Effect of a Pre-Treatment Educational Video in Improving Patient Satisfaction with 5-Fluorouracil Treatment for Actinic Keratoses: A Randomized Controlled Trial.

IntroductionPatient treatment satisfaction and adherence may be affected by the initial understanding of outcomes in the treatment of actinic keratoses with 5-fluorouracil 5% cream (5-FU). Pre-treatment educational videos may optimize this understanding. The objective of this study was to determine whether prospective patient viewing of an educational video delineating treatment effects and expectations improves patient satisfaction and treatment completion rates for the treatment of actinic keratoses with 5-FU.MethodsForty-four participants were recruited to the UC Davis Dermatology outpatient clinic. Each participant was randomized to the video (group A) or control group (group B), and topical 5-FU cream treatment was conducted for 2 weeks in both groups.ResultsA follow-up questionnaire was performed to assess patient satisfaction and adherence to the treatment regimen. The results of these questions were analyzed using the Mann-Whitney test. One item on the questionnaire asked the patient to rate their overall level of satisfaction on a score of 0-100. The results of this question were analyzed using the unpaired t test. The results of the statistical analysis show no significant difference between the patient group that viewed the video and the patient group that did not view the video.ConclusionsWe speculate that this study may establish a foundation for subsequent studies that may affect the broader medical community and promote development of educational videos

Epidural dexamethasone for postoperative analgesia in patients undergoing unilateral inguinal herniorrhaphy: A comparative study

Background. This study was designed to evaluate the effect of adding dexamethasone to epidural bupivacaine on postoperative analgesia in unilateral inguinal herniorrhaphy. Methods. Forty-four patients were enrolled in this double-blind, clinical trial study. Patients were randomly allocated into dexamethasone or control group. In the dexamethasone group, patients received 18ml of bupivacaine 0.5% and 2ml (8mg) of dexamethasone; in the control group, patients received 18ml of bupivacaine 0.5% and 2ml of normal saline. The onset of sensory block and its duration and incidence of nausea and vomiting were recorded. Results. The onset of epidural anesthesia was significantly more rapid in the dexamethasone group than in the control group (P < 0.001). Duration of analgesia was markedly prolonged in the dexamethasone group than in the control group (P < 0.001). Five patients (22.7%) in the control group had nausea in the first hour after the procedure (P = 0.048). None of the patients in the dexamethasone group had nausea. None of our patients had vomiting in the two groups. Conclusions. This study showed that adding dexamethasone to bupivacaine significantly prolongs the duration of postoperative analgesia

Did female prisoners with mental disorders receive psychiatric treatment before imprisonment?

© 2015 Mundt et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BackgroundThroughout the world, high prevalence rates of mental disorders have been found in prison populations, especially in females. It has been suggested that these populations do not access psychiatric treatment. The aim of this study was to establish rates of psychiatric in- and outpatient treatments prior to imprisonment in female prisoners and to explore reasons for discontinuation of such treatments.Methods150 consecutively admitted female prisoners were interviewed in Berlin, Germany. Socio-demographic characteristics, mental disorders, and previous psychiatric in- and outpatient treatments were assessed by trained researchers. Open questions were used to explore reasons for ending previous psychiatric treatment.ResultsA vast majority of 99 prisoners (66%; 95% CI: 58¿73) of the total sample reported that they had previously been in psychiatric treatment, 80 (53%; 95 CI: 45¿61) in inpatient treatment, 62 (41%; 95 CI: 34¿49) in outpatient treatment and 42 (29%; 21¿39) in both in- and outpatient treatments. All prisoners with psychosis and 72% of the ones with any lifetime mental health disorder had been in previous treatment. The number of inpatient treatments and imprisonments were positively correlated (rho¿=¿0.27; p¿<¿0.01). Inpatient treatment was described as successfully completed by 56% (N¿=¿41) of those having given reasons for ending such treatment, whilst various reasons were reported for prematurely ending outpatient treatments.ConclusionThe data do not support the notion of a general `mental health treatment gap¿ in female prisoners. Although inpatient care is often successfully completed, repeated inpatient treatments are not linked with fewer imprisonments. Improved transition from inpatient to outpatient treatment and services that engage female prisoners to sustained outpatient treatments are needed

Epidemiology of female reproductive cancers in Iran: Results of the gholestan population-based cancer registry

Background: Malignancies of the female reproductive tract are estimated to be the third most common group of cancers in women. Objectives: We here aimed to present their epidemiological features in Golestan provincelocated in Northeast of Iran. Materials and Methods: Data on primary female reproductive cancers diagnosed between 2004-2010 were obtained from Golestan Population-based Cancer Registry (GPCR). CanReg-4 and SPSS software were used for data entry and analysis. Age standardized incidence rates (ASR) (per 100,000 person-years) were calculated using the world standard population. Poisson regression analysis was used to compare incidence rates. P-values of less than 0.05 were considered as significant. Results: A total of 6,064 cancer cases were registered in Golestan females in the GPCR during 2004-2010, of which 652 cases (11%) were female reproductive cancers. Cancers of the ovary (ASR=6.03) and cervix (ASR=4.97) were the most common. We found significant higher rates in females living in cities than in villages. Our results showed a rapid increase in age specific incidence rates of female reproductive cancers at the age of 30 years. Conclusions: We found significant higher rates of female reproductive cancers among residents of cities than villages. Differences in the prevalence of risk factors including reproductive behavior between the two populations may partly explain such diversity. Our results also showed a rapid increase in incidence rates of these cancers in young age females. Further studies are warranted to determine risk factors of female reproductive cancers in our population

Knowledge of Type II Diabetic Patients About Their Diabetes: A Systematic Review and Meta-Analysis

Introduction: Knowledge is the critical component to counter the harmful side-effects of chronic diseases. Diabetic patients can manage their disease based on their diabetes knowledge and following good self-care behavior. Various studies about patients' knowledge of diabetes show different results. The purpose of this study is to estimate the overall knowledge score of Iranian patients about diabetes. Methods: In the current study, ten papers published by September 2018 were identified without time limitation. A literature search for the papers was conducted using the keywords: Iran, diabetes, knowledge, and their combinations. The necessary data were extracted and analyzed through meta-analysis using the random-effects model. The I2 statistic was used to measure the heterogeneity among the studies. The data were analyzed using Stata software (Version 11). Results: The pooled estimate of the knowledge score of type II diabetes patients about their diabetes was 64% (95% CI: 52%-76%). According to the meta-regression results, there was no relationship between the knowledge score with age (P = 0.487), duration of disease (P = 0.406), and the sample size (P = 0.146). The patients' knowledge score had experienced an uptrend between 2004 and 2017, the years at which the oldest and the most recent articles were published (P = 0.06). Conclusions: Iranian patients' knowledge about their diabetes was at an average level. Education, along with medication, can significantly reduce short and long-term complications of diabetes

Nucleate pool boiling heat transfer of binary nano mixtures under atmospheric pressure around a smooth horizontal cylinder

Influence of Al2O3 nanoparticles on nucleate pool boiling heat transfer of diluted binary water-glycerol mixtures has been experimentally measured up to heat flux 91 kW/m2 at diluted volume fractions of 1% to 5% of glycerol into pure water at volumetric concentrations 0.5%, 1% and 1.5% of Al2O3 nanoparticles. Obtained results indicate that presence of nanoparticles into the mixtures result in increasing the pool boiling heat transfer coefficient values and also result in decreasing the wall superheat temperature of surface. Increased values of heat transfer are increased with increasing the volume fractions of Al2O3 too. Generally, it is concurred that Al2O3 nanoparticles typically enhance the pool boiling heat transfer coefficient of binary water-glycerol mixture in comparison with absence of nanoparticles circumstances, up to 25% at 1.5% Al2O3. Additionally, new simple semi - mathematical model has been proposed for a rough estimating of enhanced values with uncertainty about 8%

Thalassaemia (part 2): Management

The management of thalassaemia with a severe phenotype includes blood transfusion, iron chelation, bone marrow transplantation, prenatal diagnosis and national programmes to co-ordinate these in countries with a high prevalence. If blood transfusion and iron chelation therapy are not administered regularly, as was the case historically and as is still the case in many poorer regions, progressive deterioration occurs, viz. impaired growth and development, hepatosplenomegaly, bony abnormalities, cardiac failure, increased susceptibility to infections and premature mortality. Remarkable progress has been made in the past few decades, which has led to much-improved survival rates. Transfusion therapy has evolved to a hyper-transfusion regimen designed to maintain a physiological haemoglobin level and achieve a post-transfusion haemoglobin of 14 g/dL, which, as a matter of course, necessitated intensification of iron chelation. The development of effective oral iron chelators has led to improved compliance. Exploration of novel therapeutic approaches continues, with several agents under study. The prospect of gene therapy is particularly exciting as it has potential to provide cure on a large scale. Currently, regular blood transfusion and iron chelation therapy remain the cornerstone of management of thalassaemia major

Multi-GeV Electron Generation Using Texas Petawatt Laser

We present simulation results and experimental setup for multi-GeV electron generation by a laser plasma wake field accelerator (LWFA) driven by the Texas Petawatt (TPW) laser. Simulations show that, in plasma of density n(e) = 2 - 4 x cm(-3), the TPW laser pulse (1.1 PW, 170 fs) can self-guide over 5 Rayleigh ranges, while electrons self-injected into the LWFA can accelerate up to 7 GeV. Optical diagnostic methods employed to observe the laser beam self-guiding, electron trapping and plasma bubble formation and evolution are discussed. Electron beam diagnostics, including optical transition radiation (OTR) and electron gamma ray shower (EGS) generation, are discussed as well.Physic