No abstract

Patients with acute myocardial infarction (MI) complicated by cardiogenic shock (CS) have poor prognosis. Over the last two decades, there has been some improvement in mortality rates associated with CS. Initial measures to stabilise patients should follow a shock protocol, including therapies such as volume expansion, inotropes/vasopressors, and early coronary revascularisation. The use of mechanical circulatory support (MCS) devices demonstrated better haemodynamic and metabolic profiles for patients with CS. However, these benefits have not been consistently translated into significant reductions in cardiovascular adverse events. This review aims to discuss emerging concepts related to CS including an update on its classification and pathophysiology. The focus is on recent evidence regarding the use of MCS and the timing of initiating in patients with CS.

No abstract

Objective The study investigated the prevalence and impact of stress urinary incontinence (SUI) among women in Jordan. Methods A correlational study was conducted to evaluate 500 Jordanian women aged >20 years. Women with symptoms of dementia, delirium, neurodegenerative changes and osteodegenerative changes were excluded. Data were collected using self-administered questionnaires (Arabic version of the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire (IIQ-7) short forms). Results A total of 200 (40%) women reported SUI; 47% reported mild symptoms, 37% reported moderate symptoms and 16% reported severe symptoms. There were positive correlations between SUI prevalence and number of pregnancies, age and obesity. SUI had a substantial impact on all aspects of quality of life (QoL), as assessed by the IIQ-7. Conclusions A moderate prevalence of SUI was reported. There was a significant association between development of SUI and age, higher body mass index and number of pregnancies. Because SUI is highly prevalent and has a major effect on QoL, healthcare professionals should inquire about this condition and refer patients to related specialties for treatment.

Importance: Gastroesophageal reflux disease (GERD) is a common digestive disorder in which acid-containing contents in your stomach persistently leak back up into the esophagus, especially in stressful lifestyle such as medical students. Objective: The aim of this study is to estimate the prevalence of GERD in Medical students in Jordan, assess factors which affect the occurrence of GERD in the study population, access the stressors of medical students during the pandemic, assess, if any, effect is present related to COVID-19 pandemic, and to look for possible preventive measures for GERD. Design: cross-sectional study including a questionnaire of 6 questions of the duration of seven days prepared on google forms and electronically. Data was collected in the period between 31st January 2021 and 18th April 2021. Setting: Medical Faculties and hospitals in Jordan. Participants: population-based sample; medical students studying in Jordan. Main outcomes and Measures: Medical students' lifestyles are stressful, and a lot of risk factors attributed to GERD are common among medical students. COVID-19 infection is known to cause GI symptoms and as an infection, it could be a stressor especially during the pandemic. Statistical methods included descriptive analysis, Cramer's V statistics, and the Chi-square test as measures of effect sizes. Our findings were not significant enough to confirm that COVID-19 infection causes GERD. However, alternation in GERD symptoms was found to be significant. Results: Out of 1009 subjects, 43.4% were males, and 56.6% were females. The most common symptoms were heartburn and regurgitations and were found in 421 (41.7%) and 325 (32.2%) students, respectively. 199 (19.7%) of students were affected by COVID-19 but it was not statistically significant (P >0.05). However, alteration in the feeling of GERD symptoms in those who were infected with COVID-19 was found to be statistically significant (P < 0.05). Conclusion and relevance: Our findings suggest that the most frequent symptoms of GERD reported by medical students are heartburn and regurgitation. In addition to that, the students who were infected with COVID-19 were in the high-risk group. Therefore, more efforts and studies are needed to look for the pathophysiology of COVID-19 infection's effect on the GERD symptoms.   Keywords:  GERD, Regurgitation, COVID-19, Pandemic.