Medicine and Health Sciences Commons^™

Improving Value (Low Cost, Optimal Clinical Outcome, Patient Satisfaction) In A Skilled Nursing Facility: A Quality Improvement (Qi) Project, Nirajan Adhikari, Joseph Mwesige, Lester Kirchner

Advances in Clinical Medical Research and Healthcare Delivery

Improving the value of care with reduced cost without compromising the quality is utmost important in the modern era of medical practice. An attempt was made in the nursing facility to observe an outcome with a plan to implement in much larger scale in the larger facility in future. In the 7-month period of this ambi- directional study, the focus was on minimizing unnecessary daily laboratory orders and to observe the reduction in the cost without adverse effect on length of stay in the nursing facility and hospitalization from the nursing facility.

The Role Of Coronary Artery Disease In Demand Mediated Myocardial Infarction: A Retrospective Study From A Community Hospital, Amr Salama, Nikhil Mehta, Abdullah Abdullah, Ruth Kouides, Jeremiah Depta, Ryan Hoefen, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

Type 2 Myocardial Infarction (T2MI) is an increasingly recognized clinical entity due to the availability of highly sensitive troponin assays for patients admitted due to common medical diagnoses. However, there is little epidemiological data on the significance and long-term prognosis of T2MI, which occurs secondary to an increase in myocardial oxygen demand and/or a decrease in myocardial blood flow. Arrhythmia, hypoxia, and sepsis are the major etiologies for T2MI. Therefore, sepsis was the identified area of interest for the study giving how common it is in a community hospital. We studied the cardiac workup of patients with elevated troponin in …

Using Adaptive Research Design To Define The Proper Methodology To Use A Data Peek For Power: Step By Step Process, Tom Wasser

Advances in Clinical Medical Research and Healthcare Delivery

When planning or conducting research in the hospital setting, often termed Real-World Environment (RWE), therapeutic assumptions and outcomes are often different than in the Randomized Clinical Trial (RCT) where medications, devices and therapies are tested and developed. This is because RWE research has a lack of experimental control, additional confounding due to patient complications and comorbid conditions, lack of pure patient selection and compliance with therapy in the patients being treated and many other factors as well. However, when RWE experiments are conducted, sample size determination using data from the RCT is common because that is the only data that …

Emergency Medicine Journal Club, David Gibbs, Dylan Norton

Advances in Clinical Medical Research and Healthcare Delivery

In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations, and bottom line interpretation.

An Integrated Multispecialty Curriculum For Point-Of-Care Ultrasound, Carina M. Brown, Karl Fields, Duncan Vincent, Alison Rumball, Joshua Zavitz, Shane Hudnall, Caroline Iskander, Alexander Raines

Advances in Clinical Medical Research and Healthcare Delivery

Point-of-care ultrasound is increasingly recognized as a valuable tool for physicians practicing in a variety of specialties. Currently there is no standard curricula or assessment model for training primary care specialty residents in the use of ultrasound. This article presents a multispecialty experience in developing a list of 11 core Pediatric, 13 core Family Medicine and 22 core Internal Medicine ultrasound scans based on best available evidence for their clinical use.

Dermatology Education And Clinical Experience In A Community Hospital Internal Medicine Residency Program, Richard A. Shellenberger, Fatima Fayyaz

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Dermatology education has been shown to be lacking in many primary care residency programs. We identified the lack of dermatology education as a gap in our internal medicine residency program in the annual program evaluation in 2017. A Needs Assessment identified the lack of a clinical experience in evaluating and treating skin disorders as our largest deficit. A team of associate program directors, faculty, and residents identified three objectives for the implementation of a dermatology curriculum for our program. We identified the development of didactic education, a procedural skills workshop and a clinical experience as our main objectives. The …

The Unicorn: The Journey For Black Doctors, Amber Robins-Hickson Md,Mba

Advances in Clinical Medical Research and Healthcare Delivery

No abstract provided.

Osteopathic Medical Students’ Perceptions Of Their Medical Education Due To Covid19, Kaitlyn Thomas, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Objective: The SARS-CoV-2 (COVID19) pandemic has led to unprecedented changes in medical education globally. Published reports on these changes have given some insight as to both positive and negative effects for specific medical schools though none have looked at osteopathic education. Our study attempts to examine the effect of COVID19 more formally on osteopathic medical students’ perception of their medical education in the third and fourth years of medical training.

Methods: Third- and fourth-year medical students at Lake Erie College of Osteopathic Medicine (LECOM) completed electronic surveys regarding their experiences with changes in medical education due to the COVID19 …

Community And Provider Acceptability Of The Covid-19 Vaccine: A Systematic Review And Meta-Analysis, Christian Akem Dimala, Benjamin Momo Kadia, Hai Nguyen, Anthony Donato

Advances in Clinical Medical Research and Healthcare Delivery

Background:

The novel coronavirus disease (COVID-19) vaccines may help control the current pandemic but would require immunization levels that would achieve herd immunity. This study aimed to quantify current COVID-19 vaccine acceptance rates, as well as characterize the determinants, enablers and barriers to vaccine acceptability across the globe by synthesizing published evidence.

Methods:

A systematic review and meta-analysis of studies was performed on studies assessing the acceptability of a COVID-19 vaccine published between November 1^st, 2019, and November 30^th, 2020. PubMed, Embase and Cochrane central were searched for eligible studies. Data extracted from retained studies was …

Managing Covid-19: Legal And Institutional Issues, Yong-Shik Lee

Minnesota Journal of Law, Science & Technology

No abstract provided.

In Memoriam: Dr. Michael T. Caley, Editorial Board

The International Journal of Ecopsychology (IJE)

No abstract provided.

The First Pediatric Heart Transplantation In Saudi Arabia Bridged By Berlin Heart (Excor) Ventricular Assist Device, Abdullah A. Alghamdi Md, Msc, Frcsc, Hatem Elmontaser Md, Ahmed A. Arifi Md, Joao Dantas Msn, Muayed A. Al-Zaibag Md

Journal of the Saudi Heart Association

Pediatric patients on the waiting list for heart transplantation incur the highest risk of death for any organ transplantation. Berlin Heart EXCOR provides a reliable support as a bridge to heart transplantation or recovery for all pediatric age groups. We report the first successful experience of Berlin Heart EXCOR mechanical circulatory support and heart transplantation in pediatric patients in Saudi Arabia. The purpose of this report is to highlight the clinical events and share lessons learned from this endeavor.

Angioplasty Of Anomalous Coronaries Arising From The Opposite Sinus With An Inter-Arterial Course, Is It Safe?, Rania Hammami, Imtinene Ben Mrad, Amine Bahloul, Salma Charfeddine, Rym Gribaa, Houssem Thabet, Emna Allouche, Aymen Ben Abdessalem, Majed Hassine, Leila Abid, Samir Kammoun, Hassen Ibn Hadj Amor

Journal of the Saudi Heart Association

Background: The coronary artery with an interarterial course CAIAC is the most threatening coronary anomaly, especially if it concerns the left coronary. Percutaneous coronary intervention PCI is scarcely described given its low prevalence and lack of long-term outcome data. Therefore, we assessed through this case series the feasibility and safety of PCI in this population. Methods This is an observational multicentric study including patients with CAIAC arising from the opposite sinus of Valsalva. The primary endpoints were immediate angiographic success and target lesion revascularization. Results During the period of the study, we performed 27235 PCI in six Cath labs, 26 …

Study Of Safety And Efficacy Of Novel Sirolimus-Eluting Stent Incorporating Properties Of Drug Coating Balloon Among Real World Patients Focusing Among Younger Population ( Under 35 Years), Santosh Kumar Sinha, Umeshwar Pandey, Mahmodullah Razi, Awadesh K. Sharma, Puneet Aggarwal, Mohit Sachan, Praveen Shukla, Ramesh Thakur

Journal of the Saudi Heart Association

Objective- Aim of study was to evaluate safety and efficacy of abluminal Mitigator DES+ Sirolimus Eluting Stent (Envision Scientific, Surat, India) incorporating novel technology of fusion coating of bioresorbable polymer on both abluminal surface of stent and exposed parts of balloon among real world patients specially focusing younger patients ( < 35 years). Method- 1293 patients received Mitigator DES+ at LPS Institute of Cardiology, Kanpur, India. Primary outcome was target lesion failure (TLF)- composite of cardiovascular death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR) and secondary end points including peri-procedural device failure (failure of stent delivery, change of stent, stent fracture), target vessel failure (TVF), and patient oriented composite end point (POCE)- composite of all deaths, MI, and revascularization and stent thrombosis (ST) at 1-year follow-up. Result- Younger population comprised of 374(29%) patients. Various indications of interventions were STEMI (n=614, 47.4%), NSTEMI (n=416, 32.2%), UA (n=161, 12.5%), and CCS (n=102, 7.9%). TLF at 1 year in overall population was 3.5% which was driven by TVMI and TLR in 1.3% and 1.1% patients respectively. POCE was observed in 9.5% mainly contributed by any revascularization (3.9%). Failure of stent delivery (1.1%) and edge dissection (0.5%) caused stent failure (2.2%). Definite and probable ST was observed in 1% and 0.8% patients respectively. Young patients showed insignificantly lower TLF, TVF, ST and POCE and significantly lower device failure (1.3% vs. 2.6%, p=0.04) when compared to patients >35 years. Conclusion- Mitigator DES+™ is safe among real world patients especially young population.

Retention Of Rapid Prototyped Complete Dentures Using Two Different Types Liquid Resin, Lina Khalaf Ismail, Mohammed Farouk Abdullah, Mohammed Mahmoud Dohiem

Future Dental Journal

Objectives: Comparing the retention of upper complete denture manufactured using two different denture base materials, both of them were manufactured using rapid prototyping method.

Methods: Nineteen patients were selected. For both groups, the dentures were manufactured using Rapid prototyping method following the next steps, a preliminary impression was made & trial denture bases were constructed on the primary casts for the upper & lower arches for a jaw relation record. A facebow record was used to mount the upper cast, while the lower cast was mounted using a centric relation record. Setting of artificial teeth was performed, then the denture …

Effect Of Hydrothermal Aging On Translucency Of Different Types Of Zirconia And Lithium Disilicate At Variable Thicknesses, Tarek Salah Morsi, Mennatallah M. Wahba

Future Dental Journal

Objective: The aim of this in vitro study was to investigate the effect of hydrothermal aging on translucency parameter (TP) of different zirconia ceramics in different thicknesses. Material and Methods: This is an in-vitro study in which translucency of six pre-sintered and pre-shaded zirconia materials (In Coris ZI, In Coris TZI, Bruxzir Solid, KATANA HT, KATANA ST, and KATANA UT) was compared to a low-translucency, lithium disilicate glass-ceramic material (IPS e.max CAD LT, Ivoclar Vivadent). The ceramic blocks were cut in the form of plates of dimensions (14x10 mm) and of different thicknesses (0.5, 0.7,1 mm). Thirty specimens of …

Assessment Of Association Between Pain And Root Resorption During Canine Retraction: An Exploratory Study, Hend S. Elsayed

Future Dental Journal

Background: Pain and root resorption are common adverse events reported in the orthodontic literature. Both are side effects of the sterile inflammatory tissue reaction related to the application of orthodontic force. Aim: The aim of this exploratory study was to assess the association between pain and root resorption during canine retraction. Materials and Methods: Twenty-four patients indicated for first premolar extraction and canine retraction were recruited. All patients were treated with 0.022” X 0.028” Roth prescription brackets. After leveling and alignment, canines were retracted over 0.017” X 0.025” stainless steel arch wires. Canines were retracted with elastomeric chains applying 150g …

Efficacy Of Psychological Interventions In The Reduction Of Orthodontic Pain At Its Peak Of Intensity In Patients Undergoing Fixed Orthodontic Treatment: A Systematic Review And Meta-Analysis, Mahmoud Mando Dr., Sameh Talaat Dr.

Future Dental Journal

Objectives: To investigate the efficacy of psychological interventions in the reduction of orthodontic pain at its peak of intensity.

Data sources: A search strategy was implemented using both manual hand search and electronic databases, including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ScienceDirect, Scopus and EBSCO.

Resources selection Randomized controlled trials involve 1) patients undergoing fixed orthodontic treatment 2) minimum age of 10 years old, 3) receiving a psychological intervention to control resulted pain and discomfort, 4) medically fit and 5) no previous orthodontic treatment, were included in the systematic review. All articles were checked against the inclusion and …

The Interleukin-17 (Il-17) Concentration In Saliva Of Patients With Oral Lichen Planus, Mai Talaat Elgendi, Radwa Ragheb Hussien, Ahmed Abdel Aziz Hassan, Olfat Shaker

Future Dental Journal

Background: The aim of the present study was to measure the clinical and pain score in these patients and to measure the level of IL-17 in saliva of patients having different forms of Oral lichen planus lesions (OLP).

Subjects and methods: According to sample size calculation, the present study was done on a total of 40 subjects divided into 3 groups Group (I) Twenty patients having erosive/atrophic OLP. Group (II) Ten patients having reticular OLP and Group (III) Ten healthy control patients. Salivary samples were collected from the subjects of the three groups to evaluate the levels of IL-17 using …

Clinical Periodontal Assessment Following The Adjunctive Use Of Lycopene And Vitamin C In Non Surgical Therapy Of Chronic Periodontitis: A Randomized Clinical Trial, Nevein Mohammed Osama Algammal, Nivine Ibrahim Ragy, Mohammed Wagdy Bissar, Mohammed El-Mofty

Future Dental Journal

Objective: To evaluate the clinical outcome of chronic periodontitis patients by clinical measurement of pocket depth (PD) and clinical attachment level (CAL) following non-surgical periodontal treatment with adjunctive use of lycopene and vitamin C.

Subjects and Methods: 42 eligible systemically healthy patients with chronic periodontitis assigned to each group after assessment of clinical parameters plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (CAL), were recorded. Cases were allocated into 3 groups by computerized randomization, 14 patients each group (n = 14). Group I (Lycopene): patients were supplemented with 10 mg lycopene soft gels once daily for …

Evaluation Of Locally Delivered 1.2% Atorvastatin Gel Versus 2% Melatonin Gel As Adjunctive To Non-Surgical Periodontal Therapy On Gcf Osteocalcin Level In Stage Ii Periodontitis Patients: A Randomized Controlled Trial, Sarah Gamal Moussa

Future Dental Journal

Abstract:

Objective: Atorvastatin (ATV) and melatonin have antioxidant and anti-inflammatory properties and were suggested to have positive effects when used in periodontitis cases. In periodontitis, osteocalcin (OC) was suggested to be a bone formation marker. Regarding bone turnover in periodontium, gingival crevicular fluid (GCF) osteocalcin levels are more accurate than salivary or serum levels.

Aim: The aim of the present study was to assess the effectiveness of local delivery of ATV gel and melatonin gel as adjuncts to scaling and root planing (SRP) in the treatment of stage II periodontitis patients.

Subjects and method: Thirty-six patients having stage II periodontitis …

The Effect Of Doxorubicin And Thioridazine On Squamous Carcinoma Cell Line, Bassant Mahmoud Moustafa

Future Dental Journal

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers occupying the sixth position worldwide. PI3k/Akt signaling pathway plays a significant role in regulating diverse cellular functions. This includes cell growth, proliferation and survival via inhibition of apoptosis, transcription and protein synthesis. One of the most acknowledged and approved chemotherapeutic agents is Doxorubicin (DOX) which is a non- selective class I anthracycline. In spite of DOX being one of the most acknowledged chemotherapeutic agents, its use has been limited by its toxic side effects and the development of chemoresistance. Nowadays, Thioridazine (TZ) which is …

Accuracy Of Diffusion Weighted Magnetic Resonance Imaging In Differentiation Between Malignant And Non-Malignant Maxillofacial Lesions, Rana M. Ashraf, Mostafa S. Ashmawy, Mena E. Y. Ekladious, Gihan A. Omar, Mona Abu El Fotouh

Future Dental Journal

Objectives: to evaluate the signal characteristics of Diffusion Weighted Magnetic Resonance Imaging (DWMRI) of maxillofacial intraosseous lesions and their corresponding apparent diffusion coefficient (ADC) values and assess their ability to differentiate between malignant and non-malignant lesions.

Methods: This study included 17 patients (10 males and 7 females) selected from the outpatients’ clinic of Oral Surgery Department, Faculty of Dentistry, Ain-shams University. They were examined by MRI machine; Philips 1.5 Tesla Achieva, Netherlands using DWMRI, T1 and T2 sequences and ADC values were measured.

Results: There was a statistically significant difference between T1 signal distributions among patients with …

The Potential Ameliorating Effect Of Bone Marrow Derived Mesenchymal Stem Cells On The Tongue Papillae Of Rats With Experimentally Induced Hypothyroidism, Aya Reyad, Rehab Abdel Moneim

Future Dental Journal

Purpose: This study aimed to evaluate the potential ameliorating effect of bone marrow derived mesenchymal stem cells (BM-MSCs) on tongue papillae of rats with experimentally induced hypothyroidism using environmental scanning electron microscope (ESEM) and fluorescent microscopic evaluation. Material and Methods: For this study 30 adult male albino rats were divided into three groups (ten rats each): (1) Control group: The rats allowed to access freely balanced diet and freshwater supply during the course of the experimental period (8 weeks). (2) Hypothyroidism group: To induce hypothyroidism the rats received carbimazole dissolved in distilled water (5 mg/250g body weight/day) for 35 …

Treatment Of Implant Labial Soft Tissue Dehiscence With Guided Bone Regeneration Vs Subepithelial Connective Tissue Graft. A Randomized Clinical Trial, Mahmoud El-Rayes, Waleed F. Esmael, Mohamed Atef, Lobna Abdelaziz

Future Dental Journal

Background: Implant soft tissue dehiscence is a frequently reported esthetic complication, that more often than not affects the functional integrity of the dental implant with eventual loss of osteointegration. Many treatment modalities with different success rates have been proposed aiming to solve this complication or prolong the survival of the dental implant, of which are guided bone regeneration and soft tissue regeneration around the affected implants.

Material and Methods: This prospective study was carried in the hospital of Future University. 11 Patients (1 Male – 10 Females) with 20 Maxillary implant sites demonstrating soft tissue dehiscence were randomly allocated to …

Three-Dimensional Maxillary Alveolar Ridge Augmentation Using Modified Cortical Shell Technique And Composite Bone Graft, Mostafa Azab, Mohammed Diaa, Waleed El-Beialy, Amr Amin Ghanem

Future Dental Journal

Objective: The present study was performed to assess the 3D alveolar ridge augmentation using the cortical shell from retromolar region and composite bone particulate regarding the width of the residual alveolar ridge. Methods: Thirteen patients with age range 21-40 years old having atrophic anterior maxillary ridge ≤3mm horizontally were included in the study. All patients were subjected to ridge augmentation using composite bone graft and retromolar cortical shell that was fixed in place by two micro-screws. The alveolar ridges were assessed and compared by cone beam computed tomography (CBCT) in the pre-operative, immediate and 4 months post-operative phases by taking …

Postoperative Pain After Different Root Canal Irrigant Activation Methods; (Randomized Clinical Trial), Yasmine Ashraf Abou Khalaf, Ahmed Abdelrahman Hashem, Wael H. Kamel, Mahmoud Mohamed Badr

Future Dental Journal

Objective: This study was designated to evaluate postoperative pain in irreversible symptomatic teeth after different irrigation activation methods using visual analogue scale. Materials and Methods:78 Patients having symptomatic irreversible pulpitis in mandibular first molar (vital pulp) with no periapical involvement were involved in the study. Cases were classified into three groups according to the the final irrigation agitation method used, twenty-six patients each group (n=26). Group A: Root canals were irrigated using NaOCl2* 2.6% with NaviTip (31-gauge 27mm) with double side port irrigator tip (SVN). Group B: Root canals were irrigated using 2.6% NaOCl with manual dynamic agitation using master …

Assessment Of Middle-Distance Runners Cardiovascular System In Rest And Load Conditions, Rashid Akhadovich Burnashev

Eurasian Journal of Sport Science

Purpose: Assessment of cardiovascular response of qualified middle-distance runners to aerobic and anaerobic physical loads.

Methods: Qualified middle-distance runners at the stage of sportsmanship improvement (n = 20) were studied. Sports qualification - 2 and 1 categories. The analysis of Heart Rate Variability was carried out using the application “CardioMood” with “Polar h10” and “Polar M430”. A 5-minute electrocardiogram recording was performed. Only normal NN cardio cycles were studied. When analyzing Heart Rate Variability, the following parameters were obtained: HR, SDNN, pNN50, TP, entropy (H), modes (Mo), AMo, stress index. The complex “vegetative indicator” was calculated. Statistical processing of obtained …

Evaluation Of Surgical Versus Vaser Assisted Liposuction In Management Of Submental Adiposity In Moderate To Severe Skin Laxity And Significant Lipodystrophy, Ahmed Borhamy, Ahmed Taha, Abd Elmonem Hota

Al-Azhar International Medical Journal

Background Submental adiposity is one of visible signs of the aging process which affects the aesthetic look of the face and neck , and its management usually is difficult without surgery, nowadays we can achieve a good results in double chin without surgical lifting of neck by new technology (VASER liposuction) in many cases. Aim of the work: To Evaluation of surgical versus VASER assisted liposuction in management of submental adiposity in moderate to severe skin laxity and significant lipodystrophy. Patient and Methods: This study is prospective study was conducted on 30 male and female patients starting from September 2018 …

Acute Induced Scurvy: Implications For Covid-19 And The Cytokine Storm, Chawki Belhadi

Field Notes: A Journal of Collegiate Anthropology

Using an evolutionary genetic disease model, this review considers Vitamin C (VC) and its potential for treating COVID-19 (CV-19). The model’s validity rests on VC’s potent antioxidant property and the mutation sustained by the primate ancestor (est.) 61 MYA that left humans unable to produce VC. The result is humans cannot -by diet or oral supplementation- achieve plasma VC concentrations typical of vitamin C synthesizers. This may leave humans chronically vulnerable to infectious disease (hypoascorbemia). VC deficiency can become more acute during severe disease (anascorbemia) and, because of the relationship between disease severity and oxidative stress, can intensify the oxidative …