Mixed-Methods Research: A Discussion on its Types, Challenges, and Criticisms

The article positions mixed-method research (MMR) as a principled complementary research method to the traditional quantitative and qualitative research approaches. By situating MMR in an analysis of some of the common research paradigms, the article presents it as a natural choice in order to complement and cater to the increasingly complex needs of contemporary researchers. It proffers MMR as a flexible and adaptive conceptual framework for designing and conducting mixed methods research in a simplified manner. By explaining fundamental principles and major theoretical tenets of a mixed-methods approach, which involves both quantitative and qualitative data collection in response to research questions, it elucidates several benefits of adopting MMR since it integrates post-positivism as well as interpretivism frameworks. There is abundant literature around this research design aiming to provide researchers an understanding of the approach. Yet there is limited literature that provides illustrative guidance to research novices in comprehending mixed methods, understanding reasons for choosing it, and selecting an appropriate mixed methods design. Based on an analysis of some notable works in the field, this article provides an overview of mixed methods designs, discusses its main types, and explains challenges one can potentially encounter when in using them with a view to assisting early career researchers in particular and other researchers in general

Preparations for and practices of online education during the Covid‑19 pandemic: A study of Bangladesh and Nepal

Online education has been adopted widely to address the educational chaos created by the Covid-19 pandemic. Reports on its constraints and challenges appear daily in the global media. However, accounts of teachers’ and students’ experiences of this abrupt shift in pedagogical modality are conspicuously absent in the available literature. This article reports the findings of a study that explored teachers’ and students’ experiences of online education during the pandemic in the context of higher education in Bangladesh and Nepal. The online survey with 147 students and 76 teachers and interviews with a sub-sample of 17 participants indicate that they adapt the action potentials of the digital artifacts to local contexts and use them in the best possible ways to facilitate their communication and enhance student learning in difficult circumstances. The major challenges and constraints they experience in transitioning to online education include poor network, lack of digital skills, lack of technological support from institutions among others. The study findings indicate some pressing policy, pedagogical and research implications, which are discussed in the final section

Upper Gastrointestinal Bleeding Induced by Gastric Ulcer Secondary to Strongyloidiasis: A Case Report

Strongyloidiasis, a parasitic infestation by Strongyloides stercoralis, involves the gastrointestinal tract with a spectrum from duodenitis to enterocolitis. However, gastric involvement with the manifestation of upper gastrointestinal bleeding is an extremely rare condition due to Strongyloides stercoralis. Due to irregular excretion of larvae, unclear symptoms, paucity of effective diagnostic tools and low parasitic load, makes clinicians difficult to reach the diagnosis of strongyloidiasis. Here, we present a case of upper gastrointestinal bleeding due to a large gastric ulcer whose aetiology was identified to be Strongyloides stercoralis infection of the gastric region by the diagnosis of exclusion

Ciprofloxacin induced toxic epidermal necrolysis with cholestatic hepatitis: A case report with literature review and revisit to the Naranjo adverse drug reaction probability scale

Abstract Ciprofloxacin, among the many Fluoroquinolones, has been widely used as a broad‐spectrum antibiotic due to its wide range of action and relatively safe adverse effect profile. However, among the cutaneous adverse drug reactions due to Ciprofloxacin, toxic epidermal necrolysis occurring along with cholestatic hepatitis is a rare one. Here, we present a case of a 22‐year‐old male patient who was diagnosed with toxic epidermal necrolysis with cholestatic hepatitis secondary to Ciprofloxacin. Naranjo adverse drug reaction probability scale was used for the causal association

Differences in clinical presentation and outcomes in pregnancy-associated Takotsubo Syndrome- A scoping review of the literature: Outcomes in pregnancy-associated Takotsubo

BACKGROUND: Takotsubo syndrome (TS) during pregnancy and postpartum is rare but may lead to significant maternal and fetal morbidity. We compared clinical characteristics and prognosis according to [a] timing of presentation (pregnancy vs post-partum) and [b] modes of delivery (cesarean section vs vaginal delivery). METHODS: Systematic review of articles published in PubMed, Scopus, Embase, and Medline databases from inception to July 30, 2023. Patient demographics, obstetric, electrocardiographic, laboratory, echocardiographic characteristics, and prognosis were summarized descriptively. RESULTS: An initial database search identified 2162 articles, of which 81 studies were included in this review. TS during pregnancy can have emotional, obstetric, and metabolic triggers and has a higher proportion of adverse fetal outcomes when compared with women who developed TS postpartum. Women with TS after cesarean section had an earlier onset and higher proportion of anesthesia use when compared with those who developed TS after vaginal delivery. There were no differences regarding the degree of systolic dysfunction or the need for advanced therapies, including ventilator support, intra-aortic balloon pump, and extracorporeal membrane oxygenation among groups. CONCLUSIONS: TS is associated with various triggers and adverse fetal outcomes when it develops during pregnancy than in the postpartum period. TS occurs more rapidly and with a more aggressive course after cesarean section than after vaginal delivery

Direct oral anticoagulants (DOAC) versus vitamin K antagonist in left ventricular thrombus: An updated meta‐analysis

Abstract Background and Aims Current clinical guidelines for treating left ventricular thrombus (LVT) are limited by inadequate evidence to inform the comparative efficacy of oral anticoagulants. In this meta‐analysis, we aimed to compare the efficacy and safety of direct oral anticoagulants (DOAC) to vitamin K antagonists (VKA) in patients with LVT. Methods Four standard databases were searched for relevant literature comparing the efficacy and safety between DOAC and VKA for LVT treatment, published before August 19, 2023. Both the randomized controlled trials and observational studies were included in the analysis. The outcomes of interest were the resolution of LVT, all‐cause mortality, stroke, systemic embolism, and bleeding. Data from the selected studies were extracted and analyzed using RevMan 5.4 using odds ratio. Results Among 3959 studies from the database search and bibliography review, 33 were included in the analysis. LVT resolution was observed in 72.59% in the DOAC group versus 67.49% in the VKA group (odds ratio [OR]: 1.28, confidence interval [CI]: 1.07–1.53). Mortality was lower in the DOAC group (11.71% vs. 18.56%) (OR: 0.60, CI: 0.36–1.00; borderline statistical significance). Likewise, bleeding events (9.60% vs. 13.19%) (OR: 0.65, CI: 0.52–0.81) and stroke (7.54% vs. 11.04%) (OR: 0.71, CI: 0.53–0.96) were also significantly lower in the DOAC group. Conclusion DOAC use for LVT showed better thrombus resolution and reduced risk of bleeding and stroke compared to VKA. Likewise, DOAC use was associated with lower mortality with borderline statistical significance

Clinical efficacy and safety outcomes of bempedoic acid: An updated systematic review and meta-analysis after CLEAR Outcomes trial

Purpose: Statins are the cornerstone therapy for primary or secondary prevention of atherosclerotic cardiovascular disease (ASCVD). However, a significant portion of patients are intolerant to statin or show inadequate lipid-lowering. Bempedoic acid (BA) has been shown to decrease low-density lipoprotein cholesterol (LDL-C) in clinical trials. However, the evidence on the effect of BA on clinical cardiovascular outcomes was limited until the CLEAR Outcomes trial. Thus, to fully appraise the available data, we performed this meta-analysis. Methods: PubMed, Pubmed Central, Embase, and Scopus databases were searched for relevant articles published before May 1, 2023. Pertinent data from the included studies were extracted and analyzed using RevMan v5.4. Results: Out of 2209 studies evaluated, five randomized control trials with 17,384 patients with established ASCVD or at high risk of ASCVD were included for analysis. The BA therapy reduced major adverse cardiovascular events (OR 0.85, CI 0.77-0.93; <0.0001), non-fatal myocardial infarction (OR 0.75, 95 % CI 0.64-0.88; p <0.0001), hospitalization for unstable angina (OR 0.69, CI 0.53-0.89; p = 0.005) and coronary revascularization (OR 0.80, CI 0.61-0.91; <0.0001) significantly without decreasing the risk of all-cause death (OR 1.19, CI 0.73-1.94; p = 0.49), cardiovascular death (OR 1.04, CI 0.87-1.25; p = 0.68) and non-fatal stroke (OR 0.84, CI 0.66-1.06; p = 0.15). Conclusion: Based on our analysis the bempedoic acid addition to therapy reduced cardiovascular events in selective patients who are either intolerant to statins or do not achieve recommended LDL-C levels despite being on a maximum dose of statins and/or ezetimibe