Pattersoncarstensen7751

The pooled proportion of GERD (random-effects model) was 15.573 (95% CI 11.046 to 20.714). In the meta-regression model, sample size (p= 0.005) explained about 50% of the heterogeneity.

The pooled prevalence of GERD in the Indian population is 15.6 (95% CI 11.046 to 20.714). The risk factors were age, body mass index (BMI), non-vegetarian diet, tea/coffee intake, tobacco, and alcohol consumption. However, there was significant heterogeneity in the studies.

The pooled prevalence of GERD in the Indian population is 15.6 (95% CI 11.046 to 20.714). The risk factors were age, body mass index (BMI), non-vegetarian diet, tea/coffee intake, tobacco, and alcohol consumption. However, there was significant heterogeneity in the studies.

Therapeutic plasma exchange (TPE) has been utilized in various liver disorders. There is limited data on the efficacy of TPE in patients with acute liver failure (ALF).

Study group consisted of patients who underwent TPE for ALF due to yellow phosphorous poisoning (YPP) between 2015 and 2019. Demographic data and biochemical parameters were recorded before and after TPE. Overall survival and transplant-free survival (based on King's College Hospital Criteria [KCHC]) were analyzed.

Forty-three patients underwent TPE for ALF due to YPP. Most of them were young males. Overall survival was 34 (79.06%). In our study population, 20 patients fulfilled KCHC (GroupA) and 23 did not fulfill KCHC (GroupB). Both the groups showed significant improvement in alanine aminotransferase, aspartate aminotransferase, and international normalized ratio (INR) after TPE (p< 0.05). In Group B, there was significant improvement in ammonia after TPE (p< 0.05) and all 23 patients (100%) survived after TPE. In Group A, 4 underwent liver transplantation (LT), 7 survived without LT, and the remaining 9 died without LT. Mean survival after completing TPE was 41.2 ± 44.5days in Group A and 90days in Group B. This difference was statistically significant (p= 0.001). There was statistically significant difference in post-TPE values of INR (p= 0.012) and ammonia (p= 0.011) between non-survivors and survivors. Adverse events such as hypotension (11.62%) and minor allergic reaction (4.65%) were managed conservatively.

TPE is an effective procedure in ALF due to YPP, not fulfilling KCHC for LT. In KCHC fulfilled group, though it shows LT-free survival benefit, there is requirement of prospective, large volume, multi-center study to assess its efficacy.

TPE is an effective procedure in ALF due to YPP, not fulfilling KCHC for LT. In KCHC fulfilled group, though it shows LT-free survival benefit, there is requirement of prospective, large volume, multi-center study to assess its efficacy.It is known that estrogen deficiency increases osteoclast formation and activity. Autophagy, a cell survival pathway, has been shown to be crucial for osteoclast function. However, little is known about the effects of estrogen depletion on osteoclast autophagy. Here, we evaluated the effects of estrogen deficiency in the immunoexpression of autophagy mediators in alveolar bone osteoclasts of ovariectomized rats. Twelve adult female rats were ovariectomized (OVX-group) or SHAM-operated (SHAM-group). After three weeks, the rats were euthanized and maxillary fragments containing alveolar bone of the first molars were processed for light microscopy or transmission electron microscopy (TEM). Paraffin-sections were subjected to the TRAP method (osteoclast marker) or to the immunohistochemical detections of beclin-1, LC3α, and p62 (autophagy mediators); araldite-sections were processed for TEM. The number of TRAP-positive osteoclasts and the number of immunolabeled-multinucleated cells (MNCs) along the alveolar bone surface of the first molar were computed. The number of TRAP-positive osteoclasts and the number of beclin-1-, LC3α- and p62-immunolabelled osteoclasts were significantly higher in OVX-group than the SHAM-group. MNCs were frequently located juxtaposed to Howship lacunae along the alveolar bone surface, indicating that these cells are osteoclasts. TEM revealed osteoclasts exhibiting autophagosomes. Our data indicate that autophagy plays an important role during estrogen deficiency-induced osteoclastogenesis. Thus, our results contribute to a better understanding on the role of autophagy on osteoclasts under estrogenic deficiency, and reinforce the idea that modulation of autophagy may be a useful tool to inhibit excessive oral bone resorption in post-menopausal women.

Doctors in training, especially psychiatrists, are at high risk of depression and burnout, which have been linked to increased medical errors. This study looks at prevalence and risk factors of depression and perceived stress among psychiatry residents in Singapore.

An anonymous online questionnaire was completed by 65.3% (47/72) of residents, which included the Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale (PSS), and 2 burnout screening questions. They were asked if they were concerned about making a medical error.

Majority of residents (70.2%) slept 6-8h/night, while 55.3% worked <60h/week. Based on PHQ-9 score ≥10, 38.3% had depression. Depression was associated with sleeping <6h/night (OR 13.62, 2.96-62.6; p=0.0008) and working ≥60h/week (OR 3.8, 1.096-13.18; p=0.035). Six residents (12.8%) endorsed suicidal ideation. The mean score on the PSS scale was 23.89±1.95. see more Higher PSS scores were associated with sleeping <6h/night (OR 4.92, 1.51-8.33; p=0.007). One third of residents (34%) reported feeling burnt out fairly or very often. Residents who slept <6h/night were more likely to report feeling burnt out (OR 6.69, 1.69-26.45; p=0.0068). PHQ scores correlated highly with PSS scores and burnout measures. Self-perceived medical errors were associated with depressive symptoms, suicidal thoughts, and <6h/night of sleep.

Less sleep and longer working hours were associated with higher risk of depression, suicidality, stress, and perceived medical errors in Singapore psychiatry residents. It is important to address depression and stress as it can affect physician well-being and patient care.

Less sleep and longer working hours were associated with higher risk of depression, suicidality, stress, and perceived medical errors in Singapore psychiatry residents. It is important to address depression and stress as it can affect physician well-being and patient care.