Objective: To evaluate the efficacy of oral rivaroxaban compared to warfarin in patients with deep vein thrombosis (DVT). Study Design: Open label randomized controlled study.
Introduction: Mak nyahs (male-to-female transgenders) often consume feminizing hormones to achieve and maintain the female physical appearance. They do it without professional prescription/advise, and often take excessive doses. This renders them at risk of developing complications of hormone consumption. This paper provides some quantitative data on hormone consumption among mak nyahs in Kuantan, Pahang, in Malaysia. Materials and Methods: A cross-sectional study was carried out from July to August in 2015 among 35 mak nyahs. Convenience sampling was used. Participants who gave consent answered an interview-guided questionnaire which documents socio-demographic profile, hormone usage, and morbidities as a result of hormone consumption. Data was analysed using SPSS, Version 16.0. (version 16). Results: Majority of the subjects were Malays (91.4%) and Muslims (97.1%), their median (IQR) age being 31 (±17) years, more than half (57.1%) were between 20 to 40 years old. Most (80.0%) of them are sex workers. Oral hormone was most commonly used (88.6%), while more than half (67.7%) of them added hormone injections. Almost all subjects purchased hormones over the counter from local pharmacies (94.2%). However, many received information on hormone from non-professional sources. Possible adverse effects of hormones reported among subjects were hypertension, ischemic heart disease, diabetes mellitus, and venous thrombo-embolism. Conclusion: Hormone consumption was very common among the subjects in this study, and may be associated with certain medical problems. Medical personnel must pay more attention in educating the mak nyahs on adverse effects of hormones consumption. Mak nyahs should also be screened for complications every time they seek medical attention.
Background: In lower levels of play, the lateral ankle sprain is the most common time loss injury, especially amongst male youth soccer players.Purpose: The aim of the present study was to evaluate the effects of an injury prevention program on the incidence of ankle injuries in male youth amateur players.Study Design: Randomized controlled trial study.Methods: Fifty boys (mean ±SD: age 13.3±0.4 yr; body mass index of 20.9 ± 1.5 kg/m2; stature: 1.6 ± 0.1 m) from two sport schools, with 4.4 ± 0.5 years playing experience, participated. Players were randomly assigned to either an experimental (EXP, n = 25) or a control (CON, n = 25) group. A physical exercise program designed exclusively for youth male soccer players was combined with education of athletes and coaches to increase awareness of injury risk. Over 1 year all injuries were documented monthly by physiotherapist. Complete monthly injury reports were available for 50 players.Results: Nine ankle injuries occurred in the EXP group and 20 injuries occurred in the CON group, corresponding to incidence rates of 0.96 and 2.16, respectively, per 1000 player hours, which equates to 55% fewer injuries in the EXP group.Conclusions: The incidence of ankle injuries among youth male soccer players can be reduced by implementation of a multifaceted, soccer-specific physical exercise program. Coaches and players need better education regarding injury prevention strategies and should include such interventions as part of their regular training.
Background: The present study was designed to assess the comparative performance of the Simplified Acute Physiology Score III (SAPS III) and sequential organ failure assessment (SOFA) score in predicting mortality among critically ill ICU patients. Methodology: A cross-sectional study was conducted from January 2019 to December 2019, including 162 patients admitted to the medical intensive care unit (ICU) of PIMS, Islamabad. The SOFA and SAPS III scores were calculated for all patients on admission. Outcome parameters included death or discharge from the hospital and disability. The receiver operating characteristic (ROC) curve was constructed for the studied models, and the scores were correlated with mortality. Results: The overall mortality rate in the studied population was 46.9%. The mean SAPS III and SOFA scores were 55.26±18.46 and 14.41±5.67, respectively. The area under the ROC curve (aROC) for the SAPS III was 0.71 at a cut-off value of 43.5, whereas the aROC for SOFA was 0.64 at a cut-off score of 12.5. The ROC curve for predicting hospital mortality exhibited that both SAPS III and SOFA scores were sensitive predictors of mortality, given SAPS III had relatively better prediction (85%) compared to SOFA (76%). Conclusion: It is concluded that SAPS III and SOFA scores are sensitive predictors of mortality; however, SAPs score is better at predicting mortality than SOFA score.
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