Journal of Medical Research and Innovation (JMRI)
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Eating behaviors of American adults during the COVID-19 pandemic
Full text linkThe objective was to assess the impact of the COVID-19 pandemic on eating behaviors of a cross section of the US adult population. Participants (N=844) completed a survey via Amazon Mechanical Turk which evaluated frequency of consumption of five food categories - mixed dishes, salty, sweet, creamy foods and beverages during perceived stress. Physical, emotional and psychological self-care and demographics were also collected. Males eating behaviors especially mixed dishes, sweet foods, and creamy foods decreased when stressed. However, in females there was an increase in the consumption of sweet and creamy foods. When compared to their counterpart, there was a reduction in food choices among minorities and Hispanics. Participants with higher BMI had increased eating behaviors of mixed dishes, salty, and sweet foods. The physical self-care scale revealed there was limited consumption of sweet foods but the psychological self-care demonstrated that there was an increase in creamy food intak
Povidone iodine hookah therapy for the treatment of COVID-19 and other respiratory viruses: A hypothesis we must test
Full text linkPovidone – Iodine has been known to have strong bactericidal and virucidal properties for a long time. It has been in clinical use as an antiseptic agent for over fifty years. Now a new indication for this old drug is recommended as Hookah therapy. It is hypothesized that in this form it will be an effective therapeutic agent to kill the coronavirus (SARS-COV2) or significantly inhibit its multiplication to achieve a cure. Details of treatment and dosage form are presented
Incidence of Hashimoto Thyroiditis Among Libyans: A Retrospective Epidemiological Study
Full text linkBackground and aims. Hashimoto's disease is an autoimmune disorder in which the body produces antibodies that attack the thyroid gland, leading to chronic inflammation, destruction of the gland, and hypothyroidism. This study aimed to assess the epidemiology of this disease among Libyan patients. Methods. A cross-sectional retrospective study conducted from June 2012 to April 2020 in order to examine the anti TPO level among Libyan population. Data was collected from eastern and western part of Libya, and were analyzed from available sample for 244 apparently patients with thyroid disorders collected from different private clinic’s laboratories. The analysis for serum anti-TPO was done by electrochemiluminescence protein binding assay (ECLIA) using Roche diagnostics and Cobas e411 analyzer. Results. The current results showed that females predominate the study, and most of them were in the age group of (>40) years old. About 49.18% of these cases were suffering from Hashimoto's disease (High ATPO level). The mean value of anti-TPO status among females was (0.5±2) nmol/L, while among males it was (0.45±3) nmol/L. Significantly, more women (81.66%) had Anti- TPO Above (34 IU/ml), compared to (18.33%) of male participants. Conclusion. Hashimoto disease is common among patients with thyroid dysfunction especially females. Our findings suggest that different interventional strategies are needed to reduce the chances of developing Hashimoto’s and its associated negative health outcomes in Libya
The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem-resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics
Full text linkIntroduction: Infection with the bacteria carpamenease-producing Klebsiella pneumoniae represents a significant cause of mortality in hospitalised patients. These multidrug resistant bacteria are resistant to currently used antibiotics as a result of carbapenemase production. Dual carbapenem therapy has been proposed as a valid therapeutic option, this therapy combines two carbapenem antibiotics, with one acting as a suicide inhibitor allowing the subsequent carbapenem to exert a bactericidal effect.
Aim: The aim of this meta-analysis was to determine if dual carbapenem therapy had a significant effect on mortality rate and microbiological cure rate in patients diagnosed with carbapenemase-producing Klebsiella pneumoniae infections in comparison to standard antibiotic therapies.
Methods: The search terms “(dual OR double) carbapenem (therapy OR treatment) AND klebsiella pneumoniae” were used to search databases and inclusion and exclusion criteria were applied to retrieved papers, a total of seven studies were identified for inclusion in the meta-analysis. The quality of included studies was assessed using the cochrane tool for risk of bias assessment and funnel plots were produced to determine the influence of publication bias. A random effects model was used to assess the outcomes; mortality rate and microbiological cure rate.
Results and Conclusion: Dual carbapenem therapy had a time dependent effect on patient mortality rates. Dual carbapenem therapy significantly lowered mortality rates in patients in comparison to standard antibiotic therapy, especially in comparison to monotherapy treatment regimens. Additionally, dual carbapenem therapy significantly improved microbiological cure rate in patients when compared to standard antibiotic treatment regimens demonstrating the possible clinical applications of a dual carbapenem antibiotic regimen in the treatment of carbapenemase-producing Klebsiella pneumoniae infections. 
A study on the quality of life among stroke survivors: A cross sectional study
Full text linkBackground: The World Health Organization defines - Health as a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
Methodology: A cross sectional study on 96 patients with stroke aged more than 30 years was carried out NIMS Hospital, Jaipur for a period of 4 months from 1st January 2018 to 30th April 2018.
Results: Out of 96 patients, Mean quality of score of patients with stroke was 65.04±9.982 there was significant difference seen in quality of life score according to sex, side of lesion, duration of stroke, socioeconomic status, occupation and hypertension.
Conclusions: It can be said that quality of life is a multidimensional concept. As stroke cases is among the most devastating of health aspect, having multiple and profound effects upon all aspects of life, hence evaluation of quality of life is very important. Each and every effort should be made to improve these aspects and in turn to activity daily living (ADL) and improve the overall quality of stroke patients
Contrast media volume is significantly related to patient lung volume during CT pulmonary angiography when employing a patient-specific contrast protocol
Full text linkAim: The purpose of this study is to investigate the relationship between contrast media volume and patient lung volume when employing a patient-specific contrast media formula during pulmonary computed tomography angiography (CTA).
Materials and methods: IRB approved this retrospective study. CTA of the pulmonary arteries was performed on 200 patients with suspected pulmonary embolism (PE). The contrast media volume (CMV) was calculted by employing a patient-specific contrast formula. Lung volume was quantified employing semi-automated lung software that calculated lung volumes (intellispace -Philips). The mean cross-sectional opacification profile of central and peripheral pulmonary arteries and veins were measured for each patient and arteriovenous contrast ratio (AVCR) calculated for each lung segment. Mean body mass index (BMI) and lung volume were quantified. Receiver operating (ROC) and visual grading characteristics (VGC) measured reader confidence in emboli detection and image quality respectively. Inter and intra-observer variations were investigated employing Cohen’s kappa methodology.
Results: Results showed that the mean pulmonary arterial opacification of the main pulmonary circulation (343.88±73HU), right lung; upper (316.51±23HU), middle (312.5±39HU) and lower (315.23±65HU) lobes and left; upper (318.76±83HU), and lower (321.91±12HU) lobes. The mean venous opacification of all pulmonary veins was below 182±72HU. AVCR was observed at all anatomic locations (p<0.0002) where this ratio was calculated. Moreover, larger volumes of contrast significantly correlated with larger lung volumes (r=0.89, p<0.03) and radiation dose (p<0.03). VGC and ROC analysis demonstrated increased area under the curve: 0.831 and 0.99 respectively (p<0.02). Inter-observer variation was observed as excellent (κ = 0.71).
Conclusion: We conclude that increased CMV is significantly correlated to increased patient lung volume and radiation dose when employing a patient-specific contrast formula. The effects patient habitus is highlighted
Omeprazole vs Lansoprazole in the Management of Gastroesophageal Reflux Disease: A Systematic Literature Review
No full textObjective: To evaluate the effectiveness and safety of omeprazole compared to lansoprazole in Gastroesophageal reflux disease patients (GERD).
Methods: A systematic search of MEDLINE, EMBASE (inception to December 2019) and CENTRAL (January 2011 to December 2019) was conducted to identify the relevant articles. A detailed inclusion-exclusion criterion was developed and implemented to screen the abstracts. Full texts of the selected abstracts were then assessed to establish their inclusion or exclusion in our review. Cochrane risk of bias criterion was used to assess the methodological quality of the included studies. All relevant data were extracted and the results were summarised narratively.
Results: 9 studies met our inclusion-exclusion criteria and were included in this review. In all three trials reporting on heartburn and regurgitation, both omeprazole and lansoprazole were found to be effective in relieving the symptoms of heartburn and regurgitation; however, there was no evidence that one is better than the other. Five out of six studies reporting on intragastric pH provided the evidence of omeprazole’s superiority over lansoprazole in controlling gastric pH. Omeprazole lowered intragastric pH faster and the results lasted longer compared to lansoprazole. The results were statistically significant.
Conclusion: There is no significant difference in the clinical effectiveness of omeprazole and lansoprazole in relieving symptoms of heartburn and regurgitation. However, omeprazole is more effective in reducing gastric acidity than lansoprazole
Barriers in Social Distancing during Covid19 pandemic - Is a message for forced lockdown
Full text linkThe world currently faces the predicament of the fast-spreading COVID-19 which as of 21st April 2020 affects 210 countries over the globe. As the disease started spreading its shadow at an alarmingly rapid rate, new information about the novel coronavirus was extracted and it has been reported to be mainly transmitted directly from person-to-person, droplet spread by cough or sneezing or by fomites. Till an effective vaccine becomes available the most potent preventive measure that can be taken is for people to maintain distance and avoid gatherings. Importance of social distancing has been discussed on many forums and disseminated among the public but the problem arises when the practical implementation does not encompass the entirety of the theoretical concepts. Understanding the barriers that stand between applying social distance in community is imperative if authorities and public health sectors expect a substantial change in incident cases. It's imperative that measures should be taken to stop the spread of misinformation, and guide the masses regarding the importance of social distancing. Since the virus spreads by droplet transmission, so without these proper social distancing measures, the burden will increase and it will not be possible to put a stop to this pandemic
A systemic literature review of the effect of proton pump inhibitors on gallbladder function
Full text linkObjective: To determine the association between proton pump inhibitors and gallbladder function
Methods: A systematic search of Medline, Embase and CENTRAL (inception to April 2020) was conducted to capture the relevant studies. A comprehensive inclusion-exclusion criterion was developed and implemented to screen the titles and abstracts. . We, however, found no eligible studies.
Results: The systematic search identified 38 unique articles for title and abstract screening. Of which, five were included as potentially relevant studies. However, upon full-text screening, none of them met our inclusion criteria. This review is, therefore, an empty systematic review.
Conclusion: There are no good quality studies determining the effect of proton pump inhibitors on gallbladder function. Given the common use of proton pump inhibitors and their potential impact on gallbladder function, there is an urgent need for conducting clinical studies to address this gap in the evidence
Health care professional knowledge and attitude towards the use of digital technologies in provision of maternal health services at Tumbi regional referral hospital in Tanzania
Full text linkObjectives: In recent years Tanzania introduced digital technologies in health industry where several initiatives such as Government of Tanzania, Hospital Management Information System (GoT-HoMIS) along other digital devices are taken to ensure quality services delivery. The purpose of this study was to assess Health Care Providers (HCPs) knowledge and attitude towards the use of Digital Health Technology (DHT) in provision of maternal health services at Tumbi Regional Referral Hospital (TRRH).
Methods: Descriptive cross-sectional design involving 50 purposively selected HCPs from obstetrics and gynecology department was used. A self-administered questionnaire and direct field observation was used to collect data from respondents. Data were analyzed using SPSS V.20 and presented by using tables, percentages and frequencies.
Results: We found that, DHT are highly used by HCPs 49(98%). Also, DHT devices are available and functioning properly thus used in providing maternal health services by enhancing effective patient management. 43(86%) of HCPs were aware on DHT practice and about 46(92%) understood the use of DHT in provision of maternal health services despite of varying knowledge level. On the side of attitude, we found that, 43(86%) of the HCP had a positive attitude on the use of DHT.
Conclusion: Knowledge, attitudes and rate of use of DHT by HCP was found to be good, despite notable challenges such as dependent on the internet signals for their proper functioning. More initiatives should be undertaken by the Ministry of Health, Community and other stakeholders to promote DHT practices in the health facilities