International Medical Publisher Journals (iMedPub)
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Prevalence of Clostridium diffiile infections among hospitalized patients in Amman, Jordan: A Multi-Center Study
Get PDFClostridium diffiile is a Gram-positive endospore-forming bacillus that was discovered as a bowel colonizer and pathogen in 1935. Healthy newborns and infants were found to be colonized with C. diffiil eat rates ranging from 45 to 70%. However, the prevalence of toxigenic strains was found to be as low as 13%. The colonization rates decline as individuals grow older, reaching rates lower than 5% in urban-dwelling healthy adults. However, colonization rates as high as 25-55% has been detected among adult hospitalized patientsand nursing home resident
The Political Economy and Stigmatization of HIV/AIDS in Patients Attending a Clinic in Lagos, Nigeria
Get PDFBackground: The aim of the study was to highlight the political economy of HIV/AIDS in people living with HIV/AIDS (PLWHA) through use of relevant literature and administration of self-administered questionnaires. Thestudy was carried out in the south- western region of Nigeria, using patients attending the HIV/AIDS clinic at the Lagos University Teaching Hospital, Lagos Nigeria.Method: The questionnaires were distributed in the HIV/AIDS clinic and respondents were interviewed by the Principal Investigator and medical students. Results were collated and analysed using computer software. Chi Square analysis was used to test for association between categorical variables at a P value of 0.05. Results were presented in tables and charts. Further, the study determined changes if any in the socio- demographic pattern of the patients particularly in marital status, employment status and residential status since diagnosis. In addition, the study sought to determine areas of stigmatization as well as the fraction of monthly income spent on HIV/AIDS care. Results: Literature showed that employers were not willing to employ a person with HIV/AIDS and that vulnerable employment was the predominant form of employment in sub-Saharan Africa. This was re-affirmed by the study. Thirteen (13%) respondents lost their jobs after diagnosis and about 75 (75.0%) of respondents were in vulnerable employment. Sixty-four (64%) of the respondents were married before diagnosis and 53 (53.0%) were still married after diagnosis, five of the respondents’ spouses had died, 3 had been divorced, and 4 had been separated from their spouses (P < 0.05). Sixty-one (61.0%) of the respondents got their financial support from their family. Stigmatization increased with the number of people that knew of their diagnosis (P < 0.05). Conclusion: Loss of job occurred in respondents when the employers knew of the diagnosis. The household income spent on HIV/AIDS care ranged from one-third to half of the monthly income. It was recommended that the government provide incentives for employers to hire PLWHA. Health education should target employers. Self-sustaining financing schemes should be developed to help PLWHA
Awareness and Knowledge on Epilepsy Among Undergraduate Medical Students in Pakistan
Get PDFBackground:  Epilepsy is a common neurological disorder which affects millions of people throughout the world. However, it has been discovered that there is a great degree of ignorance regarding the science of epilepsy among the general masses as well as the populace of medical students.  Studies have been conducted whose results have shown that, there has been fabrication regarding the clinical presentation & treatment of epilepsy among the common man. Numerous appear to link epilepsy to evil spirits and possession that can be healed by spiritual treatments by certain specialists given the designations of ‘demonologists’,’ paranormal investigators’ or ‘mystics’. In such circumstances, medical students can prove to be a major source to educate the society at large. Therefore, it is crucial that their knowledge & attitude towards epilepsy is accurate and thus, must be evaluated at an early stage in their medical career, so that these future physicians may play a pivotal role in the public awareness of epilepsy.  Method:  This study was conducted in Pakistan, at a Government sector medical college, namely, Karachi Medical and Dental College. This is a cross-sectional study. Data was collected between October to December of the year 2014. 270 medical students were given the KAP (knowledge, attitude & practice) form of epilepsy to fill out. The software used to interpret and tabulate the results was SPSS v.16 for Windows. The chi-square test was employed to determine the proportion of knowledge of epilepsy among medical students. The p-value calculated was equal to 0.05.  Findings:  In this study, 270 medical students were recruited, of which 90 were males (33.3%) where as 180 were females (66.6%). The ages of the student participants were within the range of 18 to 24 years. The analysis of our study demonstrates that: 85.1% of the medical students consider epilepsy to be a neurological disorder; 6.66% believe epilepsy is an infectious disease; 4.44% believe it to be a hereditary disease, whereas, 3.7% of the students reckon it is a psychiatric illness. Generalized tonic clonic seizures was deemed to be the most common form of epilepsy (25.5%) with complex partial seizures being the least common form(1.85%) , as well as relatively unknown by the students.            It was discovered through this study that, students were much less acquainted with the knowledge regarding the treatment of the disorder: multiple drug therapy was considered as the treatment by 56.66% of the students, spiritual treatment by 3.7%, spiritual treatment with medication by 20%, surgical treatment by 17.4% & 2.22% deemed epilepsy as a self limiting disease.  Conclusion:  It has been observed with this survey that the medical students of Pakistan are well aware of the knowledge of epilepsy and it being a medical condition. However, the students need to be educated early on in their training to be physicians, about certain aspects and details of the neurological disorder, for instance, the appropriate treatment of epilepsy, where their knowledge is lacking
Gender Differences in Risk Behaviours: Does Sexual Maturation Matter?
Get PDFBackground: Menarche is a milestone of entering puberty, representing an indicator of sexual maturity and revealing normal physical, biological, psychological, and emotional development. This study aimed to compare pre-menarche girls, same age post-menarche girls, and boys according to risk behaviours.Methods: Participants (n=2608) completed a comprehensive survey regarding headache, irritability, feeling nervous, tobacco use, drinking beer, physical fighting, diet, and perception of health.Results: The prevalence of having headaches (p<0.001), being irritable or having a bad temper (p<0.001), feeling nervous (p<0.001), being on a diet (p<0.001) was significantly higher among post-menarche girls than boys and pre-menarche girls. Post-menarche girls had a poorer perception of health (p<0.001). After adjusted data for socioeconomic status and BMI, frequency of having headaches, bad temper and feeling nervous was higher for post-menarche girls. Conclusions: Specific school-based intervention is required so that the perception of well-being and social participation can be maintained during after menarche
Oral Provocation Test on the Diagnosis of Cow's Milk Protein Allergy in Children: Integrative Review
Get PDFIntroduction: The cow's milk protein allergy (CMPA) is considered the most prevalent food allergy in children, developing, usually, during the first three years of life and can cause gastrointestinal, respiratory and skin changes. Among the diagnostic methods used, there is the oral food challenge test. However, little used in clinical practice.Objective: Identifying the importance of Oral Provocation Test (OPT) in the diagnostic confirmation of CMPA in children.Method: An integrative review of studies of the last ten years, with six relevant articles related to the theme and used and described the OPT in children with suspected CMPA.Results: The OPT is important to confirm the diagnosis, avoiding prolonged exclusion diets, nutritional risks and unnecessary expenses. The oral test with milk can be adopted as the gold standard and used as a basis for comparative studies that aims to advance the molecular diagnosis, determining the specificities and sensitivities of such tests. It can also be used with other foods. In innovative studies to determine the tolerance of dairy foods, allowing include them in the feeding of these patients during the elimination diet.Conclusion: It is important that the OPT is performed early in the onset of symptoms suggestive of CMPA, in order to avoid prolonged exclusion diets, nutritional risks and unnecessary expenses
Aparición de psoriasis tras tratamiento con Rituximab en un paciente con dermatomiositis
No full textEl anticuerpo monoclonal Anti CD20 (Rituximab) es una diana terapéutica para las enfermedades reumáticas, con un creciente número de evidencia sobre su seguridad y eficacia en una importante variedad de indicaciones. Sin embargo, hay incertidumbre sobre su uso potencial en artritis reumatoide con factor reumatoide negativo, asà como en otras enfermedades autoinmunes con autoanticuerpos negativos. En la literatura cientÃfica se ha descrito la aparición de psoriasis (incluso artritis psoriásica) post infusión de Rituximab en pacientes con artritis reumatoide o lupus. Describimos el primer caso de una paciente con dermatomiositis quien desarrolló psoriasis después de recibir rituximab.La interpretación de este posible efecto secundario de rituximab sigue siendo poco clara, pero un entorno de células con depleción de linfocitosB podrÃa inducir respuestas anormales de células T. Posiblemente, estas respuestas estarÃan provocados bien por una infección subclÃnica o por la eliminación de los mecanismos por los que las células B regulan las células T. Estos casos sugieren que la patogénesis de la psoriasis podrÃa relacionarse con cifras anormales de células B y que el tratamiento propuesto de la psoriasis y la artritis psoriásica con rituximab puede resultar en respuestas impredecibles
Survival and Growth of Bacteria in Treated Wastewater and Water Distribution Systems and their Implication in Human Health: A review
No full textMultiple antibiotic resistant bacteria (MARB) and antimicrobial drugs enter the environment via wastewater, especially from hospitals and pharmaceutical plants, and through agricultural runoff, leading to contamination of surface and groundwater. This is a serious problem in arid regions such as Oman where wastewater is recycled for irrigation and recharging aquifers. Treatment with chlorine does not completely remove bacteria from wastewater or prevent their re-growth in downstream distribution systems. MARB can infect humans via contaminated food and drinking water, or directly from the environment. Agricultural runoff and sewage, either treated or untreated, are also the main sources of MARB in coastal seawater. It is necessary to use antibiotics more prudently in medicine, treat wastewater more effectively, eliminate the discharge of untreated waste into the environment, and curtail the proflgate use of antibiotics as growth promoters for livestock
The emergence of antimicrobial resistance in enterococci isolates from infants: A review study
Get PDFThe emergence of antibiotic resistance in potential bacterial pathogens is considered as an important consequence of antibiotic misuse and overuse in humans and animals husbandry. In addition, lacks of adequate infection-control practice in hospital and medical care settings have led to the continuing development of extensive resistance problems worldwide. Certain multidrug-resistant commensal and potential pathogens are now   widely spread in community and hospital patients worldwide . Examples are meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistance enterococcci (VRE), extended-spectrum β-lactamase- and carbapenemase-producing coliforms, and toxin-hyperproducing Clostridium difficile. During the last decade, Enterococcus faecalis and Enterococcus faecium are the most prevalent species cultured from human infections. Incidence of enterococci resistant to multiple antibiotics has become increasingly common in the hospitalized patients all over the world. E. faecium is reported to be responsible for most vancomycin-resistant enterococci (VRE) infections.Â
Abstracts of the IV Neuro Interventional Radiology Master Course: beyond frontiers in NeuroInterventional Radiology
Get PDFThe theme of the fourth NeuroIMC course is BEYOND FRONTIERS IN NEUROINTERVENTIONAL RADIOLOGY. Conferences will explore the latest techniques in neurointerventional approaches to vascular pathology of the central nervous system. To summarize, on the first day we will be discussing the latest advances in endovascular embolization of complex aneurisms, flow diverters, and endovascular device flow disruption. Some of these techniques will be compared with older techniques such as the parent vessel occlusion test. A special lecture on microsurgical management of complex vascular pathology of the central nervous system will close the morning session. In the afternoon, we will continue the discussion on aneurysms and one conference will focus on a current and controversial subject: extracranial venous pathology as a potential contributor to degeneration. On Saturday, we begin with two sessions on anatomy and angioanatomy of the central nervous system, followed by series of lectures on complex pathologies, such as arteriovenous malformations and dural arteriovenous fistulae. The last group of conferences will focus on stroke, with the experiences of centers in Boston and Jacksonville, and the results of the MR CLEAN trial in the Netherlands
Thyroid Gland Volume in Adults with Epilepsy: Relationship to Thyroid hormonal function
Get PDFSeveral studies were done investigating thyroid function in patients with epilepsy. However the results of different studies were conflicting or controversial. This study aimed to evaluate thyroid hormonal changes and their relationship to thyroid volume in epileptic adults on long-term treatment with antiepileptic drugs (AEDs). This study included 135 adults with idiopathic epilepsy with mean age of 32.32±4.34years, duration of illness of 10.52±5.08years and on treatment with carbamazepine (CBZ), valproate (VPA) or CBZ+VPA for a mean duration of 8.66±3.32years. The serum levels of free thyroxine (fT4), triiodothyronine (fT3), and thyroid-stimulating hormone (TSH) were assessed. Thyroid volume was measured using ultrasonography. Compared to control subjects, patients had significant lower fT4 (p<0.01) and fT3 (p<0.01) and higher levels of TSH (p<0.0001). All patients with reduced fT4 had reduced fT3 and increased TSH levels. Nearly 26% of the patients had enlargement of the thyroid gland (p<0.001). Patients on polytherapy had more thyroid volume compared to patients on monotherapy (p<0.05) and patients on VPA had more thyroid volume compared to patients on CBZ (p<0.03). All patients were clinically euthyroid. Significant correlations were identified between fT4 concentrations and duration of illness, dose, serum level and duration of AEDs treatment, fT3 and TSH concentrations and between thyroid volume and fT4, fT3 and TSH concentrations. CBZ and VPA as mono- or poly- therapies may cause thyroid hormonal and structural abnormalities. Thyroid enlargement is due to associated subclinical hypothyroidsm. This data have implications suggesting prevention strategies