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Objectives: Observation and analysis of the risk factors associated with preeclampsia and eclampsia and its effect on maternal and fetal outcome. It is a prospective study where 500 diagnosed Methods: cases of preeclampsia and eclampsia were recruited after taking informed consent. Data collected on the basis of detailed history and clinical evaluation. The maximum number of preeclampsia and eclampsia in the present series occurred Result: between the age group 21 to 25 years (46%). Majority of cases (71.4%) in our study presented between 35.1 to 40 weeks of gestational age. 24.4% cases had BMI in range of 25-29.9. 51.4% women were primipara and 53.2% cases were unbooked. Majority of the cases (45.2%) belonged to the upper lower socio-economic class. Out of 500 cases, 23.2% had anaemia, followed by hypothyroidism in 14.8% cases, GDM in 3.8% cases, obesity 2.8% cases, chronic hypertension in 2.2% cases, diabetes mellitus in 2% cases, and PCOD in 0.4 % cases. Risk factors found in our study that affected maternal and perinatal outcome severely were: primiparity, unbooked status, lower middle class III and upper lower class IV, BMI>24.9, gestational age < 34 weeks, anaemia, hypothyroidism and chronic hypertension and gestational diabetes mellitus. Our study reveals Conclusion: that if patients present with multiple risk factors (three and more), maternal morbidity and mortality increased signi?cantly.
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Objective：We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods：Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results：During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio：1.54；95% confidence intervals：1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80；specificity, 0.94；area under the curve, 0.94；positive predictive value：0.99, negative predictive value：0.32).Conclusions：These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.
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Objective：We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods：Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results：During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio：1.54；95% confidence intervals：1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80；specificity, 0.94；area under the curve, 0.94；positive predictive value：0.99, negative predictive value：0.32).Conclusions：These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.
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Background: Down syndrome (DS) is a major cause of mental retardation of prenatal origin and has several associated co-morbidities involving cardiovascular system, respiratory, endocrine system, hematological, gastrointestinal, musculoskeletal, eye and ear defects, immunological changes and neurological system. This study was conducted to identify the common medical problems in children with Down syndrome and the morbidity associated with these conditions. The objective of the present study was to find out the occurrence of different medical problems in children with DS.Methods: 42 children with a phenotype of Down syndrome in the age group of 0-12 years attending the outpatient, inpatient and Down syndrome Clinic of the Institute of Child Health, Kottayam during the study period were included in the study by purposive sampling. Demographic details were entered, and Pediatric Clinical Examination was performed by the investigator himself to identify the medical problems. Old medical reports were reviewed, and data entered into a proforma and statistically analysed.Results: Out of the 42 children with DS, 22 were males. 15 (35.7%) were less than 1 year, 20 (48.3%) children 1-5 years and 7 (16.1%) children 5-12 years of age. Mean age of the study group was 1.78±0.51 years. Mean age of their mothers at the time of conception was 30.6±5.8 years. 26 (57%) children with Down syndrome had a medical problem during the neonatal period which required hospitalization. Almost all systems are affected and craniofacial features, developmental delay and hypotonia were universal. Various forms of congenital heart diseases were observed in 67% and hypothyroidism in 23.8%.Conclusions: Down syndrome is a common genetic disorder with multisystem involvement. Congenital heart diseases, hypothyroidism and recurrent respiratory infections were the common medical problems identified in this study.
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This article shows how a typical patient with multiple chronic medical problems can be managed well by a Family Physician despite the pressure of time in Singapore. Resources like the Agency for Integrated Care, Community Health Centres, Centre-based Services, and Social Service Offices will be discussed in the context of how they help the busy Family Physician to stabilise multiple chronic medical problems in the community based on a multidisciplinary team care model. Optimal utilisation of such resources by family physicians can significantly alleviate the chronic patient load in the hospitals and government polyclinics. Furthermore, this will promote the Ministry of Health’s vision of “One Singaporean, One Family Doctor.”
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After studying the Classic on Medical Problems (Nanjing), the records of acupuncture therapy was studied in a systematic way. Academically, the Classic on Medical Problems (Nanjing)should be attached the same importance to the Internal Canon of Medicine. The acupuncture therapies in the Classic on Medical Problems (Nanjing) can be summarized as the followings: emphasizing on both hands together acupuncture;Stating reinforcing and reducing methods in acupuncture;developing the obey and opposite. The method of reigforcing and reducing in matching acupoint; stating the four seasons in acupuncture. The acupuncture therapies discussed in the Classic on Medical Problems (Nanjing) also has a profound impact on clinical medicine until today.
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[Objective]To discuss professor Wu Kaopan’s academic thoughts by studying plain questions(Su Wen), Miraculous Pivot(Ling Shu), Medical Prob-lems. [Methods]Through the study on Wu’s papers and works of plain questions(Su Wen), Miraculous Pivot, using literature research method, sort and study these papers and works. [Results]This paper introduces Wu’s study on classics, using methods not only col ating, exegetics, annotation and modern translation, but also classification, analysis and exposition, the result is theoretical essence and academic ideas in such works are explored. [Conclusion]For researchers, the study of classics of Chinese medicine requires basic theory of it, what’s more, broad and profound literature knowledge is more important.
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BACKGROUND: Pigmented purpuric dermatoses comprise a group of benign dermatoses that are clinically characterized by pinpoint petechiae and purpura on the hyperpigmented base, and histologically by capillaritis without any fibrinoid necrosis of the vessel. The etiology of pigmented purpuric dermatoses is unknown. Identification of triggering factors will contribute to find out the pathogenesis of the pigmented purpuric dermatoses. OBJECTIVES: The aim of this study was to investigate the clinical manifestations of pigmented purpuric dermatoses and to elucidate the relationship between the causative factors and clinical manifestation of pigmented purpuric dermatoses. METHODS: Clinical observation and review of medical records, photographs, and histopathologic specimens were made by analyzing 37 cases of patients with pigmented purpuric dermatoses who visited Our Lady of Mercy Hospital from 1995 to 2003. The present medical status of each patient was surveyed by phone and detailed reviews of the clinical records included attention to clinical manifestations, possible etiologic factors and coexisting diseases of each patient. The statistical methods used was one-way ANOVA test. RESULTS & CONCLUSIONS: The results were as follows; 1. Female to male ratio was 1.47: 1. The mean age at diagnosis was 45.6+/-17.2 years. 2. The mean duration of disease was 10.2+/-9.0 months, and the disease that localized to the lower limbs was in 75.7% of patients. 3. Of the 37 patients, 23 patients were of the Schambergs disease (62.2%), 11 patients were of the Majocchis disease (29.7%), 2 patients were of the Lichen aureus (5.4%), and one patient was of the Eczematid-like purpura of Ducas and Kapetanakis (2.7%). 4. The 37 patients were treated with topical or systemic steroid (73%), pentoxyfylline (10.8%), and there was no difference in the clinical course according to the treatment. Of the 37 patients, 18 patients had improvement or clearing of their lesions. 5. The etiologic factors identified were, orthostatic hypertension (21.6%), exercise (8.1%), metals (5.4%), NSAIDs (2.7%), heat (2.7%), and a wide spectrum of disease was present in patients with pigmented purpuric dermatoses. 6. The 14 of 22 patients without etiologic factors had medical problems, whereas 3 of 15 patients with etiologic factors had medical problems. The 5 of 15 patients with etiologic factors had clearance or improvement of their lesions, but 13 of 22 patients without etiologic factors had clearance or improvement of their lesions.