Background COVID-19 may cause respiratory distress syndrome and death. Treatment of COVID-19 to prevent complications remains a priority. Our investigation sought to determine whether combination of spironolactone and sitagliptin could reduce mortality for inpatient with SARS-CoV-2 infection. Methods This single blind, 4-arms, prospective randomized clinical trial was conducted at Shiraz and Bushehr University of Medical Sciences hospitals between December 2020 and April 2021. We randomized hospitalized adult patients with COVID-19 pneumonia into four groups: control, combination therapy, sitagliptin add on, or spironolactone add on. The primary outcome was the clinical improvement of the patients in the hospital as measured on an eight-point numerical scale. The secondary outcomes included intubation, ICU admission, end organ damages, CT findings and paraclinical information. Results 263 admitted patients were randomly assigned to control group (87 patients), combination group (60 patients), sitagliptin group (66 patients) and spironolactone group (50 patients). There were no significant differences in baseline characteristics, except for higher age in control group. The intervention groups, especially combination therapy, had better clinical outcomes (clinical score on 5th day of admission was 3.11 ± 2.45 for controls, 1.33 ± 0.50 for combination, 1.68 ± 1.02 for sitagliptin, and 1.64 ± 0.81 for spironolactone; with p-value = 0.004). However, the mortality rate was lower in patients who received spironolactone (21.84% control, 13.33% combination, 13.64% sitagliptin, 10.00% spironolactone; p-value = 0.275). Our intervention reduced lung infiltration but not the area of involvement in lung. Conclusion Sitagliptin and spironolactone can potentially improve clinical outcomes of hospitalized COVID-19 patients.
Purpose In the process of reporting accounting information, the auditor’s objective is to detect possible misstatements and errors in accounting information. Audit evidence aids auditors in providing reasonable assurance about the quality of financial reporting. Studying the quality of family firms’ financial reporting is of higher importance relative to non-family firms due to lower risk of accounting manipulation. Therefore, the purpose of this paper is to examine the relationship between family ownership structure and financial reporting quality from an auditing perspective. Design/methodology/approach To analyze the research hypotheses, the authors use a sample data consisted of 221 companies listed on the Tehran Stock Exchange (including 52 family and 169 non-family firms) over a five-year span from 2011 to 2015. Findings Using multivariate regression analysis of panel data, our results indicate that audit risk in family firms is lower than their counterparts. Likewise, the findings are indicative of lower audit fees paid by family firms as compared to non-family ones. The authors also find that auditors put more effort in family firms and thus audit effort is more significant for these kinds of firms. Originality/value The study focuses on family ownership and financial reporting quality in a developing country like Iran and the results of the study may be beneficial to other developing nations, as Iran stock market possesses some unique features which are not normally prevailing in other equity markets, even in the Middle East.
Introdution: The aim of the present study was to investigate the efficacy of cognitive-behavioral therapy and hope therapy on quality of life, life expectancy, resiliency in patients with thalassemia who went to Bushehr Thalassemia Therapy Center in 2017. Methods: The study was experimental and census was used. It consisted of 21 patients with thalassemia in Bushehr province who were randomly divided into two experimental groups of cognitive-behavioral therapy and hope therapy and one control group. To conduct the research, World Health Organization Quality of Life Questionnaire, Life Expectancy Questionnaire by Schneider and Connor–Davidson Resilience Scale were used. All the patients completed the questionnaires before and after the intervention. In order to analyze data, analysis of covariance was performed. Results: In the therapy group, the majority of the patients were female, single and held a bachelor's degree. Similarly, in the control group, the highest proportion belonged to females and married patients, whereas a minority held a bachelor's degree. Compared with the control group, the findings of analysis of covariance revealed that both cognitive-behavioral therapy and hope therapy were significantly effective (p-value<0.05). Cognitive-behavioral therapy significantly increased quality of life, life expectancy and resiliency (37%), (14%) and (20%), respectively. Also, hope therapy significantly increased quality of life, life expectancy and resiliency (98%), (29%) and (11%), respectively. The findings showed that hope therapy was more effective than cognitive-behavioral therapy in increasing quality of life, life expectancy and resiliency. Conclusion: The results indicated that cognitive-behavioral therapy and hope therapy were effective in enhancing the quality of life, life expectancy and resiliency in the patients with thalassemia. Hence, considering psychological interventions, in addition to physical therapies, is of particular importance.
Introduction: Pseudomonas aeruginosa is a gram-negative, opportunistic pathogen causing infections in patients staying in the hospital and is resistant to multiple drugs. This study investigated the resistance to ciprofloxacin by the efflux system of Pseudomonas aeruginosa.Materials and Methods: For this purpose, the inhibitor of the efflux system phenylalanine-arginine beta-naphthylamide was used. In this study, 135 isolates of Pseudomonas aeruginosa were collected from the hospitalized patients of Imam Khomeini Hospital and outpatient clinics in Urmia during a ten-month period from June 2015 to March 2016. These isolates were re-identified by standard microbiological and biochemical methods. Finally, 51 isolates were selected for antibiotic susceptibility testing.Results: According to the antibiogram test, the Pseudomonas aeruginosa isolates exhibited highest resistance against ciprofloxacin (90.2%), tobramycin (88.2%), and gentamycin (86.3%) and the highest sensitivity towards colistin (76.4%), and imipenem (72.5%). The 51 isolates, which were selected for the minimum inhibitory concentration test, had multi-drug resistance regulators.Conclusion: The discovery and development of the efflux system inhibitors is an important strategy to deal with bacterial infections.
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