Health Science Reports最新文献

Background and aims: Honey has long been studied for its healing abilities in wound care. This narrative review examines its properties and their impact on wound healing, particularly its ability to accelerate wound closure and promote tissue regeneration. The review focuses on how honey's botanical origins affect its medical properties and wound-healing capabilities. Finally, clinical studies on honey's effectiveness in wound healing were reviewed compared to traditional treatments.

Methods: Relevant keywords were searched in databases, yielding 1250 documents. After excluding nonrelevant sources, 450 documents were refined, and 167 articles were selected based on thematic alignment and originality. Data extraction focused on study design, intervention details, and outcomes, with quality assessed using standardized criteria. The study adhered to CONSORT and SANRA guidelines to ensure methodological rigor and reporting transparency.

Results: Honey-based medical products have demonstrated significant antibacterial, anti-inflammatory, and tissue-regenerative properties, making them highly effective in improving wound healing outcomes, particularly in chronic and burn wounds. These products have also been shown to reduce infection rates and hospital stays. While some studies have reported positive outcomes in accelerating the healing process, others have found no significant difference compared to conventional treatments.

Conclusion: Medical-grade honey (MGH) holds potential for wound care due to its versatility, though variations in its composition present challenges. Further research is needed to optimize its clinical use. The effectiveness of MGH in wound healing remains debated, with mixed results from trials. Genetic modification of bees to enhance MGH's properties could make it more competitive against conventional treatments. Honey-based medications could reduce costs, improve energy efficiency, and have minimal side effects. Rigorous research is necessary to determine optimal use and fully unlock MGH's potential, which could revolutionize wound management globally.

Background and aims: On March 11, 2020, the World Health Organization declared Coronavirus disease 2019 (COVID-19) as a pandemic. The spread of the Delta variant of coronavirus started in June 2021 and accounted for the fifth peak of COVID-19 in Iran in July 2021. According to reports from other countries, vaccination protects against severe diseases caused by COVID-19, including the Delta variant. Studies have also shown that vaccination provides strong protection against SARS-CoV-2 infection, COVID-19-related hospitalization, and mortality. This retrospective cohort study was designed based on the medical care monitoring center database of Sayyad Shirazi Hospital.

Methods: COVID-19 confirmed patients' data were extracted for this study from June 22, 2021, to September 22, 2021 including demographic characteristics, signs and symptoms, ICU admission, need for aggressive oxygen therapy, including intubation, mortality, and vaccination status.

Results: A total of 2962 patients were enrolled. Being vaccinated was associated with a 4.14-fold increase in survival (adjusted OR = 4.14; 95% CI: 2.22-7.69; p < 0.01), and individuals in a younger age group demonstrated a 5.58-fold higher likelihood of surviving (adjusted OR = 5.58; 95% CI: 4.25-8.14; p < 0.01). The risk of severe COVID-19 was significantly lower in vaccinated individuals, showing a 3.12-fold decrease in risk (adjusted OR = 3.12; 95% CI: 2.06-4.72; p < 0.01), and in younger age groups, the risk exhibited a 3.28-fold decrease (adjusted OR = 3.28; 95% CI: 2.66-4.04; p < 0.01).

Conclusion: The present results suggest that receiving at least one dose of COVID-19 vaccine had a significant relationship with decreased COVID-19 severity and mortality in vaccinated patients compared to unvaccinated patients.

Background and aims: Bendopnea is a symptom found in patients with heart failure (HF) defined as shortness of breath when bending forward. The present study examined the correlation between bendopnea with other cardiac symptoms, echocardiographic findings, and cardiac function parameters.

Methods: This was a single-center prospective cross-sectional study of patients diagnosed with systolic HF. Medical history, bending tests, laboratory tests, electrocardiography (ECG), echocardiography, and 6-min walking test (6-MWT) were evaluated. Patients with reduced ejection fraction were followed to assess the 2-year outcomes for cardiovascular death and rehospitalization.

Results: A total of 80 patients were included in this study, of whom 54 (67.5%) were male. Bendopnea was present in 34 (42.5%) and their mean age was 62.44 years (compared to group without bendopnea, p = 0.869). Symptoms of HF such as dyspnea of exertion (DOE) and orthopnea were significantly related to the presence of bendopnea (p = 0.001, odds ratio (OR): 6.87, and p = 0.016, OR: 3.18, respectively). The bendopnea-positive group had a higher New York Heart Association (NYHA) class (p = 0.005). ECG results showed no significant difference between the two groups. The echocardiographic findings showed that the inferior vena cava (IVC) respiratory collapse was significantly lower in the bendopnea-positive group (p = 0.019, OR: 0.339, 95% CI:0.13-0.85). Moreover, they had a substantially lower performance in 6-MWT (387.39 vs. 325.58 m, p = 0.015). Neither rehospitalization nor death was related to bendopnea after a 2-year follow-up (p = 0.454).

Conclusion: Bendopnea was associated with several signs and symptoms of HF, including orthopnea, DOE, NYHA class, lower IVC collapse, and impaired functional capacity measured via 6-MWT. However, there was no association between bendopnea and ECG findings, ejection fraction, and NT-proBNP levels. Further studies with larger sample sizes are needed to assess the associations with long-term outcomes and confirm our findings.

Background and aims: The escalating complexity of diseases and the burgeoning demand for proficient nurse anesthetists underscore the critical need for graduates optimally equipped to deliver competent care across varying patient conditions. Given the gap between the expected and actual clinical competencies among graduates, this study aimed to evaluate the impact of formative assessment coupled with immediate online feedback on the clinical competence of anesthesia nursing students in peri-anesthesia care.

Methods: This educational intervention was conducted with the participation of nurse anesthesia students who were enrolled into intervention and control groups. The intervention entailed providing immediate, web-based feedback on students' performance through a visual dashboard on Microsoft Power BI, along with weekly assessments using the Common Clinical Assessment Tool (CCAT). The control group received traditional, verbal feedback.

Results: Statistical analysis revealed significant improvements in clinical competence scores in the intervention group compared to the control group. The intervention group showed a notable progression in clinical competency scores from baseline to endpoint (mean scores: 35.06 ± 1.62 to 79.58 ± 1.02), significantly outperforming the control group (mean scores: 29.93 ± 1.38 to 62.09 ± 1.47, p-value < 0.0001).

Conclusions: Integrating formative assessment with immediate online feedback (e.g., Microsoft Power BI) demonstrably enhances clinical competence in student nurse anesthetists. This study advocates for such advanced feedback mechanisms in competency-based nursing education to address competency gaps. These innovative approaches to education and evaluation hold promise for preparing competent nurse anesthetists, potentially leading to improved anesthesia care quality and patient safety.

Background and aims: Drug-drug interactions (DDIs) are a significant health issue that may adversely affect the health and well-being of patients. This study assesses and compares potential DDI (pDDI) patterns, severity, and associated risk factors in government and private hospitals in Dhaka, Bangladesh.

Methods: A total of 188 and 206 prescriptions were collected from various government and private hospitals' outdoor departments, respectively, by capturing pictures of the prescriptions. Bivariate analyses were performed through STATA 15. MedScape drug interaction checker was applied to identify pDDIs, while their consequences were obtained from DrugBank and MedScape.

Results: Private hospitals had more pDDIs containing prescriptions than government hospitals (62.62% and 57.97%, respectively). The mean pDDIs cases were 3.29 in the private hospitals, while at government hospitals they were 3.02. Among the detected pDDIs, pharmacodynamic pDDIs were predominat, accounting for 63.32% and 66.23% of total events in government and private hospitals, respectively. Severity-wise, both types of hospitals had almost equal amounts of serious (10.34% vs. 9.18%), moderate (68.96% vs. 59.61%), and minor (20.06% vs. 21.79%) pDDIs. Polypharmacy was crucial in pDDI cases, responsible for 70.21% and 81.83% of pDDIs in government and private hospitals, respectively. Multiple comorbidities with pDDIs were more common in private hospitals (24.46% vs. 18.93%), while government hospitals displayed a higher frequency of pDDIs with one comorbidity (24.75% vs. 17.55%). Non-mention of comorbidities was correlated with both types of hospitals (p ≤ 0.01) in pDDIs cases. Furthermore, considerable amounts of pDDIs in prescription error categories were detected. Both types of hospitals had a prevalence of antihypertensive, antidiabetic, psychotic, and antiplatelet-related pDDIs.

Conclusion: The two kinds of hospitals exhibited similar pDDI patterns, while their associations were random with the risk variables. When prescribing pharmacokinetics and pharmacodynamics pDDIs, physicians should evaluate the risk-benefit ratio.

Introduction: Surgical practices in low-resource countries often fail to meet established standards. Both doctors and medical students have limited exposure to surgical cases, which hinders training and the development of surgical specialization. This study highlights the current state of surgical practice from a trainee's perspective, explores existing gaps in training and capacity building, and recommends practical solutions.

Methods: We conducted a literature search on PubMed, Google Scholar, and other scientific databases using search terms such as "surgical practice," "doctors' perspectives in surgical practice," "surgery in low- and middle-income countries," and "solutions to surgical inadequacy." We included studies published from 2015 to 2024, with exceptions for a few highly relevant studies published prior to 2015.

Results: We outline the limitations identified in the literature concerning surgical training and healthcare in low- and middle-income countries. Many centers lack adequate infrastructure, human resources, and training. These challenges negatively affect the skills and quality of surgical care. However, some centers demonstrate that surgical practice is feasible through collaboration with institutions established in higher-income contexts.

Conclusion: Telesurgery, task shifting and sharing, high-impact, low-cost surgeries, and collaborations with more developed health systems could effectively bridge the gap in surgical availability in LMICs.

Background and aims: The expected outcomes of the Covid-19 pandemic have a supposedly worsened impact on mental health and suicidal risk. Traditionally, males were supposed to have heightened Aggression and impulsivity in stressful times. We aim to measure the actual differences that existed during the COVID-19 pandemic across male and female participants.

Methods: An overall number of 288 females/95 males (mean age: men = 34.97; women = 32.90 years) participants were recruited. The protocol included questionnaires about suicidal risk, anxiety, depression, impulsivity, aggression, hopelessness, and demographics.

Results: Differences exist in the sense of loneliness, the number of persons being isolated with, anxiety, and several impulsivity subdimensions. A correlation existed for both men and women for anxiety and depression, revealing the impact of aggression. Suicide men's scores correlated with anxiety and depression, lack of premeditation, and hopelessness. Women also had such correlation, except for lack of perseverance, social dimensions, and aggression. Analyses reveal the predictive impact of hopelessness and aggression on anxiety, depression, and suicidal risk predominantly in females.

Conclusion: Our results contradict common ideas that men have heightened aggression and impulsivity. Further research needs to address aggression issues.

Background and aims: Body composition parameters associated with aerobic fitness, mirrored by maximal oxygen consumption (V̇O₂max), have recently gained interest as indicators of physical efficiency in facioscapulohumeral dystrophy (FSHD). Bioimpedance analysis (BIA) allows a noninvasive and repeatable estimate of body composition but is based on the use of predictive equations which, if used in cohorts with different characteristics from those for which the equation was originally formulated, could give biased results. Instead, the phase angle (PhA), a BIA raw bioelectrical parameter reflecting body fluids distribution, could provide reliable data for such analysis.

Methods: 33 clinically and genetically characterized FSHD patients (mean age 35.7; 10 females) and 27 sex and age-matched healthy controls (HC) were included in the analysis. BIA was used to evaluate body fluids distribution (intracellular water [ICW], extracellular water [ECW], and total body water [TBW]), and PhA, while cardiopulmonary exercise test was used to estimate V̇O₂max.

Results: The groups were comparable for ECW and TBW. Instead, patients showed lower values of ICW (p = 0.020), ICW/ECW ratio (p < 0.001), and PhA (p < 0.001). Moreover, patients reported lower V̇O₂max (p = 0.001 for absolute values; p = 0.002 for values expressed in relation to body weight) which, unlike HC, was not associated to PhA.

Conclusion: Based on our results, PhA of FSHD patients is lower than HC. Since PhA mirrors the ICW/ECW ratio, the lower share of ICW seems to be the basis of such difference. Given the lack of association with V̇O₂max, PhA cannot be considered a reliable indicator of aerobic fitness in FSHD.

Background and aims: A catheter-related bloodstream infection (CRBSI) is a life-threatening complication of hemodialysis. It is responsible for significant morbidity and mortality and a costly long hospital stay. Despite its burden, little is known about the factors associated with it and the antibiogram of its responsible causative bacteria. This study aimed to evaluate the determinants of hemodialysis CRBSI and the appropriate antibiogram for the isolated bacterial pathogens among patients attending the KCMC hemodialysis unit.

Methods: A hospital-based retrospective analytical cross-sectional study involved adult patients with CKD or AKI undergoing hemodialysis at KCMC with tunneled or non-tunneled central venous catheters who attended from January 1, 2021 to December 31, 2022. Data were collected from the hospital's electronic medical record system. Statistical analysis was performed using SPSS version 27. Multivariate logistic regression was used to determine the factors associated with CRBSI. A p-value of < 0.05 was considered statistically significant.

Results: A total of 286 patients were analyzed. The patients were predominantly males (70.6%), and more than half were above 55 years old (56%), with a mean age of 58 (SD ± 14.8) years. 56.6% developed CRBSI and were predominantly gram-positive (69.7%). Major associated factors were hypoalbuminemia of < 35 g/dL, diabetes mellitus, anemia of hemoglobin < 10 g/dL, and having a femoral central venous catheter. For gram-positive bacteria, the most efficient antibiotic was vancomycin, with an overall average efficacy of 99% for all isolates. For gram-negative bacteria, the most efficient antibiotic was meropenem, with an overall average efficacy of 82.1% for all isolates.

Conclusion: Over 50% of patients developed CRBSI and gram-positive bacteria were the major causative bacteria. Associated factors were multifactorial and preventive care would be ideal to reduce the number of CRBSI based on these findings.

Background and aims: Neonatal sepsis is a major cause of neonatal mortality worldwide. It remains a detrimental bottleneck to the WHO goal of eradicating preventable deaths for children below 5 years of age by 2030. Though the risk factors for adverse clinical outcomes for neonatal sepsis have been widely studied there is no universal consensus. Length of hospitalization is considered an indicator for adverse clinical outcome of neonatal sepsis. Markedly, literature is scarce regarding the drivers of extended hospitalization for neonatal sepsis in Kenya.

Methodology: This study determined the predictors of prolonged hospital stay for neonatal sepsis at the pediatric wards, KNH, Kenya. This was prospective cross-sectional research carried out among 314 mother/neonate pairs. The neonates were confirmed to have sepsis. Logistic regression analysis was conducted to determine maternal and neonate status predictive of duration of hospitalization.

Results: The median duration of hospital stay was 11 days and the majority (52.9%) were hospitalized for more than 11 days. The findings identified that maternal age ≥ 35 years (OR = 3.72, 95% CI: 1.61-8.59, p = 0.03), UTI during pregnancy (OR = 1.82, 95% CI: 1.07-3.11, p = 0.03), not breastfeeding (OR = 2.31, 95% CI: 1.29-4.14, p = 0.005), convulsion (OR = 2.03, 95% CI: 1.22-3.37, p = 0.01), jaundice (OR = 1.45, 95% CI: 1.10-1.91, p = 0.002), reduced movements (OR = 1.72, 95% CI: 1.08-2.72, p = 0.02), low birthweight (OR = 6.1, 95% CI: 2.48-14.99, p < 0.001) and preterm birth (OR = 3.1, 95% CI: 1.64-5.86, p < 0.001) were significant predictors of longer hospital stay.

Conclusion: The findings provide insights into the factors that can be monitored to predict the prognosis of neonatal sepsis. Besides, remedies can target these variables to mitigate prolonged hospitalization and severity of neonatal sepsis.