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Background: Gastroparesis with its varied etiology is one of the major health issues in India. Poor correlation between delayed gastric emptying and its symptoms is well-known. This study was planned to evaluate the proportion of confirmed gastroparesis by scintigraphy among patients with suggestive clinical features, their underlying aetiologies and clinical profiling in a real-world setting in India. Settings and Design: Patients clinically diagnosed with gastroparesis, presenting varyingdegreesofsymptoms for at least 12-weeks, were enrolled in this multic-entric,cross-sectional, clinico-epidemiological study. Results: Overall, 196/201 enrolled patients underwent gastric scintigraphy; 88 (45%) were found to be scintigraphically positive and 108 (55%) patients were only clinically positive. Underlying etiologies of gastroparesis were idiopathic (51.2%), type-2 diabetes (44.8%), type-1 diabetes (2.5%) and psychological conditions (1.5%). Most patients presented symptoms like postprandial fullness (75.6%), bloating (50.7%), abdominal pain (45.3%), nausea (41.3%), abdominal discomfort (40.3%), early satiety (37.8%) and vomiting (17.9%) of moderate severity. Common dietary risk factors were fatty diet (66.7%), fiber-rich food (57.7%) and carbonated drinks (18.9%). Weight loss (6.5%), esophagitis (5.5%) and electrolyte disturbances (0.5%) were the associated complications. About 89.8% were on proton-pump inhibitors, followed by prokinetics (51.8%) and antiemetics (8.4%). The mean PAGI-QoL score was 3.6 ± 0.94, suggesting a moderate effect of gastroparesis on QoL. Conclusion: Poor correlation exists between gastric scintigraphy and gastrointestinal symptoms, thus reiterating the significance of the clinical diagnosis of gastroparesis, especially in diabetes. Only about half of the patients were prescribed prokinetics, emphasizing the need for appropriate pharmacotherapy using prokinetics for holistic management of gastroparesis.
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Background: The urbanization and urban growth is going through very rapid in Bangladesh. This growth is being fuelled by rising incomes due to rapid expansion of commerce and industry. The rapid and incessant growth of urbanization on Kushtia district is creating continuous pressure on urban health care services. Urban poor people are also a vital factor for promoting urban primary health care services delivery project (UPHCSDP) to provide health care facilities.Methods: A cross sectional survey was carried out among 576 patients in 3 selected urban primary health care centres in Kushtia Municipality with a major concentration of people residing in urban areas. Data were collected using questionnaires regarding type of care or treatment patients demanded and type of care they received from the clinic.Results: Study results showed that total of 46.5% of the subjects demanded maternal and obstetric health services and 8.6% demanded child health diagnosis and care. It was found that a total of 22.0% of the subjects received physical diagnosis from the centres. About 7.1% clients received advice or suggestions and 8.0% received normal delivery service from the centres.Conclusions: The result shows that these clinics provide a lot of health care services to the clients especially on maternal and child health care delivery system. These services are provided to the patient with less or free of cost. Study exhibited that the overall health care services of health care centres are good. The clients come to these centres for the good quality of treatment.
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Background: ‘Sanitary labourers’ are known by different names such as ‘Health Labourers’, ‘Manual Scavengers’ garbage man, trash man etc. They are mainly involved in street cleaning, waste carrying, drainage and toilet cleaning in the cities. Intake of alcohol and tobacco products is prevalent to cope with the inhuman task of cleaning filthy sewage, and as a modality to forget their health problems. The aim of the present cross-sectional study was to find out the association of dental problems with tobacco abuse among the study population.Methods: The study population included 610, 122 from each zone of Allahabad city through “Proportionate stratified random sampling”. The study subjects was interviewed and examined, Dental problems were assessed by taking history, doing a clinical examination, reviewing past medical records.Results: Dental problems were found to be higher in prevalence among “exclusive smokers”, “combined abuser” and “exclusive tobacco” chewers as compared to “non abuser”. Dental caries were found to be higher in prevalence among the entire three abusers group as compared to “non abusers”. Missed teeth were found to higher in prevalence among “combined abuser” and “exclusive tobacco chewers” group as compared to “non abusers”. Enamel erosion was found to be higher among “exclusive tobacco chewers” group as compared to “non abusers”. All these finding were found to be statistically significant.Conclusions: Dental problems were found to be more prevalent among tobacco abusers than non abusers.
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Objective: To detect the prevalence pattern of Chikungunya virus in three states of Northeast India. Methods: A total of 1 510 samples were collected from different private and government hospitals of Assam, Arunachal Pradesh and Meghalaya. Serum was tested for the presence of IgM antibodies against Chikungunya virus followed by RT-PCR for amplification of Chikungunya E1 gene region using specific primers. Results: Overall, 11.83% (172/1 454) clinical samples were positive by MAC-ELISA and/or RT-PCR assay. Asymptomatic infection was seen in 17.86%. Males were more affected than females and age group 16-30 years was mostly affected. Fever (100.00%) was the primary symptom followed by headache (72.03%) and arthralgia (41.53%). Only 118 Chikungunya positive cases could be traced, of which 25.42% complained about sequelae of infection. In entomological investigation, Aedes aegypti was more predominant (92.10%) than Aedes albopictus (7.90%). No mosquito pools could be incriminated for Chikungunya virus. Conclusions: In this study, Chikungunya was observed to be prevalent in Assam, Arunachal Pradesh and Meghalaya. Though Chikungunya is a self-limiting infection, increasing morbidity by CHIKV infection is affecting social and economic status of individual. Thus, a community empowerment to effectively control mosquito population by employing different mosquito control measures along with personal protection is mandatory to tackle future outbreak of the disease.
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Objective To assess the knowledge on Zika virus infection among healthcare providers (doctors) in Aceh province, Indonesia. Methods A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province. A set of validated, pre-tested questionnaire was used to measure knowledge regarding Zika infection and to collect a range of explanatory variables. A two-steps logistic regression analysis was employed to assess the association of participants' demographic, workplace characteristics and other explanatory variables with the knowledge. Results A total of 442 participants included in the final analysis and 35.9% of them (159) had a good knowledge on Zika infection. Multivariate model revealed that type of occupation, type of workplace, availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on Zika infection. In addition, three significant source of information regarding Zika were online media (60%), medical article or medical news (16.2%) and television (13.2%). Conclusion The knowledge of the doctors in Aceh regarding Zika infection is relatively low. Doctors who have a good knowledge on Zika infection are more confident to established Zika disease as differential diagnosis in their clinical setting. Therefore, such program to increase healthcare providers' knowledge regarding Zika infection is needed to screen potential carriers of Zika infection.
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OBJECTIVE@#To assess the knowledge on Zika virus infection among healthcare providers (doctors) in Aceh province, Indonesia.@*METHODS@#A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province. A set of validated, pre-tested questionnaire was used to measure knowledge regarding Zika infection and to collect a range of explanatory variables. A two-steps logistic regression analysis was employed to assess the association of participants' demographic, workplace characteristics and other explanatory variables with the knowledge.@*RESULTS@#A total of 442 participants included in the final analysis and 35.9% of them (159) had a good knowledge on Zika infection. Multivariate model revealed that type of occupation, type of workplace, availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on Zika infection. In addition, three significant source of information regarding Zika were online media (60%), medical article or medical news (16.2%) and television (13.2%).@*CONCLUSION@#The knowledge of the doctors in Aceh regarding Zika infection is relatively low. Doctors who have a good knowledge on Zika infection are more confident to established Zika disease as differential diagnosis in their clinical setting. Therefore, such program to increase healthcare providers' knowledge regarding Zika infection is needed to screen potential carriers of Zika infection.
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Objective: To investigate the possible therapeutic effects of camel milk on behavioral characteristics as an interventional strategy in autistic children
Study Design: Double-blind, Randomized Clinical Trial [RCT]
Place and Duration of Study: Autism Research and Treatment Center, Al-Amodi Autism Research Chair, Department of Physiology, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from October 2012 to May 2013
Methodology: Changes in behavioral characteristics in 65 [boys=60, girls=5] children with autism [aged from 2 to 12 years] were assessed. The behavioral symptoms were evaluated by Childhood Autism Rating Scale [CARS], Social Responsiveness Scale [SRS], and Autism Treatment Evaluation Checklist [ATEC] before and after the 2 weeks of camel milk therapy
Results: Significant differences were detected on Autism Spectrum Disorder [ASD] by CARS, SRS and ATEC scales, following 2 weeks of camel milk consumption, but not in the placebo group
Conclusion: The present study demonstrates that camel milk could be very promising therapeutic intervention in ASD. Further wide scale studies are strongly recommended
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A review of published clinical trials from Ghana shows the earliest trials initiated in the 1970s, were mainly trials of interventions against onchocerciasis and childhood Burkitt’s lymphoma. Subsequent trials in the 1980s and 1990s were more diverse, comprising of preventive as well as therapeutic interventions against major communicable diseases of the period. In more recent times, trials of interventions against malaria have since 2000, been the most dominant and have included some of the most recently developed vaccines. There has, since the early days of clinical trial history in Ghana, been a consistent presence of trials of reproductive health interventions and surgically-related trials. There have been few trials of tuberculosis, or neonatal-related interventions, and trials against major non-communicable diseases such as hypertension, cardiovascular diseases, and mental health disorders have been virtually non-existent. The clinical trial evolution in Ghana has reflected global health initiatives and external funding exigencies and there is an urgent need for trials that are dynamic and directed towards addressing other significant and especially non-communicable disease causes of morbidity and mortality in Ghana.
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Job satisfaction is a pleasant emotional state associated with the appreciation of one's work and contributes immensely to performance in an organization. The purpose of this study was to assess the comparative job satisfaction among regular and staff on contract in Government Primary Urban Health Centers in Delhi, India. The study was conducted in 2013, on a sample of 333 health care providers who were selected using a multistage random sampling technique. The sample included medical officers [MOs], auxiliary nurses and midwives [ANMs], pharmacists and laboratory technicians [LTs]/ laboratory assistants [LAs] among regular and staff on contract. Analysis was done using SPSS version 18, and appropriate statistical tests were applied. The job satisfaction for all the regular staff that is, MOs, ANMs, pharmacists, LAs, and LTs were relatively higher [3.3 +/- 0.44] than the contract staff [2.7 +/- 0.45] with 't'value 10.54 [P < 0.01]. The mean score for regular and contract MOs was 3.2 +/- 0.46 and 2.7 +/- 0.56, respectively, and the same trends were found between regular and ANMs on the contract which was 3.4 +/- 0.30 and 2.7 +/- 0.38, regular and pharmacists on the contract was 3.3 +/- 0.50 and 2.8 +/- 0.41, respectively. The differences between groups were significant with a P < 0.01. Overall job satisfaction level was relatively low in both regular and contract staff. The factors contributing to satisfaction level were privileges, interpersonal relations, working-environment, patient relationship, the organization's facilities, career development, and the scarcity of human resources [HRs]. Therefore, specific recommendations are suggested to policy makers to take cognizance of the scarcity of HRs and the on-going experimentation with different models under primary health care system
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To determine the lung function among Saudi type 1 diabetes mellitus [T1DM] children and adolescents. This study was conducted in the Department of Pediatrics, Division of Pediatric Pulmonology and University Diabetes Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia from December 2008 to July 2010. A group of 52 [26 male and 26 female] volunteer T1DM children were recruited with an age range from 8-14 years [mean 12.05 +/- 1.42 years], mean duration of disease of 5.25 +/- 0.47 years, and mean glycosylated hemoglobin of 11.27 +/- 0.31%. Spirometry was performed on an Electronic Spirometer [Compact Vitalograph, Stockwell, London, UK]. Pulmonary function in children with diabetes showed significant lower mean values of actual lung function parameters forced vital capacity [FVC], peak expiratory flow [PEF], and maximum mid expiratory flow rate [MMEF] compared to their predicted values. However, there was no significant reduction in the actual forced expiratory volume in the first second [FEV1], and FEV1/FVC% compared to their predicted values. The actual lung function data among Saudi T1DM children and adolescents showed significantly lower values of FVC, PEF, and MMEF compared to the predicted lung function data
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Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal [GI] cancer. Sentinel lymph node [SLN] mapping clearly has become highly feasible and accurate in staging GI cancer. This study aims to investigate the feasibility and accuracy of detection of SLN using methylene blue dye in patients with carcinoma of the esophagus and assess its potential role in determining the rational extent of lymphadenectomy in esophageal cancer surgery. Thirty-two patients of esophageal cancer diagnosed on endoscopic biopsy were enrolled in this prospective study. After laparotomy, patent methylene blue was injected into the subserosal layer adjacent to the tumor. SLNs were defined as blue stained nodes within a period of 5 min. Standard radical esophagogastrectomy with lymphadenectomy was performed in all the patients. All the resected nodes were examined postoperatively by routine hematoxylin and eosin stain for elucidating the presence of metastasis, and the negative SLNs were examined further with cytokeratin immunohistochemical staining. SLNs were detected in 26 [81.25%] patients out of 32 patients who were studied. The number of SLNs ranged from 1 to 4 with a mean value of 1.7 per case. The SLNs of esophageal cancer were only found in N1 area in 21 [80.77%] cases, and in N2 or N3 area in only 19.33%. The overall accuracy of the procedure was 75% in predicting nodal metastasis. SLN had a sensitivity of 85.7% in the case of squamous cell carcinoma and 92.86% in the cases of adenocarcinoma of the esophagus. The accuracy of the procedure for squamous cell carcinoma and adenocarcinoma was 60% and 76.47%, respectively. SLN mapping is an accurate diagnostic procedure for detecting lymph node metastasis in patients with esophageal cancer and may indicate rational extent of lymphadenectomy in these patients. SLN mapping provides [right nodes] to the pathologists for detailed analysis and appropriate staging, thereby helping in individualizing the multi-modal treatment for esophageal cancer
Subject(s)
Humans , Male , Female , Sentinel Lymph Node Biopsy , Lymph Nodes , Lymphatic Metastasis , Intraoperative Care , Disease Management , Prospective Studies , EsophagusABSTRACT
To investigate the effects of electromagnetic field radiation generated by mobile phones on serum testosterone levels in Wistar albino rats. This experimental interventional control study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period December 2006 to April 2008. A total of 34 male Albino rats [Wistar strain], 2 months of age, weighing 150-160 gm were used for the experiment. These animals were divided into 3 groups. The first group containing 6 rats was assigned as a control group. The second group containing 14 rats was exposed to mobile phone radiation for 30 minutes daily and the third group containing 14 rats was exposed to mobile phone radiation for 60 minutes daily for the total period of 3 months. At the end of experimental period, blood was collected into the container, and serum testosterone was analyzed using double-antibody radioimmunoassay method by Coat-A-Count. Exposure to mobile phone radiation for 60 minutes/day for the total period of 3 months significantly decrease the serum testosterone level [p=0.028] in Wistar Albino rats compared to their matched control. Long-term exposure to mobile phone radiation leads to reduction in serum testosterone levels. Testosterone is a primary male gender hormone and any change in the normal levels may be devastating for reproductive and general health
Subject(s)
Animals, Laboratory , Male , Cell Phone , Rats, Wistar , Testosterone/bloodABSTRACT
The ideal type of anaesthesia which could offer maximum hearing results and least complications still a point of controversy in stapes surgery. This study was conducted on 20 patients suffering from conductive hearing loss [CHL] due to otosclerosis. Patients were classified into 2 groups; group [L] included 10 patients and were operated upon under local anaesthesia and group [G], included 10 patients, operated upon under general anaesthesia. All operations were performed at Otorhinolaryngology department; Benha Teaching Hospital. Our aim was to study the effect of type of anaesthesia, whether local or general on the outcome results of stapes surgery. Our results showed hearing gain in low and mid tone frequencies in both groups with no significant difference of air-bone gap posoperatively, while the high tone frequency in group [G] had a lower bone conduction threshold compared with that in group [L], indicating the more suffering of the cochlea. We concluded that stapes surgery is better to be operated under local anaesthesia than to be operated under general anaesthesia as it gives the surgeon and the patient good chance to protect the inner ear and to test the hearing on the operative table to the satisfactory level for both. However, general anaesthesia should be used with some indviduals especially anxious ones
Subject(s)
Humans , Male , Female , Anesthesia, General , Anesthesia, Local , Hearing Loss, Conductive , Otosclerosis , Treatment OutcomeABSTRACT
Cartilage/perichondrium composite graft with concomitant placement of a ventilation tube is a common practice among otologists to repneumatize the middle ear, and to reverse atelectasis in poor Eustachian tube function. We conducted this study to investigate the necessity of a ventilation tube primarily incorporated into the cartilage/perichondrium graft for reconstruction of the tympanic membrane[TM] in tympanoplasty with a potential Eustachian tube dysfunction to improve the rate of graft success. A prospective clinical trial. Benha Teaching Hospital. Twenty patients with chronic suppurate otitis media [CSOM], were included in the study, for tympanoplasty. They were randomly divided into 2 groups. In Group [A], 10 patients underwent reconstruction of the TM with cartilage/perichondrium graft and intra-operative T-tube insertion, and in Group[B], 10 cases were operated upon using the same procedure without ventilation tube insertion. Outcome measures were: graft taking success, improvement of hearing, and postoperative complications. Analysis of the results was performed by Student's paired t test. The level of significance was set at 5%. Significant postoperative improvement of pure tone air-conduction threshold averages and air-bone gap averages were reported in the two groups. The postoperative air-bone gap averages showed statistically significant difference between Group A and B, with a better results in group A. In group A, there were one failed case, postoperative otorrhea in 2 cases which were resolved within 3 weeks follow up by medical treatment, and three plugged tubes were also encountered on the tenth day which managed successfully. In group B, we had two failed cases and another 2 post-operative otorrhea which were resolved medically. Primary insertion of a ventilation T-tube during simultaneously tympanoplasty with cartilage/perichondrium graft in cases of [CSOM] with, potential poor Eustachian tube function may improve the success rate of graft taking and hearing gain
Subject(s)
Humans , Male , Female , Middle Ear Ventilation , Otitis Media, Suppurative , Postoperative Complications , Follow-Up Studies , Prospective StudiesABSTRACT
The high Incidence of viral hepatitis among Egyptian populations compared with other developing countries deserve to pay the attention to search for the predisposing factors especially in our locality at Kaliobia. To evaluate the importance of pre-operative testing of hepatitis B and C in decreasing the incidence of their transmission. Prospective open, trial. Pre-and post-tonsillectomy [six months follow up] screening for hepatitis surface antigen [HBs Ag], hepatitis B core antigen [HBcAg-IgM] and antibodies for hepatitis C were done for 100 patients[age range4-18ys] attending E.N.T. department at Benha Teaching Hospital one seropositive case for hepatitis B representing 1% and four seropositive cases for hepatitis C representing 4% of all cases, were detected. Follow up screeing for sero negative cases of hepatitis B and C, six months post-operatively, were negative. Seropositive cases showed moderate elevation of aminotransferase enzymes [SGOT and SGPT] up to 4 months follow up. Tests for hepatitis B and C virus infection must be included in the routine laboratory investigations at Benha Teaching Hospital pre-tonsillectomy or adenotonsillectomy as well as pre any operative interference to detect the occult positive cases regardless of the additional cost. Prophylactic guidelines of hepatitis nosocomial transmission should be respected especially in preoperative seropositive cases
Subject(s)
Humans , Male , Female , Hepatitis B/epidemiology , Seroepidemiologic Studies , Tonsillectomy , Preoperative Care , Postoperative Period , Hospitals, Teaching , Liver Function Tests , Enzyme-Linked Immunosorbent Assay , Hepacivirus , Hepatitis B virusABSTRACT
We report a case of a twenty-year old female patient who got subcutaneous emphysema following tonsillectomy. The patient had general anesthesia, intubation and ventilation air bubbles were noticed intraoperatively by the surgeon; then the patient developed surgical emphysema involving the face, neck and upper chest. Clinical and radiological assessment revealed a previous surgery in emphysema which extend to the anterior mediastinum and anterior chest wall and bilateral axillae with air in the retro peritoneal cavity. Management and follow-up where discussed, and to the best of our knowledge, our case is the first to be published from Jordan
Subject(s)
Humans , Female , Subcutaneous Emphysema/diagnosis , Subcutaneous Emphysema/therapy , Tomography, X-Ray Computed , Postoperative Complications , Hospitals, UniversityABSTRACT
The most common tumours of the heart are metastatic in origin, but the most common primary cardiac tumour in adults is a myxoma. We present a recent classic case of myxoma and review the topic of cardiac tumours as a whole
Subject(s)
Humans , Female , Myxoma/diagnosis , Heart Neoplasms/pathology , Heart Neoplasms/therapy , Echocardiography , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Cardiac CatheterizationABSTRACT
Background: Gynaecological problems in children and adolescents are often both medically and psychologically unique and require a highly skilled approach differing from those utilized for an adult female population. There is paucity of data on childhood gynaecological problems in our environment. The purpose of this study was to document the prevalence and pattern of common gynaecological problems in the prepubertal child at Ahmadu Bello University Teaching Hospital Zaria; Northern Nigeria. Materials and Methods: This was a retrospective study involving case file-based data analysis over a 10-year period (1995-2004) of 62 children aged 1 month-12 years at the Gynaecology unit of Ahmadu Bello University Teaching Hospital Zaria; Northern Nigeria. Results: Sixty-two children were seen; 17 infants; 14 under 5 years of age; and the rest (31) were aged 6-12 years. The commonest condition was labial fusion (33.9); urethral prolapse (14.5); and suspected sexual assault (12). Ambiguous genitalia (9.7); vaginitis (6.5); and ovarian tumour (4.8) were also encountered. Conclusion: Labial fusion; urethral prolapse; and suspected sexual assault are the commonest childhood gynaecological morbidities in Zaria. Provision of gynaecological services at every level of health care system to cater for young females is advocated
Subject(s)
Child , Gynecological Examination , Gynecology , Hospitals, Teaching , NigeriaABSTRACT
Background: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and Gynecology. Its effectiveness; low cost; stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect; uterine rupture and post partum haemorrhage (PPH) have been documented. Method: This is to report a case of disseminated intravascular coagulopathy (DIC) associated with use of misoprostol for induction of labour and to call for extra vigilance in its use.Result: This was a case of 22-year old gravida 2 para 1 at 42 weeks gestation that was induced with 100?g of isoprostol and delivered a live female baby with good Apgar score. She subsequently developed PPH and epistaxis simultaneously; then conjunctival haemorrhage 30 minutes later. She was managed with fresh whole blood and had a satisfactory recovery. Conclusion: Life threatening complication could result from use of Misoprostol. More research and high index of suspicion are needed to establish the association of prostaglandins with DIC