ABSTRACT
Recent studies have focused on treating heart failure, primarily mitigating symptoms and reducing the risk of mortality and other cardiovascular complications. A promising new treatment approach involves using LCZ696, an angiotensin receptor-neprilysin inhibitor (ARNI) comprising sacubitril and valsartan. This treatment is superior to the conventional drugs enalapril or valsartan in patients diagnosed with heart failure. A systematic search was conducted on PubMed, the Cochrane Library, and Elsevier's ScienceDirect databases to identify studies comparing sacubitril/valsartan with other drugs in heart failure patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). The analyses were conducted using the random-effects model. The study's primary outcomes included all-cause mortality, death from cardiovascular causes, first hospitalization for heart failure, congestive heart failure, and changes in the Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical score. The pooled analysis showed that treatment with the sacubitril/valsartan combination was associated with a significantly decreased rate of first hospitalization for heart failure (RR: 0.86; 95% CI: 0.79, 0.98, p: 0.03; I2: 57%) and significantly increased KCCQ clinical score (WMD: 2.20; 95% CI: 0.33, 4.06, p: 0.02; I2: 100%). However, the two groups had no significant difference in all-cause mortality (RR: 0.90; 95% CI: 0.80, 1.01, p: 0.08; I2: 20%), death from cardiovascular causes (RR: 0.96; 95% CI: 0.87, 1.05, p: 0.34; I2: 0%), or congestive heart failure (RR: 0.97; 95% CI: 0.75, 1.25, p: 0.19; I2: 38%). The research findings suggest that sacubitril/valsartan (LCZ696) reduces hospitalizations due to heart failure and improves KCCQ clinical scores. This treatment also reduces the decline in renal function and side effects associated with enalapril or valsartan. Nonetheless, further high-quality randomized controlled trials with large sample sizes are needed to assess other impacts of this therapy on heart failure patients. Overall, the use of LCZ696 represents a promising new approach to the treatment of heart failure.
ABSTRACT
Background and aim Monkeypox outbreaks in several nations have brought focus to the emerging virus. The clinical presentation of monkeypox is less severe than smallpox but is fairly comparable, presenting with fever, headache, lymphadenopathy, back discomfort, myalgia, and skin rashes. The misinformation spread on social platforms had a major impact on the effectiveness of outbreak control measures. The clinical management of breakouts depends on the adequate knowledge of the healthcare personnel about the disease. This study aims to assess the knowledge of medical students and graduates regarding monkeypox in India. Methods A cross-sectional survey was conducted by circulating a predesigned questionnaire with 20 questions to collect information regarding the demographic characteristics of the study participants, source of knowledge about monkeypox disease, self-perceived knowledge, and number of correctly answered questions regarding the disease. The responses obtained from the questionnaire and teleconsultation were recorded and analyzed. Results Out of 404 medical students and graduates who participated in the study, the mean age of participants was 23.17±2.14 years, and only 156 students learned about monkeypox in medical colleges. Only 72 (17.82%) participants reported that their medical college or hospital organized an educational class to teach about monkey pox disease. A majority of respondents (n=350, 86.63%) received their knowledge from online sources, which were the first most used source, followed by Instagram. Conclusions The knowledge assessment about monkeypox revealed that the average correct responses of participants who perceived to be knowledgeable were significantly lower than those who perceived to have good knowledge.
