Effect of Multimodal Integrative Interventions on Pain-Related Outcomes among Critically Ill Patients

Context: Pain, a persistent problem in critically ill patients, adversely affects outcomes. Despite recommendations, no evidence-based non-pharmacological approaches for pain treatment in critically ill patients have been found. Aim: To evaluate the effect of multimodal integrative interventions on pain-related outcomes among critically ill patients. Methods: A quasi-experimental design (pre / post-test) was utilized to fulfill the aim of this study. A convenience sample of sixty adult critically ill patients was recruited from the intensive care unit at Benha University Hospital affiliated to Benha University at Qualyubia Governorate, Egypt. Three tools were used to conduct this study as follows: Critically ill patients' assessment record; The Critical-Care Pain Observation Tool (CCPOT); The Groningen Sleep Quality Scale. Results: The results show decreased frequency of pain occurrence in the post intervention periods (75%) immediately post to 50% after 48 hours of intervention compared with pre-intervention (100%). The results show a highly statistically significant differences at p ≤0.001 between pre and post of intervention periods regarding the intensity of the pain mean score among studied patients. It also shows statistically significant differences with p-value ≤0.05 regarding all items of sleep quality immediately after and after 48 hours of intervention compared to pre-intervention, except related to having a deep sleep last night, and feel like a slept poorly last night with a p-value ≥0.05. There was a highly positive statistically significant correlation at p-value ≤ 0.001 between pain intensity and other secondary outcomes, including quality of sleep, blood pressure, heart rate and respiratory rate. Conclusion: Multimodal integrative interventions effectively decrease pain and improve pain-related outcomes among critically ill patients. Appropriate pain assessment must be partnered with an adequate, multimodal, evidence-based management strategy that incorporates both pharmacologic and non-pharmacologic modalities of pain control

Deep Learning-based Polyp Detection in Wireless Capsule Endoscopy Images

Gastrointestinal (GI) system diseases have increased significantly, where colon and rectum cancer is considered the second cause of death in 2020. Wireless Capsule Endoscopy (WCE) is a revolutionary procedure for detecting Colorectal lesions. It was automatically used to detect the polyps, multiple SB lesions, bleeding, and Ulcer. The acquired video by the WCE can be processed using a Computer-Aided Diagnosis (CAD) system. However, such videos suffer several problems, including burling, high illumination. and distortion. These effects obligate the development of image processing techniques of high accuracy in detection using deep learning-based segmentation. In this paper, a transfer learning-based U-Net was proposed to transfer the knowledge between the medical images in the training phase and the subsequent segmentation using transfer learning to achieve better results and high accuracy results compared to other related studies. The improvement is done by using an algorism written in python code The results showed average segmentation accuracy of 98.67

Corporate governance and diversity management: evidence from a disclosure perspective

Purpose: Using textual analysis, this paper aims to measure diversity management disclosure; it also explore the relationship between corporate governance and diversity management disclosure. Design/methodology/approach: The study is based on a sample of the UK FTSE all-share non-financial organisations over the period from 2013 to 2019. We used a computer-aided textual analysis, and we used a bag of words to score the sample annual reports. Findings: The results show that the mean of the diversity management disclosure level is very low. Also, there is a positive relationship between the board size, women on board and board independence and the level of diversity management disclosure. The relationship is higher with more board members, women on board and more independent directors, aligning with previous literature. Practical implications: The implications of this research affect stakeholders and organisations which reflects the importance of communicating diversity practices and researchers by facilitating measuring objectively firms’ diversity management practices that have not been applied previously in the field of diversity. Originality/value: With different incidents taking place around the globe, such as the incident of George Floyd and the increased attention to diversity, organisations are under increasing social and political pressure to reflect on their diversity management practices. Previous literature has examined firms’ diversity practises from different perspectives, but to the best of the authors’ knowledge, this is the first paper to measure diversity management disclosure

Clinical pattern of pediatric ocular trauma in a tertiary referral center

Background: Pediatric ocular trauma may be a major source of lifelong visual morbidity and disability. Objective: To report on the different types of ocular injury in children in a tertiary referral center. Participants and settings: Children presenting with ocular trauma to the casualty department of the pediatric ophthalmology unit of Alexandria Main University Hospital in Alexandria, Egypt. Methods: The study was conducted from June to December 2018. Upon admission, thorough history was obtained from the attending person(s), and thorough ophthalmic examination was performed. Appropriate treatment was subsequently provided to every case (though not the scope of the current study). Results: A total of 146 children (from a total of 436 patients, 33.5%) (103 males, 70.5%) presented with various types of ocular injuries. The mean age ± standard deviation of the injured children was 98.1 ± 56.4 months. Study participants were almost equally distributed between within and outside of the city of the study locale, with a predominance of patients from urban areas in Alexandria (30%) and from rural areas outside of Alexandria (35.6%). Seventy percent of the care providers of the study children were manual workers. The places of the incidents were almost equally distributed between household (40%) and external environment with a slight predominance of the later (50%). Conclusions: Ocular injuries represent one-third of all ocular injuries in the study locale. Ocular injuries in children occur with an almost equal distribution in both urban and rural areas and in both household and external environments. Mechanical trauma was the most common cause of trauma

Primary Adenocarcinoma in a Seminal Vesicular Cyst: A Case Report

Introduction: Primary adenocarcinoma of the seminal vesicle (SVC) is very rare. Presentation to the case: Herein, we reported a case of SVA of SV cyst arising in a 51-year-old deaf mute male patient. Laboratory parameters including serum prostate specific antigen (PSA) level were normal. Contrast-enhanced magnetic resonance imaging demonstrated large reterovesical cystic lesion with mural nodules. The patient was managed by radical prostatectomy and seminovesiculolectomy.  Microscopic examination revealed well-differentiated primary mucinous adenocarcinoma of left seminal vesicle cyst.   Conclusion: To the best of our knowledge, this was the first case of SVA of SV cyst arising in deaf mute patient

Fixed gonadotropin-releasing hormone antagonist protocol versus gonadotropin-releasing hormone agonist long protocol in patients with polycystic ovary syndrome treated for intracytoplasmic sperm injection cycles

Background: Women with polycystic ovary syndrome (PCOS) are at risk of developing ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation. Use of GnRH antagonist in the general sub fertile population is associated with lower incidence of (OHSS) than agonists and similar probability of live birth but it is unclear. Our Objective was to compare the fixed GnRH antagonist and GnRH agonist long protocols in patients with PCOS undergoing IVF.Methods: In this randomized controlled trial (RCT), 200 patients with PCOS were randomly allocated in two groups: long GnRH (n = 100) and fixed GnRH antagonist protocol (n = 100).           Results: There is significant difference was observed in chemical pregnancy rate (46.0% versus 31.0%), and clinical pregnancy rate (43.0% versus 29.0%) in agonist and antagonist protocols, respectively. Duration of stimulation was significantly higher in agonist group (13.58 versus 12.381 days), respectively.  Total number of ampoules of gonadotrophin is comparable in both groups (t=1.914, p=0.057).Conclusions: The use of GnRH antagonists is more advantageous than GnRH agonists in relation to shorter duration of stimulation thus allowing a reduction in the treatment time that makes COS less costly and better patient compliance. In this study GnRH agonist shows higher pregnancy rate than antagonist, so larger studies needed to clarify their roles