Objective: Since the emergence of the COVID-19 pandemic at the end of 2019, the number of affected cases has not stopped rising. Similarly, the number of scientific publications and pre-prints has been increasing exponentially, with an effort to understand this disease more and find a proper solution. The purpose of this article is to review the current understanding of the novel coronavirus. Background: The latest COVID-19 pandemic caused by the SARS-CoV-2 has spread globally ever since it emerged in Wuhan's city in China. This rapidly spreading disease has changed our lives in unimaginable ways, spreading fear and uncertainty due to the lack of knowledge and the flooding with new information, which lacks the scientific method and cannot be critically appraised. The purpose of this article is to gather some of the best knowledge that has been published so far in a unified narrative review, making it easy for the scientific community to review the most accurate and recent understandings about COVID-19. Methods: We screened relevant articles using a specified number of keywords and specific databases, including PubMed and Embase. We selected peer-reviewed English published material related to the topic, except for a few pre-prints that we deemed necessary to include. We also screened the reference lists of these articles to find relevant publications with the same criteria. Discussion: This narrative overview comprises several subsections that discuss the epidemiology, virology, pathogenesis, clinical manifestations, diagnostic methods, and management of the disease. We also presented a section on the implications of the disease in pregnancy. We wrapped up the review with a special division regarding the response to COVID-19, which has been diverse in different countries. Conclusion: COVID-19 has been a serious global health threat with a high transmission and case fatality rate, particularly in vulnerable populations. Epidemiologic models have so far guided the response, but they need to be interpreted carefully, with an understanding of their limitations. The disease's response has varied among different countries; with no current vaccine or standard treatment, the world stands in fear, maximizing preventive strategies to reduce the damages caused by this virus. This manuscript presents a summary of everything that is so far known about COVID-19 to make it easier for the medical community to overview the disease that has changed the world.
PURPOSE: The purpose of this study was to evaluate the efficacy of the combination therapy of intravitreal aflibercept 2 mg (Eylea ® ) and a sustained-release dexamethasone 0.7 mg intravitreal implant (Ozurdex ® ) versus dexamethasone alone in providing better visual acuity in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO). METHODS: Seventy-four eyes of 74 patients with treatment-naïve ME secondary to RVO were included in this prospective nonrandomized case series and were studied over a 12-month follow-up period. Patients in the dexamethasone monotherapy group were treated with an initial Ozurdex ® injection while patients in the combination therapy group were treated with an Eylea ® injection followed 2 weeks later by an Ozurdex ® injection. The treatment was repeated as needed. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were evaluated periodically. The primary outcome measure was the BCVA. The secondary outcome measures included CMT, number of retreatments, and safety parameters. RESULTS: At 1 year, the primary endpoint was met. Patients receiving combined therapy had better mean visual acuity changes from baseline compared to those receiving monotherapy (0.369 ± 0.221 logarithm of the minimum angle of resolution [logMAR] vs. 0.218 ± 0.171 logMAR; P = 0.002). The secondary endpoints were not met since there were no significant differences in mean reductions in CMT (272.67 ± 82.35 vs. 248.11 ± 159.73; P = 0.412) and the mean number of retreatments was similar in the two groups (1.75 ± 1.13 vs. 1.42 ± 0.64; P = 0.126). CONCLUSION: Aflibercept with dexamethasone implants achieved better visual outcomes compared to dexamethasone monotherapy with no significant differences in intravitreal retreatment rates at the 1 st year in eyes with ME secondary to RVO.
Background A large proportion of the population in Arab countries suffer from chronic diseases. According to the statistics by the Global Health Estimates, chronic illnesses contribute by 71% to total deaths in the Arab region. While chronic illnesses have been demonstrated to carry high levels of social stigma, it is only recently that little research attention has been given to this topic in the Arab world. It is well-established that the social stigma construct is culturally-dependent. Therefore, the lack of an Arabic measure highlighted the urgent need for developing a culturally adapted and valid instrument to assess social stigma toward people living with chronic diseases. In this study, we aimed to examine the psychometric properties of the Arabic translation, adaptation and development of “the Social Stigma Scale of Chronic Diseases” (SSS-CD). Method Fifteen items derived from the literature and assessing social stigma towards chronic diseases have been administered to 570 Arabic-speaking adults from the Lebanese general population (aged 24.59 ± 6.75years; 68.6% women). Items were translated into Arabic using a forward-backward translation method. Exploratory factor analysis (EFA) using a principal-axis EFA on the first split-half subsample, followed by a confirmatory factor analysis (CFA) tested on the model extracted from the EFA on the second split-half subsample, were conducted to examine the construct validity of the SSS-CD. Fit indices were deemed adequate if the normed model chi-square (χ²/df) ≤ 3, the Steiger-Lind root mean square error of approximation (RMSEA) ≤ 0.08, the Tucker-Lewis Index (TLI) and the comparative fit index (CFI) ≥ 0.90. Results Findings revealed that the 10-item SSS-CD has a unidimensional factor structure, with the following fit indices: χ2/df = 92.95/34 = 2.73, RMSEA = 0.077 (90% CI 0.059, 0.096), SRMR = 0.062, CFI = 0.939, TLI = 0.919. A good internal consistency was demonstrated by a McDonald’s omega value of 0.73 for the total score. Findings also supported invariance across gender, with men exhibiting higher levels of social stigma attached to chronic diseases than women. All three dimensions of stigmatization (social, psychological and evolutionary stigmatization) were positively correlated with SSS-CD scores (Social self-interest [r = .40; p < .001], Evolutionary self-interest [r = .37; p < .001], Psychological self-interest [r = .42; p < .001]), demonstrating relatively strong convergent validity. Conclusion Our findings suggest that the SSS-CD has robust psychometric qualities. We thus preliminarily suggest that the scale is valid, reliable and suitable for use among Arabic-speaking people from the general population to measure public attitudes towards people living with chronic diseases. Providing this psychometrically sound measure will hopefully enable to foster research in this area in order to draw a clear overview of the prevalence and characteristics of social stigma attached to chronic diseases in Arabic-speaking communities. However, given that this was the first study to examine the psychometric properties of the SSS-CD, the present findings and conclusions should be considered tentative pending future cross-national validation studies.
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