Pub Date : 2021-01-01DOI: 10.1080/20905068.2021.1916244
Nadia Mohamed Ahmed Abdel Fattah, M. Zahran, R. K. Fawzy, Alaa Abdel Hamid, Hala K. Maghraby
ABSTRACT Introduction: Mammography is the most used breast screening tool and was proven to reduce breast-cancer-associated mortality. The estimated sensitivity of mammography varies between 77% and 95%; however, sensitivity could be 26% lower in dense breasts than in entirely fatty breasts. The ability to represent the complex 3D breast architecture and early changes in anatomical structures in a 2D view is the biggest challenge for mammography. In Digital Breast Tomosynthesis (DBT), tomographic images are reconstructed from multiple projections acquired from different angles. This technique allows the generation of 3D data, reduction of tissue overlap and allows better evaluation of masses, architectural distortion, and asymmetries compared with conventional two-dimensional mammographic images. Objective: To evaluate the impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings. Methods: Prospective cohort for 180 women with mammographic non-mass findings who presented to Alexandria University Radio diagnosis Department either for screening or diagnostic purposes between July 2019 and August 2020 with mean age 51.44 ± 10.67 . Digital breast tomosynthesis and ultrasound was done for all patients. Lesions were evaluated on DM; DBT alone then combined DBT & DM. Comparison of results according to changes in BIRADS, diagnostic performance using histopathology as gold standard. Results: 208 non-mass findings were detected by conventional mammography (104 asymmetry, 35 architectural distortion, 69 micro calcifications), Tomosynthesis reduced the BIRADS 3 count by 32%, upgraded the count of BIRADS 4 lesions by 11.4% while upgraded the BIRADS 2 by 18.9% with consequent improvement of sensitivity and specificity, PPV, NPV and accuracy to 96%, 95%, 94%,97%, and 95.6%. Conclusion: Combined FFDM and DBT improved the diagnostic performance in evaluation of non-mass findings and proper BIRADS categorization.
{"title":"The impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings","authors":"Nadia Mohamed Ahmed Abdel Fattah, M. Zahran, R. K. Fawzy, Alaa Abdel Hamid, Hala K. Maghraby","doi":"10.1080/20905068.2021.1916244","DOIUrl":"https://doi.org/10.1080/20905068.2021.1916244","url":null,"abstract":"ABSTRACT Introduction: Mammography is the most used breast screening tool and was proven to reduce breast-cancer-associated mortality. The estimated sensitivity of mammography varies between 77% and 95%; however, sensitivity could be 26% lower in dense breasts than in entirely fatty breasts. The ability to represent the complex 3D breast architecture and early changes in anatomical structures in a 2D view is the biggest challenge for mammography. In Digital Breast Tomosynthesis (DBT), tomographic images are reconstructed from multiple projections acquired from different angles. This technique allows the generation of 3D data, reduction of tissue overlap and allows better evaluation of masses, architectural distortion, and asymmetries compared with conventional two-dimensional mammographic images. Objective: To evaluate the impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings. Methods: Prospective cohort for 180 women with mammographic non-mass findings who presented to Alexandria University Radio diagnosis Department either for screening or diagnostic purposes between July 2019 and August 2020 with mean age 51.44 ± 10.67 . Digital breast tomosynthesis and ultrasound was done for all patients. Lesions were evaluated on DM; DBT alone then combined DBT & DM. Comparison of results according to changes in BIRADS, diagnostic performance using histopathology as gold standard. Results: 208 non-mass findings were detected by conventional mammography (104 asymmetry, 35 architectural distortion, 69 micro calcifications), Tomosynthesis reduced the BIRADS 3 count by 32%, upgraded the count of BIRADS 4 lesions by 11.4% while upgraded the BIRADS 2 by 18.9% with consequent improvement of sensitivity and specificity, PPV, NPV and accuracy to 96%, 95%, 94%,97%, and 95.6%. Conclusion: Combined FFDM and DBT improved the diagnostic performance in evaluation of non-mass findings and proper BIRADS categorization.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1916244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45619171","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 : 2021-01-01DOI: 10.1080/20905068.2021.1938425
M. Agrawal, Preeti Singh, Usha Joshi
ABSTRACT Background All drugs profoundly modify our biological processes and may manifest as adverse drug reactions (ADRs), which are unpredictable and inevitable consequences. Antibiotics are a common cause of ADR, necessitating stopping or change of antibiotics. The incidence of ADRs increases with the number of drugs prescribed in a prescription, and antibiotics are rarely prescribed as monotherapy. Aim The study aimed to assess frequency, class of antibiotics, symptoms, causality, the severity of antimicrobial-associated ADRs, and see the demographic distribution. Methods ADRs were collected and filled in suspected ADR forms and sent via vigiflow to the National Coordination Centre-Pharmacovigilance Programme of India (NCC-PvPI). These ADR reports, termed individual case safety reports (ICSRs), were analyzed from Jan 2016 to Dec 2019. Results A total of 414 (54.33%) ICSRs of 762 were identified as antimicrobial-associated. Adults in the age group 19–65 years accounted for 345 (83.09%) of ADRs. A total of 192 (46.38%) were males, and 222 (53.14%) were females. Skin and subcutaneous tissue System organ class was involved in 54% of cases. In the causality assessment, 268 (64.49%) were “probable,” 123 (29.71%) were “possible,” and 23 (5.56%) were “certain.” On severity assessment, 256 ADRs (61.83%) were mild, 133 (32.12%) were moderate, and 25 (6.03%) were severe. A total of 54 antimicrobial agents, excluding anti-tubercular drugs, were identified, and antibacterial accounted for 268 (64.73%) ADRs, followed by antiviral 90 (21.73%), antiprotozoal agents 33 (7.97%) antimalarials anti-scabicidal, antifungal accounting for the remaining. Conclusion Antimicrobials play a crucial role in treating infections, and utmost vigilance during antimicrobials prescription reduces the frequency and severity of the ADRs, thereby reducing the morbidity and mortality and the pharmacoeconomic burden to the health care system. Pharmacovigilance must be boosted to ensure the safe and effective use of antibiotics and reduce the occurrence of ADRs.
{"title":"Antimicrobials associated adverse drug reaction profiling: a four years retrospective study (Pharmacovigilance study)","authors":"M. Agrawal, Preeti Singh, Usha Joshi","doi":"10.1080/20905068.2021.1938425","DOIUrl":"https://doi.org/10.1080/20905068.2021.1938425","url":null,"abstract":"ABSTRACT Background All drugs profoundly modify our biological processes and may manifest as adverse drug reactions (ADRs), which are unpredictable and inevitable consequences. Antibiotics are a common cause of ADR, necessitating stopping or change of antibiotics. The incidence of ADRs increases with the number of drugs prescribed in a prescription, and antibiotics are rarely prescribed as monotherapy. Aim The study aimed to assess frequency, class of antibiotics, symptoms, causality, the severity of antimicrobial-associated ADRs, and see the demographic distribution. Methods ADRs were collected and filled in suspected ADR forms and sent via vigiflow to the National Coordination Centre-Pharmacovigilance Programme of India (NCC-PvPI). These ADR reports, termed individual case safety reports (ICSRs), were analyzed from Jan 2016 to Dec 2019. Results A total of 414 (54.33%) ICSRs of 762 were identified as antimicrobial-associated. Adults in the age group 19–65 years accounted for 345 (83.09%) of ADRs. A total of 192 (46.38%) were males, and 222 (53.14%) were females. Skin and subcutaneous tissue System organ class was involved in 54% of cases. In the causality assessment, 268 (64.49%) were “probable,” 123 (29.71%) were “possible,” and 23 (5.56%) were “certain.” On severity assessment, 256 ADRs (61.83%) were mild, 133 (32.12%) were moderate, and 25 (6.03%) were severe. A total of 54 antimicrobial agents, excluding anti-tubercular drugs, were identified, and antibacterial accounted for 268 (64.73%) ADRs, followed by antiviral 90 (21.73%), antiprotozoal agents 33 (7.97%) antimalarials anti-scabicidal, antifungal accounting for the remaining. Conclusion Antimicrobials play a crucial role in treating infections, and utmost vigilance during antimicrobials prescription reduces the frequency and severity of the ADRs, thereby reducing the morbidity and mortality and the pharmacoeconomic burden to the health care system. Pharmacovigilance must be boosted to ensure the safe and effective use of antibiotics and reduce the occurrence of ADRs.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1938425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44109758","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 : 2021-01-01DOI: 10.1080/20905068.2021.1952821
Herbert Mbyemeire, Kenneth Ssekatawa, C. Kato, E. Wampande
ABSTRACT Cephalosporins are the first-line therapy antibiotics used in the treatment of gram-negative bacterial infections. However, high prevalence of cephalosporins resistance in Klebsiella pneumoniae and Escherichia coli has been reported worldwide. Studies conducted in Uganda reported high incidences of cephalosporin resistance (CR). Successive studies at Mulago National Referral Hospital indicated a decline in the resistance levels pointing to the need for regular antibiotic resistance surveillance. Therefore, this study carried out molecular characterization of CR determinants in E. coli and K. pneumoniae isolated from patients attending Kampala International University Teaching Hospital (KIU-TH). A retrospective study using E. coli and K. pnuemoniae samples previously obtained from surgical wounds and urinary tract infections among patients treated at KIU-TH between September 2016 and August 2018 was conducted. Biochemical assays were used to confirm the identity of the samples. Combined disc and boronic acid assays were used to determine the cephalosporine resistance profile of the isolates. Multiplex PCR amplification was used to characterize the extended spectrum beta-lactmase (ESBL) encoding genes. The study revealed that E. coli (130/81.2%) isolates were more predominant than K. pneumoniae (30/18.8%) among the archived samples. K. pneumoniae showed the highest phenotypic resistance with a mean prevalence of 90.6% but comparable to that of E. coli (89.3%). Of the 160 isolates screened, 105 (65.6%) were ESBL producers. Multiplex PCR revealed that the most predominant ESBL encoding gene was bla SHV at a prevalence of 42.0%, followed by bla TEM at 27.3%, bla CTX-M at 22.4% and bla CTX-M-15 at 8.4%. The incidence of phenotypic resistance and distribution of ESBL genes were significantly higher in patients of Ishaka division. Our study reports a high prevalence of cephalosporin-resistant E. coli and K. pnuemoniae isolated from patients attending KIU-TH and highlights the need for routine screening of antimicrobial resistance in health-care facilities so as to guide clinicians on the rational prescription of antibiotics. List of abbreviations: ATCC: American Type Culture Collection; ESBL: extended spectrum beta-lactmases; AmpC: aminopenicillin cephalosporinase; CTX-M: cephotaxime (M-first detected in Munich) hydrolyzing capabilities; CTX-M-U: cephotaxime hydrolyzing capabilities gene Universal primer; SHV: sulfhydryl variables (variant-2); CMY-2: cephamycins (variant-2); TEM: temoneira; ACT-1: AmpC type (variant-1); Bla: Beta lactam; DNA: deoxyribonucleic acid; PCR: Polymerase chain reaction; MNRH: Mulago National Referral Hospital; MRRH: Mbarara Regional Referral Hospital; KRRH: Kabale Regional Referral Hospital (KRRH); KIU-TH: Kampala International University Teaching Hospital; CDL: Central Diagnostic Laboratory; CoVAB: College of Veterinary Medicine, Animal Resources and Biosecurity; CR: cephalosporin resistance
{"title":"Molecular characterization and distribution of cephalosporin resistance determinants in Escherichia coli and Klebsiella pneumoniae isolated from patients attending Kampala International University Teaching Hospital in Bushenyi, Western Uganda","authors":"Herbert Mbyemeire, Kenneth Ssekatawa, C. Kato, E. Wampande","doi":"10.1080/20905068.2021.1952821","DOIUrl":"https://doi.org/10.1080/20905068.2021.1952821","url":null,"abstract":"ABSTRACT Cephalosporins are the first-line therapy antibiotics used in the treatment of gram-negative bacterial infections. However, high prevalence of cephalosporins resistance in Klebsiella pneumoniae and Escherichia coli has been reported worldwide. Studies conducted in Uganda reported high incidences of cephalosporin resistance (CR). Successive studies at Mulago National Referral Hospital indicated a decline in the resistance levels pointing to the need for regular antibiotic resistance surveillance. Therefore, this study carried out molecular characterization of CR determinants in E. coli and K. pneumoniae isolated from patients attending Kampala International University Teaching Hospital (KIU-TH). A retrospective study using E. coli and K. pnuemoniae samples previously obtained from surgical wounds and urinary tract infections among patients treated at KIU-TH between September 2016 and August 2018 was conducted. Biochemical assays were used to confirm the identity of the samples. Combined disc and boronic acid assays were used to determine the cephalosporine resistance profile of the isolates. Multiplex PCR amplification was used to characterize the extended spectrum beta-lactmase (ESBL) encoding genes. The study revealed that E. coli (130/81.2%) isolates were more predominant than K. pneumoniae (30/18.8%) among the archived samples. K. pneumoniae showed the highest phenotypic resistance with a mean prevalence of 90.6% but comparable to that of E. coli (89.3%). Of the 160 isolates screened, 105 (65.6%) were ESBL producers. Multiplex PCR revealed that the most predominant ESBL encoding gene was bla SHV at a prevalence of 42.0%, followed by bla TEM at 27.3%, bla CTX-M at 22.4% and bla CTX-M-15 at 8.4%. The incidence of phenotypic resistance and distribution of ESBL genes were significantly higher in patients of Ishaka division. Our study reports a high prevalence of cephalosporin-resistant E. coli and K. pnuemoniae isolated from patients attending KIU-TH and highlights the need for routine screening of antimicrobial resistance in health-care facilities so as to guide clinicians on the rational prescription of antibiotics. List of abbreviations: ATCC: American Type Culture Collection; ESBL: extended spectrum beta-lactmases; AmpC: aminopenicillin cephalosporinase; CTX-M: cephotaxime (M-first detected in Munich) hydrolyzing capabilities; CTX-M-U: cephotaxime hydrolyzing capabilities gene Universal primer; SHV: sulfhydryl variables (variant-2); CMY-2: cephamycins (variant-2); TEM: temoneira; ACT-1: AmpC type (variant-1); Bla: Beta lactam; DNA: deoxyribonucleic acid; PCR: Polymerase chain reaction; MNRH: Mulago National Referral Hospital; MRRH: Mbarara Regional Referral Hospital; KRRH: Kabale Regional Referral Hospital (KRRH); KIU-TH: Kampala International University Teaching Hospital; CDL: Central Diagnostic Laboratory; CoVAB: College of Veterinary Medicine, Animal Resources and Biosecurity; CR: cephalosporin resistance","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42027234","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 : 2021-01-01DOI: 10.1080/20905068.2021.1936420
N. El-Sherbiny, Eman H. Ibrahim, Nashwa Sayed
ABSTRACT Background: Patient-centered care has been considered the foundation of healthcare quality and the core competency of the doctor-patient relationship. Aims: To assess the attitudes of medical students toward a patient-centered approach and identify the predictors of patient-centeredness scores. Methods: A cross-sectional study was carried out in Fayoum Medical School/Egypt using a validated Arabic version of the Patient-Practitioner Orientation Scale (PPOS). Results: The total PPOS score showed variable score as the grades move up. The total PPOS ranged from 0.05 to 4.39 with an average score of (2.71 ± 0.66) for the entire sample. The sharing and caring subscale score ranged from 0.56 to 4.44 and 0.44 to 5.33 with an average score of (2.33 ± 0.49) and (3.09 ± 0.92) respectively. Conclusion: Medical students had low patient-centered attitude. Medical curricula should be redesigned, and medical students may also benefit from engagement in patient healthcare service.
{"title":"Medical students’ attitudes towards patient-centered care, Fayoum Medical School, Egypt","authors":"N. El-Sherbiny, Eman H. Ibrahim, Nashwa Sayed","doi":"10.1080/20905068.2021.1936420","DOIUrl":"https://doi.org/10.1080/20905068.2021.1936420","url":null,"abstract":"ABSTRACT Background: Patient-centered care has been considered the foundation of healthcare quality and the core competency of the doctor-patient relationship. Aims: To assess the attitudes of medical students toward a patient-centered approach and identify the predictors of patient-centeredness scores. Methods: A cross-sectional study was carried out in Fayoum Medical School/Egypt using a validated Arabic version of the Patient-Practitioner Orientation Scale (PPOS). Results: The total PPOS score showed variable score as the grades move up. The total PPOS ranged from 0.05 to 4.39 with an average score of (2.71 ± 0.66) for the entire sample. The sharing and caring subscale score ranged from 0.56 to 4.44 and 0.44 to 5.33 with an average score of (2.33 ± 0.49) and (3.09 ± 0.92) respectively. Conclusion: Medical students had low patient-centered attitude. Medical curricula should be redesigned, and medical students may also benefit from engagement in patient healthcare service.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1936420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48627563","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 : 2021-01-01DOI: 10.1080/20905068.2021.1959259
Ahmed H. Hashish, Noha S. Elshaer, Dorria E. Meleis
The production of carbon black (CB) has been considered as one of the top 50 industrial chemicals manufactured worldwide. Working in CB manufacturing process might pose a cardiovascular risk. This ...
{"title":"Removal Statement","authors":"Ahmed H. Hashish, Noha S. Elshaer, Dorria E. Meleis","doi":"10.1080/20905068.2021.1959259","DOIUrl":"https://doi.org/10.1080/20905068.2021.1959259","url":null,"abstract":"The production of carbon black (CB) has been considered as one of the top 50 industrial chemicals manufactured worldwide. Working in CB manufacturing process might pose a cardiovascular risk. This ...","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071314","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 : 2021-01-01DOI: 10.1080/20905068.2021.1885953
Yasser Essam Elfeil, Ahmed Mohammed Alattar, T. Ghoneim, A. Abd Elaziz, E. Deghidy
ABSTRACT Introduction: Hypotension is the most frequent consequence of spinal anesthesia in cesarean section. It results in harmful effects on mother and newborn. Aim: This study aim was to evaluate the correlation of positional changes in hemodynamic (heart rate and blood pressure) measured before spinal anesthesia in anticipation of occurrence of hypotension throughout cesarean delivery. Methods: 100 ASA grade I parturient were selected for this prospective observational study. Preoperative sociodemographic data, parity, and hemodynamic parameters were recorded including changes in systolic, diastolic, mean arterial blood pressure, and heart rate after positional shift from supine to lateral and sitting positions. Intraoperative, occurrence of hypotension was noted. Results: With hypotension as the dependent variable, the age, parity, heart rate at supine position, and changes in (heart rate, systolic, diastolic and mean arterial blood pressure) from supine to lateral position, and from supine to sitting position had high statistical significant negative correlation with blood pressure as P value <.05. Multivariate logistic analysis to assess predictors of hypotension concluded that changes in hemodynamic variable from supine to lateral position only significant predictor were (∆ heart rate, ∆ diastolic and ∆ mean blood pressure), and changes in hemodynamic variable from supine to sitting position only significant predictor were (∆heart rate and ∆ diastolic blood pressure). Discussion: Elevated sympathetic activity before neuraxial anesthesia was associated with higher risk for post-spinal hypotension. The great variability in hemodynamic after positional change indicates higher sympathetic activity to blood vessels. The high rise in the autonomic activity, the higher the risk for post-spinal hypotension Conclusion: Age, parity, and positional changes in hemodynamic were correlated with blood pressure reading after spinal anesthesia during cesarean delivery.
{"title":"The Effectiveness Of Non Invasive Hemodynamic Parameters In Detection Of Spinal Anesthesia Induced Hypotension During Cesarean Section","authors":"Yasser Essam Elfeil, Ahmed Mohammed Alattar, T. Ghoneim, A. Abd Elaziz, E. Deghidy","doi":"10.1080/20905068.2021.1885953","DOIUrl":"https://doi.org/10.1080/20905068.2021.1885953","url":null,"abstract":"ABSTRACT Introduction: Hypotension is the most frequent consequence of spinal anesthesia in cesarean section. It results in harmful effects on mother and newborn. Aim: This study aim was to evaluate the correlation of positional changes in hemodynamic (heart rate and blood pressure) measured before spinal anesthesia in anticipation of occurrence of hypotension throughout cesarean delivery. Methods: 100 ASA grade I parturient were selected for this prospective observational study. Preoperative sociodemographic data, parity, and hemodynamic parameters were recorded including changes in systolic, diastolic, mean arterial blood pressure, and heart rate after positional shift from supine to lateral and sitting positions. Intraoperative, occurrence of hypotension was noted. Results: With hypotension as the dependent variable, the age, parity, heart rate at supine position, and changes in (heart rate, systolic, diastolic and mean arterial blood pressure) from supine to lateral position, and from supine to sitting position had high statistical significant negative correlation with blood pressure as P value <.05. Multivariate logistic analysis to assess predictors of hypotension concluded that changes in hemodynamic variable from supine to lateral position only significant predictor were (∆ heart rate, ∆ diastolic and ∆ mean blood pressure), and changes in hemodynamic variable from supine to sitting position only significant predictor were (∆heart rate and ∆ diastolic blood pressure). Discussion: Elevated sympathetic activity before neuraxial anesthesia was associated with higher risk for post-spinal hypotension. The great variability in hemodynamic after positional change indicates higher sympathetic activity to blood vessels. The high rise in the autonomic activity, the higher the risk for post-spinal hypotension Conclusion: Age, parity, and positional changes in hemodynamic were correlated with blood pressure reading after spinal anesthesia during cesarean delivery.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1885953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42957986","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 : 2021-01-01DOI: 10.1080/20905068.2021.1874632
Irem Akova, Öznur Hasdemir, Esma Kiliç
ABSTRACT Background The aim of this study was to evaluate the relationship between burnout, depression, anxiety, and stress levels of primary health-care workers. Methods This cross-sectional study included 338 health-care workers. The sociodemographic data form, the Maslach Burnout Inventory (MBI), and the Depression Anxiety Stress Scale-21 (DASS-21) were applied. Mann Whitney U test, Kruskal Wallis test, Chi square test, and Logistic regression analysis were used. The error level was taken as 0.05. Results The burnout levels of the health workers were lower level in Emotional Exhaustion (EE) (79.0%), Depersonalization (D) (81.1%), and Personal Accomplishment (PA) (54.1%). The level of the depression, anxiety, and stress were found to be 10.9%, 14.8%, and 5.0%, respectively. The rates of low-moderate-high EE and D, low-moderate PA were higher in physicians than midwives and nurses. There were significant differences between the mean of burnout levels and gender, marital status, occupation, and total working times. Mean depression was higher among physicians while mean stress was lower among who worked 5 years and under. EE and PA were the factors associated with depression and anxiety, while EE was the factor associated with stress. Discussion Considering that burnout, depression, anxiety, and stress are intertwined concepts, it is thought that's needed to develop strategies for health workers to regain working energy.
{"title":"Evaluation of the relationship between burnout, depression, anxiety, and stress levels of primary health-care workers (Center Anatolia)","authors":"Irem Akova, Öznur Hasdemir, Esma Kiliç","doi":"10.1080/20905068.2021.1874632","DOIUrl":"https://doi.org/10.1080/20905068.2021.1874632","url":null,"abstract":"ABSTRACT Background The aim of this study was to evaluate the relationship between burnout, depression, anxiety, and stress levels of primary health-care workers. Methods This cross-sectional study included 338 health-care workers. The sociodemographic data form, the Maslach Burnout Inventory (MBI), and the Depression Anxiety Stress Scale-21 (DASS-21) were applied. Mann Whitney U test, Kruskal Wallis test, Chi square test, and Logistic regression analysis were used. The error level was taken as 0.05. Results The burnout levels of the health workers were lower level in Emotional Exhaustion (EE) (79.0%), Depersonalization (D) (81.1%), and Personal Accomplishment (PA) (54.1%). The level of the depression, anxiety, and stress were found to be 10.9%, 14.8%, and 5.0%, respectively. The rates of low-moderate-high EE and D, low-moderate PA were higher in physicians than midwives and nurses. There were significant differences between the mean of burnout levels and gender, marital status, occupation, and total working times. Mean depression was higher among physicians while mean stress was lower among who worked 5 years and under. EE and PA were the factors associated with depression and anxiety, while EE was the factor associated with stress. Discussion Considering that burnout, depression, anxiety, and stress are intertwined concepts, it is thought that's needed to develop strategies for health workers to regain working energy.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1874632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41885159","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 : 2021-01-01DOI: 10.1080/20905068.2021.1904547
Ahmed A. Elhadidy, S. Mashal
ABSTRACT Introduction: Obesity is arising health problem that is linked to many pathological conditions. Treatment of obesity has a beneficial effect on many health problems. Little data available about effect of weight loss on prediabetes. Object: To evaluate the effect of intra gastric balloon (IGB) as obesity treatment on prediabetes. Method: In a prospective study we have followed 42 obese prediabetic patients who used IGB as obesity treatment. All patients were evaluated for anthropometric measures, lipid profile, fasting blood glucose (FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin HbA1c before and 6 months after IGB insertion. Results: There was a significant reduction in body weight, waist–hip ratio and also body mass index (BMI), as by time of balloon removal mean body weight was 86.62 ± 7.84 Kg, and mean BMI at time of removal was 29.48 ± 2.31 kg/m2 compared to 99.10 ± 7.34 Kg and 33.61 ± 2.18 Kg/m2 before balloon insertion (p < 0.05). Also, significant improvement of FBG and PPBG with mean value of FBG 93.00 ± 9.12 mg% and mean level of PPBG 133.31 ± 11.68 mg% compared to FBG 110.71 ± 12.10 mg% and PPBG 166.81 ± 18.82 mg% before balloon insertion (p < 0.05), likewise there was a significant reduction in HbA1c as its mean value has become 5.48 ± 0.35 compared to 6.01 ± 0.21 before balloon insertion (p < 0.05). Conclusions: six months treatment with IGB for obesity improved the prediabetic condition that may prevent or at least delay type II diabetes mellitus, which needs longer follow-up.
{"title":"The impact of intra gastric balloon as a treatment of obesity on pre-diabetes in obese persons","authors":"Ahmed A. Elhadidy, S. Mashal","doi":"10.1080/20905068.2021.1904547","DOIUrl":"https://doi.org/10.1080/20905068.2021.1904547","url":null,"abstract":"ABSTRACT Introduction: Obesity is arising health problem that is linked to many pathological conditions. Treatment of obesity has a beneficial effect on many health problems. Little data available about effect of weight loss on prediabetes. Object: To evaluate the effect of intra gastric balloon (IGB) as obesity treatment on prediabetes. Method: In a prospective study we have followed 42 obese prediabetic patients who used IGB as obesity treatment. All patients were evaluated for anthropometric measures, lipid profile, fasting blood glucose (FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin HbA1c before and 6 months after IGB insertion. Results: There was a significant reduction in body weight, waist–hip ratio and also body mass index (BMI), as by time of balloon removal mean body weight was 86.62 ± 7.84 Kg, and mean BMI at time of removal was 29.48 ± 2.31 kg/m2 compared to 99.10 ± 7.34 Kg and 33.61 ± 2.18 Kg/m2 before balloon insertion (p < 0.05). Also, significant improvement of FBG and PPBG with mean value of FBG 93.00 ± 9.12 mg% and mean level of PPBG 133.31 ± 11.68 mg% compared to FBG 110.71 ± 12.10 mg% and PPBG 166.81 ± 18.82 mg% before balloon insertion (p < 0.05), likewise there was a significant reduction in HbA1c as its mean value has become 5.48 ± 0.35 compared to 6.01 ± 0.21 before balloon insertion (p < 0.05). Conclusions: six months treatment with IGB for obesity improved the prediabetic condition that may prevent or at least delay type II diabetes mellitus, which needs longer follow-up.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1904547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44245527","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 : 2021-01-01DOI: 10.1080/20905068.2021.1911111
A. Davies, Sherif M Wilson
To quote Thompson: “all cleft lip surgeons have their favorite surgical technique for repairing the unilateral cleft lip. It is usually a hybrid of training experience and imagination.” [1] Of the ...
{"title":"Invited commentary on: comparative study between Fisher anatomical subunit approximation technique and Millard rotation-advancement technique in unilateral cleft lip repair","authors":"A. Davies, Sherif M Wilson","doi":"10.1080/20905068.2021.1911111","DOIUrl":"https://doi.org/10.1080/20905068.2021.1911111","url":null,"abstract":"To quote Thompson: “all cleft lip surgeons have their favorite surgical technique for repairing the unilateral cleft lip. It is usually a hybrid of training experience and imagination.” [1] Of the ...","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1911111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49419507","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 : 2021-01-01DOI: 10.1080/20905068.2021.1892306
Nivine Abou Dargham, Youssef Sultan, O. Mourad, Mariam Baidoun, Omar Aboul Hosn, Azza Abou El Naga, H. Bahmad, Bilal Azakir
ABSTRACT Background Inadequate use of statistics in biomedical research might not only affect science but also harm human beings if applied in medical practice. Biostatistics is fundamental to improve understanding and appraising of evidence-based medicine (EBM); yet, it is still not well understood and appreciated by medical students. Therefore, early exposure of medical students and physicians-in-training to research tools including Biostatistics is of utmost importance. Objective The aim of this study is to determine the perception of Biostatistics by medical students at a private medical school in Beirut, Lebanon, and to identify its best implementation time in the medical curriculum. Methods This is a cross-sectional study based on a self-administered questionnaire distributed among medical students in their pre-clerkship years (first three years of a 6-year program) who undertook Biostatistics. The assessment of perception was based on the 5-point Likert scale anchored by Strongly disagree = 1 and Strongly agree = 5 including 36 questions distributed into four domains to assess the course value, difficulty, behavioral, and expectations. Results 186 of 269 students responded to the questionnaire, yielding a response rate of 69.14%. Around 60% of students declared that the knowledge gained from biostatistics courses is useful to their future career, and almost 70% understood the main concepts of biostatistics. 57.7% of students perceived that lack of practicing exercises might contribute to making the course more difficult. The mean score of domains was higher in females but did not significantly differ within the three academic years. Only 35.1% of the students positively perceived the importance of biostatistics modules, mostly third-year students. Conclusion Although the majority of medical students perceived biostatistics modules negatively, they were aware of the relevance of biostatistics to their medical career and real-life health issues.
{"title":"Perception of Biostatistics by Lebanese Medical Students: A Cross-Sectional Study","authors":"Nivine Abou Dargham, Youssef Sultan, O. Mourad, Mariam Baidoun, Omar Aboul Hosn, Azza Abou El Naga, H. Bahmad, Bilal Azakir","doi":"10.1080/20905068.2021.1892306","DOIUrl":"https://doi.org/10.1080/20905068.2021.1892306","url":null,"abstract":"ABSTRACT Background Inadequate use of statistics in biomedical research might not only affect science but also harm human beings if applied in medical practice. Biostatistics is fundamental to improve understanding and appraising of evidence-based medicine (EBM); yet, it is still not well understood and appreciated by medical students. Therefore, early exposure of medical students and physicians-in-training to research tools including Biostatistics is of utmost importance. Objective The aim of this study is to determine the perception of Biostatistics by medical students at a private medical school in Beirut, Lebanon, and to identify its best implementation time in the medical curriculum. Methods This is a cross-sectional study based on a self-administered questionnaire distributed among medical students in their pre-clerkship years (first three years of a 6-year program) who undertook Biostatistics. The assessment of perception was based on the 5-point Likert scale anchored by Strongly disagree = 1 and Strongly agree = 5 including 36 questions distributed into four domains to assess the course value, difficulty, behavioral, and expectations. Results 186 of 269 students responded to the questionnaire, yielding a response rate of 69.14%. Around 60% of students declared that the knowledge gained from biostatistics courses is useful to their future career, and almost 70% understood the main concepts of biostatistics. 57.7% of students perceived that lack of practicing exercises might contribute to making the course more difficult. The mean score of domains was higher in females but did not significantly differ within the three academic years. Only 35.1% of the students positively perceived the importance of biostatistics modules, mostly third-year students. Conclusion Although the majority of medical students perceived biostatistics modules negatively, they were aware of the relevance of biostatistics to their medical career and real-life health issues.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1892306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037221","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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