DESIGN/METHODS: A non-randomized prospective study was conducted for various types of pterygium excision with superior bulbar conjunctival autograft (CAG) and fibrin glue. We introduced fluorescein staining to ensure thorough elimination of the Tenon tissue around the bare sclera area and the CAG. The primary outcome was the recurrence rate, and the secondary outcome was any complication associated with fluorescein staining.
RESULTS: Ninety-three participants with primary pterygium of Grades 1-3 were recruited and all completed follow-up for at least 1 year. No recurrence was identified during the follow-up period and no long-term adverse reactions were reported with the "hydro-fluorescein" method.
CONCLUSION: "Hydro-fluorescein" is effective and a safe adjunct in primary pterygium removal and is effective in various grades of pterygia to minimize recurrence with no adverse reaction within 1 year.
OBJECTIVE: We performed a systematic review of the prevalence of mild-to-moderate asthma in adolescents and adults using sputum inflammatory cell analysis and their responses to ICS.
METHODS: We searched electronic databases (PubMed, Scopus, EMBASE, Cochrane) for studies in adolescents and adults with mild-to-moderate asthma. The primary outcome was the prevalence of asthma subtypes based on sputum inflammatory cell analysis, categorized into EA and NEA. The secondary outcome involved comparing asthma outcomes between different subtypes after ICS therapy. Certainty of evidence was reported for each pooled analysis.
RESULTS: Eighteen studies involving 3,533 adolescents and adults with mild-to-moderate asthma were reviewed. The pooled prevalence (95% confidence interval) of NEA was estimated at 40.39% (27.54, 53.93) in patients with ICS naive with very low certainty of evidence. On reevaluating sputum cytology, the disease of approximately 20% to 30% of patients initially diagnosed as NEA transitioned to the EA subtype. EA patients showed significant improvements in asthma symptoms after ICS therapy: forced expiratory volume in 1 second (standardized mean difference, 0.79; 95% confidence interval, 0.30, 1.27), and airway hyperresponsiveness (standardized mean difference, 1.34; 95% confidence interval, 0.29, 2.40). NEA patients exhibited limited response.
CONCLUSION: A high proportion of adolescents and adults with mild-to-moderate asthma were identified with NEA subtype disease, which exhibited a poor response to ICS. A thorough diagnostic evaluation before initiating treatment should be integrated into clinical practice.Registered in PROSPERO (CRD42023484334).
METHODS: A mixed-methods sequential explanatory research study was adopted. In the first phase, quantitative data were gathered through a 16-item Likert scale questionnaire adapted from validated clinical reasoning questionnaires. In the second phase, focus group discussions were conducted to expand on the understanding of quantitative results.
RESULTS: In total, 160 students completed the questionnaire (45% response rate), and 26 participated in focus group discussions. Participants agreed that online case-based learning fostered clinical reasoning skills (mean = 2.94) through different formats, such as clinical role play, simulated ward rounds and virtual consultation. Compared to face-to-face clinical teaching, the focus group revealed that participants were allowed to practise giving explanations to patients, engage in more in-depth discussions, and receive more comprehensive feedback on their clinical reasoning skills during online case-based learning. The barriers to online clinical reasoning skills development were poorer communication skills development and reduced student engagement. The lack of patient complexities of cases and the inability to perform physical examinations hindered students' clinical reasoning ability. Suggestions to improve clinical reasoning cultivation include utilising actual patient cases, increasing case complexity and session interactivity.
CONCLUSION: This study highlights how online case-based learning can support the development of clinical reasoning skills in medical students, encouraging future educators to adopt a blended learning approach. Future research should focus on objective assessments, long-term impacts and innovative methods to improve clinical reasoning skill development continuously.
METHODS: We investigated the interaction between these derivatives and the hCA II isozyme via various spectroscopic and docking methods.
RESULTS: The kinetic data demonstrates that compound 1 (C1) and compound 2 (C2) share a similar inhibitory strength against hCA II, effectively inhibiting its esterase activity through a noncompetitive mechanism with Ki values at low micromolar levels. Fluorescence measurements indicated that the synthesized compounds suppressed the inherent fluorescence of hCA II via a static quenching process, with each compound showing a singular binding site within the enzyme. Thermodynamic evidences highlight the significance of van der Waals interactions and hydrogen bonding in the binding process. The results of molecular docking indicated that both C1 and C2 effectively obstruct the entrance to hCA II's active site, with no significant differences in their binding conformations.
CONCLUSION: While C1 and C2 exhibit CA inhibitory potency lower than that of sulfonamide compounds, this study offers valuable insights that could pave the way for the development of a promising scaffold for designing new carbonic anhydrase inhibitors.
OBJECTIVE: This systematic review and meta-analysis assess the effectiveness of salivary biomarkers in the diagnosis and prognosis of RA, examining current evidence and proposing avenues for future research.
METHODOLOGY: A literature review following PRISMA 2021 guidelines was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify studies from the past five years on salivary biomarkers in RA patients compared to healthy controls.
RESULT: The review focused on original research articles, and meta-analysis was performed on studies reporting standard deviation values for inflammatory markers such as IL-6, IL-8, MMP-8, and TNF-alpha. The meta-analysis included eleven studies with 394 RA patients and 255 healthy controls, evaluating IL-8, IL-6, MMP-8, and TNF-α as RA biomarkers. IL-8 showed a mean difference of 7.32 (CI: -5.48 to 20.13), not statistically significant, favouring controls. IL-6 had a CI of -0.09 (CI: -2.20 to 2.02) with high heterogeneity (I² = 98%), suggesting its potential as a diagnostic and prognostic biomarker. TNF-α and MMP-8 showed no significant differences (CIs: 4.54 and 2.71, respectively).
CONCLUSION: This systematic review and meta-analysis emphasize saliva's potential in identifying RA biomarkers, especially IL-6, which is associated with the disease's pathogenesis. However, significant evidence heterogeneity necessitates larger, multicentric studies for validation.