No abstract

IntroductionTelemedicine is the utilization of communication technologies to provide healthcare services remotely. It has an increasingly pivotal role in enabling medical professionals to extend the provision of care to patients facing geographical barriers. The benefits of telemedicine have become more apparent during the coronavirus pandemic. To maximize its application, it is crucial to ascertain the understanding and attitudes of healthcare professionals toward its use. The aim of this study is to collect data and evaluate the current knowledge and perceptions of medical staff toward the use of telemedicine. MethodsIn this cross-sectional study, we conducted a global survey of 1091 healthcare workers. Data were collected through a questionnaire after an extensive literature review. Frequency, percentages, and cumulative percentages were calculated to portray the profile of the participants. ResultsOf the respondents, the majority had heard about (90.9%), witnessed (65.3%), or were familiar with (74.6%) how telemedicine is used in practice. Seventy-two point two percent (72.2%) were familiar with the tools that may be used in this technology. The familiarity with telemedicine was noted to be consistently higher in those with a medical degree and experience of less than five years. Furthermore, attitudes toward providing healthcare remotely were generally positive with 80% thinking that telemedicine reduced staff workload, 80.6% reporting that it reduces the unnecessary transportation cost, and 83% believing that it saves clinicians' time. However, 20% of respondents said that telemedicine increases staff workload and 40.5% of healthcare workers believed telemedicine threatens information confidentiality and patient privacy. ConclusionAlthough telemedicine is a novel and emerging practice in many countries, it appears to have a promising contribution to healthcare services. This is particularly important during a pandemic, as it ensures effective healthcare with the maintenance of social distancing measures. Moreover, the respondents of this study showed good knowledge and positivity in their attitude toward telemedicine.

No abstract

Antiandrogens may carry a potential benefit as a therapeutic agent against COVID-19. However, studies have been yielding mixed results, thus hindering any objective recommendations. This necessitates a quantitative synthesis of data to quantify the benefits of antiandrogens. We systematically searched PubMed/ MEDLINE, Cochrane Library, clinical trial registers, and reference lists of included studies to identify relevant randomized controlled trials (RCTs). Results from the trials were pooled using a random-effects model and outcomes were reported as risk ratios (RR) and mean differences (MDs) with 95% confidence intervals (CIs).Fourteen RCTs with a total sample size of 2593 patients were included.Antiandrogens yielded a significant mortality benefit (RR 0.37; 95% CI; 0.25-0.55).However, on subgroup analysis, only proxalutamide/enzalutamide and sabizabulin were found to significantly reduce mortality (RR 0.22, 95% CI: 0.16-0.30 and RR 0.42, 95% CI: 0.26-0.68, respectively), while aldosterone receptor antagonists and antigonadotropins did not show any benefit. No significant between-group difference was found in the early or late initiation of therapy. Antiandrogens also reduced hospitalizations and the duration of hospital stay, and improved recovery rates. Proxalutamide and sabizabulin may be effective against COVID-19, however, further large-scale trials are needed to confirm these findings.

Background The debate on whether or not there is a difference in the incidence of thyroid cancer between the patients with Solitary thyroid Nodule (STN) and Multinodular Goiter (MNG) has been constantly present for the last few decades. With newer studies yielding mixed results, it was imperative to systematically compile all available literature on the topic. Methods PubMed/MEDLINE, Cochrane Central, ScienceDirect, GoogleScholar, International Clinical Trials registry, and reference lists of the included articles were systematically searched for article retrieval. No filter was applied in terms of time, study design, language or country of publication. Rigorous screening as per PRISMA guidelines was undertaken by 2 independent reviewers in order to identify the articles that were most relevant to the topic. Results Twenty-two studies spanning from 1992 to 2018 were included in this analysis and encompassed 50,321 patients, 44.2% of which belonged to the STN subgroup and 55.37% to the MNG subgroup. MNG was found to be associated with a significantly lower risk of thyroid cancer (OR = 0.76; 95% CI 0.61–0.96) when compared with STN. Papillary carcinoma was the most frequently occurring carcinoma across both groups, followed by follicular and medullary carcinomas. A subgroup analysis was performed to assess the efficacy of the two most commonly employed diagnostic tools i.e. surgery and fine needle aspiration cytology (FNAC), however it yielded nonsignificant results, indicating a comparable usefulness of the two. Another subgroup analysis run on the basis of the presumed iodine status of the participants also yielded nonsignificant results. Conclusion There is a higher incidence of thyroid cancer among patients of STN, however, given the low quality of existing evidence on the topic, it is crucial to conduct larger studies that can establish association with a greater precision.