/ahs2021-5(1)-001
NPWT is a promising adjunct in the treatment of surgical and non-surgical wounds. These include wounds due to trauma, pressure ulcers, chronic venous or arterial ulcers, radiation-induced wounds, burns, neuropathic wounds, necrotic wounds, high output lymph or serous fluid producing wounds. NPWT can easily become a method of treatment in the absence of other effective modalities which may be costly and only postpone an inevitable debridement or secondary closure. It may become a “lazy” way of treating wounds.
{"title":"Potential Abuse of Negative Pressure Wound Therapy (NPWT)","authors":"","doi":"10.31829/2641-7456/ahs2021-5(1)-001","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2021-5(1)-001","url":null,"abstract":"NPWT is a promising adjunct in the treatment of surgical and non-surgical wounds. These include wounds due to trauma, pressure ulcers, chronic venous or arterial ulcers, radiation-induced wounds, burns, neuropathic wounds, necrotic wounds, high output lymph or serous fluid producing wounds. \u0000\u0000NPWT can easily become a method of treatment in the absence of other effective modalities which may be costly and only postpone an inevitable debridement or secondary closure. It may become a “lazy” way of treating wounds.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129171993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-02DOI: 10.31829/2641-7456/ahs2021-5(1)-002
Abstract Background: Negative-pressure wound-therapy (NPWT) has become a mainstay of treatment for high-risk surgical wounds. In closed wounds, traditional NPWT utilizes surface level sponges alone to provide negative pressure. A technique that allows for deep dead-space management, while maintaining superficial negative pressure over a closed wound, may prove beneficial inhigh-risk patients. Purpose: A novel technique and prospective case series are described which incorporate deep hemovac drain tubings into a traditional NPWT device (Deep Inside-Out Vac; DIOV). Pilot data is needed to begin evaluating the efficacy of this technique. Methods: Fourteen patients were stratified by initial indication for DIOV placement. Group 1 patients underwent wide tumor resection, while Group 2 patients underwent extensive debridement for infection. Demographic, surgical, and microbiological data were recorded. Results: Eight patients were identified in Group 1. Six were identified in Group 2. Both demonstrated 50% positive culture rates at time of drain removal. Most common organisms were coagulase negative staphylococcus species. At final follow-up, all wounds were clinically healed. Conclusions: NPWT is an established augment in post-operative wound care. The DIOV may provide added benefit in wounds at high-risk for dead-space related complications. Contamination remains unfavorable, and further research is needed to determine this device’s efficacy.
{"title":"A Novel Wound and Soft Tissue Flap Negative Pressure Drain System - a Pilot Study","authors":"","doi":"10.31829/2641-7456/ahs2021-5(1)-002","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2021-5(1)-002","url":null,"abstract":"Abstract \u0000Background: Negative-pressure wound-therapy (NPWT) has become a mainstay of treatment for high-risk surgical wounds. In closed wounds, traditional NPWT utilizes surface level sponges alone to provide negative pressure. A technique that allows for deep dead-space management, while maintaining superficial negative pressure over a closed wound, may prove beneficial inhigh-risk patients. \u0000\u0000Purpose: A novel technique and prospective case series are described which incorporate deep hemovac drain tubings into a traditional NPWT device (Deep Inside-Out Vac; DIOV). Pilot data is needed to begin evaluating the efficacy of this technique. \u0000\u0000Methods: Fourteen patients were stratified by initial indication for DIOV placement. Group 1 patients underwent wide tumor resection, while Group 2 patients underwent extensive debridement for infection. Demographic, surgical, and microbiological data were recorded. \u0000\u0000Results: Eight patients were identified in Group 1. Six were identified in Group 2. Both demonstrated 50% positive culture rates at time of drain removal. Most common organisms were coagulase negative staphylococcus species. At final follow-up, all wounds were clinically healed. \u0000\u0000Conclusions: NPWT is an established augment in post-operative wound care. The DIOV may provide added benefit in wounds at high-risk for dead-space related complications. Contamination remains unfavorable, and further research is needed to determine this device’s efficacy.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127073678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-21DOI: 10.31829/2641-7456/ahs2020-4(1)-155
Background: Focusing on basic and clinical research, psycho-neuroimmunology researchers are looking at how the factors that cause anxiety and depression and their negative emotions can affect physiological and health conditions. Clinical studies have shown that the central nervous system is associated with endocrine and immune systems. Objectives: To investigate the impact of depression and anxiety on developing breast cancer through immune disturbance pathway Methodology: The present study is a descriptive review of systematic review studies conducted in accordance with the guidelines for preferred cases for reporting systematic and metaanalysis review articles (prisma). Electronic databases including ISI Web of Knowledge, PubMed, and Scopus, were searched from 2012 to 2020. The search strategy psychological, immune response, anxiety disorder, depression, and psychoneuroimmunology. Additionally, we searched the references of retrieved articles to find additional included a combination of the following Medical Subjects Headings (MeSH) terms: breast cancer, potentially related studies. We have considered herbal therapies, which were applied orally, or topically.The content of all articles was evaluated qualitatively after extracting from the desired databases with PRISMA checklist. Results: the impact of psychological problems on people's illness is very large, when people have a lot of psychological pressure, the incidence will be higher than ordinary people.Health Psychology considers human health to be a complex entity and believes that disease is not caused by a single factor but is the product of biological, psychological, and social factors. Recent research has previously confirmed the effect of psychosocial factors such as stress and how it reacts to the onset and course of the disease. .Most of the patients with malignant tumor had negative emotional problems such as anxiety and depression .Depression in cancer is markedly different from depression in healthy individuals, and involves a unique symptomatology and a strong biological etiology. Conclusions: A better understanding of the bidirectional communication between the neuroendocrine and immune systems could contribute to new clinical and treatment strategies.
背景:心理-神经免疫学研究人员专注于基础和临床研究，正在研究导致焦虑和抑郁及其负面情绪的因素如何影响生理和健康状况。临床研究表明，中枢神经系统与内分泌和免疫系统有关。目的:通过免疫干扰途径探讨抑郁和焦虑对乳腺癌发展的影响方法:本研究是根据系统和荟萃分析综述文章报告首选病例指南(prisma)进行的系统综述研究的描述性综述。检索了2012年至2020年的ISI Web of Knowledge、PubMed和Scopus等电子数据库。搜索策略心理，免疫反应，焦虑症，抑郁症和精神神经免疫学。此外，我们检索了检索文章的参考文献，以发现其他包括以下医学主题标题(MeSH)术语的组合:乳腺癌，潜在相关研究。我们考虑了口服或局部应用的草药疗法。使用PRISMA检查表从所需的数据库中提取后，对所有文章的内容进行定性评估。结果:心理问题对人的疾病影响很大，当人们有很大的心理压力时，发病率会高于普通人。健康心理学认为人类健康是一个复杂的整体，认为疾病不是由单一因素引起的，而是生物、心理和社会因素共同作用的产物。最近的研究已经证实了心理社会因素如压力的影响及其对疾病的发病和病程的反应。大多数恶性肿瘤患者有消极的情绪问题，如焦虑和抑郁。癌症患者的抑郁与健康个体的抑郁明显不同，具有独特的症状学和强烈的生物学病因学。结论:更好地了解神经内分泌和免疫系统之间的双向交流有助于新的临床和治疗策略。
{"title":"Role of Anxiety and Depression in Altering Immune System Associated with Breast Cancer. Systematic Review","authors":"","doi":"10.31829/2641-7456/ahs2020-4(1)-155","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2020-4(1)-155","url":null,"abstract":"Background: Focusing on basic and clinical research, psycho-neuroimmunology researchers are looking at how the factors that cause anxiety and depression and their negative emotions can affect physiological and health conditions. Clinical studies have shown that the central nervous system is associated with endocrine and immune systems. \u0000\u0000Objectives: To investigate the impact of depression and anxiety on developing breast cancer through immune disturbance pathway \u0000\u0000Methodology: The present study is a descriptive review of systematic review studies conducted in accordance with the guidelines for preferred cases for reporting systematic and metaanalysis review articles (prisma). Electronic databases including ISI Web of Knowledge, PubMed, and Scopus, were searched from 2012 to 2020. The search strategy psychological, immune response, anxiety disorder, depression, and psychoneuroimmunology. Additionally, we searched the references of retrieved articles to find additional included a combination of the following Medical Subjects Headings (MeSH) terms: breast cancer, potentially related studies. We have considered herbal therapies, which were applied orally, or topically.The content of all articles was evaluated qualitatively after extracting from the desired databases with PRISMA checklist. \u0000\u0000Results: the impact of psychological problems on people's illness is very large, when people have a lot of psychological pressure, the incidence will be higher than ordinary people.Health Psychology considers human health to be a complex entity and believes that disease is not caused by a single factor but is the product of biological, psychological, and social factors. Recent research has previously confirmed the effect of psychosocial factors such as stress and how it reacts to the onset and course of the disease. .Most of the patients with malignant tumor had negative emotional problems such as anxiety and depression .Depression in cancer is markedly different from depression in healthy individuals, and involves a unique symptomatology and a strong biological etiology. \u0000\u0000Conclusions: A better understanding of the bidirectional communication between the neuroendocrine and immune systems could contribute to new clinical and treatment strategies.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116701996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-15DOI: 10.31829/2641-7456/ahs2020-4(1)-154
Traumatic flail chest is segment of the chest wall, which is caused by multiple fractures or by separation of bone structure (at least three sequential broken ribs or separated into two fracture lines). These injuries are mainly seen in polytrauma patients. Chest trauma is the third most common injury in trauma patients (8). Early surgical intervention, as definedas being within 24-72 hours after the trauma, should be performed, assuming other potentially life-threatening injuries have been treated (9-10). Aim of the Study: Our aim is to show the therapeutic benefits of surgical treatment (operative stabilization) of the flail chest. Material and Methods: We retrospective analyzed patients who underwent surgery at the Clinic for Thoracic Surgery, University Clinical Centre of the Republic of Srpska, Banja Luka, in the period from 01.12.1997. - 31.10.2020. Results: 68 patients with average age of 53.57 years with traumatic flail chest were surgicaly treated in the twenty-three year period at the Clinic of Thoracic Surgery, University Clinical Centre of the Republic of the Srpska, Banja Luka. The average length of a hospital stay was 15 days. Survival rate in the operated group was 91.43%. Conclusion: If conservative measures such as internal stabilization, the use of analgesics, antibiotics, oxygen therapy and airway toilet does not lead to stabilization of respiratory function, surgical chest wall stabilization is necessary.
{"title":"Surgical Stabilization of Flail Chest after Blunt Trauma","authors":"","doi":"10.31829/2641-7456/ahs2020-4(1)-154","DOIUrl":"https://doi.org/10.31829/2641-7456/ahs2020-4(1)-154","url":null,"abstract":"Traumatic flail chest is segment of the chest wall, which is caused by multiple fractures or by separation of bone structure (at least three sequential broken ribs or separated into two fracture lines). These injuries are mainly seen in polytrauma patients. Chest trauma is the third most common injury in trauma patients (8). Early surgical intervention, as definedas being within 24-72 hours after the trauma, should be performed, assuming other potentially life-threatening injuries have been treated (9-10). Aim of the Study: Our aim is to show the therapeutic benefits of surgical treatment (operative stabilization) of the flail chest. Material and Methods: We retrospective analyzed patients who underwent surgery at the Clinic for Thoracic Surgery, University Clinical Centre of the Republic of Srpska, Banja Luka, in the period from 01.12.1997. - 31.10.2020. Results: 68 patients with average age of 53.57 years with traumatic flail chest were surgicaly treated in the twenty-three year period at the Clinic of Thoracic Surgery, University Clinical Centre of the Republic of the Srpska, Banja Luka. The average length of a hospital stay was 15 days. Survival rate in the operated group was 91.43%. Conclusion: If conservative measures such as internal stabilization, the use of analgesics, antibiotics, oxygen therapy and airway toilet does not lead to stabilization of respiratory function, surgical chest wall stabilization is necessary.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128519335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.21203/rs.3.rs-124401/v1
C. Huttin, J. Hausman
This paper presents a first experiment with random generator of drug prices and a first simulation on physicians’ treatment choices (case on pharmacotherapies) for diabetes type II care. It also aims to compare the effects of the price variables according to public versus private health plans on physicians’ choices (Medicare versus commercial Health Plans). The base line model used is a Mixed Logit model with Random Price variables. A series of experiments with random parameters generations is designed with various sequences and number of draws. The model is tested on a real analytical dataset, extracted from the CDC physician survey (National Ambulatory Care Survey, NAMCS), for patients with diabetes type II without complications, for previous predictive econometrics with ENDEPUSresearch, Inc. The model uses a first drug choice set with three alternatives: oral agents only, combined therapies, no drug. The choice models introduce qualitative dependent variables and complement the series of cumulative logistic models per disease. The matlab code for the new specification test on the Independence of Irrelevant Alternatives at individual level is modified to fit this type of medical applications; first runs compare main parameters of a full choice set versus reduced choice sets of alternatives. It is planned to design more experiments for extended choice sets and widespread applications, in order to lead to user friendly tools for medical systems. The collaboration with Professor Jerry Hausman on the US market will help with use of results and new ways to adjust the reliability on the selection of alternatives; it may provide additional guidance to the algorithms used by professionals and for health policies.
{"title":"Development of a Physicians’ Choice Model Using Mixed Logit With Random Prices for Drugs Case Study on Diabetes Type II","authors":"C. Huttin, J. Hausman","doi":"10.21203/rs.3.rs-124401/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-124401/v1","url":null,"abstract":"\u0000 This paper presents a first experiment with random generator of drug prices and a first simulation on physicians’ treatment choices (case on pharmacotherapies) for diabetes type II care. It also aims to compare the effects of the price variables according to public versus private health plans on physicians’ choices (Medicare versus commercial Health Plans). The base line model used is a Mixed Logit model with Random Price variables. A series of experiments with random parameters generations is designed with various sequences and number of draws. The model is tested on a real analytical dataset, extracted from the CDC physician survey (National Ambulatory Care Survey, NAMCS), for patients with diabetes type II without complications, for previous predictive econometrics with ENDEPUSresearch, Inc. The model uses a first drug choice set with three alternatives: oral agents only, combined therapies, no drug. The choice models introduce qualitative dependent variables and complement the series of cumulative logistic models per disease. The matlab code for the new specification test on the Independence of Irrelevant Alternatives at individual level is modified to fit this type of medical applications; first runs compare main parameters of a full choice set versus reduced choice sets of alternatives. It is planned to design more experiments for extended choice sets and widespread applications, in order to lead to user friendly tools for medical systems. The collaboration with Professor Jerry Hausman on the US market will help with use of results and new ways to adjust the reliability on the selection of alternatives; it may provide additional guidance to the algorithms used by professionals and for health policies.","PeriodicalId":127914,"journal":{"name":"Archives of Health Science","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122036654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-07DOI: 10.31829/2641-7456/ahs2020-4(1)-153
The aim was to evaluate the quantity of fluoridated toothpaste placed on toothbrushes by children or their parents/caregivers, at the time of daily tooth brushing, and to analyze whether this quantity is within the standards recommended by national and international institutions on this question. Methods: In total 50 children in the age-range from 3 to 12 years were analyzed. These children and their parents/caregivers/ were asked to bring the toothbrushes and toothpastes they used daily (when they came for the dental consultation). Firstly, we measured the mass of the patient’s toothbrush, without toothpaste. The next measurement was made, based on who performed the daily brushing (children/parents/caregivers), and this individual was asked to put the amount of toothpaste habitually used on the brush, during the daily brushing performed at home. Lastly, the amount of fluoridated toothpaste dispensed was measured, according to the values recommended by national and international agencies, in relation to the child’s age (“a grain of raw rice”, “the size of a pea”, horizontal scrub technique). The values obtained at all the stages were recorded and were compared by the T test (α = 5%). Results: The quantity of toothpaste put on the brush by the child or parent/caregiver ranged from 0.1g to 1.45 g, with the mean value being 0.55g (s.d 0.33). The persons responsible for the children used significantly smaller quantities when compared with the children (p˂0.05). Conclusions: Children, irrespective of age, tended to put more toothpaste on toothbrushes, when compared with the parents/caregivers.
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