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resilient health systems.

Despite widespread interest in the use of virtual (ie, telephone and video) visits for ambulatory patient care during the COVID-19 pandemic, studies examining their adoption during the pandemic by race, sex, age, or insurance are lacking. Moreover, there have been limited evaluations to date of the impact of these sociodemographic factors on the use of telephone versus video visits. Such assessments are crucial to identify, understand, and address differences in care delivery across patient populations, particularly those that could affect access to or quality of care.

The aim of this study was to examine changes in ambulatory visit volume and type (ie, in-person vs virtual and telephone vs video visits) by patient sociodemographics during the COVID-19 pandemic at one urban academic medical center.

We compared volumes and patient sociodemographics (age, sex, race, insurance) for visits during the first 11 weeks following the COVID-19 national emergency declaration (March 15 to May 31, 2020) to visits inommendations to inform the further development of virtual visit programs and their reimbursement.Hutchinson-Gilford Progeria syndrome (or Progeria) is an exceptionally rare genetic disorder in children. It is caused by a rare point mutation in the lamin gene. It encodes lamin A protein, resulting in the de-shaping of nuclear membrane. This altered structure of the nuclear membrane renders the nucleus unstable. The shortened lifespan of the nucleus makes the cell liable for rapid ageing. Children are healthy by appearance when they are born but the signs appear after 12-24 months of age. Cardiovascular system is greatly affected which became a reason for the death of most of the patients of progeria. Stiffened joints disturb the bone movements; and alopecia affects the appearance of the patient. Rate of occurrence of the disease is one per four hundred thousand of people, though both sexes are equally affected.There is currently no approved vaccine or a useful antiviral drug against respiratory syncytial virus (RSV) that causes viral infection worldwide. Crude plant extracts can be an important resource for the development of new anti-RSV agents. In this study, cytotoxic and anti-RSV effect of the extracts Ribes uva-crispa, which has been known as “gooseberry” in Turkey and fruits used in the treatment of the various disorders, were evaluated by colorimetric XTT method. Results were expressed as 50% cytotoxicity (CC50), 50% effective concentration (EC50) and selectivity index (SI CC50 / EC50). Of the tested extracts, the highest antiviral activity was found to be 96.90μg/mL EC50 and 11.70 SI from fruit aqueous extract; it was followed by leaf methanol extract (EC50 2527.41μg/mL, SI 6.55), leaf aqueous extract (EC50 1093.37µg/mL, SI 1.40) and fruit methanol extract (EC50 11262.35µg/mL, SI 0.56), respectively. As a result, we can say that these extracts, especially Ribes uva-crispa fruit aqueous and leaf methanol extracts, are worthy of further studies for the development of new and unique anti-RSV drugs.Chemotherapy, radiotherapy, surgery and depression are the conditions that run in parallel fashions. All these conditions cause the release of an increased amount of serotonin in the body. Serotonin acts on these 5HT3 receptors and causes nausea and vomiting. Ondansetron acts by blocking serotonin from acting on the receptors and thus is useful in decreasing episodes of nausea and vomiting but when used concomitantly with SSRIs (selective serotonin reuptake inhibitors) as cancer patient also suffered from depression. This combination tends to decrease the efficacy of ondansetron. PX478 The present study was carried out to observe the modulatory role of ondansetron on ileal smooth muscle motility in vitro. Experiments were performed in four groups (n=6) and ileal smooth muscle activity was recorded on the power lab (USA). The effects of increasing concentrations of serotonin, ondansetron and paroxetine alone were observed. In the fourth group effects of paroxetine in the presence of fixed concentration (1ml) of ondansetron (10-6M) was observed. The maximum response obtained by serotonin served as a control for our study (100%). Paroxetine response on intestinal motility was completely blocked in the presence of ondansetron. Our findings hence, reinforce the hypothesis that paroxetine decreases the antiemetic activity of serotonin antagonist ondansetron, by super sensitization of serotonergic receptors resulting in an increased incidence of nausea and vomiting in cancer patient despite adequate antiemetic prophylaxis.Methotrexate (MTX) is a highly renal and liver toxicity drug used in hematological malignancy treatment in children and adults. High-dose methotrexate (HD-MTX) therapy may cause impairment of kidney and decrease the elimination of MTX, at the same time, the serum concentration of MTX increased. Today the treatment for preventing MTX toxicity after renal shutdown is Carboxypeptidase. We report a patient who experienced nephrotoxicity after the HD-MTX infusions during the treatment for non-Hodgkin lymphoma (NHL) and received hemodiafiltration (HDF) with large dose of leucovorin (LV) to treat MTX intoxication. LV is very potent in the prevention of neurotoxicity and administration of LV could protect the normal cells, but the dosage and duration of LV should be according to the MTX concentration. Although a large dose of LV was applied, the patient’s condition did not improve. It was found that the HDF with large dose of LV to save the patient and steadily improved the patient’s clinical condition.Evaluation of the various pharmacognostic quality parameters and DNA fingerprint of Saudi Arabian medicinal plant namely Datura stramonium growing in Asir region was the objective of the study. The pharmacognostical parameters were done in terms of macroscopic characters, microscopic details, physico-chemical evaluations, phytochemical analysis, fluorescence analysis and DNA fingerprint by using standard techniques and random polymorphic DNA primer. The detailed microscopy of the leaf revealed the presence of pre-medullary phloem, xylem, endodermis, parenchymatous pericycle, lower epidermis and calcium oxalate crystals. There are various amounts of foreign material, ash values, moisture content and extractive values, found after estimations. Preliminary phytochemical screening exhibited the presence of alkaloids, flavonoids, glycosides, tannins and sterols in variable amounts. Random amplified polymorphic DNA (RAPD) showed there are a prominent scorbale DNA bands. These evaluations provided referential information for correct authentication and quality standardization of the important medicinal plant material.