The Libyan journal of medicine
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Introduction: Clostridioides difficile (C. difficile) infection (CDI) is one of the most common healthcare-associated (HA) infections in contemporary medicine. The risk factors (RFs) for HA CDI in medical and surgical patients are poorly investigated in countries with a limited resource healthcare system. Therefore, the aim of the study was to investigate differences in patients' characteristics, factors related to healthcare and outcomes associated with HA CDI in surgical and medical patients in tertiary healthcare centre in Serbia. ⋯ Results: During 7-year period, from 553 patients undergoing in-hospital treatment and diagnosed with CDI, 268 (48.5%) and 285 (51.5%) were surgical and medical patients, respectively. Age ≥ 65 years, use of proton pump inhibitors, chemotherapy and fluoroquinolones were positively associated with being in medical group, whereas admission to intensive care unit and use of second- and third-generation cephalosporins were positively associated with being in surgical group. Conclusions: Based on obtained results, including significant differences in 30-day mortality and in-hospital mortality, it can be concluded that medical patient were more endangered with HA CDI than surgical ones.
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Doing research when resources are severely limited will always be challenging. But by sharing resources, collaborating internationally as well as locally, developing sustainable research lines and optimizing study concept and design, researchers can significantly increase their research output and enhance its quality.
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There is an extensive body of research about chronic pain and treatment in developed countries. In contrast there is a lack of research on this topic in developing countries including China. This study was aimed to estimate the prevalence of chronic pain in different regions of China. ⋯ The location of pain was focused on back and upper limb. There has been a lack of proper treatment. Patients with pain had obvious economic burden, and their quality of life and psychology were significantly affected.
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In spite of the relatively high morbidity and mortality, there is no approved medication yet for COVID-19. There are more than 200 ongoing trials on different drugs or vaccines, but new medications may take until 2021 to develop. Defining the optimal number of patients to be included in a study is a considerable challenge in these interventional researches. ⋯ Sequential analysis has not been frequently used in many clinical trials where it should have been used. None of the authors in published literature, as far as we know, used sequential analysis techniques to test potential drugs for COVID-19. In addition to its usefulness when the results of new forms of treatment are quickly needed, other important benefit of sequential analysis includes the ability to reach a similar conclusion about the utility of a new drug without unduly exposing more patients to the side effect of the old drug, in particularly, for the treatment of a rare disease.
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The aim of this study was to assess if ureaplasmas are associated with pregnancy complications and diseases in newborns. Pregnant women with complaints and threatening signs of preterm delivery were included. A sample, taken from the endocervical canal and from the surface of the cervical portion, was sent to the local microbiology laboratory for DNA detection of seven pathogens: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, Ureaplasma urealyticum, Neisseria gonorrhoeae, and Trichomonas vaginalis. ⋯ Premature rupture of uterine membranes was found in 23 (46%) of the patients and 38 women (76%) had preterm delivery. Ureaplasma infections were associated with a premature rupture of membranes (p < 0.004), the placental inflammation (p < 0.025), a newborn respiratory distress syndrome (p < 0.019). Ureaplasmas could have affected the preterm leakage of fetal amniotic fluid and are associated with the placental inflammation and a newborn respiratory distress syndrome.