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Barriers and promotion of integrated care in dentistry: A brief communication 牙科综合护理的障碍与促进:一个简短的交流
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_165_23
HazielDiana Jenifer, VinitaA Boloor, RajeshRamesh Hosadurga, Sneha Bhat
Health-care delivery system in the modern world is facing major challenges as oral health burden and noncommunicable diseases along with aging population are on the steep rise. Interdisciplinary and Integrated care are now an important component of managing patients with complex and chronic conditions. However, there are several barriers that can impede smooth implementation of this concept. Identifying these barriers is an important step toward resolving the potential problems with delivery of inter disciplinary and integrated care. Personalized care is becoming the norm in current era. This approach requires co-operation among various disciplines and foster a common ground to achieve a holistic approach in the patient-centered treatment approach. The COVID-19 pandemic has compounded the existing problems. It has united the entire health-care fraternity in the fight against this disease. Governments have utilized the services of practitioners from diverse discipline to tackle this pandemic. The interdisciplinary and integrated approach has the potential to redefine the role of dentists in managing global pandemics like COVID-19. The specific objectives of this paper are (1) to understand the barriers for various approaches at the level of education; (2) identify the barriers to the scholarship and grant-related activities to research activities of clinicians across various disciplines; (3) discuss possible solutions that would enable, students, academicians, and clinicians to formulate a collaborative approach; and (4) try and understand the possible role of dentists in managing pandemics like COVID-19.
随着口腔卫生负担和非传染性疾病以及人口老龄化的急剧增加,现代世界的卫生保健服务系统面临着重大挑战。跨学科和综合护理现在是管理复杂和慢性疾病患者的重要组成部分。然而,有几个障碍会阻碍这一概念的顺利实施。识别这些障碍是解决提供跨学科和综合护理的潜在问题的重要一步。个性化护理正在成为当今时代的常态。这种方法需要各学科之间的合作,并促进共同基础,以实现以患者为中心的治疗方法的整体方法。新冠肺炎疫情加剧了既有问题。它使整个保健界团结起来同这种疾病作斗争。各国政府利用来自不同学科的从业人员的服务来应对这一流行病。这种跨学科和综合的方法有可能重新定义牙医在管理COVID-19等全球流行病中的作用。本文的具体目标是:(1)了解教育层面各种方法的障碍;(2)确定不同学科临床医生研究活动中奖学金和资助相关活动的障碍;(3)讨论可能的解决方案,使学生、学者和临床医生能够制定合作方法;(4)尝试了解牙医在管理COVID-19等流行病方面可能发挥的作用。
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引用次数: 0
A comparative study of picolinic acid levels in patients of severe depression with and without suicidality 伴有和不伴有自杀倾向的重度抑郁症患者picolinic酸水平的比较研究
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_79_23
Varchasvi Mudgal, Vijay Savita, VirendraSingh Pal, Koustubh Bagul
Background an Aim: Picolinic acid (PIC) is a metabolite of the kynurenine pathway, which is involved in the degradation of tryptophan, an essential amino acid. PIC has been suggested to have neuroprotective effects by inhibiting the production of quinolinic acid, a neurotoxic agent that can induce inflammation and oxidative stress in the brain. Several studies have reported the altered levels of PIC and other kynurenine metabolites in patients with suicidal behavior, indicating a possible link between PIC and suicide risk. However, the exact role of PIC in the pathophysiology of suicide is not fully understood and requires further investigation. We aim to assess the levels of PIC in patients with severe depression with and without suicidal attempts. Materials and Methods: A cross-sectional, observation study was conducted at MGM Medical College, Indore. The study consisted of two groups: Group A including patients of depression with suicidal attempt(s) and Group B including patients of depression without any suicidal attempt. After obtaining written informed consent, recruitment of the subjects was done as per strict inclusion criteria and exclusion criteria. Sociodemographic parameters such as age, gender, residence, and marital status were collected along with the clinical parameters such as Hamilton depression rating scale (HAM-D), Suicidal Behavior Questionnaire Revised (SBQ-R) score, and Beck Scale for suicidal ideation (BSSI). Blood samples of both the groups were measured for serum PIC using an auto analyzer. Results: Serum PIC levels were significantly lower (124.33 ± 51.15 ng/L) in the depression with suicidal attempt group than depression without suicide attempt which was 163 ± 41.28 ng/L (P < 0.01). SBQ-R, BSSI score, and number of suicide attempts correlated negatively with serum PIC levels. Conclusion: The depression with suicidal attempt(s) group has shown lower mean serum PIC levels than the depression without suicidal attempt(s) group, which was statistically significant. This indicates serum PIC could be a marker in severe depression.
背景和目的:吡啶酸(Picolinic acid, PIC)是犬尿氨酸途径的代谢物,参与必需氨基酸色氨酸的降解。PIC通过抑制喹啉酸的产生而具有神经保护作用,喹啉酸是一种神经毒性物质,可在大脑中诱导炎症和氧化应激。几项研究报道了自杀行为患者的PIC和其他犬尿氨酸代谢物水平的改变,表明PIC和自杀风险之间可能存在联系。然而,PIC在自杀病理生理中的确切作用尚不完全清楚,需要进一步研究。我们的目的是评估有和没有自杀企图的严重抑郁症患者的PIC水平。材料与方法:在印度米高梅医学院进行了一项横断面观察研究。研究分为两组:A组包括有自杀企图的抑郁症患者,B组包括没有任何自杀企图的抑郁症患者。在获得书面知情同意后,按照严格的纳入标准和排除标准进行受试者的招募。收集年龄、性别、居住地、婚姻状况等社会人口学参数以及汉密尔顿抑郁评定量表(HAM-D)、自杀行为修正问卷(SBQ-R)评分、贝克自杀意念量表(BSSI)等临床参数。两组血液样本均采用自动分析仪测定血清PIC。结果:有自杀企图抑郁组血清PIC水平(124.33±51.15 ng/L)明显低于无自杀企图抑郁组(163±41.28 ng/L) (P < 0.01)。SBQ-R、BSSI评分、自杀企图数与血清PIC水平呈负相关。结论:抑郁症有自杀企图组的平均血清PIC水平低于抑郁症无自杀企图组,差异有统计学意义。这表明血清PIC可能是重度抑郁症的一个标志。
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引用次数: 0
Effect of fetal movement count on prenatal attachment among primi- and Multigravida Women 初产和多胎妇女胎儿运动计数对产前依恋的影响
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_291_22
Precilla D'Silva, Velentina Senapati, ShobaP Xavier
Background: Fetal Movement counting is an important measure helps in early identification of fetal wellbeing. Aims and Objectives: This study aimed to determine the maternal and fetal attachment among primi and multigravida women and find their association with baseline variables. Materials and Methods: Study was conducted in a selected Hospital of Mangaluru in the antental OPD from february to march 2020. The study included 80 women in the age group of 20-40 years and 32-38 weeks of gestation. Study group was divided as primigravida and multigravida women. Paired and unpaired t test was used to assess the difference between the prenatal attachment score Results: No significant difference observed among primi and multgravida women. Also no association was found with baseline variables. Conclusion: There is no difference with prenatal attachment observed between primigravida and multigravida women which concludes that attachment towards the growing fetus is not dependent on gravida status.
背景:胎动计数是早期识别胎儿健康状况的重要手段。目的和目的:本研究旨在确定初产和多胎妇女的母胎依恋,并发现其与基线变量的关系。材料与方法:研究于2020年2月至3月在曼格鲁鲁的一家医院进行。该研究包括80名年龄在20-40岁、怀孕32-38周的女性。研究组分为初孕组和多孕组。采用配对和非配对t检验评估产前依恋评分的差异结果:初产和多胎妇女间无显著差异。也没有发现与基线变量的关联。结论:初产妇和多胎产妇对胎儿的依恋无明显差异,对胎儿的依恋与妊娠状态无关。
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引用次数: 0
Jigsaw: A step toward co-operative learning among medical and nursing students 拼图:医学和护理专业学生合作学习的一步
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_1_23
Vinod Kumar C S, S. Kalasuramath, S. Reddy, R. Reddy
Background and Aim: To shift the paradigm from passive tutor driven tutorials to more responsible active learning by the students, a co operative teaching learning method could be a good alternative. The Jigsaw approach, a model of co operative learning, focuses on learning in groups with fellow learner co operation and reassures team work. Thus, this study was aimed at assessing the effectiveness of jigsaw strategy in comparison to tutorials in enhancing cognitive skills among the medical students in microbiology. Materials and Methods: A cross sectional study was carried out at microbiology department for 50 consenting MBBS students of professional year II and 50 consenting B.Sc nursing students of 2nd years. Students were randomly divided into two batches: Aand B of 25 students each. They were prepared for either a jigsaw (Experimental) or tutorial (Control) a week prior on predecided topics. The same groups were crossed over for another topic. Students' performance was assessed by pretest, posttest, academic achievement level, and retention test by prevalidated multiple choice questionnaires. The student perception on TL methods was evaluated by using learning experience questionnaires. Results: Posttest scores of both groups were found to be significant at the level of P < 0.05. Among medical students, mean of posttest scores in the jigsaw is more than tutorial (12.4 v/s 9.7, crossover 13.3 v/s 11.2) and in nursing students (11.7 v/s 8.2, crossover 11.6 v/s 9.9). Mean retention tests scores and absolute achievement level were high in jigsaw groups. The students preferred jigsaw over the tutorial. Conclusion: Jigsaw strategy is a robust instructional tool, well perceived by the students to enhance cognitive skills as inferred by the results and can be tailored to the needs of varied topics across different disciplines.
背景和目的:为了让学生从被动的导师指导转变为更负责任的主动学习,合作教学法可能是一个很好的选择。Jigsaw方法是一种合作学习模式,侧重于与同伴合作的小组学习,并保证团队合作。因此,本研究旨在评估拼图策略与教程在提高医学生微生物学认知技能方面的有效性。材料和方法:在微生物学系对50名专业二年级的MBBS学生和50名护理二年级的B.Sc学生进行了横断面研究。学生被随机分为两批:A和B,每组25名学生。他们在一周前就预先确定的主题准备了拼图(实验)或教程(对照)。同样的小组被换成了另一个话题。学生的表现通过前测、后测、学业成绩水平和保留测试通过预先验证的多项选择问卷进行评估。学生对TL方法的认知通过使用学习经验问卷进行评估。结果:两组的测试后得分均显著高于对照组(P<0.05)。在医学生中,拼图组的后测平均得分高于辅导组(12.4 v/s 9.7,交叉13.3 v/s 11.2)和护理生(11.7 v/s 8.2,交叉11.6 v/s 9.9)。拼图组的平均保留测试得分和绝对成就水平较高。比起教程,学生们更喜欢拼图游戏。结论:拼图策略是一种强大的教学工具,学生们很好地理解它,可以根据结果来提高认知技能,并且可以根据不同学科的不同主题的需求进行定制。
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引用次数: 1
Awareness and use of maternal and child health-care services among people of Dagbadna Karu Local Government of Nasarawa State 纳萨拉瓦州达巴达纳卡鲁地方政府人民对妇幼保健服务的认识和使用情况
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_14_23
O. Olorunfemi, Maryjane Itula
Background and Aim: Maternal health care services are critical to reducing maternal fatalities and should be available throughout the health system due to their importance in ensuring safe motherhood and the overall well-being of families and communities. The purpose of this research is to ascertain the level of Maternal and Child Health (MCH) awareness and utilization among residents of Nasarrawa State's Dagbadna Karu Local Government Area. Materials and Methods: Purposive sampling was used to determine the sample size (n = 286) for a descriptive cross-sectional study that ran from September 2022 to December 2022. Statistical Package Service Software (SPSS) version 23.0 was used to analyze the data, which included tables, percentages, and Chi-square test statistics at the 0.05 level of significance. Results: With a mean age of 29.6 years, 42% of the participants were between the ages of 33 and 38. In comparison, 255 of the participants (89.5%) were married, while 14 (4.9%) were unmarried. The most common level of education is secondary education, which is held by 111 respondents, or 38.8%. This study found a high level of awareness (196.6, 68.7%) but a low level of utilization of MCH Care Services (137.5, 48.1%). It also demonstrates that participants' knowledge and utilization of maternal and child healthcare services are not significantly related (Chi-square (χ2)= 8.867, df = 1, P = 0.012). Conclusions: The primary goal of MCH Services remains to ensure that every woman maintains optimal health throughout pregnancy and puerperium, with a healthy mother and baby at the end of pregnancy, and to support the child's health throughout infancy and childhood. As a result, this research suggests a strategy for increasing community participation and, ultimately, sustaining and improving the quality, usability, and accessibility of maternal health care services provided by government agencies in both rural and urban areas.
背景和目的:孕产妇保健服务对减少孕产妇死亡至关重要,应在整个卫生系统提供,因为它们对确保安全孕产以及家庭和社区的整体福祉至关重要。本研究的目的是确定纳萨拉瓦州Dagbadna Karu地方政府区居民对妇幼保健的认识和利用水平。材料和方法:使用目的性抽样来确定2022年9月至2022年12月进行的描述性横断面研究的样本量(n=286)。使用SPSS 23.0版统计软件包对数据进行分析,包括表、百分比和0.05显著性水平的卡方检验统计数据。结果:平均年龄29.6岁,42%的参与者年龄在33岁至38岁之间。相比之下,255名参与者(89.5%)已婚,14名参与者(4.9%)未婚。最常见的教育水平是中等教育,共有111名受访者,占38.8%。本研究发现,人们对妇幼保健服务的认识水平较高(196.668.7%),但利用率较低(137.548.1%)。研究还表明,参与者对妇幼保健服务的认识和利用率没有显著相关性(卡方(χ2)=8.867,df=1,P=0.012)。结论:妇幼保健服务的主要目标仍然是确保每个妇女在整个妊娠期和产褥期保持最佳健康,在妊娠结束时有一个健康的母亲和婴儿,并在整个婴儿期和儿童期支持儿童的健康。因此,这项研究提出了一项战略,以增加社区参与,并最终维持和提高政府机构在农村和城市地区提供的孕产妇保健服务的质量、可用性和可及性。
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引用次数: 0
Contextual importance of leadership and management training in undergraduate medical education: Literature review 领导和管理培训在本科医学教育中的背景重要性:文献综述
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_294_22
N. Rajeh
Leadership is recently known to be necessary at all levels within an organization, causing it to be extremely important for new graduates to understand what leadership is and to be familiar with different key leadership and management competencies. Leadership is also an integral part of medical practice. However, at present several medical colleges do not have a leadership and management curriculum, and thus, our medical college is not preparing its undergraduates in such skills as effective communication, conflict resolution, and time management. The search terms used were undergraduate medical leadership and management programs, undergraduate medical student leadership development programs, student leadership, and management training, clinical leadership, challenges of leadership and management programs in medical colleges, and skills needed for leadership and management course development. The review has shed light on skills needed for proposing a program on leadership and management for students at medical universities. The review also provided a rich combination of definitions of leadership, challenges to the type of leadership as well as how other medical organizations approach leadership and management. The theories suggest approaching competencies for leadership rather than building on pure theoretical knowledge of leadership. Furthermore, the research suggests differentiating the leadership training for undergraduate students based on how to add value to their career/study progressions, standardization, and organizational contribution. The literature further revealed the different challenges and barriers to developing leadership and management programs in medical colleges.
最近,领导力在组织的各个层面都是必要的,这使得新毕业生了解什么是领导力,熟悉不同的关键领导力和管理能力变得极其重要。领导力也是医学实践不可或缺的一部分。然而,目前有几所医学院没有领导力和管理课程,因此,我们的医学院没有为本科生培养有效沟通、解决冲突和时间管理等技能。使用的搜索词包括本科生医学领导力和管理课程、本科生医学生领导力发展课程、学生领导力和管理培训、临床领导力、医学院领导力和管理项目的挑战,以及领导力和管理学科发展所需的技能。这篇综述揭示了为医科大学学生提出领导力和管理计划所需的技能。该综述还提供了领导力的定义、领导力类型的挑战以及其他医疗组织如何对待领导力和管理的丰富组合。这些理论表明,要接近领导力的能力,而不是建立在纯粹的领导力理论知识之上。此外,研究建议,根据如何为大学生的职业/学习进步、标准化和组织贡献增加价值来区分大学生的领导力培训。文献进一步揭示了在医学院发展领导力和管理课程的不同挑战和障碍。
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引用次数: 0
The paris system for urine cytology: A 2 years' experience from Western Indian population 尿细胞学巴黎系统:西印度人口2年经验
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_84_23
VaishaliPrashant Gaikwad, NilamMahesh More, LeenaP Naik
Background and Aims: The Paris System (TPS) for Reporting Urine Cytology was introduced to bring uniformity in reporting urine cytology worldwide. The aim of this study is to assess the utility of TPS for Reporting Urine Cytology and correlate it with histopathology. Materials and Methods: This was a retrospective study, conducted at the cytology section of department of pathology. All the urine cytology samples received over a period of 2 years were retrieved and categorized as per TPS. The frequency of each TPS category along with relative risk for each category was calculated using the histopathological follow-up, wherever available. Results: A total of 200 urine cytology samples from 172 patients were categorized as per TPS. The most common category was negative for high grade urothelial carcinoma (UC) (61.5%; n = 123) followed by unsatisfactory for evaluation (15%; n = 30) and positive for high grade UC (HGUC) (10%; n = 20). There were 13 cases in category of suspicious for HGUC, 11 cases in atypical urothelial cell category, 2 cases in other malignancies, and one case in positive for low-grade UC. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for diagnosing HGUC on cytology according to TPS were 92.86%, 100%, 100%, 60%, and 85.29%, respectively. Conclusions: TPS has definitely helped us to categorize the urine cytology samples with the objective criteria and thus reducing unnecessary ambiguous diagnoses and ultimately directing the correct management of the patient.
背景和目的:引入尿细胞学报告巴黎系统(TPS)是为了在全球范围内统一报告尿细胞学。本研究的目的是评估TPS报告尿液细胞学的效用,并将其与组织病理学联系起来。材料与方法:本研究为回顾性研究,在病理科细胞学部进行。在2年内收到的所有尿液细胞学样本都被检索并按TPS分类。每一类TPS的频率以及每一类的相对风险都是通过组织病理学随访来计算的。结果:172例患者共200份尿细胞学样本按TPS分类。最常见的分类是高级别尿路上皮癌(UC)阴性(61.5%;N = 123),其次是评价不满意(15%;n = 30),高级别UC (HGUC)阳性(10%;N = 20)。HGUC可疑类13例,非典型尿路上皮细胞类11例,其他恶性2例,低级别UC阳性1例。TPS对细胞学诊断HGUC的敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为92.86%、100%、100%、60%和85.29%。结论:TPS确实有助于我们对尿液细胞学样本进行客观的分类,从而减少不必要的模糊诊断,最终指导患者的正确治疗。
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引用次数: 0
Effect of Coronavirus Disease 2019 lockdown on eating habits and lifestyle behavior 2019冠状病毒病封锁对饮食习惯和生活方式行为的影响
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_44_23
Sudhir Rao, Vidusha Karavadi, KanumaleePruthvi Ganesh, NaveenSukumaran Nair
Background: The outbreak of coronavirus disease 2019 (COVID-19) affected the lives of all sections of society, as people were asked to self-quarantine in their homes to prevent the spread of the virus. The confinement and lockdown caused many lifestyle changes for Indian citizens, especially with diet and physical activity. Aim: The aim of the study was to assess the effect of COVID-19 lockdown on the dietary pattern and lifestyle behaviors in India. Materials and Methods: An online survey was conducted from July 2021 to September 2021 using a validated semi-structured questionnaire. The “snowball sampling” procedure was used to recruit the participants. The questions focused on changes experienced by the participants in their lifestyle before and during the lockdown. Results: Among the 624 study participants, the mean age was 25.81 ± 9.7 years. Nearly 71.8% (448) reported that their diet and consumption patterns changed during the lockdown. The mean body mass index before the lockdown was 24.11 ± 4.43, and after the lockdown was 23.46 ± 4.51. The change in sleep duration was reported by 494 (79.1%). Conclusion: These unprecedented circumstances provide an opportunity to better understand the negative impact of strict lockdown measures on lifestyles, and at the same time, help identify and initiate positive behavioral changes, which if consolidated, may improve chronic disease outcomes in the long run.
背景:2019冠状病毒病(COVID-19)的爆发影响了社会各阶层的生活,人们被要求在家中进行自我隔离,以防止病毒的传播。禁闭和封锁使印度公民的生活方式发生了许多变化,特别是在饮食和体育活动方面。目的:该研究的目的是评估COVID-19封锁对印度饮食模式和生活方式行为的影响。材料与方法:于2021年7月至2021年9月进行在线调查,采用经验证的半结构化问卷。采用“滚雪球抽样”方法招募参与者。这些问题的重点是参与者在封锁前和封锁期间生活方式的变化。结果:624名研究参与者的平均年龄为25.81±9.7岁。近71.8%(448人)报告说,他们的饮食和消费模式在封锁期间发生了变化。封城前平均体质指数为24.11±4.43,封城后平均体质指数为23.46±4.51。494人(79.1%)报告了睡眠时间的变化。结论:这些前所未有的情况为更好地了解严格封锁措施对生活方式的负面影响提供了机会,同时有助于识别和启动积极的行为改变,如果得到巩固,从长远来看可能会改善慢性病的预后。
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引用次数: 0
Ear infection in a child due to Kodamaea ohmeri, an emerging pathogen: A rare case report from South India 一种新出现的病原体奥梅里科达菌引起的儿童耳部感染:来自南印度的罕见病例报告
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_91_23
VimalKumar Karnaker, AsemAli Ashraf, SreelathaShankaran Veetil, Bhavya Chand, Sanjana Nair, SudhirRama Varma
This is a report of Kodamaea ohmeri isolated from a 2-year-old febrile child with stable vitals. Frank discharge of pus was present. Microbial culture testing revealed the presence of K. ohmeri. Antifungal susceptibility was performed along with intravenous antibiotic administration and antifungal ear drops in view of the discharge.
这是一例从2岁发热儿童中分离出奥梅里小野菌的报告,其生命体征稳定。有明显脓流。微生物培养检测显示存在霍氏克雷伯氏菌。观察患者的抗真菌敏感性,并根据出院情况给予静脉抗生素和抗真菌滴耳液。
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引用次数: 0
Efficacy outcomes of tenecteplase versus alteplase in patients with ischemic stroke in therapeutic window: experience from a single institution 替萘普酶与阿替普酶在缺血性脑卒中患者治疗窗口期的疗效结果:来自单一机构的经验
Pub Date : 2023-01-01 DOI: 10.4103/amhs.amhs_284_22
A. Chandra, A. Raina, Maqbool Wani, Hilal Ganie, W. Dar, Arjimand Yaqoob, Ravouf Asimi
Background and Aim: The World Health Organization estimated that 15 million people throughout the world suffer stroke every year. Only 5%–10% of all acute ischemic stroke (AIS) patients presenting to emergency departments (EDs) are eligible for and receive thrombolytic therapy. This study was conducted to assess and compare the efficacy and safety profile of thrombolysis with tenecteplase (TNK) with that of alteplase among patients with AIS who were eligible for thrombolysis. Materials and Methods: This was a hospital-based prospective observational study. All the patients who presented with AIS within the time window period of ≤4.5 h to ED of Sher-i-Kashmir Institute of Medical Sciences, Soura, from September 2018 to March 2021, were screened for eligibility of thrombolysis by TNK. A total of 76 patients were enrolled; among which 42 were thrombolysed with TNK and 34 patients were thrombolysed with alteplase. These data were compared with departmental data of patients thrombolysed by alteplase during July 2015–July 2017. Inclusion and exclusion criteria used in the study were as per the American Heart Association/American Stroke Association guidelines for thrombolysis. Efficacy and safety were assessed and compared of the two drugs. Results: After 24 h of thrombolysis, early neurological improvement occurred in 62% of TNK patients compared to only 35% of patients from alteplase group, which was significant statistically (P < 0.05). An excellent functional outcome, defined as the Modified Rankin Scale (mRS) of 0–1 at 3 months of discharge, was seen in 67.6% of TNK and 48.5% of alteplase group. A poor recovery, defined as the mRS of 4–6 at 3 months of follow-up, was seen in 16% and 21% in TNK and alteplase group patients, respectively. Conclusion: TNK appears to be characterized by a better safety and efficacy profile than alteplase; however, further multicenter studies and randomized controlled trials are required to confirm our preliminary findings.
背景和目的:世界卫生组织估计,全世界每年有1500万人患有中风。在急诊科就诊的所有急性缺血性中风(AIS)患者中,只有5%-10%有资格接受溶栓治疗。本研究旨在评估和比较符合溶栓条件的AIS患者中替萘普酶(TNK)和阿替普酶溶栓的疗效和安全性。材料和方法:这是一项基于医院的前瞻性观察性研究。所有在2018年9月至2021年3月至苏拉Sher-i-Kashmir医学科学研究所ED≤4.5小时的时间窗口内出现AIS的患者,均通过TNK进行溶栓资格筛选。共有76名患者入选;其中TNK溶栓42例,阿替普酶溶栓34例。这些数据与2015年7月至2017年7月期间阿替普酶血栓溶解患者的部门数据进行了比较。研究中使用的纳入和排除标准符合美国心脏协会/美国中风协会的溶栓指南。对两种药物的疗效和安全性进行了评估和比较。结果:溶栓24小时后,62%的TNK患者早期神经系统改善,而阿替普酶组仅为35%,这在统计学上具有显著性(P<0.05)。出院3个月时,67.6%的TNK和48.5%的阿替普蛋白酶组出现了良好的功能结果,即0–1的改良兰金量表(mRS)。TNK组和阿替普酶组患者的不良恢复率分别为16%和21%,定义为随访3个月时4-6的mRS。结论:TNK比阿替普酶具有更好的安全性和有效性;然而,需要进一步的多中心研究和随机对照试验来证实我们的初步发现。
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