Substantial effect of fenugreek seeds aqueous extract on serum estradiol level in ovarian hyperstimulation syndrome rat model

Objectives: Estradiol (E2) plays an important role in the pathophysiology of ovarian hyperstimulation syndrome (OHSS). This study aimed to evaluate the effect of fenugreek seed aqueous (FSA) extract on serum E2 levels in a rat model of OHSS. Methods: A total of 34 female Sprague Dawley rats, aged 18 days old, weighing 40 to 45 g, were randomly divided into negative control, positive control, and treatment groups. A daily dose of 1500 mg/kg per body weight of FSA extract was administrated orally to rats in the treatment group for 13 days. On day eight of the study, OHSS was induced in both positive control and treated groups by subcutaneous injection of pregnant mare’s serum gonadotropin 50 IU for four consecutive days, followed by human chorionic gonadotropin 25 IU on the fifth day. The effect of FSA extract was evaluated by measuring the concentration of serum E2 using the enzyme-linked immunosorbent assay. Results: FSA extract reduced serum E2 level significantly in the treated OHSS model (p-value < 0.050) compared to the positive control group. Conclusions: The finding has important implications on the development of female infertility adjuvant drugs for safe assisted reproduction technology cycles in terms of OHSS prevention

Aspek Moral Dalam Novel Pasung Jiwa Karya Okky Madasari: Tinjauan Sosiologi Sastra Dan Implementasi Dalam Pembelajaran Sastra Di Sma

The purpose of this study were (1) to describe sosiohistoris novelist airborne Life works Okky Madasari, (2) Describe the elements that membanngun novel airborne Life works Okky Madasari, (3) Describe the moral aspects contained in the novel airborne Life works Okky Madasari, and (4) Describe the implementation of novel Pasung Jiwa research by Okky Madasari. The method used is descriptive qualitative. Data collecting techniques, namely using library techniques, refer to, and record. Validity of data used in this research is triannggulasi theory. Data analysis techniques in this study using data analysis techniques dialectically. The results of this study indicate that (1) the background sosiohistoris Puspa Okky Madasari known as Okky Madasari born on October 30, 1984 in Magetan, East Java. (2) the novel structure of Pasung Jiwa by Okky Madasari can be seen from the cohesiveness of the theme and the facts of the story. The plot used in Okky Madasari's novel Pasung Jiwa is an advanced groove. The main character in the novel Pasung Jiwa by Okky Madasri is Sasana or Sasa. The background contained in the novel Pasung Jiwa is place, time, and social. (3) the moral aspects contained in the novel Soul airborne Okky Madasari work is divided into the moral aspect of human, social moral aspect, the moral aspect of justice, and moral aspects of religion. (4) novel Soul airborne Okky Madasari work can be implemented in pemebelajaran Indonesian high school class XII semesters 1 (odd)

Diksi dan Citraan dalam Kumpulan Cerpen Grimm Bersaudara Karya Jacob Grimm dan Wilhelm Grimm: Kajian Stilistika Sebagai Bahan Ajar Sastra di SMP

The purpose of this study are (1) to describe the sociohistorical background of the Grimm Brothers short story writers, (2) to describe the structure of the Brothers Grimm short stories by Jacob Grimm and Wilhelm Grimm, (3) to describe the diction and images in the Grimm Brothers short stories by Jacob Grimm and Wilhelm Grimm, and (4) describe the implementation of diction and images in the short story Grimm Brothers Brothers The work of Jacob and Wilhelm Grimm as literary teaching materials in junior high school. This research uses descriptive qualitative research methods. The data of this study are sentences that indicate diction and images in eight short stories in the Grimm Brothers short story by Jacob and Wilhelm Grimm. The data source comes from a collection of short stories Grimm Brothers Brothers by Jacob and Wilhelm Grimm. The data is validated with the theory triangulation technique. The data analysis technique uses a semiotic reading model consisting of heuristic and hermeneutic readings. The results of this study (1) the author's sociohistorical background, Jacob Grimm and Wilhelm Grimm are sons of Lawyers Dorothea who was born in Hanau (Germany), both of whom began writing stories after his father died to support the family's economy, the siblings began to devote themselves to researching the early history of language and German literature including folklore before writing Grimm Brothers' stories and fables, (2) the structure of the eight stories in the Grimm Brothers short story shows unanimity and wholeness shown by the theme of the main character's struggle, forward plot, characterization depicted through three dimensions (physiological, psychological, sociological) and the main characters dominate in each story line, and have a background in a forest, house, and palace, (3) diction of the eight stories in the Grimm Brothers short story collection consists of four types of diction, namely connotative words, concrete words, self-names or greetings , and vulgar words, the dominant diction is the use of the word connotative, sedangka n imaging consists of five types of images namely visual images, motion images, hearing images, palpation images, and imaging images, the dominant images are visual images, (4) the results of research can be implemented in ninth grade junior high school literature learning with KD 3.5 and 4.5 and in accordance with the criteria for teaching materials, namely in terms of language, mental maturity (psychology), and cultural background

Critically ill patients with diabetes and Middle East respiratory syndrome:a multi-center observational study

Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p &lt;0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS

Critically ill patients with diabetes and Middle East respiratory syndrome:a multi-center observational study

Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p &lt;0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS

The association between different blood group systems and susceptibility to COVID-19: a single center cross-sectional study from Saudi Arabia

Background: Since the beginning of COVID-19 pandemic, many associated factors have been investigated to clarify the susceptibility and severity among the affected individuals. Biological markers can play an important role in identification of individual susceptibility to such pandemic. Growing evidence suggest the influence of different blood group systems on susceptibility to COVID-19 virus, with a particular blood type conferring selection advantage. Objectives: The study aimed to determine the association of ABO, Rhesus (D) and P1 blood groups with COVID-19 susceptibility in Taif city, Western Saudi Arabia. Methods: ABO, D and P1 blood antigens were determined in 104 blood samples of COVID-19 patients versus 100 control samples using either automated immunohematology analyser or test tube method. Statistical differences between patients and control samples were calculated based on p-value where results of ≤ 0.05 were considered significant. Results: O+ve blood group constituted the predominant type among the studied samples. Determination of P1 antigen showed significant association where Anti-P1 was positive in 76.9% of patients compared to 61.0% of controls with a P value of 0.01 conferring the susceptibility of P1+ve patients to COVID-19. Conclusion: Although our study showed no significant association between ABO and D, and susceptibility to COVID-19, there was a significant association between P1+ve and COVID-19. P1+ve participants were 2.131 times more associated with the risk of COVID-19 infection than those with Anti P1-ve. Thus, P1 antigen can be used as a biological marker for identification of individuals susceptibility to COVID-19. It is strongly advised that such individuals should consider extra protective measures.Further studies on other contributing factors should also be considered for more scientific clarity. Keywords: ABO Blood group; Rh(D); P1 antigen, COVID-19

CONCOMITANT USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) WITH WARFARIN

Introduction: Oral anticoagulation with warfarin is the accepted technique for treatment and prophylaxis of thromboembolic diseases. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most broadly administered medications to control musculoskeletal pain or inflammation. besides to their antiplatelet work, NSAIDs can influence the pharmacologic activity of warfarin through their immediate interaction. High protein binding and the cytochrome P450 (CYP)- dependent clearance systems of NSAIDs can influence the serum levels of warfarin. Aim of work: In this review, we will discuss whether using warfarin with NSAID has any effect on the pharmacokinetics and pharmacodynamics of both drugs. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: Non-steroidal anti-inflammatory drug mechanism, warfarin mechanism, adverse effects of NSAID, adverse effect of warfarin, NSAID-warfarin interaction Conclusions: Co-administration of NSAIDs and Warfarin is a topic of debate. However, there are reasons for concern. Some NSAIDs alter hemostasis and, when combined with warfarin, may lead to an increase in bleeding time. There is also a risk of increased hepatic and renal toxicity which complicates things further. Balancing the pros and cons of this drug combination should be carefully done on a case to case basis to avoid any negative consequences. Key words: NSAID, warfarin, Aspirin, drug-drug interaction, bleedin

Substantial Effect of Fenugreek Seeds Aqueous Extract on Serum Estradiol Level in Ovarian Hyperstimulation Syndrome Rat Model

Objectives: Estradiol (E2) plays an important role in the pathophysiology of ovarian hyperstimulation syndrome (OHSS). This study aimed to evaluate the effect of fenugreek seed aqueous (FSA) extract on serum E2 levels in a rat model of OHSS. Methods: A total of 34 female Sprague Dawley rats, aged 18 days old, weighing 40 to 45 g, were randomly divided into negative control, positive control, and treatment groups. A daily dose of 1500 mg/kg per body weight of FSA extract was administrated orally to rats in the treatment group for 13 days. On day eight of the study, OHSS was induced in both positive control and treated groups by subcutaneous injection of pregnant mare’s serum gonadotropin 50 IU for four consecutive days, followed by human chorionic gonadotropin 25 IU on the fifth day. The effect of FSA extract was evaluated by measuring the concentration of serum E2 using the enzyme-linked immunosorbent assay. Results: FSA extract reduced serum E2 level significantly in the treated OHSS model (p-value < 0.050) compared to the positive control group. Conclusions: The finding has important implications on the development of female infertility adjuvant drugs for safe assisted reproduction technology cycles in terms of OHSS prevention

Enhanced Recovery After Surgery (ERAS) Protocols In General Surgery: A Review Of Implementation And Outcomes

ERAS is a group of protocols that aim at affecting positively patients &amp; surrounding lives. surgeons, nurses, physiotherapists, anesthetists, and even healthcare centers hospitals, labs, and pharmacies. Reducing the cost for both hospitals &amp;patients, decreasing the duration of residency in hospitals, and improving patient compliance, developing performance &amp; increasing teamwork between medical staff and patients all fall under the advantages of ERAS. Since it affects the 3 stages of any operation (preoperative-intraoperative-perioperative) it was necessary to implement a suitable protocol for each patient to achieve the best results mostly quitting smoking, fasting for a period before surgery, maintaining body temperature, pressure, and glucose level and the postoperative instructions , care &amp; nutrition to guarantee success and avoidance to recurrence or complications

Telemedicine in non-communicable chronic diseases care during the COVID-19 pandemic: exploring patients' perspectives

PurposeThis study aimed to explore challenges facing patients using Telemedicine consultations in non-communicable chronic disease clinics in primary care settings and to evaluate their satisfaction and willingness to use this service in the future.MethodsThis is an analytical cross-sectional study enrolling participants who were randomly selected from representative primary care centers in Bahrain and providing Telemedicine consultations. A semi-structured questionnaire permitted data collection using telephone interviews.ResultsA total of 251 individuals participated in the study of whom the majority were Bahraini (90.04%), and the mean age was 54.48 ± 10.78 years. Most of the participants 231 (92.03%) were satisfied with the Telemedicine consultation while only 142 (56.80%) were willing to use this service in the future. The main perceived challenges related to Teleconsultations were the lack of physical examination, inadequate time of TM consultation, fear of medical errors, and lack of privacy. The willingness to use TM consultation in the future was mainly determined by the degree of comfort to tell private information (p &lt; 0.01) and to less extent the ease of the communication tool (p = 0.005) on multivariate analysis.ConclusionTM consultations could be a good complement to conventional consultation formats in the future. The sustainability of this innovative healthcare delivery tool requires addressing acceptability by users, ease of use, patient-centeredness, and technological advances to ensure privacy