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To evaluate medium/long term outcomes and patient satisfaction through relief of symptoms and improved quality of life (QoL) after Jones tube conjunctivodacryocystorhinostomy (JT-CDCR) using the Naso Lacrimal Duct Obstruction symptom-score (NLDO-SS).We conducted a retrospective, non-comparative, multicentric study including patients with complete obstruction of the superior and inferior proximal lacrimal drainage system. All patients underwent JT-CDCR, and the patency of the tube was evaluated with saline irrigation and endoscopic examination. We assessed patient satisfaction and quality of life administering the NLDO-SS.We enrolled 16 patients, for a total of 21 eyes operated. The success rate for procedures was 81%. The success rate for single parameters was globally 95.9%; if considered separately, ocular symptoms and nasal symptoms were respectively 94.3% and 100%.JT-CDCR was a reliable procedure, able to solve symptoms in a majority of patients and guaranteed a good quality of life over a long period of time.L’applicazione di un questionario sui sintomi dopo congiuntivodacriocistorinostomia: risultati.Valutare gli esiti a lungo termine e la soddisfazione del paziente, attraverso la risoluzione della sintomatologia e il miglioramento della qualità della vita (QoL) dopo intervento di congiuntivodacriocistorinostomua e posizionamento di Tubo di Jones CDCR-JT, mediante l’utilizzo del questionario “Naso Lacrimal Duct Obstruction Symptoms-Score (NLDO-SS)”.Abbiamo condotto uno studio retrospettivo, non comparativo, multicentrico, includendo pazienti con ostruzione completa della lacrimale prossimale superiore e inferiore. Tutti i pazienti sono stati sottoposti a JT-CDCR, la pervietà del tubo di Jones è stata valutata con irrigazione di soluzione fisiologia ed endoscopia trans-nasale. A ciascun paziente è stato poi somministrato il questionario NLDO-SS.Abbiamo arruolato 16 pazienti, per un totale di 21 occhi operati. Il tasso di successo delle procedure è stato dell’81%. Il tasso di successo per i singoli parametri è stato globalmente del 95,9%; se considerati separatamente, i sintomi oculari e quelli nasali erano rispettivamente del 94,3% e del 100%.L’intervento di JT-CDCR ha dimostrato di essere in grado di risolvere i sintomi nella maggior parte dei pazienti e di garantire una buona qualità di vita per un lungo periodo di tempo.

Compromised lung function is a common feature of COPD patients, but certain factors increase the rate of lung function decline in COPD patients. The objective of the current study was to investigate the effect of different clinically important factors responsible for rapid deterioration of lung function quantified as ≥ 60 ml decline in FEV1 over a period of one year. COPD patients recruited from the chest clinic of Penang hospital were followed-up for one year from August 2018 to August 2019. Rapid deterioration of lung function was defined as greater than 60 ml/year decline in force expiratory volume in one second. Among 367 included patients 73.84% were male, with mean age 65.26 (9.6) years and % predicted FEV1 51.07 (11.84). 30.27% patients showed mean decline of ≥ 60 ml in FEV1. The regression analysis showed that current smoking relative risk (RR) = 2.38 (1.78–3.07), p p p p p p p p p p

Introduction The presence of lower urinary tract symptoms (LUTS) might be linked with elevated cardiovascular risk. There is a lack of data showing the prevalence of LUTS in the population of patients with cardiovascular diseases. The current study aimed to determine the prevalence of LUTS in patients hospitalized due to a cardiovascular disease. Material and methods Patients hospitalized in a tertiary cardiology department due to a primary diagnosis of cardiovascular disease (including coronary artery disease, heart failure and arrhythmia) were included in the study. All patients were screened for LUTS and assessed using the International Prostate Symptoms Score (IPSS). Results From 166 patients (age 62.8 ±12.1 years), moderate to severe LUTS was diagnosed in 62 patients (37.3%). Patients with LUTS were significantly older, but there were no other factors associated with LUTS. When we divided patients according to LUTS severity, we saw an increasing prevalence of arterial hypertension (69.5% vs 72.9% vs 100%), diabetes mellitus (29.5% vs 33.3% vs 38.5%), coronary artery disease (68.6% vs 72.9% vs 92.3%), but the observations were not statistically significant. Patients with coronary artery disease had significantly higher severity of LUTS compared to patients with arrhythmia or heart failure (mean IPSS 8.88 vs 5.6 vs 5.5, p = 0.004). Conclusions The prevalence of LUTS in patients with cardiovascular diseases is high, affecting 37.3% of the studied population. Patients with coronary artery disease have significantly higher severity of LUTS compared to other cardiovascular diseases.

Objective: To compare the efficacy of tacrolimus 0.03% ointment to olopatadine 0.2% eye drops in the treatment of vernal keratoconjunctivitis. Study Design: Prospective cross-sectional study. Place and Duration of Study: Eye Department Combined Military Hospital Quetta, from Feb to Jul 2019. Methodology: A total of 69 patients with active vernal keratoconjunctivitis (VKC) were included in this study.Thirty six (52.17%) patients were randomized in tacrolimus group and 33 (47.83%) in olopatadine group B.Baseline values of the subjective symptom score (SSS) and the objective sign score (OSS) were noted. Patientswere reviewed on weeks 2, 4, 8 and 12 and the scores at each visit were summed. These scores were used forcomparison between groups. Results: At the start of the study, the mean subjective symptoms score and objective sign score of group A was 9.0 ± 2.04 and 3.93 ± 1.93 respectively, while that of group B was 8.88 ± 2.18 and 4.36 ± 1.90 respectively. At the end of 12-weeks, the mean subjective symptoms score and objective sign score of group A reduced to 0.11 ± 0.32 and 0.08 ± 0.28 respectively, while that of group B reduced to 1.70 ± 0.77 and 0.64 ± 0.55 respectively. Total improvement of scores (as a percentage of baselines) among tacrolimus group was 98.3% and olopatadine group was 83%. Conclusion: Although both 0.03% tacrolimus and 0.2% olopatadine were effective in improving the signs andsymptoms of VKC, 0.03% tacrolimus was significantly superior.

Background The aim of the study is to find the correlation between the prostate volume and severity of lower urinary tract symptoms (LUTS) as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia (BPH). Methods The study was a prospective correlational study conducted between June 2016 and November 2017. A total of 290 patients who presented with LUTS suggestive of BPH and satisfied the inclusion criteria were consecutively recruited. Clinical evaluation including digital rectal examination of the prostate was done. Symptoms severity was assessed using the self-administered international prostate symptoms score (IPSS) questionnaire. Prostate volume was determined by transrectal ultrasound scan, and the urine flow rate was measured using uroflowmeter. Data were analyzed using SPSS version 20.0, and p value Results The mean age of the patients was 64.22 ± 9.04 years with a range of 40 to 95 years. Most of the patients had moderate symptoms (55%) on IPSS with the mean IPSS value of 16.41 ± 7.43. The mean Qmax value was 16.55 ± 7.41 ml/s, and the median prostate volume (IQR) was 45.05 (35, 59). There was a positive significant correlation between prostate volume and IPSS (r = 0.179, p = 0.002) and a negative significant correlation between prostate volume and Qmax (r = − 0.176, p = 0.003). Conclusion This study showed a significant correlation between the prostate volume and IPSS, and also between prostate volume and maximum flow rate (Qmax).

Nasya is the panchakarma to eliminate morbid doshas in head and neck. Vagbhatacharya opines that except for Vatika clinical conditions Nasya should be done for 7a days but as ekahanthara (alternate) that is with a gap of one day in between. As no previous studies were available on the efficacy and safety of ekahantara nasya, a comparative clinical study was conducted with anutaila in chronic sinusitis. 20 participants were divided by convenience sampling into group A (pratidina nasya) and group B (ekahantara nasya). The assessment was done by Scoring of symptoms, Haematological evaluation, Rhino sinusitis disability index, Event evaluation scale and Nasya samyak lakshana. Significant reduction in symptoms score was seen in both group A (psamyak yoga score was 82% in group A while in group B it was 95%. Asmyak yoga score in group A was 18% and 5% in group B and the difference was statistically significant (pekahantara practice of nasya with Anutaila was more safe and effective compared to pratidina practice of nasya in chronic sinusitis. Keywords: Ekahantara nasya, Pratidina nasya, Chronic sinusitis, Anutaila

We established severity banding ranges, bother assessment and key item content in principal patient reported outcomes measures in men seeking therapy for lower urinary tract symptoms.Data for International Prostate Symptom Score (I-PSS) and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) were derived from a study evaluating 820 men at 26 United Kingdom hospitals. ROC curves were used to establish severity bandings.Classification tree showed that thresholds between mild-moderate and moderate-severe severity bands were 15 and 27 for I-PSS, 16 and 26 for ICIQ-MLUTS/severity, and 22 and 81 for ICIQ-MLUTS/bother, respectively. Highest area under the ROC curve and lowest Akaike's information criteria of univariate logistic regression indicated that ICIQ-MLUTS/bother was more related to global quality of life than were I-PSS and ICIQ-MLUTS/severity. The symptoms affecting I-PSS-quality of life (QoL) were only fully identified by ICIQ-MLUTS, because 2 key symptoms (urinary incontinence and post-micturition dribble) are not measured by I-PSS. ICIQ-MLUTS demonstrated that bother of some lower urinary tract symptoms is disproportionate to severity, and that persisting high bother levels following surgery are more likely due to storage (18% to 25%) and post-voiding (18% to 28%) lower urinary tract symptoms than voiding lower urinary tract symptoms (5% to 13%). Symptom improvement after surgery was uncertain if baseline I-PSS-QoL score was less than 3.The severity threshold scores were measured for the 2 key lower urinary tract symptoms patient reported outcomes measures, and the results indicate suitable categories of symptom severity for use in men referred for urological care. The ICIQ-MLUTS measures all the lower urinary tract symptoms affecting quality of life and includes individual symptom bother scores.

Pegvaliase is approved to reduce phenylalanine (Phe) levels for people with phenylketonuria (PKU). PRISM-1 (NCT01819727) and PRISM-2 (NCT01889862) data were analyzed to evaluate the relationship between Phe and inattention in adult participants with PKU. In the modified-intent-to-treat population (N = 156), baseline mean (SE) plasma Phe was 1263 (29) μmol/L and the Attention Deficit Hyperactivity Disorder Rating Scale-IV Inattentive (IA) symptoms score was 9.8 (0.5). Mean (SE) IA scores fell 9.0 (1.1) in Quartile 1 (Phe reduction between 1166 and 2229 μmol/L) versus 4.3 (0.7) in Quartile 4 (Phe reduction of 139 μmol/L to increase of 934 μmol/L), p = 0.004. Least squares mean (SE) change from baseline IA score was -7.9 (0.7) for participants with final Phe ≤ 360 μmol/L and -4.5 (0.7) for final Phe > 360 μmol/L, p < 0.001. In the inattention subgroup, IA scores fell 13.3 (1.5) in Quartile 1 (Phe reduction between 1288 and 2229 μmol/L) versus 6.2 (1.3) in Quartile 4 (Phe reduction of 247 to increase of 934 μmol/L), p = 0.009. Inattention symptoms improved among those whose Phe levels decreased, particularly those with high baseline IA scores. IA improvements were larger among participants with the greatest plasma Phe reductions, supporting this value as a therapeutic goal.

Purpose: To determine the efficacy of 0.03% dermatological tacrolimus ointment in patients with refractory vernal keratoconjunctivitis Study Design: Quasi-experimental study Study Place and Duration: Eye Department, DHQ-Teaching Hospital, Gujranwala, Pakistan from April 2018 to March 2019 Material and Methods: After approval from hospital ethical committee and obtaining written informed consent from each patient/guardian, patients of either gender between 4-16 years of age with VKC not responding to conventional treatment for more than 8 weeks or having steroid-induced complications were included in this study. Dermatological tacrolimus ointment 0.03% started to be placed in inferior fornix in BD frequency along with topical lubricants. Patients were followed up on a regular schedule. Individual symptoms score was assessed from the questionnaire and signs score from observer’s clinical assessment. Data were analyzed using SPSS v23.0. P-value

Background: Comfortable working at near and intermediate tasks depend on the efficiency as well as coordination of accommodation and vergence systems. At present, the need for near and intermediate visual tasks has been dramatically increased, requiring prolonged computer- and gazette-related works. It demands excessive working of the extraocular and ciliary muscles. It may cause eye fatigue and other associated asthenopic symptoms. Globally, eye fatigue is one of the most commonly reported conditions in nonpresbyopic population with asthenopic symptoms. It is necessary to get relief from eye fatigue for better near and intermediate tasks. Materials and Methods: Thirty-two undergraduate optometry students who were symptomatic based on a validated eye fatigue questionnaire were included after a baseline comprehensive eye examination. Based on the eye fatigue symptoms score, they were equally assigned to a control group and an exercise group with sixteen participants in each. The exercise group performed yoga ocular exercises for up to 6 weeks after which the eye fatigue symptoms were reassessed in both groups. Results: In the exercise group, there was a statistically significant reduction in eye fatigue scores (P = 0.003), whereas the eye fatigue scores showed significant increment in the control group after 6 weeks (P = 0.044). Conclusions: Yoga ocular exercises reduce the eye fatigue symptoms score by increasing the efficiency of extraocular muscles. Hence, it could be considered as a therapeutic and nonpharmacologic intervention for reducing the eye fatigue and associated asthenopic symptoms.

Objective : This study looked at the incidence of overactive bladder (OAB) in KIA poly patients at Pauh Health Center in Padang City using Overactive Bladder Symptomps Score (OABSS). Method : This research is descriptive. The sampling technique was purposive sampling by considering inclusion and exclusion criteria. The inclusion criteria were women of ideal reproductive age (20-35 years) who had given birth spontaneously, were not pregnant, did not suffer from neurological disorders, diabetes, post bladder surgery and or urinary tract infections and were not treated with Overactive Bladder (OAB), while the exclusion criteria are not willing to take part in the study. The study was carried out at the KIA Poly of Pauh City Health Center in Padang during January 2019. The variable in this study was Overactive Bladder (OAB). Result : In this study, 97.22% of respondents experienced complaints of overactive bladder (OAB), (97.14%) experienced an urgent complaint, and only a small percentage (2.86%) of respondents experienced urinary incontinence. The results of this study indicate that respondents who did not experience complaints of overactive bladder (OAB) were respondents with the smallest parity (parity 1). Conclusion : Most respondents experienced complaints of overactive bladder (OAB) and urgency, and only a small proportion of respondents experienced urinary incontinence. The results of this study indicate that respondents who did not experience complaints of overactive bladder (OAB) were respondents with the smallest parity (parity 1). Keywords: overactive bladder (OAB), Urgensi,inkontinensia urin, Overactive Bladder Symptom Scores (OABSS)

Infantile colic is a common benign disease occurring in early infancy that may have a great impact on family life. In the present study, the effectiveness and safety of the complex homeopathic medicine Enterokind was compared with Simethicone for treating infantile colic.Current data were drawn from a prospective, multicenter, randomized, open-label, controlled clinical trial that was conducted in 2009 in 3 Russian outpatient clinics. Children received either Enterokind (Chamomilla D6, Cina D6, Colocynthis D6, Lac defloratum D6 and Magnesium chloratum D6) or Simethicone. Data from infants ≤ 6 months with infantile colic are presented here.The main outcomes assessments were the change of total complaints score (maximum 17 points) and total objective symptoms score (maximum 22 points) after 10 days of treatment.Data from 125 infants ≤ 6 months with infantile colic were analyzed. The differences in total complaints and objective symptoms scores between baseline and day 10, estimated from the ANCOVA model, were found to be highly significant (p 0.0001; ITT) in favor of Enterokind, both for complaints (Δ=-2.38; 95% confidence interval (CI): [-2.87; -1.89]) and for objective symptoms (Δ=-2.07; 95% CI: [-2.65; -1.49]). 1 adverse event (AE), vomiting, occurred under Enterokind and was rated to be unlikely related to it; 4 AEs occurred under Simethicone. All AEs were non-serious.The current study indicates that Enterokind is an effective and safe homeopathic treatment for functional intestinal colic in infants ≤ 6 months.

Objective: To validate an Arabic version of the Overactive Bladder Symptom Score (OABSS) questionnaire. Patients and methods: In all, 301 patients were evaluated using the Arabic-translated OABSS. They were divided into four groups: 112 patients with OAB symptoms, 115 healthy individuals with no OAB symptoms, 38 with bladder outlet obstruction (BOO) associated with storage lower urinary tract symptoms (LUTS), and 36 with BOO without storage LUTS. The reliability of the Arabic version was evaluated for internal consistency using Cronbach’s α test. Interdomain associations were examined using Spearman’s correlation coefficient (r). The discrimination validity was evaluated using the Mann–Whitney test. Results: Higher internal consistency was found for all OABSS domains in the OAB and BOO groups. There were strong correlations between all domains in the OAB group (P

Ali Abusharha, Ali Alsaqar, Raied Fagehi, Mohammad Alobaid, Ali Almayouf, Sulaiman Alajlan, Mossab Omair, Essa Alahmad, Ali Masmali Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi ArabiaCorrespondence: Ali AbusharhaDepartment of Optometry, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi ArabiaEmail aabusharha@ksu.edu.saPurpose: The purpose of the present study is to determine the effects of type 2 diabetes mellitus on tear osmolarity using a TearLab Osmolarity system. Moreover, the relationship between tear film osmolarity and ocular surface discomfort in controlled and uncontrolled diabetic patients was assessed.Materials and Methods: This study included 20 male type 2 diabetic patients aged 20 to 70 years (mean ± SD 49± 12). A control group (18– 43 years; 32.2 ± 6.5 years) consisting of 40 male subjects was also enrolled for comparison. The tear osmolarity was measured using the TearLab Osmolarity System. The ocular surface disease index questionnaire (OSDI) was used to assess ocular discomfort symptoms.Results: The mean tear osmolarity was 297 ± 8.00 and 296 ± 11 mOsm/L for controlled and uncontrolled diabetic subjects, respectively, while the average osmolarity in the control group was 299 ± 8.00 mOsm/L. No significant differences were detected in tear osmolarity between the control and diabetes groups. The ocular surface disease index questionnaire (OSDI) score was significantly higher in the diabetic patient group. No significant correlation was found between tear osmolarity and OSDI scores.Conclusion: The ocular discomfort symptoms score in diabetic patients was significantly higher compared to normal eye subjects. Tear osmolarity was not significantly different in diabetic patients. This finding may be explained by a lack of relationship between tear film parameters and diabetic severity; tear film parameters may correlate more with diabetic duration rather than severity. Therefore, studies focused on diabetes duration and tear film parameters are recommended.Keywords: diabetes, dry eye, tear film osmolarity

Objective: To establish normative reference values for the Sport Concussion Assessment Tool-5th Edition (SCAT5) for the new National Rugby League Women's Premiership.Methods: Preseason SCAT5 baseline testing was administered individually to all National Rugby League Women's Premiership players (N = 117). Testing was completed by the medical staff. Normative reference values were calculated for the components of the SCAT5, including the Standardized Assessment of Concussion, modified Balance Error Scoring System, and the Symptom Scale. A small case series of players who sustained concussions were included to illustrate the use of the new normative data.Results: The median Standardized Assessment of Concussion total score was 27.0 (M = 26.9, SD = 2.1). The median modified Balance Error Scoring System score was 2.0 (M = 2.4, SD = 2.2). The median number of symptoms score was 1.0 (M = 3.2, SD = 4.7) and the median symptom severity score was 2.0 (M = 5.4, SD = 8.2). The most common baseline symptom was fatigue or low energy (33%), followed by trouble sleeping (24%), headache (23%), neck pain (22%), and difficulty remembering (21%). In the total sample, 41% reported no symptoms. The clinical interpretation of these new normative data to a case series of women with concussions is provided.Conclusions: Normative reference values are provided for the SCAT5 for women who are professional rugby league players. Using these normative data will improve clinical interpretation of SCAT5 scores following a concussion.

Background Intralymphatic immunotherapy (ILIT) is a potential treatment option for allergic rhinitis (AR). We aimed to determine the efficacy (primary outcomes) and safety (secondary outcomes) of ILIT in treating patients with AR. Methods An electronic literature search was performed using MEDLINE and Cochrane Central Register of Controlled Trials CENTRAL (from their inception to December 2020). A random‐effects model was used to estimate the pooled prevalence with 95% confidence intervals. This study is registered with PROSPERO (CRD42019126271). Results We retrieved a total of 285 articles, of which 11 satisfied our inclusion criteria. There were 452 participants with age ranged from 15 to 58 years old. Intralymphatic immunotherapy was given in three doses with intervals of four weeks between doses in 10 trials. One trial gave three and six doses with an interval of two weeks. Both primary and secondary outcomes showed no difference between ILIT and placebo for all trials. There was no difference in the combined symptoms and medication score (SMD ‐0.51, 95% CI −1.31 to 0.28), symptoms score (SMD −0.27, 95% CI −0.91 to 0.38), medication score (SMD −6.56, 95% CI −21.48 to 8.37), rescue medication (RR 12.32, 95% CI 0.72–211.79) and the overall improvement score (MD −0.07, 95% CI −2.28 to 2.14) between ILIT and placebo. No major adverse events noted. Conclusions Intralymphatic immunotherapy possibly has a role in the treatment of AR patients. This review found it is safe but not effective, which could be contributed by the high variation amongst the trials. Future trials should involve larger numbers of participants and report standardized administration of ILIT and outcome measures.

Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p p = 0.011 and p p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.

Objective: Coronavirus disease 2019 (COVID-19) has spread worldwide, including Japan. However, little is known about the clinical symptoms which discriminate between COVID-19 and non-COVID-19 among outpatients in general practitioner clinics, which is important for efficient case detection. The aim of this study was to investigate the clinical symptoms to discriminate between COVID-19 and non-COVID-19 cases among outpatients in general practitioner clinics during the second wave of the COVID-19 pandemic in Japan in August 2020. Methods: The records of 360 patients who visited a clinic with suspicion of infectious disease and underwent COVID-19 PCR test between 1 and 14 August 2020 were used. The patients filled out a questionnaire on possible clinical symptoms and transmission routes. Multivariate logistic regression was used to investigate the association between clinical symptoms and COVID-19 status. Results: COVID-19-positive patients were 17 (4.7%). Multiple logistic regression analyses showed that anosmia (odds ratio (OR), 25.94 95% confidence interval (CI), 7.15–94.14, p &lt, 0.001), headache (OR, 3.31 95% confidence interval (CI), 0.98–11.20, p = 0.054), sputum production (OR, 3.32 CI, 1.01–10.90, p = 0.048) and history of visiting an izakaya or bar (OR, 4.23 CI, 0.99–18.03, p = 0.051) were marginally significantly associated withbeing COVID-19 positive. This model showed moderate predictive power (area under receiver operating characteristic curve = 0.870 CI, 0.761 to 0.971). Conclusions: We found that anosmia, headache, sputum production, history of visiting an izakaya or bar were associated with COVID-19, which can be used to detect patients with COVID-19 in out-patient clinics in Japan. The findings of this study need to be verified in other clinics and hospitals in Japan and other countries with universal healthcare coverages.

We aimed to investigate clinical features potentially useful in primary bladder neck obstruction (PBNO) diagnosis in men presenting with lower urinary tract symptoms (LUTS). Data from 1229 men presenting for LUTS as their primary complaint at a single centre were retrospectively analysed. All patients underwent a comprehensive medical and physical assessment, and completed the International Prostate Symptoms Score. All patients were investigated with uroflowmetry, and trans-rectal ultrasound imaging to define prostate volume. Urodynamic evaluation was performed when the diagnosis of benign prostatic enlargement was not confirmed and the patient presented a significant chance of detrusor overactivity or underactivity. As per our internal protocol, patients 60 years with a prostate volume (PV) p p p = 0.004) and lower PSA values (p p = 0.01) and lower PV values (p p = 0.003) and higher IPSS scores (OR 1.12; p = 0.01) were more likely to be associated with this subset of patients, after accounting for other clinical variables. One out of ten young/middle-aged men presenting for LUTS may be affected from PBNO. Younger patients with more severe LUTS systematically deserve an extensive assessment to rule out PBNO, thus including urethrocystoscopy and urodynamics with voiding-cysto-urethrogram.

The effect of mental and physical health on the feelings of subject welfare is known as health-related quality of life. The chronic obstructive pulmonary disease is a common respiratory diseases. Assessment of health-related quality of life is considered important in such chronic disease. The objective of the current study was to measure health-related quality of life in a sample of chronic obstructive pulmonary patients in AL- Diwanyia city/Iraq. This study was carried out on 150 already diagnosed COPD patients who attended to the Center of Respiratory Diseases/AL-Diwaniyah Teaching Hospital during September 2019 to January 2020. The Arabic version of St George’s Respiratory Questionnaire was used to assess the health-related quality of life. The mean symptoms score was 48.65 ±7.17, the mean activity score was 62.39 ±5.81, the mean impact score was 42.83 ±7.90 and the total score 49.58 ±4.82. Symptom score is predicted by disease duration (negatively) and hospital admission (positively), activity score and impact score cannot be predicted by any of independent variables and total score is predicted by forced expiratory volume in the first second (negatively) and hospital admission (positively).

Objective Research into cognitive performance during a hangover has produced equivocal findings. This study investigated the reliability of inducing hangover symptoms and effects on cognitive performance (including applied tasks) under standardised conditions. Method Twenty-one participants (13 M; 24 ± 3 years) completed two identical trials, involving alcohol consumption and an overnight laboratory stay. Outcome measures included: hangover severity (a single-item 'Hangover' rating, and a sum of hangover symptoms [Overall Symptoms Score (OSS)]), cognitive function (trail making test), simulated driving (standard deviation of lateral position; lane crossings), and typing performance. Spearman's correlations were used to assess reliability between trials for all participants, and when ratings of 'Hangover' were consistent. Results Participants demonstrated reliable 'Hangover' rating change from baseline (Trial A: 2.0 [2.0]; Trial B: 2.0 [2.0], rho = 0.680, p = 0.001), but not for OSS (Trial A: 8.0 [12.0]; Trial B: 5.0 [9.0], rho = 0.309, p = 0.173). Performance in cognitive/applied tasks (range rho = 0.447-0771) was consistent, except simulated driving (range rho = 0.035-0.272), however the impairment was trivial. The subgroup analysis did not reveal substantial changes in reliability. Conclusion A single 'Hangover' rating was a reliable way of determining 'mild' to 'moderate' hangover severity. The present data could be used to assist the methodological design of future hangover research.

Background: The herbal medicine combination (HMC) containing 2% Asiaticoside and 1% Acemannan, in a Beeswax encapsulation of 2% Acetylsalicylic acid base, was developed as a topical treatment option for mild-to-moderate chronic venous disease (CVD). For control (C), Beeswax encapsulation of 2% Acetylsalicylic acid base was used. Methods: A double-blinded, randomized controlled trial comparing HMC with C was investigated among 42 CVD patients; 21 patients was allocated to receive either HMC or C, for a continuous 12-week treatment. To assess the efficacy, the following were employed: (i) Venous Clinical Severity Score (VCSS), (ii) Patients Self-Rating Symptoms Score (PSSS), and (iii) Short-form health-related quality of life score based on a Medical Outcomes Study 14-item Chronic Venous Disease (MOS CIVIQ14). The short-term safety was assessed by the patients' self-reported adverse events. The primary endpoint was a responder rate defined by a 50% reduction of the VCSS from baseline after 4 weeks of treatment. The secondary endpoints were assessed by improvement of overall disability after employing VCSS, PSSS, and MOS CIVIQ14, accordingly. Results: CVD Thai patients (N=42), regardless of clinical severity of CEAP class (CEAP1/CEAP2)or co-morbidity, responded 57.14% to HMC (N=21) as compared with 9.52% to C (N=21) the responder rate was significantly dependent on intervention (p=0.003 and p=0.003, respectively). HMC reduced VCSS markedly better than C, over the 4 weeks: 11.9048 (6.4908) vs. 22.4702 (7.9438), p

Aim: To evaluate tolerability and efficacy of Parietaria judaica subcutaneous immunotherapy on patients with allergic rhinoconjunctivitis. Patients & methods: 51 patients were assigned to build-up scheme (six increasing doses) of P. judaica depot native extract, plus three maintenance monthly administrations. Results: Out of 470 administered doses, only 3.8% elicited systemic reactions (1.5% nonspecific and 2.3% grade I). Concerning the exploratory efficacy parameters: cutaneous reactivity at the final visit versus baseline was significantly decreased; specific titers of IgG and IgG4 increased significantly and patients showed a significant decrease in the rhinitis symptoms score. Conclusion: P. judaica subcutaneous immunotherapy (Allergovac® depot ROXALL Medicina España S.A., Zamudio, Spain) with an abbreviated up-dosing scheme showed an adequate safety and tolerability profile and induced preliminary efficacy changes.

Female sexual function is Avery important and often neglected area of research. Therefore, the purpose og this study was to assess the relationship between overactive bladder syndrome and female sexual function. The study was conducted at Urological Outpatient clinic and Obstetrics and Gynecological clinic at Benha University Hospital. The design of this study was a descriptive research design. A purposive sample included 70 sexually active women diagnosed with overactive bladder syndrome were recruited in the study. Three instruments were utilized for data collection, interviewing questionnaire sheet, Female sexual function Index (FSFI) and Overactive Bladder Symptoms score (OABSS). The results of the study showed that there was highly statistical significant correlation between overactive bladder syndrome and female sexual function. Conclusion: highly statistical significant correlation was found between overactive bladder syndrome and female sexual function at 5% level of statisical significance. Therefore, it was recommended that this syudy should be conducted on alarge number of sample.

Background To investigate the relationship between time elapsed since completion of radiotherapy (RT) and quality of life (QOL) of patients with breast cancer. Methods A total of 300 patients with breast cancer were treated at the First Affiliated Hospital of Anhui Medical University between January 2013 and April 2016. Of these, 212 patients were included in the study. Patients were divided into 4 groups based on the time elapsed since completion of RT. The generic cancer questionnaire, EORTC QLQ-30, and the breast cancer-specific questionnaire, QLQ-BR23, were used to assess the QOL. Results Analysis of time elapsed since completion of RT and QOL revealed changes in the scores for role function with passage of time; the third year’s scores were the highest. Pain symptoms during the 3rd and 4th years after RT were lower than those during the 1st and 2nd years after RT; scores for financial difficulties fluctuated with passage of time; perception of own body scores improved within first 3 years; sexual activity and enjoyment of sexual activity showed a significant decrease during the 2nd to 4th year post RT. Scores pertaining to concerns about future state of health showed a significant increase during the 2nd to 4th year after RT, while breast symptoms score showed fluctuations with passage of time. Conclusions Social function, pain symptoms, and concerns about future state of health tended to improve with passage of time after RT. Other scales showed no correlation with time elapsed since completion of RT.

Background: Prevalence of gastroesophageal reflux disease (GERD) is escalating in Asia. The present study aimed toinvestigate the prevalence of GERD symptoms as well as potential risk factors associated with GERD in residents in a rural area in Jakarta. Method: The study population consisted of subjects who aged 20 years or more and lived in rural area Kebon Bawang-Tanjung Priok, Jakarta. A self-administered questionnaire based on earlier validated questionnaire (GERDQ) was given. The questionnaire consisted of demographic characteristic, self and environment sanitary, social and past illness history, and the symptoms score for GERD. Total score for GERD’s symptoms score was 18, with a score of at least 8 was considered to have symptomatic GERD.Results: The questionnaire was completed in 90 subjects. Of the 90 subjects, 12 (13.3%) had GERDQ score ≥ 8 which was the cut-off for definingpresence of GERD. On both univariate and multivariate analysis, age 50 years old (OR = 6.33; 95% CI 1.1-35.6), handwashing habit before eating (OR = 6.93; 95% CI 1.1-43.8), and raw/tap water (OR = 10.28; 95% CI 0.8-130) were significantly associated with the presence of GERD.Conclusion: Prevalence of GERD was high (13.3%) in rural area in Jakarta. Age 50 years old, handwashing habit before eating, and raw/tap waterwere risk factors for GERD in this population.

Introduction: The outcome of patients (pts) with myelofibrosis (MF) who discontinue ruxolitinib (RUX) is poor with scarce therapeutic possibilities (Palandri et al, 2020). However, some evidences suggest that pts may respond to a rechallenge of RUX after drug stop (Gerds et al, 2018). Aims: To investigate in a real-world context: 1) frequency and reasons for rechallenge; 2) therapeutic effects of rechallenge; 3) impact of rechallenge on overall survival (OS) Methods: After IRB approval, a clinical database was created in 20 European Hematology Centers including now retrospective data of 703 MF pts who started RUX from Jan 2011 to Nov 2019. Only chronic phase (CP) pts who stopped RUX for ≥14 days and survived ≥30 days after discontinuation were included. A specific survey collected clinical/laboratory data at RUX stop and at rechallenge, reasons for discontinuation and treatments before rechallenge. OS was estimated from the date of the first/only RUX discontinuation to last contact (log-rank test). Results: A total of 219 CP pts was evaluable for this study. In 60 (27.4%) pts, RUX was re-challenged for ≥14 days after the first discontinuation (RUX-again), while 159 (72.6%) pts discontinued RUX permanently (RUX-stop). The median time from RUX start to stop was of 16.5 and 12.3 mos for RUX-again and RUX-stop pts, respectively (p=0.41). At RUX start, characteristics of RUX-again were: median age 67y (24-88); males 61.7%; PMF 53.3%; median Hb 10.2 g/dl; median PLT/WBC: 249/12.6 x109/l; median RUX starting dose: 15mg BID. Baseline characteristics of RUX-again and RUX-stop pts were comparable. In the 60 RUX-again pts, reasons for discontinuation included loss of/inadequate response (18 pts, 30%) and toxicity (42 pts, 70%). Toxicity included G3-4 thrombocytopenia (38.1%), anemia (26.2%), infections (21.4%), other (14.3%). Conversely, RUX-stop pts discontinued RUX mainly due to loss of/inadequate response (75 pts, 47.2%), while intolerable toxicity occurred in 69 pts (43.4%) (p=0.004) and other causes in 9.4%. At first RUX discontinuation, 35.7% of RUX-again pts presented with large (>10 cm) splenomegaly; median Total Symptoms Score (TSS) was 10 (TSS>20 in 30.4% of pts). The median duration of temporary RUX discontinuation was 2 mos (range 0.5-71.1). During RUX stop, 65% of RUX-again pts did not receive any therapy, 15% received only palliation (steroids, hydroxyurea), while 11.7% switched to investigational agents, 3.3% underwent splenectomy and 5% allogeneic transplantation. Compared to disease status at first RUX stop, at RUX restart there was a significant increase of pts with large splenomegaly and high TSS, while the PLT count was higher and RUX dose significantly lower (Table 1). The median duration of RUX rechallenge was 7.5 mos (0.5-72.7). During the rechallenge, 44.6% and 48.3% pts improved spleen and symptoms, and there was a significant increase in pts with TSS reduction (p=0.01); 8 pts (13.3%) continued RUX with stable/worsening spleen size and improvement in TSS. Conversely, 26.8% and 20% of pts had increase in spleen size and in symptoms, respectively. While Hb levels remained stable, PLT count significantly decreased during rechallenge (p The reasons for temporary discontinuation had no impact on the reduction of spleen/symptoms during rechallenge and on OS. However, comparing RUX-again and RUX-stop pts, RUX-again pts showed a better OS, with a median survival of 41.1 mos and 23.7, respectively in the 2 cohorts (Fig. 1). Conclusions: This real-world study highlights that RUX rechallenge is quite common in CP-MF pts, involving almost 30% of treated pts, particularly when the discontinuation is due to toxicity. The temporary discontinuation, while improving PLT count, generally caused a significant increase in disease burden. After rechallenge, almost 50% of pts achieved clinical responses regardless of reason of first discontinuation. This residual disease control activity, that correlated with improved OS, should be weighed up also given the new therapeutic possibilities available in these pts. Disclosures Palandri: Novartis: Consultancy, Honoraria. Breccia:Abbvie: Consultancy; Bristol-Myers Squibb/Celgene: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Incyte: Consultancy, Honoraria. Benevolo:Amgen: Honoraria; Celgene: Honoraria; Novartis: Honoraria. Cavazzini:Incyte: Honoraria; Pfize: Honoraria; Novartis: Honoraria. Crugnola:Janssen: Honoraria; BMS: Honoraria; Novartis: Honoraria; Celgene: Honoraria. Heidel:CTI: Consultancy; Celgene: Consultancy; Novartis: Consultancy, Research Funding. Pane:Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Jazz Pharmaceuticals: Consultancy, Other: travel expenses, Speakers Bureau; Daiichi Sankyo: Consultancy, Other: Travel Expenses; Novartis pharma SAS: Consultancy, Other: Travel Expenses, Research Funding, Speakers Bureau; Janssen: Other: Travel Expenses; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Consultancy, Other: Travel Expenses, Speakers Bureau; AbbVie: Consultancy, Other: Travel Expenses, Speakers Bureau. Cuneo:janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Gilead: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Krampera:Janssen: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees. Semenzato:Takeda: Honoraria; Roche: Honoraria; Abbvie: Honoraria. Lemoli:AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees; Jazz: Consultancy, Membership on an entity's Board of Directors or advisory committees; Daiichi Sankyo: Consultancy, Membership on an entity's Board of Directors or advisory committees; Servier: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene: Research Funding; BerGenBio ASA: Research Funding. Cavo:Jannsen, BMS, Celgene, Sanofi, GlaxoSmithKline, Takeda, Amgen, Oncopeptides, AbbVie, Karyopharm, Adaptive: Consultancy, Honoraria. Palumbo:Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

© 2020 European College of Sport Science, Objective: Analyse the relationship between different levels of physical activity (PA) and depression symptoms in a representative sample of European older adults. Methods: Data on PA, depression symptoms and sociodemographic variables from 64688 (28015 men) older adults participating in SHARE wave 6 was collected through a face-to-face interview. The EURO-D 12-item scale was administered for depression symptoms. Participants reported the frequency they engaged in moderate-intensity PA (MPA) and vigorous-intensity PA (VPA). Results: Men and women engaging in MPA and VPA once or more than once a week had less depression symptoms than those who engage less than once a week. MPA and VPA once or more than once a week were inversely associated with the depression symptoms score. Furthermore, engaging in MPA and VPA decreased the odds of depression (cut-off point of ≥4 depression symptoms) compared to engaging in PA less than once a week. Conclusions: Policies for promoting mental health should include PA for the prevention or treatment of depression symptoms. PA presents physical and psychological benefits and can be used as an overall health-promoting strategy, facing numerous problems at a time., The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N° 261982) and Horizon 2020 (SHARE-DEV3: GA N° 676536, SERISS: GA N°654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www. share-project.org).

Background: The main goal of this study was to diagnose the two most common thyroid disorders, namely, hyperthyroidism and hypothyroidism, based on multinomial logistic regression and neural network models. In addition, the study evaluated the predictive ability of laboratory tests against the individual clinical symptoms score. Materials and Methods: In this study, the data from patients with thyroid dysfunction who referred to Imam Khomeini Clinic and Shahid Beheshti Hospital in Hamadan were collected. The data contained 310 subjects in one of three classes—euthyroid, hyperthyroidism, and hypothyroidism. Collected variables included demographics and symptoms of hypothyroidism and hyperthyroidism, as well as laboratory tests. To compare the predictive ability of the clinical signs and laboratory tests, different multinomial logistic regression and neural network models were fitted to the data. These models were compared in terms of the mean of the accuracy and area under the curve (AUC). Results: The results showed better performance of neural network model than multinomial logistic regression in all cases. The best predictive performance for logistic regression (with a mean accuracy of 91.4%) and neural network models (with a mean accuracy of 96.3%) was when all variables were included in the model. In addition, the predictive performance of two models based on symptomatic variables was superior to laboratory variables. Conclusions: Both neural network and logistic regression models have a high predictive ability to diagnose thyroid disorder, although neural network performance is better than logistic regression. In addition, as achieving less error prediction model has always been a matter of concern for researchers in the field of disease diagnosis, predictive nonparametric techniques, such as neural networks, provide new opportunities to obtain more accurate predictions in the field of medical research.

Postoperative urinary retention necessitating catheterization after major lower limb arthroplasty surgery adds to the patients’ postoperative discomfort and increases the risk of urinary tract infection with potential risk of transient bacteraemia and seeding of infection to prosthetic joints. Preoperative evaluation of patients with lower urinary tract symptoms may help to identify at-risk patients and the International Prostate Symptoms Score (IPSS) has been used as a screening tool to quantify the severity of symptoms in males. A prospective cohort of 303 patients undergoing total hip or knee arthroplasty was evaluated using the IPSS. Patients were categorized into three symptom groups (mild, moderate and severe based on scores of 0–7, 8–18 and greater than 18, respectively) and four age groups (18) and urinary retention requiring catheterization in both males and females with both high specificity and sensitivity in the test in predicting postoperative catheterization. Hence, this test is a valid preoperative screen in predicting postoperative catheterization.

Introduction Lower Urinary Tract Symptoms (LUTS) can be a complication of ureteral stent insertion. Clinically, PDE5 inhibitors (Tadalafil) and alpha blockers (Tamsulosin) are the preferred drugs for treating lower urinary tract symptoms after ureteral stent insertion, also called ureteral stents-related symptoms (uSRS). This study aims to compare the effectiveness of 0.4 mg/day Tamsulosin and 10 mg/day Tadalafil for treating uSRS. Methods This study used a double-blinded experimental design. Fifty patients with uSRS were randomly assigned to one of 2 groups; group I (n = 25) received 10 mg/day Tadalafil, while group II (n = 25) received 0.4 mg/day Tamsulosin. The Ureteral Symptoms Score Questionnaire (USSQ) was administered on the 7th, 14th, 21st, and 28th day after insertion of the ureteral stent. p values of Results The administration of 10 mg/day Tadalafil had a good effect in reducing the LUTS score: mean scores were VS = 11.03, p = 4.21, GC = 3.8, WA = 1.29, SA = 1.94, and AS = 3.21. The administration of 0.4 mg/day Tamsulosin also had a good effect in reducing the LUTS score: mean scores were VS = 13.73, p = 9.89, GC = 3.85, WA = 4.31, SA = 0.59, and AS = 4.69. Conclusion Administration of 10 mg/day Tadalafil had significantly better results compared to 0.4 mg/day Tamsulosin in improving uSRS, except in VS week 2 and in GC weeks 2 and 4.

Influenza remains one of the major infectious diseases that targets humankind. Understanding within-host dynamics of the virus and how it translates into the spread of the disease at a population level can help us obtain more accurate disease outbreak predictions. We created an ordinary differential equation model with parameter estimates based on the disease symptoms score data to determine various disease stages and parameters associated with infectiousness and disease progression. Having various stages with different intensities of symptoms enables us to incorporate spontaneous behavior change due to the onset/offset of disease symptoms. Additionally, we incorporate the effect of a waning vaccine on delaying the time and decreasing the size of an epidemic peak. Our results showed that the epidemic peak in the model was significantly lowered when public vaccination was performed up to two months past the onset of an epidemic. Also, behavior change in the earliest stages of the epidemic lowers and delays the epidemic peak. This study further provides information on the potential impact of pharmaceutical and non-pharmaceutical interventions during an influenza epidemic.

Objectives To assess the feasibility and efficacy of prostatic artery embolization in relieving symptoms of benign prostatic hyperplasia. Materials and methods In a prospective study 28 patients with symptomatic benign prostatic hyperplasia were presented for prostatic artery embolization between June 2012 and June 2014. Patients age was 48–85 years with mean age 68.5 years ± 10.6 SD. International Prostate Symptoms Score (IPSS) before intervention measured 20–35 with mean score 26.3 ± 6.8 SD. Prostatic volume before intervention ranged between 48 and 166 cc 3 with mean of 82.6 ± 11.2 SD. Results Technical success was achieved in all cases (100%). All patients were followed for 6 months after the procedure. IPSS improved at 6 months in all patients with post embolization mean of 12.2 ± 3.4 SD with significant P value of 0.0006. Mean post-procedure prostatic volume at 6 months was 49.8 cc 3 ± 16.9 SD with 39.7% mean volume reduction. No major complications were recorded. We achieved clinical success in 27 patients (96.4%) with only one non responding patient (3.6%). Conclusion Prostatic artery embolization is a feasible technique and preliminary short-term results show promising high technical and clinical success rates in symptomatic patients with benign prostatic hyperplasia.

Allergic rhinitis is a common and debilitating disease that has a major effect on the health related quality of life. The usage of corticosteroids topically and newer generation antihistamines have been the hallmark of recent advances in treatment of allergic rhinitis. Hence this study was taken to clinically evaluate the efficacy of lipid-based ointment and traditional antihistamine Rupatidine in treatment of moderate persistent allergic rhinitis. This study was designed to compare the efficacy of lipid-based ointment and traditional antihistamine in the treatment of moderate persistent allergic rhinitis. 60 Patients aged between 15 and 70 years with moderate to severe symptoms of allergic rhinitis were chosen after history taking, clinical examination and relevant lab investigations—nasal smear examination and serum IgE levels in specific. They were randomized into two groups and started on either lipid based ointment (to apply ointment to nasal vestibule twice daily) with tablet Rupaditine 10 mg OD and only tablet Rupatidine 10 mg OD alone. Patients were asked to observe the efficacy of their treatment on daily basis. Mean age of patients in lipid based ointment group with tablet Rupatidine was 33.53 years and only tablet Rupatidine group was 28.9 years. Positive family history was present in 13.3 % patients in group I with 26.6 % patients in group II. Symptoms score decreased from baseline in group I as compared to group II. Lipid based ointment with tablet Rupatidine is superior in relieving moderate allergic rhinitis compared to tablet Rupatidine alone.

Purpose Convergence and accommodative insufficiency represent the main cause of complaints during close visual work and can reduce visual performance and comfort. Knowing their prevalence among schoolchildren is fundamental to define strategies for action. The purpose of this study was to estimate the frequency of these conditions in children in 5th and 6th school years in inland Portugal and to assess the impact that each visual condition has on their quality of life, based on the level of visual symptoms. Methods a cross-sectional study was carried out with children enrolled in the 5th and 6th school years. 372 children (192 girls) were assessed, with average ages of 10.9 ± 0.9 years. Refractive error and binocular vision assessment, integrating accommodative parameters, were used to analyse the visual condition. Symptoms were quantified using the Portuguese version of the CISS (Convergence Insufficiency Symptom Survey). Results The prevalence of definite Convergence Insufficiency (CI) in the children assessed was 2%. A prevalence of 6,8% could be considered if clinically significant CI (high suspect and definite categories) cases are accounted. In relation to Accommodative Insufficiency (AI), a frequency rate of 10% was recorded, with 3% of the evaluated children presenting AI and CI simultaneously. The symptoms score was higher in AI than in CI. Conclusions A frequency of approximately 10% was found for each one of the visual syndromes, and it was verified that visual discomfort is common among teenagers who carry these conditions. In cases of asthenopia, such as headaches and loss of concentration, associated with near vision activities, there is a requirement to evaluate the quality of binocular vision.

Background: Patients with schizophrenia have considerably higher rates of mortality than general population. Multiple factors may play a role in this. Despite being a major preventable cause of death, smoking is usually overlooked when dealing with patients with schizophrenia. Understanding the pattern of smoking, its severity, and the reasons to quit might be helpful in managing patients with schizophrenia and decreasing the mortality gap. Subjects and Methods: The study included smokers divided into two groups; the first included 346 patients with schizophrenia while the second group had 150 smokers with no mental illness. Both groups were assessed and compared regarding sociodemographic variables, pattern of smoking, severity of nicotine dependence, and motivation to quit smoking. Results: Earlier age of starting to smoke, higher number of cigarettes per day, and lower dependency scores were noted in patients with Schizophrenia. Positive correlation was found between positive symptoms and severity of dependence. Specific positive symptoms were correlated to number of cigarettes per day and time before first cigarette. Patients with Schizophrenia showed a significant difference in intrinsic reasons to quit (health concerns and self-control), which were also positively correlated to their positive symptoms score. Linear regression analysis for predictors of FTND score revealed that only age, sex, and schizophrenia were significant predictors of FTND score. Conclusion: Patients with schizophrenia smoke at earlier ages and smoke more cigarettes per day, yet, have less severe dependence than non-schizophrenic counterparts. Positive symptoms play a role in their smoking pattern and severity. Health concerns and self-control are their main motives to quit smoking.

Objective To evaluate the association between the components of metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) focusing at their effects on prostatic volume and on the severity of LUTS . Patients & Methods From October 2016 to January 2018, eighty patients presented with LUTS due to the BPH. LUTS were assessed using the international prostatic symptoms score (IPSS) and MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III guidelines. Patients were randomly collected into two categories: A (48 patients) had MetS and B (32 patients) without MetS. Results The mean age was 64.3 years, statistically significant variation was identified between the two categories regarding the moderate and severe IPSS, S.PSA, prostatic size and post voiding residue (PVR), the P value (

Purpose. The Dry Eye-Related Quality-of-Life Score (DEQS) is a Japanese dry eye-specific questionnaire that has been used to assess the symptoms of dry eye and their effects on the quality of life (QOL) in Japanese individuals. The purpose of this study was to determine the effect of rebamipide (RBM) on the QOL of Japanese patients with dry eye disease (DED). Method. The medical records of 43 patients (3 men and 40 women; mean age: 64 ± 14 years; range: 32 to 83 years), who were diagnosed with DED and treated with RBM at the Ehime University Hospital between November 2012 and June 2016, were reviewed. The effects of 2% rebamipide (RBM) ophthalmic suspension on the symptoms of DED was determined by the answers to the DEQS questionnaire and clinical findings. The clinical findings before and 1, 3, 6, 12, and 24 months after initiating the RBM treatment were reviewed. The following data were collected from the DEQS: the Summary score and two subscale scores, the Bothersome ocular symptoms score, and the Impact on daily life score. In addition, the standard fluorescein staining score, the Schirmer I test score, and the tear breakup time (TBUT) score were analyzed. Result. The Summary score and Impact of daily life score of the DEQS were improved significantly after 1, 3, 6, and 12 months of RBM, and the Bothersome ocular symptoms scores of the DEQS were also improved after 1, 3, and 6 months. The fluorescein staining scores were significantly decreased after 1, 3, 6, and 12 months, and the TBUT score was significantly increased after 1 month. Conclusion. RBM treatment improves the QOL by alleviating the corneal and conjunctival epithelial damages. The DEQS is a useful questionnaire that can assess the severity of the DED symptoms and their impact on the QOL. This trial is registered with UMIN000024405.

Abstract The aim of our study was to evaluate EHRA, additional cardiovascular risk (ACVR) classes and quality of life in patients during the first six months of radiofrequency ablation (RFA) of atrial fibrillation and flutter (AF, AFl). Materials and methods. 96 patients (54 men and 42 women) at the age of 59 ± 9 years who underwent RFA of AF and AFl were examined. The European Heart Rhythm Association (EHRA) classes on the arrhythmias symptoms score, ACVR classes and indicators of physical and mental health (PH and MH) components by the SF-36 questionnaire in the groups of AF, AFl and combined AF/AFl were evaluated before RFA, in the early postoperative period (on the 3–7 day) and 6 months after the procedure. Standard statistical procedures were performed for data processing using Microsoft Excel. Results. An increase in the frequency of the EHRA classes I and II at 6 months after RFA performing was observed the most in the isolated arrhythmia groups and less frequently in the context of a AF/ AFl combination. The ACVR classes 1 and 2 were observed more often by the 6 month after RFA, but only in the AF and AFl groups. In AF and AFl groups both PH and MH were increased in the postoperative period and six months after RFA, in the AF/AFl group - were increased in the early postoperative period, decreased by the 6 month not reaching the baseline values. MH across all three groups increased in the early postoperative period, remained unchanged up to the sixth month in the AF group, continued to increase in the AFl group, but decreased in the AF/AFl group altogether. Conclusions. The symptoms severity did not exceed the EHRA class I 6 months after RFA of AFl in most patients, after RFA of AF was by one third less frequently, and after RFA of combined AF/AFl was only in half of the patients. Decline of the ACVR levels 6 months after RFA was observed only in isolated AF and AFl groups. Quality of life PH and MH indicators increased in the early postoperative period after RFA in all patients, after 6 months - only in the isolated AFl group, decreasing in the combined AF/AFl group.

This study was conducted to investigate the prevalence, severity or impact of symptoms in hemodialysispatients and its relationship with self efficacy and family support to identify factors influencing their symptoms. Across-sectional design was used and the subjects were 243 patients undergoing hemodialysis at local units. The patients were Dialysis Symptom Index (DSI), a questionnaire about the presence and severity of symptoms. The datawere analyzed by descriptive statistics, independent t-test, Pearson coefficient correlation and multiple regression. There were significant differences in the total score of symptoms according to age and duration of hemodialysis. Symptoms score had significant negative correlations with family support (r=-.35, p

Objective: To investigate the correlation between Intravesical Prostatic Protrusion (IPP) and Prostate Uretral Angle (PUA) in Benign Prostatic Hyperplasia (BPH) patient with Lower Urinary Tract Symptoms (LUTS) on International Prostatic Symptoms Score (IPSS) and uroflowmetry. Methods: A cross sectional study was done to 71 BPH patients with LUTS who attended Urologic Clinic in Dr. Hasan Sadikin General Hospital and matched the inclusion and exclusion criterias. The Intravesical Prostatic Protrusion and PUA were measured using transrectal ultrasound and the degree of LUTS was measured using IPSS and uroflowmetry. Patients were classified based on PUA ( 10mm). Data were analyzed using Spearman correlation test. Results: Prostatic-Urethral Angle has a strong correlation with IPSS total and voiding (0.670 and 0.715) but the correlation was weak with IPPS storage (0.381). Furthermore, PUA has a strong negative correlation with Qmax dan Qave values. The bigger the PUA, the smaller Qmax dan Qave values. IPP has a strong correlation with IPSS total and voiding (0.645 and 0.662), but has moderate correlation with IPSS storage (0.442). Furthermore, IPP has no correlation with the values of Qmax, Qave, Voided volume and PVR. Conclusions: Prostatic-Urethral Angle and Intravesical Prostatic Protrusion have a strong correlation with the occurence of LUTS in BPH patients. Keywords: Benign prostatic hyperplasia, intravesical prostatic protrusion, lower urinary tract symptoms, prostate-urethral angle DOI: 10.15850/ijihs.v3n2.583

The most common cause for limiting mob ility of the elderly people is j oint disease , especially knee osteo arthritis. I t is the major cause of disability and socioeconomic burden at present . Qurs - e - mafasil is a Unani poly herbal compound formulation mentioned in a Unani pharmacopeia , Qarabadeen - e - Majeedi . In which it is recommended for waja - ul - mafasil (arthralgia). This formulation contains three ingredients, Chob Zard ( Curcuma longa Linn.), Surinjan Talkh ( Colchium luteum Baker.) and Samaghe Arabi ( Acacia Arabica W illd.). Aim of this study was to comprehend the effectiveness of the drug Qurs - e - mafasil in knee osteoarthritis patients. This study was done in 30 patients. Qurs - e - mafasil was administered orally as 2 pills 3 time s a day with water or milk for 4 weeks. The outcome measures such as VAS ( Visual Analogue Scale ), KOOS ( Knee injury and Osteoarthritis Outco me Score) and 15 meters walking test were used to assess the symptoms before and after treatment. These paired data were analyzed s tatistical ly accord ing to Wilcoxon Matched paired signed rank test . KOOS me an pain score was 39.73 ± 2.399 before treatment and it was 56.93 ± 2.214 after treatment with an extremely significant improvement. Similarly there was a significant (52.14± 3.449 ) improvement at 4 th week in KOOS symptoms score. There was a significant change in the mean of KOOS total score (13.6%) and, significant improvement was observed in VAS ( 56.80 ± 2.571) and walking time (22.85 ± 0.527) at 4 th week . Therefore, it is revealed that when Qurs - e - mafasil administered orally the symptoms of

Background: Metal exposure alters neurodevelopmental outcomes; little is known about critical windows of susceptibility when exposure exerts the strongest effect. Objective: To examine associations between dentine biomarkers of manganese (Mn), zinc (Zn) and lead (Pb) and later childhood behaviors. Methods: Subjects enrolled in a longitudinal birth cohort study in Mexico City provided naturally shed deciduous teeth. We estimated weekly prenatal and postnatal dentine Mn, Zn and Pb concentrations in teeth using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) and measured behavior at ages 8–11 years of age using the Behavior Assessment System for Children, 2nd edition (BASC-2). We used distributed lag models and lagged weighted quantile sum regression to identify the role of individual and combined dentine biomarkers of Mn, Zn and Pb on behavioral outcomes controlling for maternal education and gestational age. Results: Among the 133 subjects included in this study, prenatal and early postnatal dentine Mn appeared protective against childhood behavioral problems, specifically hyperactivity and attention. Postnatal dentine Mn was associated with increased reporting of internalizing problems, specifically anxiety. At 6 months, a 1-unit increase (unit = 1 SD of log concentration) in Mn was associated with a 0.18-unit (unit = 1 SD of BASC-2 score) increase in internalizing symptoms score and a 0.25-unit increase in anxiety. Postnatal Pb was associated with increasing anxiety symptoms; at 12 months, a 1-unit increase in Pb was associated with a 0.4 unit increase in anxiety symptoms. When examined as a metal mixture, we observed two potential windows of susceptibility to increased anxiety symptoms: the first window (0–8 months) appeared driven by Mn, the second window (8–12 months) was driven by the metal mixture and dominated by Pb. A 1-unit increase in the mixture index was associated with a 0.7-unit increase in SD of anxiety symptoms. Conclusions: Childhood behaviors may demonstrate postnatal windows of susceptibility to individual and mixed metal concentrations measured in deciduous teeth. Prenatal dentine Mn may be protective, while excessive early postnatal Mn may increase risk for adverse behaviors. In combination, higher concentrations of Mn, Zn and Pb may have an adverse impact on behavior. Keywords: Dentine biomarkers, Child behavior, Metal mixtures, Anxiety, Manganese

Objective: The purpose of this study was to assess the impact of acne on the quality of life. Its secondary objective was to assess the influence of gender of students and severity of symptoms on the quality of life. Methods: A cross sectional study was conducted on 100 students at Sultan Qaboos University (SQU) (40 males and 60 females) diagnosed with acne who attended the Student Clinic during a period of three months from September to December 2009. The Acne Quality Of Life index (Acne-QoL) questionnaire was used to assess the patient’s quality of life in four different domains: self-perception, social, emotional, and acne symptoms. Results: Acne affected all areas of the patients, quality of life with the emotional domain found to be the most affected. Overall, female patients reported more adverse QoL effects. The mean score for self-perception for female students was 2.5 and 2.8 for males (p=0.300). The role-social domain approached a significant difference between genders (p=0.078). There was a statistically significant correlation between severity of acne symptoms and the other three domains. The correlation was highest between acne symptoms score and self-perception score. Conclusion: This study showed that acne affects the quality of life of affected SQU students treated by primary care physicians at the Student Clinic. Therefore, physicians should take into account the effect of acne on the persons’ quality of life when individualizing treatment.

The aim of this registry study was to compare products used to control symptoms of CVI. Endpoints of the study were microcirculation, effects on volume changes, and symptoms (analogue scale). Pycnogenol, venoruton, troxerutin, the complex diosmin-hesperidin, Antistax, Mirtoselect (bilberry), escin, and the combination Venoruton-Pycnogenol (VE-PY) were compared with compressions.No safety or tolerability problems were observed. At inclusion, measurements in the groups were comparable: 1,051 patients completed the registry. Best performers: Venoruton, Pycnogenol, and the combination VE-PY produced the best effects on skin flux. These products and the combination VE-PY better improved PO2 and PCO2. The edema score was decreased more effectively with the combination and with Pycnogenol. Venoruton; Antistax also had good results. Considering volumetry, the best performers were the combination PY-VE and the two single products Venoruton and Pycnogenol. Antistax results for edema were also good. The best improvement in symptoms score were obtained with Pycnogenol and compression. A larger decrease in oxidative stress was observed with Pycnogenol, Venoruton, and with the VE-PY combination. Good effects of Antistax were also observed. Parestesias were lower with Pycnogenol and with Antistax. Considering the need for interventions, the best performers were Pycnogenol, VE-PY, and compression. The efficacy of Pycnogenol and the combination are competitive with stockings that do not have the same tolerability in warmer climates. A larger and more prolonged evaluation is suggested to evaluate cost-efficacy (and non-interference with drugs) of these products in the management of CVI. The registry is in progress; other products are in evaluation.