International Journal of Preventive Medicine
Volume:14 Issue: 12, Dec 2023

Fingolimod and interferons are used in the relapse form of multiple sclerosis (MS). The goal of this systematic review and meta‑analysis was to evaluate the efficacy of fingolimod versus interferon in patients with MS. The systematic search was done in PubMed, Scopus, Embase, Web of Science, and Google Scholar.

The references of included studies as well as conference abstracts were searched up to July 2021. The literature search revealed 8211 articles, and after deleting duplicates 5594 remained. For the meta‑analysis, four studies were included. The standardized mean difference (SMD) of the Expanded Disability Status Scale (EDSS) after treatment (interferon vs fingolimod) was −0.06 (95% CI: −0.28, 0.17) (I2 = 80.2%, P = 0.002).

The SMD of the annual relapse rate (ARR) after treatment (interferon – fingolimod) was −0.08 (95% CI: −0.53, 0.36) (I2 = 95.5%, P < 0.001). The SMD of the ARR after treatment and before treatment in the interferon group was − 1.45, (95% CI: −1.55, −1.36) (I2 = 0, P = 0.3). The SMD of ARR after treatment and before treatment in the fingolimod group was − 1.3, (95% CI: −1.94, −0.65) (I2 = 97.4%, P < 0.001).

The results of this systematic review show that efficacy of interferon and fingolimod in controlling relapse rate and disability is similar.

Clinical knowledge sharing (CKS) is one of the key points of knowledge management in the field of health and significantly increases the quality of care and patient safety. It also provides the achievement of an efficient system in hospitals and educational and treatment centers involved in clinical processes in order to make the best clinical decisions. The purpose of this research is to identify the factors that facilitate and inhibit CKS among medical specialists in the educational‑treatment hospitals in Iran.

This was an applied qualitative study with the conventional content analysis method conducted in 2022. The data collection tool was a semi‑structured interview. The participants were 13 medical specialists and sub‑specialists working in educational‑treatment hospitals of the country, who were selected by purposeful and snowball sampling. The method of data analysis was based on Graneheim and Lundman’s five‑step method, which was followed by codes, sub‑categories, main categories, and classifications.

After conducting the interviews and assessing their content, finally, 193 codes were extracted, which were identified in two general classification of facilitating and inhibiting factors with 92 and 101 concepts, respectively. Facilitating factors in the three main categories of “education in the context of culture, society and university”, “planning and implementation management”, and “behavioral‑motivational factors” and inhibiting factors in the four main categories of “infrastructural, policy‑making and cultural challenges”, “technological and scientific infrastructural challenges”, “personality‑behavioral challenges”, and “financial and non‑financial motivations” were classified.

The participants of the research pointed out the effective role of CKS in keeping them up‑to‑date in the use of diagnostic, therapeutic, and even drug prescribing methods. According to their belief, knowledge sharing (KS) in the clinical setting will reduce diagnostic errors and cause the primordial prevention of diseases as well as increase the knowledge and awareness of the society members.

The irrational use of antibiotics seriously threatens global health. Clinicians undoubtedly play an essential role in consuming antibiotics in hospitals and communities, and their attitudes may help the health system’s optimal treatment of antibiotics. In this study, we reported clinicians’ experiences with antibiotics used in Isfahan, Iran.

In a qualitative study conducted from October 2020 to March 2021, the experiences of 13 clinicians with different clinical specialties were collected through one‑to‑one interviews. Participants were selected through purposive sampling until data saturation; data collection was conducted through semi‑structured interviews. Conventional content analysis was used to analyze the transcribed interviews. The main category was recognized and subcategorized and coded by three researchers.

Eight women and five men with a mean work experience of 12.54 ± 10.047 years participated in the study. All of them worried about the overuse of antibiotics and antibiotic resistance. Clinicians believe that the antimicrobial stewardship committee is not active in our country. Laboratory challenges, healthcare providers, the poor performance of the health system, and marketing and business were the main categories of the study. Subcategrories of main categories included inefficiency in the function of laboratories, harmful profit, challenges in medical education, ups and downs of disease treatment, the unacceptable performance of hospitals, failure to upgrade the health system, threats and opportunities, and jobbery.

The participants of this study believed that excessive use of antibiotics is a serious challenge in our country. Physicians were concerned about antibiotic resistance and believed that the pattern of antibiotic resistance was not routinely reported. Therefore, in our region, we should make more efforts to collect data in this field and provide this information to physicians. Also, this study confirmed many obstacles to implementing the antimicrobial stewardship program, and the infrastructure needs strengthening. There is also a need for cultural changes and the views of physicians.

Patients with severe COVID‑19 suffer from various problems such as impaired lung function, decreased exercise capacity, mental disorders, and reduced quality of life. This study aimed to evaluate the effectiveness of short‑term pulmonary rehabilitation in patients recovering from severe COVID‑19.

The present study was a retrospective cohort study. This study was conducted in 2021 on 92 patients with severe COVID‑19 who met the inclusion criteria. Inter‑professional pulmonary rehabilitation sessions were performed for 3 weeks, twice a week (six sessions in total), for this group of patients, which included physical exercises, educational activities, and other health‑related services (counseling and psychotherapy). Outcomes assessed included a 6‑min walk test, the score of the Hospital Anxiety and Depression Scale, and the SF‑12 Quality of Life Questionnaire, which were completed before and after pulmonary rehabilitation. Data analysis was performed using analytical and descriptive statistics.

The statistical analyses showed that 60.86% of patients participating in the study were male and 39.14% were female, and the mean age of patients was 54.9 ± 12.3 years. The findings also showed that the average distance traveled in the 6‑min walk test before pulmonary rehabilitation was 289.2174 ± 130.5 m; however, after the intervention, this rate reached 343.0870 ± 103.5 m, which demonstrated a statistically significant difference (P = 0.00). Also, significant changes were observed in anxiety and depression, the ability to perform daily activities, and the physical health of patients before and after the intervention (P < 0.05).

Short‑term pulmonary rehabilitation is a safe and useful treatment without side effects that can be effective in reducing anxiety and depression, increasing the ability to perform daily activities and exercise capacity, and consequently, improving the quality of life of patients recovering from severe COVID‑19.

Dear Editor, Coronavirus disease (COVID‑19), a terrifying pandemic that has plagued the world for more than 2 years and continues to infect and kill people, mutations in its spheres, especially the omicron sphere, has accelerated the incidence of infection and death. According to the World Health Organization on February 25, 2022, more than 5 million COVID‑19 deaths were reported worldwide.

Dear Editor, In addition to the well‑known pox infections, new zoonotic pox diseases have emerged, and they are now a global concern. Monkey pox has expanded across Europe as a result of its widespread outbreak, posing a severe public health risk. Monkey pox is an uncommon pox infection that has resurfaced due to zoonosis.