International Medical Publisher Journals (iMedPub)
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Variation of PEFR with height, weight and waist-hip ratio in medical students
Get PDFOBJECTIVE: The primary aim of our study was to assess the variation of PEFR with various medical students of Karachi, PakistanDESIGN: Cross-sectional studySetting: Medical students of Karachi Medical and Dental CollegeParticipants: 276 non-smoker healthy medical students composed of 168 females and 108 males.VARIABLE PARAMETERS: They include mean age, body height and body weight and PEFR. They were marked separately for each genderRESULTS: The mean waist hip ratio in females was observed to be 0.843±0.111in relation with that of mean PEFR value 452.97±65.84 L/min, whereas in males the mean waist hip ratio was 0.864±0.028 in relation with that of mean PEFR value 445.93±66.49 L/min. Also there is a statistically significant variation in PEFR with an increase in waist hip ratio. The mean height of males was 173.63 ±7.5 cm and weight was 61.81 ±11.25 Kg while mean height of females was 158.56±7.3 cm and weight was 49.33±9.04 Kg. PEFR is positively correlated with increase in height and weight up to a certain limit.CONCLUSION: The study concludes that PEFR is affected positively by variation in waist hip ratio; moreover young females have more waist hip ratio and PEFR values than their young male counterparts. A large sample size with accurate peak flow meter is required along with ethnic consideration of the study population for better, accurate and clear results
Simultaneous tromboembolic events in a patient with heterozygous MTHFR mutation
Get PDFBackground: Hyperhomocysteinemia is a well recognised risk factor for arterial and venous thrombosis. The most common form results from methylenetetrahydrofolate reductase (MTHFR) gene mutations leading to decreased enzymatic activity.Case report: We present the case of a 34 year-old woman with a sudden onset of left hemiparesis and aphasia accompanied by retrosternal pain. She is diagnosed with acute posteroinferolateral myocardial infarction and stroke. Homocysteine level was determined and it was moderately elevated. The coronary angiogram revealed partially recanalised embolic occlusion of posterior left ventricular branch and posterior interventricular artery. A conservative treatment management is adopted. She remained haemodynamically stable, with complete resolution of neurological symptoms and evolution to subacute myocardial infarction.Conclusions: The particularity of our case is represented by symultaneous thromboembolic events causing myocardial infarction and ischemic stroke in a patient with a history of recurrent pregnancy loss, which was previously diagnosed with MTHFR gene mutation. Moderate hyperhomocysteinemia, also found in our patient, is recognised as an ethiopathogenic factor of thrombophilia. The right diagnosis and therapeutic approach could be the key to improved prognosis in this category of patients. MTHFR gene mutation causing hyperhomocysteinemia should be suspected in patients with thromboembolic events, especially when occuring repeatedly or at young age
Characterization of Temporal Trends of Dengue Fever in Municipalities in the Brazilian Northeast Outback
Get PDFIntroduction: Dengue fever is currently a major endemic health issue in the city of Brejo Santo, located in the Brazilian Northeast outback, due to the rising morbidity and mortality rates in the area. The mosquito Aedes aegypti, the main vector of dengue fever virus, is highly adapted to the domestic environment. Since 1981 Brazil has been living with epidemic outbreaks of dengue fever. Objective: To explain temporal trends of dengue fever in the municipalities of the 19th Health Region of Brejo Santo within the years 2007-2013. Methods: This is an observational, cross-sectional, descriptive study with a quantitative approach. Data were supplied by the Information System for Notifiable Diseases (SINAN) and the Mortality Information System (SIM). All notifications of dengue fever cases in the 19th Health Region of Brejo Santo between January 2007 and December 2013 were included. Results: A total of 7,766 cases of dengue fever were confirmed in the period between 2007-2013, among which 5 evolved to death. A high incidence was observed in most municipalities of the 19th Health Region. A fluctuation in incidence could be observed with interspersing periods of large epidemic outbreaks. Most of these municipalities are at risk of dengue fever epidemics. The incidence in this region was of 378.1 cases per 10,000 inhabitants, and in the municipalities it ranged from 43.8 cases / 10,000 inhabitants to 695.8 cases / 10,000 inhabitants. Deaths by dengue fever were classified as: Dengue Fever with Complications (03); Dengue Shock Syndrome (01); Dengue Hemorrhagic Fever (01). Conclusion: According to the information provided in this study, the greatest challenges health professionals have to face include the control of dengue fever and the prevention of death cases in the Health Region. To achieve good results, it is necessary to involve people in the process of co-responsibility, to strengthen links with other sectors of society, to promote adequate and timely assistance to the population and to improve the flow of health information, thus generating proactive and effective actions.Â
Perspectives of Autonomic nervous system perioperative monitoring –focus on selected tools.
Get PDFAutonomic nervous system’s role as a “life-sustaining†system is well known. However, the anatomically and functionally complexity of ANS, makes difficult its monitoring in perioperative setting. Various methods have been proposed for measuring its activity. The current review focuses on selected tools- electrodermal activity, pupilometry, heart rate variability, surgical skin index and salivatory-a amylase- and their application in the field of anesthesia, intensive care and emergency medicine
Health education for seniors: an analysis under Paulo Freire’s perspective
No full textBackgroundPopulation aging is one of the hardest challenges for the current public health, however, for a proper attention to the elders, the development of reachable social and health policies which are consistent with the real needs of this population stratum it is essential. Thus, the aim of this research is to analyze the perceptions of nurses about health education for the elderly, according to the conceptions of Paulo Freire.MethodIt is a descriptive study with a qualitative approach, conducted in the city of Juazeiro do Norte, Ceará, Brazil taking as a background the Unidades de Saúde da FamÃlia – USF (Family Health Units). Eighteen nurses participated in this survey. The semi-structured interview was used for gathering data, and to organize those data to the analyses of contents. The analysis of the obtained data started since the conceptions of Paulo Freire and from some relevant articles related to the topic.ResultsConsidering the health concept as a tool to develop people, it was observed in this sense, that some professionals associate health education focused on knowledge exchange, behavior changes, and decision making in health, matching the Freireana ideology of questionable methodology. However, they also identified someprofessionals with a misperception in relation to the health education, since they associate the approach only focused on the concept of health, grounded in the absence of a disease, thus characterizing, a learning bank methodology, since they resort to vertical transmission of knowledge. It was evinced yet that the educational actions performed by those professionals envisioning healthy aging are directed from the identification of prevalent diseases within the community, and that the strict population that receives such assistance it is restricted only to the individuals who seek theUnits (USF), or those who are affected by diseases. ConclusionIt is thought that health education is the instrument that enables the change of behavior and decision making in health care for the users, but it should be planned on an ongoing manner, considering the reality of population, using methodologies that promote dialogue, essential element to establish the necessary link for conducting practical aspectson the perspective of health promotion.Â
Inflammatory markers, tbars and vitamin E in class II and III obese patients before undergoing bariatric surgery
Get PDFBackground: Obesity and its comorbidities such as insulin resistance, endothelial dysfunction, hypertension, type 2 diabetes and atherosclerosis have been associated with chronic inflammation and oxidative stress. Weight loss with maintenance is not always possible. Bariatric surgery has been proved to be the only efficient method for weight reduction in patients with clinically severe obesity. It leads to significant weight loss and improvement and/or remission of comorbidities. On the other hand, considering that surgical intervention per se induces oxidative stress and inflammatory response, the objective of the present study was to verify if some inflammatory marker, TBARS and/or Vitamin E could be evaluated before gastric surgery. Methods: a quantitative cross-sectional study was carried out at Clinica Ana Rosa (Santo André, SP, Brazil). 100 obese patients (BMI ≥ 35-40 kg/m2) awaiting bariatric surgery were selected for this study. The control group included 29 individuals, BMI < 35 kg/m2, with or without associated comorbidities. The patients completed a structured interview. Weight, height, waist and hip circumferences were also collected. Blood was collected. Glucose (G), total cholesterol (TC), HDL cholesterol (HDLc), LDL cholesterol (LDLc), VLDL cholesterol (VLDLc), triglycerides (TG), high-sensitivity C-reactive protein (hs-CRP), vitamin E (VIT E), fibrinogen (FIB), IL-6 (human interleukin-6), TNF-alpha and thiobarbituric acid reactive substances (TBARS) were measured. Results: patients have shown increased serum levels of hs-CRP and FIB. In this study, class II and III obese patients awaiting bariatric surgery and the control group had lower than normal VIT E levels and no significant changes in TBARS levels were observed. Conclusions: excess weight and accumulated fat in subjects with severe obesity seem to be related to increased inflammatory response, therefore, our results reinforce the importance of evaluating inflammatory markers and VIT E in obese patients before bariatric surgery.Â
Congenital pseudoarthrosis of the clavicle; a rare case
Get PDFCongenital pseudoarthrosis of clavicle is a rare disease. It usually presents as a swelling in the clavicular region at birth or soon after birth. CPC first reported by FitzWilliams in 1910. In this anomaly, conduction is caused by extrinsic pressure exerted on the budding clavicle by the adjacent pulsatile subclavian artery. The best time for surgery and the best method of surgery is controversial. Surgical indication for many authors is the presence of symptoms, functional impairment or cosmetic deformities. We present a 10 years old girl with a focal painless swelling in the midpoint of the right clavicle at finally diagnosed Congenital pseudoarthrosis of clavicle. We operated the patient and removed dense fibrotic tissue, clavicle ends freshed and bone was fixed with plate. According to our results, we recommend ORIF of clavicle with local bone graft because of complete united bone without iliac crest bone graft and its morbidity. Finally we suggest usage of locking plate because of osteoporotic nature of this condition
Depression as a Risk Factor for HIV Infection
Get PDFMajor depression is the most common psychiatric diagnosis in Human Immunodefiiency Virus (HIV). However a few studies have focused on clinical depression as a risk factor for HIV infection. There are evidences to show that individuals with depressive symptoms can be predisposed to diseases such as HIV infection. Literature point out that the negative inflence of depression as a risk factor for HIV can be explained because physical deterioration or depression can result in fatigue, physical impairment, and loss of motivation and self-confience to engage in food and income generating activity.  Other authors point out that this increased risk is thought to be due to high rates of substance use including injection drug use (IDU), risky sexual behavior, sexual victimization, and prostitution. It´s consensus that are needed social support for HIV-infected patients that includes treatment for depression and substance abuse. Screening of depression should also be conducted regularly to provide a full psychiatric profie to decrease the risk of depression and improve quality of life in this populatio
Correlation between Bipolar Affective Disorder and Suicide Reviewing by the Risk Factors: a Systematic Review
Get PDFBackground: Because there are several reports associations between affective (AD) and bipolar disorder (BD) and suicide, the research develops a discussion of risk factors that inflence the occurrence of suicide attempts in patients with BD.Objectives: To relate risk factors present in patients with bipolar disorder who committed suicide or some suicide attempt.Methods: A survey was made in Scopus with the keyword "bipolar" and the terms "suicide" and "attempted"and "risk factors" from Medical Subject Headings (MeSH). We use only Scopus as the data source, and the statistical information available in tables and graphs provided from this source.Results: Frequently the AD and BD were associated with suicide occurrence in the studies included in this review. They identifid the main risk factors for suicide the previous suicide attempt and hopelessness. The main risk factors for nonfatal suicidal behavior included family history of suicide, early onset of bipolar disorder, extent of depressive symptoms, increasing severity of affective episodes, the presence of mixed affective states, rapid cycling, comorbid Axis I disorders, and abuse of alcohol or drugs. The suicide rate in this disorder reaches three times compared with other mental illnesses, and there are several risk factors: 3:1 ratio of suicide in men compared to women, but in females a greater number of attempts are observed. 25% of persons consume alcohol prior to suicidal attempt. The studies relate these factors and show how they can pose a risk to the carrier of the disorder. There are other risk factor for BD discussed on this review.Conclusions: It is inferred that the factors related to the risk of suicide in patients with bipolar disorder are important to enable the development of strategies designed to identify a possible suicidal ideation, prevention and control of these deaths. These elements are well characterized and defied in the studies
Metabolic syndrome in elderly from a northeastern brazilian city
Get PDFIntroduction: Population aging is a global reality. In Brazil, it is so expressive and in 2050 is estimated that the number of men and women over 80 years old can overcome the 20-24 years old population and also children under 14 years old. Metabolic syndrome is defined as a set of cardiovascular risk factors, detection and intervention in this age group may decrease cardiovascular mortality. We aimed to estimate the prevalence of metabolic syndrome (MS) in elderly patients in a northeastern Brazilian city. Method: This is a quantitative, observational, cross-sectional and population-based study. The population consisted of non-institutionalized individuals aged> 60 years old, attended in the Family Health Strategy (FHS) and residents in Cajazeiras, PB, Brazil. For the diagnosis of metabolic syndrome we considered the criteria recommended by the International Federation of Diabetes. Results: We studied 351 elderly patients with 72.4+8.7 years old and 66.1% were female. The prevalence of MS was 69.8% and the most frequent criterion was increased waist circumference (82.6%), followed by high triglycerides (81.5%) and low HDL-cholesterol (80.6%). We observed a statistically significant positive association between MS and women [OR: 1.38 (95% CI: 1.18 to 1.63)] and housing in urban areas [OR: 1.23 (1.02 to 1.48)]. Conclusion: There is a high prevalence of MS among the elderly mainly in women and those living in urban areas