Patient Feels Research Articles

The highlights of dialysis in 2023

There has been a wealth of new developments in dialysis this year with the publication of several trials relating to dialysis technique, physical activity and the use of new dialysis treatments. Quality of life should be assessed and managed in all dialysis patients. Lowering the temperature of the dialysis bath in the MyTemp trial does not appear to have an effect on mortality and cardiovascular events. High volume convective hemodiafiltration currently represents the reference technique in hemodialysis; the Convince study confirms its superiority in terms of all-cause mortality. The DIATT study shows the benefit of the presence of an adapted physical activity professional to promote physical activity in dialysis patients and shows that it is necessary for this support to be reimbursed. The RENAL-AF and AXADIA-AFNET 8 studies lack power to conclude on the use of new oral anticoagulants in hemodialysis. For angiotensin receptor neprilysin inhibitors, studies are too weak to allow their use. SGLT2 inhibitors could be used in peritoneal dialysis to increase diuresis or delay the appearance of peritoneal fibrosis but to date only studies on models animals exist. Factor XI inhibitors are a new therapeutic class that could be used and would reduce the risk of thrombosis and hemorrhage. Increasingly, the feelings of patients and caregivers are more and more taken into account. Patient/caregiver communication must be at the heart of care. We will also be looking at the conservative treatment, the management of pruritus in hemodialysis and finally the care of patients with calciphylaxis.

Barriers and facilitators to pressure ulcer prevention behaviours by older people living in their own homes and their lay carers: a qualitative study

ObjectiveTo identify barriers and facilitators to pressure ulcer prevention behaviours in community-dwelling older people and their lay carers.DesignTheoretically informed qualitative interviews with two-phase, deductive then inductive, thematic analysis.SettingThe study was...

Patient-dentist communication and its impact on dental services utilisation as perceived by patients in Libya.

To identify the factors influencing communication between patients and dentists in Libya and their effects on patient satisfaction and trust. We explored the impact of these interactions on the subsequent utilisation of dental health services from the patient's perspective. Qualitative descriptive study in a purposive sample of patients from oral health centres in Janzour city in Libya who were over eighteen years old. Sixteen semi-structured interviews (30-90 minutes) were conducted online. Trust was the prime concern among patients. Other factors also positively impacting communication and patient satisfaction included information interaction, active participation, moral support, explanation about processes and the dentists' comprehension of how a patient feels. The online interviews revealed four key thematic areas that reflected the patient-dentist communication phases: 1) Welcoming and establishing a good interpersonal rapport phase; 2) the Information-sharing phase; 3) Treatment decision-making phase, and 4) Satisfaction self-evaluation phase. These data emphasise the significance of soft skills, particularly effective communication, in the context of dental practice. The findings underscore the importance of personal values and interpersonal skills among dental professionals, as these factors play a pivotal role in shaping the success of dental healthcare provision.

The Influence of Outpatient Pharmacy Service Quality on Patient Satisfaction at Hermina Bekasi Hospital

Patient satisfaction is the level of patient feelings that arise due to the performance of health services obtained after comparing the patient with what he feels. This research was conducted at the Hermina Bekasi Hospital because at this institution no research had been conducted on the quality of pharmaceutical services on outpatient satisfaction. The research method used is quantitative with an associative method to determine the relationship between service quality variables and patient satisfaction variables. Based on the results of the analysis carried out using SPSS 21.0, the value of the influence of Service Quality (X) on Patient Satisfaction (Y) can be narrated using the regression formula Y= a+bX, so the regression value resulting from the calculation above is Y = 16,725 + 0.721X. The constant value (a) is = 16,725 while the coefficient value (b) = 0.721. The meaning of this equation is that if there is no quality of service, then patient satisfaction will be worth 16,725 units. However, if there is an increase of one unit/unit of the service quality variable, it will affect the increase in patient satisfaction by 0.721. Based on the calculations obtained, tcount is 13.092 > t table 1.984, it can be concluded that is rejected and is accepted because t count is greater than t table. Thus it can be concluded that there is an influence of Service Quality on Patient Satisfaction.

The effects of an electronic head-mounted display in vision rehabilitation for patients with tunnel vision

PurposeTo investigate the effect of a new head-mounted electronic visual aid-Acesight on improving visual function and daily activities in patients with tunnel vision.Methods57 patients with tunnel vision participated in this study. The visual field (VF), visual acuity (VA), search ability, time of finding people from the side (TFPS), walking ability, and the subjective feelings of patients with and without Acesight were measured.Results15 (36%) patients thought Acesight was “helpful”, 16 (28%) thought it was “a little help”, and 26 (46%) believed that it was “not helpful.” The proportion of people aged < 60 years found Acesight helpful was higher. When wearing Acesight, the average horizontal VF diameter (°) (35.54[8.72]) and vertical VF diameter (°) (26.63[5.38]) were larger than those without visual aids (20.61[9.22], 18.19[6.67]) (P all < 0.001). The average TFPS before and while wearing the Acesight was 1.77s(0.32) and 1.19s(0.29), respectively (t = 14.28, P < 0.001). The average search times, number of collisions, walking speeds when wearing the Acesight were not statistically different from those without visual aids (P all > 0.05).ConclusionMore than half of patients with tunnel vision found the Acesight helpful, and a higher proportion of those aged < 60 years old found it helpful. Acesight can expand the horizontal and vertical VF of patients with tunnel vision and can enable patients to detect objects coming from the side earlier.Trial registrationChiCTR2000028859; Date of registration: 2020/1/5; URL: http://www.chictr.org.cn/showproj.aspx?proj=47129

Comparison of the Effect of 2 Virtual Education Methods: Family-based Versus Peer-Support on Perceived Stress and Stress Coping in Women with Breast Cancer: A Randomized Controlled Trial.

Stress is an overwhelming feeling in patients with breast cancer (BC). However, The effect of virtual education has not been fully regulated. Hence, this study intends to compare the impact of 2 virtual education methods on perceived stress and stress coping in women with BC. A 3-armed randomized clinical trial was conducted among 315 women with BC who were referred to the Cancer Institute in Tehran. They were randomly assigned to 3 groups: (a) Family-based, receiving family-based training package; (b) peer-support, receiving peer-support educational package; and (c) control, receiving routine hospital care. Data were collected through demographic and disease characteristics, the Perceived Stress Scale (PSS-14), and Coping Inventory for Stressful Situations (CISS-21) questionnaires before and 3 months after the intervention. The effect of the group factor after controlling the before-intervention scores in perceived stress, problem-oriented, emotion-oriented, and avoidance-oriented strategies were P < 0.0001, P = 0.015, P < 0.0001, and P = 0.111, respectively. Also, the effect of the confounding factor of BC disease stage in the dependent variables was P = 0.527, P = 0.275, P = 0.358, and P = 0.609, respectively. The effect size test showed that before the intervention, the mean scores of perceived stress, problem-oriented, emotion-oriented, and avoidance-oriented strategies were 32.00 ± 7.03, 19.36 ± 4.68, 25.10 ± 5.90, and 17.65 ± 6.64 respectively, but after the intervention showed a decrease in mean scores of perceived stress, emotion-oriented, and avoidance strategies. What is vibrant in virtual family-based education is far more effective than peer support when problem-oriented coping increases. Conversely, reducing perceived stress in women with BC receiving enough information and family support should be considered.

Management of Lateral Canthal Coloboma in Goldenhar Syndrome: A Rare Case Report

Introduction : Goldenhar syndrome is a rare congenital disorder characterized by a wide range of physical anomalies affecting the face, ears, eyes, and spine.&#x0D; Case Illustration : Patient, female 19-year-old, complained of growing mass and blurry vision on right eye since childhood. The patient also has an asymetric face with the right side being smaller then left. She also has hearing disorder on her right ear. Ophthalmology examination revealed right eye's visual acuity is 6/120, lateral canthus coloboma , trichiasis and mass on the inferior palpebral, and conjunctiva attached to the cornea. Left eye is within normal limit. The right ear appears deformed, with no ear canal and preauricular skin tags. Patient underwent conjungtiva tumor excision and given labia mucosa graft with canthoplasty. Histology examination revealed benign lipomatous tumor. Patient feels more confident after oculoplasty surgery.&#x0D; Discussion : Goldenhar syndrome is a rare condition caused by abnormal development of the first and second branchial arches. It is characterized by a wide range of ocular features, including eyelid and iris coloboma, conjungtiva dermoid or dermolipoma, and more. Beside ocular features, other features are ear malformations, facial asymmetry, cleft lip or palate, and vertebral anomalies. It was unique case because an unformed canthus was found due to a large of conjunctival fornix mass. Appropriate management is necessary for a fulfilling life, though the disorder can have significant psychosocial effects.&#x0D; Conclusion : Goldenhar syndrome is a rare disease with numerous symptoms and its management is crucial for individuals to have a fulfilling life despite its potentially significant psychosocial impacts.

CLINICAL OUTCOME USING MODIFIED LATERAL TARSAL STRIP AND RESCESS LEVATOR IN PATIENTS WITH OCULAR PROBLEM DUE TO FACIAL NERVE PALSY

Introduction : Facial nerve palsy is a condition that affects various organ including the eyes. We report a case of facial nerve palsy with eye manifestations in one patient that requires immediate action to save the cornea.&#x0D; Case Illustration : A 63-year-old male presented to our OPC with the primary complaint of right eyelid inability to close since September 2021after brainstem tumor excision, which had worsened since May 2022. Visual acuity: 2 meters counting fingers; IOP: 11 mmHg. Anterior segment examination revealed lagophthalmos (8 mm) in the right eye, a pinch test result of 10mm (horizontal laxity), conjunctival hyperemia, conjunctivalization of the cornea, a fluorescein test result of 7 x 4 mm, and band keratopathy. The wrinkles on the patient's right face disappeared. There was numbness, and the smile was asymmetrical. Patient underwent right eye modified lateral tarsal strip and recesses levator 8mm. The patient's eyelids can close tightly almost symmetrically with the left eye and no ptosis after operations. One week after operation, patient feels more comfortable, and the conditionof the cornea has improved. The facial nerve is vulnerable to trauma because of its path from the brainstem through the temporal bone to the facial muscles. In conditions of irreversible facial nerve palsy, managements are focus to overcome the complications. Modified lateral tarsal strips and levator recesses are relatively simple and inexpensive techniques that can help to overcome lagophthalmos.&#x0D; Discussion : &#x0D; Conclusion : Ocular manifestations can occur in patients with facial nerve paresis. Modified lateral tarsal strips and recesses levator eyelids can help protect the cornea.

Kissing Nevus of Eyelid: A Rare Case Report

Introduction : Kissing nevus, also known as kissing mole, is a rare dermatological condition in the world and characterized by the presence of congenital nevi on both the upper and lower eyelids in symmetrical fashion. Additionally, this report highlights the treatment options available for patients with kissing nevus and discusses the importance of regular monitoring.&#x0D; Case Illustration : An 11-year-old female patient came with a complaint of a mole on the upper and lower eyelids since birth. The mole was felt to be getting bigger and starting to bother her. The patient feels insecure with the presence of this mole. The patient underwent nevus excision followed by retroauricular graft placement on the superior and inferior eyelidss. Then a biopsy showed benign nevus. After follow-up, it was found that the graft had grown and there was no necrotic tissue.&#x0D; Discussion : Kissing nevus is a rare skin condition that affects babies and young children. It is characterized by two identical birthmarks that appear on either side of the body, such as on the eyelids. Surgery involves removing the birthmarks surgically. Our patient underwent wide excision and palpebral reconstruction.&#x0D; Conclusion : Kissing nevuse is a unique skin condition marked by the presence of congenital nevi on both the upper and lower eyelids in a symmetrical pattern. It is worth noting that while treatment may be effective, there is a risk of scarring, infection, and other side effects associated with these procedures.

Patients' testimonies, feelings, complaints and emotional experiences with dermatoses on open social media: The French infodemiologic patient's free speech study.

Dermatoses represent a significant burden. Patients and their caregivers can turn to social media and digital communities to exchange with each other. These public exchanges constitute real-life data that can be analysed to better understand the patients' feelings and expectations, and the daily difficulties encountered. An infodemiologic study of public testimonies of patients and caregivers related to five dermatoses: eczema, rosacea, vitiligo, acne and psoriasis, over a 3-year time frame (September 2018 to September 2021) in France. To identify main topics of discussion, encountered difficulties and unmet medical needs. Data extraction was performed based on a list of pertinent keywords. Web-users' profiles were determined by a specifically trained machine learning algorithm. Encountered difficulties were identified by manual annotation based on a standardized search grid. Co-occurrence analysis of difficulties allowed contextualization of challenges and unmet needs for each dermatosis. A total of 20,282 messages coming from 16,800 web users was extracted. The main topics of discussion were 'Impact on self- image and self-confidence' (23.6%), 'Generic discussion about therapeutics' (23.3%) and 'Burden of others' gaze' (12.8%). The top three mentioned difficulties for the five targeted dermatoses were similar and focused on 'Fear of/and management of symptoms', 'Impact on/and mood management' and 'Damaged self-image'. This infodemiologic study highlighted the real-life management of five skin diseases by patients and their caregivers, who turned to social networks to openly express their suffering and seek solutions. The joined analysis of the five diseases enabled a common comprehension of what it is to live with a skin disease, from a patient-centric point of view. The specific analysis of each patient group objectified specific challenges, and main unmet medical needs.

From Molar Pregnancy, Thyrotoxicosis, to Pulmonary Hypertension: A Case Report

Background: Molar pregnancy is a benign condition with the dominant symptom being dark brown to bright red bleeding from the vagina. This disease can induce hyperthyroidism and result in pulmonary hypertension. This case report describes a patient who had molar pregnancy with thyrotoxicosis and pulmonary hypertension.Case: A 30-year-old woman presented with complaints of lower abdominal pain for the last month. The patient feels that her stomach has enlarged in the last 3 months. Other complaints include bleeding and observed bubbles from the birth canal, shortness of breath, and chest pain. The serum cobas β-hCG level of 7954.00 mIU/mL. On abdominal ultrasound examination, vesicles formed a honeycomb appearance, measuring 7.4 cm×5.3 cm. Hematologic laboratory tests revealed low TSH levels (&lt;0.01 μIU/mL), T3 levels of 2.35 ng/ml, and FT4 levels of 2.62 ng/dL. The results of the echocardiography examination showed there is a high probability of pulmonary hypertension.Conclusion: Molar pregnancy can exacerbate thyrotoxicosis through hCG activity. Smoking and breastfeeding also have similar effects. Consequently, increased thyroid hormone levels can worsen or cause pulmonary hypertension.

From Molar Pregnancy, Thyrotoxicosis, to Pulmonary Hypertension: A Case Report

Background: Molar pregnancy is a benign condition with the dominant symptom being dark brown to bright red bleeding from the vagina. This disease can induce hyperthyroidism and result in pulmonary hypertension. This case report describes a patient who had molar pregnancy with thyrotoxicosis and pulmonary hypertension.Case: A 30-year-old woman presented with complaints of lower abdominal pain for the last month. The patient feels that her stomach has enlarged in the last 3 months. Other complaints include bleeding and observed bubbles from the birth canal, shortness of breath, and chest pain. The serum cobas β-hCG level of 7954.00 mIU/mL. On abdominal ultrasound examination, vesicles formed a honeycomb appearance, measuring 7.4 cm×5.3 cm. Hematologic laboratory tests revealed low TSH levels (&lt;0.01 μIU/mL), T3 levels of 2.35 ng/ml, and FT4 levels of 2.62 ng/dL. The results of the echocardiography examination showed there is a high probability of pulmonary hypertension.Conclusion: Molar pregnancy can exacerbate thyrotoxicosis through hCG activity. Smoking and breastfeeding also have similar effects. Consequently, increased thyroid hormone levels can worsen or cause pulmonary hypertension.

Objective and subjective evaluation of the efficacy of trans-sutural distraction osteogenesis: A correlation analysis between computed tomography measurements and FACE-Q scores

Previous studies on the efficacy of trans-sutural distraction osteogenesis (TSDO) to treat midface hypoplasia caused by cleft lip and palate (CLP) have mainly focused on objective measurements while ignoring the subjective feelings of patients. This study aimed to analyse the changes in and correlation between computed tomography (CT) measurements and FACE-Q scores in patients who underwent TSDO by performing a comprehensive evaluation from both objective and subjective perspectives. This retrospective study included 25 patients with an average age of 10.7 years who had midface hypoplasia caused by CLP and underwent TSDO between August 2018 and December 2022. The average follow-up time was 18.8 ± 7.7 months. Facial morphology and CT measurements, including A-CR, N-A⊥HR, the SNA angle and the L-ZA, indicated significant improvements in midface concavity (all p < 0.0001). All FACE-Q scores (except for facial function) exhibited a significant increase. The ΔA-CR, ΔN-A⊥HR, and ΔSNA angle were strongly correlated with specific aspects of the FACE-Q-Appearance items, including the ΔFACE-Q-Appearance of the cheeks (all p < 0.0001), the ΔFACE-Q-Appearance of the face (all p < 0.0001), the ΔFACE-Q-Appearance of the jaws (all p < 0.01), the ΔSatisfaction with decision (all p < 0.0001) and the ΔSatisfaction with outcome (all p < 0.001). However, the ΔA-CR, ΔN-A⊥HR, and ΔSNA were weakly correlated with other FACE-Q-Health-related quality of life and function items. These findings suggest that both CT findings and FACE-Q scores have their own emphases and advantages. It is necessary to establish an integrated curative effect evaluation model that combines FACE-Q scores with CT measurements to evaluate both the physical health and psychological status of patients.

Advanced-stage presentation of cancer at the time of diagnosis and its associated factors among adult cancer patients at Northwest Amhara comprehensive specialized hospitals, Northwest Ethiopia 2022

IntroductionScreening of cancer is the maximum effort and critical element for providing health related care in order to decrease cancer related dealt because of the disease burden is in its advanced stages. Unfortunately, advanced-stage presentation and late diagnosis of cancers endure a problem in low-income countries including Ethiopia. However, there is scarcity of published articles about the problem in Ethiopia.ObjectiveThis study aimed to assess the prevalence of advanced-stage -stage presentation of cancer at the time of diagnosis and associated factors among adult cancer patients at Northwest Amhara comprehensive Specialized Hospitals, oncology treatment units, Northwest Ethiopia, 2022.MethodsAn institution based cross-sectional study was conducted in Northwest Amhara public referral hospitals on 422 study participants. A systematic random sampling technique was performed. The data were collected through face to face interview and document review via structured, pretested questionnaires. Epi. Data version 4.6 and Stata version 14.0 software’s were used for data entry and analysis respectively. Logistic regression were carried out to recognize factors associated with advanced-stage -stage presentation of cancer at the time of diagnosis. Adjusted odds ratio with a 95% confidence interval were used to measure the strength of association. Variables having p-value less than 0.2 in bivariable analysis were entered in to multivariable analysis; variables with a p-value < 0.05 were declared significantly associated with advanced-stage -stage presentation of cancer at the time of diagnosis.ResultsThe overall prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be 67.57%. Age ≥ 60 years old patients (AOR = 6.10, 95%: (1.16–32.1)), patients had have a feeling of burden (AOR = 1.82, 95%, CI: (1.04–3.20)), and cancer patients with comorbidity illness (AOR = 2.40, 95%, CI: (1.40–4.12)) were significantly associated with advanced-stage presentation of cancer at the time of diagnosis.ConclusionThe prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be high. Its better, health care providers in oncology treatment facilities need to give special attention to older patients, having feeling of burden and cancer patient with comorbidity to reduce the risk of developing late stage presentation of cancer.

Ontological Psychoanalysis in Clinical Practice

The author describes and then clinically illustrates what he terms the ontological dimension of psychoanalysis (having to do with coming into being) and the epistemological dimension of psychoanalysis (having to do with coming to know and understand). Neither of these dimensions of psychoanalysis exists in pure form; they are inextricably intertwined. Epistemological psychoanalysis, for which Freud and Klein are the principal architects, involves the work of arriving at understandings of play, dreams, and associations; while ontological psychoanalysis, for which Winnicott and Bion are the principal architects, involves creating conditions in which the patient might become more fully alive and real to him- or herself. The author provides clinical illustrations of the ontological dimension of psychoanalysis in which the process of the patient’s coming more fully into being is facilitated by the experiences in which the patient feels recognized for the individual he is and is becoming. This occurs in an analysis in which the analyst and patient invent a form of psychoanalysis that is uniquely their own.

The Analgesic Efficacy of Lidocaine/Prilocaine Cream during Fine-needle Aspiration Biopsy of Thyroid Nodules: A Randomized Double-blind Clinical Trial

Introduction: Fine-needle aspiration biopsy (FNAB) method is an effective method in diagnosis and approach to patients with thyroid nodules that create pain. This study investigates the analgesic effect of lidocaine/prilocaine cream during fine-needle aspiration (FNA) of thyroid nodules to reduce discomfort in patients during the procedure. Materials and Methods: In a double-blind clinical trial, two groups including patients with thyroid nodules who were rubbed with lidocaine + prilocaine 5% on their skin before FNA and patients with thyroid nodules, who have had topical placebo cream applied to their skin before FNA, were recruited. The Numerical Rating Scale was used to check the pain level. The Chi-square test, Fisher’s exact test, independent t-test, and Mann–Whitney’s nonparametric test were used for data analysis in SPSS software. Results: The average pain sensation in the intervention group is lower than the scores obtained in the control group, but despite the existing difference, this difference was not statistically significant (P = 0.7). The investigations showed that with the increase in the size and diameter of the thyroid nodules, the amount of pain that the patient feels during the procedure is reduced. Moreover, increasing the size of the nodule significantly reduces the amount of pain felt by the patient in the intervention group (P = 0.04). Conclusion: The results of this study indicated that the use of lidocaine/prilocaine cream in patients who are candidates for thyroid nodule biopsy did not have a significant effect on reducing their pain in contrast with literature. Therefore, based on the findings of the study, the use of lidocaine/prilocaine cream in these patients does not offer any significant decrease in pain sensation compared to using just a placebo.

Percutaneous Removal of an Old Calcified Free-Floating Harmful Thrombus in a Patient with Severe Pulmonary Embolism and at Risk for Surgical Treatment

We present a case of a 53-year-old male patient with recurrent pulmonary embolism due to a free-floating right atrial thrombus formation. While thrombolysis was contraindicated due to previous intracranial hemorrhage, and the patient was at high risk for surgical thrombectomy, interventional removal using a percutaneous thrombus aspiration system (AngioVasc) was considered. Despite it’s calcified, free- floating and vulnerable nature, the thrombus aspiration could be carried out safely and the patient feels well. This case highlights the complexities associated with managing high-risk patients with recurrent embolism and the importance of considering modern interventional approaches in cardiac thrombus removal discussions.

Initial outcomes in a sickle cell disease transition clinic

BackgroundTransition in sickle cell disease (SCD) is associated with an alarming increase in acute care utilization, cost, and risk of early mortality. Effective transition preparation is crucial to address these issues. We established a multidisciplinary transition clinic at our urban SCD center in the fall of 2021. At each visit patients were introduced to the transition process and met with a pediatric and adult SCD provider. MethodsWe reviewed charts of patients attending the clinic from September 2021 to May 2023. Data were collected on the number of visits in the transition and adult SCD clinics. Clinic notes were reviewed, identifying the main topics of discussion, and examining patient attitudes and feelings towards transition. ResultsTwenty-two patients aged 20–27 years with 35 total visits were included in the analysis. Eighteen (82%) patients had at least 1 visit to transition clinic. Out of 10 scheduled patients, 8 attended their first adult care visit within 2.4 months of their last transition visit. Medical topics brought up by patients included difficulty remembering to take hydroxyurea, questions about reproductive and menstrual health, and support pursing higher education with a chronic disease. Patients expressed a variety of feelings about transition from “no concerns” to “nervousness” and questioning “what to expect”. Concerns were alleviated by learning about the process. One patient reported feeling “much better" after being introduced to the adult provider. ConclusionWe demonstrated that a collaborative transition clinic prepares young adults with SCD for transition to adult care. Meeting with their adult SCD provider prior to transfer helped alleviate patients’ concerns. Future work will involve tracking patients as they integrate into adult clinic.

Post-Chemotherapy Clinical Perianal Infection Features in Patients with Acute Leukemia

Objective: This study aims to examine the incidence of post-chemotherapy perianal infection and its influencing factors in patients with acute leukemia.&lt;br&gt;Methods: A total of 243 patients with acute leukemia who underwent chemotherapy in the Three Gorges Hospital affiliated to Chongqing University, China, between January 2019 and December 2020 were selected as study subjects. In the present retrospective study, patients with post-chemotherapy perianal infection were monitored, and the perianal infection rate and clinical features of perianal infection were determined. Categorical variables were compared using the Chi-square test, and the influencing factors of post-chemotherapy perianal infection in patients with acute leukemia were evaluated using logistic analysis.&lt;br&gt;Results: A total of 24 patients (9.88%) with acute leukemia suffered post-chemotherapy perianal infection. Age, basic perianal disease (hemorrhoids) history, constipation, diarrhea, duration of agranulocytosis, and length of hospital stay were compared among the patients. Perianal disease classification, perianal ultrasound, colonoscopy, postoperative pathology, and other clinical data were compared and discussed in relation to the occurrence and development of the disease. The results showed that there were no significant differences in perianal infection degrees between genders and among different types of leukemia (p &gt; 0.05). There were no statistically significant differences in age, pain score, minimum white blood cell count, deficiency duration, and length of hospital stay among patients with different degrees of infection. The Spearman rank correlation test showed that the perianal infection degree was positively correlated with the highest hypersensitive C-reactive protein (hs-CRP) level (p &lt; 0.05). The difference was statistically significant; the higher the maximum hs-CRP/procalcitonin levels, the more serious the perianal infection.&lt;br&gt;Conclusions: Perianal infections are common in the procession of chemotherapy or myelosuppression. This is worthy of clinical recognition. Early recognition of perianal infection and the strengthening of infection risk factor control may be beneficial to improving the subjective feelings of patients with acute leukemia undergoing chemotherapy.

Behind the Scenes of Isotretinoin: My Journey and Recommendations.

Isotretinoin is a form of Vitamin A used in treatment of severe, refractory acne vulgaris with treatment duration ranging anywhere from 3 to 12 months. The side effects of isotretinoin require monthly dermatologist visits and utilize a risk-management program called iPLEDGE REMS run by the Federal Drug Administration (FDA), which verifies that patients are not pregnant while starting or while taking isotretinoin. The physical and mental side effects experienced on isotretinoin are unique to each patient and can be severely debilitating. My own experience taking isotretinoin for 8 months was filled with multiple unexpected side effects that affected both my physical and mental health. As a result, I strongly believe dermatologists should help patients in analyzing the risk versus benefit profile of isotretinoin, present all other options, and ultimately emphasize patient-provider shared-decision making. Furthermore, at monthly visits dermatologists should be required to implement open dialogue regarding side effects to avoid patient feelings of fear and shame. Additionally, the iPLEDGE REMS system should consider creating a systematic documentation of symptoms to help normalize experiences and guide treatment plans.