Τρίτη, 15 Νοεμβρίου 2016



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Editorial Board



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Table of Contents



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Chest compression fraction in ambulance while transporting patients with out-of-hospital cardiac arrest to the hospital in rural Taiwan

Introduction

Maintaining the standard two-handed chest compression is difficult in high-speed ambulances in rural areas.

Methods

A retrospective, video-based, observational study was conducted from June to September 2013 in Nantou, a rural county of central Taiwan, to evaluate the chest compression fraction in an ambulance carriage during the travel from the scene to the hospital. The chest compression fraction was calculated as the chest compression time period divided by the ambulance travelling time period; the one-handed and two-handed chest compression fractions were also calculated.

Results

During the 4-month study period, a total of 102 videos that were recorded in an ambulance carriage were reviewed, including 97 cases of manual chest compressions. When there was only one emergency medical technician (EMT) in the carriage, the combined chest compression fraction was 50.6±20.7%; when there were two EMTs, the fraction was 58.3±16.0% and the fraction was 58.3±21.0% in a three-EMT scenario (p=0.221). Moreover, in the carriage, EMTs usually performed one-handed chest compressions.

Conclusions

The chest compression fraction was low for patients with out-of-hospital cardiac arrest in a moving ambulance, irrespective of the number of providers. Reasons for this observation, as well as the effectiveness of the one-handed chest compression require further evaluation.



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Emergency procedures for patients with a continuous flow left ventricular assist device

The number of ventricular assist devices (VADs) being implanted for terminal heart failure is rising at an exponential rate. These implanted patients have a decreased mortality, but still have significant morbidities, as the prevalence of these patients increases in the community. When VAD patients are discharged to home, they will very likely require emergency medical services (EMSs) and emergency medical doctors (EDs) with their future care. The interface of these patients with the community would suggest an increasing prevalence of encounters requiring the need for acute medical care. This will place the initial responsibility of these patients in the hands of EMS first responders and emergency room providers. To date, there is very little literature published on out-of-hospital or ED care for VAD patients. Most EMS personnel and ED feel uncomfortable treating a patient with a VAD because they have not had sufficient exposure. The cardiovascular treatment of VAD patients in the field can pose different challenges typically encountered including difficulties measuring a pulse and sometimes undetectable BP. Despite these unique challenges, official guidelines or even standard operating procedures regarding the emergency treatment of VAD patients are still lacking. We present a basic overview of the most commonly used left VAD systems and propose guidelines that should be followed in the event of an emergency with a VAD patient out of hospital.



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Issue Information



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Enhancing the specificity of polymerase chain reaction by graphene oxide through surface modification: zwitterionic polymer is superior to other polymers with different charges

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Lifestyle factors associated with infertility in a rural area: A cross-sectional study

2016-11-15T10-47-57Z
Source: International Journal of Medical Science and Public Health
Shilpa Acharya, Chethana Rame Gowda.
Background: Lifestyle factors are the modifiable habits and ways of life that can greatly influence overall health and well-being, including fertility. Objectives: (1) To describe the sociodemographic characteristics prevailing among infertile subjects of the study population, (2) to identify lifestyle factors associated with infertility. Materials and Methods: A cross-sectional descriptive study was conducted at rural field practice area of Tertiary Hospital, Bengaluru. Complete enumeration of entire primary health center (PHC) area covering 26,190 population. In-depth interview using a pre-tested pre-structured questionnaire was conducted enumerating all couples with infertility in the entire PHC area and their lifestyle factors. Results: The significant lifestyle factors include frequency of intercourse, body mass index, alcohol, and tobacco consumption. Conclusion: Thus, lifestyle factors play a role in determining reproductive status and have a significant impact on fertility.


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Study of knowledge and skills of anganwadi workers regarding breastfeeding and infant and young child feeding practices

2016-11-15T10-47-57Z
Source: International Journal of Medical Science and Public Health
Amanjot K Singh, Anuradha Nadda, Ritu Rochwani, Parmal Singh, Zahid Ali Khan, Goel R K D.
Background: Field workers from the community are the key persons for spreading the knowledge about breastfeeding and infant and young child feeding practices among people. Antenatal counseling on breastfeeding and postnatal lactation support are likely to improve rates of exclusive breastfeeding. Objective: The present study was designed with the aim to examine the knowledge and skills of the anganwadi workers (AWWs), with respect to a few key elements of the services provided by them, in an urban city Patiala. Materials and Methods: An observational and cross-sectional study was carried out among the AWWs of urban Patiala in October-November 2012. 197 AWWs voluntarily participated. After taking oral consent, AWWs were interviewed with a pretested, semistructured, self-administered questionnaire developed in a local language. The answers were compared with the desired responses. The collected data were compiled in Microsoft Excel and analyzed with the help of SPSS version 20. Results: In the present study, more than 80% of all the AWWs had correct knowledge regarding initiation of breastfeeding, prelacteal feed, colostrum, exclusive breastfeeding, and complementary feeding. However, there were still some serious gaps such as in frequency of breastfeeding, continuation of breastfeeding after starting a complementary feed and during illness, and the concept of bottle feeding. Conclusion: The existing antenatal advice by AWWs on Breastfeeding and optimal infant and young child feeding is inadequate and needs to be strengthened.


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Appraisal of integrated management of neonatal and childhood illness program in two districts of Assam

2016-11-15T10-47-57Z
Source: International Journal of Medical Science and Public Health
Swapna D Kakoty, Priyanka Das.
Background: Integrated management of neonatal and childhood illness (IMNCI) is an important reproductive and child health strategy to lower infant and neonatal mortality in the country. In India, Assam is one of the states with very high infant mortality. Objectives: Assess the status of IMNCI implementation in Barpeta and Nalbari district/s of Assam. Materials and Methods: A rapid appraisal of IMNCI was undertaken in Nalbari and Barpeta districts of Assam. Qualitative survey methods and secondary data analysis was used. Interview of stakeholders, observation of services, logistic, and supervisory support to the program was assessed. The data were manually analyzed for thematic areas. Results: Logistics and drug support were good. Gaps in program implementation were found at all level. Integrated Child Development Services involvement lacked clear direction. Conclusion: An intersectoral resource intensive program requires supportive environment for implementation.


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A study of adherence pattern toward antihypertensive therapy (antihypertensive drugs, dietary habits, and physical activity) and certain factors affecting it

2016-11-15T10-47-57Z
Source: International Journal of Medical Science and Public Health
Pratiksha A Sutar, Hemangini K Shah.
Background: Adherence to antihypertensive treatment (pharmacological intervention and lifestyle modification) and related factors is an essential to hypertension (HTN)management and aids in planning intervention for its control. Objectives: The objective of this study was to analyze the adherence pattern of hypertensives toward antihypertensive treatment and factors affecting it and assess the impact of such adherence on HTN control. Materials and Methods: A hospital-based cross-sectional study was carried out at the outpatient department of medicine department at a tertiary hospital in Goa. Totally 213 patients with confirmed diagnosis of HTN and currently on antihypertensive treatment, selected through systematic randomized sampling, were interviewed using structured and clinically assessed questionnaire. Results: Adherence to antihypertensive drugs, dietary approach to stop HTN (DASH)diet, and recommended physical activity was studied along with sociodemographic factors, comorbidities, addiction, body mass index, medication, and other factors. Nearly 64.79% were highly adherent toward the antihypertensive drug treatment while 30.52% and 4.69% showed moderate and low adherence, respectively. A significant association was noticed between the presence of comorbidities and drug adherence, wherein patients with comorbidities showed higher adherence. Nearly 23.94% patients were highly adherent toward the DASH diet, while 51.64% were moderately adherent although not significantly associated. Almost 68.08% showed moderate activity while only 10.83% indulged in vigorous activity. A significant association was noted with age, employment status, and number of medications prescribed in determining adherence to physical activity. Conclusion: Presence of comorbidities, sex and age, number of antihypertensives, and employment status were seen to be associated with high adherence toward the treatment.


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An epidemiological study of animal bite cases in a tertiary care center of Bhopal city: A cross-sectional study

2016-11-15T10-47-57Z
Source: International Journal of Medical Science and Public Health
Seema Patel, Manju Toppo, Rama Lodha.
Background: Rabies is 100% fatal, 100% vaccine preventable disease, yet continues to kill. There are no global estimates of dog bite incidence; however, studies suggest that dog bites account for tens of millions of injuries annually. Tens of thousands of people die from rabies each year; one person dies every 10 min, with the greatest burden in Asia and Africa. Rabies is the 10th biggest cause of death due to infectious diseases worldwide, and it causes more than 59,000 fatalities per year worldwide. Objective: To determine the profile of animal bite cases attending the Anti-rabies Clinic of Hamidia Hospital, Bhopal. Materials and Methods: It was a cross-sectional study carried out at Anti-rabies Clinic of Hamidia Hospital, Bhopal. The study was carried out by interviewing 1200 cases of animal bite for a period of 1 year. Result: A total of 1200 cases of animal bites were interviewed and examined in the present study. Most commonly (34.58%) affected age group was


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HOSPITAL BASED STUDY OF THYROID DISORDERS IN RURAL POPULATION OF GURGAON, HARYANA

2016-11-15T00-10-33Z
Source: International Journal of Current Research and Review
Poonam Arora, Smita Prasad, Busi Karunanand.
Introduction: Endocrine disorders pose a major threat to public health. Current research shows that 300 million people are suffering from thyroid disorders globally and 42 million among them reside in India. Objective: Our objective is to find the prevalence of thyroid disorders in rural population of Gurgaon, Haryana. Materials and Methods: This study was conducted in SGT Medical College & Hospital, Budhera, Gurgaon, Haryana from January, 2015 to July, 2016. 3940 patients were screened for thyroid function. Thyroid function was assessed by quantitative estimation of T3 (Triiodothyronine), T4 (Thyroxine) and TSH (Thyroid Stimulating Hormone) in serum by chemiluminscent immuno assay. Results: The prevalence of thyroid disorder was found to be 25.17% (992) in the study population. 74.82% (2948) patients were euthyroid. Among the thyroid dysfunction patients 16.85% (665) belonged to hypothyroidism group (11.70% primary, 3.20% sub clinical and 3.24% clinically euthyroid) and 8.29% (327) to hyperthyroidism group (2.66% primary, 0.15% T3 thyrotoxicosis, 0.58% sub clinical and 4.89% central) Conclusion: The study findings call for a review of current practices in the management of thyroid disorders because of high prevalence of thyroid disorder in the reproductive age group (21-40). Thyroid disorders must be actively screened and monitored and to be effectively treated in diagnosed patients.


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CONCENTRATED GROWTH FACTOR MEMBRANE - A NOVEL BARRIER FOR ACCELERATED REPAIR OF GINGIVAL DEFECT ALONG WITH SLIDING FLAP TECHNIQUE

2016-11-15T00-10-33Z
Source: International Journal of Current Research and Review
Ramakrishnan T., Shobana P., VidyaSekhar, Nirmala J.I., Ebenezer, Sivaranjani K..
Aim: Periodontal regenerative procedures like root coverage procedures are still a valid treatment option for exposed root surfaces caused by gingival recession. So far, many alloplastic as well as autologous materials were used for regeneration; of which platelet was found to be having greater regenerative potentiality and several platelet aggregates were developed recently in the field of regeneration. The concentrated growth factor (CGF) is the new generation platelet aggregate; this CGF may be a valuable aid in the field of regeneration to speed up the process of healing. Case Report: This case report elaborates the use of CGF as a barrier membrane, along with laterally displaced procedure to accelerate soft tissue healing, in lower anterior tooth (31) with class II gingival recession in a 20 years old female patient. Discussion: Many studies about concentrated growth factor showed a great regenerative properties and versatility. Its use has been proposed in various procedures like filling the extraction socket, sinus lift procedures, moreover it can also be combined with bone grafts to accelerate bone formation. Conclusion: The result of this case report suggested that the CGF barrier membrane has the potential to accelerate the soft tissue healing which when combined with the root coverage procedures like sliding flap technique, thus results in achieving the expected gain in the width of the attached gingival in class II Gingival recession defects.


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