Study of pattern and etiological factors of nosocomial infections in critical care unit in a multispecialty, tertiary care hospital in Central India

Background: Nosocomial infection is a key factor determining the clinical outcome, especially among patients admitted in critical care areas. The objective of the study was to ascertain the pattern and risk factors of nosocomial infections in Critical Care Unit in a tertiary care hospital.Methods: This prospective, observational clinical study included patients admitted in intensive care unitover a period of one and a half years. Routine surveillance of various nosocomial infections such as catheter?associated urinary tract infections, central?line?associated blood stream infections, and ventilator?associated pneumoniaswas done through specific infection surveillance proforma.Results: Out of 679 patients, 166 suffered 198 episodes of device?associated infections. The infections included CAUTI, CLABSI, and VAP. The number of urinary tract infectionepisodes was found to be 73 (10.75%) among the ICU patients who had indwelling urinary catheter. In addition, for 1 year CAUTI was calculated as 9.08/1000 catheter days. The number of episodes of blood stream infection was 86 (13.50%) among ICU patients having central line catheters. Also, CLABSI was found to be 13.86/1000 central line days. A total of 39 episodes (6.15%) of VAP was found in ICU patients over 18 months and VAP present for 6.04/1000 ventilator days.Conclusions: The organisms most commonly associated with nosocomial infections were Pseudomonas Aeruginosa and Acinetobacter species. The risk factors identified as being significantly associated with device associated infections in our ICU were diabetes, COPD and ICU stay for ?8 days (p<0.05).

Prevalence of gingival recession and associated etiological factors among the school children

Objective: The objective of this study is to assess the prevalence of gingival recession (GR) and associated etiological factors among school children. Methodology: The study sample consisted of 2095 children from the Nellore region divided into three groups of age ranges from primary dentition (<7 years), mixed dentition (7–12 years), and permanent dentition (>12 years) respectively, attending the department of pediatric and preventive dentistry and the school dental health programs organized by the department. The clinical examination involved measuring GR using William's periodontal probe and evaluating associated etiological factors. Data were statistically analyzed using the Chi-square test. Results: The GR among the study population was 7.9% (n = 165). Among them, males were 46% and females were 54% (P > 0.05). The GR was more in children in the 7–12 years age group (75%), followed by <7 years (21%) and >12 years (4%) age groups. The associated factors include malocclusion (69%), deleterious habits (5%), and anomalies (26%). Anomalies showed an association with GR (P < 0.05) compared to malocclusion and deleteriousness habits (P > 0.05). Conclusion: The prevalence of GR is 7.9%, and GR is more prevalent in males and the 7–12 years age group. GR is associated with transient malocclusion, deleterious habits, and anomalies.

Prevalencia de las causas de pérdida gestacional recurrente en un centro médico de tercer nivel de atención / Prevalence of the causes of recurrent pregnancy loss in a third-level health care center

Resumen OBJETIVO: Determinar la prevalencia de los principales factores etiológicos de pérdida gestacional recurrente en la población de un hospital de tercer nivel de atención. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo llevado a cabo en pacientes con protocolo de estudio de dos o más pérdidas gestacionales recurrentes que iniciaron el control prenatal en el servicio de Obstetricia o que ingresaron al Instituto Nacional de Perinatología con diagnóstico de infertilidad entre los meses de enero de 2017 a enero de 2020. En cada grupo se revisaron los factores etiológicos descritos en la bibliografía internacional como posibles causas de pérdida gestacional recurrente. RESULTADOS: Se estudiaron 280 pacientes y el factor con mayor prevalencia de pérdida gestacional recurrente fue el endocrino con el 56.78% (n = 159), seguido del anatómico-uterino con el 42.14% (n = 118) y en tercer lugar el infeccioso con 40.35% (n = 113). En las 75 pacientes del grupo de infertilidad, el factor etiológico más prevalente fue el endocrino (88%; n = 66), seguido del anatómico-uterino (53.3%; n = 40) y a continuación del masculino (50.6%; n = 38). En las pacientes del grupo de Obstetricia, el factor con mayor prevalencia fue el endocrino (45.36%; n = 93), seguido del anatómico-uterino (38.04%; n = 78) y el infeccioso (37%; n = 76). CONCLUSIONES: Los factores relacionados con la pérdida gestacional recurrente, descritos en la bibliografía internacional y analizados en este estudio, mostraron prevalencias similares en población institucional. Las que difieren están influidas por las características de la población estudiada, los recursos de la institución e, incluso, el diagnóstico y servicio por el que ingresaron como pacientes al INPer.

Abstract OBJECTIVE: To determine the prevalence of the main etiological factors of recurrent gestational loss in the population of a tertiary care hospital. MATERIALS AND METHODS: Retrospective, cross-sectional, descriptive study carried out in patients with study protocol of two or more recurrent gestational losses who initiated prenatal control in the Obstetrics service or who were admitted to the Instituto Nacional de Perinatologia with a diagnosis of infertility between the months of January 2017 to January 2020. In each group, the etiological factors described in the international literature as possible causes of recurrent gestational loss were reviewed. RESULTS: 280 patients were studied and the factor with the highest prevalence of recurrent gestational loss was endocrine with 56.78% (n = 159), followed by anatomic-uterine with 42.14% (n = 118) and thirdly infectious with 40.35% (n = 113). In the 75 patients in the infertility group, the most prevalent etiologic factor was endocrine (88%; n = 66), followed by anatomic-uterine (53.3%; n = 40) and then male (50.6%; n = 38). In patients in the obstetrics group, the factor with the highest prevalence was endocrine (45.36%; n = 93), followed by anatomic-uterine (38.04%; n = 78) and infectious (37%; n = 76). CONCLUSIONS: The factors related to recurrent gestational loss, described in the international literature and analyzed in this study, showed similar prevalences in institutional population. Those that differ are influenced by the characteristics of the population studied, the resources of the institution and, even, the diagnosis and service for which they were admitted as patients to the INPer.

Assessment of Etiological Factors of Female Primary Infertility

Aims: The aim of the study was to assess the etiological factors of female primary infertility.Place and Duration of the Study:This prospective study was conducted in the Gynaecology clinic of Sree Balaji Medical College and Hospital, Chennai, from August 2016 to February 2018.Methods:All the reproductive age group women coming to Gynaecology opd out patient clinic with historyof anxious to conceive. Those patients who satisfy the above criteria those have been selected for the study.The test has been carried out in hospitalized patients:1.A detailed history were taken.2.General physical and systemic examination were done.3.Ovarian factors and uterine factors ruled out.4.For tubal cannulation.The data collection technique adopted in this technique is structured questionnaire on the evaluation of infertility in couple of less than 35 years of age in a period of infertility less than 5 years from infertility OPD for one and half years of Sree Balaji Medical College and Hospital. Detailed history obtained from the couple and evaluate, informat ion with the help of various investigation in evaluating an infertile couple[1].Results:Age: The prevalence of infertility in the age group 21 –29 years were about 76% in women. Menarche This showed that maximum number of female attain menarche at the age group of 12 to 14years. In our study, it is observed that there is a strong relationof infertility with BMI, the prevalence of infertility increases as BMI Increases in population. 22% of the women have BMI above 30 (obese).In our study, 8% of the women has hydrosalpinx, 4%of the women had fibroids and 6% of the women has polyps. We observed that 4% of the women had unilateral fallopian tubal block and 2% had bilateral fallopian tubal block [2].Conclusion:In modern era of economically growing world we have concluded that the prevalence of infertility is about 76% in women age group of21-29, 40% of the women has attained menarche at 12-14 years, observed hydrosalpinx in 8%, polyps in 6% and fibroids in 4% [3].

Assessment of Risk Factors, Etiological Factors and Visual Outcomes of Infected Globe Injuries among Paediatrics and Adults – A Prospective Study

Introduction: Ocular trauma is the major cause of monocularvisual impairment and blindness in the world. The aim of thepresent study was to assess the infected globe injury withreference to demography, etiology, clinical features and visualoutcomes among paediatric and adult patients.Material and Methods: The present study was a prospectivestudy which was done among 92 patients. All patients whopresented to ophthalmology department with mechanicalglobe injuries leading to ocular infection (see methodologyfor definition of ocular infection) were included in the study.Visual status assessment was done with a Snellen chart for allage groups except for children below 5 years of age where ageappropriate tests will be used for VA assessment.Results: The total number of patients in the study was92 patients. Majority of which 77 were found to be males(83.7%) and females were 15 (16.3%). Majority of thepatients were less than 20 years (39.5%). At 6 months followup after management, we found that there was a significantimprovement in BCVA level (P <0.001) and there was alsosignificant relationship of increase in the OTS score withbetter VA in our study. The factors such as Cornea infiltrate(OR = 7.37, 95%CI (1.13 – 47.96), p-=0.037), Fundus goodglow (OR = 0.02, 95%CI (0.001 – 0.23), p=0.002) and Dullglow (OR = 0.16, 95% CI (0.03 – 0.99), p =0.049) were foundto be significant after multivariate analysis.Conclusion: Corneal infiltrate was identified as the singlemost independent risk factor for poor outcome in ourstudy. Children were the mostly affected group with malesoutnumbering females. Wooden sticks were the commonestinsulting agent. Despite the late presentation and predominantzone I injury, eye could be salvaged in majority with visualrecovery of 6/12 and better in 41 cases (44.6%).

Prevalence of Median Diastema in a Sample of Iraqi Population Concerning on the Mesiodistal Width of Anterior Teeth and Frenal Attachment as Etiological Factors

Aim: The purpose of this study was to evaluate the prevalence of mid line diastema between the group of Iraqi students of Dentistry College in Baghdad University, and to determine the etiological factors of this diastema whether it is due to height frenal attachment or due to the discrepancy in the width of the anterior teeth as etiological factors or/and another cause and to determine the gender difference. Materials and methods: Out of 600 students aged between 18-23 years were clinically examined; only 41 students (30 females and 11 males) fulfilled the inclusion criteria and were having diastema. Maxillary median diastema and mesiodistal width of the sex upper anterior teeth was measured directly (intra orally) with stainless steel vernier calipers. Results: Results showed that about 30 females and 11 males were only having maxillary midline diastema from the total sample. There was no significant difference between males and females concerning the width of maxillary middiastem. In both sexes, the mesiodistal width of all anterior teeth was nearly equal except the maxillary left lateral incisors which were significantly wider in females than in males. Conclusion: In dentally aware societies the presence of diastema was un-aesthetic so many students improved such appearance by orthodontic treatment or restorative veneer, therefore Iraqi students had less prevalence of maxillary diastema than other studies. Females express more prevalence of maxillary midline diastema than male. Mesiodistal width of upper anterior teeth is nearly within the normal range of Iraqi norms. Another etiological factor such as hereditary, genetic or oral habit can be considered as a cause of diastema in our sample who have diastema without high frenal attachment or tooth width discrepancy.

Ureterovaginal Fistula: Aetiological Factors and Treatment Outcome

Ureterovaginal fistula commonly occurs as a result of complication of pelvic surgeries with gynaecologic surgeries accounting for approximately two thirds. It is one of the most feared complications of pelvic surgery. Objectives: This study aims to determine the aetiological factors, role of ultrasound in the confirmation of dignosis and outcome of surgical repair of ureterovaginal fistula at the National Obstetric Fistula Centre, Katsina (NOFIC). Methods: This was a two-year retrospective review of all cases that underwent surgical repair for ureterovaginal fistula at the National Obstetric Fistula Centre Babbar Ruga, Katsina from 1st Jan, 2016 to 31st Dec, 2017. Result: A total of 27 patients had surgery for ureterovaginal fistula during the study period. However only 25 case notes were eligible for data entry and analysis. The mean age of the patients was 29.88 ± 8.53 with a modal parity of one. Eighty-eight percent presented with history of leakage of urine per vagina following emergency caesarean section, caesarean hysterectomy in 8%, prolonged obstructed labour in 8% and gynaecological hysterectomy in 4%. The onset of leakage varied from 2 to 10 days with a mean duration of onset of 5.64 ± 1.70. In addition to the ureterovaginal fistula, 3 had vesicouterine (VUF) fistula and 1 had vesicocervicovaginal (VCVF) fistula. The fistula was bilateral in 2 of the patients. The fistulae involved the left ureter in 13 patients and the right ureter in 10. Abdominal ultrasound was the main means of confirmation of diagnosis. Abdominal reimplantation of the ureter was the most common (88%) treatment approach. Majority 88% (22/25) were healed and continent at discharge. Conclusion: Emergency caesarean section was found to be commonest aetiological factor and the use of abdominopelvic ultrasound was found to be effective in the confirmation of diagnosis and identifying the affected ureter.

Rational Management of Unintentional Weight Loss / 胃肠病学

Unintentional weight loss is one of the common clinical symptoms with potential serious clinical implications. There are a variety of potential etiologies and special factors to be considered. Comprehensive evaluation of these patients should be based on the relevant results found in the medical history,physical examination,and laboratory tests. The purpose of this paper is to discuss the clinical importance,underlying etiologies,and rational management of unintentional weight loss.

Probe into lacking of protection in traditional Chinese medicine psychology pathogenesis / 国际中医中药杂志

Lack of protection in education was one of possible reason contributed to the traditional Chinese medicine(TCM) psychology pathogenesis while the research conducted. This paper discusseds the following aspects: the concept, the causes, the impact and the types of protection. It also provided series thought on the development of TCM psychology pathogenesis, TCM psychology family treatment and family education of TCM psychology prevention.

The development of the knee osteoarthritis TCM syndrome evaluation scale as the Patient-Reported Outcome / 国际中医中药杂志

Objective To develop the knee osteoarthritis (KOA) TCM syndrome evaluation scale. Methods Resrarch team collected subjective symptoms from all kinds of syndrome types of KOA and classified the subjective symptoms, which formed the first version of item pool containing 24 subjective symptoms. Expert questionnaires were conducted to calculate the weight coefficient of items, and formed the item pool of the Knee Osteoarthritis TCM Syndrome Evaluation Scale. According to the patient's attention to the 11 items, the items were weighted.Results The Knee Osteoarthritis TCM Syndrome Evaluation Scale contained 11 items, including pain, swelling and stiffness with different weighted scores.Conclusions The Knee Osteoarthritis TCM Syndrome Evaluation Scale were introduced to assess the KOA outcomes on the basis of TCM syndromes. It showed the characteristic of TCM and TCM syndrome.It could provide an objective and standardized measurement for TCM treating KOA.

Traumatismos dentarios en niños y adolescentes / Dental Trauma in Children and Adolescents

Los traumatismos dentoalveolares son lesiones que afectan a los dientes y los tejidos de sostén, incluyendo desde la pérdida de la integridad del diente hasta el desplazamiento total o parcial de su posición anatómica. Actualmente constituyen la segunda causa de atención odontopediátrica después de la caries. La búsqueda de información se realizó en la base de datos de PubMed de INFOMED y EBSCO; se utilizó dental trauma como descriptor. También se revisaron revistas médicas nacionales e internacionales en INFOMED, así como libros de texto. Se describieron los aspectos esenciales y actuales de los traumatismos en cuanto a prevalencia e incidencia, clasificación, etiología, factores predisponentes, localización, tipo de lesión, pronóstico y alteraciones de los dientes en desarrollo.

Dental and alveolar traumas are lesions that affects teeth and supporting tissue they may range from the loss of the whole integrity of the tooth to the total or partial displacement of its anatomical position. Nowadays they are the second cause of dentist pediatric care after cavities. The searching for information was carried out in PubMed and INFOMED and EBSCO using the descriptor dental trauma. In International and national medical journals were also reviewed as well as books. The current and essential aspects of traumas were described taking into account prevalence, incidence, classification, etiology, predisposing factors, site, kind of lesion, prognosis and teeth alteration.

Prevalence of Halitosis and its Correlation with Various Intraoral Etiological Factors: A Cross-Sectional Study.

Background: Halitosis is one of the most frequent complaints while a patient visits to a dentist. It has negative impact on the psychology of the individuals because of the social stigma related to it. Halitosis can produce by the degrading action of gram-negative anaerobic bacteria on sulfur containing substance such as debris and plaque. In majority of cases the source of halitosis is oral cavity. Methods: A total of 300 patients were selected from the OPD of department of Periodontics. Out of all, 166 were male and 134 were female. Organoleptic scoring system was used to detect the grade of halitosis. Complete dental checkup of the patients were performed to find out the possible cause of malodor. Results: Prevalence of halitosis in the given population was 63% (n=188). Out of total subjects with halitosis, 62 subjects (32%) presented with grade-I, 46 subjects (24%) with grade-II, 38 subjects (20%) with grade-III, 24 subjects (13%) with grade-IV and 18 subjects (11%) with grade-V. Strongest correlation was found between tongue coating and prevalence of halitosis. Other causes reported was, dental caries, periodontal disease, smoking, tobacco chewing, and pericoronitis. Conclusion: Prevalence of halitosis in the given population was 63%. Men had significantly greater prevalence of halitosis compared to women. The major reported etiological factor for halitosis was tongue coating.

Explore the pathogenesis of type 2 diabetes based on 583 internal medicine parties / 国际中医中药杂志

Objective Through the analysis of endocrinology outpatient data of Jiangsu provincial hospital,the law and the pathogenesis of TCM for type 2 diabetes was discussed.Methods The data of patients who were diagnosed of type 2 diabetes in Jiangsu provincial hospital outpatient in January 2014-October 2014 were collected,which including the oral medicine,establishment of a database,statistical analysis of single herb drugs appear frequency and its clinical efficacy.Results We collected a total of 583 prescriptions which contain 281 kinds of medcicines.Among these medicines,107 medicines were used more than 30 times,with the most frequently used medicines were poria,root of herbaceous peony and Astragalus.The clinical efficacy of these 107 medicines belonged to 10 kinds,medinces with the tonics and antipyretic functions occupied highest proportion(frequency of 30.4％,22.2％),followed by promoting blood circulation,diuretics for eliminating dampness,and promoting qi flow.Conclusions The pathogenesis of type 2 diabetes was mainly deficieny of both yin and fluid,and dryness heat inside,accompanied by blood stasis,phlegm,Qi stagnation.Therefore the treatment should be nourishing yin and clearing away heat,besides invigorating blood circulation and eliminating stasis,removing dampness and promoting diuresis,and disperse the depressed liver Qi.

Status and Control Strategy of TCM-induced Diseases / 中国药师

In recent years, Chinese medicine preparations have been applied in clinic increasingly with the development of tradi-tional Chinese medicine ( TCM) . Meanwhile, TCM-induced diseases and adverse reactions have attracted more and more attention. In the study, the main symptoms and etiological factors of TCM-induced diseases were summarized, and relative control methods and strat-egies were suggested. The summarization can provide theoretical support for clinical rational drug use, which shows clinical significance and scientific value for preventing TCM-induced diseases and reducing the frequency and severity of the diseases.

Recent trends in peptic perforation.

Background: The peptic perforation is one of the commonest abdominal surgical emergencies. Common causes are H.pylori, increased inadvertent use of NSAIDS, smoking and stress of modern life. During last few years there has been great revolution in availability of the newer broad spectrum antibiotics, better understanding of disease, effective resuscitation, prompt surgery under modern anaesthesia techniques, and intensive care unit resulted in reducing the mortality. Aims & Objective: To study the recent trends in peptic perforation. Material and Methods: This prospective study was carried out in the department of surgery during period from 1st May 2009 to 30th November 2011. All were indoor patients with diagnosis of peptic perforation in stomach and/or duodenum excluding other sites. Each patient was study in detail with relevant clinical history, examination, laboratory investigations and management. The study comprised of total 50 patients operated for peptic perforation by various modalities. Results: The middle age group was commonest. Smoking, alcohol and stress were common etiological factors. The perforation was common in anterior surface of the first part of duodenum. Wound infection and bronchopneumonia were common post-operative complications. Conclusion: The duration of perforation more than 24 hours and size of the perforation more than 1 cm has increase morbidity & mortality. Early diagnosis and prompt management of shock & septicaemia is important for better prognosis of patients. The simple closure with omentopexy of peptic perforation still remains the first choice as a treatment. H-pylori eradication treatment is mandatory after simple closure of the perforation to prevent recurrence of ulcer.

Cáncer de la vesícula biliar: estudios necesarios para el diseño de estrategias de prevención y diagnóstico precoz / Gallbladder cancer: necessary studies to design strategies for prevention and early diagnosis

Chile tiene la mayor tasa de incidencia de cáncer de vesícula biliar (CVB) en el mundo (> 30 por 100.000). Siendo la principal causa de muerte por cáncer entre las mujeres chilenas. Para diseñar estrategias de prevención y diagnóstico precoz del CVB hay que entender los factores etiológicos del proceso carcinogénico vesicular. Hay consenso que para el desarrollo de este cáncer concurren factores -genéticos, hormonales, infecciones crónicas, e inflamaciones crónicas asociadas a litiasis vesicular; y también que este cáncer ocurre en condiciones de pobreza. Desafortunadamente es insuficiente el conocimiento sobre la carcinogénesis vesicular, sobre el mecanismo de acción de los factores de riesgo clásicos y sobre cuáles son relevantes en la iniciación y promoción del CVB. En este artículo centramos la discusión en la litiasis vesicular, considerado el principal factor de riesgo del CVB. Se analiza las estrategias de prevención y control y se discuten los programas actuales. Finalmente se presentan dos estudios sobre factores de riesgo y de susceptibilidad para CVB que están siendo implementados en Chile.

Chile has the highest gallbladder cancer (GBC) incidence rate in the world (>30 per 100,000 person-years) and is the leading cause of cancer deaths among Chilean women. To design strategies of prevention and early diagnosis of GBC we must understand the etiological factors of the gallbladder carcinogenic process; There is consensus that in the development of this cancer concurs genetic and hormonal factors, infection, and chronic inflammation associated with lithiasis; and that is strongly associated with poverty conditions; But unfortunately there is not enough information about this process or how the classic risk factors associated play a role in its development. There is also no information on which are important in the initiation and promotion of GBC. In this article we focus the discussion in gallstones, considered the main risk factor for GBC. We analize some strategies of prevention and control and discuss some aspects of the current program. Finally we will point out two studies on risk factors and genetic susceptibility to GBC that are being implemented in Chile.

Analysis of the causes and risk factors of cerebral stroke in 392 young patients / 中国医师进修杂志

Objective To explore the causes and risk factors of cerebral stroke in young adults.Method The clinical data of 392 young patients (≤45 years old) of cerebral stroke were analyzed retrospectively,and analyzed its causes and risk factors. Results The most common etiology in youth ischemic cerebral stroke was atherosclerosis (48.70%, 112/230), followed by cardiogenic cerebral embolism (13.04% ,30/230). The main cause in youth hemorrhagic cerebral stroke was hypertension (39.51% ,64/162), followed by intracranial aneurysm(14.81%,24/162) and cerebral vascular malformation(10.49%,17/162). The main risk factors for young patients with cerebral stroke were hypertension (40.31% ,158/392),smoking (36.22%, 142/392),drinking (33.93%, 133/392),prior stroke (13.78% ,54/392),hyperlipidemia (11.99% ,47/392), others were heart disease (9.69% ,38/392), family history of strokehistories (8.16%,32/392) and diabetes (5.36%,21/392) and so on. As far as 160 young patients and 110 young patients were detected separately homocysteine and anticardiolipin antibody, positive rates were 39.38%(63/160) and 3.64%(4/110) respectively. Conclusions The main etiological factor of ischemic cerebral stroke in young adults is atherosclerosis, cardiogenic cerebral embolism is followed. The main etiological factor of hemorrhagic cerebral stroke in young adults is hypertension, intracranial aneurysm and cerebral vascular malformation are followed. The order of risk factors for the young patients with cerebralstroke were hypertension, smoking,drinking, prior stroke, hyperlipidemia,heart disease, family history of stroke-histories, diabetes and hyperhomocysteinemia.

Intellectual disability: definition, etiological factors, classification, diagnosis, treatment and prognosis

Etiology and classification: Causal factors related with cognitive disability are multiples and can be classified as follows: Genetic, acquired (congenital and developmental), environmental and sociocultural. Likewise, in relation to the classification, cognitive disability has as a common denominator a subnormal intellectual functioning level; nevertheless, the extent to which an individual is unable to face the demands established by society for the individual’s age group has brought about four degrees of severity: Mild, moderate, severe and profound. Diagnostic: The clinical history must put an emphasis on healthcare during the prenatal, perinatal and postnatal period and include the results of all previous studies, including a genealogical tree for at least three generations and an intentional search for family antecedents of mental delay, psychiatric illnesses and congenital abnormalities. The physical exam should focus on secondary abnormalities and congenital malformations, somatometric measurements and neurological and behavioral phenotype evaluations. If it is not feasible to establish a clinical diagnosis, it is necessary to conduct high-resolution cytogenetic studies in addition to metabolic clinical evaluations. In the next step, if no abnormal data are identified, submicroscopic chromosomal disorders are evaluated. Prognosis: Intellectual disability is not curable; and yet, the prognostic in general terms is good when using the emotional wellbeing of the individual as a parameter. Conclusions: Intellectual disability should be treated in a comprehensive manner. Nevertheless, currently, the fundamental task and perhaps the only one that applies is the detection of the limitation and abilities as a function of subjects’ age and expectations for the future, with the only goal being to provide the support necessary for each one of the dimensions or areas in which the person’s life is expressed and exposed.

Etiología y clasificación: múltiples factores causales están relacionados con la discapacidad cognoscitiva y pueden clasificarse de la siguiente manera: genéticos, adquiridos, (congénitos y de desarrollo), ambientales y socioculturales. Del mismo modo, en cuanto a la clasificación, la discapacidad cognoscitiva tiene como común denominador un nivel de funcionamiento intelectual por debajo de lo normal; sin embargo, la medida en que una persona es incapaz de afrontar las demandas establecidas por la sociedad para su grupo de edad ha dado origen a cuatro grados de severidad: ligera, moderada, severa y profunda. Diagnóstico: el historial clínico debe hacer énfasis en el cuidado de la salud durante el periodo prenatal, perinatal y postnatal e incluir los resultados de todos los estudios previos, incluyendo un árbol genealógico de al menos tres generaciones y una búsqueda intencional de antecedentes familiares de retraso mental, enfermedades psiquiátricas y anomalías congénitas. El examen físico debe concentrarse en anomalías secundarias y en malformaciones congénitas, mediciones somatométricas, y evaluaciones del fenotipo neurológico y conductual. Si no es posible establecer un diagnóstico clínico, se deben hacer estudios citogenéticos de alta resolución en adición a las evaluaciones clínicas metabólicas. Si no se identifican datos anormales, el siguiente paso consiste en la evaluación de trastornos cromosómicos submicroscópicos. Prognosis: la discapacidad intelectual no es curable, sin embargo el prognóstico es bueno en términos generales cuando se usa como parámetro el bienestar emocional del individuo. Conclusiones: el tratamiento para discapacidad intelectual requiere de un enfoque amplio. Sin embargo, la tarea principal y quizás la única que tiene aplicación es la detección de las limitaciones y habilidades en función de la edad y expectativas para el futuro de la persona, con el único fin de proporcionar el apoyo necesario para cada...

Discussion on the etiological factors and pathogenesis of chloasma / 中华中医药杂志

This article presents the discussion on the etiological factors and pathogenesis of chloasma.On the basis of clinical experience and related literature from every dynasty,the author concludes that the causes and pathogenesis of chloasma can be summarized into 8 aspects: 1.Menoxenia,lesion of uterus and cunnus,tumors in pelvic cavity in women;excessive heat and deficiency of kidney essence in men.2.Damages in Chong-Ren meridians,e.g.infection of pathogen which goes directly into Chong-Ren;exhaustion of essence blood;coldness,phlegm or blood clot congests within the Chong-ren meridians.3.Stasis of liver-qi induced by insufficiency of blood storage and dysfunction in conveyance and dispersion.4.Shortage of essence blood.5.Lack of kidney-yang.6.Disharmony between spleen and stomach,including deficiency of spleen-stomach qi,spleen-stomach yang,and stomach yin,and surplus of stomach heat.7.Flooding of turbidness and heat,like moisture and heat in liver-gallbladder and in spleen-stomach.8.Invaded by exogenous pathogen of wind and sunlight.Knowing these points has great significance on directing therapy according to syndrome differentiation.

Discussion on etiopathogenisis and pathogenesis of idiopathic pulmonary fibrosis / 中华中医药杂志

Idiopathic pulmonary fibrosis is divided into chronic progression stage and acute exacerbation stage according to progression of disease;early,middle and late stage according to onset time and clinic symptoms.It is considered that the etiological factors of idiopathic pulmonary fibrosis are repeated suffering of exogenous pathogen,environmental pathogen, deficiency of lung and kidney.The basic pathological products are blood stasis and phlegm turbid,the key point of pathopoiesis is that phlegm and stasis hides deeply and stagnated,the pulmonary collaterals are blocked.In addition,the evolutions of pathogenesis during its different stage are discussed.