Australasian Medical Journal
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Web-based Information About Warfarin For Patients
Get PDFBackground Warfarin is a high-risk medication where patient information may be critical to help ensure safe and effective treatment. Considering the time constraints of healthcare providers, the internet can be an important supplementary information resource for patients prescribed warfarin. The usefulness of internet-based patient information is often limited by challenges associated with finding valid and reliable health information. Given patients’ increasing access of the internet for information, this study investigated the quality, suitability and readability of patient information about warfarin presented on the internet. Method Previously validated tools were used to evaluate the quality, suitability and readability of patient information about warfarin on selected websites. Results The initial search yielded 200 websites, of which 11 fit selection criteria, comprising seven non-commercial and four commercial websites. Regarding quality, most of the non-commercial sites (six out of seven) scored at least an ‘adequate’ score. With regard to suitability, 6 of the 11 websites (including two of the four commercial sites) attained an ‘adequate’ score. It was determined that information on 7 of the 11 sites (including two commercial sites) was written at reading grade levels beyond that considered representative of the adult patient population with poor literacy skills (e.g. school grade 8 or less). Conclusion Despite the overall ‘adequate’ quality and suitability of the internet derived patient information about warfarin, the actual usability of such websites may be limited due to their poor readability grades, particularly in patients with low literacy skills
Self‐Medication Patterns Among Medical Students in South India
Get PDFBackgroundSelf-medication results in wastage of resources, increases resistance of pathogens and generally causes serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. This study was undertaken to determine the reasons for self-medication and the pattern of self-medication among medical students. Method This cross-sectional descriptive study was conducted at the K.S. Hegde Medical Academy, Mangalore. The participants were medical students from first to final year. Medical students were selected through convenience sampling. The data was collected using a pre-tested semi-structured questionnaire. The data was analysed using SPSS version 16 and the results expressed as proportions.Results A total of 200 students, 121 (60.5%) female and 79 (39.5%) male, were included in the study. Of the medical students surveyed, self-medication was reported among 92%. The respondents who used self-medication found it to be time-saving in providing relief from minor ailments. The most common ailments for which self-medication were used were: the common cold (69%), fever (63%) and headache (60%). The students consulted their textbooks (39%) and seniors or classmates (38%) for the medications. Antipyretics (71%), analgesics (65%), antihistamines (37%) and antibiotics (34%) were the most common self-medicated drugs. Of the respondents, 33% were unaware of the adverse effects of the medication and 5% had experienced adverse reactions. The majority (64%) of students advised medications to others, more often to family and friends. Conclusion The prevalence of self-medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors. A significant number of students are unaware of the adverse effects of the medication that they themselves take and suggest to others. Therefore, potential problems of self-medication should be emphasised to the students
Female Medical Student Admissions in Nepal
Get PDFBackground In Nepal, a developing country in South Asia, the number of female medical students has increased significantly. Aims The present study was carried out to explore perceived perceptions for this increase, study the perceived impact on teaching-learning activities, medical school infrastructure and possible perceived changes in the doctor-patient relationship. Method First, second and third year students were invited to participate in focus group discussions (FGDs). Fifty-four students were willing to participate. Twenty-five were from the first year, 20 from the second and 9 from the third year. The FGDs conducted over a 90 minute period were voice and video recorded. The groups consisted of both males and females from a particular intake. The findings were transcribed verbatim. Results Participants felt more female students were taking up medicine in the country because of more colleges opening in the cities and towns making it easier for female students to enrol in the course. Also parents consider medicine as a safe, noble and dignified profession for their daughters. Participants suggested women are more empathetic doctors and the doctor-patient relationship might become more patient-focused. Women doctors can serve as a source of inspiration and the overall impact on Nepal would be positive. Conclusion Participating students perceived the increasing number of female medical students may be due to changes in Nepalese society. This study was carried out only among three batches of students in a single medical school. Further studies among different batches of students and among interns in other medical schools are required. Studies among postgraduate students and doctors are also needed.
Automated Medical Literature Retrieval
Get PDFBackground The constantly growing publication rate of medical research articles puts increasing pressure on medical specialists who need to be aware of the recent developments in their field. The currently used literature retrieval systems allow researchers to find specific papers; however the search task is still repetitive and time-consuming. Aims In this paper we describe a system that retrieves medical publications by automatically generating queries based on data from an electronic patient record. This allows the doctor to focus on medical issues and provide an improved service to the patient, with higher confidence that it is underpinned by current research. Method Our research prototype automatically generates query terms based on the patient record and adds weight factors for each term. Currently the patient’s age is taken into account with a fuzzy logic derived weight, and terms describing blood-related anomalies are derived from recent blood test results. Conditionally selected homonyms are used for query expansion. The query retrieves matching records from a local index of PubMed publications and displays results in descending relevance for the given patient. Recent publications are clearly highlighted for instant recognition by the researcher. Results Nine medical specialists from the Royal Adelaide Hospital evaluated the system and submitted pre-trial and post-trial questionnaires. Throughout the study we received positive feedback as doctors felt the support provided by the prototype was useful, and which they would like to use in their daily routine. Conclusion By supporting the time-consuming task of query formulation and iterative modification as well as by presenting the search results in order of relevance for the specific patient, literature retrieval becomes part of the daily workflow of busy professionals
Ileal Volvulus and Carcinoid Tumours
No full textSmall bowel volvulus is a rare cause of bowel obstruction in the Western World. It is often divided into primary and secondary causes. This report presents a case of secondary ileal volvulus with underlying carcinoid tumour
Left Ventricular Thrombus and Acute Myocardial Infarction
No full textDespite the well documented benefit of echocardiography in acute coronary syndromes, its wide-scale use in the Caribbean is limited by access, health literacy and affordability. Because of the limited use of echocardiography in the region, routine complications of acute myocardial infarction (AMI) are not fully appreciated and may go unrecognized, further contributing to increased cardiovascular morbidity and mortality. It is therefore necessary to bring focus to this common clinical condition and highlight the clinical utility of echocardiography in facilitating timely and accurate diagnosis. We report here a case of large left ventricular (LV) thrombus in a patient with AMI. Coronary angiography showed completely occluded left anterior descending artery (LAD) with angiographically normal remaining vessels. Immediate anticoagulation was commenced with heparin and overlapped with warfarin. No Primary Angioplasty (PA) was done based on the evidence from occluded artery trial. LV thrombus was completely resolved on echocardiography at three months. No evidence of thrombo-embolism was found during the resolution of LV thrombus
Carotid Stenting in a Nonagenarian Patient
Get PDFCarotid artery stenosis is a disabling disease in all age groups. Elderly people are more prone to recurrent strokes due to advancing age and multiple co-morbidities. Treatment options for symptomatic carotid stenosis in the very elderly are the same as in younger patients although with a higher operative risk. We describe a successful case of carotid artery stenting in a nonagenarian with symptomatic carotid artery stenosis, a subgroup for whom treatment options are rarely discussed in guidelines
Emphysematous Cystitis and Bladder Rupture
Get PDFWe describe a 32-year-old lady who was admitted with a urinary tract infection following vacuum-assisted delivery. She was diagnosed with Enterococcus faecium related emphysematous cystitis, bladder gangrene and rupture necessitating emergency laparotomy and partial cystectomy. She had a repeat laparotomy nine days later due to continuing bladder necrosis on cystoscopy. The patient stayed in hospital for over two months due to complications including hospital acquired Klebsiella pneumonia, adult respiratory distress syndrome and malnutrition. Discharge occurred one week after an ileal conduit and ileostomy were performed