Introduction The rapid spread of the pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)(COVID-19) virus resulted in governments around the world instigating a range of measures, including mandating the wearing of face coverings on public transport/in retail outlets. Methods We developed a sequential assessment of risk reduction provided by face coverings using a step-by-step approach. The United Kingdom Office of National Statistics(ONS) Population Survey data was utilised to determine the baseline total number of community-derived infections. These were linked to reported hospital admissions/hospital deaths to create case admission risk ratio/admission-related fatality rate. Results Overall, we show that only 7.3% of all community-based infection risk associates with public transport/retail outlets. The reported weekly community infection rate was 29,400 new cases at the start (24th July). The rate of growth in hospital admissions and deaths for England was around -15%/week, suggesting the infection rate, R, in the most vulnerable populations was just above 0.8. In this situation, average infections over the evaluated 13week follow-up period was 9,517/week. With face covering of 40% effectiveness, this reduced average infections by 844/week, hospital admissions by 8/week and deaths by 0.6/week; a fall of 9% over the period total. If, however, the R-value rises to 1.0, then average community infections would stay at 29,400/week and face coverings could reduce average weekly infections by 3,930, hospital admissions by 36 and deaths by 2.9/week; a 13% reduction. These reductions should be seen in the context of 102,000/week all-cause hospital emergency admissions in England and 8,900 reported deaths in the week ending 7thAugust 2020. Conclusion We have illustrated that the policy on mandation of face coverings in retail outlets/on public transport may have limited value in reducing hospital admissions/deaths. Impact appears small compared to all other sources of risk, thereby raising questions regarding effectiveness of the policy.

Background: Bacterial vaginosis is a frequent source of vaginal infection among reproductive-aged women. Astodrimer gel is a novel drug which demonstrated favorable outcomes for treatment of patients with bacterial vaginosis. Aim: We attempted to conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) which examined the efficacy and safety of astodrimer gel in patients with bacterial vaginosis. Methods: We searched four databases from inception to August 15th, 2020 using relevant keywords. We identified all RCTs which surveyed the efficacy and safety of astodrimer gel in treating patients with bacterial vaginosis. We appraised the quality of the included RCTs using the Cochrane risk of bias assessment tool. We pooled dichotomous outcomes as numbers and totals and reported them as risk ratios (RR) with 95% confidence intervals (95% CI) under random- or fixed-effects meta-analysis models depending on heterogeneity. Results: Three eligible studies comprising four independent RCTs and 1165 patients were identified (614 and 551 patients received astodrimer gel and placebo, respectively). For efficacy outcomes (n=320 astodrimer gel versus n=260 placebo), astodrimer gel was significantly superior to placebo for all pooled efficacy outcomes, including clinical cure rate (at 9-12 and 21-30 days), microbiological Nugent cure rate (at 9-12 and 21-30 days), patient self-reported absence of vaginal odor/discharge (at 9-12 and 21-30 days), resolution of Amsel criteria (at 9-12 days) and percentage of patients who received rescue therapy (during study). With respect to safety outcomes (n=614 astodrimer gel versus n=551 placebo), astodrimer gel demonstrated equal tolerability to placebo for all pooled safety endpoints, expect unfavorably for vulvovaginal candidiasis and treatment-related vulvovaginal candidiasis. Conclusions: Astodrimer gel is effective in treating bacterial vaginosis and corroborated by clinical (Amsel criteria) and microbiological (Nugent score) measurements as well as patient-reported symptoms. Moreover, astodrimer gel is largely safe and associated with marginal rate of vulvovaginal candidiasis.

Aim: We evaluated the COVID-19 threat in patients receiving intravesical BCG therapy which has immunotherapeutic effects and is of vital importance in most of the individuals with high-risk non-muscle-invasive bladder cancer (NMIBC) and investigated the need for postponement of this therapy. Methods: A total of 71 patients, who were diagnosed with high-risk NMIBC and on intravesical BCG treatment regularly (induction or maintenance), were enrolled in the study. The patients were classified into two groups depending on whether they were diagnosed with COVID-19 during the pandemic period or not. Results: Of 71 patients, 26 underwent a COVID-19 polymerase chain reaction test with clinical suspicion during the pandemic period. Of these 26 patients, 4 were diagnosed with COVID-19. Age of the patients, working status (working/retired), compliance with containment measures against the pandemic, number of BCG courses, adverse effects after BCG therapy, and systemic immune-inflammation index, which is an inflammation-related parameter, were not different between groups (p>0.05). Neutrophil/lymphocyte ratio was significantly higher in the COVID-19 positive group (p<0.05). COVID-19 positivity was higher in age groups 50-64 (6.6%) and 65-80 (5.8%) years than that in similar age groups of the normal population. Conclusion: Every effort should be made to administer intravesical BCG treatment in high-risk NMIBC patients even during the pandemic period. However, increased risk of COVID-19 transmission should be kept in mind and protective measures against COVID-19 for healthcare providers and patients before the procedure should be taken optimally. The procedure should be postponed in patients with lymphopenia in recent complete blood count.

Aim: The purpose of this study is to determine the level of attention between shifts and to make recommendations about the regulation of shifts. Methods:The researchers applied the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Pittsburgh Sleep Quality Index (PSQI) and Stroop color word interaction test (SCWI) in 72 intensive care workers working in different shifts. Result: The study included a total of 72 participants, including 30 (43.3%) females and 42 (58.3%) males. There were statistically significant differences between the groups in the sub-items of the HAM-D and SCWI test (Table 3). There was a significant elongation in the night shift employees at all times within the SCWI sub-items. A significant height in the number of errors and corrections in the cards applied in the continuation of the test was also determined in the night shift group. Conclusion: This study revealed a significant decrease in the level of attention in the night-shift compared to the day-shift. This increase in attention deficit may also be a preventable cause of increased mortality in the night-shift What is already known about this topic? • Mortality rates in intensive care units are higher than in other clinics. What this paper adds? • Our study reported significantly poor results of the SCWI test in the night-shift compared to the day-shift. The implications of this paper: • This study revealed a significant decrease in the level of attention in the night-shift compared to the day-shift. We believe that it will be beneficial to shorten the shift times, to keep the number of patients per staff at international standards, to set active rest periods and to plan personnel and hours to reduce the lack of attention observed in the night shift. KEYWORDS Attention, healthcare worker, night-shift, intensive care

Aim: To describe the clinical characteristics and outcomes of severe COVID-19 adult patients, with the exploration of risk factors for mortality in the hospital. Methods: This study included 20 adult patients diagnosed with COVID-19 in the ICU of DHQ Hospital Faisalabad (Pakistan) and were categorized into the survival group and death group according to the outcome. We retrieved demographics, clinical manifestations and signs, laboratory indicators, treatment measures, and clinical outcomes from the medical record, and summarized the clinical characteristics and outcomes of these patients. Results: The average age of patients was 70 ± 12 years, of which 40% were male. They were admitted to the ICU 11 days after the onset of symptoms. The most common symptoms on admission were cough (19 cases, 95%), fatigue or myalgia (18 cases, 90%), fever (17 cases, 85%), and dyspnea (16 cases, 80%). Eleven (55%) patients had underlying diseases, of which hypertension was the most common (11 cases, 55%), followed by cardiovascular disease (4 cases, 20%), and diabetes (3 cases, 15%). Six patients (30%) received invasive mechanical ventilation and continuous renal replacement therapy and eventually died. Acute heart injury was the most common complication (19 cases, 95%). Ten (50%) patients died between 2 and 19 days after admission to the ICU. Compared to dead patients, the average body weight of surviving patients was lower (61.70± 2.36 vs 68.60±7.15, P = 0.01), Glasgow Coma Scale score was higher (14.69±0.70 vs 12.70±2.45, P = 0.03), with fewer concurrent shocks (2 vs 10, P = 0.001) and acute respiratory distress syndrome (2 vs 10, P = 0.001). Conclusion: The mortality rate is high in patients with critical COVID-19 disease. Lower Glasgow Coma Scale, higher body weight, and decreased lymphocyte count appear to be potential risk factors for the death of COVID-19 patients in the ICU.

Objective: We aimed to evaluate the effect of body mass index (BMI) on oncological and surgical outcomes in patients who underwent radical cystectomy (RC) for bladder cancer (BC). Materials and Methods We retrospectively assessed data from patients who underwent RC with pelvic lymphadenectomy and urinary diversion for BC recorded in the bladder cancer database of the Urooncology Association, Turkey between 2007 and 2019. Patients were stratified into three groups according to the BMI cut-off values recommended by the WHO; Group 1 (normal weight, <25 kg/m2), Group 2 (overweight, 25.0–29.9 kg/m2) and Group 3 (obese, ≥30 kg/m2) Results In all, 494 patients were included, of them 429 (86.8%) were male and 65 (13.2%) were female. The median follow-up was 24 months (12-132 months). At the time of surgery, the number of patients in groups 1, 2 and 3 were 202 (40.9%), 215 (43.5%) and 77 (15.6%), respectively. The mean operation time and time to postoperative oral feeding were longer and major complications were statistically higher in Group 3 compared to Groups 1 and 2 (p=0.019, p<0.001 and p=0.025 respectively). Although the mean overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS) and metastasis-free survival (MFS) was shorter in cases with BMI ≥30 kg/m2 compared with other BMI groups, differences were not statistically significant (p=0.532, p=0.309, p=0.751 and p=0.213 respectively). Conclusion Our study showed that, although major complications are more common in obese patients, the increase in BMI does not reveal a significant negative effect on OS, CSS, RFS, and MFS.

Objective: To identify pathophysiological mechanisms of nocturia and the correlation of these mechanisms with nocturia severity. Methodology: After approval by the local ethics committee, all patients with nocturia (≥1 nocturnal void/night) were included and filled the overactive bladder questionnaire (OABq), nocturia quality of life (N-QoL), ICIQ-MLUTS (male), ICIQ-FLUTS (female) and 3-day frequency-volume chart. Patients were divided into three groups according the severity of nocturia: group 1 consisted of patients with mild (1-2 voids/night), group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia (>4 voids/night). Comparative analysis were performed between groups, p<0.05 was deemed as statistically significant. Results: 68.1%, 64.1% and 8.7% of the patients had nocturnal polyuria, reduced bladder capacity and global polyuria; respectively. 42.7% of the patients had mixed nocturia. 6.1% of the patients did not comply with the afore-mentioned subtypes and defined as isolated nocturia. Regarding the severity of nocturia; 155 (41%) patients had mild, 167 (45%) patients had moderate and 57 (15%) patients had severe nocturia. Increased nocturia severity was related with decreased quality of life; higher age, urinary tract symptom scores, nocturnal urine volume, evening fluid consumption and beta-blocker medication rates. Increased nocturia severity was also associated with higher nocturnal polyuria, global polyuria and reduced bladder capacity rates. Conclusions: Nocturia mechanisms may vary between mild and moderate to severe nocturia groups according to the present study. Nocturia grading with identification of subtypes may help for better standardization of the diagnostic and treatment approaches as well as for the design of future clinical trials.

Introduction: Patient adherence is a cornerstone in successful management of psychiatric disorders and is affected by patient perspectives and barriers, differing from rural to urban areas. In this perspective, pharmacists have a vital role in identifying patients in need of help and in dealing with barriers to adherence. This paper investigates perspectives of patients diagnosed with psychiatric disorders, living in rural areas in Jerash, Jordan, regarding their awareness about their psychiatric conditions, including religious and cultural factors, adherence to their treatment and related barriers, with special focus on pharmacist’s role. Methods: This cross-sectional survey study was conducted in Jordan from August to November 2019. A validated questionnaire was administered by two pharmacists, asking patients as they were waiting in the psychiatric clinic (following the specialists’ approval). Data were analyzed using the Statistical Package for the Social Science (SPSS). Results: Most patients (n= 120, age 39.4±9.5, 66.7% males) reported that they always/usually adhere to their medications (71.0%), and 47.5% of them reported complete control of their symptoms after treatment. Most patients (69.2%) reported that they perceive their psychological illness in terms of religious faith as being counted for their favor in the Hereafter, and 52.5% of them always/usually looked at themselves positively and unaffected by the existence of their illness; with both factors correlating significantly with better treatment adherence (p < 0.045 and p < 0.001; respectively). Barriers affecting adherence included mainly suffering from adverse effects (31.9%) and being unconvinced that they needed a medication (23.3%). Only 14.2% of patients reported that they refer to the pharmacist to get information about their medications. Conclusion: Most psychiatric patients reported suboptimal control of their symptoms. Nonadherence is one reason, with barriers identified. Positive religious and cultural perspectives are associated with better adherence, and most patients do not refer to pharmacists for medication informatio

Purpose: To evaluate the awareness of the use of fluoroscopy in endourological procedures, as well as the theoretical and practical applications of preventive measures. Material and Method: Between May 2018 - April 2019, a 26-question survey prepared using Google Docs was sent to urologists via e-mail. Personal information, radiation training and behaviors related to radiation and fluoroscopy usage, and the use of protective equipment were queried. Results: A total of 226 participants fully completed and returned the email survey. Of the 226 participants 78 (34,5%) were academics, 44 (19,4%) were residents while 104 (46.1%) were experts. More than 60% of the participants stated that they participated in the operation requiring less than five fluoroscopy-use per week. The majority of operations requiring fluoroscopy consisted of endourological procedures. The lead apron was used by 93% of the participants, but the use of protective glasses and gloves was very low (3.5%). The majority of academicians, experts and residents did not use dosimeters (76.9%, 82,7 and 81,8%, respectively). More than 50% of the participants did not have literature information about the harmful effects of radiation due to the use of fluoroscopy. The most common complaints on the day of fluoroscopy were fatigue and headache. Conclusion: The lack of information regarding the radiation protection measures and harmful effects of radiation are common among urologists in Turkey. Therefore, systematic training programs on fluoroscopy use and radiation exposure should be provided during urology residency. Keywords: Urologist, fluoroscopy, radiation, radiation protection

Aim: The cognate receptor expression of AGE (RAGE; receptor for AGE) on malignant tissues in diabetic patients has been suggested as a co-factor in determining the clinical course and prognosis. We aimed to search this relationship between RAGE expression and clinicopathological features of prostate neoplasia. Methods: A total of 197 patients; 64 (diabetic n=24; non-diabetic n=40) with benign prostate hyperplasia, and 133 (diabetic n=71; non-diabetic n=62) with localized (LPCa)/metastatic prostate cancer (MetPCa) were included the study. The expression of RAGE was studied by immunohistochemically on prostate specimens. The RAGE score was assessed in the specimens according to the extent of immunoreactivity and staining intensity. Results: The RAGE scores of BPH patients (diabetic and non-diabetic) were found as negative. Patients with both LPCa and MetPCa showed significantly higher scores, respectively (LPCa and MetPCa vs. BPH; p<0.01). RAGE scores of diabetic patients with LPCa and MetPCa were found to be 4.71±3.14 and 4.97±3.69, respectively. RAGE scores of the non-diabetic patients who had LPCa and MetPCa were 1.52±1.87 and 1.69±1.58, respectively. When compared both groups with LPCa, RAGE scores of the diabetic patients were significantly higher than that of the non-diabetics (p=0.01). Similar results were revealed as for the patients with MetPCa (4.97±3.69 vs. 1.69±1.58 (diabetic vs. non-diabetic), respectively (p<0.01). Conclusion: We found a high rate of RAGE expression in malign prostate neoplasias to the BPH. Furthermore, as expected, higher scores were demonstrated in those with diabetes than non-diabetics. Disease progression and survival parameters were worse in the patients with high RAGE levels. RAGE may be useful in the diagnosis of prostate cancer and in determining its prognosis.

Background: COVID-19 is considered a widespread concern in global public health. Diagnoses of COVID-19 in some cases are necessary due to severe prognosis. In this study, clinical and demographic characteristics of patients with COVID-19 were studied in Taleghani Hospital, Urmia, Iran. Methods: This descriptive-analytical cross-sectional (retrospective) study carried out on 215 patients with COVID-19 during March and April 2020.. Approved COVID-19 case was considered as a person with a positive respiratory sample performed by at least one of two RT-PCR methods or genetic sequencing. Results: The mean age of patients was 50.93±17.92 years. The mean hospital stay, the temperature at admission, and onset of symptoms were 4.91±3.68 days, 37.40±0.96 0C, and 5.88±4.80 days, respectively. Shortness of breath and cough were found in 62.8 % and 49.3 % of patients. Regarding lung involvement, 33 patients (33%) were normal, most of the patients (n=71) had 5-25% involvement in their lung and a minority of patients (n=13) had a severe condition of 50-75% lung involvement. .Spo2 can increase the risk of death by 16% with each unit reduction. Kidney involvement increases the chance of mortality by 1.386 times (95% CI: 11.010-2.704). Hemoglobin was also significantly marginal, with a 35% risk of death per unit reduction in blood hemoglobin, which is a very important finding in this study. The odds ratio of spo2 and hemoglobin for mortality due to COVID-19 was 1.16 (95% CI: 1.073-1.262) and 1.350 (95% CI: 0.989-1.842), respectively. Conclusion: COVID-19, like other viral diseases, can involve different organs of the body with different severity. In the meantime, smoking was not a risk factor for the virus or associated with severe manifestations of the disease. Patients with high creatinine and CPK, pulmonary involvement above 25%, and hypoxemia had a higher mortality

OBJECTİVE In this study, we aim to investigate the thoughts and attitudes of individuals towards the future COVID-19 vaccine. METHODS This descriptive study was carried out on the web between 10/06/2020 - 10/07/2020. The sample constitutes all individuals above 18 years of age using social media and smartphone. The e-survey form was shared by the researchers via the web for a month, and those who completed the survey were included in the study and formed the sample of the research. RESULTS 759 were participated. 49.7% of the participants stated to be vaccinated; 38.4% of them stated to be vaccinated their children against COVID-19; if the vaccine for COVID-19 is developed. The request for the COVID 19 vaccine had relationship with gender, occupation, health insurance, anxiety level, having children, willing to get vaccinated for their children. “Afraid of the side effects of vaccine”, “don’t think it can be reliable as it will be a new vaccine” and “COVID-19 infection is a biological weapon and the vaccine will serve those who produce this virus” were the most common reasons for rejection of vaccine. CONCLUSION In our study afraid of the side effects of vaccine and not thinking it can be reliable as it will be a new vaccine is the most reasons of indecision and rejection about COVID 19 vaccine. In order for the future COVID 19 vaccination campaign to not fail, media, politicians, healthcare professionals should closely follow the vaccination development processes, inform the public transparently and consider public’s concerns.

Abstract Background The benefits of hospital clinical pharmacy services are well established, though staff numbers required for its delivery have not been well described, leading to variation in pharmacy staffing between hospitals. The need to identify a consistent, objective method of determining staffing levels was recognised at a UK University Hospital and a Clinical Pharmacy Workforce Calculator (CPWC) was developed. Objective To report on the validation of the CPWC across acute hospital settings in Great Britain. Method Using the World Health Organisation’s Workload Indicators of Staffing Need (WISN) methodology, a two-round Delphi consensus study with an Expert Panel of UK hospital pharmacy managers was undertaken to develop the Activity Standard for pharmaceutical care and to identify the time unavailable for clinical work inherent in employing staff. Consenting Panel members then tested the CPWC by calculating the staff resource required for three staffing scenarios to determine whether it could be reliably used by different operators. Results Thirty-six participants consented to participate, and data was returned from 22 participants (61%) of whom 20 (56%) supplied analysable data. Consensus was achieved on the tasks required for pharmaceutical care delivery, the mean time each takes, the frequency of completion and the unavailable time in the employment of each grade of staff identified. The CPWC uses this data in an algorithm to calculate staffing requirements. Eleven participants (55%) tested the CPWC and analysis of their responses showed that 31 of 33 (94%) calculations were accurately completed using the CPWC. Conclusion This study has defined the WISN Activity Standard for pharmaceutical care delivery to hospital inpatients and validated the CPWC for acute medical and surgical hospital settings. The CPWC offers hospital pharmacy managers a useful tool to negotiate adequate staffing to deliver pharmaceutical care and its development methodology could be applied widely in pharmacy practice internationally.

Purpose: COVID-19 pandemic has created a serious psychological impact worldwide since it has been declared. This study aims to investigate the level of psychological impacts of COVID-19 pandemic on Turkish population and to determine related factors. Methods: The study was carried out by using an online questionnaire using the virtual snowball sampling method. The sociodemographic data were collected on the following subjects: Participants’ experience on any signs of infection within the last month, the history of COVID-19 contact-treatment-quarantine, level of compliance with precautionary measures, the sources of information and level of knowledge about the pandemic process and their belief levels on the knowledge they acquire. Besides, questions that take place in the depression, anxiety, stress scale (DASS-21), and impact of events scale (IESR) were asked. Results: Of the 3549 participants, anxiety was found in 15.8%, depression in 22.6%, stress in 12.9%, and psychological trauma in 20.29%. Female gender, young age, higher education level, being single, high monthly income, presence of psychiatric illness, a high number of people living together, having any signs of infection, and contact history with COVID-19 infected person or contaminated object are identified as risk factors that may increase psychological impact. Compliance with the rules was found to reduce the risk of psychological response. Conclusions: During the pandemic, reducing the spread of the virus and knowing the risk factors in protecting the mental health of individuals will be guided in determining the measures to be followed and the policies to be followed.

Background: Radiofrequency ablation in patients with atrial fibrillation (AF) is effective but hampered by pulmonary veins reconnection due to insufficient lesions. High power shorter duration ablation (HPSD) seen to increase efficacy and safety. This analysis aimed to evaluate the clinical benefits of HPSD in patients with AF. Methods: The Medline, PubMed, Embase, and the Cochrane Library databases were searched for studies comparing HPSD and Low power longer duration (LPLD) ablation. Results: A total of seven trials with 2023 patients were included in the analysis. Pooled analyses demonstrated that HPSD showed a benefit of first-pass pulmonary vein isolation (PVI) [risk ratio (RR): 1.27; 95% confidence interval (CI): 1.18–1.37, P < 0.001]. HPSD could reduce recurrence of atrial arrhythmias (RR: 0.70; 95% CI: 0.50–0.98, P = 0.04). Additionally, HPSD was more beneficial in terms of procedural time [Weighted Mean Difference, (WMD): −44.62; 95% CI, −63.00 to −26.23, P < 0.001], ablation time (WMD: −21.25; 95% CI: −25.36 to −17.13, P < 0.001), and fluoroscopy time (WMD: −4.13; 95% CI: −7.52 to −0.74, P < 0.001). Moreover, major complications and esophageal thermal injury (ETI) were similar between two groups (RR: 0.75; 95% CI: 0.44–1.30, P = 0.31) and (RR: 0.64; 95% CI: 0.17–2.39, P = 0.51). Conclusion: HPSD was safe and efficient for treating AF with clear advantages of procedural features, it also showed benefits of higher first-pass PVI and reducing recurrence of atrial arrhythmias compared with the LPLA. Moreover, major complications and ETI were similar between two groups.

OBJECTIVE: To collect and review data from consecutive patients admitted to Queen’s Hospital, Burton on Trent for treatment of Covid-19 infection, with the aim of developing a predictive algorithm that can help identify those patients likely to survive. DESIGN: Consecutive patient data was collected from all admissions to hospital for treatment of Covid-19. Data was manually extracted from the electronic patient record for statistical analysis. RESULTS: Data, including outcome data (discharged alive / died) was extracted for 487 consecutive patients, admitted for treatment. Overall, patients who died were older, had very significantly lower Oxygen saturation (SpO2) on admission, and higher CRP as evidenced by a Bonferroni-corrected P<0.0056). Evaluated individually, platelets and lymphocyte count were not statistically significant but when used in a logistic regression to develop a predictive score, platelet count did add predictive value. The prediction algorithm we developed was: P(survival) = ___________________1______________________ 1+e-1(-16.7104-3.3810LN(age)+6.5592LN(SpO2)-0.4584LN(CRP)+0.7183LN(Plt)) CONCLUSION: Age, SpO2 on Admmission, CRP and platelets were an effective marker combination that helped identify patients who would be likely to survive. The AUC under the ROC Plot was 0.737 (95% Conf. Interval 0.689-0.784; P< 0.001). Further research adding extra markers, is underway.

Aims: Inappropriate polypharmacy poses adverse drug events, mortality, and high healthcare costs. Deprescribing could minimise inappropriate polypharmacy and the consequence thereof. This study aims to evaluate healthcare providers’ (HCPs) attitudes toward, and experiences with the deprescribing practice. Methods: An institution-based cross-sectional study was conducted among HCPs at the University of Gondar Referral Hospital, Ethiopia. Perception of HCPs on deprescribing was measured by Linsky et al. validated tool. This tool has five dimensions that could affect HCPs’ decision to discontinue medications intentionally. One-way ANOVA was used to test the association between socio-demographic variables and their perception of deprescribing decisions. Results: Of 85 HCPs approached, about 82 HCPs with a 96.5% response rate were included in the final analysis of this study. Most HCPs (87%) were less likely or not at all to be affected by a strong relationship between HCPs and their patients to make a deprescribing decision. However, HCPs believed that formal education, significant physical health conditions, objective response to the clinical endpoint of the medication (e.g., blood pressure), and on-the-job experience profoundly influenced them to decide on deprescribing. According to the post-hoc analysis of one-way ANOVA, clinical pharmacists seemed to have a better attitude toward deprescribing decisions compared to physicians. (p = 0.025). Conclusion: HCPs’ decision to discontinue a medication could be multifactorial, and HCPs could be influenced by education level and their experience to discontinue a medication intentionally. A therapy-specific deprescribing algorithm, multidisciplinary collaboration, and continuous education development should be instituted to guide HCPs in the deprescribing decision process.

Aim: Ultrasound-guided plane blocks are increasingly used in the multi-modal analgesic concept for reducing opioid consumption. The present study was conducted to compare the analgesic effect of intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) and erector spinae plane (ESP) block in renal colic patients. Methods: In this prospective randomized study, 40 patients with renal colic pain were randomly assigned to into two groups; Group NSAID (n=20) received an intravenous infusion of 50 mg of dexketoprofen trometamol, Group ESP (n=20) received ultrasound-guided erector spinae plane block with 30 ml 0.25% bupivacaine at the T8 level. The pain severity of patients was assessed using the visual analog scale (VAS) at baseline, 5., 15., 30., 45. and 60. minutes after intervention. Opioid consumption, patient satisfaction and side effects were recorded. Results: In the ESP group, the VAS scores were significantly lower than the NSAID group at 5., 15., 30., 45. and 60. minutes after the procedure (P<0.001). Opioid consumption was significantly higher in the NSAID group compared with the ESP group (10/20 vs. 0/20, respectively; p<0.001). Patient satisfaction was significantly higher in the ESP group (p<0.001). Conclusions: ESP block can be an alternative, efficient, and safe method for the relief of acute renal colic pain.