ABSTRACT
BACKGROUND: School Health Services (SHS) is commonly considered to be one of the more crucial parts of the health program in schools, and they are responsible for the students' overall health. Active school health services aid in the early detection and prevention of illnesses among students. SHS are those that are worried with the health and educational attainment of students at an appropriate age by providing direct services of health care to students in coordination with the administration and staff of the school. AIMS: To evaluate the quality assurance for school health services in all essential components as structure, process, and outcome and identify the correlation between them. MATERIALS AND METHODS: A descriptive study consists of (171) respondent selected by convenient sample distributed on (6) main primary health care centers, (32) health and nursing staff, and (133) consumers (school principals) at Al-Numaniya district from July 5, 2022 to January 25, 2023. Questionnaire comprised of three forms distributed on structure, process, and outcome data, which were collected by interview and researcher observation with directors of main primary health care centers, health and nursing staff, and school principals and through the use of a descriptive statistical (frequencies, percentages, statistical mean) and inferential (Pearson correlation coefficient) and the data were analyzed. RESULTS: Showed overall evaluation of the quality assurance related to structure standards of primary health care centers PHCs was fair (66.7%). Regarding process standards showed that 50.0% of the nurses' staff expressed a fair activity and duties. On the other hand, regarding outcome showed that 64.7% of the school principals expressed somehow satisfied toward elementary school health care services. CONCLUSIONS: Overall evaluation of quality assurance regarding school health services in PHCs was fair as described by moderate average in all essential components as structure, process, and outcome. It also showed a significant positive correlation between outcomes of quality assurance for school health services and regard structure of PHCs. RECOMMENDATIONS: Ministry of Education and Health can benefit from the study to identify the strengths and weaknesses in the structure of PHCs. Equipping health centers with essential supplies such as computers, vaccines, eye glasses, and laboratory materials PHCs to provide integrated services for students.
ABSTRACT
OBJECTIVE: The aim was to assess the early and mid-term safety and clinical outcomes of a modified sandwich-graft technique (MSGT) that employed the Aorfix and Viabahn stent-grafts to preserve hypogastric flow in cases of complex aortoiliac and isolated common iliac artery (CIA) aneurysms including internal iliac artery (IIA) ostium who were not suitable for an iliac branch device (IBD). METHODS: A review of prospective collected data of all consecutive cases of treatment of complex aortoiliac or isolated CIA aneurysms including IIA ostium using the MSGT to preserve the hypogastric flow in three European centres between April 1, 2010, and December 31, 2013, was performed. All patients included were unfit for open repair and not suitable for an IBD. RESULTS: During the study period, 21 patients met the study criteria and had 25 MSGTs. The mean follow-up duration was 17.2 months. The technical success rate was 100%, with no perioperative mortality and stent-graft or MSGT-treated IIA occlusions. There were two cases with Type Ib endoleaks and one Type III endoleaks intraoperatively that were successfully managed. There was also no reported early and late pelvic ischaemia. The primary patency rate was 90.5%, and two cases of MGST treated IIA occlusions with no reported symptoms of pelvic ischaemia during follow-up. CONCLUSIONS: MSGT was a safe and feasible strategy to preserve hypogastric flow in cases of complex aortoiliac and isolated CIA aneurysms including IIA ostium and who were not suitable for IBD, with encouraging early and mid-term outcomes.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Endovascular Procedures/methods , Iliac Aneurysm/surgery , Regional Blood Flow/physiology , Stents , Vascular Grafting/methods , Aged , Aged, 80 and over , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/physiopathology , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnostic imaging , Feasibility Studies , Female , Follow-Up Studies , Humans , Iliac Aneurysm/complications , Iliac Aneurysm/diagnostic imaging , Iliac Artery/diagnostic imaging , Iliac Artery/physiopathology , Male , Middle Aged , Prospective Studies , Prosthesis Design , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Vascular Patency/physiologySubject(s)
Lupus Erythematosus, Systemic/complications , Polyradiculoneuropathy/etiology , Adrenal Cortex Hormones/administration & dosage , Cyclophosphamide/administration & dosage , Electromyography , Female , Humans , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/therapy , Magnetic Resonance Imaging , Physical Therapy Modalities , Polyradiculoneuropathy/diagnosis , Polyradiculoneuropathy/therapy , Young AdultABSTRACT
Blastomycosis is a rare case. We report a first Moroccan case. A 41-year-old male presented with a 6-month history of dyspnea, fever and significant chest pain associated with night sweats and weight loss. The physical examination disclosed a firm painful paravertebral mass. The chest radiograph demonstrated a left apical opacity. The thoracic scan showed parenchymal infiltration of the apico-dorsal segment of the left upper lobe with vertebral and costal lytic lesions. Surgical biopsy showed granulomatous inflammation with giant-cell intracytoplasmic inclusions. Fungal studies yielded Blastomyces dermatitidis which responded excellently to ketoconazole. Outcome has been excellent at 3.5 years months follow-up. The clinical and radiographic presentation of blastomycosis is non-specific and can be mistaken for a neoplasm. Delay in diagnosis is common.
