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Frilled Lizard Optimization: A novel Bio-Inspired Optimizer for Solving Engineering Applications

Computers, Materials & Continua 2024年第6期79卷 3631-3678页

作者： Ibraheem Abu Falahah Osama Al-Baik saleh Alomari Gulnara Bektemyssova Saikat Gochhait Irina Leonova OmParkash Malik Frank Werner Mohammad Dehghani Department of Mathematics Faculty of ScienceThe Hashemite UniversityP.O.Box 330127Zarqa13133Jordan Department of Software Engineering Al-Ahliyya Amman UniversityAmman19328Jordan Faculty of Science and Information Technology Software EngineeringJadara UniversityIrbid21110Jordan Department of Computer Engineering International Information Technology UniversityAlmaty050000Kazakhstan Symbiosis Institute of Digital and Telecom Management Constituent of Symbiosis International Deemed UniversityPune412115India neuroscience Research Institute Samara State Medical UniversitySamara443001Russia Faculty of Social Sciences Lobachevsky UniversityNizhny Novgorod603950Russia Department of Electrical and Software Engineering University of CalgaryCalgaryAB T2N 1N4Canada Faculty of Mathematics Otto-von-Guericke UniversityP.O.Box 4120Magdeburg39016Germany Department of Electrical and Electronics Engineering Shiraz University of TechnologyShiraz***Iran

This research presents a novel nature-inspired metaheuristic algorithm called Frilled Lizard Optimization(FLO),which emulates the unique hunting behavior of frilled lizards in their natural *** draws its inspiration from the sit-and-wait hunting strategy of these *** algorithm’s core principles are meticulously detailed and mathematically structured into two distinct phases:(i)an exploration phase,which mimics the lizard’s sudden attack on its prey,and(ii)an exploitation phase,which simulates the lizard’s retreat to the treetops after *** assess FLO’s efficacy in addressing optimization problems,its performance is rigorously tested on fifty-two standard benchmark *** functions include unimodal,high-dimensional multimodal,and fixed-dimensional multimodal functions,as well as the challenging CEC 2017 test ***’s performance is benchmarked against twelve established metaheuristic algorithms,providing a comprehensive comparative *** simulation results demonstrate that FLO excels in both exploration and exploitation,effectively balancing these two critical aspects throughout the search *** balanced approach enables FLO to outperform several competing algorithms in numerous test ***,FLO is applied to twenty-two constrained optimization problems from the CEC 2011 test suite and four complex engineering design problems,further validating its robustness and versatility in solving real-world optimization ***,the study highlights FLO’s superior performance and its potential as a powerful tool for tackling a wide range of optimization problems.

关键词： Optimization engineering bio-inspired metaheuristic frilled lizard exploration exploitation

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Various Organic nutrient Sources in Combinations with Inorganic Fertilizers Influence the Yield and Quality of Sweet Corn(Zea mays ***)in new Alluvial Soils of West Bengal,India

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Phyton-International Journal of Experimental Botany 2024年第4期93卷 763-776页

作者： Anindita Das Kanu Murmu Biplab Mitra Pintoo Bandopadhyay Ritesh Kundu Moupiya Roy saleh Alfarraj Mohammad Javed Ansari Marian Brestic Akbar Hossain Department of Agronomy School of Agricultural SciencesJIS UniversityKalyaniNadiaWest Bengal741235India Department of Agronomy Bidhan Chandra Krishi ViswavidyalayaMohanpurWest Bengal741252India Department of Agronomy Uttar Banga Krishi ViswavidyalayaCoochbeharWest Bengal736101India Office of The Assistant Director of Agriculture Gosaba BlockArampurSouth 24 ParganasWest Bengal743370India Department of Agricultural Statistics Bidhan Chandra Krishi ViswavidyalayaMohanpurWest Bengal741252India Zoology Department College of ScienceKing Saud UniversityRiyadh11451Saudi Arabia Department of Botany Hindu College Moradabad(Mahatma Jyotiba Phule Rohilkhand UniversityBareilly)MoradabadUttar Pradesh244001India Institute of Plant and Environmental Sciences Slovak University of AgricultureTr.A.Hlinku 2Nitra94901Slovak Division of Soil Science Bangladesh Wheat and Maize Research InstituteDinajpur5200Bangladesh

nutrient management plays a crucial role in the yield and quality of sweet corn.A field experiment was conducted in consecutive two kharif seasons in 2018 and 2019 to investigate the effect of various organic sources of nutrients in combination with inorganic sources on the yield and quality of sweet corn under new alluvial soils of West Bengal,*** were:T_(1):Control(without fertilizers);T_(2):100%recommended dose(RDF)of chemical fertilizers(CF)(RDF CF_(100%));T_(3):100%recommended dose of n(RDn)through vermicompost(VC)(RDn VC_(100%));T_(4):50 RDn through CF+50%RDn through VC(RDn CF_(50%)+RDn VC50%);T_(5):50%RDF through CF+50%RDn through organic source(OS)1,Soligro(Ascophyllum nodosum)granular(RDn CF_(50%)+RDn OS_(150%));T6:50%RDn through CF+50%RDn through OS 2,Bioenzyme(liquid)(RDn CF_(50%)+RDn OS250%);T7:50%RDn through CF+50%RDn through OS 3,Opteine(Ascophyllum nodosum)filtrate[RDn CF_(50%)+RDn OS350%];T8:50%RDn through VC+50%RDF through OS 1,Soligro(Ascophyllum nodosum)granular(RDn VC50%+RDn OS_(150%)).The OS of fertilizers were VC,SoliGro Gr(OS1)(Ascophyllum nodosum),Bioenzyme liquid(OS2),and Opteine(Ascophyllum nodosum)filtrate(OS3).The inorganic source was traditional CF applied at the RDF(150:75:75 kg ha^(−1) of n:P2O5:K2O).The VC was used to supply 100%RDn as one source or 50%RDn when combined with CF or *** fruit yield(10.75 and 10.79 t ha^(−1) in 2018 and 2019,respectively)was recorded when RDF was substituted through CF only,being statistically at par with 50%CF+50%VC on a nitrogen equivalent basis(9.92 and 10.00 t ha^(−1) in 2018 and 2019,respectively)and 100%VC(8.22 and 8.32 t ha^(−1) in 2018 and 2019,respectively).Compared to chemical sources of nutrients,VC-based treatments produced a larger percentage of large-size cob(>25 cm).The 100%VC increased antioxidant(8.35 and 8.45 mg g^(−1)),carotenoid(0.59 and 0.61 mg/100 g),and phenol(55.06 and 55.02 mg 100 g^(−1))content compared with its 50%dose in combination with other *** s

关键词： Biostimulants Ascophyllum nodosum crop quality crop yield sweet corn

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The interplay mechanism between IDH mutation, MGMT-promoter methylation, and PRMT5 activity in the progression of grade 4 astrocytoma: unraveling the complex triad theory

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Oncology Research 2024年第6期32卷 1037-1045页

作者： MAHER KURDI ALAA ALKHOTAnI ABDULRAHMAn SABBAGH EYAD FAIZO AHMED I.LARY AHMED K.BAMAGA MAJID ALMAnSOURI BADR HAFIZ THAMER ALSHARIF saleh BAEESA Department of Pathology Faculty of MedicineKing Abdulaziz UniversityRabighSaudi Arabia Department of Pathology College of MedicineUmm Al-Qura UniversityMakkahSaudi Arabia Department of Surgery Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Surgery Faculty of MedicineUniversity of TabukTabukSaudi Arabia Section of neurosurgery Department of SurgeryKing Abdulaziz Medical CityJeddahSaudi Arabia Department of Pediatrics Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Clinical Biochemistry Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of neurosciences King Faisal Specialist Hospital and Research CenterJeddahSaudi Arabia Department of Surgery King Abdulaziz Specialist HospitalTaifSaudi Arabia

Background:The dysregulation of Isocitrate dehydrogenase(IDH)and the subsequent production of 2-Hydroxyglutrate(2HG)may alter the expression of epigenetic proteins in Grade 4 *** interplay mechanism between IDH,O-6-methylguanine-DnA methyltransferase(MGMT)-promoter methylation,and protein methyltransferase proteins-5(PRMT5)activity,with tumor progression has never been ***:A retrospective cohort of 34 patients with G4 astrocytoma is classified into IDH-mutant and IDH-wildtype *** groups were tested for MGMT-promoter methylation and PRMT5 through methylation-specific and gene expression PCR ***-cohort statistical significance was ***:Both IDH-mutant WHO grade 4 astrocytomas(n=22,64.7%)and IDH-wildtype glioblastomas(n=12,35.3%)had upregulated PRMT5 gene expression except in one *** of the 22 IDH-mutant tumors,10(45.5%)tumors showed MGMT-promoter methylation and 12(54.5%)tumors had unmethylated *** IDH-wildtype tumors had unmethylated *** was a statistically significant relationship between MGMT-promoter methylation and IDH in G4 astrocytoma(p-value=0.006).Statistically significant differences in progression-free survival(PFS)were also observed among all G4 astrocytomas that expressed PRMT5 and received either temozolomide(TMZ)or TMZ plus other chemotherapies,regardless of their IDH or MGMT-methylation status(p-value=0.0014).Specifically,IDH-mutant tumors that had upregulated PRMT5 activity and MGMT-promoter methylation,who received only TMZ,have exhibited longer ***:The relationship between PRMT5,MGMT-promoter,and IDH is not ***,accumulation of D2-hydroxyglutarate(2-HG),which partially activates 2-OG-dependent deoxygenase,may not affect their *** IDH-wildtype glioblastomas,the 2HG-2OG pathway is typically inactive,leading to PRMT5 *** alone,compared to TMZ-plus,can increase PFS in upregulated PRMT5 ***,using a PRMT5 inhibitor in G4

关键词： Grade 4 astrocytoma Glioblastoma Isocitrate dehydrogenase(IDH) O-6-methylguanine-DnA methyltransferase(MGMT) Protein methyltransferase proteins-5(PRMT5) Progression-free survival(PFS)

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加速康复外科对初次全膝关节置换术后血液管理的影响：倾向评分匹配分析

加速康复外科对初次全膝关节置换术后血液管理的影响：倾向评分匹...

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作者： Mogalli Abdullah saleh Hussein Ahmed 吉林大学

学位级别：硕士

背景:全膝关节置换术(TKA)是缓解慢性膝关节炎患者关节疼痛和增强关节功能的重要手段。TKA的并发症常常与大量失血相关,并直接导致术后血红蛋白水平下降,从而高达69%的患者需要异体输血来应对术后贫血。这已被证明是增加不良结果风险的... 详细信息

背景:全膝关节置换术(TKA)是缓解慢性膝关节炎患者关节疼痛和增强关节功能的重要手段。TKA的并发症常常与大量失血相关,并直接导致术后血红蛋白水平下降,从而高达69%的患者需要异体输血来应对术后贫血。这已被证明是增加不良结果风险的独立因素,包括延长住院时间和增加术后感染的易感性。由丹麦学者Henrik Kehlet于1997年首次提出的加速康复外科(ERAS)已成为现代外科实践中的一个关键方法。ERAS最初在腹部手术中实施,逐渐扩展到包括骨科和泌尿科在内的各个医学专业。然而,尽管ERAS方案的采用日益增加,系统评估关节置换术后的血液指标仍然有限。这种多方面的策略在减轻手术压力、加速术后恢复、减少住院时间和提高整体功能结果方面发挥着重要作用,同时保持低并发症率。之前的研究已证明ERAS在减少失血和优化全髋关节置换术结果方面的有效性。问题是这些发现是否也适用于TKA。THA和TKA之间的关键区别,包括患者人口统计学、手术时间和软组织损伤程度,强调了优化每项手术中患者护理的需要。TKA患者通常比THA患者平均年龄更大,皮肤对皮肤时间更长,并且由于股骨和胫骨截骨术,软组织损伤增加。ERAS方案有效控制围手术期失血量。ERAS组术后CRP和ESR水平较低,表明炎症和凝血活动减少,这可能归因于ERAS计划提供的全面护理,其中包括人性化和以患者为中心的干预措施,以减轻焦虑。ERAS手术已显示出相当大的好处,例如通过利用术前优化、术中程序和术后管理等循证策略,最大限度地减少围手术期失血、降低并发症和改善营养状况。WOMAC、OKS和SF-12的理想结果表明ERAS方案有利于改善术后短期内的短期恢复和生活质量结果。目的:评估在加速康复外科(ERAS)下进行单侧全膝关节置换术(TKA)的患者的血液指标管理效果。材料与方法:回顾性研究了2019年1月至2023年10月在我们医院接受单侧TKA的患者。通过使用0.2校准器进行倾向评分匹配后,这些病例被分为两组:非ERAS组(n=51)接受标准护理,ERAS组(n=51)接受全面ERAS管理。术后比较了主要血液参数/血液指标,同时在第3个月随访时也评估了临床结果。结果:ERAS组术后Hb明显高于非ERAS组(P<0.05)。非ERAS组术前ESR明显高,而ERAS组CRP明显低于非ERAS组(P<0.05)。ERAS组的LOS和Alb明显少于非ERAS组(P<0.05)。WOMAC和OKS得分在第1个月和第3个月均在ERAS组。结论:ERAS方案在术后第一天到第三个月的术后期间提供了良好且现实的临床和功能结果,对接受单侧初次TKA的患者满意度很高。此外,ERAS方案已被证明可以有效减少围手术期失血、最大限度地减少术后并发症并维持这些患者的最佳营养水平。

关键词：全膝关节置换术快速康复血液管理住院时间并发症随访

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Delay for Performing Laparotomy for Extra Uterine Pregnancy in n’Djamena Mother and Child University Hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 520-527页

作者： Gabkika Bray Madoué saleh Abdelsalam Khadidja Mahayadine Salah Serfeurbe Pefah Foumsou Lhagadang Faculty of Human Health Sciences of n’ Djamena N&#8217Djamena Chad n’ Djamena Mother and Child University Hospital N&#8217Djamena Chad

Background: Ectopic pregnancy is defined as any pregnancy developed outside the uterine cavity. Objective: to study the relationship between the duration of laparotomy for EP and maternal prognosis. Patients and method. This was a prospective analytical study performed during a period of six (06) months, from May 1st to October 30, 2023, on delay time to perform laparotomy for EP in n’Djamena Mother and child University hospital (nMCUH). We included in this series all patients admitted for EP managed by laparotomy. Data were collected using Word software and analyzed using SPSS 18.0 version 2018. The p value statistical test was used to compare variables (p significant if ≤5%). Results: We recorded 92 cases of EP out of 5751 pregnancies, giving a frequency of 1.6%. Among patients diagnosed with EP, 76/92 (82.6%) had an indication of laparotomy. In 90.8%, the EP was ruptured. On admission, the diagnosis of EP was made within 1 hour in 15.8% of cases. The time to sign the consent allowing doctor to operate was >1 hour in 14.5% of cases. The operating room was unavailable in 34.2% of cases, with an unavailability of >1 hour in 17.1% of cases. Total salpingectomy was performed in 93.4%. Salpingotomy was performed in 6.6%. The lethality rate was 3.9% with significant value when the delay after indication and admission in the operating room is >1 (p value = 0.03). Conclusion: Various factors, such as the search for blood products, the time loss to sign the consent form and the unavailability of the operating room, delay the laparotomy, influence maternal prognosis. Anticipation on these factors is necessary in order to limit the proportion of delays.

关键词： Delay Laparotomy nMCUH Chad

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Upper Tract Treatment of Urogenital Fistulas at the national Fistula Treatment Center (CnTF)

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Open Journal of Urology 2024年第1期14卷 11-19页

作者： Mahamat Ali Mahamat Vadandi Valentin Aché Haroun saleh nedjim Abderassoul Abdraman Gadam Kimassoum Rimtebaye Faculty of Health Sciences University of N’Djamena N’Djamena Chad Faculty of Health Sciences University of Adam Barka Abeche Chad University Hospital of national Reference N’Djamena Chad

Introduction: Urogenital fistula is the existence of an abnormal pathway between a urinary organ and a genital organ. It is a public health problem because of its frequency and social aspect. The aim of this study was to analyse the management of urogenital fistulas by the upper route at the national Fistula Treatment Centre in n’Djamena. Material and Methods: This was a 10-year retrospective descriptive and analytical study from May 2011 to April 2021. The records of all patients who had received fistula treatment during this period were identified and analysed. Results: During the study period 2369 patients were managed for cure of urogenital fistula including 84 by the upper route, i.e. 3.5%. The mean age was 28.5 ± 8.13 years. Loss of urine was the most common reason for consultation (71.4%). Primigravida were represented in 50% (n = 42). The average gestational age was 3.2 ± 2.8 with extremes of 0 to 9 pregnancies. Obstetric aetiology was the most common (92.8%). Ureterovaginal fistulas were the most common anatomoclinical type (36.9%). Uretero-vesical reimplantation was the main surgical procedure (41.7%). Late postoperative follow-up was successful in 85.7% of cases. Conclusion: Urogenital fistulas are common in our practice. The only way to combat this scourge is through prevention through information, education and communication.

关键词： Urogenital Fistula Upper Tract CnTF n’Djamena Chad

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Caesarean Section in the Mother and Child University Hospital of n’Djamena: Indications and Prognosis

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1463-1470页

作者： Gabkika Bray Madoué Mahamat Alhadi Chene saleh Abdesalam neramadji Doumbé Félicité Foumsou Lhagadang nDjamena Faculty of Human Health Sciences NDjamena Chad. nDjamena Mother and Child University Hospital NDjamena Chad.

Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the n’Djamena Mother and Child University Hospital (nMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the n’Djamena Mother and Child University Hospital (nMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.

关键词： Caesarean Section Indications Prognosis nMCUH Tchad

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Eradication Treatment of Helicobacter pylori Infection: Evaluation of Therapeutic Strategies in n’Djamena

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Open Journal of Gastroenterology 2024年第2期14卷 59-67页

作者： Mayanna Habkréo Ali Mahamat Moussa Tahir Mahamat saleh Djerabet Franckly Fany Haby Mairé Dehainssala Adama ngaré Mahamat Ali Hachim Service de Medecine Interne et Gastroenterologie Centre Hospitalier Universitaire La Reference Nationale N’Djamena Tchad Service de Medecine Interne Centre Hospitalier Universitaire La Renaissance N’Djamena Tchad Service de Médecine Hopital de l’Amitié Tchad-Chine N’Djamena Tchad

Background: Helicobacter pylori (Hp) infection is the most widespread bacterial infection in the world. The infection is generally acquired in childhood, but can persist into adulthood. Eradication therapy has undergone several modifications. The aim of this study was to evaluate the different therapeutic strategies used in the eradication of Helicobacter pylori infection in the Centre Hospitalier Universitaire La Reference nationale of n’Djaména. Patients and Methods: This was a prospective, descriptive analytical study spread over one year, from September 2021 to September 2022. Patients at least 15 years of age presenting with dyspeptic symptoms, seen consecutively in a hepato-gastroenterology consultation and with a positive stool test for H. pylori infection, were included in the study. Equally, 1/3 of patients were treated with dual or triple therapy. The remaining third received quadritherapy. Results: A total of 268 patients were included in the study (mean age 38.40 ± 14.66 with extremes of 16 and 80 years). Males predominated in 58% of cases. Overall therapeutic efficacy was 88.9%. According to different therapeutic strategies, efficacy was 90.75% for dual therapy with PPI (Rabeprazole) and Amoxicillin. On the other hand, efficacy was 87% and 88.88% for PPI-based triple therapy and dual antibiotic therapy, and for PPI-based quadruple therapy and triple antibiotic therapy. Conclusion: H. pylori infection is a common disease in Chad. Dual therapy with rabeprazole combined with a high dose of amoxicillin over a period of at least two weeks showed similar if not better efficacy than triple or quadruple therapy.

关键词： Helicobacter pylori Therapeutic Strategies Eradication Dyspepsia Chad

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Adherence to Advisory Committee on Immunization Practices in diabetes mellitus patients in Saudi Arabia:A multicenter retrospective study

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World Journal of Diabetes 2024年第3期15卷 440-454页

作者： saleh Fahad Alqifari Aya K Esmail Dalal M Alarifi Ghalya Y Alsuliman Maram M Alhati May R Mutlaq Mohammed Aldhaeefi Shaden A Alshuaibi Palanisamy Amirthalingam Abrar Abdallah Afaf S Wasel Heba R Hamad Shoroq Alamin Tasneem H Atia Tariq Alqahtani Department of Pharmacy Practice University of TabukTabuk 71491Saudi Arabia Department of Clinical Sciences Sulaiman Alrajhi UniversityQassim 52726Saudi Arabia Department of Family Medicine International Medical CenterJeddah 23214Saudi Arabia Clinical and Administrative Pharmacy Sciences College of PharmacyHoward UniversityWashingtonDC 20059United States Department of Pharmacology King Saud Bin Abdulaziz University for Health SciencesKing Abdullah International Medical Research CenterRiyadh 11481Saudi Arabia

BACKGROUnD Patients with diabetes mellitus(DM)are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe *** Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices(CDC/ACIP)issued immunization recommendations to protect this patient *** To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence *** An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online *** Among participants,10.01%(n=71)had never received any vaccine,while 85.89%(n=609)received at least one dose of the coronavirus disease 2019(COVID-19)vaccine,and 34.83%(n=247)had received the annual influenza *** 2.96%(n=21),2.11%(n=15),and 1.12%(n=8)received herpes zoster,tetanus,diphtheria,and pertussis(Tdap),and human papillomavirus(HPV)vaccines,*** patients with DM in Saudi Arabia,the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster,Tdap,pneumococcal,and *** such as vaccine recommendations provided by family physicians or specialists,site of care,income level,DM-related hospitalization history,residency site,hemoglobin A1c(HbA1c)level,and health sector type can significantly influence the vaccination rate in patients with *** non-vaccinated patients with DM,the most reported barriers were lack of knowledge and fear of side *** signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with *** In S

关键词： Diabetes mellitus Vaccine recommendation COVID-19 vaccine Influenza vaccine Pneumococcal vaccine Immunization Retrospective study

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Evaluation of the Strategy and Efficacy of Treatment of Chronic Viral Hepatitis C with the Sofosbuvir/Daclatasvir Combination in a Resource-Limited Country

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Open Journal of Gastroenterology 2024年第7期14卷 233-240页

作者： Mayanna Habkreo Ali Mahamat Moussa Adama Ahmed ngare Abdraman Kossou Tahir Mahamat saleh Maire Dehainsala Mahamat Ali Hachim Mahamat Ali Bolti Oumaima Djarma Joseph Madtoingue Service de Gastroentrologie/Mdecine Interne du Centre Hospitalier Universitaire la Rfrence nationale NDjamena Chad Service de Gastroentrologie du Centre Hospitalier Universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du Centre Hospitalier Universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du Centre Hospitalier Universitaire la Rfrence nationale NDjamena Chad

Introduction: The treatment of viral hepatitis C (HCV), a major public health problem, has evolved considerably since the introduction of direct-acting anti-virals (DAAs). The aim of this study was to evaluate the strategy for initiating treatment with Sofosbuvir/Daclatasvir, and also to assess its efficacy. Patients and Methods: Included were patients aged at least 15 years, with detectable hepatitis C viremia and treated with a pan-genotypic Sofosbuvir/Daclatasvir regimen at the Centre “Hospitalier Universitaire la Référence nationale de n’Djamena” between October 2019 and October 2023. The APRI score was used to assess fibrosis. Cure was defined by an undetectable viral load 12 weeks after the end of treatment. Results: A total of 835 patients were included (sex ratio 1.55, mean age 50.5 ± 13.73, extremes 20 and 84 years). The 60 - 69 age group was the most represented. The mean APRI score was 0.42 ± 0.29, with extremes of 0.019 and 1.84. The mean viral load was 2,316,193.086 IU/mL. All subjects had good renal function. Cytolysis was absent in 70% of cases. Without genotyping, a pan-genotypic regimen was used in all patients: Sofosbuvir (400 mg)/Daclatasvir (60 mg). The cure rate was 99.4%, with good tolerability. However, four cases of failure were recorded out of the 668 patients who underwent follow-up HCV-PCR testing after 12 weeks of treatment. Conclusion: The Sofosbuvir/Daclatasvir regimen is highly effective, with an excellent safety profile. However, the still high cost of these molecules limits their accessibility to a large proportion of patients.

关键词： Efficacy Tolerance Sofosbuvir/Daclatasvir HCV Chad

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