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Many different strategies have been used to fight against the Coronavirus disease (COVID-19) pandemic as a therapeutics or prophylaxis approaches. However, not enough attention has been paid to general and specific immune factors and nutritional components found in hyper-immunized dairy products. Hyper-immune bovine colostrum (HBC) has been used against many different respiratory and gastrointestinal tracts infections during past decades. An isolated dairy farm was established, and nine mixed Holstein X Simmental dairy cattle in their 6-7 months of gestation period were chosen for hyper-immunization with inactivated Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). For this, six cows were inoculated with 2 ml of 109.4/ml (TCID50) of the virus. As a control group, three cows were inoculated with the carrier without virus. Specific IgG level against the SARS-CoV-2 was measured before and after immunization in the sera, and in the colostrum and milk following parturition in hyper-immunized cows using indirect Enzyme-linked immunosorbent assay (ELISA). Neutralizing antibodies in the serum and colostrum was measured by a quantitative ELISA. The safety of the product was determined in40 healthy volunteers aged between 18-65 years old (13 females and 27 males) in the phase 1 clinical trial (https://www.irct.ir/trial/51259). No adverse effects were observed in the experimental cows. A very high level of IgG was observed in the first colostrum that sharply decreased in the following 7 days in the milk. The titer of specific neutralizing antibody in the colostrum samples was 69 times higher than the sera. No adverse effects and clinical complications were reported by the authorized ethics committee, and an official certificate on the safety of the product was issued. Beside other strategies, this approach could be used for large-scale and low-cost production of immune components to be used as a nutritional supplement to confront current SARS-CoV-2 and future pandemics. Clinical Trial Registration: [https://www.irct.ir/trial/51259].
RESUMO
BACKGROUND: It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. MATERIALS AND METHODS: This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1) patients' satisfaction derived from the relationship with doctors and (2) medication adherence named "Morisky Medication Adherence Scale" with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR) of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. RESULTS: A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06-0.71 and OR = 0.20) and empathy subscales (CI = 0.95, 13-0.80 and OR = 0.33) was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. CONCLUSION: Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.
RESUMO
BACKGROUND: Patient satisfaction is a key indicator of the quality and effectiveness of a therapeutic method. Assessing the satisfaction of patients undergoing homeopathic therapy is essential in the early steps of educating the community, if suitable outcomes are to be achieved. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted in 2008 on 125 patients from the city of Isfahan. Patients aged above 15 years who had referred to the homeopathic practitioners and received homeopathic drugs for at least three times were randomly selected and included in the study. Patient satisfaction was assessed in three main areas (general health, physician performance, and symptoms relief) using a valid questionnaire. The results were compared with those of a similar study conducted in 2004 on 240 patients. RESULTS: Mean score of satisfaction with homeopathic treatment was 77.48 ± 6.36 out of 100. In 2004, it was 77.4 ± 8.13. Median age was 36.41 ± 11.25 years. Median time of therapy was 16.80 ± 17.94 months. The highest level of satisfaction was related to relief of symptoms. Satisfaction of physician performance and improvement of general health came next. The degree of satisfaction with therapy was not significant between the different groups with regard to their sex and different levels of education, but there was significant difference in the duration of treatment. The four symptoms that showed better improvement in 2008 were headache, gastrointestinal (GI) disturbances, fatigue, and insomnia. CONCLUSIONS: After using homeopathy for several years, patients' satisfaction was found to be still high. Shifting the area of satisfaction from general health to relief of symptoms could be related to physicians' experiments for remedy selection. Scientific centers should do more surveys about the effectiveness of homeopathic treatment. Integration of homeopathy with medicine may bring in more success at less cost. It seems rational to support homeopathy as an effective practice.
