WEIBULL DISTRIBUTION BASED ON EDUCATION PARTLY INTERVAL CENSORED DATA

The work in this project is concerned with the applying of techniques for the assessment of survival analysis in data that include censored observations. Survival analysis has a lot of achievement in the medical, engineering, economic, education and other fields and it also known as failure time analysis. Partly Interval Censoring (PIC) is one of the techniques of the censoring that used in the survival analysis and it can help to treat many types of data especially the incomplete data. One of the most commonly lifetime distribution used in the reliability applications is Weibull distribution. In this project we use Weibull model based on modified education partly interval censored data as well as medical data and simulation data. Based on the medical data, we found that our model is comparable with Turnbull method. From the education data and simulation study for this particular case, we can conclude that our proposed distribution describes well the nature of the model as compared to the Turnbull method in terms of the value of scale and shape parameter estimates. Plots of survival distribution function against failure time are used to examine the predicted survival patterns for the two types of failures

Community Pharmacists’ Level of Knowledge, Attitude, and Patient Counseling Among COPD Patients and the Use of Inhaler Devices

Chronic obstructive pulmonary disease (COPD) is part of a group of chronic inflammatory diseases that are the leading causes of morbidity and mortality worldwide and also prove to be an economic burden. The prevalence of COPD is mostly related to smoking. Thus, smoking cessation is the most effective option in the prevention and treatment of the disease. Community pharmacists are the ones in charge of delivering the best services in terms of inhalation technique, counseling, and medication adherence. Counseling, which plays a main role in the management of COPD, is an essential prerequisite for achieving full therapeutic effect in patients. The purpose of this study is to research the extent of knowledge, attitude, and patient counseling exhibited by community pharmacists towards COPD patients and to understand the use of inhaler devices by evaluating the level of awareness pharmacists have about it. In February 2019, a questionnaire for assessment of knowledge of COPD was distributed among Palestinian pharmacists (n=300)

MATERIALISM AND UAE NATIONALS

Amongst examined populations, research has found materialistic values to be empirically associated with lower levels of life satisfaction. While the causes of materialistic values are plentiful, extant research suggests that a primary driver is the rapid urbanization and commercialization of a society, with youth being more susceptible. The dramatic transformation of the UAE over the past four decades, coupled with the relatively young population, increases the likelihood that materialistic values have been cultivated among the population. This study sheds light on the interesting but under researched case of materialism in the UAE. A self-report survey measured the materialism and life satisfaction levels of 210 UAE residents (80 nationals and 130 non-nationals). Materialistic values were found to be negatively correlated with life satisfaction amongst our sample. In addition, UAE nationals reported significantly higher levels of materialism than non-national residents. To uncover the causes and consequences of high levels of materialism amongst UAE nationals, four focus groups and 25 in-depth interviews were conducted. Five major consequences of materialistic values were revealed: 1) the development of an increasingly competitive and narcissistic society, 2) the development of a more judgmental and less accepting society, 3) the use of consumption as a tool to boost confidence and self-esteem, 4) an increase in family conflicts and the delaying of marriage, and 5) a lack of savings and an increase in debt. The primary causes of materialistic values were: 1) the rapid development and commercialization of the UAE, 2) the consequences of materialism propagating the values in a self-perpetuating cycle, 3) narcissism and competition on social media, 4) Emirati values of generosity, hospitality, perfection and pride, and 5) parenting and youths lack of financial responsibilities. To advance life satisfaction levels within the UAE population, we propose that policy makers implement awareness campaigns, educational programs, and legislation to reduce the current levels of materialism

Updates In Diagnosis And Management Of Genital Herpes

Herpes genitalia is mainly caused by herpes simplex virus type 2 and can appear as a primary or recurring infection. It is among the most prevalent sexually transmitted illnesses. This review article provides a comprehensive overview of the diagnosis, management, treatment, and prophylaxis of herpes genitalis, caused by herpes simplex virus type 2. It addresses critical areas of concern and aims to improve the often inadequate counseling and utilization of lab diagnoses, as well as provide updated information on treatment and management of the infection. This is a valuable resource for healthcare professionals and individuals seeking information on the pathogen and clinical manifestations of herpes genitalis

An Immunohistochemical and Polarizing Microscopic Study of the Tumor Microenvironment in Varying Grades of Oral Squamous Cell Carcinoma

Background Invasion of epithelial cells into the connective tissue brings about massive morphological and architectural changes in the underlying stroma. Myofibroblasts reorganize the stroma to facilitate the movement of tumor cells leading to metastasis. The aim of this study was to determine the number and pattern of distribution of myofibroblasts and the qualitative and quantitative change that they cause in the collagen present in the stroma in various grades of oral squamous cell carcinoma (OSCC). Methods The study was divided into two groups with group I (test group, 65 cases) consisting of 29 cases of well-differentiated squamous cell carcinoma, 25 moderately differentiated SCC, and 11 poorly differentiated SCC, and group II (control group) consisting of 11 cases of normal mucosa. Sections from each sample were stained with anti–α-smooth muscle actin (α-SMA) antibodies, hematoxylin and eosin, and Picrosirius red. Several additional sections from each grade of OSCC were stained with Masson’s trichrome to observe the changes in collagen. For the statistical analysis, Fisher’s exact test, Tukey’s post hoc honest significant difference test, ANOVA, and the chi-square test were used, and p < .05 was considered statistically significant. Results As the tumor stage progressed, an increase in the intensity α-SMA expression was seen, and the network pattern dominated in more dedifferentiated carcinomas. The collagen fibers became thin, loosely packed, and haphazardly aligned with progressing cancer. Additionally, the mean area fraction decreased, and the fibers attained a greenish yellow hue and a weak birefringence when observed using polarizing light microscopy. Conclusions Myofibroblasts bring about numerous changes in collagen. As cancer progresses, there isincrease in pathological collagen,which enhances the movement of cells within the stroma

Evaluation of the Task Compliance of Medical Education Development Centers from the Viewpoint of the Managers of the Centers

Background: Medical education development (MED) centers are established in order to improve the quality of medical education. It seems that after more than two decades since the establishment, the centers still have difficulties to perform some tasks. Objectives: According to the important role of MED centers, the current study aimed at adapting the performances of such centers with their assigned tasks. Methods: The current qualitative applied study was conducted in 2013. The statistical population of the study included managers of MED centers in Iran. Data were collected through a questionnaire containing open questions. During a national meeting the questionnaire distributed among 40 managers of MED centers and then analyzed using content analysis. Results: More than half of the major functions that the managers stated, were referred to the first, second, and fourth tasks of the centers, and only 18% of the major functions were related to other tasks (11 cases). About 28% of the functions performed in such centers had no direct correlation with any of the 14 tasks. Conclusions: Despite the history of MED centers for several decades, they are not justified in respect to their duties. It is recommended that guidelines be developed to address all duties and adequately monitor their implementation. Keywords Medical Education Development Centers Performance Indicator Quality Medical Education Ira

An Overview of the Opportunities the Presence of Specialist Doctors Resident in Hospitals

Attention to the functions and pattern organized staff are important to achieve organizational goals, especially for hospitals that are one of the important components into account an element in improving the health system and providing a fair field of utilization of health intervention. So this study was to review the opportunities of presence resident doctors in hospitals based on the instructions of the health system reform plan. This is a narrative review that returning to the site of the Persian (Magiran, Irandoc, Google Scholar, Iranmedex, SID) and English (PubMed, Scopus, EMBASE and Sciencedirect) and also library studies with keywords (physicians, resident physicians, health equity, project development, opportunity specialist and human resources) and the English word for them in this area and the 30 related articles was extracted. Given the evidence may not be fully implemented in all government hospitals because of problems such as the lack of doctors in public hospitals or other administrative problems, but it can be said that is one of the best model to achieve better clinical outcomes in hospitals. In order to solve problems, there is the need to design and create the appropriate environment for the successful implementation plan, or create an ideal environment for the implementation of evidence-based medicine moved

Infectious Agents And Disease In Clinical Laboratory, Role Of Nurses, Pharmacist To Increase Awareness; Review

The occurrence and dissemination of infectious diseases with the potential to cause pandemics have transpired throughout human history. Throughout history, there have been significant outbreaks of bacterial infectious diseases including plague, cholera, and tuberculosis. In more recent times, viral infectious diseases such as influenza and the most recent COVID-19 pandemic, which began in late 2019, have spread worldwide and resulted in millions of deaths. Pandemics sometimes arise from infectious diseases that are caused by zoonotic infections, which originate from animals such as cattle, wildlife, or companion animals. The essential role of the microbiology laboratory in diagnosing infectious diseases necessitates a strong and collaborative relationship between the physician/advanced practice provider and the microbiologists, who contribute immense value to the healthcare team.&nbsp

Myocardial inflammation, injury and infarction during on-pump coronary artery bypass graft surgery

Abstract Background Myocardial inflammation and injury occur during coronary artery bypass graft (CABG) surgery. We aimed to characterise these processes during routine CABG surgery to inform the diagnosis of type 5 myocardial infarction. Methods We assessed 87 patients with stable coronary artery disease who underwent elective CABG surgery. Myocardial inflammation, injury and infarction were assessed using plasma inflammatory biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and cardiac magnetic resonance imaging (CMR) using both late gadolinium enhancement (LGE) and ultrasmall superparamagnetic particles of iron oxide (USPIO). Results Systemic humoral inflammatory biomarkers (myeloperoxidase, interleukin-6, interleukin-8 and c-reactive protein) increased in the post-operative period with C-reactive protein concentrations plateauing by 48 h (median area under the curve (AUC) 7530 [interquartile range (IQR) 6088 to 9027] mg/L/48 h). USPIO-defined cellular myocardial inflammation ranged from normal to those associated with type 1 myocardial infarction (median 80.2 [IQR 67.4 to 104.8] /s). Plasma hs-cTnI concentrations rose by ≥50-fold from baseline and exceeded 10-fold the upper limit of normal in all patients. Two distinct patterns of peak cTnI release were observed at 6 and 24 h. After CABG surgery, new LGE was seen in 20% (n = 18) of patients although clinical peri-operative type 5 myocardial infarction was diagnosed in only 9% (n = 8). LGE was associated with the delayed 24-h peak in hs-cTnI and its magnitude correlated with AUC plasma hs-cTnI concentrations (r = 0.33, p 10-fold the 99th centile upper limit of normal that is not attributable to inflammatory or ischemic injury alone. Peri-operative type 5 myocardial infarction is often unrecognised and is associated with a delayed 24-h peak in plasma hs-cTnI concentrations

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely