International Medical Publisher Journals (iMedPub)
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Respiratory Fluoroquinolones vs. Other Commonly Used Antimicrobials in Mild-to-Moderate Severity Community-Acquired Pneumonia
Get PDF ObjectiveRespiratory Fluoroquinolones (RFQs) are widely used in the treatment of community-acquired pneumonia (CAP) in our part of the world. Our aim was to find if there was outcome difference between RFQ-based versus RFQ-exempt regimens. MethodsA retrospective study of RFQs versus other commonly used antimicrobial therapy (OUAT) in the treatment of patients with mid-to-moderate CAP adjusted by pneumonia severity score (PSI). Rates of treatment outcome at end-of- therapy i.e. clinical improvement, length of hospital stay and speed of recovery were evaluated. Patients were included if they had Mild-to-Moderate severity CAP, ≥18 years old, completed ≥ 3 days of antimicrobials.Results320 patients were included, mean age for all groups was 49.63 years (P = 0.204), males 60.3 % (P = 0.219). All had similar PSI score (Pearson X2 test = 13.75, P = 0.185). The first group (24.4%) is composed of RFQs monotherapy. The second group (50.6%) is composed of RFQs plus β-lactams. The third group (25%) is composed of OUAT. Diabetes was the most common comorbidity among all (P = 0.847). There was no significant difference among the three groups in clinical improvement (P = 0.424) and speed of recovery (P = 0.398), however length of hospital stay was significantly shorter for the RFQs monotherapy (P = 0.004)Cumulative curve for probability of discharge did not show significant difference among the three therapy groups (P ≥ 0.20)ConclusionThere were no significant difference among the groups regarding end-of-treatment clinical improvement rates, speed of recovery and probability of hospital discharge. However, they significantly differ in length of hospital stay for RFQs monotherapy (P = 0.004).Â
Bladder Diverticulum and Sepsis
Get PDFÂ Introduction: Bladder diverticula are rare both in adults and in children and may be congenital or acquired, are rare in females. Objective: To describe the case of occasional finding of bladder diverticulum in women, which developed into sepsis. Case report: Patient MIB, 81, female was admitted to the Cariri Regional Hospital after a fall from height resulting in trochanteric fracture of left femur .No fifth day of hospitalization, the patient developed an abdominal mass in pit right iliac, associated the signs of inflammation and painful abdomen. Computed tomography of the abdomen with contrast revealed a cystic collection of air-fluid content and inflammatory aspect in the right lower abdomen measuring approximately 212 mL volume with continuity with the bladder. Discussion: bladder diverticula are usually asymptomatic, and occasionally found more commonly in men. It is a rare condition in women and its clinical presentation is associated with infection or neoplasia. There are reports of peritonitis after spontaneous perforation of the diverticulum, however, its evolution to sepsis is rare. Conclusion: bladder diverticulum in women and evolving to sepsis without drilling is a rare condition, with few reports in the literature
Ways to Measuring Quality of Life in Mental Health
Get PDFAs quality is of life considered as a measure of clinical outcome that prioritizes client assessment itself and the effects of a disease, a life change or a treatment has on their daily life and their level of satisfaction and well-being, their evaluation allows obtain a safe parameter for implementing clinical interventions that may have more positive impact on the lives of these people. It is believed that investigate the QoL of a given population is a strategy that will enable to broaden the understanding of the problems experienced by patients in order to facilitate effective future interventions, improving the quality of lived days. This information can also be used to identify patients at higher risk of problems and thus anticipate interventions, contributing to health promotion thereof. Nevertheless, there is currently a growing interest in transforming the QoL in a quantitative measure. To this end, the measurement of quality of life through the perception of the patient has been recommended. Some studies indicate that the measurement of quality of life the mental patient is an indicator of the care he receives and that this issue should be included in the assessment and care planning. There are few studies witch accessed the influence of health intervention on patients ‘quality of life, anxiety, and depressive symptom levels. With this brief contribution, we hope can deepen discussion regards public health and mental wellbeing, as well as the options of measurement instruments to assess mental health interventions and thus able to gather more arguments to answer the following question: What`s the best way for measuring quality of life in Mental health
A Descriptive Study of the Knowledge-Base of Malaria between the Visually-impaired and the Non-Visually impaired in Two Primary Schools in Lagos, Nigeria; implications for health education.
Get PDFBackground: The study was carried out in two primary schools in Lagos State, Nigeria. One hundred students were from Pacelli School for the Blind and one hundred and sixty-four students were from Onitolo Primary School, a main stream school. The study compared the knowledge base of the two groups on malaria prevention and treatment options. Approval for the study was granted by the Ethics Committee of the Lagos University Teaching Hospital, Nigeria and consent was sought from parents/ guardians of the students and from the principals of the two schools.Method: The instrument of data collection was a close ended questionnaire. The average time it took to fill the questionnaire was twenty minutes. Analysis of categorical variables was done by Chi- Square Analysis.Results: The respondents from Pacelli School for the Blind were older than the respondents from Onitolo Primary School when matched by class in primary school (P < 0.05). The majority of the respondents were Yorubas, 178 (70.5%). In Pacelli School, the number of males that were visually-impaired was more than the number of females (P < 0.05).There was a statistically significant difference on their knowledge base on the cause of malaria (P < 0.05). The students from Pacelli School 92 (92%) knew that malaria was caused by mosquitoes and only 75 (45.7%) of the respondents from Onitolo knew that malaria was caused by mosquitoes. The age at which respondents from Pacelli School became visually impaired was not statistically related to the correct knowledge that malaria was caused by mosquito (P < 0.05).The number of respondents that preferred the parental route for treatment of malaria was fewer in Pacelli School than in Onitolo School (P < 0.05). A greater number of respondents from Pacelli School did not like to take malaria tablets because the malaria tablets were bitter (P < 0.05). The major source of information about malaria from both schools was from their doctors and other health personnel 116 (43.9). When the responses from both groups were combined, the least source of information about malaria in both groups was from teacher/school 27 (10.2%).Two hundred and twenty-seven (85%) of the respondents would choose a doctor as their health-care provider if they had malaria (P > 0.05). In Pacelli School, 44 (44%) of the respondents had had malaria in the past twelve months. In Onitolo School, 49 (29.9%) of the respondents had had malaria in the past twelve months. There was no statistically significant difference in the number of times both groups had had malaria in the past twelve months.Conclusion: There were more visually-impaired males in Pacelli School than females. There was a statistically significant difference on their knowledge base on the cause of malaria. More students from Pacelli School had the correct knowledge on the cause of malaria. The major source of information about malaria from both schools was from their doctors and other health personnel. Teacher/School was the least source of information about malaria in Pacelli School and in Onitolo. Health Education on preventable diseases like malaria should be strengthened in both schools. More schools for the visually –impaired should be replicated across the states in Nigeria and more schools for the visually-impaired should be replicated in Lagos State.Keywords: Malaria; Health Education; Visually-impaired; knowledge base; Pacelli School; Onitolo School; The Blind; Treatment; Prevention
A Comparative Study of the Cognitive Function of the Hearing-Impaired and Non-Hearing Impaired in Two Primary Schools in Lagos State, Nigeria
Get PDF Background: Thestudy was carried out in two primary schools in Lagos State, Nigeria using 302 respondents aged 6-20 years. The study compared the cognitive function of pupils from Wesley School for the hearing-impaired with pupils from Onitolo Primary School a main stream school to see if similarities or differences existed in their cognitive function and to determine the factors determining their performance on a standard non-verbal test.Method: The instrument of data collection was the Raven’s Standard Progressive Matrices, a standard, non-verbal intelligence test. Statistical association using Chi-Square was used to test for associations between categorical variables. Kruskal-Wallis was used to test for association that was not normally distributed. The students were statistically matched and compared by bivariate analysis and multiple regression analysis for selected variables. Correlation Coefficient was used to examine linear relationships between selected independent variables and multiple linear regression analysis was used to examine which variables were significant predictors of performance taking possible confounders into consideration.Results: Respondents from Wesley School were much older than respondents from the public main-stream school, class for class. There was no statistically significant difference in their cognitive functions. The mean score difference between the two schools was 0.54 with respondents from Wesley School scoring higher. Sex and class in primary school were determinants of score. Males scored higher than females. Respondents of skilled parents had the highest scores. There was no relationship between the time the child became hearing-impaired and their scores. The mean score difference between children that became hearing-impaired by their first year of life and children that became hearing-impaired after the first year of life was 1.83. The children that became hearing-impaired after their first year of life scored higher (P=0.46).Conclusion: There was no statistically significant difference in the cognitive functions between the hearing-impaired and the non-hearing-impaired pupils. Children that are hearing-impaired should be given equal opportunities.Keywords:Lagos, Nigeria; hearing-impaired; cognitive function; Standard non-verbal test; Deaf; Wesley School; Onitolo School; Cognition; Intelligence Test; Raven’s Intelligence Test
The Influence of Religiosity/Spirituality on Mental Health
Get PDFHealth care workers and researchers are increasingly recognizing the religiosity/spirituality great dimension in health
Ebola Virus Disease Stigmatization; The Role of Societal Attributes
Get PDFGlobally, persons with diseases like leprosy, tuberculosis, H1N1, SARS or HIV/AIDS have been stigmatized. The ongoing Ebola virus disease (EVD) outbreak in West Africa has been the longest outbreak in the history of the disease and the first outbreak to ever occur in West Africa. The strain of ebolavirus in West Africa is one of the most virulent strains of the filoviridae family and case fatalities can be as high as 90%. Treatment of EVD is mainly supportive and societal attributes contribute to stigmatization of the disease and ultimately the spread of the disease. The method used in this study was a search in major databases including PUBMED and Google Scholar. The study also included a review of current events and data from the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). In this review, an overview of filoviral hemorrhagic fevers was discussed. The cultural beliefs on the causes of diseases and the stigmatization of infectious diseases in history were examined. In addition, the virulence between severe acute respiratory syndrome (SARS) and EVD were compared. Specifically, it examined Ebola stigmatization and identified societal attributes responsible for the stigma and the implications for controlling the spread. It also points to ways to reduce EVD stigmatization as a way of controlling the spread of EVD. While there is a lot of ongoing research for the cure and control of EVD, little attention is being paid to the role of stigmatization in the control of the disease. Fear is the driving force of EVD stigmatization because EVD is a virulent, fast killing disease that has no cure. Powerlessness is another driving force in stigmatization. The sensationalism in news reporting and the mistrust of the government are factors playing on fear and rumor. Counselling should be provided to the community before survivors of EVD return home. Survivors of EVD should be counselled before going home. The government should set up a task force on stigmatization and make efforts to regain the trust of the people. Memorials for those that died from EVD should be erected in each of the districts affected. Schools should not be closed for long periods and should only be closed if there is recourse to distance education. Faith based organizations can also use the methods for distance education as a means to encourage their followers.Keywords: Ebola virus disease; cultural beliefs; stigmatization; EVD survivors; outbreak; Ebola; stigma; SARS;HIV/AIDS; Infectious diseases.Â
Chromobacterium Violaceum Sepsis in Minas Gerais
Get PDFInfection by Chromobacterium violaceum, known as chromobacteriosis, is a rare cause of severe sepsis with rapid spread and high mortality. In February 2009, a 14-year-old male patient was admitted to Santa Casa of Misericórdia of Juiz de Fora Hospital, and he deteriorated rapidly with severe sepsis and death by chromobacteriosis. In this article we discuss the main clinical fidings, sensitivity profie, and antimicrobial therapy of this case
Cut Out Complications and Anisomelia of the Lower Limbs In Surgery With Valgus Reduction for Intertrochanteric Fractures
Get PDFBackground: The proximal fractures of the femur are counted among the group of orthopedic and traumatic pathologies which consume most of the financial resources set aside for health worldwide. Surgical treatment continues to be the treatment of choice for intertrochanteric fractures of the femur. However, although the surgical treatment of the proximal fracture of the femur is widely known and accepted in the orthopedic field, it is not without risk with the cut out being the most feared complication. Objective: This paper describes the complications of cut out or the anisomelia of the lower limbs of patients with intertrochanteric fractures who underwent valgus reduction surgery. Method: Sixty-one patients with 3rd and 4th degree, according to Tronzo classification, intertrochanteric fractures underwent surgery with the use of Dynamic hip screw type sliding screw and valgus reduction. The data were analyzed one year after surgery, when a functional assessment was made by scanometry, Tip-Apex Distance index diaphyseal cervical angle and the modified Merle d'Aubigné & Postel questionnaire. Kruskal-Wallis and Mann-Whitney tests were used for the statistical analysis, Spearman’s correlation test for the quantitative variables and the chi-squared test for the qualitative variables. Results: The correlation between the Tip-Apex Distance index and the diaphyseal cervical angle was statistically significant (rho=0.391, p=0.002), while the correlations between the Tip-Apex Distance index and the scanometry and the diaphyseal cervical angle and the scanometry were not significantly correlated. In accordance with the modified Merle d’Aubigné & Postel questionnaire, 23 patients (37.7%) achieved a very good result, 29 patients (47.5%) had a good result, five patients (8.2%) obtained a moderately good result, one patient (1.6%) presented a reasonable result and three patients (4.9%) obtained a poor result. Conclusion: No cut out complications occurred in the 3rd and 4th degree intertrochanteric fractures with a Baumgaertner index ≥ 25 mm, when the reduction and valgus fixation of the intertrochanteric fracture was performed with the Dynamic hip screw type sliding pin, as there was also, in the majority of patients, no anisomelia of the lower limbs
Prognostic implications of ischemic mitral regurgitation following non-ST-Segment elevation acute myocardial infarction
Get PDFIntroduction: Ischemic mitral regurgitation (MR) is a common complication of acute myocardial infarction and has a negative impact on prognosis. However, few studies have been carried out on MR after non-ST-segment elevation acute myocardial infarction (NSTEMI).Aim: Investigate the clinical predictors of ischemic MR and its impact on the outcome after 1st NSTEMI .Methods: 40 consecutive patients were selected retrospectively after a first NSTEMI. Each underwent echocardiography and coronary angiography during their hospital admission. Patients were divided into two groups according to the presence or absence of MR at echocardiography: Group I : 20 patients without MR , Group II : 20 patients with MR. The patients were followed up clinically for at least one year. The incidence of readmission for heart failure, unstable angina, reinfarction, or all combined (i.e, major adverse cardiac event [MACE]) was recorded.Results: The patients’ mean age was 59.62 ± 10.97 years and 67.5 % were male. They were followed–up for a median of 640.5 days . No significant differences between both groups regarding baseline data ,cardiac isoenzymes , or revascularization (P > 0.05) , but there was significantly increased number of diseased coronary arteries in MR group (P 0.04). LA diameter was significantly increased with decreased LVEF% and increased wall motion abnormalities in MR group ((P < 0.05) . During follow-up period ,more admissions for unstable angina were seen in patients with MR but with little significance (P  0.05) . Regarding MACE, a greater incidence was found in the MR group (P<.05). Using Kaplan-Meier curves ,a long-term association of MACE with the presence of MR was found (P 0.04), and a higher grades of MR were associated with poor prognosis (P .05) . In conclusion: Ischemic MR yield poor prognosis. Thus, current MR should be carefully assessed after an NSTEMI,and probably requires even more meticulous treatment including early revascularization and stricter follow-up than usual