ABSTRACT
Introduction Laser therapy and more specifically, High Intensity Laser Therapy (HILT), is an emerging non-invasive and non-ablative treatment modality, that appears promising for treating provoked vestibulodynia (PVD). However, evidence supporting this treatment remains limited so far as no prospective study has examined the feasibility, acceptability and effects in women with PVD. Objective 1) to evaluate the feasibility and acceptability of HILT in women with PVD and 2) to explore the effects of active and sham HILT on pain intensity during intercourse. Methods Women aged 18-45 years suffering from PVD participated in this randomized pilot study. Women were included if they reported pain at the entry of the vagina during vaginal intercourse (intensity of ≥5 on a numerical rating scale (NRS)) for more than three months. A standardized pelvic examination was performed by a gynecologist from our team to confirm the eligibility of participants. Women were randomized to receive bi-weekly sessions of active (n=20) or sham HILT (n=20) for 6 weeks. Women were assessed at baseline and post-treatment (2 weeks after the end of the treatment). Patients, outcome assessors and data analysts were blinded to group assignation. The attendance rate at laser sessions (≥80% of participants attending ≥10 sessions), the dropout rate (˂15%) and the absence of serious adverse events served as feasibility and acceptability outcomes and benchmarks. Patients’ perceived improvement and satisfaction were also assessed. The effects of treatment on mean pain intensity during intercourse were measured. Results A total of 45 women were screened by the gynecologist and 40 were enrolled in the study (n=5 were excluded because of other diagnoses i.e. infection, dermatological conditions). Among the women included, only one participant in the real HILT group dropped out of the study at post-treatment due to time constraints. Regarding the attendance rate for treatment, the 12 sessions were completed by all participants, except for two women who had 11 sessions due to Covid-related reasons. No serious side effects were observed in either group. In regard to patients’ global impression of change, 79% of women reported significant improvement in the active HILT group as opposed to 47% in the sham group. In the sham group only, 10% reported worsening of their condition. Regarding satisfaction to treatment, women in the active group were more satisfied with a mean of 6.6/10 (SD 2.8) compared to 4.6/10 (SD 3.1) in the sham group (p<0.05). A significant reduction in pain from baseline to post-treatment was found for women in the active HILT group (baseline 7.3±1.3;post-treatment 4.1±2.2;p˂.001) and sham HILT group (baseline 7.4±1.6;post-treatment 5.4±3.2;p=.002). Conclusions HILT is a feasible and acceptable intervention to treat women with PVD. With the significant improvements observed, findings support conducting a randomized controlled trial to confirm the efficacy of this promising intervention. Disclosure No
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As COVID-19 has become more widespread in Vietnam, the government has taken preventative measures including mandating social distancing and closing brick-and-mortar businesses considered unessential. To maintain operations, many restaurants have converted their business models to providing delivery sales via online platforms. This article focuses on understanding exactly why customers order meals online from restaurants during the COVID-19 pandemic and introduces a theoretical model for these developments centered on individual self-protective behavior as a response to the crisis.
ABSTRACT
OBJECTIVES: Nucleic acid testing is the gold standard method for the diagnosis of coronavirus disease 2019 (COVID-19); however, large numbers of false-negative results have been reported. In this study, nucleic acid detection and antibody detection (IgG and IgM) were combined to improve the testing accuracy of patients with suspected COVID-19. STUDY DESIGN: The positive rate of nucleic acid detection and antibody detection (IgG and IgM) were compared in suspected COVID-19 patients. METHODS: A total of 71 patients with suspected COVID-19 were selected to participate in this study, which included a retrospective analysis of clinical features, imaging examination, laboratory biochemical examination and nucleic acid detection and specific antibody (IgM and IgG) detection. RESULTS: The majority of participants with suspected COVID-19 presented with fever (67.61%) and cough (54.93%), and the imaging results showed multiple small patches and ground-glass opacity in both lungs, with less common infiltration and consolidation opacity (23.94%). Routine blood tests were mostly normal (69.01%), although only a few patients had lymphopenia (4.23%) or leucopenia (12.68%). There was no statistical difference in the double-positive rate between nucleic acid detection (46.48%) and specific antibody (IgG and IgM) detection (42.25%) (P = 0.612), both of which were also poorly consistent with each other (kappa = 0.231). The positive rate of combined nucleic acid detection and antibody detection (63.38%) was significantly increased, compared with that of nucleic acid detection (46.48%) and that of specific antibody (IgG and IgM) detection (42.25%), and the differences were statistically significant (P = 0.043 and P = 0.012, respectively). CONCLUSIONS: Nucleic acid detection and specific antibody (IgG and IgM) detection had similar positive rates, and their combination could improve the positive rate of COVID-19 detection, which is of great significance for diagnosis and epidemic control.