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Drugs Side Effects in Pregnant Women Infected with HIV Referred to Imam Khomeini Hospital, Voluntary Counseling and Testing Center Tehran, Iran 2009 – 2013
Get PDFObjective: To have enough information about the prevalence of the ARV side effects in pregnant women infected with HIV and their infants and also evaluate drug efficacy in decreasing HIV infection in their children.Method: This descriptive study was based on information of 40 pregnant women infected with HIV files at voluntary and counseling center, Imam Khomeini Hospital, Tehran, Iran during 2009 -2013. In this study, we evaluated epidemiologic, demographic, clinical, laboratory data and drugs side effects,.Results: The most commonly used drug group was AZT/3TC/EFV; about 75.5% of patients received mother to child prevention and 27.5% received ARV Antiretroviral therapy treatment. 5% anemia, 2.5% rash and 2.5% pre rupture of membranes were reported and no preeclampsia or gestational diabetes were reported in patients files. Only one abortion (2.5%) was occurred in late first trimester. Except rash, other adverse effects were solely reported in ARV treatment group. All neonates had normal Apgar score. Fetal defects were not reported at birth.Conclusion: In this evaluation, safety of ARV in pregnancy period and at birth was observed especially in the group received prevention of mother to child transmission (PMTCT). So we advise ARV treatment or PMTCT in pregnancy period
Hypovitaminosis D and Type 2 Diabetes: What Correlation? Control Case Study about 110 Cases
No full textIntroduction: Relationship between diabetes and the (OH) vitamin D status raises several controversies; The aim of our study is to evaluate Vitamin D status in Moroccan type 2 diabetic women (DT2) by comparing it with a non-diabetic group (T).Secondary purpose was to establish relationships between Vitamine D status and T2D patients various metabolic, clinical and therapeutic parameters.Materials and Methods: This a cross-sectional case-control study including 110 patients with a Vitamin D dose (60 DT2 / 50 controls> 30 years). We excluded patients with a disease involving phosphocalcic metabolism or receiving Vitamin D supplementation or advanced renal or hepatic failure. Variables studied in the DT2 group were age, diabetes duration, glycemic equilibrium, BMI, degenerative complications, antidiabetic treatment, the menopause and vitamin D. Results were compared to a non-diabetic control group according to age, BMI and menopausal status.Results: Mean age was 51.5 ± 10.95 (DT2) vs 48.9 ± 11.2 years (T). Mean DT2 BMI was 32.1 vs 27.7 Kg / m2. Mean diabetes duration was 7.13 years with mean HBA1c at 9.17%. Hypovitaminosis D was present in 85% DT2, these results were comparable to the control group (84%). Mean level of Vitamin D was lower in the DT2 group: 17 ± 10.6 vs 22.2 ± 11.4 ng / ml (p = 0.005). 39% of TD2 were deficient vs 23% (T) p <0.001. Hypovitaminosis D was more frequent in DT2 patients with a BMI> 35kg / m2 (p= 0.003) with no significant relationship to age or menopausal status. In the DT2 group, there was a negative correlation between serum vitamin D levels and diabetes duration and BMI. Without relationship with HbA1c, degenerative complications or antidiabetic treatment.Conclusion: Hypovitaminosis D is as frequent in the diabetic population as in non-diabetic patients with lower rates and high prevalence in obese patients with ancient diabetes
Analgesia/Anesthesia in Reptiles
No full textNowadays, conducting clinical practice means dealing with a wide range of animal species, whose availability on the market is becoming more common and interest among owners is growing, which is why reptile patients may appear more often in the surgery. Due to the completely different nature of these animals, distinguishing them from the world of our most frequent patients, that is mammals, you must have the appropriate expertise to help them in accordance with the accepted international standards. We will often need general anesthesia, not only for surgical patients. Often, we must deal with aggressive and dangerous animals, which means that they require immobilization to ensure the safety of the staff, owners, and the suffering animal. The aim of this study is to familiarize the reader with the methods of conduct and methods of using analgesia and anesthesia in reptiles
Examination of the Relationship between Emotional Disturbance and Tumors: Introduction to Emotional Soothing Therapy through Two-Case Studies of Uterine Fibroids
No full textThe role of emotional disturbance in the development of tumors have been well documented and verified in both theoretical and empirical studies among Chinese and Western medicine. However, there has been little work addressing emotional disturbance through therapy that focuses on emotional releasing in the treatment of tumors in general. We believe a lack of clinical evidence for the improvement of a patient’s physical condition through effective emotional releasing or guidance may be a key reason for the absence of psychologists in most existing tumor treatment protocols. Providing clinical evidence in emotion-disease association may be an important first step to enhancing existing treatment modalities with emotional-focused components. As an example, this paper describes two case studies of uterine fibroids, with the primary focus on the emotional pathogenic mechanism of tumor growth. In both cases, Emotional Soothing Therapy (EST) is used to help the patients shrink their uterine fibroids in one to two short treatments. The treatment procedures and dialogue between the patient and the therapist are provided to demonstrate how the EST was used to defuse negative emotions, reduce emotional disturbance, and help ease physical and psychological pain, In both cases, the uterine fibroids shrank significantly (by 50% and 90% respectively) after 1-2 EST sessions. These documented clinical cases provide an important reference for future clinical treatment of tumors, and warrant further randomized controlled trials on the EST, as well as the association between emotions and tumor reduction
Loxapine for Management of Delirium in Older Adult Surgical Patients
No full textThe use of antipsychotics for the treatment of post-operative delirium is often practiced after non-pharmacologic methods of re-orientation have failed. Loxapine is a drug with medium-potency antagonism at dopamine receptors and is used frequently at our institution for delirium. In this small uncontrolled open-label study, we provide early findings that it is effective at reducing the severity and duration of delirium in an older population and may be a reasonable alternative for management. Delirium Rating Scale (DRS-R-98) scores were recorded in 31 older adult surgical patients (mean age 72, 2/3 male). Treating physicians ordered loxapine according to clinical judgment. We monitored for extrapyramidal side-effects, QTc changes, and other adverse events. The mean maximum cumulative loxapine dose per day was 44mg (s.d. 31). DRS-R-98 score after 2 days of treatment (mean 10.19, s.d. 6.61) was significantly reduced compared to DRS-R-98 score at time of diagnosis (mean 18.68, s.d. 4.66) [t(30) = 6.65, p < 0.001]. The mean number of days to resolution of delirium was 3.2 (s.d. 2.5). Only 3 participants experienced very mild extrapyramidal symptoms and there was no significant difference between baseline QTc (mean 422ms, s.d. 19.86) and mean QTc during treatment (mean 426ms, s.d. 18.47) in a subsample for which QTc data were available [t(11) = 0.45, p > 0.5]. Although there are several limitations to this small uncontrolled open-label study, the findings suggest loxapine is a reasonable alternative in treating delirium in older adult surgical patients
Kimura’s Disease in the West-Case Report and Review of Literature
No full textWe report a 58 yr old lady, who had right temple swelling for 2 years, which on excision biopsy showed features of vasculitis. During the Rheumatology review, Clinical evaluation didn’t reveal any features suggestive of Giant cell arteritis and inflammatory markers were normal. She had localised granulomatous changes without giant cells and pathologist gave the opinion as Kimura’s disease. It has been described in East Asia especially in Japan as Juvenile Giant cell vasculitis (also known as Kimura’s disease (KD). It was reported by Kimura et al. as chronic inflammatory disorder of unknown aetiology with granulomatous changes mimicking vasculitis but no giant cells. It is very rare in Caucasians and early diagnosis will result in appropriate treatment and sparing the immunomodulatory treatment. This case is presented to increase awareness of KD and to highlight the features which may aid the diagnosis
Case Report: Spindle Cell Sarcoma of the Pulmonary Artery
No full textPrimary pulmonary artery sarcomas are rare. Moreover, they are notorious for masquerading as a chronic pulmonary embolus. There is much symptom overlap that leads to this relatively common misdiagnosis. We present such a case
Prevalence and Psychosocial Consequences of Rape in Jos, North–Central Nigeria
No full textBackground: Rape is common throughout the world. It is often under-reported by victims and their families for fear of social stigma and cultural sanctions. Several studies have revealed that majority of rape victims are females, with males being the most perpetrators.Objectives: The study was aimed at determining the prevalence of rape and to examine the psychological and social consequences as well as responses to rape by the victim, the family and society.Methods and Materials: The study was a cross-sectional descriptive study of 284 respondents from 4 communities in Jos, Plateau State Capital, Nigeria. A semi-structured socio-demographic questionnaire was used to collect participants’ socio-demographic data while a questionnaire on rape designed by the authors was used to enquire about rape and other associated factors. The Mini International Neuropsychiatric Interview (MINI) questionnaire was used to determine the psychological consequences of rape.Results: The result revealed a rape prevalence of 31.0% (28.2% in females and 2.8% among males). Rape was statistically associated with young victims (P<0.001). Majority (59.1%) of the victims were raped before 16 years of age. Rape by neighbors/family friends accounted for 50% of all cases involving female victims while that by strangers was 15%. A large proportion (63,6%) of the victims were raped once, 13.6% were raped more than thrice. All female victims were raped through the vagina (81.2% with penis and 18.8% by fingering). The male victims were raped with penis through anal orifice. Only 9.2% were gang raped. About two-thirds of the victims did not report to anyone, but, 36.4% did so. As high as 49.8% of the respondents believed there was no justification for anyone to rape another person just as others cited seductive dressing, substance abuse, and moral decadence as factors that contribute to the offence. Negative psychological and social consequences such as depression, anxiety, post –traumatic stress disorder, social isolation, loss of trust etc were found to be associated with rape. Conclusion: The study showed that rape is a serious problem in our community and therefore urgent measures must be put in place to deal with its increasing prevalence and consequences
Black MSM and the National Strategy for HIV/AIDS: A Strengths Based Policy Analysis
No full textThe National Strategy on HIV/AIDS (NHAS) is the latest in a long line of policy measures that attempt to address the needs of domestic populations who are vulnerable to HIV/AIDS. This article utilizes a strengths framework to guide policy formulation, implementation, and analysis. It explores whether the NHAS is strengths based and how effectively it addresses the unique vulnerability of Black Men Who Have Sex with Men (BMSM) to HIV/AIDS. Recommendations for policy practitioners include embracing the diversity and strengths of BMSM and enhancing the involvement of social workers in the implementation and evaluation of NHAS programs
Assessment of Correlates of Stigma in Mental Health Nursing Practice Among Nursing Students in Two Universities in Nairobi-Kenya
No full textMental health and psychiatric nurses are considered important and integral members of the multidisciplinary mental health care team offering 90% of mental health services in Kenya. Stigma towards mental health nursing practice has led to acute shortage in mental health nursing workforce and consequently poor quality of mental health care.Aim: to assess the correlates of stigma towards mental health nursing practice among Bachelor of Science Nursing students.Research Method: Cross-sectional study was conducted among 90 Undergraduate nursing students at the Universities of Nairobi and Eastern Africa-Baraton. Only students who had completed and passed both theory and clinical experience in mental health nursing course were selected for the study. A structured questionnaire and focus group discussion were used. Ethical approval was sought form the UON/KNH ERC.Data Analysis: The SPSS version 22 was used to analyze the quantitative data whereas the qualitative data from the focus group discussion were analyzed using deductive approach. The correlates were tested using chi-square test and at a P-Value of ≤ 0.05. The final data presented using frequency distribution tables, pie charts, graphs.Findings: Stigma in mental health nursing practice stands at 85.6% (N=87). Marital status significantly correlated with stigma towards mental health nursing practice p=0.04 (χ2 = 7.731). Belief that mental illness is due to demonic possession, shorter clinical placement, a motivation by the course lecturers and poor environment of practice correlated significantly with stigma towards mental health nursing practice.Recommendations: Improve minimum clinical placement hours, over emphasize on psychopathology of mental disorders, encourage thorough orientation of students in clinical area upon arrival.Dissemination: Results will be delivered in scientific conferences, the schools of nursing and to policy makers in mental health care to guide policy development