Bioprosthetic reoperative aortic valve replacement in patients under 50

A clinical decision report using: Chan V, Lam BK, Rubens FD, et al. Long-term evaluation of biological versus mechanical prosthesis use at reoperative aortic valve replacement. J Thorac Cardiovasc Surg. 2012;144(1):146-151. https://doi.org/10.1016/j.jtcvs.2011.08.041 for a patient considering reoperative aortic valve replacement

Should the State Control Tariffs?

Tariffs or price control has been a controversial subject in recent years. The debate between legal experts and economists is still a hot topic in any discussion. Tariff control regulated in the work creation omnibus law seems to be a topic that must be discussed again regarding this regulation’s urgency. Are specific prices so impressive that the government can intervene in regulating them? This article examines the urgency of rules regarding price controls to create a healthy competitive environment. After conducting a critical literature review, it was analyzed with critical analysis and looking at the objective of competition law was to maximize welfare by protecting competition. The results in this article indicated that the government could only intervene in regulating price-fixing only if companies’ pricing could harm the country’s economy and consumer welfare. The government, therefore, had an interest in regulating the price ceiling. Meanwhile, the price floor, which was believed to be pro-consumer and could promote consumer welfare had no interest and should not have been limited by the government

Nigerian Nursing Students’ Readiness to Use Electronic Health Records in Clinical Practice

Most hospitals in Nigeria still rely on paper-based medical records. This aspect  has created a lot of challenges to the documentation in the health care system in the country. The purpose of this descriptive cross-sectional  study conducted in 2019 was to assess Nursing Students’ readiness to use electronic health records in clinical practice. A systematic sampling technique was used to recruit a total of 189 nursing students from two schools of nursing in Ibadan, Oyo State Metropolis in Nigeria; 63 from each year of  the three year program. Data collection involved a self-constructed questionnaire comprised of four sections. Data analysis, which involved SPSS, version 21.0, included frequency counts and percentages. The findings of the study included the following:  less than half of the respondents (49%), mostly female (78%) were within the age range 16-20;  a significant number of respondents (86.2%) were ready to utilize electronic health records in clinical practice; the  perceived barriers to electronic health records use were computer illiteracy, lack of training, unstable power supply, and cost of maintenance and implementation (64.0%; 56.6%; 64.0% 56.1%) respectively. In conclusion, the study highlighted nursing students' readiness to use electronic health records and  the substantial impediments to doing so. Therefore, it is recommended that all relevant stakeholders must work together to reduce the obstacles that could prevent the deployment of electronic health records in clinical nursing practice

HIV-TB Coinfection among 57 Million Pregnant Women, Obstetric Complications, Alcohol Use, Drug Abuse, and Depression

Objective. HIV and tuberculosis represent diseases of major public health importance worldwide. Very little is known about HIV-TB coinfection among pregnant women, especially from industrialized settings. In this study, we examined the association between TB, HIV, and HIV-TB coinfection among pregnant mothers and obstetric complications, alcohol use, drug abuse, and depression. Method. We examined inpatient hospital discharges in the United States from January 1, 2002, through December 31, 2014. We employed multivariable survey logistic regression to generate adjusted estimates for the association between infection status and study outcomes. Results. We analyzed approximately 57 million records of pregnant women and their delivery information. HIV-TB coinfection was associated with the highest risks for several obstetric complications, alcohol use, and drug abuse. The risk for alcohol abuse was more than twice as high among HIV-monoinfected as compared to TB-monoinfected mothers. That risk gap more than doubled with HIV-TB coinfection. Both HIV-monoinfected and HIV-TB coinfected mothers experienced similarly increased risks for depression. Conclusions. Mothers with HIV-TB coinfection experienced relatively heightened risks for obstetric complications, alcohol use, and drug abuse. The findings of this study underscore the importance of augmenting and enhancing social and structural support systems for HIV-TB coinfected pregnant women

Dietary supplementation of different parts of Andrographis paniculata affects the fatty acids, lipid oxidation, microbiota, and quality attributes of longissimus muscle in goats

The effects of dietary supplementation of different parts of Andrographis paniculata on fatty acids, lipid oxidation, microbiota and quality attributes of Longissimus thoracis et lumborum (LTL) muscle in goats were assessed. Twenty four, entire Boer bucks (4 months old; 20.18 ± 0.19 kg BW) were randomly allotted to either a basal diet without additive (AP0), a basal diet + 1.5% Andrographis paniculata leaves (APL) or a basal diet + 1.5% Andrographis paniculata whole plant (APW). The bucks were fed the diets for 100 d and slaughtered. The LTL muscle was subjected to a 7 d chill storage. The AP0 meat had higher (p  .05) on muscle glycogen, pH, drip loss, chemical composition and lactic acid bacteria count. Cooking loss, shear force, and TBARS values were lower (p < .05) in APL (23.98%, 0.76 kg, 0.12 mg MDA/kg) and APW (24.53%, 0.80 kg, 0.15 mg MDA/kg) meat compared with AP0 (26.49%, 1.13 kg, 0.23 mg MDA/kg) meat. Meat redness was higher (p < .05) in APL (13.49) and APW (12.98) than AP0 (10.86). Sensory scores for juiciness, tenderness, and overall acceptability of APL (7.92, 7.88, 7.89) and APW (7.90, 7.08, 7.77) meat were higher (p < .05) than that of the AP0 (5.38, 5.95, 5.41) meat. Total viable counts and populations of Pseudomonas spp, Escherichia coli and Enterobacteriacea were higher (p < .05) in AP0 meat than in APL and APW meat. The APL exhibited higher (p < .05) antimicrobial potential than the APW. Chill storage affected (p < .05) the physicochemical properties, lipid oxidation and microbial counts in chevon. Dietary APL and APW enhanced the beneficial fatty acids, quality attributes and oxidative stability, and reduced microbial counts in chevon

A Scoping Review: Overview of Current Respectful Maternity Care Research by Research Approach and Study Location

Introduction: Disrespectful care during childbirth contributes to poor health outcomes, perpetuates disparities, and encourages childbirth outside of healthcare facilities. To measure disrespectful care, investigators use many research approaches. Most research has focused on low/low-middle income countries. This scoping review aims to 1) summarize current research and research approaches to analyze whether these approaches identify the same types of mistreatment and 2) identify gaps in current research analyzing disrespectful care during childbirth. Methods: Following PRISMA guidelines, this review utilized search terms to filter articles from the Pubmed database. Using specific criteria, articles were then excluded by title and abstract, then full article review. Included articles were organized by research approach and analyzed for study location and the presence of 9 types of mistreatment. Results: 102 included articles were organized by research approach, including direct labor observation, survey, interview, and focus groups, yielding 144 total studies to account for articles with more than one research approach. Each research approach identified all 9 types of mistreatment, with neglect/abandonment, verbal mistreatment, and physical mistreatment reported the most. Low-income countries represented 134/144 studies, with most research centered in East Africa and India. High-income countries represented only 7% of research. Discussion: This review is the first to organize current respectful maternity care research by research approach and study location. Analysis of study location shows gaps in research, particularly among high-income countries. Further research, particularly in high-income countries, is necessary to better this global health concern

Factors influencing choice of healthcare facilities utilisation by rural households in Ogun State, Nigeria

Understanding the choice of healthcare facility utilisation is essential to the provision of need-based healthcare services to the population. This study was carried out to estimate factors influencing the choice of healthcare facilities utilised by rural households. A multistage sampling procedure was used to select 240 rural households comprising 1440 persons. Data were collected with the use of a structured questionnaire and analysed with descriptive techniques and a multivariate probit (MVP) model. The MVP result showed that households supplement public healthcare facilities with private clinics, support traditional medical treatment with self-medication, and replace self-medication with public healthcare facilities and private clinics. Similarly, age, gender, household size, cost of drugs, distance to public healthcare facilities, travelling cost, contact with community health workers, total income, awareness of public health facilities, quality of health facilities, and terrain of health facilities influence the choice of healthcare facilities utilised. The study concluded that increased total income, contact with community health extension workers, awareness of health facilities, and perceived quality of services rendered positively influence the choice of healthcare facilities sorted after while the increase in the cost of drugs, distance to health facilities, travelling cost and difficult terrain of health facilities negatively impact the choice of healthcare facilities utilised. The study recommended that public healthcare facilities should be located within the reach of the people and equipped with essential drugs at a reduced cost. Households should also engage in activities that will increase their income so that they can use better healthcare facilities

Effects of dietary supplementation of leaves and whole plant of Andrographis paniculata on rumen fermentation, fatty acid composition and microbiota in goats

Background: The nature and amount of dietary medicinal plants are known to influence rumen fermentation and nutrient digestibility in ruminants. Nonetheless, changes in nutrient digestibility and rumen metabolism in response to dietary Andrographis paniculata (AP) in goats are unknown. This study examined the effects of dietary supplementation of leaves and whole plant of AP on nutrient digestibility, rumen fermentation, fatty acids and rumen microbial population in goats. Twenty-four Boer crossbred bucks (4 months old; average body weight of 20.18 ± 0.19 kg) were randomly assigned to three dietary groups of eight goats each. The dietary treatments included a control diet (Basal diet without additive), basal diet +1.5% (w/w) Andrographis paniculata leaf powder (APL) and basal diet +1.5% (w/w) Andrographis paniculata whole plant powder (APW). The trial lasted 100 d following 14 d of adjustment. Results: The rumen pH and concentration of propionate were greater (P < 0.05) in goats fed the APL and APW diets than those fed the control diet. The concentrations of ammonia nitrogen and acetate were greater (P < 0.05) in the control goats than the APL and APW goats. The digestibilities of crude protein, dry matter, acid detergent fibre and neutral detergent fibre were greater (P < 0.05) in the APL and APW goats compared to the control goats. Dietary APL and APW decreased (P < 0.05) the ruminal concentration of C18:0 and increased (P < 0.05) the ruminal concentration of C18:2n-6 and C18:3n-3. The APL goats had greater (P < 0.05) ruminal concentration of C18:1 trans-11 and CLA cis-9 trans-11 than the APW and control goats. Dietary treatments had no significant effect on the population of protozoa and methanogens in the rumen of goats. The ruminal populations of Ruminococcus albus, Ruminococcus flavefaciens and Fibrobacter succinogenes were greater (P < 0.05) in the APL and APW goats than the control goats. Conclusion: Dietary supplementation of leaves and whole plant of Andrographis paniculata can be used to manipulate rumen metabolism for improved nutrient digestibility in goats

HIV-TB Coinfection among 57 Million Pregnant Women, Obstetric Complications, Alcohol Use, Drug Abuse, and Depression

Objective. HIV and tuberculosis represent diseases of major public health importance worldwide. Very little is known about HIV-TB coinfection among pregnant women, especially from industrialized settings. In this study, we examined the association between TB, HIV, and HIV-TB coinfection among pregnant mothers and obstetric complications, alcohol use, drug abuse, and depression. Method. We examined inpatient hospital discharges in the United States from January 1, 2002, through December 31, 2014. We employed multivariable survey logistic regression to generate adjusted estimates for the association between infection status and study outcomes. Results. We analyzed approximately 57 million records of pregnant women and their delivery information. HIV-TB coinfection was associated with the highest risks for several obstetric complications, alcohol use, and drug abuse. The risk for alcohol abuse was more than twice as high among HIV-monoinfected as compared to TB-monoinfected mothers. That risk gap more than doubled with HIV-TB coinfection. Both HIV-monoinfected and HIV-TB coinfected mothers experienced similarly increased risks for depression. Conclusions. Mothers with HIV-TB coinfection experienced relatively heightened risks for obstetric complications, alcohol use, and drug abuse. The findings of this study underscore the importance of augmenting and enhancing social and structural support systems for HIV-TB coinfected pregnant women

Approaches and geographical locations of respectful maternity care research: A scoping review

Background Peripartum mistreatment of women contributes to maternal mortality across the globe and disproportionately affects vulnerable populations. While traditionally recognized in low/low-middle-income countries, the extent of research on respectful maternity care and the types of mistreatment occurring in high-income countries is not well understood. We conducted a scoping review to 1) map existing respectful maternity care research by location, country income level, and approach, 2) determine if high-income countries have been studied equally when compared to low/low-middle-income countries, and 3) analyze the types of disrespectful care found in high-income countries. Methods A systematic search for published literature up to April 2021 using PubMed/MEDLINE, EMBASE, CINAHL Complete, and the Maternity & Infant Care Database was performed. Studies were included if they were full-length journal articles, published in any language, reporting original data on disrespectful maternal care received from healthcare providers during childbirth. Study location, country income level, types of mistreatment reported, and treatment interventions were extracted. This study was registered on PROSPERO, number CRD42021255337. Results A total of 346 included studies were categorized by research approach, including direct labor observation, surveys, interviews, and focus groups. Interviews and surveys were the most common research approaches utilized (47% and 29% of all articles, respectively). Only 61 (17.6%) of these studies were conducted in high-income countries. The most common forms of mistreatment reported in high-income countries were lack of informed consent, emotional mistreatment, and stigma/discrimination. Conclusions Mapping existing research on respectful maternity care by location and country income level reveals limited research in high-income countries and identifies a need for a more global approach. Furthermore, studies of respectful maternity care in high-income countries identify the occurrence of all forms of mistreatment, clashing with biases that suggest respectful maternity care is only an issue in low-income countries and calling for additional research to identify interventions that embrace an equitable, patient-centric empowerment model of maternity care