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Background: Deep Venous Thrombosis (DVT) and subsequent Pulmonary Embolism (PE) are one of the mosteminent causes of preventable deaths in nosocomial settings. The prevalence is increasing and they have variableclinical presentations encountered in community settings as well as hospitalized patients requiring timely andobligatory prophylaxis. Objective: This study aims to review prophylactic measures for deep venousthrombosis/pulmonary embolism highlighting implemented pharmacologic and mechanical interventions, newerand yet investigational techniques such as neuromuscular electrical stimulation towards reducing prevalence ofvenous thromboembolism. Materials and Methods: A review of relevant articles published between the years of2000 to 2019 in English language was done using the databases of PubMed Pico, Google Scholar and Google,using the predetermined keywords. Conclusion: Venous thromboembolism prevalence is increasing and amongthe various available methods for thromboprophylaxis, pharmacologic approach is the most superior whichinvolves making use of either unfractioned or low molecular weight heparin although the most efficacious is lowmolecular weight heparin as evidenced by several meta-analyses. Anticoagulants have numerous side effectsleading to limitations of their use and in such situations, mechanical methods such as intermittent pneumaticcompression (most effective), graduated compression stockings, and venous foot pump scan can be used. Incircumstances where both medicines and mechanical approach become impractical, neuromuscular electricalstimulation can be implemented even though additional research is required to further elucidate its efficacy andimplications.
RESUMO
Background: Informed consent has become a vital factor for the clinical treatment of modern practice in the medical field, it is participating in legal, ethical and administrative compliance side. However, informed consent is variably applicable and rarely fulfills its theoretical ideal. Disclosure of adequate information is very important before signing informed consent. It is important to make patient enable to take a proper decision with good knowledge about his/her case. Informed consent for the surgical procedure is consent that taken from the patient before surgical operations and invasive procedures after explaining advantages and disadvantages. Getting patient's signature for the consent of operations and the surgical procedure is surgeon's job. The opinion of the surgeon about informed consent is important, as that may affect the performance of surgeon in explaining procedure with its risks and benefits
Aim: Assessment of knowledge, opinion, and attitude of surgeons towards informed consents. Find out how to improve the quality of informed consent from surgeons' suggestions
Method: This cross-sectional study is questionnaire-based study. Our target was to reach many surgeons in Saudi Arabia with different specialties, different status and from different hospitals. We take our sample using random sampling technique. We selected surgeons from each hospital that our data collector can reach and enter easily. Collection of data was done by interview. Our questionnaire contained four parts in addition to demographic data part. The first part was asking about surgeons' opinions regarding informed surgical consent process. The second part was responsible for inquire about obtaining informed surgical consent. The third part is about the refusal to sign informed surgical consent. Last part is to ask about surgeons' suggestions to improve informed surgical consent
Result: Total number of respondents was 140 [Response rate is 93.3%]. Around 34% of participants agreed that surgeons don't give adequate information about the surgical procedure. 33.6% insisted to know about their surgery. After asking each surgeon about the importance of informed surgical consent they selected the following answers in descending order; informing patients about advantages, hazards and alternatives [81.4%], Medico-legal importance [79.3%], decision taking about procedure [72.1%], hospital policy [50.7%] and surgical tradition [19.3%]. Most of the doctors [85%] complained that sometimes, their patients refused to sign consent. Fear was the most common cause of singing consent refusal according to opinions of 62.9% of surgeons
Conclusion: Surgeons in Saudi Arabia have acceptable knowledge about informed surgical consent and how to obtain it. But still there were some opinions of surgeons opposite to what is practiced, and also some of them practiced something not ideal while obtaining informed surgical consents. However, most of the surgeons know the importance of consent and what is important to be disclosed in it. In general, the frequency of consent refusal was low
RESUMO
Background: Sugar- and artificially-sweetened beverage consumption have been connected to cardio metabolic hazard factors, which rise the danger of cerebrovascular illness and dementia
Purpose: We studied whether sugar or artificially sweetened beverage intake was related with the prospective dangers of incident stroke or dementia
Materials and methods: We studied 361 members aged more than 45 years for incident stroke [mean age 61 [SD, 10] years; 163 men] and 185 participants aged >60 years for incident dementia [mean age 68 [SD, 7] years; 85 men]. Beverage consumption was computed using a food-frequency questionnaire at cohort studies. We quantified latest consumption at investigation 7 and cumulative intake by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 5 years. We observed 12 cases of incident stroke [10 ischemic] and 10 cases of incident dementia [8 consistent with Alzheimer's disease]
Results: After modifications for age, gender, education [for analysis of dementia], caloric consumption, diet feature, physical activity, and smoking, higher recent and higher cumulative consumption of artificially sweetened soft drinks were related with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer's disease dementia. When comparing day-to-day aggregate consumption to 0 per week [reference], the risk ratios were 2.87 [95% confidence interval, 1.24-6.89] for ischemic stroke and 2.91 [95% confidence interval, 1.15-6.99] for Alzheimer's disease. Sugar-sweetened beverages were not associated with stroke or dementia
Conclusions: Artificially sweetened soft drink consumption was allied with a higher risk of stroke and dementia