International journal of clinical practice
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Vaginal intraepithelial neoplasia (VaIN) is a rare disease of the lower genital tract, strongly associated with HPV infection, which may progress to vaginal carcinoma. ⋯ The choice of treatment depends upon many factors. Surgical excision is the mainstay of treatment and should be performed if invasion cannot be excluded. Topical agents are useful for persistent, multifocal lesions or for women that cannot undergo surgical treatment. Brachytherapy is associated with high morbidity rates and should be reserved for women who have multifocal disease, are poor surgical candidates and/or have failed other treatments. CO2 laser ablation achieves minimal scarring and sexual dysfunction; however, invasive disease should be ruled out with biopsies before the initiation of the treatment.
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Int. J. Clin. Pract. · Nov 2020
Multicenter StudyInter-hospital Variation in Surgical Intensity for Trauma Admissions: A Multicenter Cohort Study.
Guidelines for injury care are increasingly moving away from surgical management towards less invasive procedures but there is a knowledge gap on how these recommendations are influencing practice. We aimed to assess inter-hospital variation in surgical intensity for injury admissions and evaluate the correlation between hospital surgical intensity and mortality/complications. ⋯ Results should be interpreted with caution as they may be a result of residual confounding. However, they may suggest that there are opportunities for quality improvement in surgical care for injury admissions, particularly for orthopaedic injuries. Moving forward, we should aim to prospectively evaluate adherence to guidelines on non-operative management and their impact on mortality and morbidity.
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Int. J. Clin. Pract. · Nov 2020
ReviewAre patient expectations associated with treatment outcomes in individuals with chronic low back pain? A systematic review of randomised controlled trials.
The importance of patient expectations (PEs) on treatment outcomes is poorly understood in clinical practice. The aim of this review is to investigate the evidence behind association between pre-treatment PEs and treatment outcomes such as pain intensity (PI), level of function (LF) and health-related quality of life (HRQoL) among individuals with chronic low back pain (CLBP). ⋯ PEs is associated with PI at short and long terms. Also, evidence suggests association between PEs and LF at medium and long terms. Currently, there is no evidence of association between PEs and HRQoL. Further studies with valid tools to measure PE are warranted among individuals with CLBP.
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Int. J. Clin. Pract. · Nov 2020
Knowledge, Attitude, Perception and Practice of Antibiotics Usage Among the Pharmacy Students.
Resistance to antibiotics causes negative impact on health of the patients. Antibiotic resistance is the major global concern that has to be nullified for the better health outcome. The knowledge on antibiotics is very essential for the students who undertake pharmacy and health science courses. Hence a study was aimed to assess the level of knowledge, attitude, perception and practice on antibiotics usage among the pharmacy students of King Khalid University, KSA. ⋯ The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.
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Int. J. Clin. Pract. · Nov 2020
ReviewInstruments to assess self-efficacy among people with cardiovascular disease: A COSMIN systematic review.
Self-efficacy plays an important role in recovery. There is a need for valid tools that can assess self-efficacy in cardiovascular diseases to provide evidence-based practices. ⋯ The Self-Efficacy Expectations After Implantable Cardioverter Defibrillator Implantation Scale is categorised as A and is recommended as the most suitable instrument. All other the four instruments categorised as B with potential to be recommended should be evaluated with further psychometric studies.