Total Number Of Patients Research Articles

Autopsy findings in cancer patients infected with SARS-CoV-2 show a milder presentation of COVID-19 compared to non-cancer patients.

COVID-19, caused by SARS-CoV-2, manifests with differing severity across distinct patient subgroups, with outcomes influenced by underlying comorbidities such as cancer, which may cause functional and compositional alterations of the immune system during tumor progression. We aimed to investigate the association of SARS-CoV-2 infection and its complications with cancer in a large autopsy series and the role of COVID-19 in the fatal sequence leading to death. A total of 2641 adult autopsies were investigated, 539 of these were positive for SARS-CoV-2. Among the total number of patients analyzed, 829 had active cancer. Overall, the cohort included 100 patients who simultaneously had cancer and SARS-CoV-2 infection. The course of COVID-19 was less severe in cancer patients, including a significantly lower incidence of viral and bacterial pneumonia, occurring more frequently as a contributory disease or coexisting morbidity, or as SARS-CoV-2 positivity without viral disease. SARS-CoV-2 positivity was more frequent among non-metastatic than metastatic cancer cases, and in specific tumor types including hematologic malignancies. COVID-19 was more frequently found to be directly involved in the fatal sequence in patients undergoing active anticancer therapy, but less frequently in perioperative status, suggesting that the underlying malignancy and consequent surgery are more important factors leading to death perioperatively than viral disease. The course of COVID-19 in cancer patients was milder and balanced during the pandemic. This may be due to relative immunosuppressed status, and the fact that even early/mild viral infections can easily upset their condition, leading to death from their underlying cancer or its complications.

Coronary heart disease in old age people

Background; The burden of coronary heart disease (CHD) worldwide is one of great concern to patients and healthcare agencies alike. Exercise‐based cardiac rehabilitation aims to restore patients with heart disease to health. Objective: To determine coronary heart disease in old age people Methods: A cross-sectional study was conducted at First affiliated hospital of Xinjiang Medical University, Urumqi, Xinjiang, China which was performed between October 2022 to May 2024, The total number of patients in our study were 100. The number of Male patients in our study were 70 and female were 30. For all patients, we did diagnostic tests, (coronary angiogram, ECG, Echocaediography) boold test. We also took parameters of BMI (kg/m2). We excluded pregnant women and children in our study. Data was tabulated and analyzed by SPSS version 27. Result: In a current study total 100 patients were enrolled. The minimum age of patients were 53 years and the maximum age of the patients were 81 years. The mean age were 62.35±7.016 years. The minimum BMI were 24 (kg/m2) and the maximum BMI were 39 (kg/m2). The frequency of chest pain symptoms were 75 and its percentage were 75 %. The frequency of shortness of breath symptoms were 25 and its percentage were 25%. P-value were less than < 0.04. The frequency of atherosclerosis were 85 and its percentage were 85%. The frequency of diagnose on coronary angiogram were 10 . the frequency of ECG were diagnosed in 35 patients and the frequency of echocardiogram were in 55 patients and its percentage were 55%. The frequency of treatment angioplasty were done in 85 patients and its percentage were 85%. The frequency of treatment on medication were done in 15 patients. The frequency of major complication chest pain were in 13 patients and heart attack were in 7 patients and the frequency of no major complication were in 80 patients and its percentage were 80 %. In our study P-Value were less than (< 0.05). Conclusion: We concluded that Elderly patients with Coronary heart disease had higher risk of cardiovascular disease. Elderly coronary artery disease (CAD) patients, are similar to younger CAD patients. Patients of coronary heart disease can be diagnosed early and can save many lives. In our study males patients were more as compared to females.

Prevalence of, and Disability Due to, Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder in Japan by the Fifth Nationwide Survey.

All 4 previous nationwide surveys of multiple sclerosis (MS) in Japan were conducted before the discovery of anti-aquaporin-4 (AQP4) antibodies; thus, neuromyelitis optica spectrum disorder (NMOSD) was included in MS, as optic-spinal MS. We aimed to clarify the epidemiologic features and trends of MS and NMOSD in Japan separately using a fifth nationwide survey. The primary survey, in which a questionnaire was sent to 3,799 selected departments (including neurology/internal medicine, pediatrics, and ophthalmology), explored the estimated number and prevalence of patients with MS or NMOSD in 2017, and the secondary survey collected detailed characteristics of the patients using a second questionnaire. The response rates for the primary and secondary surveys were 60.1% and 53.9%, respectively. The estimated total number of patients with MS or NMOSD was 24,800, 2.5-fold higher than that in the fourth survey in 2003. The crude prevalence was 19.6 per 100,000 patients (14.2 for MS and 5.4 for NMOSD), compared with 7.7 per 100,000 patients in the fourth survey. Patients with MS showed milder disability (median Expanded Disability Status Scale [EDSS] score: 2.0 [interquartile range 1.0-4.5] vs 2.5 [1.0-6.0]), decreased secondary progression (8.5% vs 15.2%), and increased usage of disease-modifying drugs (63.7% vs 37.2%) compared with those with conventional MS in the fourth survey. The proportions of oligoclonal bands and Barkhof criteria fulfillment on MRI, which are features of classical MS, increased with advancing year of birth. Patients with NMOSD also showed less disability and shorter disease duration than patients with optic-spinal MS in the fourth survey (EDSS score: 3.5 [2.0-5.5] vs 3.8 [2.0-6.0]; disease duration: 8.0 [3.9-14.8] vs 10.0 [5.0-16.0]). Among patients with NMOSD, disability was exacerbated by a history of longitudinally extensive spinal cord lesions and anti-AQP4 antibody positivity, which both decreased with advancing year of birth. The prevalences of MS (particularly with classical features) and NMOSD have been increasing in Japan, suggesting the contribution of environmental factors. However, disabilities in patients with MS and NMOSD have been mitigated. Extensive usage of various disease-modifying drugs could be a factor contributing to this disability mitigation in MS.

Bimekizumab cumulative clinical benefit in patients with moderate to severe hidradenitis suppurativa through 1 year of the BE HEARD I&II phase 3 trials

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease which significantly impacts health-related quality of life.1 Bimekizumab (BKZ) is a humanized IgG1 monoclonal antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A.2 ere, the cumulative benefit of BKZ treatment on HS clinical response (HiSCR) through 16 and 48 weeks (wks) is reported using area under the curve (AUC) analyses.Procedure/study: Pooled data from BE HEARD I&II included an initial (Wks0–16) and maintenance treatment period (Wks16–48).3 Randomization: 2:2:2:1 (initial/maintenance) BKZ 320mg every 2 wks (Q2W)/Q2W, BKZ Q2W/Q4W, BKZ Q4W/Q4W, or placebo (PBO)/BKZ Q2W. HiSCR50/75/90 response was achieved at a given visit if there was ≥50/75/90% reduction in the total abscess/inflammatory nodule count with no increase from baseline in abscess or draining tunnel count. Cumulative clinical benefit estimation: total AUC through Wk48 for HiSCR50/75/90 achievers. Calculation of estimated number of days patients achieved each response: proportion of total possible AUC for each outcome multiplied by total number of days in the period (Wks0–16: 112 days, Wks0–48: 336). Data are reported as observed case, where N represents number of patients with a non-missing lesion count assessment in the given week, and percentages are calculated accordingly (i.e. where data recorded after an intercurrent event are included).Results: Overall, 1,014 patients were randomized to BKZ Q2W/Q2W (N=288), BKZ Q2W/Q4W (N=292), BKZ Q4W/Q4W (N=288) and PBO/BKZ Q2W (N=146). Through 16wks, the total number of days patients achieved HiSCR50 was almost double in BKZ Q2W/Q2W (47 days), BKZ Q2W/Q4W (49), and BKZ Q4W/Q4W (47) groups vs PBO (27). To Wk16, the total number of days patients achieved HiSCR75/90 was at least double in the BKZ groups vs PBO. To Wk48, total number of days with HiSCR50 achievement: BKZ Q2W/Q2W, 211; BKZ Q2W/Q4W, 212; BKZ Q4W/Q4W, 206 vs PBO/BKZ Q2W, 178. Comparable results were observed for HiSCR75/90 at Wk48, with BKZ groups maintaining higher responses vs PBO. Conclusion: High levels of cumulative clinical benefit were observed for patients on BKZ through Wk16; benefits increased substantially through Wk48. The cumulative benefit of BKZ through 48wks was evident for patients receiving continuous BKZ and PBO switchers. The total number of days of clinical outcome achievement remained higher in those on continuous BKZ vs PBO switchers. These results demonstrate the rapid, high-level and durable responses that can be obtained with BKZ.

Worldwide Clinical and Real-World Exposure to Baricitinib

Introduction: Baricitinib (BARI), an oral selective JAK inhibitor, is approved in many geographies for adults with rheumatoid arthritis or alopecia areata and for patients as young as age 2 years with atopic dermatitis or juvenile idiopathic arthritis. It is also approved in the US for hospitalized patients with COVID-19 infection. We report the worldwide clinical trial and real-world exposure to BARI across a range of diseases, ages and racial backgrounds. Methods: Real-world patient exposure estimates were calculated based on total mg sold, average daily dose, and average length of therapy as reported to regulatory agencies through the cumulative timeframe ending Jan. 31, 2024. Clinical trial exposures were based on actual exposures from completed trials through Feb. 13, 2024, and estimates were made for ongoing blinded trials based on the enrolment/randomization schemes Results: In the real-world setting, an estimated 1,836,600 patients have been exposed to the following BARI doses: 1 mg, ~2,000 (0.1%); 2 mg, ~524,900 (28.6%); 4 mg, ~1,309,600 (71.3%). Of these estimated exposures, ~ 57% were for COVID-19 with the remaining for all other indications combined. Across 59 clinical trials (completed and ongoing), an estimated 14,660 subjects (548 healthy volunteers and 14,112 patients) have received BARI since June 2008. Exposures from completed studies include 10,276 patients (62% female), 399 of whom were <18 yrs of age (≤1 month, N=4; 1 month - ≤2 yrs, N=24; >2 - ≤12 yrs, N=111; >12 - ≤18 yrs, N=260), 8820 were >18 to ≤65 yrs, 1027 were >65 yrs, and 30 had age unknown. An additional 467 adolescent and pediatric patients down to the age of 2 have been treated with BARI for atopic dermatitis in an ongoing clinical trial, bringing the total number of patients <18 years of age to 866 across dermatologic, rheumatologic, other autoimmunologic, and acute infectious diseases (excluding alopecia areata for which there is an ongoing pediatric trial). Clinical trial exposures by racial and ethnic background are as follows: Asian, N=2,491; Black, N=450; Caucasian, N=6,237; other, N=496; multiple, N=135; unknown, N=467. Conclusion: There has been extensive real-world exposure to BARI across indications and populations, and BARI is a well-studied molecule in clinical trials, across varied disease states, racial populations and ages. Since average daily dose and length of therapy may vary over time, real-world exposures are only an estimate of total patients receiving BARI. Exposures in clinical trials include patients as young as less than 1 month of age up to patients over the age of 65 years. While these exposures do not indicate efficacy or safety, they provide data to establish the overall profile of the drug and can inform on its performance over time across a variety of populations.

Analysis of cutaneous leishmaniasis among military personnel in the Islamic Republic of Iran: a spatiotemporal study between 2018 and 2022, trend forecasting based on ARIMA model.

Cutaneous leishmaniasis is one of the few infectious diseases whose global prevalence is on the rise. Iran ranks among the eight most affected countries in the world. Iranian military personnel are often sent to endemic areas for cutaneous leishmaniasis without prior immunity, and they have fewer health facilities in military centers than the general population. This study aims to comprehensively investigate the situation of cutaneous leishmaniasis in Iranian military personnel across all units from 2018 to 2022 and predict the disease trend using time series analysis up to the end of 2025. We analyzed data from the Iranian Ministry of Health to perform spatiotemporal and descriptive analyses based on patient frequency. Variables examined included age distribution, cutaneous leishmaniasis types (zoonotic or anthroponotic), month of healthcare facility visits, and lesion locations. This study employed the ARIMA model (p = 2, d = 0, q = 1)(P = 3, D = 0, Q = 0), for time series analysis and forecasting the disease trend up to 36 months after 2022. Over five years, 2,894 patients were reported. The Esfahan, Khuzestan, and Ilam provinces had the highest average patient counts, with hot spots primarily found in central, south, southwestern, and western Iran. Although the total number of patients with zoonotic cutaneous leishmaniasis was almost equal to anthroponotic cutaneous leishmaniasis, in high-risk provinces such as Esfahan, Khuzestan, and Ilam, the confirmed cases of zoonotic cutaneous leishmaniasis were much more than anthroponotic cutaneous leishmaniasis. patient numbers peak in October and November. Demographic analysis revealed that younger patients outnumbered older patients. Lesion locations were frequent on the forelimbs and lower limbs. The time series analysis for 36 months after 2022 indicated the seasonal pattern of the disease and predicted an upward trend after 2022. While overall cases have declined, provinces such as Esfahan exhibit an upward trend. The expansion of hotspots from the west and southwestern to the center and south of Iran, coupled with an increasing trend in time series analysis, suggests the potential emergence of new foci and a rise in patient numbers in the future. In provinces with high disease prevalence, preventive measures should be prioritized, particularly in Ilam, Khuzestan, and Esfahan.

HPB SO48 - Evaluating the timeframe for the provision of laparoscopic cholecystectomy in acute cholecystitis patients at a regional hospital

Abstract Background Acute biliary disease comprised a substantial proportion of the general emergency surgical workload. AUGIS and NICE guidelines recommend early laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) patients as it is associated with reduced readmission rates, healthcare costs and faster recovery without notable complication risks. According to the local trust policy, it advocates early LC to be performed within 72 hours of admission for AC patients. If this is not possible a delayed LC should be performed within 8 weeks of admission. Our aim is to examine variations in the provision of LC between current practice and local trust/ NICE guidelines. Method This is a retrospective audit looking at the total number of surgical patients diagnosed with AC between Jan and Dec 2023. The number of patients who had LC in 2023, unfit for surgery and did not consent for the procedure were also included. This data was obtained from electronic patient records (investigative reports, discharge letters, outpatient letters) and then collated on a Microsoft Excel sheet for analysis. Surgical patients who were not diagnosed with AC such as those with biliary pancreatitis, cholelithiasis or cholangitis but subsequently underwent LC were excluded. Results The number of AC patients who were fit and consented to surgical intervention in 2023 was 88. The total number of delayed procedures done was 75 (85.2%). The number of patients who had early LC within 1 week was 13 (14.8%). Of the 75 patients who had delayed LC, 19 (25.3%) patients had delayed LC within 8 weeks from the diagnosis date. The remaining 56 (74.7%) patients had delayed LC after 8 weeks. For patients who had delayed LC, the readmission rate within 6 months of their discharge while waiting for their operative dates was 29 (38.7%). Conclusion One-third of AC patients were readmitted while waiting for LC, some had complications of gallstone disease such as perforation/ gallstone ileus. Therefore, the early provision of LC is crucial in minimising the readmission and complication rates. This data was highlighted in a departmental meeting and teaching session for consultants and junior doctors. We plan to liaise with stakeholders and theatre managers in implementing further solutions to improve compliance where possible. One critical area is auditing the condition of surgical patients in order to be put on the hospital’s twice-weekly hot gallbladder list to consider prioritising AC patient surgical time.

BS SO15 - Outcomes of Braun procedure for reflux after OAGB- Audit from a single center

Abstract Background Braun procedure is a procedure used for management of reflux in gastric bypass patients. It is a simple procedure offering a jejuno-jejunal anastomosis to bypass bile away from stomach to prevent symptoms of reflux. It has been used in cancer patients needing bypass surgery. This has also been used in One anastomosis gastric bypass patients presenting with reflux. Method We would like to present the steps of Braun procedure. At the same time, we would like to take this opportunity to present the results of our audit of patients presenting with bile reflux needing surgical management of symptoms. We analysed our operation sheets from December 2016- Jan 2024 and retrospectively looked into the patients who needed surgical management of bile reflux. Results Total number of OAGB procedures done –1024, out of these 30 patients presented with bile reflux needing surgical management. 26 of these 30 patients underwent Braun procedure and 4 underwent RYGB. 6 patients out of the 26 patients who underwent Braun procedure needed conversion to RYGB because of non-resolution of symptoms. Since we looked at operation sheets, we have not analysed the total number of patients who have reflux post OAGB. Conclusion Conversion to RYGB is the gold standard procedure for managing bile reflux after OAGB. Braun’s procedure is a simpler procedure which can be done as day case and suffices in 86 % of patients. Patients should be offered both the procedures.

Abstract 4114597: Spontaneous coronary artery dissection: Case series and review of associated cardiovascular risks

Background: Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of ACS, myocardial infarction, and sudden death particularly among young women and individuals with few conventional atherosclerotic risk factors. We reveiwed possible risk factors that could predispose to SCAD. Methods: We reviewed 13 consecutive patients presenting with SCAD across three different institutions over a period of 5 yrs and determined risk fatcors associated with this disase entity. Results: 13 patients presented with SCAD represented % 0.5 of the total number of patients who underwent cardiac cathaterizations for chest pain requiring admissions. 11/13 (84%) were female. 5/13 (38%) were Caucasian or Hispanic, and 3/13 (23%) were African-American. Mean age age was 49.3 + years. 8/13 (61%) had associated hyperlipidemia with LDL levels > than 110 mg/dL, 9/13 (64%) had an A1c < 5.6% and only 1/13 (0.07%) had A1c of 6.4%. HTN was present in 6/13 (46%) of patients, and family history of SCD or heart disease were only seen in 2/13 (15%). None of the patients had features suggestive of associated fibromuscular dysplasia or connecive tissue disease. D-dimer was elevated in 5/13 (38%) with average value of 1578 ng/dL. Inflammatory markers were reviewed, only 3 patient has had ESR and CRP ordered, and only 1/3 had a mildly elevated CRP 3.9 mg/dL. Only 1/13 (0.07%) required intervention which was due to further drop in her ejection fraction requiring PCI, with improvement in her symptoms. All patients were treated with dual anti-platelet therapy for 1 year, 1 was discontinued due to persitent chest pain and decision was made to treat with only aspirin. Traditionally, risks for SCAD were thought to be due to non-atheresclerotic factors, however our case series shows that more then 60% of patients had elevated LDL's and 46% with hypertension, implying that traditional atheresclerotic risk factors should not be ignored and may play a crucial role. Autoimmune diseases were not found in any of our patients. Conclusion and implications: In this series patients who had SCAD had conventional risk factors of CAD including HLD and hypertension. The variability of co morbidities makes the identification of specific risk factors very difficult and none of the patients had Fibromuscular dysplasia or any signs of inflammation. Elevated D Dimer was also seen in a majority of patients, and all but one was managed medically with a favorable outcome

Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales.

To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between National Health Service (NHS) Wales, industry and academia was developed. Data were collected from Welsh national datasets and used to construct a novel linked dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments. An approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017-2020) was n = 99, and 286 in the control cohort (2014-2016). The final outcome variables selected were: (1) 1-year survival,( 2) intolerance to treatment (deferral), and (3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design. The design of an OBA is a complex process that requires a multi-disciplinary approach. By assessing solutions to data, outcomes and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK. Outcome-based agreements (OBAs) are a way to pay for medicines if they help patienthealth in a specific way over time. These agreements can make it faster for people to get new medicines, but they also have challenges, like needing a lot of time and effort to manage them. A team from the NHS Wales, life sciences, and Swansea University created Project IDEATE to find a better way to design OBAs and solve some of these problems. Welsh datasets were used to create a new breast cancer dataset to test different OBAs and see how payments would change. A breast cancer treatment was used for the project. The project had 99 patients who got the medicine (2017-2020) and 286 patients who had breast cancer but did not get the medicine (2014-2016). Three health outcomes were measured: (1) living for one year after treatment, (2) patients needing to stop the medicine, and (3) days spent in care. The main OBA option we tested used all three health outcomes; the more the outcomes improved, the more the payments could go up until they hit the highest amount agreed. The analysis showed that the way an OBA is designed can make a big difference in how stable or risky it is, especially if one ofthe health outcomes has only two options. Project IDEATE showed that making an OBA can be hard, but when people from different fields work together, they can overcome many challenges and succeed.

NCMP-30. GLUCOCORTICOID-INDUCED HYPERGLYCEMIA IN BRAIN TUMOR PATIENTS: A SINGLE CENTER RETROSPECTIVE STUDY

Abstract BACKGROUND Glucocorticoid (GC) therapies are integral in managing brain tumor-associated cerebral edema and neurological deficits in the neuro-oncology perioperative setting. Despite their effectiveness, GCs can induce significant morbidity, including hyperglycemia. METHODS This single-center retrospective study at the University of North Carolina neurological surgery department examines the incidence and risk factors for glucocorticoid-induced hyperglycemia in brain tumor patients treated with high-dose GCs. Data from clinical databases, electronic medical records, laboratory systems, and pathology information banks will be utilized. Documented glucose measurements, glycated hemoglobin test (HbA1c) and clinical outcomes (mortality, infection, hypoglycemia) in brain cancer patients treated with Glucocorticoid (GC) that developed hyperglycemia will be compared with brain tumor patient with normoglycemia. RESULTS We will document the total number of brain tumor patients referred over the study period, eligibility rates, and the percentage that developed glucocorticoid-induced diabetes (defined as two glucose measurements ≥200 mg/dL within the first week of treatment). Timing of hyperglycemia onset, treatments received, and risk factors for developing glucocorticoid-induced diabetes will also be analyzed. CONCLUSIONS The findings could underscore the necessity for proactive screening for glucocorticoid-induced diabetes in brain tumor patients to mitigate the associated morbidity. This study may guide future research on the benefits of optimized glucose control on clinical outcomes in patients with GC-induced hyperglycemia. Keywords: brain tumor, steroid-induced hyperglycemia, glucocorticoid-induced diabetes, dysglycemia, risk factors, outcomes.

Transrectal ultrasound-guided intraprostatic injection therapy for treatment of chronic prostatitis in a Ugandan population

Abstract Background Globally, the clinical understanding of prostatitis has been obscured mainly due non-specificity of clinical features, no uniform diagnostic criteria and its protracted treatment course. Conventional treatment of chronic prostatitis by oral or parenteral routes of drug administration remains a challenge basically because of the poor ability of drugs to penetrate prostate epithelium; the alternative of direct prostate injection has not been thoroughly studied in an African population. The aim of this retrospective study was to determine the effect of transrectal ultrasound (TRUS)-guided intraprostatic injection of a cocktail of antibiotics, antifungal and long-acting steroids on alleviating symptoms attributed to chronic prostatitis in Ugandan patients. Methods We conducted a retrospective review of records among patients who were referred with symptoms attributed to chronic prostatitis at the Radiology Department of Ernest Cook Ultrasound Research and Education Institute (ECUREI). Patients were treated using TRUS-guided intraprostatic injection of a cocktail of antibiotics, antifungal agents and long-acting steroids. Results At baseline, we found that out of the 131 patients, 90 had pain or burning during urination in the last week to seeking care and 89 had symptoms, which had kept them away from doing the kinds of things they would usually do. Additionally, 85 of the total number of patients felt terrible about their symptoms. Post intervention, after 1 year following completion of intraprostatic injection therapy (IPIT), we found that most patients had mild residual symptoms which were largely; mild pain and burning at urination. None of the patients had symptoms, which kept them away from doing the kind of things they would usually do. Furthermore, 62 patients felt delighted about their quality of life, whereas prior to treatment, none was delighted. Eighty-five patients had felt terrible about their quality of life prior to the IPIT, but post therapy, no patient felt terrible. Conclusion Transrectal ultrasound-guided intraprostatic injection therapy of a drug cocktail composed of antibiotics, antifungal agents, long-acting steroids and lidocaine for treatment of patients presenting with symptoms attributed to chronic prostatitis and refractory to conventional oral therapy has shown a good response in this study.

Suppurative Meningitis in the Infectious Diseases Clinic - Etiology, Clinic, Laboratory, Course and Outcome

Suppurative meningitis is a bacterial infection of the meninges, which are the protective membranes for the brain and spinal cord, resulting in inflammation[1]. Bacterial meningitis is most commonly caused by Streptococcus pneumoniae and Neisseria meningitidis and continues to pose a major public health threat. The morbidity and mortality of meningitis depend on the uncontrolled inflammatory response of the infected person or host [2]. The purpose of this paper is to present the epidemiological, clinical and laboratory features of cases with bacterial meningitis treated at the Infectious Diseases Clinic within the studied period January 2021 – December 2022. To present the impact of the COVID-19 pandemic on the number of cases treated at the Infectious Diseases Clinic in Prishtina, Kosovo. The total number of patients with bacterial meningitis who received treatment at the Infectious Diseases Clinic during the period from January 2021 to December 2022 was 66. The number of cases was much higher in 2022 compared to 2021.

Clinical audit on postpartum hemoglobin levels: A study on postpartum anemia

Objectives: The present study was carried out to assess the prevalence of anemia with reference to the Hb levels during postpartum period. The study also investigates the influence of age and mode of delivery on postpartum Hb levels. Material and Methods: It is a hospital-based retrospective descriptive study. The postpartum patients’ data were obtained from the medical records department of a tertiary care hospital. Data of the patients registered for routine blood investigation in the period of December 2023 to January 2024 were collected from the records. Based on patient’s hospital ID, other details including age, Hb level, and mode of delivery data were obtained. Statistical analysis was performed to check the effect of age and mode of delivery on postpartum Hb level by Pearson correlation using IBM Statistical Package for the Social Sciences Statistics version 24.0. Results: About 64.3% of the patients belonged to the age group of 20–30 years and remaining 35.7% within 30–40 years. The percentage of postpartum patients who underwent lower segment cesarean section (LSCS) and normal vaginal delivery (NVD) were 85.7% and 14.3%, respectively. However, cumulative percentage of NVD was higher (100%) than LSCS (85.7%). The postpartum Hb level ranged from 7.9 to 15.2 g/dL. About 54% of patients showed moderate anemia (8–10.9 g/dL), followed by 24% mild (11.9–11 g/dL) and 2% with severe anemic (<8 g/dL) condition. Conclusion: The study highlights the prevalence of PPA associated with both LSCS and NVD modes of delivery. Although the number of anemic patients was higher in LSCS (48) compared to NVD (8), the percentage remains the same at 80% each considering the total number of patients in each category. These observations point out the risk of high-volume blood loss associated with both modes of delivery and emphasize the need for adopting precautionary measures.

Current aspects of diabetic polyneuropathy in children

Diabetes mellitus (DM) is a serious medical and social problem of our time due to its high prevalence, lethality, early onset of disability and increasing morbidity. In children and adolescents, type 1 diabetes (DM1), characterized by absolute insulin deficiency due to autoimmune or idiopathic lesions of pancreatic β-cells, is registered more often. Every year, the total number of patients with DM1 under 18 years of age in the Russian Federation increases by several tens of thousands of people. DM is accompanied by various complications and one of the most frequent is diabetic polyneuropathy (DP), which occurs in half of children with DM1 more than 3 years. The progressive course of DP leads to the development of serious consequences affecting the quality of life and prognosis of patients. At the same time, at present, many aspects of this complication are insufficiently studied or have contradictory data, which justifies the expediency of systematization of materials on the pathogenesis of DP, effective methods of diagnostics and treatment of the disease in childhood.The aim of the work was to analyze modern scientific publications devoted to the study of DP in children, based on the search of literature sources in PubMed, CyberLeninka and RINC databases. A total of 58 bibliographic publications were reviewed, including contemporary resources from the period 2019–2023.

Abbe Flap for Upper Lip Reconstruction.

Lips are complex structures that are part of the facial esthetics. Their integrity may be affected by congenital diseases, trauma, burns, and cancers, among other pathologies. The reconstruction of the upper lip subunit can be a challenge for the surgeon. The purpose of this paper is to review the Abbe flap technique with the help of tips from the primary surgeon (surgical tips) and present a series of cases as experience in upper lip reconstruction. A retrospective study at Chilean centers Fundación Gantz and Clínica Alemana de Santiago from 2003 to 2023. The surgical technique was described, and different variables were assessed. The Strasser scale was used as an objective method for assessing the results. Sixteen surgery patients, 50% female and 50% male. Fourteen patients (87.5%) with cleft lip and palate. In total, 85.71% of the total number of patients with follow-up had a good score of 1 to 4 on the Strasser scale. There were no mediocre results comparable to results described in other series. There were no complications relating to the technique. The Abbe flap technique continues to be an excellent option in upper lip reconstruction, especially in patients with a condition of the middle third of the lip. Knowledge of the anatomy, the surgical technique, the function of the lip, and facial esthetics leads to acceptable results for the patient and their environment with this technique.

LOCAL DIAGNOSTIC REFERENCE LEVEL BASED ON CLINICAL INDICATIONS IN HEAD CT EXAMINATION

Diagnostic Reference Level (DRL) in Computed Tomography (CT) examination should be developed based on clinical indications because each clinical indication uses different scanning parameters. This study aimed to create Local DRL values based on clinical indications (DRLCIL) in Head CT examinations. A retrospective study was conducted on patients who underwent Head CT examinations with clinical indications of Hemorrhagic Stroke (HS), Non-Hemorrhagic Stroke (NHS), Space Occupying Lesion (SOL) without contrast (SOL –C), SOL with contrast (SOL + C) and trauma. The total number of patients used in this study was 745 patients, patients with clinical indications of HS 231 patients, NHS 163 patients, SOL –C 158 patients, SOL + C 67 patients, and trauma 126 patients. The local DRLCIL value was determined using the 2nd quartile value of each clinical indication. The DRLCIL values obtained for the volume weighted CT dose index (CTDIvol) and dose length product (DLP) were respectively HS (52.9 mGy; 1020.4 mGy.cm), NHS (52.9 mGy; 1046.9 mGy.cm), SOL –C (52.9 mGy; 941.1 mGy.cm), SOL +C (52.9 mGy; 1935.0 mGy.cm), and trauma (52.9 mGy; 1469.9 mGy.cm). The DRLCIL value is relatively lower (except for clinical indications of trauma) than the Indonesian Diagnostic Reference Level (I-DRL) for the type of Non-Contrast Head CT examination with the percentage difference of CTDIvol and DLP respectively being HS (–11.83%; –19.97%), NHS (–11.83%; –17.89%), SOL –C (–11.83%; –26.19%) and SOL +C compared to I-DRL Head CT with contrast (–11.83%; –22.60%). For clinical indications of trauma, the local DRLCIL value from DLP is higher than the I-DRL value, with a percentage difference of 15.29%. However, the local DRLCIL value from CTDIvol is lower, with a percentage difference of –11.83%. Local DRL has been developed at the hospital level and can be used as a recommendation for protocol optimization based on clinical indications. Keywords: X-ray, CT scan, Head CT, diagnostic reference level (DRL), local DRL from clinical indications (DRLCIL).

Adverse Drug Reactions and Safety Profiles in Cardiovascular Drug Therapy: A Pharmacovigilance Analysis

Aims: The purpose of the study is to identify adverse drug reactions (ADRs) and evaluate patient knowledge of the disease using the Knowledge Assessment Questionnaire (KAQ). This study was designed to compare adverse effects on Cardiovascular Drug Therapy. Adverse drug reaction (ADRs) is a major cause of mortality worldwide. The objective of the present study were a) to find out the prevalence of adverse drug reaction (ADRs) in the hospitalized patient by active surveillance, b) to study the profile of ADRs detected. (3) This study was done in superspecialty hospital Netaji Subhash Chandra Bose medical college & Hospital, Jabalpur, for three month study. Methodology: This study was Pharmacovigilance group, belonging to department of cardiology at Netajisubhash Chandra bose medical college, Jabalpur M.P. (5) Total number of patients taken for study was 90 in number. Results and Conclusion: Total 90 subjects were recruited in the study. Drug used for their co morbidities to find out ADRs in which maximum ADRs found in chronic rheumatoid heart diseases, for this diseases patient took in two combination mainly Digoxin with Clopidogrel (47.36%) and another were with atorvastatin, spironolactone and warfarin (47.30% ADRs Adverse drug reactions on particular body system were mostly observed on CNS (32.14% ADRs). According to Naranjonaranjo causality assessment scale applied to this study illustrates that the maximum possible and probable adverse drug reaction were shown on Furosemide as well as for Digoxin and Spironolactone.

The Objective Response and Disease Control Rates in Patients with Liver Metastastic Breast Cancer Receiving Transarterial Radioembolization: A Meta-Analysis

Aim: To meta-analyze the utility of transarterial radioembolization (TARE) in patients with liver metastatic breast cancer (BC), based on the objective response rate (ORR) and disease control rate (DCR). Methods: A literature search was performed retrieving studies with (1) at least 10 patients with liver metastatic BC treated with TARE and (2) adequate information to derive ORR and DCR. The ORR is the ratio between patients with liver lesions showing complete response (CR) or partial response (PR) over the total number of patients treated with TARE; the DCR is the ratio between patients with CR, PR, or stable disease (SD) over the total number of patients treated with TARE. Results: Eighteen studies (650 patients) were eligible; the ORR of TARE resulted 50.71% (95% C.I.: 40.04–61.36) and the DCR resulted 88.37% (95% C.I.: 81.89–93.57). Taking into account resin spheres (395 patients), the ORR was 60.35% (95% C.I.: 46.55–73.36) and the DCR was 92.73% (95% C.I.: 87.17–96.80%). Considering glass spheres (144 patients), the ORR was 32.38% (95% C.I.: 18.43–48.16) and the DCR was 82.69% (95% C.I.: 59.29–97.26). Conclusions: This meta-analysis favors the use of TARE in patients with liver metastatic BC either with resin or glass spheres.

Gender Based Differences in Electronic Medical Record Utilization in an Academic Ophthalmology Practice

PurposeTo evaluate gender differences in EMR interaction among female and male ophthalmologists at a large tertiary academic center. DesignRetrospective, cross sectional analysis MethodsData from Electronic Medical Record (EMR) system log files and health system administrative data from May 2022 to May 2023 were collected at an academic center. Primary outcomes were differences in time spent interacting with the EMR and In-basket message load between male and female ophthalmologists. Statistical analysis was adjusted for each physicians’ patient panel size, patient panel gender breakdown, and number of appointments. ResultsThere were 30 ophthalmologists, 8 (27%) of whom were female. There was a significantly shorter mean length of employment, defined as years of employment at this institution, for female ophthalmologists (5.62 ± 8.24 vs 15.26 ± 13.34 years, p=0.028). In the 12-month analysis period, there was no significant difference in the total number of patients seen between female and male ophthalmologists. However, female ophthalmologists spent 69.6% more total time in the EMR system (24,553 vs 14,480 minutes/MD, p<0.001), and 70.9% more cumulative time on clinical tasks (18,424 vs 10,887 minutes/MD, p<0.001). Female ophthalmologists spent 114% more time than male counterparts on placing orders, scheduling tasks, and responding to in-basket messages (6484 vs 3024 minutes/MD, p<0.001). Female ophthalmologists also received 750% higher volume of patient notification messages (187 vs 22, p<0.001). ConclusionsIn our cohort, male ophthalmologists’ mean duration of employment was nearly 3 times longer than female ophthalmologists. Despite comparable patient panels and appointment completion rates, female ophthalmologists spent significantly more time in the EMR system and received significantly more in-basket messages and tasks. These findings underscore the need for further studies addressing gender disparities and promoting gender equity in ophthalmology practice settings.