MATERIALS AND METHODS: A community-based prospective cohort study was carried out in the Udupi district. Over 12 months, all newly diagnosed TB patients of either gender were included from 63 primary health centers and 6 community health centers, and ADRs were recorded by personal interviews.
RESULTS: A total of 710 patients were enrolled, among whom 453 (63.8%), were males, and 257 (36.2%) were females. Pulmonary TB was diagnosed among 510 (71.8%) and 200 (28.2%) were extrapulmonary cases. During the intensive phase (IP) of treatment, 480 (67.6%) patients reported at least one ADR and 79 (11.1%) experienced two ADRs during IP and 31 (6.5%) had ADRs during the continuation phase. Out of 480, 140 (29.2%) had gastritis, 132 (27.5%) had vomiting, 105 (21.9%) had nausea, 60 (12.5%) had skin rashes, 27 (5.6%) had drug-induced hepatitis, and 16 (3.3%) had vision problems. Among 480 patients with ADRs, 462 (96.3%) had successful treatment outcomes, the remaining 17 patients (3.5%) died, and one (0.2%) had treatment failure.
CONCLUSIONS: Adverse events were more common in the 1st few months of treatment than in subsequent months. All mild-to-moderate ADRs were effectively managed, and most had successful treatment outcomes.
METHODS: Twleve months duration long randomized controlled trial from January to December 2021 will be carried out at Shaikh Zayed Medical Complex (SZMC), Lahore. A total of 440 patients aged 18 years and older diagnosed with hypertension in the last month with non- adherence to antihypertensive therapy <80% of pills used in the last 30 days and have access to a smartphone will be randomized into either the intervention group (n=220) or the control group (n=220). For the intervention arm, a comprehensive intervention, the "Multi-Aid-Package," consisting of seven items: written, voice, and graphics messages, animated video, educational material, and a 24/7 help service, has been designed. Standard care will be provided to the control group. The primary outcome will be improved adherence to antihypertensive medication, while the secondary outcome will be an alteration in systolic blood pressure (SBP). The analysis will be intention to treat.
CONCLUSION: According to this study, if the multifunctional Multi-Aid-Package proves to be a useful mobile health tool for improving hypertension patients' medication adherence, it will also significantly affect systolic blood pressure. In Pakistan and other comparable low- and middle-income countries LMICs, the Multi-Aid-Package ought to be taken into consideration as a means of enhancing adherence to medications among hypertension patients.
METHODS: We systematically searched PubMed, EMBASE, and Web of Science up until April 01, 2024, to find studies reporting the prevalence and severity of neurological and musculoskeletal complications associated with Lyme disease. Screening and data extraction were conducted using Nested Knowledge software. Two independent reviewers performed the quality assessment using the Newcastle-Ottawa Scale. Meta-analyses were performed using R software v4.3, employing a random-effects model.
RESULTS: Out of 3576 records, 17 studies were included, involving 3932 participants. These studies revealed significant prevalence of musculoskeletal symptoms (21.1%) and neurological disabilities (18%) among Lyme disease patients. The analysis showed a notable increase in risk for both complications in individuals with Lyme disease, with pooled Risk Ratios (RR) of 1.82 for musculoskeletal symptoms and 1.64 for neurological disabilities, indicating a significantly higher risk compared to control groups. Although heterogeneity across the studies was high, sensitivity analysis confirmed the consistency of our findings. Additionally, there was evidence of publication bias.
CONCLUSION: The study reveals significant neurological and musculoskeletal complications in Lyme disease patients, emphasizing the importance of early diagnosis, comprehensive treatment, and supportive care. The noted heterogeneity and potential publication bias highlight the need for transparent research and further study on long-term outcomes.
METHODS: In the present research, Aspergillus unguis, an endophytic fungal strain derived from the marine sponge A. suberitoides was successfully isolated and characterized. Subsequently, ethyl acetate extraction and isolation of chemical constituents produced was performed. The structures of the isolated compounds were identified using several spectroscopic methods, ie, UV, NMR, and mass spectrometry. Thereafter, MDA-MB-231, MCF-7 breast cancer cells and HaCat cells were treated with the isolated compounds. Not only viability, apoptosis, and cell cycle analyses were conducted, but also the mRNA expression of MCL1, BCL2L1, AKT1 and CDK2 were evaluated.
RESULTS: The extract showed cytotoxic activity in breast cancer cells. Two novel compounds were successfully isolated and identified, ie, Unguisol A (15.1 mg) and Unguisol B (97.9 mg). Both compounds share the same basic skeleton and comprise an aromatic ring which is attached to a sulphur-containing, seven-membered ring via an oxygen atom. This marked the first-time isolation of Unguisol A and Unguisol B from A. unguis, highlighting their novelty. Both compounds induced early apoptosis (p < 0.01) and cell cycle arrest at the S phase (p < 0.05) in MDA-MB-231 cells, but not in HaCat cells. Both compounds suppressed BCL2L1 and AKT1 mRNA expression (p < 0.01).
CONCLUSION: Two novel compounds were isolated from A. unguis. Unguisol A and Unguisol B induced apoptosis in MDA-MB-231 breast cancer cells via BCL2L1 mRNA downregulation, while both compounds induced cell cycle arrest at the S phase through AKT1 mRNA downregulation.
METHODS: Previous studies relevant to this topic were identified from 7 databases. Searches were performed in PubMed, CINAHL, Web of Science (WOS), Scopus, Psychology and Behavioral Science Collection (PBSC), Embase, PsychINFO from 1 Jan 1980 to 31 December 2023. The findings were reported according to caregiver burden, caregiver needs, and coping strategies.
RESULTS: 22 studies were included in this review, including 14 quantitative and 8 qualitative studies. Six types of burdens were identified: psychological, physical, medical, economic, social, and family. The predominantly reported burden was the psychological burden in developed and developing countries. However, caregivers in developing countries reported additional physical, social, and economic burdens due to cultural and socioeconomic factors. Furthermore, inaccessible and unaffordable health care with a lack of medical knowledge exacerbated the challenges. Stigma and misconceptions led to more psychological distress and social restriction. There is a need for psychological, social, and family support as well as medical information to promote self-efficacy among caregivers. Most caregivers develop their own coping strategies for dealing with caregiving stress.
CONCLUSION: The caregiving burden for AWE is an understudied area that needs to be addressed by healthcare professionals. The caregivers are experiencing unaddressed psychological and other types of burdens, together with a lack of appropriate interventions and healthcare information.
DESIGN AND SETTING: A retrospective secondary data analysis using data from the National Health and Morbidity Survey 2019, a cross-sectional household survey among the population in Malaysia.
PARTICIPANTS: All adults aged 18 years and above.
OUTCOME MEASURES: The two outcome variables were multimorbidity and outpatient services utilisation. Characteristics of respondents and those having multimorbidity were described using complex sample descriptive statistics. We used multivariable logistic regression to determine the associated factors of having multimorbidity and the association between the number of non-communicable diseases and outpatient services utilisation.
RESULTS: Overall, 11 347 respondents were included in the analysis. This study found a prevalence of 11.4 (95% CI=10.43-12.39) for multimorbidity. Age, marital status and working status were the factors associated with multimorbidity. Adults with multimorbidity were high users of outpatient services (20.4%, 95% CI=17.5-23.7), approximately threefold of adults with no non-communicable diseases. In the final model, multimorbidity showed an adjusted OR of 3.28 (95% CI=2.48-4.32) for outpatient services utilisation.
CONCLUSION: Understanding factors associated with multimorbidity and the magnitude of the impact of having multimorbidity towards outpatient services utilisation could help in future planning for healthcare system transformation. The recently launched Health White Paper for Malaysia has emphasised primary healthcare as a critical component to achieve aspirations of the health system, which includes equity and responsiveness. Strengthening primary care services and improving patient navigation across healthcare levels are critical to supporting individuals with multimorbidity. Avenues for further research include exploring a wider range of conditions and assessing the longitudinal impact of multimorbidity on healthcare utilisation and health outcomes.
METHODS: Twenty patients who had previously undergone implant surgery were included in the study. Ten patients had received the allograft (Group 1) and ten had received autogenous connective tissue (Group 2).An independent examiner retrospectively analyzed the patient records at 7, 15, and 60 days, and five years post-procedure. Data from these observations were collected and analyzed using SPSS Statistics, version 25. Descriptive statistical analysis was conducted.
RESULTS: All patients exhibited an increase in KT. For Group 1, the mean KT width measurements were 1.27 ± 0.46 mm at the initial evaluation, increasing to 2.00 ± 0.38 mm, 2.80 ± 0.78 mm, 3.27 ± 0.80 mm, and 3.01 ± 0.68 mm at 7, 15, and 60 days post-surgery (with prosthesis delivery on day 60), and five years after prosthetic rehabilitation, respectively.
CONCLUSIONS: Within the limitations of this retrospective clinical study, both amnion/chorion and connective tissue show significant potential for KT expansion when used in conjunction with implant surgery.
CLINICAL RELEVANCE: The use of allografts, due their low morbidity, and acceptable results should be considered as a viable option for soft tissues augmentations.
METHODS: Adhering the PRISMA 2020 guidelines and registered in the PROSPERO database, we conducted a systematic review and meta-analysis using the PubMed, Embase, and Web of Science databases up to October 2024. Nested Knowledge was used for screening and data extraction. Studies reporting quantitative data on the prevalence or mortality of dengue and leptospirosis co-infections were included. Data extraction and quality assessment were performed independently by two reviewers using the Modified Newcastle-Ottawa Scale. Statistical analyses, including prevalence and mortality estimation, sensitivity analysis were conducted using R, with heterogeneity evaluated by the I² statistic.
RESULTS: Out of 3,982 records, 14 studies met the eligibility criteria, yielding a pooled prevalence of dengue and leptospirosis co-infection at 2.33% (95% CI: 1.41-3.46%) across 16,638 participants, with significant heterogeneity (I² = 90%). The prediction interval for co-infection ranged from 0.05 to 7.27%. The pooled mortality rate among co-infected patients was 9.96% (95% CI: 0-53.49%), with moderate heterogeneity (I² = 71%). The prediction interval for mortality ranged from 0.00 to 100%. Publication bias was indicated by an LFK index of 2.52.
CONCLUSION: This meta-analysis revealed a moderate prevalence and a notable mortality rate for dengue and leptospirosis co-infections, with significant variability observed across different studies. Further research into the immunopathology and the implementation of integrated surveillance systems could enhance the effectiveness of diagnosis and treatment strategies in regions where these diseases are endemic.
METHODS: PubMed, Web of Science and EBSCOHost was systematically searched for empirical studies between 2000 and 2023 that discussed on factors that influenced family planning usage among women with diabetes. This systematic literature review was conducted in accordance to Joanna Briggs Institute's approach for conducting systematic review of associations. Factors were categorised to either individual and non-individual factors. Narrative synthesis approach was adopted that appropriately accommodates the heterogeneity of the reviewed studies.
RESULTS: A total of 29 studies met the inclusion criteria. Studies included in this review mostly reported individual-level factors that influence family planning practice among women with diabetes mellitus which were mainly the presence of diseases and other sociodemographic characteristics. Only six studies reported factors beyond individual variables which include geographic region, access to care, opinion of significant others, healthcare providers' perception, role of doctors and types of service providers.
CONCLUSIONS: This systematic review provides evidences that highlighted the gap in knowledge on variables that were beyond individual-level factors which influence family planning practice among women with diabetes mellitus. Further studies that explored structural and systemic factors may benefit future program planning to identify and target modifiable factors.