3rd Month Research Articles

Treatment of fibromyalgia among patients with mastalgia and fibromyalgia improved mastalgia.

The aim of this study is to examine the effect of fibromyalgia (FM) treatment on mastalgia by performing fibromyalgia screening in patients who applied for mastalgia and whose underlying cause could not be found. Patients who applied to Kocaeli University General Surgery Outpatient Clinic between November 2017 and November 2020 with breast pain were included (n=120). Patients without cancer, systemic disease, previous breast surgery, and breast mass larger than 3 cm (n=30) were referred to the Physical Therapy and Rehabilitation Outpatient Clinic. A total of 13 patients (43%) were diagnosed with FMS. Twelve of them were given selective serotonin-noradrenaline reuptake inhibitor (duloxetine) treatment for 3 months. Turkish version of the Short Form - 36 (SF-36) quality of life scores, Visual Analog Scale (VAS), Cardiff breast pain score before and after treatment were compared. The remaining 17 patients were followed as only mastalgia. Patients with fibromyalgia and mastalgia had similar demographic results. At the end of the 3rd month, the complaints of breast pain completely regressed in all of the patients. Statistically significant changes were detected in VAS score, the number of trigger points, and SF-36 quality of life scores, Cardiff breast pain score after duloxetine treatment. In the presence of unexplained mastalgia, fibromyalgia should be kept in mind. Duloxetine treatment improved the breast pain and quality of life in patients with mastalgia and fibromyalgia.

Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer: A 1-year longitudinal study

Objective: The objective of this study was to investigate the frequency of acute and late toxicities, as well as changes in the quality of life (QOL) for breast cancer patients following radiotherapy (RT). Materials and Methods: A total of 108 breast cancer women were recruited for this prospective study. Data were collected at various intervals; prior to, and 1, 3, 6 months, and 1 year after radiation therapy. The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer (EORTC) criteria. Our secondary outcome was QOL, measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale. We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year. Results: The early toxicities that are most commonly experienced include pharyngeal, skin, and mucous membrane toxicity. Late toxicities frequently involve skin and submucosal toxicity. To measure patient functionality, all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT. Symptoms of the patients, which were included in the QOL symptom scale, decreased during the follow-up period, except for fatigue; however, changes in pain, insomnia, and loss of appetite did not significantly change. We identified the analogous symptom profiles in Edmonton. Although patients’ overall health scores declined in the 1st and 3rd months after radiotherapy (RT), they rebounded at 6 and 12 months. Conclusion: For breast cancer patients, RT did not adversely affect functional capacity or exacerbate symptoms, but persistent fatigue did increase during the observation period. Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.

Effectiveness of Oral Zinc Therapy as an Adjunct to Intralesional Measles, Mumps, and Rubella Vaccine in Patients of Verruca Vulgaris

Abstract Background: Verruca vulgaris (VV) is caused by human papillomavirus affecting both keratinized and nonkeratinized epithelium. Different treatment modalities are available leading to scarring, pain, and ineffectiveness. Injection of measles, mumps, and rubella (MMR) not only clears treated warts but also distant warts by stimulating cell-mediated immunity. Objectives: The objective of this study was to study the efficacy of adjuvant zinc with injectable MMR vaccine in treatment with side effects of treatments, the pattern of regression, the number of injections required for clearance, and the recurrence of verruca. Materials and Methods: Fifty patients having verruca were divided into groups A and B with 25 patients each. Group A received an injection of MMR and tablet of zinc whereas group B only injection MMR. A total of five injections were given in the largest wart at intervals of 2 weeks i.e., 0, 2, 4, 6, and 8 weeks. Follow-up was done at 3rd month and 6th months following 1st dose. Improvement in warts and patient satisfaction were assessed using visual analog scale and Likert scale, respectively. Results: Mean age of patients in groups A and B was 30.36 and 32.68 with male-to-female ratio 5.28:1 (21:4) and 1.77:1 (16:9), respectively. Mean numbers and size of lesions in group A and B were 2.24 (±1.59), 1.84 (±1.40) and 5.52 mm, 5.08 mm, respectively. Eighty-four percentage of patients in both groups needed five injections for complete clearance. Pain was the most common side effect in all patients of both groups whereas gastritis, fever, and lymphadenopathy were observed only in one patient of Group A. Patients in both groups were strongly satisfied on Likert’s scale. Conclusion: Oral zinc as an adjuvant with MMR vaccine for the treatment of VV was equally safe but did not prove to be of higher efficacy in our study.

Evaluating the effectiveness and feasibility of a digital health intervention to community-based rehabilitation in older adults: A cluster randomized controlled trial study protocol.

The escalating global aging population underscores the need to effectively manage geriatric diseases, constituting a significant public health concern. Community-based rehabilitation has emerged as a crucial and accessible paradigm for the rehabilitation of older adults. In China, however, the practical implementation of community-based rehabilitation faces formidable challenges, including a dearth of specialized rehabilitation therapists, substantial disparities between demand and supply, and suboptimal satisfaction rates. We aimed to develop a community-based rehabilitation management platform for older adults centered around digital health technology, with the plan to conduct a cluster randomized controlled trial to gather more evidence to explore the best practices and service models of community-based rehabilitation based on digital health technology. This cluster randomized controlled trial will be conducted in Zunyi City, China. We will recruit 286 adults aged ≥60 years and randomly allocate 20 subdistricts in a 1:1 ratio into either the intervention group, which will use the Rehabilitation Journey application, or the control group, which will be given a Rehabilitation Information Booklet for Older Adults. Both groups will undergo a 12-month rehabilitation management program, encompassing six months of guidance and an additional six months of follow-up through online and offline methods. The evaluation indicators will be assessed at enrollment and at 3rd, 6th, and 12th month. This study endeavors to furnish novel insights to develop a tailored community-based rehabilitation management program for older adults, delivering customized, intelligent, and precise rehabilitation services.

Evaluation of Intraocular Pressure in Eyes After Femtolasik Surgery

Introduction: Femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) surgery is a surgical procedure performed in the treatment of refractive errors. Given the changes in central corneal thickness, intraocular pressure may be lower and underestimated, which may lead to a late diagnosis of ocular hypertension/glaucoma. Aims: The aim of this study was to evaluate and compare intraocular pressure, by different methods, before and after FS-LASIK, for correction of myopia or myopic astigmatism. Methods: Retrospective and observational study, which included eyes undergoing FS-LASIK surgery (November 2020 to November 2022). The intraocular pressure values were measured (preoperatively, on the 1st, 3rd and 6th postoperative month) using contact tonometry (Goldmann applanation tonometry) and non-contact tonometry (by Corvis®ST according to the formulas: pachymetry – Ehlers, Shah, Dresden, Spoerl – and biomechanics – corrected and uncorrected). The intraocular pressure values obtained at 6 months with the different methods were compared with the Goldmann applanation tonometry intraocular pressure values obtained at baseline. Results: Ninety patients (of a total of 174 eyes) underwent FS-LASIK, with a preoperative spherical equivalent of -3.7±1.7. Preoperatively (mean ± standard deviation) Goldmann applanation tonometry was 15.0±1.9 mmHg; the intraocular pressure values obtained through the Corvis® ST (in mmHg) according pachymetry: Ehlers (13.5±2.6), Shah (14.3±2.3), Dresden (14.5±2.2) and Spoerl (14.5±2.1); and biomechanics: corrected (14.4±1.9) and not corrected (15.3±2.1), respectively. At 6 months postoperatively, all showed statistically significant differences, with the exception of Shah's formula (p=0.074); comparing the preoperative Goldmann applanation tonometry with each of the formulas at the end of the follow-up, the Ehlers formula did not present statistically significant differences (p=0.434), the Shah formula a value of p=0.047 and the others a value of p<0.001. Conclusion: Femtosecond laser-assisted laser in situ keratomileusis surgery underestimates intraocular pressure measurement by contact tonometry. In non-contact tonometry, at 6-month follow-up, the Shah formula appears to be less influenced by this bias. More studies are needed to evaluate the best method to assess I intraocular pressure measurement after FS-LASIK surgery.

A prospective observational study on efficacy and tolerability of the drugs used in treating rheumatoid arthritis

Background: Rheumatoid arthritis (RA) is an autoimmune disorder requiring long-term combination therapy with disease-modifying antirheumatic drugs (DMARDs), non-steroidal anti-inflammatory agents (NSAIDS), low-dose steroids, proton pump inhibitors, calcium, and folic acid and these drugs cause multitude of side effects. This study on the efficacy and tolerability of drugs used in RA among South Indian patients can guide in tailoring a treatment regimen more suited for South Indian population. Aims and Objectives: The main objective of this study was to evaluate the efficacy and tolerability of drugs used in the treatment of RA among South Indian patients. Materials and Methods: In this prospective observational study, 120 newly diagnosed RA patients attending rheumatology outpatient department in a tertiary care center in South India were recruited after obtaining Institutional Ethics Committee approval and informed consent. Sociodemographic details and baseline investigations were done. Each patient was followed up for a period of 6 months wherein, response to treatment was evaluated and adverse drug reactions (ADRs) reported were collected, analyzed and appropriate treatment was instituted. Data analysis was done using SPSS software. Results: One hundred patients completed the study. There was female preponderance (85%) and 38% were rheumatoid factor positive. Efficacy of combination therapy was evidenced falling erythrocyte sedimentation rate (P < 0.001), modified health assessment questionnaire,and disease activity score 28 scorings after 1st, 3rd, and 6th month of therapy (P < 0.001) and improvement in hemoglobin count (P < 0.001). The number of swollen joints was also significantly reduced (P < 0.001). Common ADRs reported were gastritis (29%), mucosal ulcers (10%), macrocytic anemia (3%), chloroquine-related ocular toxicity (2%). Conclusion: NSAIDS and steroids helped to achieve early remission and caused most of adverse effects. Methotrexate and chloroquine had good tolerability and were preferred DMARDs in our center. Thus, we conclude that the combination therapy used in our center is efficacious and well tolerated by South Indian population.

Comprehensive analysis of systemic, metabolic, and molecular changes following prospective change to low-carbohydrate diet in adults with type 2 diabetes mellitus in India.

South Asians, especially Indians, face higher diabetes-related risks despite lower body mass index (BMI) compared with the White population. Limited research connects low-carbohydrate high-fat (LCHF)/ketogenic diets to metabolic changes in this group. Systematic studies are needed to assess the long-term effects of the diet, such as ocular health. In this prospective, observational study, 465 candidates aged 25-75 years with type 2 diabetes included with institutional ethics approval. A total of 119 subjects were included in the final study assessment based on the availability of pathophysiological reports, tears, and blood samples collected at baseline, 3rd, and 6th months. Serum and tear samples were analyzed by an enzyme-linked lectinsorbent assay, to examine secreted soluble protein biomarkers, such as IL-1β (interleukin 1 Beta), IL-6 (interleukin 6), IL-10 (interleukin 10), IL-17A (interleukin 17A), MMP-9 (matrix metalloproteinase 9), ICAM-1 (intercellular adhesion molecule 1), VEGF-A (vascular endothelial growth factor A), and TNF-α (tumor necrosis factor-alpha). A Wilcoxon test was performed for paired samples. Spearman's correlation was applied to test the strength and direction of the association between tear biomarkers and HbA1c. p-value of < 0.05 was considered significant. After a 3- and 6-month LCHF intervention, fasting blood sugar decreased by 10% (Δ: -14 mg/dL; p < 0.0001) and 7% (Δ: -8 mg/dL; p < 0.0001), respectively. Glycated hemoglobin A1c levels decreased by 13% (Δ: -1%; p < 0.0001) and 9% (Δ: -0.6%; p < 0.0001). Triglycerides reduced by 22% (Δ: -27 mg/dL; p < 0.0001) and 14% (Δ: -19 mg/dL; p < 0.0001). Total cholesterol reduced by 5.4% (Δ: -10.5 mg/dL; p < 0.003) and 4% (Δ: -7 mg/dL; p < 0.03), while low-density lipoprotein decreased by 10% (Δ: -11.5 mg/dL; p < 0.003) and 9% (Δ: -11 mg/dL; p < 0.002). High-density lipoprotein increased by 11% (Δ: 5 mg/dL; p < 0.0001) and 17% (Δ: 8 mg/dL; p < 0.0001). At the first follow-up, tear proteins such as ICAM-1, IL-17A, and TNF-α decreased by 30% (Δ: -2,739 pg/mL; p < 0.01), 22% (Δ: -4.5 pg/mL; p < 0.02), and 34% (Δ: -0.9 pg/mL; p < 0.002), respectively. At the second follow-up, IL-1β and TNF-α reduced by 41% (Δ: -2.4 pg/mL; p < 0.05) and 34% (Δ: -0.67 pg/mL; p < 0.02). Spearman's correlation between HbA1c and tear analytes was not statistically significant. The LCHF diet reduces the risk of hyperglycemia and dyslipidemia. Changes in tear fluid protein profiles were observed, but identifying promising candidate biomarkers requires validation in a larger cohort.

Effect of regular physical activity and lifestyle changes on insulin resistance in patients after kidney transplantation.

Insulin resistance (IR) is the most significant risk factor for post-transplant diabetes mellitus (PTDM). This study aimed to determine the effects of regular physical activity on IR and PTDM in patients after kidney transplantation (KT). The study group (n = 22) participated in aerobic or combined sports (aerobic and anaerobic). Monitoring was provided by asports tracker (Xiaomi Mi Band 4, compatible with the Mi Fit mobile application). Waist circumference was significantly lower (p = 0.0437, p= 0.0372), graft function was better (p= 0.0036, p= 0.0137), fasting blood glucose was lower (p = 0.0016, p= 0.0003), C-peptide level was lower (p = 0.0447, p= 0014) in the 3rd and 6th months of monitoring, and low-density lipoprotein was lower at 6months (p = 0.0444) in the observed group than in the control group. IR was significantly lower at 6 months (p = 0.0202), and fasting blood glucose was significantly lower at 3 and 6 months (p = 0.0227) in the observed group. We confirmed the significant effect of regular physical activity on preventing the development of IR and impaired fasting glucose levels in patients after KT (Tab. 1, Fig. 4, Ref. 27). Text in PDF www.elis.sk Keywords: kidney transplantation, insulin resistance, physical activity.

Outcomes of Surgical Revascularization in Trans-Atlantic Society Consensus (TASC II) Type C &amp; D Aortoiliac Occlusive Disease

Introduction: Aortoiliac occlusive disease is a disabling illness. This study was conducted on the patients of Trans-Atlantic Society Consensus (TASC II) type C &amp; D aortoiliac occlusive disease. Open surgical revascularization in the form of aortofemoral and aorto-bifemoral bypass grafting was done and the demography of patients of AIOD, the efficacy and outcomes of open surgical bypass in the patients of TASC II, type C &amp; D aortoiliac occlusive disease was studied. Methods: in this study, total of 52 patients were revascularized and were observed for various parameters thoroughly throughout the course of diagnosis, preoperative, intra-operative and postoperative phase and until 6 months of follow-up. The demographics, clinical characteristics of the patients, co-morbid conditions, type of aorto-iliac occlusive disease (AIOD), the surgical procedure conducted and the outcomes of surgery in terms of limb salvageability, healing of ulcer, relief of claudication and graft patency were observed. Results: 50 (96.16%) out of 52 patients were males, with a mean age of presentation 55.01 + 8.58 years. 47 (90.38%) were smokers, 43 (82.69%) had hypertension, 17 (32.69%) had diabetes, 11 (21.15%) had CAD, 12 (23.07%) had COPD, 22 (42.30%) had type C and 30 (57.69%) patients had type D disease. Aorto-bifemoral bypass grafting was done in 42 (80.76%) . Mean duration of ICU stay was 1.9 days, 6 (11.53%) patients expired postoperatively. The graft patency and limb salvageability were 100% and 96.15% respectively during 1st, 3rd and 6th months of follow-up with complete healing of ulcers in 21 (91.30%) patients by the end of 6 months. Conclusion: Surgical revascularization is an important, high yielding, life changing intervention which serves as a boon for the patients with extensive or advanced aortoiliac disease. The surgery has excellent outcomes in terms of graft patency as well as limb salvageability.

A simplified sclerocorneal tunnel approach in performing pediatric cataract surgery.

Performing pediatric lensectomy, anterior vitrectomy with intraocular lens implantation in one session, using a long sclerocorneal tunnel and covering the incision site with 8/0 Vicryl sutures. This study includes 52 eyes of 30 patients with pediatric cataracts. At the temporal side, the conjunctival peritomy was performed, followed by two long sclerocorneal side ports and the main incision for intraocular lens (IOLs) implantation. At the end of the operation, the side port and the conjunctiva incisions were sutured with 8/0 Vicryl sutures. The IOLs were implanted in children older than 24 months, not in smaller ones. The operations and intraoperative complications were recorded. After the operation, the patients were examined on the 1st postoperative day, then six times for the first 6 months. During follow-ups, the impact of the suture on the anterior segment complications and astigmatism was evaluated. The age of the patients ranged between 2 months and 8 years. The average operation time was 28 ± 6 min. Due to the suture-related complication, neither re-suturing nor stitch removal was carried out; therefore, general anesthesia was not repeated. The average astigmatism value of the children in the postoperative 1st week was 1.5 ± 1.2 D (0.5-4.0). The mean astigmatism value was 0.8 ± 0.5 D (0.5-1.5) in the 3rd postoperative month. The long corneoscleral tunnel method has been found safe in pediatric cataract surgery.

Peripheral hypertrophic subepithelial degeneration – case report

Purpose: The aim of the paper is to present the case of a 53-year-old female patient who, based on the clinical picture and optical coherent tomography of the anterior segment (AS-OCT), was diagnosed with peripheral hypertrophic subepithelial degeneration (PHSD) and underwent surgical treatment in the form of superficial keratectomy with mechanical removal of degenerative plaques.&#x0D; Methods: Analysis of AS-OCT images and corneal tomography based on Scheimpflug images and surgical treatment – superficial keratectomy with mechanical removal of degenerative plaques.&#x0D; Results: Before treatment, the best corrected visual acuity (BCVA) for distance, as assessed by the Snellen chart, was 3/50 c.cor +10.50/-6.50 ax 18° in the right eye (RE) and in the left eye (LE) 5/10 c.cor +10.75/-3.00 ax 48°. Preoperative keratometry performed with the Pentacam device was K1 32.7 D and K2 46.0 D in the OP and K1 42.5 D and K2 44.7 D in the LE. Postoperative BCVA in RE was 5/8 c.cor +3.50/-1.00 ax 120° at 5 months of follow-up and in LE 5/6 c.cor +4.75/-1.00 ax 64° at 3rd month of observation. Postoperative keratometry (Pentacam) in RE K1 was 44.6 D, K2 46.9 D in the 5th month of observation, and in LE K1 45.6 D, K2 46.5 D in the 3rd month of observation. As a result of the treatment, BCVA improved, astigmatism decreased and corneal translucency improved.&#x0D; Conclusions: AS-OCT and Scheimpflug-based corneal tomography are helpful in the diagnosis of PHSD. Superficial keratectomy with mechanical removal of degenerative plaques seems to be an effective treatment for PHSD

경기종합지수 단기 예측모형 구축 연구

After the declaration of the ‘Endemic,’ it is crucial to understand the cyclical fluctuations and turning points in the overall economic status of the nation. To promptly and accurately grasp the magnitude and speed of these economic changes, a short-term forecasting analysis was conducted using the composite index of business indicators data from January 2003 to April 2023. In this study, a two-step analysis was performed to propose a standardized forecasting process.&#x0D; Firstly, for short-term forecasting of the composite index of business indicators, the results of time series analyses considering only endogenous variables were compared with those incorporating exogenous variables. Subsequently, the study explored machine learning methods, which have been actively discussed recently, and compared and analyzed their prediction performance with traditional time series analysis methods. The analysis revealed that the addition of exogenous variables in time series analysis resulted in higher prediction accuracy compared to analyses considering only endogenous variables. Furthermore, machine learning models exhibited superior prediction performance compared to traditional time series models. As a result of the analysis with the Time-GAN model, which has the best predictive performance, it was found that there would be a rise for 1-2 months due to the growth of private consumption caused by the endemic, but it would decrease again in the 3rd month.

Management of initial and surgical management of amlodipine-induced gingival enlargement with multifactorial etiology: a case report with 6 months follow-up

Drug-induced gingival enlargement can be seen as a side effect of systemically used drugs such as calcium channel blockers, anticonvulsants, and immunosuppressants. One of these drugs is amlodipine, a dihydropyridine derivative calcium channel blocker used in the treatment of high blood pressure and coronary artery disease. Amlodipine-induced gingival overgrowth is rarely seen compared to other calcium channel blockers. The aim of this case is to present the diagnosis of gingival overgrowth due to amlodipine use and the identification of other etiologic factors such as labial frenulum, phase 1 initial, and phase 2 surgical treatment approaches. A 56-year-old female patient presented to our clinic with severe gingival overgrowth, intense bleeding, difficulty feeding, and pain. The anamnesis revealed that she had hypertension and had been taking amlodipine derivative Norvasc 10 mg once a day for 8 years. A look inside the mouth showed that there was a lot of gum tissue growing over the crowns from the labial and palatal sides, mainly in the front of the maxilla. Phase 1 treatment was initiated. As a result of the consultation with the patient's cardiologist, the hypertension medication Norvasc 10 mg was replaced with Candexil 16 mg by the medical physician. The preoperative tension and blanch test was positive, and the labial frenulum was seen to mobilize the free gingival margin of the central teeth. After the same session of gingivoplasty, the labial frenulum was removed by a frenectomy operation. After the operation, antibiotics, analgesics, and mouthwash were prescribed. The patient stated that he did not have any problems after the operation. 6-month follow-up showed uneventful healing. No recurrence of gingival growth was found in the 1st, 3rd, and 6th month follow-ups. In conclusion, this case report shows that non-surgical periodontal treatment alone isn't always enough to treat drug-induced gingival overgrowths. The gingival shape should be changed so that the patient can properly clean their teeth, and drug-induced gingival overgrowths, like the one in this case, may have more than one cause and may need additional surgery like a labial frenectomy.

The Effects of Resveratrol Supplementation on the Quality of Life of Diabetic Patients with Neuropathy: Small Randomized Clinical Trial

The diabetic neuropathy complication exerts a considerable decline in the level of patient’s well-being. The main approaches to hamper the progression of diabetic complications and improve patient’s life quality are controlling the glycemic levels and amelioration of the hyperglycemia-induced neuroinflammation, oxidative stress and pain. Supplementation of appropriate anti-inflammatory and anti-oxidants such as resveratrol may therefore be effective in the management of diabetic complications. The aim of this trial was to assess resveratrol’s impact on improving life quality of patients with the neuropathic complication of diabetes. Sixty-one patients with diabetic neuropathy were recruited in this double-blinded placebo-controlled trial. Patients were randomized into the resveratrol (n=31) group; who received a 500mg resveratrol capsule once daily concomitantly with the conventional hypoglycemic agents for three months, and the placebo (n=30) group. From each group 25 patients completed the study. The quality of life (QoL) of the patients was estimated utilizing RAND 36-item survey questionnaire. Fasting blood glucose levels were analyzed at the baseline and on the last day of the 3rd month. There was a significant decrement (p&lt; 0.001) in the fasting serum glucose level of the patients supplemented with resveratrol at the end of the 3rd month, in comparison with the patient using the placebo. There was also a significant improvement in patient’s severity of pain (p&lt;0.001) as shown in the bodily pain score of the RAND 36 scale and a remarkable (p &lt; 0.05) improvement in physical functioning, physical health, social functioning, emotional well-being, energy/fatigue, and health change subscales of the questionnaire. The study concluded that resveratrol is the polyphenol that has a positive effect on reducing pain associated with diabetic neuropathy and improving the overall QoL of the patient.

Effect of Teneligliptin in comparison with Voglibose as an add on therapy in reducing microvascular complications in type II Diabetes Mellitus patients – A Prospective randomized control trial

Background: The strict glycaemic control postpones all the microvascular and macrovascular complications. In type 2 diabetes the initiation of metformin is the cornerstone in reducing blood sugar. The next option is either insulin or oral hypoglycaemic agents. The DPP-4 inhibitors like gliptins have the advantages of less incidence of hypoglycaemia, good safety profile and can be combined to any oral hypoglycaemics. The meta-analysis showed that teneligliptin has less adverse profile in number of Japanese and Korean studies. It was proved that the fasting glucose and postprandial glucose substantially reduced with a potential benefit of reducing cholesterol, thereby reducing the risk of cardiovascular diseases. The advantage of using this drug as is does not worsen the hepatic and renal status. Voglibose an α-glycosidase inhibitors delay the glucose absorption from GIT hence effective in reducing postprandial hyperglycaemia. Methods: This prospective randomized controlled study was designed to compare the efficacy of teneligliptin and voglibose as an add on therapy on patients with uncontrolled blood sugar in addition to metformin 500mg BD and glimepiride 2 mg OD. Totally 80 patients were included between the age groups of 40 to 70 years. Patients were divided into two groups 40 patients each, group A were given teneligliptin and group B patients were given voglibose for a period of 6 months. At the end of 3rd month and 6th month investigations were done for FBS, PPBS and HbA1c.Statisticalmethods: Data were tabulated and results were analysed by using Analysis of Variance. AP value of &lt;0.05 was considered as statistically significant. Results: At the end ofsix months group II showed significant reduction in fasting blood sugar and post-prandial blood sugar level. A significant reduction in FBS, PPBS, HbA1c is seen in both the groups, where teneligliptin has a favourable glucose reduction along with voglibose. Conclusions: Our study concludes that teneligliptin is better than voglibose as the 2nd line add on therapy to sulphonylureas, metformin or insulin.

The Effect of Education, Telephone Monitoring on Self-Efficacy and Shock Anxiety of Implantable Cardioverter Defibrillator Patients

Objective: Implantable cardioverter defibrillators (ICDs), which are used in the treatment of fatal ventricular arrhythmias, have many life-saving benefits. On the other hand, it has negative effects in terms of physical, social and psychological aspects by commonly causing anxiety and depression. The aim of this study is to examine the effects of education and telephone monitoring on self-efficacy and shock anxiety in patients with implantable cardioverter defibrillator implantation.&#x0D; Methods: 65 patients hospitalized for ICD insertion were randomly divided into intervention (n=33) and control (n=32) groups. The intervention group was given a training booklet prepared by one-on-one training about ICD. Telephone monitoring was performed once every two weeks for three months and then once a month. No intervention was applied to the control group. Self-Efficacy and Outcome Expectation Scales, Florida Shock Anxiety Scale were applied in the third and sixth months after ICD implantation in both groups.&#x0D; Results: The self-efficacy scores at the sixth month were higher in the intervention group than in the control group (p=.03). There was no difference between the shock anxiety scores at 3 months (p=.58) and 6 months (p=.64) between the groups. Shock anxiety mean scores of both groups in the 6th month are lower than the mean scores in the 3rd month (p

The application of cluster nursing to prevent bacterial pneumonia in stroke patients in neurology department

The research aims to explore the intervention effect of cluster nursing methods on bacterial pneumonia in stroke patients in neurology. A retrospective analysis is conducted on 120 patients diagnosed with stroke in the hospital from 2020 to 2022, who are diagnosed as stroke patients in the neurology department by doctors. 120 patients are randomly separated into a control group (CG) and a research group (RG) for the experiment, with 60 people in each group. The CG receive normal nursing; The RG adopt cluster nursing methods. Comparison have done in the general information, nursing satisfaction, physical improvement after intervention, and oral hygiene indicators of the 2 groups of patients, and the intervention effect of the 2 nursing methods on patients suffering from bacterial pneumonia is evaluated. When the time reached the 7th day, the nutritional risk screening scores of both groups were (9.53 ± 2.29) and (8.10 ± 2.12), respectively. The serum albumin levels were (36.46 ± 4.80) g/L and (34.16 ± 3.69) g/L, respectively. After simultaneous nursing intervention, there were P &lt; .005 in respiratory rates in the 2nd and 4th months of intervention, as well as after the completion of nursing intervention. The respiratory rates of the RG patients improved toward a larger range of normal respiratory rates, with significant statistical significance (P &lt; .005). As time passed, the number of people with shortness of breath in the CG increased sharply to 46, while those in the RG was only 27, indicating P &lt; .05 between the 2 groups. At the beginning of the 3rd month, the satisfaction rates of the RG and the CG were (92.33 ± 1.17)% and (78.18 ± 1.07)%, respectively, and there was P &lt; .0.05 between the 2 groups of data. The cluster nursing strategy has a significant relieving effect on bacterial pneumonia in stroke patients in the neurology department, which can effectively reduce the probability of pneumonia, improve their physical condition, and enhance their quality of life. It has certain clinical application value.

A prospective and observational study to assess the efficacy of pregabalin versus Gabapentin in relieving early post operative neuropathic pain with respect to clinical and functional outcomes in patients undergoing open lumbar discectomy surgery

Background: Post-operative neuropathic pain is one of the most dreadful complications following lumbar spine surgeries. Owing to the similarities in the pathophysiological and biochemical mechanisms underlying epilepsy and neuropathic pain, many anti-epileptic drugs (AEDs) like pregabalin and gabapentin are being used in the treatment of post-operative neuropathic pain. Methods: This prospective and observational study included a total of 60 patients out of 261 patients undergoing lumbar discectomy surgery, who postoperatively had neuropathic pain as diagnosed with LANSS score; and were randomly divided into pregabalin (n=30) and gabapentin (n=30) supplementation groups, and the efficacy was compared with respect to visual analog scale (VAS) score (clinically) and Oswestry disability index (ODI) score (functionally) at pre-operative and post-operative follow-ups; and also, total analgesia consumed. Results: No statistical differences were observed between any of the demographic variables and surgical levels operated upon between the two groups. Both the groups showed significant improvements in clinical (VAS) and functional (ODI) outcome as compared to pre-operative status. Leeds assessment of neuropathic symptoms and signs scale (LANSS) score was significantly increased in both the groups postoperatively till the 3rdmonthfollow-up, after which there was a significant decrease in the score. The Pregabalin group showed significant (p&lt;0.05) improvement in VAS and ODI scores at the post operative 1st, 3rd, and 6th month, as compared to the gabapentin group; however, at other follow-ups the difference was insignificant. Total analgesia consumed was significantly higher in the gabapentin group. Conclusions: Our study concluded that both pregabalin and gabapentin are highly effective in the treatment of early post-operative neuropathic pain; showing encouraging clinical and functional improvements. Pregabalin had significantly better outcomes on short-term follow-ups; however, on longer follow-ups, both had similar beneficial outcomes. Pregabalin supplementation showed a significant analgesia-sparing effect as compared to gabapentin.

Kolon Kanseri Hastalarında FOLFOX ve CAPOX’un CEA ve CA 19-9 Üzerine Etkisinin Araştırılması

The most common markers used in the diagnosis of the colon cancer are CEA and CA 19-9. Chemotherapy is applied as an adjuvant and a neo-adjuvant treatment in colon cancer.&#x0D; Our aim was to investigate the effects of FOLFOX and CAPOX on CEA and CA 19-9 levels before and after chemotherapy in different patient groups.&#x0D; The CEA and CA 19-9 values before and after chemotherapy for the 60 patients diagnosed with metastatic colon cancer having FOLFOX or CAPOX therapy age over 18 whom hospitalised between 2017-2020, were used. &#x0D; The mean value for CA 19-9 of T0 for FOLFOX receiving group was calculated as 263.71 ± 709.87 U/ml and was 119.57 ± 246.34 U/ml of for the 3rd month. The mean value for CEA for receiving FOLFOX was calculated as 76.11 ± 204.22 ng/g at T0, and 50.53 ± 142.50 ng/g at the 3rd month. The mean value of CEA for receiving CAPOX was calculated as 139.62 ± 388.87 ng/g at T0, and 117.05 ± 272.08 ng/g at the 3rd month. Intertemporal CEA levels of individuals receiving CAPOX were found to show significant differences (p=0.074). CA 19-9 mean of T0 was calculated as 218.43 ± 605.53 U/ml and the 3rd month mean of 174.40 ± 465.61 U/ml of the patients receiving CAPOX. It was found that the intertemporal values of the individuals in terms of CA 19-9 levels were not statistically significant (p=0.649).&#x0D; In conclusion, CA 19-9 and CEA levels of the patients decreased even more in the 3rd month when treated with FOLFOX. The decrease in CEA was found to be more significant. In terms of CAPOX treatment, the interquartile range T0 and the 3rd month levels did not show a significant difference, statistically (p=0.143 and p=0.089).

Decreasing central line-associated bloodstream infections rates in intensive care units in 30 low- and middle-income countries: An INICC approach

Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden. We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates. These variables were measured at baseline and during the intervention, specifically during the second month, third month, 4 to 16 months, and 17 to 29 months. Comparisons were conducted using a two-sample t test. To explore the exposure-outcome relationship, we used a generalized linear mixed model with a Poisson distribution to model the number of CLABSIs. During 1,837,750 patient-days, 283,087 patients, used 1,218,882 CL-days. CLABSI per 1,000 CL-days rates decreased from 15.34 at the baseline period to 7.97 in the 2nd month (relative risk (RR)=0.52; 95% confidence interval [CI]=0.48-0.56; P<.001), 5.34 in the 3rd month (RR=0.35; 95% CI=0.32-0.38; P<.001), and 2.23 in the 17 to 29 months (RR=0.15; 95% CI=0.13-0.17; P<.001). In-ICU all-cause mortality rate decreased from 16.17% at baseline to 13.68% (RR=0.84; P=.0013) at 17 to 29 months. The implemented approach was effective, and a similar intervention could be applied in other ICUs of low- and middle-income countries to reduce CLABSI and in-ICU all-cause mortality rates.