Psoriasis is a chronic inflammatory disease, with multisystemic implications and genetic predisposition, characterized by the development of erythematous, scaling plaques on the skin. Management of moderate to severe psoriasis vulgaris may involve a biological treatment that suppresses the immune system. Because of this, the patients with psoriasis on an immunosuppressive treatment are theoretically at an increased risk of infections, including SARS-CoV- 2 infection. SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is responsible for the current pandemic. In Romania, COVID-19 (Coronavirus Disease 19) was first reported on February 26, 2020, by confirming the first patient with SARS-CoV-2 by RT-PCR method. COVID-19 progression was divided into three phases: early infection, pulmonary phase, and hyperinflammatory phase. Although the inhibition of pro-inflammatory cytokines by biologic therapy is detrimental in the viral phase, it seems to be beneficial in the hyperinflammatory phase, by protecting the patients with psoriasis in progressing towards extra-pulmonary manifestations and death. Analyzing the evolution of the 8 cases of patients from our dermatology department – Colentina Clinical Hospital, with generalized psoriasis vulgaris on biologic immunosuppressive treatment and SARS-CoV-2 infection, we observed that they did not develop a more severe form of COVID-19 than the general population. Patients on biologic immunosuppressive treatment are more susceptible to the development of infections, including by SARS-CoV-2, but it was found that the biologic therapy can protect against a more severe type of COVID-19.
Introduction and Purpose: Tuberculosis is the most common cause of death from infectious diseases in the world. This study aimed to evaluate the findings of chest radiography in patients with pulmonary tuberculosis referred to the Zabol tuberculosis center. Materials and Methods: This descriptive-analytical study was performed on 101 patients with positive tuberculosis from January to December 2020. Data were collected using an information form and finally analyzed by SPSS software version 22. Results: In this study, 101 patients were studied, of which 71 were female and 30 were male, and the mean age of patients was 62.68±13.61 years. The frequency of turbidity in patients with smear grades 1, 2, and 3 was 71.4%, 78.5%, and 76.5%, respectively. The frequency of cavitation in patients with grades 1, 2, and 3 was 11.5%, 28.5%, and 52.9%, respectively. The frequency of nodular view in patients with grades 1, 2, and 3 was 18.6, 42.8, and 35.3%, respectively. Conclusion: In general, the results of this study showed that with increasing smear grading, the frequency of cavitation cases increases significantly and the frequency of reticulonodular view cases decreases significantly.
Background and Aim: All hospital services are carried out to serve the patient, which is the main axis in the hospital. Patient satisfaction can be indicative of the right performance service delivery and is considered a reliable source for evaluating the quality of health care. The present study was conducted to evaluate the satisfaction rate of discharged patients in a Navy hospital. Methods: The descriptive cross-sectional study was performed on 220 discharged patients selected by convenience sampling in a Navy hospital during 2019. The data gathering tool was the Patient Satisfaction Questionnaire designed by Amerioon in 2009 and its validity and reliability were confirmed in 2016. The questionnaire assessed patient satisfaction in two healthcare sections with 21 questions and three dimensions of hygiene, nursing and physician services, and non- health care with 27 questions and six dimensions of acceptance, staff attitudes, nutrition, welfare, facilities, religious issues, and refines evaluation. Data were analyzed by SPSS software version 18. Results: The patient satisfaction in the medical and non-medical wards was 88.1% and 86.57% respectively. Satisfaction in the medical and non-medical wards was excellent at all dimensions. There was a significant relationship between satisfaction with the cause of referral, and level of education (P 0.05). Conclusion: Considering the high level of patients 'satisfaction in medical and non-medical services, patient satisfaction in medical services was slightly higher than that of non-medical services, this highlights the need for independent research in this area and the actions taken by hospital managers to improve satisfaction in these sectors. It is also suggested to consider patient satisfaction as part of the discharge process in all hospitals
Background and aim: Preoperative anxiety and fear of separation from parents are some of the most important preoperative problems for children with deaf muteness. Here, the effect of intravenous administration of ketamine and midazolam was compared on sedation in children who candidates for choral cochlear implantation at the time of separation from parents. Patients and methods: This double-blind, prospective clinical study was performed on 74 children with deaf-muteness before cochlear implantation. Patients were randomly divided into two groups, midazolam (0.1 mg /kg) and ketamine (1 mg/kg). The sedation anxiety score scale (SASS) form was filled in to assess the anxiety and sedation status for each child. The children's relaxation score from recovery was assessed by the PACU sedation score scale (PACUSSS). Results: The average of the children's anxiety score after the injection of both drugs during the separation from their parents was 3, and there was no significant difference in the mean of SASS between the two groups (p>0.05). The mean PACU sedation score scale in both ketamine and midazolam groups was 1.08 ± 0.89 and 1.32 ± 1.01, respectively (p = 0.27). The mean of extubation and recovery times in the ketamine group were 10.44 ± 4.47 and 30.27 ± 6.87, respectively, while the mean extubation and recovery times in the midazolam group were 11.83 ± 3.33 and 29.81 ± 6.31 minutes, respectively. Conclusion: Both ketamine and midazolam caused equal sedation scores in children with deaf muteness at the time of separating from their parents.
The main objective of this study is to investigate the impact of Bamillo website quality on customer loyalty through the mediating role of social capital. This research is applied in terms of purpose and it is a field study in terms of data collection. The population of the study included all users of the Bamilo website who had at least one purchase order from this site. Accordingly, 384 people were selected through available sampling. The instrument used in the research was the standard questionnaire of China et al. (2016), which confirmed the validity and reliability of the questionnaire. Structural equation modeling with the partial least squares method was used to analyze the data. The results showed that the quality of information on-site information quality on cognitive capital was rejected and its impact on structural capital was confirmed. The quality of the site system on cognitive capital is also rejected and its impact on structural capital is confirmed. On the other hand, the quality of site services has an impact on cognitive capital and structural capital. Also, cognitive capital and communication capital affect communication capital, and cognitive capital and communication capital affect customer loyalty. However, the impact of the capitalist mediation mediated the relationship between information quality and system quality with customer loyalty. Cognitive capital also mediates the relationship between service quality and customer loyalty, and structural capital mediates the relationship between information quality and customer loyalty. On the other hand, the mediating role of structural capital in the relationship between system quality and customer loyalty was confirmed and structural capital mediated the relationship between service quality and customer loyalty.
Psoriasis is a chronic, immune-mediated inflammatory disease that significantly affects a patient’s quality of life. Several systemic complications can influence disease progression and response to treatment. Biological therapy is considered the most effective therapeutic option in treating moderate to severe forms of psoriasis. The success of therapy may depend on its persistence, also known as drug survival. The dermatologist needs to be aware of comorbidities and factors that influence the persistence or discontinuation of biological treatment to make appropriate treatment decisions. We have identified several studies on the persistence of biologic therapy or drug survival in patients with psoriasis and summarized some of the most important issues known to date. In several recently published studies, the survival of ustekinumab is better than TNF‐α inhibitors but lower than ixekizumab. Notably, the studies were performed on a limited number of patients and follow-up time. Moreover, secukinumab appears to have a shorter drug survival than other biological agents, especially in patients with biological experience. A real indicator of therapeutic success could be a high quality of life. Female gender and obesity have been consistently highlighted among the predictors of treatment discontinuation, while psoriatic arthritis could be a predictor of persistence and maintenance of biological therapy. We are currently aiming to improve the therapy for patients treated with biological agents to reduce the pressure on the national public health system.
Antibiotic resistance has been reported as one of the world's most critical public health problems. Recent investigations have demonstrated that the venom of some species of snakes has antimicrobial and anticancer activities. The purpose of this study was to examine the antibacterial activity of Persian horned viper venom toward Escherichia coli, Bacillus subtilis, and Staphylococcus aureus bacteria and also investigate antitumor effects of concentrations of venom with higher antibacterial activity in a human hepatocellular liver carcinoma cell line (HepG2) to evaluate the potential use of its components as antimicrobial and anticancer agents. Bactericidal activity of crude venom in concentrations of 6.25-400 μg/ml was performed using MTT reduction, minimum inhibitory concentration (MIC), agar- well diffusion, and disc diffusion methods. Tetracycline (50 μg/ml) was used as a standard antibiotic. Cytotoxic effect in HepG2 cells was measured by MTT reduction assay and confirmed with neutral uptake assay following exposure of cells with different concentrations of venom (50-400 μg/ml). The apoptotic effect was investigated using the comet assay. Our findings demonstrated that venom displays higher inhibitory effects against Gram-positive bacteria as compared to Gram- negative. Furthermore, venom showed anticancer activity on the HepG2 cell line through induction of apoptosis and necrosis. The results of this study confirmed that the venom of Persian horned viper induces antibacterial and anticancer effects. These properties make the venom of this viper a potential source for isolation of effective molecule(s) having antibacterial and antitumor activity.
This study aims to analyze the 25-hydroxyvitamin D (25OHD) corelations with TRab (anti-TSH receptor Antibodies) at baseline and after corections of 25OHD deficit. Method: Prospective, interventional, controled, single-centre, clinical study on 62 patients with active Basedow disease (BD), admitted at C.I. Parhon National Institute of Endocrinology, Bucharest, Romania, between 2013 and 2020. Patients were divided into two groups: one group (N=37) received 2000 IU of daily cholecalciferol and a second one (N=25) without vitamin D supplementation, all subjects being under anti-thyroid drugs (standard guideline therapy). 25OHD and TRab levels were assessed at start and after 6, respective 12 months. Results: Initial evaluation confirmed vitamin D deficiency (mean 25OHD of 18.33±6.45 ng/mL). At start, TRab negatively correlates with 25OHD (N=62, r= -0.22, p=0.08). The decrease in TRab was statistically significant higher in group 1 versus group 2 after 6 months (35.84% versus 3.53%, p=0.03). After 12 months, TRab decreased with 56.28% in group 1, respective 27.16% in group 2 (p=0.03). In group 1, inverse correlation between 25OHD and TRab was consistent at 6 and 12 months. Conclusion: In patients with active BD, TRab values were negatively correlated with 25OHD at baseline and during follow-up. Correction of vitamin D deficiency is correlated with the decrease of TRab levels.
The diagnosis in Carpian tunnel syndrom is based on clinical symptoms and electrodiagnostic studies. Electrodiagnostic studies help to stage both motor and sensory nerve damage.
Posttraumatic stress disorder (PTSD) is a psychological-psychiatric state caused by exposure to stressful, traumatic events that manifests as a vivid reminiscence of them by flashbacks, nightmares, reccurent memories, emotional and physical manifestations. Cardiovascular diseases (CVD) are of interest in patients suffering from PTSD because there is an increasing body of evidence that these pathologies are linked. Hypertension, dyslipidemia, diabetes, and other cardiovascular risk factors are common in patients with PTSD and all of them increase the incidence of coronary syndromes, both chronic and acute. Posttraumatic stress disorder has a major impact on the lifestyle and health of subjects exposed to trauma or stress. Cardiovascular diseases tend to appear sooner in PTSD diagnosed patients due to a variety of reasons: poor habits, low addressability to health care systems, chronic inflammation status, changes at molecular levels, etc. Otherwise, PTSD tends to be induced by CVD, thus inclining the balance towards whis association. According with data published until now, there is a strong pathophysiologic relatonship between PTSD and some CVD; there is also outlining a vice versa relationship, from some CVD to PTSD.
