Major adverse cardiovascular events (MACE) remain the major cause of mortality and morbidity in patients with STEMI (ST-elevation myocardial infarction). The current literature is aimed to analyze the occurrence of MACE following STEMI irrespective of treatment provided, and follow up after the first diagnosis of STEMI. A PubMed search for Studies of STEMI identified 24,244 articles. After applying our inclusion/exclusion criteria, we found out 75 articles of relevance wherein MACE and its components were considered to be the primary endpoint. These 75 articles included eight Cohort Studies, 13 clinical trials including five randomized controlled trials (RCT), one case-control Study, one cross-sectional study, one review article, and 51 other observational studies. Our analysis shows that MACE remains one of the strongest adverse outcomes among STEMI patients. The current literature review found out the incidence of MACE was 4.2 % to 51% irrespective of the mode of treatment, and follow-ups lasting up to 10 years from the time of STEMI diagnosis.
Teenage Pregnancy as "any pregnancy from a girl who is 10-19 years of age", the age being defined as her age at the time the baby is born. The objective of the study to identify the consequences of teenage pregnancy among the Chepang women in Korak village development committee in Chitwan. This study design was descriptive, cross sectional and 148 respondents were selected randomly and interviewed by using semi-structured questionnaires. Data entry was done by using Epi data and analyzed by SPSS. The study finding revealed that, majority of the respondents 56.1% had got married before the age of 16 years, 58.1% gave first child birth the age of 17-19 years and 57.1% had 1-3 numbers of children. Similarly, 10.1% had preterm birth, 18.2% had history of miscarriage and 99.3% had delivered at home. There was significant relationship between the age of child birth with complications of teenage pregnancy which gave birth before term (p=0.020) and women having ≥4 children had the difficulty to control urine during coughing and sneezing (<0.001). the study concluded that there is a need of public awareness programme which can be done through orientation and training regarding reproductive health.
This literature review is aimed to determine if metformin alone improves menstrual irregularities in females with the polycystic ovarian syndrome. The current literature review involves females with polycystic ovarian syndrome experiencing menstrual irregularity. The data was collected in PubMed and inclusion criteria included articles published in the past 10 years, articles involving only humans, articles written in the English language and considering women age 19 or more. The number of discovered articles was 1550 after the first search and only 25 articles that met the inclusion criteria were selected after quality assessment. The selected 25 articles that met the inclusion criteria after a review showed evidence for regulating menstrual cycles with metformin therapy alone among females with the polycystic ovarian syndrome. When metformin was used in addition to other pharmacologic agents, there was a more significant restoration of menstrual cycles. Monotherapy with metformin is found to be highly effective in treating menstrual irregularities experienced among patients with the polycystic ovarian syndrome. Greater improvement was noted with the addition of another agent to metformin.
It was interesting to read the article Teenage Pregnancies in Nepal-The Problem Status and Socio-Legal Concerns. 1 This article indeed takes consideration of scenario of teenage pregnancies in major health care facilities of Nepal. We appreciate the author's effort to draw attention of readers that may also include the Health Policy makers of Nepal regarding legal age of marriage and teenage or adolescent pregnancies. It is obvious from the article that authors have made a considerable effort in identifying the number of teenage pregnancies occurring within a marriage and outside of marriage. 1 Authors have also stated that they analyzed the data to include the number of adolescent mothers who are less than 20 years of age at the time of delivery. 1 Nepal stands to have open borders with the neighboring nation of Union of India. 2 Healthcare facilities are widely utilized by citizens of both the nations on each other's land. The authors do not clearly state the nationality of the participants of the study. The residence of the participants also remains a major factor as people of both Indian and Nepalese nationality have been living within each other's community. People who officially write their nationality as Nepalese have been living most of their lives in India and vice versa. So, if the above scenario is the case, it is utterly unfair to project the data on behalf of Nepal and people living in Nepal who have a distinct cultural and socioeconomic background. Conflict of Interest: None.
Coronavirus Disease 2019 (COVID-19) is a respiratory illness caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is considered to be first reported from Wuhan, Hubei Province, China in December 2019. As of present, there are over 3.7 million identified cases worldwide and more than 259,000 deaths have been reported. This disease, its incubation period, course, complications, and the basis of spread remains a potential question due to variation in the pattern of spread around the globe and relatively fewer number of large-scale studies at present. This literature review aims to study the available data on its spread and incubation period. A literature search using PubMed with regular keywords ‘coronavirus’ and ‘COVID-19’, and Medical Subject Headings (MeSH) search for their etiology and pathogenicity was done with the search builder. The literature search revealed 26,689 studies among which 14 studies were selected for review. Studies were selected after the application of inclusion criteria and exclusion criteria with the removal of duplicates, and careful review for the outcome of interest ‘incubation period’. Among the 14 studies selected for review, there were eight review articles, five case reports, and one comparative study. The current literature review concludes that the mean incubation period for most of the literature falls between five days to 12 days with minimum reported time from known exposure to the onset of a symptom being one day and the maximum reported time from exposure to the onset of a symptom being 18 days.
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