International Journal of Research in Medical Sciences
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Hughes-Stovin syndrome: a case report and literature review
Get PDFHughes-Stovin syndrome (HSS) is a rare clinical entity comprised of thrombophlebitis and multiple pulmonary and bronchial aneurysms. Medical literature has documented fewer than 40 cases of HSS. Its pathogenesis and etiology are still unknown. It is considered a variant of Behcet’s disease (BD). HSS is being managed either medically or surgically. We report the case of a 32-year-old Saudi male patient with HSS who initially presented with a pulmonary embolism (PE). Later, he developed hemoptysis that was treated successfully with methylprednisolone. The genetic, etiologic, and pathologic basis of HSS should be explored more in the future to elucidate the disease. Exploration of better and optimal medical and surgical therapeutic regimens is a need for time to treat and prevent morbidity in BD and HSS. There is a dilemma of anticoagulation in these patients that needs to be addressed and investigated properly
Role of adipose tissue in people with obesity and its relationship with the appearance of metabolic diseases
Get PDFThe alteration of adipose tissue plays a fundamental role in the appearance of chronic inflammation diseases; insulin resistance, lipid deposition in obese patients. In recent years it has been shown that under the stimulation of adipocytes in stressful situations, their endoplasmic reticulum generates a response that over activates the inflammatory response of adipose tissue and interferes with normal mentalism, generating the secretion of adipokines, affecting the thermogenic pathways of the tissue. adipose, which causes the manifestation of metabolic syndrome. This article summarizes the relationship between adipocyte endoplasmic reticulum and adipose tissue dysfunction in obese patients
Optimizing healthcare outcomes and broadening nursing capabilities in digital era: telemedicine transformative impact
Get PDFThe telemedicine concept brought about a revolution in caring and led to efficient and effective nursing practice. The aforementioned improvements in patient outcomes and the positive advancements in patient care and accessibility were catalysed by the 2020 pandemic. The advent of this patient-centred care under telemedicine has ensured patient access, reduced costs, and encouraged general patient satisfaction. More so, the innovations are felt more in underserved populations, and rural populations recorded appreciable improvement in care pathways with professional access on a hospital proximity basis. Moreover, telemedicine has helped bridge critical gaps in healthcare for so long within the underserved regions. In nursing, telemedicine has maintained workable handover and helped expand safety from viral or bacterial infection chain to mental health and sanity. For example, patient circumstances such as diabetes have seen telemedicine innovations in ways that ensure patients are being monitored in remote places and doctors or nurses update patients simultaneously using modern telemedicine platforms. However, the noted issues have been challenges integrating machine operations with existing hospital setups. The future of telemedicine promises continuous remote caring achievable with real time data entry that will improve patient outcomes and nursing practice. In conclusion, telemedicine provides efficient, effective, and accessible nursing care that centers itself with the patient
Assessing knowledge, attitude, and practice of adaptive designs in clinical trials among Indian stakeholders
Get PDFBackground: This study attempted to evaluate the knowledge, attitude and practices of various stakeholders addressing adaptive clinical trials (ACT), as no analogous studies have been published in India.
Methods: Ethics committee (EC) approval was sought before circulating an online pre-validated questionnaire (28 questions in three domains) among 200 stakeholders involving the clinicians, clinical trial unit personnel, and medical advisors from various pharmaceutical industries. The responses collected were analysed using appropriate statistical tests. A p value <0.05 was considered significant.
Results: Out of the 200 participants surveyed, 169 responded, yielding a response rate of 84.5%. When the three distinct stakeholders’ median knowledge scores were evaluated, there was no statistically significant difference. The median knowledge score of stakeholders with more than five years of experience did not vary statistically from those with less than five years. In the attitude domain, 21.8% and 17.1% of participants agreed that the validity and integrity of research in ACT are hampered respectively. However, 73.9% felt that ACT has potential benefits while 79.2% believed they were underutilized. In the practice domain, only 4.7% of stakeholders have been a part of adaptive clinical trials.
Conclusions: The study found that fewer stakeholders participated in studies utilizing adaptive designs, which resulted in a decrease in knowledge, perception, and practices among the various stakeholders. This emphasizes the necessity for further educational initiatives in the future, such as planning conferences or training sessions, to raise the understanding of adaptable designs in clinical trials
Association of poor sleep quality and short sleep duration on the development of coronary artery disease
Get PDFBackground: Sleep disturbances, including poor sleep quality and short sleep duration, are strongly linked to cardiovascular disorders. However, limited data exist on the relationship between sleep parameters and coronary artery disease (CAD) in Bangladesh. This study analyzed the association of sleep quality and duration with CAD in Bangladeshi population.
Methods: This case-control study was conducted in the Department of Cardiology, Chittagong Medical College Hospital. It included 139 patients hospitalized with acute coronary syndrome (ACS) as cases and 139 age-matched, healthy individuals with no CAD history as controls. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index (PSQI), with poor sleep quality defined as a PSQI score ≥5 and short sleep duration as <6 hours. Logistic regression models, adjusted for sex and other CAD risk factors, were used to analyze the data.
Results: The baseline characteristics of cases and controls were similar except for gender. Short sleep duration (<6 hours) was independently associated with CAD (Odds Ratio (OR)=2.01, 95% Confidence Interval (CI)=1.09-4.24), as was poor sleep quality (PSQI score ≥5, OR=1.89, 95% CI=1.02-3.24).
Conclusions: Poor sleep quality and short sleep duration are significantly associated with CAD in Bangladeshi adults. These findings suggest that improving sleep quality and duration could serve as potential strategies for CAD prevention. Further research is warranted to explore these relationships and implement targeted interventions in this population
Multivisceral resection for colon cancer with adjacent organ invasion: Whipple procedure, right hemicolectomy, and hepatic segmentectomy
Get PDFFemale patient, 55 years old, with a medical history of arterial hypertension and type 2 diabetes mellitus, diagnosed with a tumor in the hepatic flexure of the colon infiltrating the duodenum, the pancreatic head, the biliary tract, and segment V of the liver. A right hemicolectomy, Whipple procedure, and hepatic segmentectomy of segment V were performed. The patient exhibited a favorable postoperative course on the first day without signs of immediate complications. This case highlights the importance of multivisceral resection in the management of advanced colon tumors with invasion into multiple organs.
Association between rheumatoid arthritis and atrial fibrillation: a new perspectives
Get PDFRheumatoid arthritis (RA) is a disease with an autoimmune component that directly and indirectly affects various organs, causing significant damage and complications. However, knowledge about the subject and its association with atrial fibrillation (AF) is limited, making its study important due to its close relationship with the incidence of acute coronary syndrome (ACS). AF is the most common cardiac arrhythmia worldwide, showing a significant increase in morbidity and mortality in people who suffer from it. RA characterized by being a systemic inflammatory disease, affects 0.5-1.0% of the adult population. It is associated with a higher incidence of cardiac arrhythmias such as AF. Several epidemiological studies find that the risk of AF is increased in RA compared to the general population. Considering that inflammation plays an important role in AF, RA may be involved in the onset and development of AF. This review summarizes the epidemiology, pathophysiology, and management of AF in patients with RA.
A retrospective analysis of outcomes of rhino-orbito-cerebral mucormycosis at tertiary care hospital
Get PDFBackground: This study aimed to report outcomes of rhino-orbital-cerebral mucormycosis (ROCM) at tertiary care centre.
Methods: Retrospective analysis of in-patients diagnosed to have ROCM during the year 2021 was done. Diagnosis was confirmed based on lab and MRI investigations. Clinical features and management outcomes were noted.
Results: Among 113 suspected cases, 81 were confirmed to have ROCM. Majority of the patients had suffered COVID-19 disease. 67 cases out of 81 underwent maxillectomy with sinus debridement. Among the 67 cases,11 patients had orbital involvement with no PL, orbital exenteration was performed. Among remaining 14 patients, mortality due to cardiac and respiratory illness was seen in 3 patients, 7 went against advice and 4 had CNS involvement. All the patients were treated with liposomal amphotericin-B.
Conclusions: Early diagnosis, surgical intervention followed by amphotericin B in ROCM has favourable outcome. CNS involvement has a high mortality rate
Correlation of serum albumin levels with early outcome and complications among gastric cancer surgery patients
Get PDFBackground: Serum albumin, a marker of nutritional status, has been associated with surgical outcomes. This study evaluated the correlation between serum albumin levels and early postoperative complications in gastric cancer surgery patients.
Methods: A prospective cross-sectional observational study was conducted from July 2017 to March 2019 at the National Institute of Cancer Research and Hospital (NICRH), Dhaka. Forty patients with biopsy-proven operable gastric carcinoma were included using purposive sampling. Serum albumin levels were measured preoperatively and postoperatively, and complications were assessed. Data were analysed using SPSS version 22, with statistical significance set at p<0.05.
Results: The mean preoperative serum albumin level was 3.8±0.4 gm/dl, which significantly decreased to 3.3±0.2 gm/dl postoperatively (p<0.05). Postoperative hypoalbuminemia (<3.5 gm/dl) was observed in 52.5% of patients and was significantly associated with complications, including wound infections (38.1%), pneumonia (14.29%), urinary tract infections (28.57%), and duodenal sump leaks (9.52%). No complications were observed in patients with serum albumin levels ≥3.5 gm/dl (p<0.001).
Conclusions: Serum albumin is a reliable predictor of postoperative complications in gastric cancer surgery. Maintaining adequate serum albumin levels through nutritional optimization can significantly reduce morbidity, especially in resource-constrained settings. These findings underscore the need for integrating serum albumin monitoring into routine perioperative care
Caregiver-supported nursing intervention for smoothing the transition from pediatric intensive care units to ward: protocol for a pre-post interventional study
Get PDFBackground: Transitioning patients from pediatric intensive care units (ICUs) to general wards involves high risk for adverse events, highlighting the need for structured, patient-centered transition protocols. Currently, informal transfer processes often compromise patient safety and care quality, underscoring the value of a formalized model to guide this critical phase.
Methods: This pre-post interventional study will involve caregivers of pediatric patients preparing for ICU discharge. The intervention includes a structured transition model, with targeted training and support provided to caregivers to enhance their engagement and readiness. Data on caregiver satisfaction, understanding, and quality of care metrics will be collected pre- and post-intervention to evaluate outcomes.
Conclusions: The structured intervention is anticipated to enhance caregivers' comprehension and satisfaction with the transition process, while promoting improved care quality and safety during the critical shift from ICU to ward
Trial registration: The study protocol is registered in CTRI/2023/07/054787