Background: Anemia is a global public health problem all around the world, principally the developing countries like Nepal. Anemia results in maternal mortality alongside low birth weight which contributes to an increased infant mortality rate. The prevalence of anemia ranges from 27% to 42% among pregnant women depending on geographical regions. Iron and folic acid tablets are supplied free of charge to pregnant women as part of the Nepal government's National Anemia Control Strategy and Iron Intensification Program. Methods: A cross-sectional study was carried out among pregnant women attending Manekharka health center for an antenatal checkup. Hemoglobin levels of pregnant women from April 2018-2020 were obtained and analyzed. Hemoglobin level was determined using the indirect cyanmethemoglobin method. Results: We used the World Health Organization (WHO) standard classification of hemoglobin levels below 11 gm/dl to determine the prevalence of anemia in pregnant women. The result suggested that a total of 30.7%, (n=63) of the pregnant women were anemic. Among which 4.76% had moderate anemia (hemoglobin 7-9.9gm/dl) and 96.58% had mild anemia (hemoglobin ≥9.9mg/dl to <11gm/dl). Conclusion: The study and its results suggest that the women in the age group 16-19 had a higher prevalence of anemia whereas the age group 25-29 had the lowest prevalence of anemia. Moreover, the study revealed that the prevalence of anemia in hills is substantial.
{"title":"Prevalence of Anemia Among Pregnant Women in Rural Village of Sindhupalchowk District of Nepal - A Cross-Sectional Study","authors":"Biyas Thapa, Smriti Bohara, Sistu Kc, M. Sapkota, Bibek Dhakal, Binod Gaire","doi":"10.5195/ijms.2022.1777","DOIUrl":"https://doi.org/10.5195/ijms.2022.1777","url":null,"abstract":"Background: \u0000Anemia is a global public health problem all around the world, principally the developing countries like Nepal. Anemia results in maternal mortality alongside low birth weight which contributes to an increased infant mortality rate. The prevalence of anemia ranges from 27% to 42% among pregnant women depending on geographical regions. Iron and folic acid tablets are supplied free of charge to pregnant women as part of the Nepal government's National Anemia Control Strategy and Iron Intensification Program. \u0000Methods: \u0000A cross-sectional study was carried out among pregnant women attending Manekharka health center for an antenatal checkup. Hemoglobin levels of pregnant women from April 2018-2020 were obtained and analyzed. Hemoglobin level was determined using the indirect cyanmethemoglobin method.\u0000Results: \u0000 We used the World Health Organization (WHO) standard classification of hemoglobin levels below 11 gm/dl to determine the prevalence of anemia in pregnant women. The result suggested that a total of 30.7%, (n=63) of the pregnant women were anemic. Among which 4.76% had moderate anemia (hemoglobin 7-9.9gm/dl) and 96.58% had mild anemia (hemoglobin ≥9.9mg/dl to <11gm/dl).\u0000Conclusion: \u0000The study and its results suggest that the women in the age group 16-19 had a higher prevalence of anemia whereas the age group 25-29 had the lowest prevalence of anemia. Moreover, the study revealed that the prevalence of anemia in hills is substantial.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90601609","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}
I. Dike, Uzochukwu Eustace Imo, Jeremiah Adepoju Moyondafoluwa
Background: The rate of tobacco use is on a steady increase worldwide and is associated with over 7 million deaths per year, three-quarters of which occur in low-and middle-income countries. Inadequate cessation programs/interventions, difficulties quitting tobacco, and a lack of information about tobacco health risks and tobacco harm reduction methods, have all contributed to the rapid rise of tobacco use in Nigeria, with the country's smoking rate increasing at a rate of approximately 4% each year. Tobacco harm reduction (THR) methods are alternatives to cigarette smoking that have been shown to assist in smoking cessation and reduce the mortality and morbidity associated with tobacco and nicotine use, however, these methods are still controversial and have drawn some criticism in recent times. Due to the prevalence of THR methods among young people and the growing health debate around them, medical students are likely to have a direct or indirect encounter with THR methods. A greater grasp of their viewpoint is beneficial while training them. Therefore, this study aims to determine the knowledge, attitude, and perception of THR strategies among medical students in southwest, Nigeria. Methods: A cross-sectional study was carried out among clinical medical students in 6 medical schools in southwest, Nigeria, and data was collected via an online semi-structured based questionnaire. Descriptive analysis was done and a chi-square test was used to test the association between the level of knowledge of tobacco health risks and the socio-demographic variables. Results: 199 participants’ data were fully collected, 105(53%) were male while 94(47%) were female. Most (79%) of the respondents were of the age group 21-25. The majority (99.5%) of them never smoked. The majority of the participants 190(95%) have good knowledge about the health risks of tobacco and a Chi-square test showed only age as a significant socio-demographic variable, with participants between the 16-20 age group having a higher frequency of poor knowledge. Only 83(42%) understood what THR means. Also, 185(93%) do not know about THR methods regulation in Nigeria. 179(90%) have an interest in knowing about THR and 147(74%) said they will recommend it to smokers as a future doctor. 60.3% of participants perceived THR products to be less harmful than conventional cigarettes and 23% perceived THR products to be harmful to people in the vicinity of the users. 50.8% of participants see THR products to be a “gateway” to conventional cigarette use in the future. Conclusion: From this result, most medical students have good knowledge about tobacco harm risks, therefore, they will be able to confidently discuss this topic with patients and the public. However, there is poor knowledge of THR methods among medical students. This highlights the critical need to further educate medical students as well as give evidence-based recommendations at all levels to assist in advising patients who enquire or
{"title":"Knowledge, Attitude, and Perception of Tobacco Harm Reduction Strategies Among Medical Students in Southwest, Nigeria","authors":"I. Dike, Uzochukwu Eustace Imo, Jeremiah Adepoju Moyondafoluwa","doi":"10.5195/ijms.2022.1766","DOIUrl":"https://doi.org/10.5195/ijms.2022.1766","url":null,"abstract":"Background: The rate of tobacco use is on a steady increase worldwide and is associated with over 7 million deaths per year, three-quarters of which occur in low-and middle-income countries. Inadequate cessation programs/interventions, difficulties quitting tobacco, and a lack of information about tobacco health risks and tobacco harm reduction methods, have all contributed to the rapid rise of tobacco use in Nigeria, with the country's smoking rate increasing at a rate of approximately 4% each year. Tobacco harm reduction (THR) methods are alternatives to cigarette smoking that have been shown to assist in smoking cessation and reduce the mortality and morbidity associated with tobacco and nicotine use, however, these methods are still controversial and have drawn some criticism in recent times. Due to the prevalence of THR methods among young people and the growing health debate around them, medical students are likely to have a direct or indirect encounter with THR methods. A greater grasp of their viewpoint is beneficial while training them. Therefore, this study aims to determine the knowledge, attitude, and perception of THR strategies among medical students in southwest, Nigeria.\u0000Methods: A cross-sectional study was carried out among clinical medical students in 6 medical schools in southwest, Nigeria, and data was collected via an online semi-structured based questionnaire. Descriptive analysis was done and a chi-square test was used to test the association between the level of knowledge of tobacco health risks and the socio-demographic variables.\u0000Results: 199 participants’ data were fully collected, 105(53%) were male while 94(47%) were female. Most (79%) of the respondents were of the age group 21-25. The majority (99.5%) of them never smoked. The majority of the participants 190(95%) have good knowledge about the health risks of tobacco and a Chi-square test showed only age as a significant socio-demographic variable, with participants between the 16-20 age group having a higher frequency of poor knowledge. Only 83(42%) understood what THR means. Also, 185(93%) do not know about THR methods regulation in Nigeria. 179(90%) have an interest in knowing about THR and 147(74%) said they will recommend it to smokers as a future doctor. 60.3% of participants perceived THR products to be less harmful than conventional cigarettes and 23% perceived THR products to be harmful to people in the vicinity of the users. 50.8% of participants see THR products to be a “gateway” to conventional cigarette use in the future.\u0000Conclusion: From this result, most medical students have good knowledge about tobacco harm risks, therefore, they will be able to confidently discuss this topic with patients and the public. However, there is poor knowledge of THR methods among medical students. This highlights the critical need to further educate medical students as well as give evidence-based recommendations at all levels to assist in advising patients who enquire or","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83816229","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}
P. Kuwar Chhetri, A. Montasir, Renu Gupta, Shamsul Alam, Shafwanur Rahman, Fahim Rahman
Background: Varicella-zoster virus (HHV3) is one of the virus in herpes family. Herpes zoster results from the reactivation of varicella-zoster virus in the dorsal root ganglion. This reactivation occurs in immunocompromised conditions such as people with cancer, organ transplant recipients or those receiving chemotherapy, and people with HIV. Old age is also an important risk for the development of herpes zoster. Immunocompromised patients are at increased risk of VZV reactivation because of reduced T cell-mediated immunity. Emotional stress has also been mentioned as an associated factor in people with herpes zoster. The Classic clinical presentation consists of clear vesicular eruptions in dermatomal distribution which are painful. An immunocompromised individual may have frequent attacks of herpes zoster, cutaneous dissemination, organ involvement, and hemorrhagic herpes zoster. Haemorrhagic herpes zoster is an atypical form of herpes zoster develops in patients who are immunosuppressed and people of advanced age who are taking antiplatelets, and anticoagulants, and also in patients with thrombocytopenia due to any cause. The most common Association of herpes zoster is observed with lymphocytic leukemia and less frequently with myeloid leukemia. Management icludes antiviral therapy along with management of haemorrhagic conditions. Case Report: A nondiabetic male of 60 years attended the medicine outpatients department with complaints of epistaxis for two days. No history of bleeding from other sites was evident. There was no history of trauma or taking of anticoagulants or antiplatelets. No history of fever. The patient was anaemic and an erythematous rash was evident along the right T6 dermatome. He was admitted to the general medicine ward. On the second day of his admission, our patient developed painful haemorrhagic bullous lesions over the right T6 dermatome resembling a bunch of grapes and erythematous popular lesions all over his body (Figure 1). The bullous lesions became larger in size in the subsequent two days of admission. On query, he mentioned that he had suffered from Varicella Zoster in his early childhood. Patients haemoglobin was 10.70 gm/dl, total count of white blood cell (WBC) was 13.20 K/ mm3 (normal value 4.00 – 11.00 K/ mm3), neutrophil and lymphocyte counts were 2.38 K/ mm3 (normal value 2.16 – 6.04 K/ mm3) and 10.38 K/ mm3 (normal value 0.6 – 3.06 K/ mm3) respectively. His platelet count was 5.00 K/ mm3 (normal value 150.00 – 400.00 K/ mm3). The patient denied skin biopsy. A diagnosis of haemorrhagic herpes zoster was made after a dermatology consultation and oral valacyclovir was started along with oral and topical antibiotics and regular dressings. After six units of platelet transfusion patients, the platelet count was raised to 30 K/ mm3. Peripheral blood film was suggestive of acute leukaemia. A bone marrow examination was suggestive of acute myeloid leukaemia. The patient was transferred to the haemato-oncolog
{"title":"A Case of Haemorrhagic Herpes Zoster","authors":"P. Kuwar Chhetri, A. Montasir, Renu Gupta, Shamsul Alam, Shafwanur Rahman, Fahim Rahman","doi":"10.5195/ijms.2022.1804","DOIUrl":"https://doi.org/10.5195/ijms.2022.1804","url":null,"abstract":"Background: Varicella-zoster virus (HHV3) is one of the virus in herpes family. Herpes zoster results from the reactivation of varicella-zoster virus in the dorsal root ganglion. This reactivation occurs in immunocompromised conditions such as people with cancer, organ transplant recipients or those receiving chemotherapy, and people with HIV. Old age is also an important risk for the development of herpes zoster. Immunocompromised patients are at increased risk of VZV reactivation because of reduced T cell-mediated immunity. Emotional stress has also been mentioned as an associated factor in people with herpes zoster. The Classic clinical presentation consists of clear vesicular eruptions in dermatomal distribution which are painful. An immunocompromised individual may have frequent attacks of herpes zoster, cutaneous dissemination, organ involvement, and hemorrhagic herpes zoster. Haemorrhagic herpes zoster is an atypical form of herpes zoster develops in patients who are immunosuppressed and people of advanced age who are taking antiplatelets, and anticoagulants, and also in patients with thrombocytopenia due to any cause. The most common Association of herpes zoster is observed with lymphocytic leukemia and less frequently with myeloid leukemia. Management icludes antiviral therapy along with management of haemorrhagic conditions.\u0000Case Report: A nondiabetic male of 60 years attended the medicine outpatients department with complaints of epistaxis for two days. No history of bleeding from other sites was evident. There was no history of trauma or taking of anticoagulants or antiplatelets. No history of fever. The patient was anaemic and an erythematous rash was evident along the right T6 dermatome. He was admitted to the general medicine ward. On the second day of his admission, our patient developed painful haemorrhagic bullous lesions over the right T6 dermatome resembling a bunch of grapes and erythematous popular lesions all over his body (Figure 1). The bullous lesions became larger in size in the subsequent two days of admission. On query, he mentioned that he had suffered from Varicella Zoster in his early childhood. Patients haemoglobin was 10.70 gm/dl, total count of white blood cell (WBC) was 13.20 K/ mm3 (normal value 4.00 – 11.00 K/ mm3), neutrophil and lymphocyte counts were 2.38 K/ mm3 (normal value 2.16 – 6.04 K/ mm3) and 10.38 K/ mm3 (normal value 0.6 – 3.06 K/ mm3) respectively. His platelet count was 5.00 K/ mm3 (normal value 150.00 – 400.00 K/ mm3). The patient denied skin biopsy. A diagnosis of haemorrhagic herpes zoster was made after a dermatology consultation and oral valacyclovir was started along with oral and topical antibiotics and regular dressings. After six units of platelet transfusion patients, the platelet count was raised to 30 K/ mm3. Peripheral blood film was suggestive of acute leukaemia. A bone marrow examination was suggestive of acute myeloid leukaemia. The patient was transferred to the haemato-oncolog","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88121174","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}
Thoybah Yousif Ibrahim Gabralla, H. Bashir, O. Mohamed
Background: As of December 2021, the World Health Organization (WHO) reports that Coronavirus disease 2019 (COVID-19) led to about 5,403,662 deaths. While COVID-19 has resulted in millions of deaths worldwide to date, vaccination remains the mainstay of infection control. AZD1222 (AstraZeneca vaccine) was distributed in Sudan by the COVID-19 Vaccines Global Access facility in March 2021. It was added to the emergency use list by WHO in the middle of February 2021. However, vaccine safety among patients with autoimmune diseases, such as myasthenia gravis (MG), is yet to be established. MG is a relatively rare illness that could result in life-threatening complications. Myasthenic crisis is considered the most serious complication of MG that can lead to death due to aspiration and respiratory failure. Plasma exchange (PLEX), Immunoadsorption (IA), and intravenous Immunoglobulin (IVIG) are the first-line treatment for myasthenic crisis. It is proven that cortisone has a positive effect when used as add-on therapy with PLEX/IA and IVIG. The case: We report the case of a 37-year-old Sudanese female who presented to the emergency room with an exacerbation of her previously well-controlled MG following her second dose of AZD1222 vaccination. The exacerbation symptoms at time of presentation were severe generalized body weakness that increasing overtime and shortness of breath. Computerized tomography of the chest was performed, and it revealed no evidence of COVID-19. Management at the ER started with rehydration and IV methylprednisolone 1g, followed by IV hydrocortisone 200mg. She continued to deteriorate and was admitted to the intensive care unit where she was intubated and placed on a mechanical ventilator. IVIG was requested but couldn't be obtained due to the low-income setting, and fourteen days after admission patient died due to circulatory collapse. Our study aims to present an MG case with features of MG exacerbation following the administration of the second dose of AZD1222. Conclusion: Little is known about the effect of different COVID-19 vaccines on subgroups of patients with autoimmune diseases like MG. Although the safety profile of AZD1222 is generally reassuring, people with severe underlying diseases were excluded from trials. Therefore, more efforts and experimental studies may be needed, with closer vigilance in MG patients. It has not been elucidated how the COVID-19 vaccine might provoke autoimmunity, but several theories have been proposed. Molecular mimicry theory can explain how the genetic material of a virus could provoke autoimmunity, it describes the cross-reactivity of antibodies produced against proteins that are encoded by viral genetic material with the proteins located at the post-synaptic membrane. There is a debate about whether vaccine benefit outweighs the risk in MG patients or not. However, we believed that MG patients should be informed about the benefit and risks of COVID-19 vaccination.
{"title":"Myasthenia Gravis Exacerbation Following COVID-19 Vaccine: A Case Report","authors":"Thoybah Yousif Ibrahim Gabralla, H. Bashir, O. Mohamed","doi":"10.5195/ijms.2022.1741","DOIUrl":"https://doi.org/10.5195/ijms.2022.1741","url":null,"abstract":"Background: As of December 2021, the World Health Organization (WHO) reports that Coronavirus disease 2019 (COVID-19) led to about 5,403,662 deaths. While COVID-19 has resulted in millions of deaths worldwide to date, vaccination remains the mainstay of infection control. AZD1222 (AstraZeneca vaccine) was distributed in Sudan by the COVID-19 Vaccines Global Access facility in March 2021. It was added to the emergency use list by WHO in the middle of February 2021. However, vaccine safety among patients with autoimmune diseases, such as myasthenia gravis (MG), is yet to be established. MG is a relatively rare illness that could result in life-threatening complications. Myasthenic crisis is considered the most serious complication of MG that can lead to death due to aspiration and respiratory failure. Plasma exchange (PLEX), Immunoadsorption (IA), and intravenous Immunoglobulin (IVIG) are the first-line treatment for myasthenic crisis. It is proven that cortisone has a positive effect when used as add-on therapy with PLEX/IA and IVIG. \u0000 \u0000The case: We report the case of a 37-year-old Sudanese female who presented to the emergency room with an exacerbation of her previously well-controlled MG following her second dose of AZD1222 vaccination. The exacerbation symptoms at time of presentation were severe generalized body weakness that increasing overtime and shortness of breath. Computerized tomography of the chest was performed, and it revealed no evidence of COVID-19. Management at the ER started with rehydration and IV methylprednisolone 1g, followed by IV hydrocortisone 200mg. She continued to deteriorate and was admitted to the intensive care unit where she was intubated and placed on a mechanical ventilator. IVIG was requested but couldn't be obtained due to the low-income setting, and fourteen days after admission patient died due to circulatory collapse. Our study aims to present an MG case with features of MG exacerbation following the administration of the second dose of AZD1222. \u0000 \u0000Conclusion: Little is known about the effect of different COVID-19 vaccines on subgroups of patients with autoimmune diseases like MG. Although the safety profile of AZD1222 is generally reassuring, people with severe underlying diseases were excluded from trials. Therefore, more efforts and experimental studies may be needed, with closer vigilance in MG patients. It has not been elucidated how the COVID-19 vaccine might provoke autoimmunity, but several theories have been proposed. Molecular mimicry theory can explain how the genetic material of a virus could provoke autoimmunity, it describes the cross-reactivity of antibodies produced against proteins that are encoded by viral genetic material with the proteins located at the post-synaptic membrane. There is a debate about whether vaccine benefit outweighs the risk in MG patients or not. However, we believed that MG patients should be informed about the benefit and risks of COVID-19 vaccination. \u0000 ","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80551745","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}
Hidar Alibrahim, S. Swed, H. Bohsas, S. Shoib, S. Alsakka, Nagham Jawish, Zain Alabdeen Othman, B. Sawaf
Background: After the widespread of COVID-19 around the globe, it was imperative to establish preventative measures to restrict the virus's transmission and enable clinicians to remotely monitor patients' status and avoid direct contact with them. The purpose of this research was to present an overview of the awareness, knowledge, attitude, and abilities of Syrian physicians about telemedicine technology. Methods: An online cross-sectional study was conducted from 1 April to 15 May, 2022 to assess Syrian doctors' awareness, knowledge, attitude, and skills towards telemedicine. The questionnaire was taken from published study, and the inclusion criteria consist the Syrian doctors who worked in hospitals during the COVID19 pandemic, mainly those who had direct contact with patients. Data were analyzed using descriptive and multivariate logistic regression analysis in IBM, SPSS V. 28.0. Results: Among 385 responses, 52.72% of them were females, 83.9% of them were aged less than 30 years old, and 66% were working in the governmental sector. 66% of participants have moderate knowledge about using computers and the internet, 80% have heard about telemedicine. Despite that, 95.1% of participants have not attended any training workshop on telemedicine, and most of them have reported no availability of a telemedicine unit in their department. Only 31.7% participants have shown high awareness of telemedicine. Furthermore, no significant correlation was identified between the academic level with the age and telemedicine awareness, knowledge, attitude, or computer skills. Despite that, there was an obvious correlation between age and computer skills (P Value<0.05). There was a significant correlation between the medical specialty and awareness, and computer abilities, especially the anesthesiology (88.5±5.2), (84±8.7) respectively. Conclusion: The study results demonstrate that most of the participating clinical doctors have a neutral view of telemedicine, even though they don't know much about it and don't have considerable experience with it. It is practical to educate and train academic staff, practicing physicians, residents and medical students within the clinical stages about telemedicine.
背景:在COVID-19在全球广泛传播后，必须制定预防措施以限制病毒的传播，并使临床医生能够远程监测患者的状态并避免与患者直接接触。本研究的目的是概述叙利亚医生对远程医疗技术的认识、知识、态度和能力。方法:于2022年4月1日至5月15日进行了一项在线横断面研究，以评估叙利亚医生对远程医疗的意识、知识、态度和技能。问卷取自已发表的研究成果，纳入标准为在2019冠状病毒病大流行期间在医院工作的叙利亚医生，主要是与患者直接接触的医生。采用IBM、SPSS V. 28.0软件进行描述性和多变量logistic回归分析。结果:385名受访者中，女性占52.72%，年龄在30岁以下的占83.9%，在政府部门工作的占66%。66%的参与者对使用计算机和互联网有一定的了解，80%的人听说过远程医疗。尽管如此，95.1%的参与者没有参加过任何远程医疗培训讲习班，其中大多数人报告说，他们所在部门没有远程医疗单位。只有31.7%的受访者对远程医疗有较高的认识。此外，学术水平与年龄与远程医疗意识、知识、态度或计算机技能之间没有显著的相关性。尽管如此，年龄与计算机技能之间存在明显的相关性(P值<0.05)。医学专业与意识、计算机能力有显著相关性，以麻醉学(88.5±5.2)、(84±8.7)显著。结论:研究结果表明，大多数参与的临床医生对远程医疗的看法是中立的，尽管他们对远程医疗的了解并不多，也没有足够的经验。在临床阶段对学术人员、执业医师、住院医师和医学生进行远程医疗教育和培训是可行的。
{"title":"Awareness, Knowledge, Attitude, and Skills Regarding Telemedicine Among Syrian Healthcare Providers During the COVID-19 Pandemic: A Cross-Sectional Study","authors":"Hidar Alibrahim, S. Swed, H. Bohsas, S. Shoib, S. Alsakka, Nagham Jawish, Zain Alabdeen Othman, B. Sawaf","doi":"10.5195/ijms.2022.1774","DOIUrl":"https://doi.org/10.5195/ijms.2022.1774","url":null,"abstract":"Background: After the widespread of COVID-19 around the globe, it was imperative to establish preventative measures to restrict the virus's transmission and enable clinicians to remotely monitor patients' status and avoid direct contact with them. The purpose of this research was to present an overview of the awareness, knowledge, attitude, and abilities of Syrian physicians about telemedicine technology.\u0000Methods: An online cross-sectional study was conducted from 1 April to 15 May, 2022 to assess Syrian doctors' awareness, knowledge, attitude, and skills towards telemedicine. The questionnaire was taken from published study, and the inclusion criteria consist the Syrian doctors who worked in hospitals during the COVID19 pandemic, mainly those who had direct contact with patients. Data were analyzed using descriptive and multivariate logistic regression analysis in IBM, SPSS V. 28.0.\u0000Results: Among 385 responses, 52.72% of them were females, 83.9% of them were aged less than 30 years old, and 66% were working in the governmental sector. 66% of participants have moderate knowledge about using computers and the internet, 80% have heard about telemedicine. Despite that, 95.1% of participants have not attended any training workshop on telemedicine, and most of them have reported no availability of a telemedicine unit in their department. Only 31.7% participants have shown high awareness of telemedicine. Furthermore, no significant correlation was identified between the academic level with the age and telemedicine awareness, knowledge, attitude, or computer skills. Despite that, there was an obvious correlation between age and computer skills (P Value<0.05). There was a significant correlation between the medical specialty and awareness, and computer abilities, especially the anesthesiology (88.5±5.2), (84±8.7) respectively.\u0000Conclusion: The study results demonstrate that most of the participating clinical doctors have a neutral view of telemedicine, even though they don't know much about it and don't have considerable experience with it. It is practical to educate and train academic staff, practicing physicians, residents and medical students within the clinical stages about telemedicine.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82124113","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}
A. Khaity, Mohammed Tarek, Y. Alabdallat, K. Albakri, M. Gabra, Hazem. S Ghaith
Background: A cesarean section (CS) is one of the most common operations globally, with an estimated 18.5 million surgical procedures each year. Accordingly, music therapy has become a trendy possible solution in many clinical conditions and surgical procedures. However, most previous studies have shown conflicting findings regarding the efficacy of music in reducing pain and anxiety in women with cesarean delivery. Therefore, in this meta-analysis, we aimed to investigate whether music intervention has a beneficial effect on preoperative, intraoperative, and postoperative anxiety, pain, and vital signs in women with cesarean section. Method: We conducted a comprehensive search of Scopus, Web of Science, PubMed, and Cochrane Central was conducted for relevant randomized controlled trials (RCTs) from inception until August 2022. Data were extracted from eligible studies and pooled as standardized mean difference (SMD) or mean difference (MD) values in a random-effect model meta-analysis, using RevMan software. All the steps of this study were performed according to the PRISMA statement guidelines. Results: Thirteen RCTs were included in this meta-analysis with a total of 1513 patients. Our study showed that music was superior to control in terms of overall anxiety score (SMD = - 0.26, 95% CI [- 0.39, - 0.14], p <0.0001), postoperative pain (SMD = - 0.50, 95% CI [- 0.74, - 0.26], p < 0.0001), and the overall effect of diastolic blood pressure (DBP) (MD = -1.58, 95% CI [- 3.11, - 0.04], p = 0.04). The overall effect did not favor either of the two groups in terms of systolic blood pressure (SBP) and heart rate ((MD = - 1.87, 95% CI [-4.04, 0.30], p = 0.09), (MD = - 2.10, 95% CI [- 4.78, 0.58], p = 0.12); respectively). Conclusion: Ultimately, the current evidence supports using music to alleviate the anxiety and pain of women during and after cesarean sections. In addition, our analysis revealed that music has a beneficial effect on DBP and intraoperative heart rate over control in patients with CS. However, the music did not differ significantly from the placebo in preoperative anxiety, postoperative heart rate, as well as SBP. Future RCTs are recommended to confirm the efficacy of music in the preoperative period and vital signs among women undergoing cesarean section.
背景:剖宫产(CS)是全球最常见的手术之一，每年估计有1850万例手术。因此，音乐疗法在许多临床条件和外科手术中已经成为一种可能的解决方案。然而，关于音乐在减轻剖宫产妇女疼痛和焦虑方面的功效，大多数先前的研究都显示了相互矛盾的结果。因此，在本荟萃分析中，我们旨在探讨音乐干预是否对剖宫产妇女术前、术中和术后的焦虑、疼痛和生命体征有有益的影响。方法:全面检索Scopus、Web of Science、PubMed和Cochrane Central，检索自成立至2022年8月的相关随机对照试验(RCTs)。数据从符合条件的研究中提取，并使用RevMan软件在随机效应模型荟萃分析中汇总为标准化平均差(SMD)或平均差(MD)值。本研究的所有步骤均按照PRISMA声明指南进行。结果:本荟萃分析纳入13项随机对照试验，共1513例患者。我们的研究表明，音乐在总体焦虑评分(SMD = - 0.26, 95% CI [- 0.39， - 0.14]， p <0.0001)、术后疼痛(SMD = - 0.50, 95% CI [- 0.74， - 0.26]， p <0.0001)和舒张压(DBP)的总体影响(MD = -1.58, 95% CI [- 3.11， - 0.04]， p = 0.04)方面优于对照组。在收缩压(SBP)和心率方面，总体效果对两组均不利(MD = - 1.87, 95% CI [-4.04, 0.30]， p = 0.09)， (MD = - 2.10, 95% CI [- 4.78, 0.58]， p = 0.12);分别)。结论:最终，目前的证据支持使用音乐来减轻妇女在剖宫产期间和之后的焦虑和痛苦。此外，我们的分析显示，音乐对CS患者的舒张压和术中心率的控制有有益的影响。然而，在术前焦虑、术后心率和收缩压方面，音乐与安慰剂没有显著差异。建议未来的随机对照试验，以确认音乐在剖宫产妇女术前和生命体征的疗效。
{"title":"The Effect of Music Intervention on Anxiety and Pain During Cesarean Delivery: A Meta-Analysis of 1513 Patients","authors":"A. Khaity, Mohammed Tarek, Y. Alabdallat, K. Albakri, M. Gabra, Hazem. S Ghaith","doi":"10.5195/ijms.2022.1812","DOIUrl":"https://doi.org/10.5195/ijms.2022.1812","url":null,"abstract":"Background: A cesarean section (CS) is one of the most common operations globally, with an estimated 18.5 million surgical procedures each year. Accordingly, music therapy has become a trendy possible solution in many clinical conditions and surgical procedures. However, most previous studies have shown conflicting findings regarding the efficacy of music in reducing pain and anxiety in women with cesarean delivery. Therefore, in this meta-analysis, we aimed to investigate whether music intervention has a beneficial effect on preoperative, intraoperative, and postoperative anxiety, pain, and vital signs in women with cesarean section.\u0000Method: We conducted a comprehensive search of Scopus, Web of Science, PubMed, and Cochrane Central was conducted for relevant randomized controlled trials (RCTs) from inception until August 2022. Data were extracted from eligible studies and pooled as standardized mean difference (SMD) or mean difference (MD) values in a random-effect model meta-analysis, using RevMan software. All the steps of this study were performed according to the PRISMA statement guidelines.\u0000Results: Thirteen RCTs were included in this meta-analysis with a total of 1513 patients. Our study showed that music was superior to control in terms of overall anxiety score (SMD = - 0.26, 95% CI [- 0.39, - 0.14], p <0.0001), postoperative pain (SMD = - 0.50, 95% CI [- 0.74, - 0.26], p < 0.0001), and the overall effect of diastolic blood pressure (DBP) (MD = -1.58, 95% CI [- 3.11, - 0.04], p = 0.04). The overall effect did not favor either of the two groups in terms of systolic blood pressure (SBP) and heart rate ((MD = - 1.87, 95% CI [-4.04, 0.30], p = 0.09), (MD = - 2.10, 95% CI [- 4.78, 0.58], p = 0.12); respectively).\u0000Conclusion: Ultimately, the current evidence supports using music to alleviate the anxiety and pain of women during and after cesarean sections. In addition, our analysis revealed that music has a beneficial effect on DBP and intraoperative heart rate over control in patients with CS. However, the music did not differ significantly from the placebo in preoperative anxiety, postoperative heart rate, as well as SBP. Future RCTs are recommended to confirm the efficacy of music in the preoperative period and vital signs among women undergoing cesarean section.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85856037","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}
Background Peripheral venous catheterization (PVC) and blood sampling (BS) represent some of the first basic techniques that a medical student learns when starting clinical practice. As they are invasive maneuvers, there is a level of self-doubt that can be overcome through practice in a simulated setting. Peer-assisted medical simulation learning is an innovative educational technique that allows students to gain confidence in conducting clinical maneuvers in a safe environment. Simulation based learning focuses on trial and error, participants being able to approach the technique multiple times, without the risk of hurting a real patient. Additionally, the fact that the workshop is conducted by fellow students, creates a more comfortable learning setting. Aim of study Our aim is to determine the effectiveness of medical simulation in learning to perform PVC and BS and in increasing the level of confidence of the participants. Materials and methods Our study was conducted at the Department of Medical Simulation of the Center for Innovation and e-Health (CIeH), part of the University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania, between March and December 2021. During this period, 2186 first year students took part in a peer-conducted simulation workshop, conducted by undergraduate medical students in all years of studies, who had previously undergone extensive training and evaluation. The aim of the workshop was to learn the basics in PVC and BS in a controlled environment. Through a questionnaire, we collected data regarding knowledge acquisition and auto-evaluation of the students’ skill and knowledge prior and after the training on a five-point scale. At the beginning of the questionnaire we obtained informed consent from the study participants. Results The response rate to the questionnaire was 66,10%. The participants obtained an average score of 60%. There were few participants that did not acquire enough information in order to answer correctly to the questionnaire. 80% of the respondents answered accurately on 2 out of 3 questions. We observed a 48,35% increase in the confidence level of participants regarding clinical knowledge and skill acquisition after the workshop. Prior to the workshop, only 10% of participants self-evaluated with a score of 4 or 5, compared to 85% of respondents after the workshop. Conclusions The medical simulation training led to a significant rise in students’ confidence and a high impact on the development of skill and knowledge. Through our basic workshops we want to familiarize the participants with the clinical environment, additional knowledge and skills being acquired once throughout their studies. The workshop's objective of increasing participants’ comfort regarding basic clinical techniques, such as blood sampling and peripheral venous catheterization, was accomplished. The outcome of the study enables us to adapt the curriculum and testing procedures to better me
{"title":"Simulation Based Peer-Assisted Learning: Peripheral Venous Catheterization and Blood Sampling","authors":"Didina Cătălina Barbălată, C. Toma","doi":"10.5195/ijms.2022.1796","DOIUrl":"https://doi.org/10.5195/ijms.2022.1796","url":null,"abstract":"Background \u0000Peripheral venous catheterization (PVC) and blood sampling (BS) represent some of the first basic techniques that a medical student learns when starting clinical practice. As they are invasive maneuvers, there is a level of self-doubt that can be overcome through practice in a simulated setting. \u0000Peer-assisted medical simulation learning is an innovative educational technique that allows students to gain confidence in conducting clinical maneuvers in a safe environment. Simulation based learning focuses on trial and error, participants being able to approach the technique multiple times, without the risk of hurting a real patient. Additionally, the fact that the workshop is conducted by fellow students, creates a more comfortable learning setting. \u0000 \u0000Aim of study \u0000Our aim is to determine the effectiveness of medical simulation in learning to perform PVC and BS and in increasing the level of confidence of the participants. \u0000 \u0000Materials and methods \u0000Our study was conducted at the Department of Medical Simulation of the Center for Innovation and e-Health (CIeH), part of the University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania, between March and December 2021. During this period, 2186 first year students took part in a peer-conducted simulation workshop, conducted by undergraduate medical students in all years of studies, who had previously undergone extensive training and evaluation. The aim of the workshop was to learn the basics in PVC and BS in a controlled environment. \u0000Through a questionnaire, we collected data regarding knowledge acquisition and auto-evaluation of the students’ skill and knowledge prior and after the training on a five-point scale. At the beginning of the questionnaire we obtained informed consent from the study participants. \u0000 \u0000Results \u0000The response rate to the questionnaire was 66,10%. The participants obtained an average score of 60%. There were few participants that did not acquire enough information in order to answer correctly to the questionnaire. 80% of the respondents answered accurately on 2 out of 3 questions. \u0000We observed a 48,35% increase in the confidence level of participants regarding clinical knowledge and skill acquisition after the workshop. Prior to the workshop, only 10% of participants self-evaluated with a score of 4 or 5, compared to 85% of respondents after the workshop. \u0000 \u0000Conclusions \u0000The medical simulation training led to a significant rise in students’ confidence and a high impact on the development of skill and knowledge. Through our basic workshops we want to familiarize the participants with the clinical environment, additional knowledge and skills being acquired once throughout their studies. The workshop's objective of increasing participants’ comfort regarding basic clinical techniques, such as blood sampling and peripheral venous catheterization, was accomplished. The outcome of the study enables us to adapt the curriculum and testing procedures to better me","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88755950","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}
Alexandra C. Skoczek, Patrick W. Ruane, Cassidy Onley, Torhiana Haydel, Maria Valeria Ortega, H. Dean Sutphin, Alexis M. Stoner
Background: In the midst of the COVID-19 pandemic, countries, and governments around the world have implemented different measures and guidelines for the containment and mitigation of the COVID-19 virus. In addition to implemented policies and initiatives, social media and personal beliefs have affected medical students’ social, emotional, financial, and academic stability and success both domestically and internationally. The objective of this study was to assess medical student's perspectives, attitudes, and insight in the face of the COVID-19 pandemic and determine if differences exist between countries. Methods: This qualitative study, recruited students enrolled in the Global Seminar for Health and Environment elective course in their respective medical schools to complete a weekly, non-graded journaling assignment for 6 weeks. To measure outcomes, open-ended questions within the assignment asked students across four different countries questions regarding the COVID-19 pandemic including personal beliefs and knowledge, policies and initiatives within their country, global policies and initiatives, and social media presentations. Thematic analysis was then completed using the QCoder package in R Studio. Results: Both internationally and in the US, COVID-19 has had a large impact on medical students; however, their perspectives are distinct in personal beliefs, policies, and social media. International medical students believed that their country's COVID-19 response contained more restrictions than the global response, with the theme being expressed in 11 of 67 responses (16.4%) compared to 1 of 75 responses (1.3%) of US responses. This was enforced by the US medical students' views that the US had fewer COVID-19 restrictions. US medical students had a higher number of responses with the theme “more restrictions internationally” which was present in 21 of 75 responses (28%). US medical students were more likely to express a decrease in the number of academic opportunities and academic performance. The theme “decrease in academic opportunities and performance” was present in 15 of 75 US responses (20%) compared to 9 of 67 international responses (13.4%). A US response containing this theme was as follows: “I have had to adjust to a new way of doing school, mainly online, as well as coming to terms with the fact that I am not getting to experience many of the social aspects of medical school that I was looking forward to.” The US responses showed less of a mental health impact and expressed stronger negative views on how COVID-19 was handled with 40 of 75 US responses (53.3%) reporting the theme “need better initiatives and policies. Conclusion: The COVID-19 pandemic continues to affect medical students globally. The current study was limited by responses and student participation each week. Future studies aimed at analyzing specific COVID-19 policies around the world and the extent of the pandemic’s impact on mental health may provide greater i
{"title":"Comparison of Multinational Medical School Students Experiences in the Face of the COVID-19 Pandemic: A Qualitative Analysis","authors":"Alexandra C. Skoczek, Patrick W. Ruane, Cassidy Onley, Torhiana Haydel, Maria Valeria Ortega, H. Dean Sutphin, Alexis M. Stoner","doi":"10.5195/ijms.2022.1792","DOIUrl":"https://doi.org/10.5195/ijms.2022.1792","url":null,"abstract":"Background: In the midst of the COVID-19 pandemic, countries, and governments around the world have implemented different measures and guidelines for the containment and mitigation of the COVID-19 virus. In addition to implemented policies and initiatives, social media and personal beliefs have affected medical students’ social, emotional, financial, and academic stability and success both domestically and internationally. The objective of this study was to assess medical student's perspectives, attitudes, and insight in the face of the COVID-19 pandemic and determine if differences exist between countries. Methods: This qualitative study, recruited students enrolled in the Global Seminar for Health and Environment elective course in their respective medical schools to complete a weekly, non-graded journaling assignment for 6 weeks. To measure outcomes, open-ended questions within the assignment asked students across four different countries questions regarding the COVID-19 pandemic including personal beliefs and knowledge, policies and initiatives within their country, global policies and initiatives, and social media presentations. Thematic analysis was then completed using the QCoder package in R Studio. Results: Both internationally and in the US, COVID-19 has had a large impact on medical students; however, their perspectives are distinct in personal beliefs, policies, and social media. International medical students believed that their country's COVID-19 response contained more restrictions than the global response, with the theme being expressed in 11 of 67 responses (16.4%) compared to 1 of 75 responses (1.3%) of US responses. This was enforced by the US medical students' views that the US had fewer COVID-19 restrictions. US medical students had a higher number of responses with the theme “more restrictions internationally” which was present in 21 of 75 responses (28%). US medical students were more likely to express a decrease in the number of academic opportunities and academic performance. The theme “decrease in academic opportunities and performance” was present in 15 of 75 US responses (20%) compared to 9 of 67 international responses (13.4%). A US response containing this theme was as follows: “I have had to adjust to a new way of doing school, mainly online, as well as coming to terms with the fact that I am not getting to experience many of the social aspects of medical school that I was looking forward to.” The US responses showed less of a mental health impact and expressed stronger negative views on how COVID-19 was handled with 40 of 75 US responses (53.3%) reporting the theme “need better initiatives and policies. Conclusion: The COVID-19 pandemic continues to affect medical students globally. The current study was limited by responses and student participation each week. Future studies aimed at analyzing specific COVID-19 policies around the world and the extent of the pandemic’s impact on mental health may provide greater i","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136389486","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}
A. Khaity, K. Albakri, Y. Alabdallat, Othman Saleh, Hazem. S Ghaith
Background: Magnesium is one of the most important nutritional factors that have a beneficial effect on pregnant women. Many studies evaluated the role of oral magnesium supplements as a non-pharmacological intervention for mother and neonatal protection in terms of these outcomes. There is a conflict between several clinical trials about the efficacy of oral magnesium supplements during pregnancy. Therefore, in this review, we represent class 1 evidence and address an unmet clinical need on the efficacy of different types of oral magnesium in pre-eclampsia, and prenatal outcomes in pregnant women. Method: During the preparation of this meta-analysis, we followed the PRISMA statement guidelines. A literature search of the Web of Sciences, Cochrane Central Register of Controlled Trials, and PubMed were conducted from inception until September 2022. We included randomized controlled trials (RCTs) comparing oral magnesium whether citrate, oxide, or aspartate hydrochloride with a placebo. The records of quality studies were screened and extracted. Additionally, the pre-eclampsia, preterm birth, and neonatal intensive care unit (NICU) admissions data were pooled as odds ratio (OR) in a fixed-effect model using Review Manager (v.3). Subgroup analysis was performed to investigate the efficacy of each type of oral magnesium on the outcomes. Results: Five RCTs were included in this meta-analysis with a total of 2370 patients. The overall effect did not favor either of the two groups in terms of pre-eclampsia (OR= 0.99, 95% CI, [0.72, 1.37], p = 0.9), preterm birth (OR= 0.87, 95% CI, [0.62, 1.22], p = 0.4), and NICU admissions (OR= 1.37, 95% CI, [0.84, 2.22], p = 0.2). Based on the subgroup analysis findings, the use of oral magnesium supplements whether citrate, oxide, or aspartate hydrochloride in this population did not significantly increase or decrease the incidence of pre-eclampsia, preterm birth, and NICU admissions when compared with the control group. Conclusion: Ultimately, oral magnesium supplementation whether citrate, oxide, or aspartate hydrochloride may not have a beneficial effect on maternal and fetal outcomes during pregnancy. Therefore, the current evidence is insufficient to confirm the efficacy of oral magnesium for care practice among pregnant women. Despite that, these results need to be affirmed by major RCTs using magnesium supplements which have related to neonatal and maternal outcomes.
背景:镁是对孕妇有益的最重要的营养因子之一。根据这些结果，许多研究评估了口服镁补充剂作为一种非药物干预对母亲和新生儿保护的作用。关于怀孕期间口服镁补充剂的功效，几个临床试验之间存在冲突。因此，在这篇综述中，我们代表了一级证据，并解决了不同类型口服镁对先兆子痫的疗效和孕妇产前结局的临床需求。方法:在本荟萃分析的准备过程中，我们遵循PRISMA声明指南。文献检索的Web of Sciences, Cochrane Central Register of Controlled Trials和PubMed从成立到2022年9月进行。我们纳入了比较口服镁(无论是柠檬酸盐、氧化物还是天冬氨酸盐酸盐)与安慰剂的随机对照试验。筛选和提取质量研究的记录。此外，使用Review Manager (v.3)将先兆子痫、早产和新生儿重症监护病房(NICU)入院数据汇总为固定效应模型中的优势比(OR)。采用亚组分析的方法，探讨不同类型口服镁对预后的影响。结果:本荟萃分析纳入5项随机对照试验，共2370例患者。在先兆子痫(OR= 0.99, 95% CI， [0.72, 1.37]， p = 0.9)、早产(OR= 0.87, 95% CI， [0.62, 1.22]， p = 0.4)和新生儿重症监护病房入院(OR= 1.37, 95% CI， [0.84, 2.22]， p = 0.2)方面，总体效果对两组均不利。根据亚组分析结果，与对照组相比，在该人群中使用口服镁补充剂，无论是柠檬酸盐、氧化物还是天冬氨酸盐酸盐，都没有显著增加或减少先兆子痫、早产和新生儿重症监护室入院的发生率。结论:最终，无论是柠檬酸盐、氧化物还是天冬氨酸盐酸盐，口服镁补充剂都不会对妊娠期间的母婴结局产生有益影响。因此，目前的证据不足以证实口服镁对孕妇护理实践的有效性。尽管如此，这些结果需要通过使用镁补充剂的主要随机对照试验来证实，镁补充剂与新生儿和产妇的结局有关。
{"title":"The Effect of Oral Magnesium Supplement on Pre-eclampsia and Perinatal Outcomes in Pregnancy: A Meta-Analysis of Randomized Controlled Trials","authors":"A. Khaity, K. Albakri, Y. Alabdallat, Othman Saleh, Hazem. S Ghaith","doi":"10.5195/ijms.2022.1808","DOIUrl":"https://doi.org/10.5195/ijms.2022.1808","url":null,"abstract":"Background: Magnesium is one of the most important nutritional factors that have a beneficial effect on pregnant women. Many studies evaluated the role of oral magnesium supplements as a non-pharmacological intervention for mother and neonatal protection in terms of these outcomes. There is a conflict between several clinical trials about the efficacy of oral magnesium supplements during pregnancy. Therefore, in this review, we represent class 1 evidence and address an unmet clinical need on the efficacy of different types of oral magnesium in pre-eclampsia, and prenatal outcomes in pregnant women. \u0000Method: During the preparation of this meta-analysis, we followed the PRISMA statement guidelines. A literature search of the Web of Sciences, Cochrane Central Register of Controlled Trials, and PubMed were conducted from inception until September 2022. We included randomized controlled trials (RCTs) comparing oral magnesium whether citrate, oxide, or aspartate hydrochloride with a placebo. The records of quality studies were screened and extracted. Additionally, the pre-eclampsia, preterm birth, and neonatal intensive care unit (NICU) admissions data were pooled as odds ratio (OR) in a fixed-effect model using Review Manager (v.3). Subgroup analysis was performed to investigate the efficacy of each type of oral magnesium on the outcomes. \u0000Results: Five RCTs were included in this meta-analysis with a total of 2370 patients. The overall effect did not favor either of the two groups in terms of pre-eclampsia (OR= 0.99, 95% CI, [0.72, 1.37], p = 0.9), preterm birth (OR= 0.87, 95% CI, [0.62, 1.22], p = 0.4), and NICU admissions (OR= 1.37, 95% CI, [0.84, 2.22], p = 0.2). Based on the subgroup analysis findings, the use of oral magnesium supplements whether citrate, oxide, or aspartate hydrochloride in this population did not significantly increase or decrease the incidence of pre-eclampsia, preterm birth, and NICU admissions when compared with the control group. \u0000Conclusion: Ultimately, oral magnesium supplementation whether citrate, oxide, or aspartate hydrochloride may not have a beneficial effect on maternal and fetal outcomes during pregnancy. Therefore, the current evidence is insufficient to confirm the efficacy of oral magnesium for care practice among pregnant women. Despite that, these results need to be affirmed by major RCTs using magnesium supplements which have related to neonatal and maternal outcomes.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90181598","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}
Yazan Khair Eldien Jabban, S. Swed, H. Bohsas, Hidar Alibrahim, Nagham Jawish, B. Sawaf, W. Hafez
Background: Based on the stroke mortality rate, Syria was ranked 98th worldwide in 2020. Approximately 80% of strokes are avoidable by managing well-known modifiable risk factors, such as diabetes, hypertension, and cardiovascular disease. Due to the high prevalence of several modifiable risk factors for stroke in Syria, it is necessary to increase Syrians' understanding of strokes and encourage people to engage in healthy practices to eradicate these risk factors. This research aimed to evaluate the knowledge, attitudes, and health-related perceptions of adult Syrians about stroke. Methods: This cross-sectional research was conducted between 2 September and 10 October 2022 among Syrians using an online survey to measure their knowledge, attitudes, and practices regarding stroke. This questionnaire was derived from a previously published article, and the inclusion criteria for this research were all Syrian residents aged 18 or older. The questionnaire utilized for this study consisted of three major sections: socio-demographic data, knowledge of stroke, and attitudes and perceptions about stroke. RESULTS: 53.3 % of the 1,143 research participants were female. Most respondents (94.3%) recognized the brain as the organ impacted by stroke. Hypertension was the stroke's most identifiable cause and risk factor (72.8% and 73.6%, respectively). 72.8 % of participants recognized hypertension and atherosclerosis as causes of stroke. 94.3 % of survey participants accurately identified the oranges impacted by the stroke; however, only 50.1% properly identified the warning symptoms. 61.4 % of participants utilize the Internet as a source of stroke-related information. 22.3% of individuals aged 21 to 30 had identified at least one stroke warning sign. 12.58% of individuals with a high socioeconomic position have shown a solid understanding of stroke risk factors. Females were projected to be 1.55 times more knowledgeable about stroke warning signs than men (P value<0.05). It was expected that participants who believed that stroke is avoidable would be 2.2 times more knowledgeable about stroke warning signals than those who disagreed (P value<0.05). Participants who identified more than four causes of stroke were expected to have 14.77 times more knowledge of stroke risk factors than those who did not (P value<0.05). Conclusion: Our research shows that although knowledge of stroke risk factors and symptoms is moderate to good, there is still a lack of perceptions toward this disease. Hopefully, this will encourage hospitals and other medical groups to continue their awareness-raising campaigns about the dangers of this illness. Stroke prevention and community response may be greatly enhanced by raising public consciousness of the condition and fostering individual agency in coping with it.
{"title":"Assessment Syrian Population Knowledge, Attitudes and Perceptions Towards Stroke: A Cross-Sectional Study from Syria","authors":"Yazan Khair Eldien Jabban, S. Swed, H. Bohsas, Hidar Alibrahim, Nagham Jawish, B. Sawaf, W. Hafez","doi":"10.5195/ijms.2022.1827","DOIUrl":"https://doi.org/10.5195/ijms.2022.1827","url":null,"abstract":"Background: Based on the stroke mortality rate, Syria was ranked 98th worldwide in 2020. Approximately 80% of strokes are avoidable by managing well-known modifiable risk factors, such as diabetes, hypertension, and cardiovascular disease. Due to the high prevalence of several modifiable risk factors for stroke in Syria, it is necessary to increase Syrians' understanding of strokes and encourage people to engage in healthy practices to eradicate these risk factors. This research aimed to evaluate the knowledge, attitudes, and health-related perceptions of adult Syrians about stroke. \u0000 \u0000Methods: This cross-sectional research was conducted between 2 September and 10 October 2022 among Syrians using an online survey to measure their knowledge, attitudes, and practices regarding stroke. This questionnaire was derived from a previously published article, and the inclusion criteria for this research were all Syrian residents aged 18 or older. The questionnaire utilized for this study consisted of three major sections: socio-demographic data, knowledge of stroke, and attitudes and perceptions about stroke. \u0000 \u0000RESULTS: 53.3 % of the 1,143 research participants were female. Most respondents (94.3%) recognized the brain as the organ impacted by stroke. Hypertension was the stroke's most identifiable cause and risk factor (72.8% and 73.6%, respectively). 72.8 % of participants recognized hypertension and atherosclerosis as causes of stroke. 94.3 % of survey participants accurately identified the oranges impacted by the stroke; however, only 50.1% properly identified the warning symptoms. 61.4 % of participants utilize the Internet as a source of stroke-related information. 22.3% of individuals aged 21 to 30 had identified at least one stroke warning sign. 12.58% of individuals with a high socioeconomic position have shown a solid understanding of stroke risk factors. Females were projected to be 1.55 times more knowledgeable about stroke warning signs than men (P value<0.05). It was expected that participants who believed that stroke is avoidable would be 2.2 times more knowledgeable about stroke warning signals than those who disagreed (P value<0.05). Participants who identified more than four causes of stroke were expected to have 14.77 times more knowledge of stroke risk factors than those who did not (P value<0.05). \u0000 \u0000Conclusion: Our research shows that although knowledge of stroke risk factors and symptoms is moderate to good, there is still a lack of perceptions toward this disease. Hopefully, this will encourage hospitals and other medical groups to continue their awareness-raising campaigns about the dangers of this illness. Stroke prevention and community response may be greatly enhanced by raising public consciousness of the condition and fostering individual agency in coping with it.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83789228","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}
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