Scabies: update on treatment and efforts for prevention and control in highly endemic settings.

Scabies is a contagious parasitic skin disease caused by Sarcoptes scabiei infestation which can be transmitted through direct or indirect contact. WHO classified scabies as a neglected tropical disease. The prevalence of scabies is high in certain countries ranging from 32.1% to 74%, especially in crowded conditions such as prisons, boarding schools, and orphanages. Indonesia is one of the most heavily affected countries worldwide. Scabies might cause great impact on patients, which includes decreased concentration and academic achievement at school, social stigma, sleep disturbances, and decreased economic productivity in community. Management of scabies with anti-scabies needs to be carried out appropriately, accompanied with treatment for all contacts. Mass treatment with permethrin cream or ivermectin can be given directly to patients. Prevention is conducted by providing medical treatment and breaking the chain of transmission. Source elimination and disinfection of fomites is very important. Participation of non-medical personnel such as teachers, cadres, and parents together with the local health workers (primary health care) is highly recommended. Using checklists or application can aid non-medical personnel to determine suspected cases, thus contributing to scabies elimination. Cooperation between patients, patient's family, health workers and other non-medical personnel will greatly reduce the prevalence of scabies and ultimately improve patient's quality of life. The aim of this review is to provide an update on scabies treatment and efforts for prevention and elimination, with focus on the situation in Indonesia.

Significance and research status of quality management of cardiopulmonary resuscitation training for Chinese public / 中国实用护理杂志

The quality of public cardiopulmonary resuscitation training plays an important role in improving the survival rate of patients with cardiac arrest. Various forms of training have been carried out all over China, which plays a great role in promoting the work of cardiopulmonary resuscitation. However, there is still a lot of room for improvement in the quality management and effect sustainability of training. This paper reviews the current situation and deficiencies of quality management of public cardiopulmonary resuscitation training, and the role of training quality in enhancing people's self-confidence in learning and rescue, training contents, training methods, quality evaluation indicators, evaluation methods, and quality influencing factors and retraining time requirements, and so on. And it puts forward some practical suggestions on the quality management of public cardiopulmonary resuscitation training in China. Such as it will more emphasize standardized training, deliberate practice, proficient training, National Training, long-term maintenance of knowledge and skills, and using useful tools to improve the quality of cardiopulmonary resuscitation training, etc. In order to improve the training quality management level of the public, so that the trainees can really master cardiopulmonary resuscitation skills, so as to improve the rescue rate and survival rate of patients with cardiac arrest. To promote the sustainable development of people's health.

Pediatric Online Disaster Preparedness Training for Medical and Non-Medical Personnel: A Multi-Level Modeling Analysis.

IntroductionTerrorism and natural catastrophes have made disaster preparedness a critical issue. Despite the documented vulnerabilities of children during and following disasters, gaps remain in health care systems regarding pediatric disaster preparedness. This research study examined changes in knowledge acquisition of pediatric disaster preparedness among medical and non-medical personnel at a children's hospital who completed an online training course of five modules: planning, triage, age-specific care, disaster management, and hospital emergency code response. METHODS: A multi-disciplinary team within the Pediatric Disaster Resource and Training Center at Children's Hospital Los Angeles (Los Angeles, California USA) developed an online training course. Available archival course data from July 2009 to August 2012 were analyzed through linear growth curve multi-level modeling, with module total score as the outcome (0 to 100 points), attempt as the Level 1 variable (any module could be repeated), role in the hospital (medical or non-medical) as the Level 2 variable, and attempt by role as the cross-level effect. RESULTS: A total of 44,115 module attempts by 5,773 course participants (3,686 medical personnel and 2,087 non-medical personnel) were analyzed. The average module total score upon first attempt across all participants ranged from 60.28 to 80.11 points, and participants significantly varied in how they initially scored. On average in the planning, triage, and age-specific care modules: total scores significantly increased per attempt across all participants (average rate of change ranged from 0.59 to 1.84 points) and medical personnel had higher total scores initially and through additional attempts (average difference ranged from 13.25 to 16.24 points). Cross-level effects were significant in the disaster management and hospital emergency code response modules: on average, total scores were initially lower among non-medical personnel compared to medical personnel, but non-medical personnel increased their total scores per attempt by 3.77 points in the disaster management module and 6.40 points in the hospital emergency code response module, while medical personnel did not improve their total scores through additional attempts. CONCLUSION: Medical and non-medical hospital personnel alike can acquire knowledge of pediatric disaster preparedness. Key content can be reinforced or improved through successive training in an online course. PhamPK, BeharSM, BergBM, UppermanJS, NagerAL. Pediatric online disaster preparedness training for medical and non-medical personnel: a multi-level modeling analysis Prehosp Disaster Med. 2018;33(4):349-354.

Presence, distribution and molecular epidemiology of multi-drug-resistant Gram-negative bacilli from medical personnel of intensive care units in Tianjin, China, 2007-2015.

BACKGROUND: Multi-drug-resistant Gram-negative bacteria (MDRGNB) have become an important cause of nosocomial infection in intensive care units (ICUs). AIMS: To investigate the molecular epidemiology of MDRGNB isolated from medical personnel (MP) and non-medical personnel (NMP) at 69 ICUs in Tianjin, China. METHODS: From April 2007 to October 2015, 2636 nasal and hand swab samples from 1185 MP and 133 NMP were cultured for GNB (including MDRGNB), meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The susceptibilities of GNB to 14 antimicrobial agents were determined, and 80 MDRGNB were characterized using pulsed-field gel electrophoresis (PFGE) and dendrogram analysis. FINDINGS: In total, 301 GNB were identified in 269 MP, including 109 MDRGNB isolates in 104 MP. Forty-two GNB were isolated from 39 NMP, which included 20 NMP with MDRGNB. Overall, 8.8% of MP were colonized with MDRGNB, which greatly exceeded colonization rates with MRSA (0.9%) and VRE (0.1%). Three pairs of Klebsiella pneumoniae and one pair of Enterobacter aerogenes were indistinguishable from each other, but the majority of isolate tests had distinct PFGE profiles. CONCLUSIONS: The prevalence of MDRGNB was high among ICU MP in Tianjin, and greatly exceeded that of VRE and MRSA. There was no difference in the rates of nasal carriage of MDRGNB between MP and NMP, but NMP were significantly more likely to have hand colonization with MDRGNB. PFGE profiles showed that there was only limited sharing of strains of MDR E. aerogenes and K. pneumoniae between personnel.

Two Cases of Adverse Events Following Illegal Practices by Non-medical Personnel / 대한피부과학회지

Dermatologists often treat patients with complications arising from illegal cosmetic practices. Large numbers of non-medical personnel who claim to be “beauty experts” currently offer laser treatment, surgery, or injections that result in serious complications. Here we report two cases of adverse events: one after epilation with an unidentified laser device and the other after rhytidectomy performed using an unproven surgical method. Dermatologists should be aware of these complications and be able to educate both patients and fellow doctors about the potential risks.

Irritant Contact Dermatitis Following Microneedle Therapy by Non-medical Personnel / 대한피부과학회지

No abstract available.

Seventy-four Complicated Cases Referred to a Tertiary Hospital in Korea after Dermatologic Procedures / 대한피부과학회지

BACKGROUND: During the last dozen years, tremendous changes have occurred in dermatologic care in Korea. Unlike in the past, dermatologic procedures, including cosmetic treatments, are now frequently carried out by non-dermatologists, oriental medicine doctors, dentists, or non-medical personnel. Procedure-related complications are increasing, but few studies have addressed this issue. OBJECTIVE: This study aims to analyze the scope of complicated cases after dermatologic procedures at Chonbuk National University Hospital. METHODS: This study analyzed the records of 74 patients with complications after dermatologic procedures that visited Chonbuk National University Hospital between January 2008 and December 2013. RESULTS: The numbers of complicated cases increased yearly. The ratio of male to female patients with complicated cases was 1:6.4, and the mean age was 44.4 years. The ratio of practitioners who treated the patients was 1u1. 6u5.7 dermatologists to non-medical personnel to non-dermatologists, and the majority of non-dermatologists who treated the patients were general practitioners. A total of 82.5% of the patients who visited non-dermatologists mistook them as dermatologists. The most common complication was a pigmentation change detected by non-dermatologists (n=21, 38.9%), and dermatologists (n=4, 44.4%). Foreign body granulomatous reactions were detected by non-medical personnel (n=12, 80.0%). Especially, laser ablations of undiagnosed skin cancer by non-dermatologists were seven times greater than dermatologist. CONCLUSION: Complications after dermatologic procedures are increasing and happen more commonly when patients are seen by non-dermatologists, including oriental medicine doctors, dentists, and non-medical personnel, than dermatologists. This study may help improve strategies for health-care safety management and quality in the dermatological field in Korea.

Relationship between multiple drug resistance and biofilm formation in Staphylococcus aureus isolated from medical and non-medical personnel in Yaounde, Cameroon.

INTRODUCTION: Monitoring the prevalence of nasal carriage of multiple drug resistance (MDR) Staphylococcus aureus (SA) strains in hospital personnel is essential. These strains when transmitted from hospital personnel to patients with already weakened immune states or in-built medical devices, may limit the latter's treatment options. This study aimed at assessing the potential exposure of patients to these MDR SA in a resource-limited hospital setting by assessing the prevalence and relationship between antimicrobial susceptibility and biofilm forming capacity of SA isolates from hospital personnel. METHODS: A total of 59 bacteria isolates phenotypically identified as Staphylococcus aureus obtained from medical (39) and non-medical personnel (20) in Yaounde were used in the study. Multiple drug resistance defined as resistance to four or more of twelve locally used antibiotics were determined by Kirby Bauer disc diffusion technique whereas quantification of biofilm production was by the microtitre plate method. RESULTS: Among the 59 SA isolates, the prevalence of MDR was 50.9%. Among medical personnel 48.7% had MDR as against 55.9% for non-medical personnel (p-value=0.648). The overall percentage of weak biofilm producers was 35.6%. Although the prevalence of weak biofilm formers was higher in isolates from non-medical personnel (40%) than medical personnel (33.3%) the difference was not statistically significant (p-value= 0.246). Slightly less than half (42.9%) of the weak biofilm producers were MDR. CONCLUSION: Considering the high rates of MDR and that slightly less than half of biofilm formers were MDR, these trends need to be monitored regularly among hospital personnel in Yaounde.

An Adverse Effect Following Illegal Medical Procedure by Unlicensed Non-medical Personnel / 대한피부과학회지

No abstract available.

Case Analysis of Side Effects following Illegal Therapeutic Attempts by Non-medical Personnel / 대한피부과학회지

BACKGROUND: Cases of patients presenting side effects after illegal therapeutic attempts by non-medical personnel have been increasing and the patterns of attempts and related side effects become complicated. OBJECTIVE: To analyze the causes and characteristics of illegal therapeutic attempts and its' side effects performed by non-medical personnel. METHODS: Between April 1, 2008 and April 30, 2008, a total of 120 case reports of patients who developed side effects after illegal therapeutic attempts by non-medical personnel were collected from the members of the Korean dermatological association and analyzed. RESULTS: Clinical diagnoses, suggested to have before receiving illegal therapeutic attempts, revealed that 44 (36.6%) patients presented various pigmentary disorders, such as acquired melanocytic nevi and melasma, 22 (18.3%) wanted to have tattooing for permanent make up, skin aging in 16 (13.3%) cases, and acne in 10 (8.3%). Illegal therapeutic attempts performed included tattooing for permanent make up in 22 (18.3%) cases, peelings 19 (15.8%), laser therapies 18 (15.0%), and filler injection 12 (10.0%). The various clinical diagnoses of the patients with side effects were suggested, such as contact dermatitis in 34 (25.6%) cases, scarring in 33 (24.8%), post-inflammatory hyperpigmentation 20 (15.0%), secondary infection 19 (14.3%), and acne or acneiform eruption 9 (6.8%). CONCLUSION: In this report, we demonstrated patterns of illegal therapeutic attempts by non-medical personnel and its' side effects. We suggest that more effort should be followed by dermatologists to inform patients the risks of the illegal therapeutic attempts by non-medical personnel and to increase public health awareness.

Complications of Various Genital Procedures Performed by Non-medical Personnel / 대한비뇨기과학회지

PURPOSE: The penis has been attracted to everyone associated with various diseases and sexual activity. Lots of materials and instruments has been applied to the penis for sexual arousal. Furthermore, those ar e usually made and applied in inappropriate ways by non-medical personnel. This resulted in lots of complications in various degrees. So, we investigated the real problems concerning various procedures performed on the genitalia by non-medical personnel. MATERIALS AND METHODS: We reviewed retrospectively medical records of 32 male and one female patients having complications which had been developed following some procedures on the genitalia by non-medical personnel from January 1995 to December 1999. These patients were analyzed according to characteristics of the patients, the methods, purposes, complications and treatments. RESULTS: Their age at first visit was various from 12 years to 70 years (mean, 35.8 years). At that time when procedures had been performed, their age were 12 years to 56 yeats (mean, 30.8 years) in 26 cases whose ages were identified. Among them 22cases (66.7%) were the married and 11 (33.3%) were the unmarried. Occupations were various and out-of-work were 10 (30.4%), commerce 8 (24.2%), firm worker 6(18.2%), student 5 (15.2%), and private job manager and the not-identified 2 (6.1%). according to the school career, the high school graduates were 18 (54.6%), the college graduates 7 (21.2%), middle school graduates 4 (12.1%), and 4 were under middle school. These procedures were performed for sexual satisfaction in 29 cases (87.9%) and for cheap and easy circumcision in 4 cases (12.1%), of which 26 cases (78.8%) had been performed by other person and 7 cases (21.2%) by himself. According to the materials used, 22 (66.7%) cases had been injected vaseline or paraffin in to the penis and one (3.0%) into the vulva, and one (3.0%) plicated his penile skin with rubber band using sewing needle, which 24 cases (72.7%) were for enlargement of the genitalia. 2 (6.0%) cases inserted plastic balls into the penile skin for sexual arousal of partner. 3 (9.1%) cases put a metallic ring, a ceramic ring, and a vacuum device over their penis for improving erection quality, respectively. 4(12.1%) cases had applied the commercially-maid self-circumcision devices over their prepuce, Complications were foreign body sensation, pain at erection, inflammation, skin necrosis, and septic condition, which were variable case by case. Treatments were removal of foreign materials and devices, necrotic tissue, and primary repair of defected skin, for that, in 2 (6.0%) cases, skin flap and graft were needed. CONCLUSIONS: Lots of complications, severe in some cases, had been developed on external genitalia following various procedures performed by medically unauthorized person. So, we have to strongly for their purpose and it would be rather harmful. At the same time, we have to strongly recommend the government to control strictly such materials and instruments not to be sold and used inappropriately.