MATERIALS AND METHODS: This was a cross sectional prospective study done in 18 public hospitals in Malaysia from 7/4/2019 to 2/7/2019. Data was collected prospectively with universal sampling. All adult Muslim patients with previous diagnosis of diabetes, who were admitted for hypoglycemia, DKA or HHS were included if they had fasted and had intentions to fast.
RESULTS: 295 admissions for diabetes emergencies were analyzed. The pre-Ramadan period recorded the highest number of admissions (119) followed by during (106) and post-Ramadan (70). Admissions for hyperglycemic emergencies accounted for 2/3 of total admissions. 37% of admissions for hypoglycemia occurred during pre-Ramadan period compared to 32.1% during Ramadan. Contributing factors included use of sulphonylurea (59.6%), presence of nephropathy (54.5%) and past history of hypoglycemia (45.5%). Admissions for DKA were more common than HHS (119 versus 77) and highest during Ramadan period (36.1%). Most of the admissions for hyperglycemic emergencies were among those with Type 2 diabetes (75.9% for DKA and 97.4% for HHS). Only 31.5% of patients admitted for diabetes emergencies recalled having received Ramadan advice in the past.
DISCUSSION: Admissions for diabetes emergencies were highest during pre-Ramadan period followed by Ramadan and post-Ramadan period. This suggests that fasting during Ramadan does not increase admissions for diabetes emergencies.
DESIGN/METHODOLOGY/APPROACH: Preinterventional study was conducted in one-month period of January 2019, followed by intervention period from February to March 2019. Postintervention study was conducted from April to July 2019. The CLABSI rates were compared between pre and postintervention periods. A multifaceted intervention bundle was implemented, which comprised (1) educational program for healthcare workers, (2) weekly audit and feedback and (3) implementation of central line bundle of care.
FINDINGS: There was a significant overall reduction of CLABSI rate between preintervention and postintervention period [incidence rate ratio (IRR) of 0.06 (95 percent CI, 0.01-0.33; P = 0.001)].
PRACTICAL IMPLICATIONS: CLABSI rates were reduced by a multifaceted intervention bundle, even in non-ICU and resource-limited setting. This includes a preinterventional study to identify the risk factors followed by a local adaption of the recommended care bundles. This study recommends resources-limited hospitals to design a strategy that is suitable for their own local setting to reduce CLABSI.
ORIGINALITY/VALUE: This study demonstrated the feasibility of a multifaceted intervention bundle that was locally adapted with an evidence-based approach to reduce CLABSI rate in non-ICU and resource-limited setting.
METHODS: We searched databases Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Google Scholar up to January 2021 and identified randomised controlled trials comparing ketorolac to any other medications in treating patients presenting with migraine headache.
RESULTS: Thirteen trials were included in our review, comprising of 944 participants. We derived seven comparisons; ketorolac versus phenothiazines, metoclopramide, sumatriptan, dexamethasone, sodium valproate, caffeine, and diclofenac. There were no significant differences in the reduction of pain intensity at 1-hour under the comparisons between ketorolac and phenothiazines (standard mean difference (SMD) 0.09, P 0.74), or metoclopramide (SMD 0.02, P 0.95). We also found no difference in the outcome recurrence of headache [ketorolac vs phenothiazines (risk ratio (RR) 0.98, P 0.97)], ability to return to work or usual activity [ketorolac vs metoclopramide (RR 0.64, P 0.13)], need for rescue medication [ketorolac vs phenothiazines (RR 1.72, P 0.27), ketorolac vs metoclopramide (RR 2.20, P 0.18)], and frequency of adverse effects [ketorolac vs metoclopramide (RR 1.07, P 0.82)]. Limited trials suggested that ketorolac offered better pain relief at 1-hour compared to sumatriptan and dexamethasone, had lesser frequency of adverse effects than phenothiazines, and was superior to sodium valproate in terms of reduction of pain intensity at 1-hour, need for rescue medication and sustained headache freedom within 24-hour.
CONCLUSIONS: Ketorolac may have similar efficacy to phenothiazines and metoclopramide in treating acute migraine headache. Ketorolac may also offer better pain control than sumatriptan, dexamethasone and sodium valproate. However, given the lack of evidence due to inadequate number of trials available, future studies are warranted.
MATERIALS AND METHODS: This study aimed are to characterize Bi2O3 particles synthesized at 60, 90 and 120 °C via hydrothermal method and investigated cytotoxicity of cell viability assay, cell morphology analysis, intracellular reactive oxygen species (ROS) assay and expression of ER stress genes by real-time PCR.
RESULTS: Results indicated that the size of rod-shaped Bi2O3 particles increased with rising synthesizing temperatures. The cytotoxicity of Bi2O3 particles in Chang liver cells was size-dependent. Bigger-sized Bi2O3 particles resulted in lesser toxicity effects. mRNA expressions of GRP78 and C/EBP homologous protein (CHOP) were down-regulated in all treated Chang liver cells due to the increasing size of Bi2O3 particles. Bi2O3 particles synthesized at 120 °C was found to be less toxic than iodine.
CONCLUSION: Data suggested that the response of Chang liver cells to Bi2O3 particle cytotoxicity has a significant relationship with its reaction temperatures. This outcome is important in hazard assessment of Bi2O3 particles as a new contrast media and provides better understanding in synthesizing control to enhance its biocompatibility.
METHODS: This cross-sectional study was conducted between 1 July and 31 December 2019 among patients in medical wards who had a blood glucose (BG) level of > 7.8 mmol/L and stayed in the wards for ≥ 24 h. We retrieved information on demographics, diabetes history and BG profiles. The definition of controlled glycaemic status is when ≥ 80% of BG readings were between 4.0 mmol/L and 10.0 mmol/L during the hospital stay.
RESULTS: The prevalence of inpatient hyperglycaemia was 55.2%. There were 841 patients who met the eligibility criteria; their mean age was 60 (13.8) years old. Most (79.4%) of the patients were Malay and 53.9% were male. There were 452 (53.7%) patients in the uncontrolled group. They were younger and admitted with more kidney complications compared to those in the controlled group. The median LOS for both groups was 3 (2) days. The uncontrolled group showed a higher percentage of readmission within 30 days (7.5% versus 4.6 %) and death during admission (3.3% versus 1.6 %) (P = 0.100 and P = 0.082).
CONCLUSION: The prevalence of inpatient hyperglycaemia was high. More than half of them had uncontrolled BG. Both groups had a similar average length of stay. The 30-day readmission rate and death during admission were higher in the uncontrolled group, although statistically not significant.
METHODS: A cross-sectional study was conducted among 244 breast cancer women in The Medical City Teaching Oncology Hospital, Baghdad, Iraq, from August 2023 to October 2023. QOL, coping skills, and psychological factors were assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Group Core-30 (QLQ-C30), BRIEF COPE-28, and Hospital Anxiety and Depression Scale (HADS) scale, respectively. Sociodemographic and clinical characteristics were also assessed. The associations between the association factors and quality of life were assessed using multiple linear regression.
RESULT: The mean (SD) quality of life scores for global, functional, and symptom domains were (53.24 ± 16.80, 46.23 ± 25.16, and 53.82 ± 22.10), respectively. Multiple linear regression analysis revealed significant factors influencing global quality of life were age, marital status, disease duration, hormonal therapy, passive coping, and anxiety. Age, disease duration, passive coping, and anxiety were significant factors for the functional domain. The symptom domain was notably affected by menstrual status, mastectomy, passive coping, and depression.
CONCLUSION: These results provide crucial insights for developing targeted interventions to enhance the quality of life for breast cancer patients in Iraq.
METHODS: A cross-sectional study was conducted from December 2022 to April 2023, using a valid and reliable self-administered six sections questionnaire consisting of; (i) sociodemographic, (ii) work-related factors, (iii) MHSU, (iv) perception of stigmatisation by others, (v) enabling factors, and (vi) need factors. Respondents were selected through proportionate stratified random sampling based on job categories. Multiple Logistic Regression using SPSS version 26 was used to determine the predictors of MHSU.
RESULTS: A total of 294 respondents participated in this study, with a response rate of 83.5%. The 12-months MHSU prevalence was 45.6%. Mental health services were predominantly utilised for screening (96.3%) and treatment purposes (28.4%), primarily accessed through health clinics (85.1%), and interaction with paramedics (44.0%) and medical officers (38.8%). Significant drivers predicting MHSU were B40 household income (aOR = 3.426, 95% CI: 1.588, 7.393, p-value = 0.002) and M40 household income (aOR = 3.781, 95% CI: 1.916, 7.460, p-value<0.001), low supervisor support (aOR = 2.302, 95% CI: 1.206, 4.392, p-value = 0.011), received mental health training (aOR = 2.058, 95% CI: 1.221, 3.469, p-value = 0.007) and high co-worker support (aOR = 1.701, 95% CI: 1.034, 2.798, p-value = 0.036).
CONCLUSION: Almost half of respondents used mental health services, predicted by lower and middle household income, received mental health training and high co-worker support. Conversely, MHSU was also predicted by low supervisor support. To sustain high levels of MHSU, it is essential to implement regular mental health training targeted HCWs with lower to middle household incomes and those experiencing low supervisor support, while simultaneously enhancing co-worker support and screening program for early detection of mental health problems.