Journal of Ideas in Health
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Non-invasive thrombectomy: magnetized antibodies in reperfusion of thromboses
Get PDFBackground: Five multi-center randomized controlled trials have shown superior outcomes for mechanical thrombectomy to standard intravenous thrombolysis for acute anterior ischaemic stroke. This idea-paper aims to provoke multi-disciplinary expertise to develop a less invasive and more rapid thrombectomy technology. The hypothesis is that by adapting existing technology to magnetize in vivo blood clots, we should be able to dislodge clots from major vessels magnetically and achieve minimally invasive reperfusion.
Methods: First, magnetized antibodies against specific epitopes in blood clots must be developed (such as the previously used Fibrin Beta-chain specific antibody, 59D8) and an external portable magnetic device with superlens magnetic-field focusing would be used to dislodge and guide the clot proximally to establish reperfusion; subsequently, the clot will be removed. A distal magnet, statically held at the original location of the dislodged clot, would prevent microemboli from occluding distal vessels during dislodgement and removal of the clot.
Conclusion: Developing specific antibodies against in vivo blood clots (immunology) with attached superparamagnetic nanoparticles (nanoscience) and an external portable magnetic device with a focused magnetic flux (applied medical physics) will significantly improve time to revascularization in acute ischaemic stroke, minimize risks of intervention, and thus improve outcomes further
The prevalence and risk of missing outcome data in prenatal vitamin D supplemented gestational diabetes mellitus patients: a systematic review and meta-analysis protocol
Get PDFBackground: Missing outcome data in clinical trials are important determinants of internal validity; however, its burden and risk in gestational diabetes mellitus (GDM) mothers supplemented with vitamin D remain poorly studied. Therefore, a systematic review and meta-analysis protocol is proposed here to study it.
Methods: The English language publications, irrespective of its publication date, will be searched in electronic databases for randomized controlled trials studying the above outcome. The eligible trials will undergo the risk of bias assessment by the Cochrane tool. Data on its trial design, population characteristics, interventions compared, and the outcome will be abstracted. The prevalence and incidence (in risk ratio) of missing outcome data will be estimated meta-analytically. The statistical heterogeneity assessment will include the use of Chi2 and I2 statistics. For the explanation of any substantial heterogeneity, a meta-regression analysis will ensue. The statistical significance will be determined at P <0.05 and 95% CI. All analyses will be done in Stata statistical software. If the quantitative analysis is not possible, narrative reporting will happen.
Results: The reporting of the review will follow the PRISMA guideline. Statistically significant pairwise meta-analysis finding\u27s grading will occur by the GRADE approach.
Conclusion: The proposed review will estimate the prevalence of missing outcome data in vitamin D supplemented GDM mothers in clinical trials and compare its risk with the placebo recipients.
PROSPERO registration ID: CRD42020180634
References
Quintanilla Rodriguez BS, Mahdy H. Gestational Diabetes. [Updated 2019 Dec 23]. StatPearls. Treasure Isl StatPearls Publ. 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545196/
Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131: e49–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29370047
Mack LR, Tomich PG. Gestational Diabetes: Diagnosis, Classification, and Clinical Care. Obstet Gynecol Clin North Am [Internet]. 2017; 44:207–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28499531
Coustan DR. Gestational Diabetes Mellitus. Clin Chem. 2013; 59:1310–21. Available from: http://www.clinchem.org/cgi/doi/10.1373/clinchem.2013.203331
Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42: S165–72. Available from: http://care.diabetesjournals.org/lookup/doi/10.2337/dc19-S014
Saha S. Compliance and barriers to self-monitoring of blood glucose in patients with gestational diabetes mellitus: A systematic review. Int J Health Sci (Qassim).2019;13:44–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31123440
Akbari M, Mosazadeh M, Lankarani K, Tabrizi R, Samimi M, Karamali M, et al. The effects of vitamin d supplementation on glucose metabolism and lipid profiles in patients with gestational diabetes: a systematic review and meta-analysis of randomized controlled trials. Horm Metab Res.Germany; 2017;49:647–53. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-115225
Saha S, Saha S. A comparison of the risk of cesarean section in gestational diabetes mellitus patients supplemented antenatally with vitamin D containing supplements versus placebo: A systematic review and meta-analysis of double-blinded randomized controlled trials. J Turkish-German Gynecol Assoc. 2020; 21:201–12. https://dx.doi.org/10.4274%2Fjtgga.galenos.2020.2019.0164
Saha SS, Saha SS. The risk of morbidities in newborns of antenatal vitamin D supplemented gestational diabetes mellitus patients. Int J Health Sci (Qassim). Qassim University; 2020; 14:3–17. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475207/
Saha S, Saha S. A Comparison of the Changes in Gestational Weight, Body Mass Index, and Serum Vitamin D Level in Gestational Diabetes Mellitus Patients Complemented with Vitamin D in Contrast to Those Who Did Not Receive the Supplement: A Protocol for Systematic Review a. Int J Diabetes Metab. S. Karger AG; 2019; 25:74–9. https://doi.org/10.1159/000505269
Mavridis D, White IR. Dealing with missing outcome data in meta‐ Res Synth Methods.2020;11:2–13. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jrsm.1349
Higgins JPT GS (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Cochrane Collab. 2011 [cited 2020 Aug 27]. Available from: https://training.cochrane.org/handbook/archive/v5.1/
Asemi Z, Hashemi T, Karamali M, Samimi M, Esmaillzadeh A. Effects of vitamin D supplementation on glucose metabolism, lipid concentrations, inflammation, and oxidative stress in gestational diabetes: a double-blind, randomized controlled clinical trial. Am J Clin Nutr.2013;98:1425–32. https://doi.org/10.3945/ajcn.113.072785
Asemi Z, Karamali M, Esmaillzadeh A. Effects of calcium–vitamin D co-supplementation on glycaemic control, inflammation and oxidative stress in gestational diabetes: a randomised placebo-controlled trial. Diabetologia .2014;57:1798–806. https://doi.org/10.1007/s00125-014-3293-x
Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Washington (DC): National Academies Press (US); 2011. Available from: https://books.google.co.in/books?id=VF2aRQJ6IZ4C
Gossman W, Chauhan K, Huecker MR. Vitamin D. StatPearls. 2019. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28722941
Curtis EM, Moon RJ, Harvey NC, Cooper C. Maternal vitamin D supplementation during pregnancy. Br Med Bull. 2018; 126:57–77. https://doi.org/10.1093/bmb/ldy010
Knabl J, Vattai A, Ye Y, Jueckstock J, Hutter S, Kainer F, et al. Role of Placental VDR Expression and Function in Common Late Pregnancy Disorders. I Int J Mol Sci. 2017;18(11):2340. https://doi.org/10.3390/ijms18112340
Yazdchi R, Gargari BP, Asghari-Jafarabadi M, Sahhaf F. Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: a randomized, double-blinded, placebo-controlled clinical trial. Nutr Res Pract. 2016; 10:328. Available from: http://synapse.koreamed.org/DOIx.php?id=10.4162/nrp.2016.10.3.328
Jamilian M, Samimi M, Ebrahimi FA, Hashemi T, Taghizadeh M, Razavi M, et al. The effects of vitamin D and omega-3 fatty acid co-supplementation on glycemic control and lipid concentrations in patients with gestational diabetes. J Clin Lipidol. 2017; 11:459–68. https://doi.org/10.1016/j.jacl.2017.01.011
Li Q, Xing B. Vitamin D3-Supplemented Yogurt Drink Improves Insulin Resistance and Lipid Profiles in Women with Gestational Diabetes Mellitus: A Randomized Double Blinded Clinical Trial. Ann Nutr Metab. 2016; 68:285–90. https://doi.org/10.1159/000447433
Karamali M, Bahramimoghadam S, Sharifzadeh F, Asemi Z. Magnesium–zinc–calcium–vitamin D co-supplementation improves glycemic control and markers of cardiometabolic risk in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Appl Physiol Nutr Metab. 2018; 43:565–70. Available from: http://www.nrcresearchpress.com/doi/10.1139/apnm-2017-0521
Hosseinzadeh-Shamsi-Anar M, Mozaffari-Khosravi H, Salami M-A, Hadinedoushan H, Mozayan MR. The efficacy and safety of a high dose of vitamin d in mothers with gestational diabetes mellitus: a randomized controlled clinical trial. Iran J Med Sci. 2012; 37:159–65. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23115447
Saha S. Impact of missingness on clinical trials on the effectiveness of antenatal vitamin D supplementation in gestational diabetes mellitus patients. J Ideas Heal. 2020; 3:138–9. https://doi.org/10.47108/jidhealth.Vol3.Iss1.47
Saha S, Saha S. The variation in participant attrition between prenatal vitamin D supplemented and not supplemented gestational diabetes mellitus patients: a systematic review and meta-analysis of randomized controlled trials. PROSPERO. 2020. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020180634
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4:1. https://doi.org/10.1186/2046-4053-4-1
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016; 5:210. https://doi.org/10.1186/s13643-016-0384-4
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37 Suppl 1: S81-90. https://doi.org/10.2337/dc14-s081
Rossi G, American Diabetes Association. [Diagnosis and classification of diabetes mellitus]. Recenti Prog Med. 2010; 101:274–6. http://www.ncbi.nlm.nih.gov/pubmed/20842952
Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Heal. 2014; 72:39. http://archpublichealth.biomedcentral.com/articles/10.1186/2049-3258-72-39
Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003; 327:557–60. http://www.bmj.com/cgi/doi/10.1136/bmj.327.7414.557
Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004; 328:1490. http://www.bmj.com/lookup/doi/10.1136/bmj.328.7454.1490
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol.2009;62: e1–34. https://doi.org/10.1016/j.jclinepi.2009.06.006
 
Effect of concomitant HIV infection on adverse drug reactions by first line antitubercular drugs - a case series analysis
Get PDFThe pattern and severity of adverse drug reactions (ADRs) due to first-line anti-tubercular drugs in solely tubercular and TB-HIV co-infected patients could be different due to drug-disease and drug-drug interactions in TB-HIV co-infected patients. Nevertheless, the studies regarding this aspect are very meager. Hence a retrospective appraisal of individual case safety reports (ICSR) due to first-line antitubercular drugs spontaneously submitted to the ADR monitoring center was done for solely tubercular and TB-HIV coinfected patients. Out of eight ICSRs, four had concomitant HIV infection, and two of them were on antiretroviral (ARV) drugs. Co-infected patients showed rare and severe ADRs like optic neuritis, acute renal failure, and drug-induced liver injury (DILI). In contrast, four non-HIV co-infected tubercular patients suffered from comparatively less severe cutaneous reactions and vertigo. A high negative (-0.774) correlation coefficient between HIV co-infection and recovery status found that HIV co-infected patients had low chances of fully recovering. In conclusion, HIV co-infection and ARV drugs can affect the pattern, severity, and recovery status of adverse drug reactions due to first-line antitubercular drugs
Time to change to improve health: clinical pharmacy and pharmaceutical care education in Turkey
Get PDFThe practice of clinical pharmacy had a positive impact on the profession by giving pharmacists more job opportunities. Moreover, the pharmacy began to gain the status it deserved, which was lost many years ago. In this paper, we aimed to give a brief explanation of the clinical pharmacy philosophy and definition of pharmaceutical care. What are the general and specific roles of clinical pharmacists in the modern world healthcare system? Also, how to implement clinical pharmacy in education to obtain competent pharmacists. We shared our observation and experience, specifically on the progress of implementation of clinical pharmacy education in Turkey. The stepwise method has been successfully followed in the implementation of clinical pharmacy education in Turkey. In the undergraduate program, the first step taken was the addition of clinical courses, such as the role of clinical pharmacy, patient education, etc. and practical hospital rounds (internal medicine, pediatrics, and surgery). The post-graduate program, such as master (MSc) and doctoral (Ph.D.) degrees, also offered to prepare clinically oriented pharmacy academicians. The continuous education programs were structured to implement clinical pharmacy idea for the pharmacists in practice. In conclusion, the stepwise approach significantly smoothed the transition from the product-oriented to the patient-oriented pharmacy education. Moreover, the adoption of the skills education system to educate pharmacists needs to review the policy regularly and gradually change it accordingly
Impact of missingness on clinical trials on the effectiveness of antenatal vitamin D supplementation in gestational diabetes mellitus patients
Get PDFGestational diabetes mellitus (GDM) is a vital medical complication of pregnancy in which glucose intolerance is first detected or develops during gestation. GDM is associated with adverse maternal and neonatal outcomes, and contemporarily, several clinical trials have tested their incidence in antenatal vitamin D receiving GDM patients. Considering their clinical significance, these trials\u27 findings pertaining to the above outcomes require cautious interpretation, in terms of the risk of bias due to missingness. Any such bias in randomized controlled trials (RCT) can contaminate the results of a meta-analysis that extracts data from these RCTs
Emphysematous epididymo-orchitis with involvement of the prostate, seminal vesicles, and the scrotum: a case report
Get PDFEmphysematous epididymo-orchitis is a rare clinical entity. Up until July 2020, only 9 cases have been reported in PubMed and Scopus platforms, one of which also had scrotal involvement. Therefore, we are reporting the second case with prostate, seminal vesicle, and scrotal involvement. The condition represents an aggressive form of infection caused by gas-forming microbes. The radiological detection of air within the organs involved in the characteristic diagnostic sign. The case we are reporting is a 47 years old diabetic, chronic renal failure patient on regular hemodialysis who had a fulminant emphysematous infection in the left testis, epididymis, spermatic cord, the prostate, seminal vesicles, and the scrotum. Emergency orchiectomy has been carried out. The most significant part of the case is the pictures showing ballooning scrotum and gas bubbles in abnormal anatomical locations
Detection of human adenovirus 40/41 among children with some hematological disorders
Get PDFBackground: Different parts of the world are witnessing a significant increase in the prevalence of human adenoviruses (HAdVs) diarrhea among children. This study aimed to assess the prevalence rate of HAdVs type 40 and type 41 (40/41) infections in children with diarrhea and to assess the relationship between viral infection and different socio-demographic and clinical parameters.
Methods: A cross-sectional study was recruited to analyze a convenient sample of children presented with diarrhea. Data was collected from 8th August 2018 till 6th July 2019 at Al-Batool teaching hospital for gynecology and pediatrics in Baquba city, Center of hematology in Baquba city, and the Central teaching hospital of pediatric in Baghdad. Depending on the clinical examination, patients categorized into four groups; Group I with acute diarrhea, Group II with iron deficiency anemia and diarrhea, Group III with thalassemia and diarrhea, and Group IV with leukemia and diarrhea. Each patient gave one stool sample stored in a deep freeze at -20 ̊C for further analysis. Enzyme-linked immunosorbent assay and immunochromatographic test used to test the samples.
Results: A total of 184 children aged one month to fifteen years have been included in this study. More than half (97, 52.7%) of children were males. The prevalence rate of HAdVs 40/41 was 4.34%. Patients in the age group ranged from one month to five years, G IV (leukemia and diarrhea), male gender, low educated mothers, and those who changed to spoon feeder are more likely to have a high prevalence of diarrhea due to HAdVs 40/41. The most top clinical sign was fever (7, 87.5%), and the lowest was the loss weight (1, 12.5%), however vomiting, abdominal pain, and dehydration seen among at least three cases.
Conclusion: Human adenovirus 40/41 appeared to play a significant role causing acute gastroenteritis among children with leukemia and less than five years old
Assessment of obesity and central obesity among patients with knee osteoarthritis in Al-Sadder Hospital, Baghdad, Iraq
Get PDFBackground: Obese individuals are at increased risk for many chronic and life-threating conditions. The most significant burden on the musculoskeletal system resulted from osteoarthritis, mainly knee osteoarthritis. This study aimed to determine the prevalence of obesity and central obesity among a group of patients with knee osteoarthritis, analyze the effect of demographic variables, and examine the relationship between these two types of obesity.
Methods: A cross-sectional study was conducted in Al-Sadder hospital in Baghdad from June through September 2017. A convenience sample of 200 patients with knee osteoarthritis was collected. Those with body mass index (BMI) equal to or more than (30 kg/m2) considered obese. The cutoff point for central obesity was the waist-hip ratio (WHR) above (0.9) for men and above (0.85) for women. The risk ratio and 95% confidence interval (95% CI) calculated to determine the strength of the relationship. P-value ≤ 0.05 was considered statistically significant.
Results: The number of obese patients, according to BMI, was 163 (81.5%). For central obesity, the men and women with unhealthy WHR were 53 (96.4%) and 131 (10.3%), respectively. No significant difference in the rate of obesity among age groups (p= 0.986). Central obesity is significantly lower in those less than 45 years (p=0.023). In men, the risk of obese to have central obesity is (1.06) with no significant association (95% CI = 0.89 - 1.27, P = 0.481). In women, risk ratio = 1.56 and association is significant (95% CI = 1.03 - 1.36, P = 0.037).
Conclusion: The increasing age was associated with a rise in the rate of central obesity, but not with obesity. The overlap between the two types of obesity was evident and significant only in women
The impact of displacement on the social, economic and health situation on a sample of internally displaced families in Anbar Province, Iraq
Get PDFBackground: Internally displaced people in Iraq are still suffering because the solutions were not radical. This study aims to assess the impact of displacement on the socio-economic, well-being, and mental health status of internally displaced families in Anbar province, Iraq.
Methods: A descriptive cross-sectional study was conducted from 3rd to 17th April 2017. Data was collected using a universal sampling technique. A total of 355 households interviewed with a modified questionnaire consisting of 26 close-ended questions related to the socio-economic, demographic, wellbeing, and mental health characteristics.
Results: At the time of the study, about 55.5% of the surveyed displaced families have not returned home yet. Big families of more than seven members (59.4%) and residency in renting houses (82.8%) are two variables that may contribute to an economic burden. Mental health disorders such as depression and anxiety spread among 62.3% of surveyed families. Significant rise in chronic diseases from 64 (18.0%) cases before displacement to 102 cases (28.7%) after displacement. Few of them (21.6%) were able to access public health services. People who experienced violence are verbally abused at 52.1%. Lack of services (50.3%), the inability to repair the destroyed houses (26.4%), and the loss of houses due to complete destruction (23.3%) were the significant factors that inhibited families to return home back.
Conclusion: Our findings indicate the need for urgent and strategic plans to improve the quality of logistics, health, and infrastructure services to motivate the displaced families to return back to their homes
Evaluation of efficacy and safety of platelet rich plasma (PRP) and microneedling (radiofrequency) in the treatment of atrophic acne scars
Get PDFBackground: Acne Vulgaris is a self-limiting, chronic skin lesion, which may heal with squally of different types of scars (ice pitted, boxcar, rolling, and keloid). Different options used to deal with scars such as laser dermabrasion, surgical excision, and chemical peeling. This study aims to assess the safety and effectiveness of using a combination of radiofrequency (RF) microneedling and platelet-rich plasma (PRP) in managing the atrophic acne scars among a sample of Iraqi patients.
Method: An interventional study conducted from January 2017 to December 2018 at a private dermatological clinic in Kalar City, Al-Sulaymmania Province, Iraq. Patients with the atrophic scar and willing to participate are adequately assessed and treated by RF and PRP. A different number of sessions of therapy used, and patients followed for three months after the last meeting.
Results: Thirty-one patients were involved in the study. The majority of them (27, 87.0%) were females with a mean age of 26.41±8 years. Twenty patients (64.5%) had opened mouth (boxcar and rolling) scars, and eleven (35.5%) had ice pitted scars. Ten patients (32.25%) showed an excellent response to RF and PRP therapy with two grades improvement, fifteen patients (48.38%) showed good response with one-grade improvement and six patients (19.6%) showed poor response without improvement in grades, (all of them of ice pitted scars). There was a direct relationship between the number of sessions and the response to therapy. Three patients developed folliculitis at sits of puncturing with the isolation of staphylococcus auras bacteria, which cleared by topical and systemic antibiotics.
Conclusions: Although ice pitted scars showed an inadequate response to therapy, however, the reaction of the boxcar and rolling scars to RF and PRP was excellent, indicating that combination procedure is a safe, efficient and satisfactory option for the treatment of atrophic acne scars