The Patterns of Democracy in Context of Historical Political Science

The patterns of democracy are related to the success or failure of national governance; hence, they are a key topic in the theoretical research of political science. It is difficult to comprehend the worldwide political conflicts caused by the promotion of liberal democracy in the study of democratic models that have liberal democracy as their core. The emphasis of historical political science on the genes of civilization provides an opportunity to reinterpret the patterns of democracy. Relying on specific civilization genes, the patterns of democracy can be divided into the “value pattern”, which is shaped by historical civilization genes, and the “practice pattern”, which is based on the “value pattern”. Based on Christian concepts, Western civilization produced liberal democracy as the value pattern, and the value is inherited through the practice pattern of party democracy. Chinese civilization has continued the tradition of people-orientation and consultative practice, establishing socialist democracy in value and consultative democracy in practice. Theoretically, the analytical framework of the value pattern and the practice pattern of democracy illustrates the source of the diverse patterns of democracy, which helps demonstrate the limitations of liberal democracy and points out the possibility of developing a non-liberal democracy pattern.

Surgical Preferences in the Management of Primary Pterygium among Anterior Segment Specialists

Purpose: The purpose of this study is to reflect anterior segment specialists’ current practice pattern regarding the management of primary pterygium. Methods: A 24-item survey regarding indications for surgery, different surgical techniques, use of adjuvant pharmacological therapy, type of intraoperative and postoperative pharmacological therapy, and the preferred treatment of early recurrences was sent to members of the Saudi Ophthalmological Society (SOS) and practicing cornea experts including consultants, specialists, and fellows in Saudi Arabia. Results: A total of 61 cornea specialists completed the questionnaire (response rate 49%). More than 95% considered the proximity of the pterygium to the visual axis an indication for excision. The most frequent technique for pterygium excision was extensive head and conjunctival resection, including the base (69%) and intermediate resection of the Tenon's capsule (53%). For conjunctival replacement, conjunctival autograft was preferred by 79%, amniotic membrane (54%), and simple conjunctival closure (46%). Interrupted vicryl sutures, fibrin glue, and combined sutures and tissue adhesive were the preferred graft fixation conveyed by 85%, 46%, and 34% of our experts, respectively. An estimated recurrence rate of 1-5% was stated by 29% of respondents and 46% reported recurrence within 6 to 12 months. Half of the respondents specified using mitomycin C intraoperatively to prevent early pterygium recurrences. When recurrence occurred, corticosteroid was the agent of choice. Conclusion: This study set out to reflect the practice pattern of anterior segment specialists regarding the management of primary pterygium, and it may serve as an insight for further studies to define the optimal management of pterygium.

Obstetrics–Gynecology Educational Achievements in Iran (1979-2017): Trends, Consequences and Future Implications

Background: To study the current trends in Obstetrics–Gynecology (Ob-Gyn) education and workforce in Iran since 1979 and to discuss the consequences and implications. Methods: This descriptive-analytical study was conducted to describe the Ob-Gyn residency and fellowship growth and workforce profile in Iran (1979-2017).The first-hand data gathered from MOHME and Iran’s Medical Council. The Obstetrician-Gynecologist (Ob-Gyns) per 100000 populations’ ratio and the percentage changes calculated and the trends analyzed. Results: Between 1979 and 2017, the proportion of trained Ob-Gyns at national universities increased by 86.27%, the number of certified Ob-Gyns increased by 333% and, female Ob-Gyns increased by 1142%.The ratio of active gynecologists per 100,000 people was 5.0 in 1979 and 8.05 in 2017, represents an increase of 70%. Since 1979 the number of active gynecologists has increased by 278 and the number of active female gynecologists has increased by 996%. Since 1990 the maternal mortality per 100,000 live births decreased by 79.9% in Iran. However, since 1980 the Cesarean proportion increased by 203% in Iran. Conclusion: Ob-Gyn education has undergone remarkable growth. Ongoing research should focus on Ob-Gyn’s geographic distribution, and potential implications of female Ob-Gyns practice pattern and technologies on women’s health.

Practice pattern variation: treatment of pelvic organ prolapse in The Netherlands

Introduction and hypothesis Great variety in clinical management of pelvic organ prolapse (POP) has been described over the last years. Practice pattern variation (PPV) reflects differences in care that cannot be explained by the underlying condition. We aim to explore whether PPV in management of POP in The Netherlands has changed between 2011 and 2017. Methods We conducted a multicenter cohort study, using prospective routinely collected benchmark data from LOGEX, a healthcare analytics company (Amsterdam, The Netherlands). Data of patients with a diagnosis POP from 50 hospitals (16 teaching and 34 non-teaching hospitals) were collected for the years 2011 and 2017. All treatments were categorized into three groups: conservative treatment, uterus-preserving or uterus-removing surgery. Using meta-analysis, we evaluated whether the proportions of conducted treatments changed over time and estimated the between-center variation (Cochran’s Q), reflecting the PPV in 2011 and 2017. This variation was analyzed using F-tests. Results Compared to 2011, referral for POP in 2017 decreased by 16.2% (−4505 patients), and the percentage of hysterectomies decreased by 33.6% (p < 0.0001). The PPV of POP surgery decreased significantly by 47.2% (p = 0.0137) and of hysterectomies by 41.5% (p = 0.0316). Conclusions We found a decline in PPV for POP surgery between 2011 and 2017. Furthermore, the number of surgical interventions decreased, which was mostly due to a decline of hysterectomies. This indicates a shift toward more conservative therapy and uterus preservation. A further reduction of PPV would be beneficial for the quality of health care.

Practice pattern and use of a novel skin moisturizer containing skin barrier therapy in patients with atopic dermatitis: a cross-sectional survey among dermatologists in India

<p class="abstract"><strong>Background:</strong> Atopic dermatitis is considered as the most common chronic, inflammatory dermatological disorder. Skin barrier dysfunction represents an early pathology of this condition. Various factors contribute to development of such defects. Skin moisturizers remain the mainstay of therapy for AD along with other treatment modalities.</p><p class="abstract"><strong>Methods:</strong> Dermatologists across India were administered a questionnaire consisting of questions related to number of the patients seen with AD every week and their clinical experience regarding the use of novel skin moisturizer containing skin barrier therapy for the management of AD. The responses were analysed as number and percentages.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 1605 patients were included in this survey. The complete responses were obtained from a total of 58 dermatologists. The majority (98%) of the dermatologists found the overall efficacy of novel skin moisturizer (Atoderm Intensive Baume) in AD patients as ‘satisfactory’. Atoderm Intensive Baume was found as efficacious in improving various parameters of AD such as skin dryness, severity of pruritus, inflammation, insomnia, itching, and urge to scratch. It was also well tolerated. It plays an important role in the repair of damaged skin barrier caused by AD.</p><p class="abstract"><strong>Conclusions:</strong> This survey findings indicated that novel skin moisturizer (Atoderm Intensive Baume) is a preferred formulation by dermatologists across India for the management of AD with proven efficacy and safety.</p>