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31.
Mohd. Aamir Kundan Mittal Jaya Shankar Kaushik Haripal Kashyap Gurpreet Kaur 《Indian journal of pediatrics》2014,81(11):1167-1170
Objective
To determine the sociodemographic and clinical factors leading to stress among parents whose children are admitted in pediatric intensive care unit (PICU).Methods
A prospective observational study was conducted in PICU of a tertiary care hospital of north India. Parents of children admitted to PICU for at least 48 h duration were eligible for participation. At the end of 48 h, parental stress was assessed using parental stress scale (PSS:PICU) questionnaire which was administered to the parents. Baseline demographic and clinical parameters of children admitted to PICU were recorded. The parental stress was compared with demographic and clinical characteristics of children using appropriate statistical methods.Results
A total of 49 parents were finally eligible for participation. Mean (SD) parental stress scores was highest in domains of procedures [1.52 (0.66)] and behavior and emotional [1.32 (0.42)] subscales. Mean (SD) total parental stress score among intubated children [1.31 (0.25)] was significantly more than among non intubated children [0.97 (0.26)] (p?0.001). However, parental stress score were comparable in terms of gender (p?=?0.15) and socioeconomic status (p?=?0.32). On subscale analysis, it was found that professional communication is a significant stressor in age groups 0–12 mo [0.61(0.41)] (p?=?0.02). It was observed that parents of intubated children were significantly stressed by the physical appearance of their children (p?0.001), procedures performed on them (p?=?0.008) and impairment in parental role (p?=?0.002). Total parental stress score had a positive correlation with PRISM score (r?=?0.308).Conclusions
Indian parents are stressed maximally with environment of PICU. Factor leading to parental stress was intubation status of the child and was not affected by gender or socio demographic profile of the parents. 相似文献32.
33.
We report the case of an 85-year-old male with platypnoea-orthodeoxia associated with patent foramen ovale (PFO) and ectatic ascending aorta, in the absence of any significant pulmonary pathology. 相似文献
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Amina Asghar Muhammad Yousuf Ghulam Fareed Rabia Nazir Abida Hassan Aneela Maalik Tayyaba Noor Naseem Iqbal Lubna Rasheed 《RSC advances》2020,10(33):19346
Synthesis of a compound with balanced bioactivities against a specific target is always a challenging task. In this study, a novel compound (1) has been synthesized by combination of flurbiprofen and isoniazide and shows ∼2.5 times enhanced acetylcholinesterase (AChE) inhibition activity and ∼1.7 times improved butyrylcholinesterase (BuChE) inhibition activity compared to flurbiprofen and a standard drug (i.e. physostigmine). A comparative AutoDock study has been performed, based on the optimized structure, by the DFT/B3LYP method, which confirmed that compound (1) is more active against AChE and BuChE, with calculated binding energies of −12.9 kcal mol−1 and −9.8 kcal mol−1 respectively as compared to flurbiprofen and an eserine (physostigmine) standard for which the binding energy was calculated to be −10.1 kcal mol−1 and −8.9 kcal mol−1, respectively. A mixed mode of inhibition of AChE and BuChE with compound 1 was confirmed by Lineweaver–Burk plots. AChE and BuChE inhibition activity alongside docking results suggests that compound (1) could be used for treatment of Alzheimer''s disease. Moreover, compound (1) also exhibit better α-chymotrypsin activity compared to flurbiprofen. Furthermore, in vitro and in vivo analysis confirmed that compound (1) exhibit more activity and less toxicity than the parent compounds.A novel compound (1) shows ∼2.5 and ∼1.7 times enhanced AChE inhibition activity and BuChE inhibition activity respectively compared to flurbiprofen and standard drug (i.e. physostigmine). It has also been confirmed by comparative AutoDock studies. 相似文献
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Now how do we get them home? Outpatient care of pediatric patients on mechanical circulatory support
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Jennifer Conway Christina VanderPluym Aamir Jeewa Selvi Sinnadurai Amanda Schubert Angela Lorts 《Pediatric transplantation》2016,20(2):194-202
The last five yr have been monumental for the pediatric heart failure community. In the US, the most notable has been the FDA approval of the first pediatric specific device (Berlin Heart EXCOR®; Berlin Heart, Inc., Berlin, Germany). Subsequently, the field of heart failure has gained a great deal of knowledge regarding the nuances of MCS in children. Despite FDA approval in the US, the Berlin EXCOR® is only currently indicated for in‐hospital use. Due to the limitations with discharge and the positive in‐ hospital experiences with the Berlin EXCOR®, there has been an increased interest in the implantation of adult durable devices into children. While many institutions have focused their intial efforts on the first phase of care within the hospital, they are now ready to tackle the challenge of how to safely transition children to the community setting. 相似文献
39.
Javariya Aamir Syed Mustafa Ali Maged N. Kamel Boulos Naveed Anjum Muhammad Ishaq 《Health Policy and Technology》2018,7(1):88-97
Objective
The objective of this review is to identify enabling and inhibiting factors for mHealth adoption in low resource settings, by giving emphasis on the stakeholders representing the caregiving side. Another objective of this study is to support implementation agencies (governmental and non-governmental) in designing scalable mHealth interventions.Methods
A PEO (Population, Exposure, Outcome) approach was used to formulate the review question. A pre-defined search strategy was implemented; Google Scholar, PubMed and gray literature were searched using alternate terms for “mHealth”, “adoption” and “developing countries”. CASP [7] tools were used to assess the quality of selected evidence. After applying inclusion and exclusion criteria on search results and critical appraisal of the selected evidence, twelve studies were selected for the review.Results
Adoption factors operated at the levels of organization, facility-based service provider and frontline health worker. Engagement of end users during design phase, informed clinical decision making, utilization of mHealth evidence, employers’ tolerance of some personal use of devices, automation of tasks and user-friendliness of application are key enabling factors for mHealth adoption in developing countries. On the contrary, absence of national policy on mHealth, poor knowledge base on mHealth, using two systems in parallel, duplication of efforts, poor Internet connectivity and shortage of electricity are important inhibiting factors for mHealth adoption.Conclusions
The review provides an insight about the challenges and opportunities related to mHealth adoption in developing countries. Implementation agencies should give careful consideration to these factors before designing and deploying any mHealth-enabled intervention. It is also important to understand the concept of incremental innovation so that resources spent on pilot interventions are optimized and full potential is achieved. 相似文献40.
Gaurav Gupta Idris Yakubu Chandra S. Bhati Yiran Zhang Le Kang Julie A. Patterson Ayana Andrews‐Joseph Anam Alam Andrea Ferreira‐Gonzalez Dhiren Kumar Irfan K. Moinuddin Layla Kamal Anne L. King Marlon Levy Amit Sharma Adrian Cotterell Trevor W. Reichman Aamir Khan Pamela Kimball Rodney Stiltner Mary Baldecchi Nathaniel Brigle Todd Gehr Richard K. Sterling 《American journal of transplantation》2020,20(3):739-751
We conducted an adaptive design single‐center pilot trial between October 2017 and November 2018 to determine the safety and efficacy of ultra‐short‐term perioperative pangenotypic direct acting antiviral (DAA) prophylaxis for deceased hepatitis C virus (HCV)‐nucleic acid test (NAT) positive donors to HCV negative kidney recipients (D+/R?). In Group 1, 10 patients received one dose of SOF/VEL (sofusbuvir/velpatasvir) pretransplant and one dose on posttransplant Day 1. In Group 2A (N = 15) and the posttrial validation (Group 2B; N = 25) phase, patients received two additional SOF/VEL doses (total 4) on Days 2 and 3 posttransplant. Development of posttransplant HCV transmission triggered 12‐week DAA therapy. For available donor samples (N = 27), median donor viral load was 1.37E + 06 IU/mL (genotype [GT]1a: 70%; GT2: 7%; GT3: 23%). Overall viral transmission rate was 12% (6/50; Group 1:30% [3/10]; Group 2A:13% [2/15]; Group 2B:4% [1/25]). For the 6 viremic patients, 5 (83%) achieved sustained virologic response (3 with first‐line DAA therapy; and two after retreatment with second‐line DAA). At a median follow‐up of 8 months posttransplant, overall patient and allograft survivals were 98%, respectively. The 4‐day strategy reduced viral transmission to 7.5% (3/40; 95% confidence interval [CI]: 1.8%‐20.5%) and could result in avoidance of prolonged posttransplant DAA therapy for most D+/R ? transplants. 相似文献