Πέμπτη, 3 Μαρτίου 2016

Out & About Calendar - The Telegraph

Out & About Calendar
The Telegraph
Hosted by the Coliseum Cancer Institute to celebrate Colon Cancer Awareness Month. Racers will wear their underwear on the outside of their race attire as a tongue-in-cheek reference to the area on the body affected by colon cancer. There will also be ...

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Management of odontogenic fibromyxoma in pediatric Nigerian patients: A review of 8 cases

KU Omeje, IO Amole, OD Osunde, AA Efunkoya

Annals of Medical and Health Sciences Research 2015 5(6):461-465

Odontogenic fibromyxoma (OFM) is a benign, locally invasive and aggressive nonmetastasizing neoplasm of jaw bones. They are considered relatively rare and known to be derived from embryonic mesenchymal elements of dental origin. Treatment of OFM depends on the size of the lesion and on its nature and behavior. Varying treatment modalities ranging from curettage to radical excision have been documented.Aim; This paper is a review of management of 8 pediatric patients with histologically diagnosed OFM at a Nigerian tertiary health care facility. This was a retrospective study of all patients aged 15 years and below who presented to the Oral and Maxillofacial Surgery Clinic of Aminu Kano Teaching Hospital, Kano, over a 5-year period (January 2008 to December 2012), with a histologic diagnosis of OFM. The information obtained included patients' demographics, as well as their clinical characteristics such as the anatomical site and side of lesions. Other information collated included presenting features, the onset of symptoms, type of treatment carried out, as well as treatment outcome. The data were analyzed and the results presented as frequencies and percentages. Among the 8 patients with OFM, more males (n = 5/8; 62.5%) were affected than females (n = 3/8; 37.5%). The mandible (n = 5/8; 62.5%) was the most frequent site of occurrence, and the anterior mandible was the most favored location (n = 4/8; 50%). Seven patients had excision of the lesion with peripheral ostectomy of the underlying bone while only one patient had a bone resection. These patients have been followed up for at least 1 year, and no recurrence was observed throughout the follow-up period. OFM causes gross facial disfigurement and may result in the destruction of the entire jaw bone; the impact of which may be grave for a growing child. Prompt surgical intervention and follow-up have proven to be adequate management protocol.

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Predictors of loss to follow-up among HIV-infected patients in a rural South-Eastern Nigeria Hospital: A 5-year retrospective cohort study

KN Eguzo, AK Lawal, CC Umezurike, CE Eseigbe

Annals of Medical and Health Sciences Research 2015 5(6):373-378

Background: Patient attrition has been a challenge in managing HIV programs in resource-limited settings. Aim: This study reviews the predictors of loss to follow-up (LTFU) in our hospital and suggests the best practices for dealing with the issue. Subjects and Methods: A 5-year retrospective cohort study of 1256 HIV-infected patients. Baseline CD4 counts, age, gender, year of enrolment, and antiretroviral therapy combination regimen were considered in this study. Kaplan–Meier models were used to estimate the univariate time-to-LTFU and Cox proportional hazards models to identify the multivariate predictors of LTFU. Results: Twenty-four percent (23.9% [301/1256]) of patients were lost to follow-up. Baseline CD4 count, year of enrolment, and drug combination were significant predictors of LTFU. Patients enrolled earlier (2008/2009) were twice as likely to be LTFU compared with those enrolled later (2010–2013). Gender and age did not significantly predict LTFU nor confound other predictors. Conclusion: The program showed higher LTFU rates than most studies in Nigeria and Africa, maybe due to difficulties with the access to the hospital and possible treatment fatigue. This study recommends the provision of transportation subsidies and proactive patient follow-up with “peer-tracking” to reduce LTFU among HIV infected patients, especially in resource-limited settings.

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Periodic peritoneal dialysis in end stage renal disease: Is it still relevant? A single center study from India

K Gandhi, D Prasad, V Malhotra, D Agrawal, P Beniwal, M Mathur

Annals of Medical and Health Sciences Research 2015 5(6):379-384

Background: High cost of maintenance hemodialysis (HD) and continuous ambulatory peritoneal dialysis (PD) in India has made renal replacement therapy out of reach of many patients with end stage renal disease (ESRD). Repeated puncture PD although inferior to HD biochemically, is easily and freely available across Rajasthan, India, and is simple to perform, and does not require sophisticated machines, thus making it an attractive option for dialysis for ESRD. Aim: To analyze the outcomes of periodic PD in patients with ESRD requiring dialysis support. Subjects and Methods: A prospective study analyzing the data of patients who underwent PD between August 2010 and January 2013 in Sawai Man Singh Hospital, Jaipur, India was conducted. Patients were divided into three groups based on the time period between first and second session of PD. Detailed demographic and clinical data during the study period were collected along with PD related complications. The main outcome studied was technique survival 1 year post initiation of PD. Results: 234 patients received an initial session of PD, of which 174 had a good response and were included in the study. 19 patients received the second PD within 7 days of first (Group 1), 45 patients within 8–14 days (Group 2) and 110 patients within 15–21 days (Group 3). The overall 1 year technique survival was 68.4% (91/133), with a rate of 50% (5/10), 56.8% (21/37), and 75.6% (65/86) for Group 1, Group 2, and Group 3, respectively. The time duration between first and second PD proved to be reliable indicator of the subsequent response, with a technique survival rate significantly lower in Group 1 patients compared to Groups 2 and 3 (P = 0.04). Median dialysis free days were 11, 16 and 21 days in Group 1, Group 2, and Group 3, respectively. Peritonitis rate observed was 2.1% (49/2261) during the study period. Conclusion: Periodic PD is a simple, safe and cheap procedure, which can be considered as used as a palliative measure in terminal uremia in underprivileged areas.

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Intrapartum pubic symphysis disruption

RES Pires, PJ Labronici, V Giordano, KE Kojima, M Kfuri, M Barbisan, A Wajnsztejn, MAP de Andrade

Annals of Medical and Health Sciences Research 2015 5(6):476-479

During pregnancy, high progesterone and relaxin levels produce physiological ligament relaxation on the pelvis. Therefore, moderate pubic symphysis and sacroiliac joints relaxing provide birth canal widening, thereby facilitating vaginal delivery. Sometimes, functional pain or pelvic instability may occur during pregnancy or puerperium, which is defined as symptomatic pelvic girdle relaxation. In rare cases, a pubic symphysis disruption can occur during the labor, causing severe pain and functional limitations. The early recognition of this injury is crucial to prevent complications and improve clinical and functional outcomes. This study reports an acute symphyseal disruption resulting from childbirth in a primiparous patient who underwent open reduction and internal fixation with plate and screws. After a 6 months follow-up, the patient presented no pain and satisfactory functional recovery.

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Association of maternal working condition with low birth weight: The social determinants of health approach

Z Mahmoodi, M Karimlou, H Sajjadi, M Dejman, M Vameghi, M Dolatian, A Mahmoodi

Annals of Medical and Health Sciences Research 2015 5(6):385-391

Background: The socioeconomic conditions have made more job opportunities available to women. This has created interest to conduct studies on the effect of working lifestyle on pregnancy outcomes. Aim: This study was conducted with the aim to assess the relationship between mothers' working status as a social determinant and the incidence of low birth weight (LBW) of the newborn. Subjects and Methods: This case–control study was conducted on 500 women with normal weight infants (control group) and 250 women with LBW infants (case group) in selected hospitals in Tehran. Data were collected using a researcher-made questionnaire, designed to assess the effect of mothers' prenatal lifestyle, as a social determinant, on LBW of the newborn. A section of the questionnaire involved assessment of mother's working condition in terms of the work environment, activities, and job satisfaction. Data were analyzed using Chi-square and logistic regression tests. Results: LBW among employed mothers was 5 times more likely than unemployed ones (odds ratio = 5.35, P < 0.001). Unfavorable work conditions such as humid environment, contact with detergents, and being in one standing or sitting position for long hours were significantly associated with LBW (P < 0.001).Conclusion: The present study showed that unfavorable work conditions were associated with LBW; therefore, they need special attention.

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Clinical and laboratory predictors of articular disorders among HIV-infected patients seen at Teaching Hospital Southeast Nigeria

CC Okwara, G Ozoh, BC Nwatu

Annals of Medical and Health Sciences Research 2015 5(6):447-453

Background: HIV infection may be associated with different arthropathies that are often underdiagnosed. There is also paucity of reported studies of relationship between clinical and laboratory features of HIV-infected patients and articular disorders. Aims: To determine the predictors of articular disorders among HIV-infected patients seen at tertiary hospital Nigeria. Subjects and Methods: Hospital-based cross-sectional descriptive study. Subjects were recruited from outpatient clinics of the study centers. Persons aged 16 years and above were recruited via stratified sampling method. Subjects with trauma, degenerative arthritis, malignancy, hepatitis B surface antigen and anti-hepatitis C virus positivity or previously known to have pulmonary tuberculosis or rheumatological disorders were excluded. Pretest-improved semi-structured questionnaire was administered to the recruited 480 subjects comprising 240 HIV positive subjects (HPS) and 240 HIV-negative subjects (HNS). Blood for relevant laboratory tests and radiographs were done where necessary. Diagnosis of articular disorder was based on American College of Rheumatology and European Spondyloarthropathy Study Group classification guidelines. Statistical Package for Social Sciences version 15 (SPSS Inc., Chicago, IL, USA) was used for data entry, validation, and analysis. Results: Of the 480 participants, both HPS and HNS were made up of 95 males and 145 females. There was statistically significant difference between the frequency of occurrence of articular disorders among the HPS of 37.1% (89/240) and the HIV-negative controls of 16.2% (39/240) (χ2 = 26.63 P = <0.01). Arthralgia frequency of 29.6% (71/240), HIV-associated arthritis 4.6%, (11/240) (Reiter's disease 1.3% (3/240), undifferentiated spondyloarthropathy 1.3%, (3/240) and gout 0.4% (1/240) (were seen among the HPS. Only arthralgia was found among HNS. Erythrocyte sedimentation rate (ESR) and age were the best predictors of arthralgia presence. CD4+ T-cell count was predictive of HIV-associated arthritis. Conclusions: Articular disorders are commoner among HIV patients than HNS. ESR and age were the best predictors of Arthralgia presence among HIV-infected patients. CD4+ T-cell count was predictive of HIV-associated arthritis.

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Prevalence of needlestick injuries among healthcare workers in the Accident and Emergency Department of a Teaching Hospital in Nigeria

AR Isara, KE Oguzie, OE Okpogoro

Annals of Medical and Health Sciences Research 2015 5(6):392-396

Background: Healthcare workers (HCWs) are continually exposed to hazards from contact with blood and body fluids of patients in the healthcare setting. Aim: To determine the prevalence of needlestick injuries (NSIs) and associated factors among HCWs in the Accident and Emergency Department of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Subjects and Methods: This was a cross-sectional study. Data were collected using a structured, self-administered questionnaire and analyzed using IBM SPSS version 20. Univariate, bivariate, and binary logistic regression analyses were done. The level of significance was set at P < 0.05. Results: The prevalence of NSIs 12 months preceding the study was 51.0% (50/98). Doctors 8/10 (80.0%) and nurses 28/40 (70.0%) had the highest occurrence. Recapping of needles 19/50 (38.0%) and patient aggression 13/50 (26.0%) were responsible for most injuries. The majority 31/50 (62.0%) of the injuries were not reported. The uptake of postexposure prophylaxis (PEP) was low 11/50 (22.0%). The factors that were significantly associated with NSI include age 30 years and above (odds ratio [OR] =0.28, confidence interval [CI] = 0.11–0.70), work duration of three years and above (OR = 0.29, CI = 0.11–0.75), and being a nurse (OR = 3.38, CI = 1.49–9.93) or a paramedic (OR = 0.18, CI = 0.06–0.52). Conclusion: The high prevalence of NSIs among the HCWs, especially in doctors and nurses is an indication that HCWs in UBTH are at great risk of contracting blood-borne infections. Efforts should be made to ensure that injuries are reported and appropriate PEP undertaken following NSIs.

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Follicular adenomatoid odontogenic tumor in mandible: A rare case report

UI Belgaumi, MI Parkar, NA Malik, KV Suresh, AM Havewala, PM Bhalinge

Annals of Medical and Health Sciences Research 2015 5(6):469-472

Adenomatoid odontogenic tumor (AOT) is a relatively rare, benign, hamartomatous, and cystic odontogenic neoplasm that was first described more than a century ago. The lesion still continues to intrigue experts with its varied histomorphology and controversies regarding its development. The present article describes a case of cystic AOT with an unusual histomorphology associated with an impacted 44 in a 21-year-old male.

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The influence of method, timing of onset and duration of enteral feeding on the duration of hospitalization of newborn infants in a Nigerian special care baby unit

TA Ogunlesi, OB Ogunfowora

Annals of Medical and Health Sciences Research 2015 5(6):397-402

Background: Feeding practices among high-risk newborn babies have not been extensively studied in the resource-constrained parts of the world. Aim: To describe the pattern of milk use among infants in a resource-poor special care baby unit (SCBU) and relate these to the outcome of hospitalization. Subjects and Methods: Setting – SCBU of Olabisi Onabanjo University Teaching Hospital, Sagamu. Design – Prospective study of consecutively admitted inborn babies within the first 24 h of life. The data analyzed included the weight and estimated gestational age (EGA) of the babies, the age at the onset of and duration of feeds (breast milk and artificial milk [AM]). Results: Out of the 118 infants studied, (78.8%) 93/118 received breast milk and 16.1% (19/118) received AM. The mean age at the commencement of enteral feeding was 3.9 days. The age at the onset of suckling was negatively correlated with the EGA and body weight. The age at the onset and duration of enteral feeding were directly related to the duration of admission. Conclusion: More than three-quarter of the infants hospitalized in the unit received breast milk, but commencement was mostly delayed beyond the 3rd day of life. The duration of admission may be related to the timing of onset and duration of milk use.

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Orgasm induced seizures: A rare phenomenon

SP Chaukimath, PS Patil

Annals of Medical and Health Sciences Research 2015 5(6):483-484

A variety of stimuli can cause reflex seizures, Some triggers include light, music and cognitive phenomenon. There are case reports however where the phenomenon of sexual activity has been a trigger for epileptic seizures. Most of these cases reported are in women so far, and were found to be localized to right cerebral hemisphere. We report a case of a 36-year-old male with orgasm-induced seizures, with other atypical features compared to majority of previous reports.

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Identifying the optimal age to perform newborn screening for hearing loss in Uganda

M Walsh, E Redshaw, E Crossley, C Phillips

Annals of Medical and Health Sciences Research 2015 5(6):403-408

Background: Permanent congenital hearing loss affects up to 6/1000 births in developing countries. Currently, in Uganda there is no newborn screening for hearing loss (NSHL) program and no published work on this topic. Within the existing healthcare system there are two opportunities to deliver screening, at birth or 6 weeks of age when infants receive their immunizations. Aim: This study explored the outcomes of otoacoustic emission (OAE) testing in infants at birth and 6 weeks of age, to identify the optimal age for screening. Subjects and Methods: This cross-sectional pilot study recruited 60 consecutive infants from two health centres in Kampala, Uganda. Thirty infants were newborns recruited from the postnatal ward and 30 were aged 4–8 weeks from the immunization clinic, we performed OAE testing on all infants. Results: The results showed 56.7% (17/30) of newborn infants passed OAE testing compared with 90.0% (27/30) of the immunization infants, P < 0.01. Furthermore, of the 11 newborn infants aged ≥24 h of age 90.9% (10/11) passed, compared with the 19 infants <24 h of age where 37% (7/19) passed, P < 0.01. Conclusions: This study demonstrates a higher pass rate for OAE testing for infants ≥24 h of age compared to those <24 h of age. The overall lower pass rate of the newborn infants could be due to external ear debris and middle ear fluid compromising the OAE testing. These findings would support a NSHL programme in Uganda that offers screening to infants ≥24 h of age, to maximize the cost-effectiveness of the program.

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A 10-year review of the clinical presentation and treatment outcome of Asherman's syndrome at a center with limited resources

IU Takai, AS Kwayabura, EA Ugwa, A Idrissa, JY Obed, M Bukar

Annals of Medical and Health Sciences Research 2015 5(6):442-446

Background: Many women suffer from some degree of intrauterine adhesions (IUAs) presenting with various clinical symptoms and signs. Hysteroscopy is the mainstay of diagnosis, classification, and treatment of the IUA. Aim: This study was undertaken to review the clinical features and treatment outcome in patients diagnosed with Asherman's syndrome at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, over a 10 years period, 1997–2006. Subjects and Methods: This is a retrospective study of cases of Asherman's syndrome managed at the UMTH over a 10-year period, from January 1, 1997 to December 31, 2006. Case records of the patients were retrieved from medical records' Department. Sociodemographic and clinical information relating to clinical presentations, treatment modalities, and outcomes were collated. The data were analyzed using SPSS 16.0 Statistical Computer Package (SPSS Inc., IL, USA 2006). Chi-square and binary logistic regression were used for inferential statistics. Results: Asherman's syndrome constituted 8.1% (81/996) of all gynecological operations in UMTH during the study period. The case records retrieval rate was 96.3% (78/81 folders). Most of the patients, 59% (46/78) were in their third decade and majority 85.9% (67/78) were married. The most common risk factor was pregnancy-associated, accounting for 61.5% (48/78). Infertility and hypomenorrhea were the most common mode of presentations in 55.1% (43/78) and 32.1% (25/78) of cases, respectively. Most of the patients 85.9% (67/78) were treated by blind dilatation and curettage (D/C), Foley's catheter insertion and estrogen-progesterone combination. Correction of menses was seen in 37.2% (29/78) of the patients while the pregnancy rate was 32.1% (25/78). On binary logistic regression age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) emerged as the only respondent's related risk factors associated with the development of Asherman's syndrome. Conclusion: Asherman's syndrome is relatively common due to complications of pregnancy and delivery, and blind D/C has a relatively poor outcome. Age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) were associated with the development of Asherman's syndrome. Therefore, other methods of adhesiolysis such as hysteroscopic adhesiolysis should be explored.

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Verification of entrance dose measurements with thermoluminescent dosimeters in conventional radiotherapy procedures delivered with Co-60 teletherapy machine

OB Evwierhurhoma, ZA Ibitoye, CA Ojieh, JTK Duncan

Annals of Medical and Health Sciences Research 2015 5(6):409-412

Background: The use of in vivo dosimetry with thermolumiscent dosimeters (TLDs) as a veritable means of quality control in conventional radiotherapy procedures was determined in this work. Aim: The objective of this study was to determine the role of in vivo dosimetry with thermoluminescent dosimeters (TLDs) as part of quality control and audit in conventional radiotherapy procedures delivered with Co-60 teletherapy machine. Subjects and Methods: Fifty-seven patients with cancers of the breast, pelvis, head and neck were admitted for this study. TLD system at the Radiation Monitoring and Protection Centre, Lagos State University, Ojo, Lagos-Nigeria was used for the in vivo entrance dose readings. All patients were treated with Co-60 (T780c) teletherapy machine at 80 cm source to surface distance located at Eko Hospitals, Lagos. Two TLDs were placed on the patient surface within 1 cm from the center of the field of treatment. Build-up material made of paraffin wax with a density of 0.939 g/cm3 and a thickness 0.5 cm was placed on top of the TLDs. A RADOS RE 200 TLD reader was used to read out the TLDs over 12 s and at a temperature of 300°C. Results: The results showed that there was no significant difference between the expected dose and measured dose of breast (P = 0.11), H and N (P = 0.52), and pelvis (P = 0.31) patients. Furthermore, percentage difference between expected dose and measured dose of the three treatment sites were not significantly different (P = 0.11). More so, 88.9% (16/18) treated breast, 91.3% (21/23) pelvis, and 86.7% (13/15) H and N patients had percentage deviation difference less than 5%. In general, 89.3% (50/56) patients admitted for this study had their percentage deviation difference below 5% recommended standard limit. Conclusion: The values obtained establish that there are no major differences from similar studies reported in literature. This study was also part of quality control and audit of the radiotherapy procedures in the center as expected by national and international regulatory bodies.

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Prevalence, reasons, and perceived effects of Khat chewing among students of a college in Gondar town, Northwestern Ethiopia: A cross-sectional study

FS Teni, AS Surur, A Hailemariam, A Aye, G Mitiku, AE Gurmu, B Tessema

Annals of Medical and Health Sciences Research 2015 5(6):454-460

Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro-intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution-based cross-sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two-thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.

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Linguistic adaptation and psychometric properties of tamil version of general oral health assessment index-Tml

DP Appukuttan, M Vinayagavel, A Balasundaram, LK Damodaran, P Shivaraman, K Gunasshegaran

Annals of Medical and Health Sciences Research 2015 5(6):413-422

Background: Oral health has an impact on quality of life hence for research purpose validation of a Tamil version of General Oral Health Assessment Index would enable it to be used as a valuable tool among Tamil speaking population. Aim: In this study, we aimed to assess the psychometric properties of translated Tamil version of General Oral Health Assessment Index (GOHAI-Tml). xsSubjects and Methods: Linguistic adaptation involved forward and backward blind translation process. Reliability was analyzed using test-retest, Cronbach alpha, and split half reliability. Inter-item and item-total correlation were evaluated using Spearman rank correlation. Convenience sampling was done, and 265 consecutive patients aged 20–70 years attending the outpatient department were recruited. Subjects were requested to fill a self-reporting questionnaire along with Tamil GOHAI version. Clinical examination was done on the same visit. Concurrent validity was measured by assessing the relationship between GOHAI scores and self-perceived oral health and general health status, satisfaction with oral health, need for dental treatment and esthetic satisfaction. Discriminant validity was evaluated by comparing the GOHAI scores with the objectively assessed clinical parameters. Exploratory factor analysis was done to examine the factor structure. Results: Mean GOHAI-Tml was 52.7 (6.8, range 22–60, median 54). The mean number of negative impacts was 2 (2.4, range 0–11, median 1). The Spearman rank correlation for test-retest ranged from 0.8 to 0.9 (P < 0.001) for all the 12 items between visits. The Cronbach alpha for 265 samples was 0.8 suggesting good internal consistency and homogeneity between items. Item scale correlation ranged from 0.4 to 0.8 (P < 0.001). Concurrent and discriminant validity was established. Principal component analysis resulted in extraction of four factors which together accounted for 66.4% (7.9/12) variance. Conclusion: GOHAI-Tml has shown acceptable psychometric properties, so that it can be used as an efficient tool in identifying the impact of oral health on quality of life among the Tamil speaking population.

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Cesarean delivery for a life-threatening preterm placental abruption

II Okafor, EO Ugwu

Annals of Medical and Health Sciences Research 2015 5(6):466-468

Placental abruption is one of the major life-threatening obstetric conditions. The fetomaternal outcome of a severe placental abruption depends largely on prompt maternal resuscitation and delivery. A case of severe preterm placental abruption with intrauterine fetal death. Following a failed induction of labor with a deteriorating maternal condition despite resuscitation, emergency cesarean delivery was offered with good maternal outcome. Cesarean delivery could avert further disease progression and possible maternal death in cases of severe preterm placental abruption where vaginal delivery is not imminent. However, further studies are necessary before this could be recommended for routine clinical practice.

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Awareness and knowledge of ergonomics among Medical Laboratory Scientists in Nigeria

BH Oladeinde, IM Ekejindu, R Omoregie, OD Aguh

Annals of Medical and Health Sciences Research 2015 5(6):423-427

Background: Ergonomics awareness helps in its right application and contributes significantly to general wellbeing and safety of worker at workplace. Aim: This cross-sectional descriptive study aimed at assessing the level of awareness and knowledge of the science of ergonomics among Medical Laboratory Scientists in Benin City, Nigeria. Subjects and Methods: A total of 106 medical laboratory scientists comprising 64 and 42 in public and private laboratories, respectively, were recruited for this study using systematic random sampling technique. Data were obtained from the study participants using a questionnaire and subsequently analyzed with the statistical software INSTAT®. Results: Out of 106 study participants, 27 (25.5%) were reported to have heard of the term ergonomics. Awareness was significantly associated with gender (male vs. female: 38.5% [15/39] vs. 17.9% [12/67]; odds ratio = 2.9; 95% confidence interval = 1.2, 7.1;P = 0.02). Awareness of ergonomics was not significantly affected by affiliation (P = 0.18), area of specialization (P = 0.78), post-qualification experience (P = 0.43), and educational qualification (P = 0.23) of the study participants. Irrespective of the affiliation of the participant, only 6 of 27 (22.2%) participants who were aware of ergonomics knew at least a benefit of right application of ergonomics in the laboratory. Knowledge of risk factors for the development of musculoskeletal disorders was reported by 8 of 27 (29.6%) persons who claimed to be aware of ergonomics. Conclusions: Awareness of ergonomics and knowledge of gains of its right application was poor among the study participants. Regular ergonomic education of medical laboratory scientists in Nigeria is advocated.

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Tropical diabetic hand syndrome

TC Okpara, BA Ezeala-Adikaibe, O Omire, E Nwonye, J Maluze

Annals of Medical and Health Sciences Research 2015 5(6):473-475

Any adult with diabetes in the tropics with hand cellulitis, infection and gangrene qualifies for tropical diabetic hand syndrome (TDHS). We reviewed a 39-year-old woman with a 3-week history of swelling of the left index finger following an insect bite. The swelling progressively increased in size, was very painful, and extended to the palm. There was no history or symptoms suggestive of chronic complications of diabetes. Random blood sugar on presentation was above 600 mg/dl using a glucometer. Examination revealed an edematous left palm draining pus from multiple sinuses, necrotic and gangrenous left index finger extending down to just above the thenar eminence. A diagnosis of TDHS in a patient with hyperosmolar state was made. She was managed accordingly and subsequently underwent aggressive debridement and desloughing. Two fingers were amputated and the wound was allowed to heal by secondary intention.

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A method for investigating “instructional familiarity” and discerning authentic learning

KD Royal, MW Hedgpeth, KW Smith, D Kirk

Annals of Medical and Health Sciences Research 2015 5(6):428-434

Background: Presently, most medical educators rely exclusively on item difficulty and discrimination indices to investigate an item's psychometric quality and functioning. We argue “instructional familiarity” effects should also be of primary concern for persons attempting to discern the quality and meaning of a set of test scores. Aim: There were four primary objectives of this study: (1) Revisit Haladyna and Roid's conceptualization of “instructional sensitivity” within the context of criterion-referenced assessments, (2) provide an overview of “instructional familiarity” and its importance, (3) reframe the concept for a modern audience concerned with medical school assessments, and (4) conduct an empirical evaluation of a medical school examination in which we attempt to investigate the instructional effects on person and item measures. Subjects and Methods: This study involved a medical school course instructor providing ratings of instructional familiarity (IF) for each mid-term examination item, and a series of psychometric analyses to investigate the effects of IF on students' scores and item statistics. The methodology used in this study is based primarily on a mixed-method, “action research” design for a medical school course focusing on endocrinology. Rasch measurement model; correlation analysis. Results: The methodology presented in this article was evidenced to better discern authentic learning than traditional approaches that ignore valuable contextual information about students' familiarity with exam items. Conclusions: The authors encourage other medical educators to adopt this straightforward methodology so as to increase the likelihood of making valid inferences about learning.

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Considerations in management of rhegmatogenous retinal detachment in one eyed pregnant females: A report of two cases

M Ashish, S Alok, J Elesh, T Shubhi

Annals of Medical and Health Sciences Research 2015 5(6):480-482

The aim of this case report is to discuss issues related to management of one eyed pregnant female. A 26-year-old female (Patient A) and 28-year-old female (Patient B) both in second trimester and one eyed presented to our outpatient department with diminution of vision due to rhegmatogenous retinal detachment (RRD). Retina was attached in Patient A following scleral buckling surgery but Patient B required pars plana vitrectomy with silicon oil tamponade. Best corrected visual acuity in both patients did improve from 1/60 to 6/24 and 6/18, respectively at 6 months follow-up. Exudative RDs are known to occur in pregnancy as a complication of preeclampsia, but RRD in pregnancy although co-incidental poses certain challenge with regard to management of such cases especially if the patient is one-eyed. Things to consider for management include (1) type of anesthesia (2) surgical positioning (3) positioning after surgery (4) anti-glaucoma medication if required (5) corticosteroid treatment in pregnancy (6) to provide them ambulatory vision as early as possible. With proper management and monitoring it is possible to provide them with early ambulatory vision without offering any harm to her pregnancy and fetus.

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Baseball Players Brace For San Francisco's Chewing Tobacco Ban - CBS Local

Baseball Players Brace For San Francisco's Chewing Tobacco Ban
CBS Local
He quit a couple years ago after Hall of Famer Tony Gwynn — a career-long dipper — died at 54 of salivary gland cancer. “I was a tobacco user for a lot of years. I'm not proud of that. I finally was able to quit. It's a dirty, filthy habit,” he said ...

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Basilea Launches Antifungal CRESEMBA (isavuconazole) In Germany - Quick Facts - Nasdaq

Basilea Launches Antifungal CRESEMBA (isavuconazole) In Germany - Quick Facts
... such as patients with cancer and after transplantation. Invasive aspergillosis is often fatal, while Mucormycosis (also known as zygomycosis) is a rapidly progressive and life-threatening invasive fungal infection, often affecting the nose and ...

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Students the focus of anti-tobacco forum - Jamaica Observer

Jamaica Observer

Students the focus of anti-tobacco forum
Jamaica Observer
Tobacco contributes to cancers of the lung, mouth, lips, nose, sinuses, voice box, throat, oesophagus, stomach, pancreas, kidney, bladder, uterus, cervix, colon, rectum and ovaries, as well as myeloid leukaemia. According to a 2010 NCDA study, Jamaican ...

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Patents and Information in Genes: Australia, Policy and the Distinction between DNA and cDNA

The post Patents and Information in Genes: Australia, Policy and the Distinction between DNA and cDNA appeared first on Welcome to Avens.

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Rugae Profiling: A Pilot Study in Udaipur, Rajasthan

The post Rugae Profiling: A Pilot Study in Udaipur, Rajasthan appeared first on Welcome to Avens.

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Advaxis Study in Head and Neck Cancer Selected for Late-Breaking Poster at the American Association for Cancer ... - Nasdaq

Proactive Investors USA & Canada

Advaxis Study in Head and Neck Cancer Selected for Late-Breaking Poster at the American Association for Cancer ...
More than 90 percent of head and neck squamous cell oropharyngeal cancers originate from the mucosal linings of the oral cavity, pharynx, or larynx. Currently, 60 to 80 percent of these cancers are caused by HPV. Head and neck cancers are treated by ...
Advaxis to present 'remarkable progress' at cancer conferenceProactive Investors USA & Canada

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