Search results for: dietary diversity practice and associated facrors among hypertension patients at tirunesh beijing hospital

Authors: A.Knox

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Student diversity in postgraduate classes puts major challenges on educators seeking to encourage student engagement and desired to learn outcomes. This paper outlines the impact of a set of teaching initiatives aimed at addressing challenges associated with teaching and learning in an environment characterized by diversity in the student cohort. The study examines postgraduate students completing the core capstone unit within a specialized business degree. Although relatively small, the student cohort is highly diverse in terms of cultural backgrounds represented, prior learning and/or qualifications, as well as duration and type of work experience relevant to the degree, is completed. The wide range of cultures, existing knowledge and experience create enormous challenges with respect to students’ learning needs and outcomes. Subsequently, a suite of teaching innovations has been adopted to enhance curriculum content/delivery and the design of assessments. This paper explores the impact of these specific teaching and learning practices, examining the ways they have supported students’ diverse needs and enhanced students’ learning outcomes. Data from surveys and focus groups are used to assess the effectiveness of these practices. The results highlight the effectiveness of peer-assisted learning, cultural competence-building, and advanced assessment options in addressing diverse student needs and enhancing student engagement and learning outcomes. These findings suggest that such practices would benefit students’ learning in environments marked by diversity in the student cohort. Specific recommendations are offered for other educators working with diverse classes.

Keywords: assessment design, curriculum content, curriculum delivery, student diversity

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Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

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Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

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Authors: Jin-Ming Wu, Te-Wei Ho, Yu-Wen Tien

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Background: The aim of this population-based study was to determine the occurrence of diabetes and exocrine pancreatic insufficiencies (EPI) on non-diabetes subjects receiving distal pancreatectomy (DP). Method: A nationwide cohort study between 2000 and 2010 was collected from the Taiwan National Health Insurance Research Database. Among 3264 DP patients, we identified 1410 non-diabetes and 966 non-diabetes non-EPI. Results. Of 1410 non-diabetes DP subjects, 312 patients (22.1%) developed newly-diagnosed diabetes after PD. On a multiple logistic regression model, co-morbid hyperlipidemia (odds ratio, 1.640; 95% CI, 1.362–2.763; P < 0.001) and pancreatitis (odds ratio, 2.428; 95% CI, 1.889–3.121; P < 0.001) significantly contributed to higher incidences of diabetes after DP. Moreover, 380 subjects (39.3%) developed EPI, and pancreatic cancer is the statistically significant risk factor (odds ratio, 4.663; 95% CI, 2.108–6.085; P < 0.001). Conclusion: The patients with co-morbid hyperlipidemia and chronic pancreatitis had higher rates of newly-diagnosed diabetes after DP, moreover, pancreatic cancer subjects had higher rates of pancreatic exocrine insufficiency after DP. The clinicians should be alert to follow up glucose metabolism and clinical symptoms of fat intolerance for DP patients.

Keywords: distal pancreatectomy, National database, diabetes, exocrine insufficiency

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Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

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Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Aurora Sheehy, Caitlin Prince

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Within current orthodox medical protocols, trauma and mental health issues are deemed to reside within the realm of cognitive or psychological therapists and are marginalised in these areas, in part due to limited drugs option available, mostly manipulating neurotransmitters or sedating patients to reduce symptoms. By contrast, this research presents examples from the clinical practice of how trauma can be assessed and treated physiologically. Adverse Childhood Experiences (ACEs) are a tally of different types of abuse and neglect. It has been used as a measurable and reliable predictor of the likelihood of the development of autoimmune disease. It is a direct way to demonstrate reliably the health impact of traumatic life experiences. A second assessment tool is Allostatic Load, which refers to the cumulative effects that chronic stress has on mental and physical health. It records the decline of an individual’s physiological capacity to cope with their experience. It uses a specific grouping of serum testing and physical measures. It includes an assessment of neuroendocrine, cardiovascular, immune and metabolic systems. Allostatic load demonstrates the health impact that trauma has throughout the body. It forms part of an initial intake assessment in clinical practice and could also be used in research to evaluate treatment. Examining medicinal plants for their physiological, neurological and somatic effects through the lens of Polyvagal theory offers new opportunities for trauma treatments. In situations where Polyvagal theory recommends activities and exercises to enable parasympathetic activation, many herbs that affect Effector Memory T (TEM) cells also enact these responses. Traditional or Indigenous European herbs show the potential to support the polyvagal tone, through multiple mechanisms. As the ventral vagal nerve reaches almost every major organ, plants that have actions on these tissues can be understood via their polyvagal actions, such as monoterpenes as agents to improve respiratory vagal tone, cyanogenic glycosides to reset polyvagal tone, volatile oils rich in phenyl methyl esters improve both sympathetic and parasympathetic tone, bitters activate gut function and can strongly promote parasympathetic regulation. Auricular Acupuncture uses a system of somatotopic mapping of the auricular surface overlaid with an image of an inverted foetus with each body organ and system featured. Given that the concha of the auricle is the only place on the body where the Vagus Nerve neurons reach the surface of the skin, several investigators have evaluated non-invasive, transcutaneous electrical nerve stimulation (TENS) at auricular points. Drawn from an interdisciplinary evidence base and developed through clinical practice, these assessment and treatment tools are examples of practitioners in the field innovating out of necessity for the best outcomes for patients. This paper draws on case studies to direct future research.

Keywords: polyvagal, auricular acupuncture, trauma, herbs

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Seyedeh Somayeh Amiri, Mozhgan Shakhseniaei, Amin Asadi Hieh

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The purpose of this research was to determine the effectiveness of sexual cognitive behavioral therapy on strategic thinking and communication patterns of couples in colostomy patients. In this study, experimental research was conducted with a pre-test and post-test design with a control group and a follow-up period. The statistical population studied were married female colostomy patients referring to the Iranian Ostomy Association. 30 qualified people were selected by voluntary sampling and randomly divided into two experimental and control groups (15 people in each group). Both groups responded to Goleman's strategic thinking (2007) and the communication patterns of Christensen and Sulawai questionnaires (1984). The results of covariance analysis showed that sexual cognitive behavioral therapy has an effect on improving strategic thinking. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving the strategic thinking of colostomy patients until the follow-up stage. Also, sexual cognitive behavioral therapy has an effect on improving the communication patterns of couples in colostomy patients. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving communication patterns of couples in patients with colostomy until the follow-up stage. Based on the results of this research, sexual cognitive behavioral therapy can be used to improve strategic thinking and communication patterns of couples of colostomy patients.

Keywords: sexual cognitive behavioral therapy, strategic thinking, communication patterns of couples, colostomy

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Authors: Nilanchali Singh, Alka Kriplani, Reeta Mahey, Garima Kachhawa

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Objective: Resection of larger uterine septa does improve obstetric performance but whether smaller septa need resection and their impact on obstetric outcome is not clear. We wanted to evaluate the role of septal resection of septa of various sizes in obstetric performance. Methods: This retrospective cohort study comprised of 107 patients with uterine septum. The patients were categorized on the basis of extent of uterine septum into four groups: a) Subsepta (< 1/3rd), b) Septum > 1/3 to ½, c) Septum>1/2 to whole uterine cervix, d) Septum traversing whole of uterine cavity and cervix. Out of these 107 patients, 74 could be contacted telephonically and outcomes recorded. Sensitivity and specificity of investigative modalities were calculated. Results: Infertility was seen in maximum number of cases in complete septa (100%), whereas abortions were seen more commonly, in subsepta (18%). MRI had maximum sensitivity and positive predictive value, followed by hysteron-salpingography. Tubal block, fibroid, endometriosis, pelvic adhesions, ovarian pathologies were seen in some but no definite association of these pathologies was seen with any subgroup of septa. Almost five-year follow-up was recorded in all the subgroups. Significant reduction in infertility was seen in all septal subgroup (p=0.046, 0.032 & 0.05) patients except in subsepta (< 1/3rd uterine cavity) after septum resection. Abortions were significantly reduced (p=0.048) in third subgroup (i.e. septum > ½ to upto internal os) after hysteroscopic septum resection. Take home baby rate was 33% in subsepta and around 50% in the remaining subgroups of septa. Conclusions: Septal resection improves obstetric performance in patients with uterine septa of various sizes. Whether septal resection improves obstetric performance in patients with subsepta or very small septa, is controversial. Larger studies addressing this issue need to be planned.

Keywords: septal resection, obstetric outcome, infertility, septum size

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Authors: Nasiruddin Khan, Hanan A. Alfawaz, Sobhy M. Yakout, Malak N. K. Khattak, Amani A. Alsaikhan, Areej A. Almousa, Taghreed A. Alsuwailem, Taghreed M. Almjlad, Nada A. Alamri, Sahar G. Alshammari, Nasser M. Al-Daghri

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The consumption of coffee as a beverage is increasing in every part of the world. However, its excessive intake might exert negative effects. Our objective was to demonstrate the prevalence and awareness of coffee consumption among Saudi students and its determinants among this section of the population. Nine hundred thirty female students participated from various departments of King Saud University in a survey-based study using a face-to-face interview. The study demonstrates a high prevalence of coffee consumption (88.2%) among students in the Riyadh region. Certain situations such as exams were associated with increased frequency of coffee intake combined with unhealthy dietary habits of adding other ingredients such as sugar and spices in amount more than needed. Unmarried and fresh year students with high academic grades were associated with higher coffee consumption. The main determinants of coffee consumption among university students were high BMI and increased family income level. Continued awareness and basic knowledge, along with understanding the importance of reading food labels, should be provided to young generations. The university students must be cautioned to limit excessive coffee consumption and maintain healthy dietary habits.

Keywords: academic performance, BMI, coffee, health awareness

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Y. Mohammed, A. I. Kabuga

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Sexually transmitted infections (STIs) have continued to be a major public health problem in sub-Saharan Africa especially with the recent resurgence of syphilis. Syphilis is a systemic disease caused by the bacterium, spirochete Treponema pallidum and has been reported as one of the common sexually transmitted infections (STIs) in Nigeria. Presence of genital ulcer disease from syphilis facilitates human immunodeficiency virus (HIV) transmission and their ¬diagnosis is essential for the proper management. Venereal Disease Research Laboratory (VDRL) test is used as a screening test for the diagnosis of syphilis. However, unusual VDRL test results have been reported in HIV-infected persons with syphilis. There are reports showing higher than expected VDRL titers as well as biological false positive in most of the studies. A negative Rapid Plasma Reagin (RPR) test or VDRL test result may not rule out syphilis in patients with HIV infection. For laboratory confirmation of syphilis, one specific Treponemal test, namely, Fluroscent Treponemal Antibody Absorption (FTA-ABS) test or Treponema Pallidum Haemagglutination Assay (TPHA) should be done along with VDRL. A prospective cross sectional study was conducted for 2 years from Jun, 2012 to Jun 2014 to determine the prevalence of syphilis in HIV-seroreactive patients at 5 selected HIV/AIDS treatment and counseling centers in Kano State, North Western, Nigeria. New HIV-Seroreactive patients who gave informed consent to participate in the study were recruited. Venereal Diseases Research Laboratory (VDRL) test for Syphilis screening was performed on the same sera samples which were collected for HIV testing. A total of 238 patients, 113 (47%) males and 125 (53%) females, were enrolled. In the present study, 238 HIV-seropositive patients were screened for syphilis by VDRL test. Out of these 238 cases, 72 (32%) patients were positive for TPHA and 8 (3.4%) patients were reactive for VDRL in various titers with an overall prevalence of 3.4%. All the eight patients who were reactive for VDRL test were also positive for TPHA test. In Conclusions, with high prevalence of syphilis among HIV-infected people from this study, it is recommended that serological testing for syphilis should be carried out in all patients with newly diagnosed HIV infection. Detection and treatment of STI should have a central role in HIV prevention and control. This will help in proper management of patients having STIs and HIV co infection.

Keywords: HIV, infections, STIs, syphilis

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Authors: Aziz Rezapour, Abdosaleh Jafari, Marziye Hadian, Elaheh Mazaheri

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Introduction: Cardiac rehabilitation is an accurate educational and sporting program designed to help heart patients to increase their physical activities and reduce the risk factors that make their health worse and help to a healthier lifestyle so that they can return to their families and society with a better spirit. The aim of this study was to examine the cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases. Methods: In the present review study, published articles related to cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases within the time interval between 2004 and 2019 were searched using electronic databases. The methodological quality of the structure of articles was examined by Drummond’s standard checklist. Results: The results of reviewing studies showed that most of the studies related to the economic evaluation of cardiac rehabilitation programs in patients with cardiovascular disease were flawed in Drummond’s criteria, and only one study adhered to Drummond’s criteria. The results of the present study indicated use of cardiac rehabilitation programs in patients with cardiovascular disease was cost-effective. Conclusion: The results of this review study showed that although the results of the studies were different in terms of a number of aspects, such as the study perspective, the time horizons, and the costs of rehabilitation programs, they achieved a similar conclusion, they concluded that the use of cardiac rehabilitation programs in patients with cardiovascular diseases, leading to higher quality-adjusted life years (QALYs) and lower costs.

Keywords: economic evaluation, systematic review, cardiac rehabilitation, Drummond’s checklist

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Authors: S. Salah, S. A. El-Masry, H. F. Sheba, R. A. El-Banna, W. Saad

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Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). Objective: To assess BMD in Egyptian children with FMF on genetic basis. Subjects and Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes, with age range between 3-16 years old. The patients were reclassified into 2 groups: Group I (A) 23 cases used colchicines for 1 month or less, and Group I (B) 22 cases used colchicines for more than 6 months. For both patients and control, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at 2 sites: proximal femur and the lumber spines. Results: four frequent gene mutations were found in the patient group: E148Q (35.6%), V726A (33.3%), M680I (28.9.0%) and M694V (2.2%). There were also 4 heterozygous gene mutations in 40% of control children. Patients received colchicines treatment for less than 1 month had highly significant lower values of BMD at femur and lumber spines than control children (p<0.05). Patients received colchicines treatment for more than 6 months had improved values of BMD at femur compared to control, but there were still significant differences between them at lumbar spine (p>0.05). There are insignificant effect of type of gene mutation on BMD and the risk of osteopenia among the patients. Conclusion: FMF had significant effect on BMD. However, regular use of colchicines treatment improves this effect mainly at femur.

Keywords: familial mediterranean fever, bone mineral density, genes, children

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Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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Authors: Mengnan Sun

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It is unclear about the association between air pollution and Tourette Syndrome (TS), although people have suspected that air pollution might trigger TS. TS is a type of neural system disease usually found among children. The number of TS patients has significantly increased in recent decades, suggesting an importance and urgency to examine the possible triggers or conditions that are associated with TS. In this study, the correlation between air pollution and three allergic diseases---asthma, allergic conjunctivitis (AC), and allergic rhinitis (AR)---is examined. Then, a correlation between these allergic diseases and TS is proved. In this way, this study establishes a positive correlation between air pollution and TS. Measures the public can take to help TS patients are also analyzed at the end of this article. The article hopes to raise people’s awareness to reduce air pollution for the good of TS patients or people with other disorders that are associated with air pollution.

Keywords: air pollution, allergic diseases, climate change, Tourette Syndrome

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Authors: Novi Prasanty, Mustafa Ma, Elmeida Effendy

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Background: Schizophrenia is a psychotic disorder that most often encountered. Nearly 1% of the world population suffers from schizophrenia during their lifetime. Schizophrenia is a severe form of psychotic disorders, and tend to be chronic. Vitamin D plays crucial roles in neuroprotection and neurodevelopment, and low levels are commonly associated with schizophrenia. Lower vitamin D levels were correlated with more severe positive, negative, and overall symptoms in schizophrenia patient men and women. Methods: 54 schizophrenic patients, male and female, who are diagnosed with semistructured MINI ICD-X. A symptom of schizophrenia was measured by using positive and negative Syndrome Scale (PANSS). Examination of serum vitamin D using ELFA. Analysis to compare the serum levels of vitamin D male and female with Independent T-test, and the relationship between serum level of vitamin D and symptom with correlation. Results: In this study serum levels in male schizophrenic patients 22.12 (4.16), and 16.54 (2.88) in female schizophrenic patients. There are differences in male schizophrenic patients and women (p < 0.001). The negative correlation between serum levels of vitamin D in the PANSS total score in patients with schizophrenic male with r -0.58, p (0,016), and the female schizophrenic patients with r -0.69, p (0.031). Conclusion and Suggestion: There is a negative correlation between serum levels of vitamin D with a total score of PANSS, the lower the serum levels of vitamin D, the higher the total score of the PANSS.

Keywords: PANSS, schizophrenia, serum levels of vitamin D, severity illness

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Authors: Sabiha Sahin, Kursad Bora Carman, Coskun Yarar

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Introduction: Measuring the diameter of the optic nerve sheath is a noninvasive and easy to use imaging technique to predict intracranial pressure in children and adults. The aim was to measure the diameter of the optic nerve sheath in pediatric head trauma. Methods: The study group consisted of 40 children with healthy and 40 patients with head trauma. Transorbital sonographic measurement of the optic nerve sheath diameter was performed. Conclusion: The mean diameters of the optic nerve sheath of right and left eyes were 0.408 ± 0.064 mm and 0.417 ± 0.065 mm, respectively, in the trauma group. These results were higher in patients than in control group. There was a negative correlation between optic nerve sheath diameters and Glasgow Coma Scales in patients with head trauma (p < 0.05). There was a positive correlation between optic nerve sheath diameters and positive CT findings, systolic blood pressure in patients with head trauma. The clinical status of the patients at admission, blood pH and lactate level were related to the optic nerve sheath diameter. Conclusion: Measuring the diameter of the optic nerve sheath is not an invasive technique and can be easily used to predict increased intracranial pressure and to prevent secondary brain injury.

Keywords: head trauma, intracranial pressure, optic nerve, sonography

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: Ravid Yinon

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Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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Authors: Zakieh Rostamzadeh, Zahra Shirmohammadi

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Human cytomegalovirus is a species of the cytomegalovirus family of viruses, which in turn is a member of the viral family known as herpesviridae or herpesviruses. Although they may be found throughout the body, HCMV infections are frequently associated with the salivary glands. HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised such as HIV-infected persons, organ transplant recipients, or newborn infants. After infection, HCMV has an ability to remain latent within the body over long periods. Cytomegalovirus (CMV) causes infection in immunocompromised, hemophilia patients and those who received blood transfusion frequently. This study aimed at determining the prevalence of cytomegalovirus (CMV) antibodies in hemophilia patients. Materials and Methods: A retrospective observational study was carried out in Urmia, North West of Iran. The study population comprised a sample of 50 hemophilic patients born after 1985 and have received blood factors in West Azerbaijan. The exclusion criteria include: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling. All samples were evaluated with the method of ELISA, with a certain kind of kit and by a certain laboratory. Results: Fifty hemophiliacs from 250 patients registered with Urmia Hemophilia Society were enrolled in the study including 43 (86%) male, and 7 (14%) female. The mean age of patients was 10.3 years, range 3 to 25 years. None of patients had risk factors mentioned above. Among our studied population, 34(68%) had hemophilia A, 1 (2%) hemophilia B, 8 (16%) VWF, 3(6%) factor VII deficiency, 1 (2%) factor V deficiency, 1 (2%) factor X deficiency, 1 (2%). Sera of 50 Hemodialysis patients were investigated for CMV-specific immunoglobulin G (IgG) and IgM. % 91.89 patients were anti-CMV IgG positive and %40.54 was seropositive for anti-CMV IgM. 37.8% patient had serological evidence of reactivation and 2.7% of patients had the primary infection. Discussion: There was no relationship between the antibody titer and: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling.

Keywords: bioinformatics, biomedicine, cytomegalovirus, immunocompromise

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Authors: Dessy Arumsari, Ais Assana Athqiya, Mulyaminingrum

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Healthcare in remote areas is one of the major concerns in Indonesia. Building hospitals in a nation of 18.000 islands with a larger-than-life bureaucracy and problems with corruption, a critical shortage of qualified medical professionals and well-heeled patients resigned to traveling abroad for health care is a hard feat to accomplish. To assuring that all populations have access to appropriate and cost-effective care, a new solution to tackle this problem is with the presence of RV Car Clinic. This car has a concept such as a walking hospital that provides health facilities inside it. All of the health professionals who work in RV Car Clinic will do the rotation for a year in order to the equitable distribution of health workers. We need to advocate the policy makers to help realize RV Car Clinic in remote areas. Health services can be disseminated by the present of RV Car Clinic. Summarily, the local communities can get cost effectively because RV Car Clinic will come to their place and serve the health services.

Keywords: health policy, health professional, remote areas, RV Car Clinic

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Authors: Arif İsmailov, Naila Hasanova, Gunay Orujalieva

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Homocysteine (HCY) is an indicator of prognostic value in monitoring regenerative processes in osteoporosis and osteoporotic fractures. The osteoporosis is known to be a serious health and economic problem, especially for women in the postmenopausal period. The study was carried out on patients 45-83 years old divided into 3 groups: group I – 14 patients with osteoporosis , group II – 15 patients with non-osteoporotic fractures, group III – 25 patients with osteoporotic fractures. The control group consisted of practically healthy 14 people. A blood sample was taken at 3 stages to monitor the dynamics of HCY level: on the 1st day before treatment, on the 10th day of treatment and 1 month after it. Blood levels of Hcy were determined at a wavelength of 450 nm by the ELİSA(Cloud Clone Corp.Elisa kits,USA). The statistical evaluation was performed by using SPSS 26.0 program (IBM SPSS Inc., USA).The results showed that on the 1st day before the treatment HCY concentration was statistically increased 2.7 times(PU = 0.108) in group I, 5.6 times (PU <0.001) in group II and 6.5 times (PU <0.001) in group III compared to the control group. Thus, the average value of HCY in group I was 1.76 ± 0.56 μg/ml; in group II – 3.57 ± 0.62 μg/ml; in group III – 4.2 ± 0.50 μg/ml. HCY level increases more sharply after fractures,especially in osteoporotic patients. In treatment period Vitamin D plays an important role in synthesis of the Cystathionine β‐synthase enzyme, which regulates HCY metabolism. Increased Hcy levels could lead to an increase in the risk of fracture through the interference in collagen cross-linking.

Keywords: homocysteine, osteoporosis, osteoporotic fractures, Vitamin D

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Authors: Avantika Verma

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In industrialized nations, corneal lacerations are one of the most common reason for hospitalization. This study was designed to study visual and clinical outcome in patients presenting with full thickness corneal lacerations in Indian population and to ascertain the impact of various preoperative and operative factors influencing prognosis after repair of corneal lacerations. Males in third decade with injuries at work with metallic objects were common. Lens damage, hyphema, vitreous hemorrhage, retinal detachment and endophthalmitis were seen. All the patients underwent primary repair within first 24 hours of presentation. At 3 months, 74.3% had a good visual outcome. About 5.7% of patients had no perception of light.In conclusion, various demographic and preoperative factors like age, time of presentation, vision at presentation, length of corneal wound, involvement of visual axis, associated ocular features like hyphaema, lenticular changes, vitreous haemorrhage and retinal detachment are significant prognostic indicators for final visual outcome.

Keywords: corneal laceration, corneal wound repair, injury, visual outcome

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Authors: Dada. O.Akinola, Uche. I. Ebele, Bamiro .A.Rafatu, Akinbami A. Akinsegun, Dada O. Adeyemi, Adeyemi. O. Ibukun, Okunowo O.Bolanle, Abdulateef O. Kareem, Ibrahim.N. Ismaila, Dosu Rihanat

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Background: Hyperglycaemia alters qualitatively and quantitatively all the full blood count parameters. The alterations among other factors are responsible for the macrovascular and microvascular complications associated with diabetes mellitus (DM). This study is aimed at correlating haematological parameters in DM subjects with their fasting blood glucose (FBG) and anthropometric parameters. Materials and Methods: This was a cross-sectional study of participants attending DM clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja. The study recruited one hundred and two (102) DM subjects and one hundred (100) non-DM controls. Venous blood samples were collected for full blood count (FBC) assay while FBG was done, structured questionnaires were administered, and anthropometric measurements of all participants were done. Data were analyzed with Statistical Package for Social Science (SPSS) version 23. P was set at ≤0.05. Results: The mean age of DM patients was 64.32± 11.31 years. Using a haemoglobin concentration cut-off of 11g/dl, 39.2%, and 13% DM and control participants respectively had values lower than 11g/dl. A total of 22.5% and 3% of DM and controls respectively gave a history of previous blood transfusion.White blood cells count and platelet count means were (6.12±1.60 and 5.30±7.52,p=0.59) and (213.31±73.58 and 228.91±73.21,p = 0.26) *109/L in DM subjects and controls respectively. FBG and all the anthropometric data in DM subjects were significantly higher than in controls. Conclusions: The prevalence of anaemia in DM subjects was three times higher than in controls. The white blood cell count was higher but not statistically significant in DM compared with controls. But platelet count was higher but not statistically significant in controls compared with DM subjects.

Keywords: haematological profile, diabetes mellitus, anthropometric data, fasting blood glucose

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Authors: Alexander Dao, Oscar Wambuguh

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Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.

Keywords: irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder

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Authors: Ya-Ling Huang, Ming-Chun Tsai, Fan Hsu, Kai-Ru Hsieh

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This paper mainly discusses the research and practice process of a laboratory curriculum by leading students to perform field investigation into time-honoured shops that have existed for more than 50 years in the downtown area of Tainan, Taiwan, and then search again for design elements and completing the design. The participants are juniors from the Department of Visual Communication Design, Kun Shan University. The duration of research and practice is two months. Operators of these shops are invited to jointly appraise the final achievements. 9 works out of 27 are chosen for final exhibition and commercialization.

Keywords: culture creative industry, visual communication design, curriculum experimental, visual arts

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Authors: Valerie A. Conrade

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Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

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Authors: Bahago I. N., Oyewole O. E.

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Nigeria has the second highest prevalence of intestinal worms globally, which has not declined since the 1970s, especially in rural communities. Identifying the gaps in self-care practice will pave a way for a suitable intervention. This study investigated the knowledge, perception, and practice of deworming among mothers of under-five children in rural communities of Lafia Local Government Area, Nasarawa State. This study was descriptive cross-sectional and involved 419 mothers selected by systematic sampling technique. Information was obtained using a valid interviewer-questionnaire. Knowledge, perception, and practice was measured using a 10-point scale for each variable, respectively. Scores of 0-4, >4-6, and >6 were categorised as poor, average/fair, and good, respectively, at p<0.05 level of significance. Respondents’ age was 30.3±9.2 years; 46.5% were into trading, 26.7% were unemployed, 9.3% were skilled labour, and 7.4% were farmers. On literacy, secondary school (25.5%) while 9.1% above secondary school. Many (51.1%) had 2-3 children, while 42.2% had 5 or more children. Most of the respondents (96.2%) had good knowledge of deworming, and 3.8% had fair knowledge. Using multivariate model, Mothers between the ages of 25-34 years were 20 times likely to be more knowledgeable, given they have access to health information (O.R 2.39 -164.31). Most (62.3%) had good perception scores, 33.2% had fair scores, while 4.5% had poor perception scores. Majority (66.4%) had a good deworming practice of deworming, 66.4% had good, 28.4% had fair, and 5.3% had poor practice. The test of association between Parent's literacy level, religion, and age were significantly associated with the level of knowledge of deworming. Knowledge of deworming was above average; perception and practice was good. Women of ages 25-34 years could be trained as community volunteers to propagate the right information about deworming in rural communities, especially among young women of ages 13-19 years. Preferred channels to obtaining health information identified in the study should be explored.

Keywords: deworming, mothers of under-five, intestinal worms, rural communities

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Authors: Haji Ali Haji, Hussein Suleman, Ulrike Rivett

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This paper presents the design, development and evaluation of an application prototype developed to support tuberculosis (TB) patients’ treatment adherence. The system makes use of graphics and voice reminders as opposed to text messaging to encourage patients to follow their medication routine. To evaluate the effect of the prototype applications, participants were given mobile phones on which the reminder system was installed. Thirty-eight people, including TB health workers and patients from Zanzibar, Tanzania, participated in the evaluation exercises. The results indicate that the participants found the mobile graphic-based application is useful to support TB treatment. All participants understood and interpreted the intended meaning of every image correctly. The study findings revealed that the use of a mobile visual-based application may have potential benefit to support TB patients (both literate and illiterate) in their treatment processes.

Keywords: ICT4D, mobile technology, tuberculosis, visual-based reminder

Procedia PDF Downloads 417