Hasil untuk "Medicine"

Jinlong Ru, Peng Li, Jinan Wang et al.

BackgroundModern medicine often clashes with traditional medicine such as Chinese herbal medicine because of the little understanding of the underlying mechanisms of action of the herbs. In an effort to promote integration of both sides and to accelerate the drug discovery from herbal medicines, an efficient systems pharmacology platform that represents ideal information convergence of pharmacochemistry, ADME properties, drug-likeness, drug targets, associated diseases and interaction networks, are urgently needed.DescriptionThe traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP) was built based on the framework of systems pharmacology for herbal medicines. It consists of all the 499 Chinese herbs registered in the Chinese pharmacopoeia with 29,384 ingredients, 3,311 targets and 837 associated diseases. Twelve important ADME-related properties like human oral bioavailability, half-life, drug-likeness, Caco-2 permeability, blood-brain barrier and Lipinski’s rule of five are provided for drug screening and evaluation. TCMSP also provides drug targets and diseases of each active compound, which can automatically establish the compound-target and target-disease networks that let users view and analyze the drug action mechanisms. It is designed to fuel the development of herbal medicines and to promote integration of modern medicine and traditional medicine for drug discovery and development.ConclusionsThe particular strengths of TCMSP are the composition of the large number of herbal entries, and the ability to identify drug-target networks and drug-disease networks, which will help revealing the mechanisms of action of Chinese herbs, uncovering the nature of TCM theory and developing new herb-oriented drugs. TCMSP is freely available at http://sm.nwsuaf.edu.cn/lsp/tcmsp.php.

S. Murphy, A. Atala

K. Chiappa, A. Ropper

L. Reimer

G. Williams, R. Nesse

Hatice Merve Alptekin, Seval Ulubay, Seda Cansu Yeniğün Akbulut

Abstract Background Thinking about surgery generally causes fear and anxiety among patients. These negative feelings may affect the healing process. This study aimed to investigate the effects of a stress ball on surgical fear, anxiety and comfort among patients undergoing cholecystectomy. Method This randomized controlled study was performed with 90 patients from 03 April to 30 November 2024 in the preoperative waiting unit of an operating room in a public hospital. The intervention group received stress balls before surgery, and the control group received no intervention. The participants were randomly allocated to the intervention and control groups. Data were collected before and after the intervention via the Patient Description Form, Surgical Fear Questionnaire, Visual Analog Scale-Anxiety (VAS-A) and General Comfort Questionnaire. The data were analysed via the SPSS version 27.0 program. Descriptive statistics, t tests, Pearson chi-square tests, and stepwise multiple linear regression were applied, with significance set at p < 0.05. Results In terms of the measures taken after the stress ball intervention, patients in the intervention group had significantly lower surgical fear (t = 8.607; p < 0.001) and anxiety (t = 10.776; p < 0.001), whereas the general comfort level was greater (t = 15.765; p < 0.001). When the surgical fear subscales were investigated, the intervention group had lower values for both short- and long-term surgical fear than did the control group (t = 8.480 and 8.613; p < 0.001). Conclusion Stress balls appear to be effective, low-cost, mobile and practical tools for reducing preoperative fear and anxiety while increasing patient comfort. Their integration into routine nursing practice as a nonpharmacological intervention could contribute to better emotional preparedness and potentially improve overall surgical outcomes. Trial registration no NCT06345768 (Registration date:02.04.2024) https://clinicaltrials.gov/study/NCT06345768 .

Mohamed Ahmed Mosilhy, Sadiah M A Aljeddani, Mahmoud H Abu-Moussa

This paper discusses the estimation of the discrete mixed Poisson-Erlang distribution (DMPED). Compared to many traditional discrete distributions, DMPED offers several surprising benefits, especially when examining count data with high variation and that are positively skewed. We have explored several statistical characteristics of the assumed distribution, such as moments, the moment-generating function, the failure rate function, the monotonicity of the probability mass function, and a couple of descriptive measures (central tendency and dispersion). We have used the maximum likelihood estimation technique to estimate the parameters of the DMPED. We conducted a simulation study to validate the proposed estimators. Finally, four applications related to cancer diseases have been discussed, where DMPED (especially DMPEIID) fits the number of doses required for treatment, remission times, and therapy type comparisons.

Tanvi Kale, Vijay Hegde, Nikhil V Dhurandhar

Yunhuan Li, Xiaolin Hu

Background: Chinese lung cancer patients experience various cancer-related symptoms during the course of disease, which usually occur as symptom clusters, leading to heavy symptom burden and low quality of life. Identifying symptom cluster and core symptom is conducive to developing symptom management interventions so as to improve health-related outcomes of patients with lung cancer. To investigate the symptom clusters and core symptom of Chinese patients with lung cancer. Methods: Approved by the ethics committee, a cross-sectional study was conducted at one of the most influential general hospitals in Southwest China. The MD Anderson Symptom Inventory and the revised lung cancer-specific module were utilized to collect symptom experience of patients with lung cancer. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and network analysis. Findings: A total of 219 lung cancer patients were recruited. Four symptom clusters were identified as psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters, which could explain 59% of the total variance. The results of the symptom severity network analysis revealed that short of breath (rc= 1.35) was the symptom with the highest closeness score among all symptoms. In the symptom clusters network, short of breath (rc= 1.35), lack of appetite (rc= 1.27), fatigue (rc= 1.04) and feeling drowsy (rc= 0.82) were the symptoms with the closeness score in the four symptom clusters, respectively. Interpretation: Chinese lung cancer patients experienced four symptom clusters among lung cancer patients, which highlighted the significance of addressing general symptoms and cancer-specific symptoms in cancer symptom cluster management. The identification of core symptoms offered health care professionals potential interventional targets in future clinical practice in symptom management among patients with lung cancer. Tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients’ outcomes.

M. Gold

Rukhsana Tumrani, S. Sabahat Haider, Mehvish Sana

Background: Serum electrolytes are one of the most frequently requested tests in patients from critical care settings. Methodsfor estimation of serum electrolytes include direct and indirect ion selective electrode (ISE). In case of indirect ISE, the pre-analytical dilution step can result in pseudonormonatremia or pseudohypernatremia in setting of hypoalbuminemia. Discrepancy in sodium results can lead to the misdiagnosis and mismanagement of critically ill patients. Objective: To evaluate the difference of mean serum sodium level measured by direct and indirect ISE in critically ill patients with hypoalbuminemia. Study type,settings & duration: This cross-sectional study conducted in Department of Chemical Pathology, Sheikh Zayed Hospital,Rahim Yar Khan from February to August 2022. Methodology: A total 408 study subjects aged between 20 to 60 years admitted in intensive care units of Sheikh Zayed hospital Rahim yar khan with serum albumin level <3.5g/dl were included in study. Serum sodium level was estimated concurrently by both methods for all study subjects satisfying the inclusion criteria. Mean difference of serum sodium level measured by both methods was evaluated to see the statistically significant difference between two methods. Results: Mean difference of serum sodium level measured by indirect and direct ISE (Indirect ISE-direct ISE) was 4.216±13.571mmol/L withstatistically significant difference (pvalue: 0.000). The difference was not acceptable according to CLIA (Clinical Laboratory Improvement Amendments) requirements for acceptable performance between the methods. Effect of triglyceride was statistically significant for mean difference of serum sodium level between two methods (pvalue: 0.026). No statistically significant difference of mean difference of serum sodium level with respect to other variables was found. Conclusion: Interchangeable use of directand indirect ISE should be avoided in the setting of hypoalbuminemia. Indirect ion selective electrode results of serum sodium level are misleading in the setting of hypoalbuminemia and critically ill patients can be misdiagnosed and mismanaged if sodium level is measured by indirect ion selective electrode. Standardization should be considered by hospital laboratories to use direct ISE for serum sodium measurement.

Zijian Guo, P. Sadler

Trisha Greenhalgh

Kateryna Metersky PhD, RN, Rezwana Rahman MN(c), BScN, RN, Jennifer Boyle PhD

Patient-partners are invaluable in health professions’ education. Sharing their lived experiences with prospective and current healthcare providers can provide an opportunity for these participants to hone their patient-centric skills. However, sharing stories publicly is a vulnerable role and may feel emotionally risky for patient-partners. Using reflective dialogue, this manuscript outlines recommendations through the Sender-Receiver Model of Communication for Patient-Partners encounters when working with patient-partners in health professions’ education. These recommendations include recognizing that: Patient-partners need to consider if they are ready to share their story. Some stories are wounds requiring further healing; other stories are scars fully processed by patient-partners and ready to be shared publicly. The audience should differentiate between questions that can promote critical thinking versus feel like a “personal attack.” Audiences should recognize vulnerability patient-partners may experience in sharing their stories and engage accordingly. Pre-session and post-session debriefs are important. Shared stories may elicit intense emotions from patient-partners and audiences. Both groups should be given an opportunity to process and work through emotions.

Walla Malkawi, Areeb Lutfi, Maaz Khan Afghan et al.

ObjectiveMost of the work in terms of liquid biopsies in patients with solid tumors is focused on circulating tumor DNA (ctDNA). Our aim was to evaluate the feasibility of using circulating tumor cells (CTCs) in peripheral blood samples from patients with advanced or metastatic gastrointestinal (GI) cancers.MethodsIn this prospective study, blood samples were collected from each patient in 2 AccuCyte® blood collection tubes and each tube underwent CTC analysis performed utilizing the RareCyte® platform. The results from both tubes were averaged and a total of 150 draws were done, with 281 unique reported results. The cadence of sampling was based on convenience sampling and piggybacked onto days of actual clinical follow-ups and treatment visits. The CTC results were correlated with patient- and tumor-related variables.ResultsData from a total of 59 unique patients were included in this study. Patients had a median age of 58 years, with males representing 69% of the study population. More than 57% had received treatment prior to taking blood samples. The type of GI malignancy varied, with more than half the patients having colorectal cancer (CRC, 54%) followed by esophageal/gastric cancer (17%). The least common cancer was cholangiocarcinoma (9%). The greatest number of CTCs were found in patients with colorectal cancer (Mean: 15.8 per 7.5 ml; Median: 7.5 per 7.5 ml). In comparison, patients with pancreatic cancer (PC) had considerably fewer CTCs (Mean: 4.2 per 7.5 ml; Median: 3 per 7.5 ml). Additionally, we found that patients receiving treatment had significantly fewer CTCs than patients who were not receiving treatment (Median 2.7 versus 0.7). CTC numbers showed noteworthy disparities between patients with responding/stable disease in comparison to those with untreated/progressive disease (Median of 2.7 versus 0). When CTCs were present, biomarker analyses of the four markers human epidermal growth factor receptor 2 (HER2)/programmed death-ligand 1 (PD-L1)/Kiel 67 (Ki-67)/epidermal growth factor receptor (EGFR) was feasible. Single cell sequencing confirmed the tumor of origin.ConclusionOur study is one of the first prospective real-time studies evaluating CTCs in patients with GI malignancies. While ctDNA-based analyses are more common in clinical trials and practice, CTC analysis provides complementary information from a liquid biopsy perspective that is of value and worthy of continued research.

Alkhateeb A, Mahmoud HEM, AK M et al.

Areej Alkhateeb,1 Hossam Eldin M Mahmoud,1 Mohammed AK,1 Mohammed H Hassan,2 Abdel Rahim Mahmoud Muddathir,3 Ahmed G Bakry1 1Cardiology Division of Internal Medicine Department, South Valley University Hospital, Faculty of Medicine, South Valley University, Qena, 83523, Egypt; 2Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, 83523, Egypt; 3Department of Hematology and Blood Transfusion, Faculty of Medical Laboratory Science, Alzaeim Alazhari University, Khartoum, SudanCorrespondence: Abdel Rahim Mahmoud Muddathir, Department of Hematology and Blood Transfusion, Faculty of Medical Laboratory Science, Alzaeim Alazhari University, Khartoum, Sudan, Email abdelrahimm@gmail.comBackground: The prognostic role of the soluble circulating suppression of tumorigenicity 2 marker (sST2) in different cardiovascular diseases (CVD) is still under investigation. This research aimed to assess the serum levels of sST2 in the blood of individuals with ischemic heart disease and its relation to disease severity, also to examine any changes in sST2 levels following a successful percutaneous coronary intervention (PCI) in those patients.Methods: A total of 33 ischemic patients and 30 non-ischemic controls were included. The plasma level of sST2 was measured using commercially available ELISA assay kit, at baseline and 24– 48 h after the intervention in the ischemic group.Results: On admission, there was a significant difference between the group of acute/chronic coronary syndrome cases and controls regarding the sST2 plasma level (p < 0.001). There was an insignificant difference between the three ischemic subgroups at the baseline sST2 level (p = 0.38). The plasma sST2 level decreased significantly after PCI (from 20.70 ± 1.71 to 16.51 ± 2.43, p = 0.006). There was a modestly just significant positive correlation between the acute change in post-PCI sST2 level and the severity of ischemia as measured by the Modified Gensini Score (MGS) (r = 0.45, p = 0.05). In spite of the highly significant improvement in the coronary TIMI flow of ischemic group after PCI, there was insignificant negative correlation between the post- PCI delta change in the sST2 level and the post-PCI TIMI coronary flow grade.Conclusion: A significantly high plasma level of sST2 in patients with myocardial ischemia and controlled cardiovascular risk factors showed an immediate reduction after successful revascularization. The high baseline level of the sST2 marker and the acute post-PCI reduction was mainly related to the severity of ischemia rather than left ventricular function.Keywords: soluble circulating suppression of tumorigenicity 2 marker, percutaneous coronary intervention, acute/chronic coronary syndrome, severity of ischemia, modified gensini score, revascularization

Wei Liu, Chenglong Liu, Xiaofan Yu et al.

AbstractBackground:Systemic immune-inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic immune-inflammatory index (SII) are associated with the prognosis of many cardiovascular and neoplastic diseases. Moyamoya disease (MMD) is associated with inflammation, but the relationship between systemic immune-inflammatory markers between MMD is unclear. The aim of our study was to analyse the association between systemic immune-inflammatory markers and the risk of MMD and its subtypes.Methods:We consecutively recruited 360 patients with MMD and 89 healthy control subjects in a case-control study to calculate and analyse the association of systemic immune-inflammatory markers with the risk of MMD and its subtypes.Results:The risk of MMD increased with higher levels of NLR (OR 1.237, 95% CI [1.008, 1.520], p = .042). When NLR and SII were assessed as quartile-spaced subgroups, the third quartile grouping of NLR and SII had a higher risk of MMD than the first quartile grouping (NLR: OR 3.206, 95% CI [1.271, 8.088], p = .014; SII: OR 3.074,95% CI [1.232,7.672], p = .016). When NLR was combined with SII, the highest subgroup had a higher risk of MMD than the lowest subgroup (OR2.643, 95% CI [1.340, 5.212], p = .005). The risk of subtypes also increased with higher levels of NLR and SII. The association between the levels of NLR and SII with the staging of the Suzuki stage follows an inverted U-shape. The highest levels of NLR and SII were found in patients with MMD at Suzuki stages 3–4.Conclusion:The risk of MMD increases with elevated systemic immune-inflammatory markers. This study analysed the association of systemic immune-inflammatory markers with the risk of developing MMD and its subtypes, and identified novel inflammatory markers for MMD.

Nadia Shams, Zaid Umar, Lubna Meraj et al.

BACKGROUND & OBJECTIVES: Novel corona virus has claimed significant mortality and morbidity. Timeline of long-term complications and effects on humanity are yet to be explored. Current study aims to evaluate the spectrum of post Covid syndromes in our Covid survivors. METHODOLOGY: This observational study was conducted at Medicine Dept. RIHS Islamabad after ethical approval. 195 recovered COVID cases were selected and followed 3 monthly over a year. Inclusion criteria: Age >12 years, both genders, Covid PCR+ve >4 weeks earlier. Exclusion criteria: Malignancies, pregnancy, recurrent Covid and that lost follow-up. Patients were evaluated for new onset generalized symptoms, respiratory, cardiovascular, neurological, hematological, gastrointestinal, dermatological and genitourinary supported by relevant investigations. Data analyzed by SPSS-22 with significant p<0.05. RESULTS: Amongst 195 cases, 102(52.3%) males and 93(47.7%) females, mean age was 42.35+14.31 years, mean duration since Covid recovery 32+24.47 weeks. There was history of mild COVID in 89(45.6%), moderate 71(36.4%), severe 32(16.4%) and life threatening 02(01%) having significant association with increased mean age and female gender (p<0.05). ninety four (48.2%) cases had post COVID syndromes. persistent fatigue (58), fever (29), myalgia’s (27),  dyspnea (26), persistent cough (19), weight loss/gain (18), smear positive TB (2), bronchitis (7), asthma exacerbations (3) and pleural effusion (1). X-ray findings showed lung fibrosis in 12, ground glass appearance 10. Spirometry showed reduced exercise capacity in 11. Anemia in 11, leukopenia 02, thrombocytopenia 02, pancytopenia 01 case. In CVS, retrosternal chest pain in 11, orthopnea/PND 05, myocarditis/myocardial fibrosis 04, pericardial effusion 01, new onset hypertension 03, worsened hypertensive control 02, palpitations 10 and POTS 03. Regarding ENT, sinusitis in 12 and mucor-mycosis 03. Reduced GFR 05 and COVAN 01. New onset diabetes 05, worsened diabetic control 06, bone-demineralization 03 and thyroiditis 01. Persistent diarrhea 06, IBS 04, gastritis 08, esophagitis 06, GERD 11. Seven of 93 females reported menstrual irregularities. Hair loss 15, rash 07. headache in 23, anxiety 17, disturbed sleep 14, depression 09, peripheral neuropathy 03, CVA 03, amnesia and PTSD 03 each. 03 cases expired with cardiopulmonary arrest. CONCLUSION: Post COVID syndrome observed in half of Covid survivors. The respiratory, cardiovascular, dermatological, neuropsychiatric and generalized symptoms were frequent. Authors suggest follow-up of Covid survivors. The clinical evaluation and timely management may improve quality of life and morbidity amongst survivors. KEY WORDS:  COVID-19. Post Covid Syndromes. Long Covid syndrome. Covid complications. Persistent post-Covid syndrome (PPCS), Myocarditis. Lung Fibrosis.  

Hadeer Rasheed, Zaid W. Ajil

Objective(s): To (1) find out the association between palliative care for children with malignancies and mothers’ level of education, and (2) investigate the differences in the quality of palliative care among mothers’ level of education groups. Methodology: descriptive predictive correlational design is carried out to find The Difference Between palliative care for Children with Malignancies and mothers’ level of education. This study was conducted in each of Pediatric Welfare Teaching Hospital – Medical City Complex and Child’s Central Teaching Hospital – Al-Karkh Health Directorate, Baghdad City. Data were collected through structured interview with the study participants for the period from December 2nd, 2022 to January 31st, 2023.  A non-probability (convenience) used to select sample of 165 mothers of children with malignancies. Results: The study results display that the palliative care is good from the perspectives of most of mothers (n = 114; 76.0%), followed by those who perceive it as fair (n = 31; 20.7%), and those who perceive it as poor (n = 5; 3.3%).The study results reveal that there is a statistically significant difference in the Psychosocial and spiritual dimensions among mothers’ level of education groups (p-value = .016). Conclusion: Mothers who hold a bachelor’s degree perceive the psychosocial and spiritual dimensions as the lowest compared to mothers of other levels of education. Recommendations: There is a need for the pediatric nurses to devote special attention to mothers of children with malignancies whose level of education is low with the goal of raise their awareness of the palliative care their children are receiving.

Zhongru Fan, Dongyu Han, Xin Fan et al.

BackgroundOvarian cancer (OC) is one of the malignant tumors that poses a serious threat to women’s health. Natural killer (NK) cells are an integral part of the immune system and have the ability to kill tumor cells directly or participate indirectly in the anti-tumor immune response. In recent years, NK cell-based immunotherapy for OC has shown remarkable potential. However, its mechanisms and effects remain unclear when compared to standard treatment.MethodsTo explore the value of NK cell-based immunotherapy in the treatment of OC, we conducted a literature review. In comparison to standard treatment, our focus was primarily on the current anti-tumor mechanisms, the clinical effect of NK cells against OC, factors affecting the structure and function of NK cells, and strategies to enhance the effectiveness of NK cells.ResultsWe found that NK cells exert their therapeutic effects in OC through mechanisms such as antibody-dependent cell cytotoxicity, perforin release, and granule enzyme secretion. They also secrete IFN-γ and TNF-α or engage in Fas/FasL and TRAIL/TRAILR pathways, mediating the death of OC cells. In clinical trials, the majority of patients experienced disease stability with mild side effects after receiving NK cell-based immunotherapy, but there is still a lack of high-quality research evidence regarding its clinical effectiveness. OC and prior experience with standard treatments have an effect on NK cells, and it may be considered to maximize NK cell effects through the modulation of the tumor microenvironment or combination with other therapies.ConclusionsIn this review, we have summarized the current evidence of NK cell applications in the treatment of OC. Furthermore, factors and strategies that influence and enhance the role of NK cell immunotherapy are discussed.