Objectives: This study determined the current awareness and knowledge among physicians about biosimilars in Saudi Arabia. Methods: This study used a cross-sectional study design and data were ...acquired by the convenience sampling method. The research tool was self-developed, prevalidated and self-administered to achieve the sample size. The physicians from various parts of the country participated in the study. Both, inferential statistics with the help of descriptive statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0 and Microsoft Excel. A p-value <0.05 was considered statistically significant. Results: A total of 105 practicing physicians throughout the country participated in the study. The majority of the participants were well informed and had adequate knowledge and awareness about numerous aspects of biosimilars except for the local healthcare policies and payer policies, where around half of them very aware of them. Statistically, a non-significant association (p-value >0.05) was observed. Conclusion: It is concluded that the study physicians had adequate knowledge and awareness about biosimilars in Saudi Arabia. Statistically, a non-significant association (p <0.05) was observed between adequate and inadequate knowledge among the studied physicians in Saudi Arabia.
Background
Residents have limited time and much to learn. Retrieval practice—studying using exam-style review questions—is a powerful educational tool for aggregate groups of learners, but it has not ...been tested for individual graduate medical education (GME) trainees.
Methods
We conducted a retrospective observational study examining how individual residents’ self-directed retrieval practice affected their learning. We used linear regression models to compare the number of exam-style multiple-choice practice questions each resident answered per year to their scores on annual In-Training Exams (ITE).
Results
We found that the higher a resident’s ITE score was at the start of a year, the fewer practice questions they answered that year for both first- (
p
= 0.023) and second-year (
p
= 0.020) trainees. Then, the more questions a resident answered in a year, the more their ITE score increased over that year for both first- and second-year trainees (
p
= 0.026 and 0.025, respectively). Residents’ prior ITE scores also independently predicted their subsequent ITE scores (
p
= 0.024 in the first and 0.007 in the second year), and the effect of their baseline scores was larger than the effect of the number of practice questions they answered.
Conclusions
Individual residents’ prior exam scores significantly predict their future exam scores, and their independent retrieval practice using exam-style review questions also significantly predicts the annual improvement in their scores. These findings add to the growing evidence supporting retrieval practice in GME, and they can inform individualized educational coaching for GME trainees.
Gastric carcinoma represents the second most common type of malignancy that contributes to cancer-related mortality worldwide. However, the geographic incidence of gastric carcinoma had changed over ...the last few decades, possibly due to increased hygiene, increased awareness of the importance of healthy nutrition, and increased rates of eradication of Helicobacter pylori infection. Gastric carcinoma consists of two pathological variants, intestinal and diffuse. Early cases of gastric carcinoma may be asymptomatic. However, advanced cases may present with significant weight loss, dysphagia, abdominal pain, vomiting, and even severe upper gastrointestinal bleeding. Patients at high risk of developing gastric carcinoma should be adequately screened at primary healthcare centers for early detection and effective management. Lines of treatment vary according to the stage of the disease but surgical resection of the tumor with regional lymphadenectomy remains the gold standard of therapy. This review sheds light on gastric carcinoma given the recent trends regarding its prevalence, risk factors, types, clinical picture, methods of diagnosis, possible lines of management, and the role of primary care.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Melanoma remains the most lethal form of skin cancer and most challenging to treat despite advances in the oncology field. Our work describes the utilization of nanotechnology to target melanoma ...locally in an attempt to provide an advanced and efficient quality of therapy. Amino-functionalized mesoporous silica nanoparticles (MSN-NH2) were developed in situ through the utilization of anionic surfactant and different volumes of 3-aminopropyltriethoxysilane (APTES) as a co-structure directing agent (CSDA). Prepared particles were characterized for their morphology, particles size, 5-flurouracol (5-FU) and dexamethasone (DEX) loading capacity and release, skin penetration, and cytotoxicity in vitro in HT-144 melanoma cells. Results of transmission electron microscopy (TEM) and nitrogen adsorption–desorption isotherm showed that using different volumes of APTES during the functionalization process had an impact on the internal and external morphology of the particles, as well as particle size. However, changing the volume of APTES did not affect the diameter of formed mesochannels, which was about 4 nm. MSN-NH2 showed a relatively high loading capacity of 5-FU (12.6 ± 5.5) and DEX (44.72 ± 4.21) when using drug: MSN-NH2 ratios of 5:1 for both drugs. The release profile showed that around 83% of 5-FU and 21% of DEX were released over 48 h in pH 7.4. The skin permeability study revealed that enhancement ratio of 5-Fu and DEX using MSN-NH2 were 4.67 and 5.68, respectively, relative to their free drugs counterparts. In addition, the accumulation of drugs in skin layers where melanoma cells usually reside were enhanced approximately 10 times with 5-FU and 5 times with DEX when delivering drugs using MSN-NH2 compared to control. MSN-NH2 alone was nontoxic to melanoma cells when incubated for 48 h in the range of 0 to 468 µg/mL. The combination of 5-FU MSN-NH2 and DEX MSN-NH2 showed significant increase in toxicity compared to their free dug counterparts and exhibited a synergetic effect as well as the ability to circumvent DEX induced 5-FU resistance in melanoma cells.
The AcPase exhibits a specific activity of 31.32 U/mg of protein with a 728-fold purification, and the yield of the enzyme is raised to 3.15 %. The Zn2+-dependent AcPase showed a purification factor ...of 1.34 specific activity of 14 U/mg of proteins and a total recovery of 5.14. The SDS-PAGE showed a single band corresponding to a molecular weight of 18 kDa of AcPase and 29 kDa of Zn2+-dependent AcPase. The AcPase enzyme has shown a wide range of substrate specificity for p-NPP, phenyl phosphate and FMN, while in the case of ZnAcPase α and β-Naphthyl phosphate and p-NPP were proved to be superior substrates. The divalent metal ions like Mg2+, Mn2+, and Ca2+ increased the activity, while other substrates decreased the enzyme activity. The Km (0.14 mM) and Vmax (21 μmol/min/mg) values of AcPase were higher than those of Zn2+-AcPase (Km = 0.5 mM; Vmax = 9.7 μmol/min/mg). The Zn2+ ions activate the Zn2+-AcPase while Fe3+, Al3+, Pb2+, and Hg2+ showed inhibition on enzyme activity. Molybdate, vanadate and phosphate were found to be competitive inhibitors of AcPase with Ki values 316 μM, 185 μM, and 1.6 mM, while in Zn2+-AcPase tartrate and phosphate also showed competitive inhibition with Ki values 3 mM and 0.5 mM respectively.
•A novel Acid phosphatases and zinc dependent acid phosphatases were purified from chicken’s brain.•AcPase and zinc-dependent AcPase showed a single protein band on SDS-PAGE corresponding to molecular weights of about 18 kDa and 29 kDa.•The Acid phosphatase and zinc dependent AcPases were optimally active at 45 °C pH 6.0.•The Km of zinc-dependent AcPase and AcPase has been determined to be 0.5 mM and 0.14 mM, respectively. The Vmax 7 μmol/min/mg of protein and 21 μmol/min/mg of protein.
Medication-induced gingival hyperplasia (MIGH) has been linked to several medications, with a reported prevalence ranging between 0.5% and 85%. The aim of this study was to systematically review the ...management approaches for MIGH and estimate recurrence rate and time to relapse.
An electronic literature search was conducted using PICO questions (P = patients with medication-induced gingival hyperplasia; I = surgical and/or nonsurgical treatment options; C = no control is required; and O = partial or complete resolution and recurrence) and medical subject heading terms in the PubMed and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol up to December 2019. All English-language articles on MIGH surgical and nonsurgical management options were included. Eligible articles were systematically reviewed and assessed for bias using preset criteria and multiple levels of elimination. Data were extracted from eligible studies and analyzed.
Twenty-two eligible articles were included in this study. Management approaches included discontinuation or change of the offending medication if medically feasible in addition to surgical and nonsurgical interventions. Nonsurgical approach included scaling and root planing, oral hygiene instructions, and antimicrobial mouthrinses. Persistent or relapsed cases had complete resolution with excision of hyperplastic gingiva. Laser-assisted surgeries combined with intensive plaque control measures demonstrated less risk of recurrence.
Several treatment options for MIGH have been reported with variable outcomes. Duration and size of hyperplastic gingival tissue may have an effect on overall recurrence rate.
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