Evaluation Of Public Knowledge And Clinical Management Of Depression In The State Of Penang, Malaysia

Depression is one of the most important public health issues in Malaysian and global context. Depresi atau kemurungan (depression) merupakan satu daripada isu kesihatan global yang paling penting, begitu juga dalam konteks di Malaysia

Effectiveness And Tolerability Of Pregabalin Usage Among Patients In King Fahad Hospital, Saudi Arabia: A Quasi Longitudinal Study

Satu kajian membujur kuasi eksperimen bukan rawak telah dijalankan untuk menilai keberkesanan serta keselamatan dan ketoleranan pengambilan 75mg pregabalin pos hemodialisis (pHD) sekali sehari secara lisan, bagi uremic pruritus (UP) yang resistan pada rawatan, di kalangan pesakit ESRD dalam pusat buah pinggang Aljaber, Hospital King Fahad, Alahsa Arab Saudi. Pengukuran untuk keterukan dan intensiti gatal dilakukan dengan menggunakan skala gatal-5D versi Bahasa Arab yang telah divalidasi (α = 0.847 p = 0.001, Kaiser- Meyer-Oklin value = 0.810). Pengukuran tahap selamat dan ketoleranan pada pregabalin telah dilakukan dengan menggunakan algoritma Naranjo. Model linear teritlak digunakan untuk mengukur kesan selang waktu pengambilan pregabalin. Selanjutnya, untuk menentukan perbezaan kesan pregabalin pada selang masa yang berbeza, persamaan anggaran teritlak digunakan. Akhirnya untuk pentaksiran hubungan unsur-unsur demografi dan tahap keterukan UP, simulasi Monte Carlo telah dipilih. A quasi, non-randomized longitudinal study was conducted to assess the effectiveness of 75mg pregabalin post hemodialysis (pHD) once daily orally in treatment-resistant uremic pruritus (UP), and the safety and tolerability among ESRD patients at Aljaber kidney center, King Fahad Hospital, Alahsa Saudi Arabia. Assessment for the severity and intensity of itching was done using the validated Arabic version of 5D- itching scale (α= 0.847, p=0.001, Kaiser- Meyer-Oklin value= 0.810). Safety and tolerability of pregabalin was done by using Naranjo’s algorithm. The effect of the pregabalin over the time was assessed using the generalized linear model. Furthermore, to pinpoint the differences in the effect of pregabalin at different time intervals, generalized estimated equations were used. Finally for the assessment of the association among demographics and UP severity, Monte Carlo simulations were preferred

Outcome of Non-Invasive Ventilation in Severe Corona Virus Disease of 2019 Patients; A Prospective Cohort Study

Objective: To determine the Outcome of non-invasive ventilation in patients with severe COVID-19 pneumonia. Methodology: A prospective cohort study was conducted at Pak Emirates Military Hospital, Rawalpindi, from 4th June to 30th Dec 2021. This study included 87 patients between the ages of 45 and 75 who were admitted due to severe acute respiratory syndrome coronavirus 2 (SARSCoV2) infection.Infection was confirmed by SARS-COV-2 PCR (polymerase Chain reaction). These patients were symptomatic with radiological evidence consistent with COVID-19 pneumonia requiring non-invasive ventilation (NIV) trial. The primary outcome was to analyze the success and failure of using NIV, the need for invasive ventilation, as well as the mortality rate. SPSS 21 was used to enter and analyze the data. Results: The mean age was 62.89 ±7.55 years. There were 65(74.7%) males and 22(25.3%) females. NIV was successful in 33 (37.9%) patients, while 54 (62.1%) patients required endotracheal intubation (invasive ventilation). Out of these 54 patients, 44 (81.4%) died after intubation. The mean duration of NIV support was observed as 6.2 ± 3.9 days. Conclusion: NIV can prevent intubation in less than half of the patients, according to our findings

Educational needs and awareness of pharmacy and medical students toward Halal medicine

Halal pharmaceuticals are medicines permitted by Shariah law, and refers to medicines that do not contain any parts of animals that are categorised as haram (dogs, pigs, and ones with pointed teeth), alcohol, and other substances/preparations/extraction methods that are prohibited as ‘haram’ under Shariah law.(1

Evaluation of Medication Adherence and its Predictors Among Psychiatric Outpatients at a Mental Healthcare Hospital in Lahore, Pakistan: A Cross-Sectional Study

The study aimed to assess the level of medication adherence among psychiatric outpatients and to determine the main predictors associated with medication non-adherence. A cross sectional study was conducted among 298 psychiatric outpatients at Punjab Institute of Mental Health (PIMH), Lahore, Pakistan. A designed questionnaire was used as data collection tool and adherence was evaluated using MARS (Medication Adherence Rating Scale). Data was analyzed using SPSS version 21.0. Logistic regression was applied to determine the predictors of non-adherence. Medication adherence rate varied from low (39.3%) to high (60.7%) adherence. The impact of demographic factors such as age, gender, diagnosis, employment status and comorbidity on medication adherence were insignificant. Results of chi-square found that marital status, duration of illness from last visit, patient factors, medication factors, disease factors were significantly associated with adherence (p<0.05). Multivariate binary logistic regression indicated that qualification, marital status, number of tablets per day, duration of illness from last visit, patient factors, disease factors were the main predictors of medication non-adherence.&nbsp

Psychometric Properties of the Urdu Version of Diabetes Knowledge Questionnaire

Objective: Patient education is a key element in the treatment of diabetes. Assessment of diabetes knowledge is important for optimum treatment. For the assessment of diabetes knowledge, validated tool is essential. None of such validated tool is available in Urdu language. Therefore, the aim of this study was to translate and examine the psychometric properties of the 24-item Urdu version of Diabetes Knowledge Questionnaire (DKQ) among type 2 diabetes patients. Methods: Standard “forward–backward” process was used to translate DKQ into Urdu language. Later, it was validated on a convenience sample of 130 patients with type 2 diabetes, between July and September 2016. Internal consistency was assessed by reliability analysis, one-way analysis of variance was applied for known group validity and multivariate linear logistic regression was applied for identifying significant predictors for patients’ DKQ score. results: Good internal consistency was observed for DKQ (Cronbach’s α = 0.702). The mean HbA1c of the patients was 8.55% (±1.91). DKQ scores of patients’ with “good glycemic control” (14.22 ± 2.4) were observed significantly higher (P < 0.05) than patients with “poor glycemic control” (12.56 ± 2.75). Multiple linear regression revealed that patients’ HbA1c (OR −0.17, CI −1.111, −0.023) and patients’ education (OR 0.17, CI −0.032, 0.758) were significant predictors for DKQ sum score. conclusion: Urdu version of the DKQ is a valid and reliable instrument for adequate estimation of disease knowledge and its association with glycemic control in type 2 diabetes patients in Pakistan

Uma abordagem baseada em seleçao pelas conseqüencias para aprendizagem de redes neurais multi-camadas voltadas r concepçao de sistemas autômos inteligentes

Orientador : Maurício F. FigueiredoDissertaçao (mestrado) - Universidade Federal do ParanáResumo: Um modelo de rede neural artificial é proposto. A rede neural possui múltiplas camadas. Cada camada da rede neural é formada por uma grade quadrangular de neurônios (em um espaço toroidal). As conexões sinápticas de cada neurônio abrangem três tipos: excitatórias inter-camadas, laterais inibitórias intra-camada e laterais excitatórias intra-camada. A disposição espacial das conexões é do tipo Gaussiana e específica para cada tipo de sinapse. Cada neurônio estabelece um número restrito de conexões. O modelo de arquitetura contribui para eliminar restrições apresentadas por arquiteturas em que entradas e conexões são distribuídas a todos os neurônios de cada camada. O modelo do neurônio apresenta dinâmica interna, proporcionando uma memória da atividade recente e assumindo papel importante na aprendizagem. A aprendizagem ê baseada na seleção pelas conseqüências, conforme princípios de aprendizagem por reforço. Em particular, a de aprendizagem por reforço utilizada é do tipo clássico. Os experimentos definidos para investigação e confirmação das capacidades da rede neural consideram um ambiente simulado, condizente com o modelo de Seleção pelas Conseqüências. Os resultados obtidos em simulações mostram que o modelo é capaz de reproduzir diversos fenômenos comportamentais, que são: aquisição de comportamento respondente, extinção de comportamento respondente, aquisição de comportamento operante, extinção de comportamento operante, capacidade de generalização de estímulos, habilidade no controle da intensidade das respostas, capacidade de controle de múltiplas respostas e fusão de sensores. Experimentos também ilustram o importante papel das conexões laterais inibitórias e das conexões laterais excitatórias na modelagem da formação de grupos neurais em nível operante. Entende-se que a capacidade de aprendizagem alcançada pela rede neural proposta torna-a viável para a concepção de sistemas autônomos inteligentes com potencialidades superiores àqueles divulgados na literatura especializada.Abstract: A model of an artificial neural network is proposed. The neural network has multiple layers. Each network layer is formed by a quadrangular grid of neurons (on a toroidal space). The synaptic connections that every neuron has are defined between tree types: inter-layer excitatory, lateral intra-layer inhibitory and lateral intra-layer excitatory. The spatial disposition of connections is of a Gaussian type and specific for each type of synapse. Each neuron has a limited number of connections. The model contributes to eliminate restrictions presented by other architectures in witch connections are distributed to all of the neurons of each layer. The neuron model presents an internal dynamic, working as a memory of its recent activity and having important role in the learning process. The learning procedure is based on the selection by consequences according to reinforcement learning principles. Particularly the reinforcement learning approach used is of the classical type. The experiments defined for the investigation and confirmation of the capacities of the neural network consider a simulated environment that works according to the Selection by Consequences model. The simulation results show that the model is capable of reproducing several behavioral phenomena that are: acquisition of respondent behavior, extinction of respondent behavior, acquisition of operant behavior, extinction of operant behavior, stimulus generalization capacity, ability to control the response intensity, capacity to control multiple responses and sensor fusion. Besides that, the experiments also illustrate the important role of the lateral inhibitory and lateral excitatory connections for a correct shaping of operant level responses and neural groups. It is understood that the learning capacities that the proposed neural network exhibits make it viable for the conception of intelligent autonomous systems with potentialities superior to those already presented in the specialized literature

Safety of pregabalin among hemodialysis patients suffering from uremic pruritus

AbstractObjectives: The aim of this study was to assess the safety and probability of adverse events associated with the use of 75mg pregabalin post hemodialysis (pHD) among patients with UP. Methods: A cross-sectional study done among the hemodialysis patients suffering from uremic pruritus (UP) Aljaber Kidney Center (AJKC), Al-Ahsa, Eastern Province, Saudi Arabia. Assessment for the safety profile of pregabalin was done using Naranjo’s algorithm. A predictive model was developed using binary multiple logistic regression to explore association of patients’ demographics and risk factors with the occurrence of AEs. Throughout statistical significance level was considered significant at 0.05. Key findings: Assessment of safety of pregabalin revealed that somnolence and dizziness were the two frequent adverse events followed by constipation, weight gain and edema. However, it was noticed that female patients aged less than 50years were found to be at a higher risk in comparison with men. Moreover, those patients having one comorbid complication (i.e. hypertension or diabetes mellitus alone) were at a higher risk of somnolence, weight gain and dry mouth. Conclusion: Naranjo’s quantification for the possibility and probability of adverse events reflect that all the events were probable. Age, gender and comorbid medical conditions are some of the factors that might have clinical association with the occurrence of the AEs