Australasian Medical Journal
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Assessment of Under-treatment of Pain among Cancer Patients Admitted to Palliative and Oncology Units using Pain Management Index
Get PDFAim: To assess the prevalence, intensity and adequacy of cancer pain management in adult cancer patients admitted to palliative and oncology units. Methods: This prospective cross-sectional study included 323 adult cancer patients including all accessible and eligible inpatients who were seen and managed under the oncology department and interviewed in a randomly selected week excluding weekends of each month for 6 consecutive months. The adequacy of pain management assessed using PMI. Results: This study showed that 66.8% of patients had pain; 71% of them had moderate to severe pain; however, the pain was adequately treated in 90% of patients based on PMI ≥ zero. The satisfaction survey showed that 84.5% of patients were satisfied about pain management and 15.5% were not satisfied. 89% of patients treated by analgesics and 85% of them treated by opioids and there was no correlation between demographic factors and level of adequacy of pain control. Conclusion: Moderate to severe cancer pain is common and affects patients at different disease stages; however, optimal and effective pain management is affected by many obstacles that could be patient and family related or care provider related. This study showed that 90% of the patients included were adequately treated and 84% of them were satisfied
Immediate Relief of Cyanosis Following Surgical Removal of a Large Pulmonary Arteriovenous Malformation: A Case Report
No full textBackground: Pulmonary arteriovenous malformation (PAVM) is a rare structurally abnormal communication between the pulmonary arterial and pulmonary venous network, creating a pathologic intrapulmonary right-to-left shunt. Methods: A four-year-old boy presented with the history of chest pain, cyanosis, respiratory distress, cough and hemoptysis for two years. He was diagnosed to have a congenital pulmonary arterio-venous malformation occupying the posterior segment of the right upper lobe. The data and photos were collected from hospital records with the consent from the parents of the patient. Ethical aspects were discussed by our departmental review board. Results: CT Angiogram revealed that a large vascular mass in the posterior segment of right upper lobe. The lesion was supplied by branches from pulmonary arterial system as well as descending thoracic aorta. A joint team of cardiac and thoracic surgeons opened the chest by a posterolateral incision along the right 4th intercostal space. A large AVM mass, measuring approximately 10 cm x 6 cm x 5 cm, was seen occupying the lower part of the upper lobe of right lung. Following ligation of the feeding vessels, the AVM had shrunk and the affected part of the upper right lobe could be removed with the help of a stapler gun. Immediately after resection, the saturation went up to 100%. He made an uneventful recovery and was discharged from the hospital on the 8th postoperative day. Histopathologic examination confirmed diagnosis of AVM. Conclusion: Surgical removal of the Pulmonary arteriovenous malformation may improve the oxygen saturation immediately and relieve cyanosis
A Novel AI Tool for Automated Detection Of Osteoporotic Vertebral Fractures On Routine Chest Radiographs
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Review of SGLT2 Inhibitors in Heart Failure with Reduced Ejection Fraction
No full textSodium-glucose cotransporter-2 (SGLT2) inhibitors are a type of per oral antihyperglycemic medicine.It works by reducing glucose i.e. C6H1206 reabsorption in the proximal renal tubules, resulting in increased urine glucose excretion by the human body, which, thereby proving useful in diabetes mellitus. They seem to have a cardiovascular benefit in addition to lowering glucose levels, with mechanisms including eventually lead up to decreased preload and afterload, improved cardiac metabolism and bioenergetics, inhibition of myocardial Na+/H+ exchange, reduction of necrosis and cardiac fibrosis, and changes in adipokines, cytokine production, and in majority of epicardial adipose tissue mass. We, for the most part, give an up-to-date narrative literature overview of SGLT2 inhibitor mechanisms of action, at present definite clinical knowledge, known and researched therapeutic utility, and potential side effects in this review paper, in our own perspective.This narrative review article is based on the gathered information via dedicated and thoroughly conducted CV Outcome trials with SGLT2 inhibitors and related review articles. In October 2022, we used PubMed and Google Scholar to conduct a thorough electronic web search for papers and journals published between January 2000 and October 2022 related to our review. EMPA-REG OUTCOME, DECLARE-TIMI, CANVAS Program, DAPA-HF, and EMPEROR-Reduced are some of the studies that instated that using SGLT2 inhibitors reduced the risk of CV death or hospitalisation due to heart failure with some potential side effects. SGLT2 inhibitors were documented to reduce 3-point MACE (CV mortality, definitely non-fatal MI, non-fatal stroke) by 14 percent in a double-blind, placebo-controlled RCT (phase 3) as per our searched articles. SGLT2 inhibitors are a fairly recent class of antihyperglycemic medication that definitely has been shown to help heart failure with reduced ejection fraction ( HFrEF) patients with and without Type 2 Diabetes Mellitus (T2DM).However, it appears that doctors who are looking after this medically sensitive patient group with HFrEF will be need to be knowledgeable and comfortable with SGLT2 inhibitors
Prevalence and determinants of hypoglycemia in neonates admitted in the neonatology unit of the bamenda regional hospital
Get PDFThe purpose of this study was to determine the prevalence and identify risk factors associated with neonatal hypoglycemia at the neonatology unit of the Bamenda regional hospital, Cameroon. Patients and Methods: This was a prospective cross-sectional study carried out from 9th February 2022 to 31st May 2022 at the Neonatology unit of the Bamenda Regional Hospital, in the Northwest Region (NWR) of Cameroon. It involved 204 newborns between 0 – 28 days of life, admitted at the neonatology unit of the Bamenda regional hospital for any reason. Data was collected through interviews with parents, examining the newborns, reviewing follow-up records, and analyzing glucose levels in capillary blood from the fingertips. A structured questionnaire was used to gather information on sociodemographic, maternal, and neonatal factors. Blood glucose levels were measured using a test strip and a glucometer. Hypoglycemia was defined as having a random blood glucose level of less than 45mg/dl. The data collected was entered and analyzed using SPSS version 20. Results: Newborns of 0-3 days (59.8%) were the most represented with a female predominance (sex ratio = 0.7). The most common diagnosis on entry was neonatal infections (47.8%). The mean neonatal blood glucose level was 105.6mg/dl. The prevalence of hypoglycemia was 8.8%. Following multivariate analysis, the risk factor associated with neonatal hypoglycemia was low birth weight (OR=1.681; CI95 (0.994-2.842); p=0.043). Conclusion: The prevalence of neonatal hypoglycemia was 8.8%. The significant factor associated with hypoglycemia was low birth weight. Regardless of why a newborn is admitted to the neonatology unit, it’s important to carefully check for hypoglycemia. Using capillary blood glucose is a good option because it allows for quick management
UNUSUAL PRESENTATION OF ICHTHYOSIS: A CASE REPORT OF COLLODION BABY
No full textA newborn with a unique condition, known as “collodion baby,” is born with a rare translucent skin sheet that resembles parchment. This condition is extremely uncommon, occurring in approximately 1 out of 3,00,000 live births. Symptoms may include a collodion membrane with cracks, ectropion and eclabium. The shedding of the membrane can raise the risk of dehydration and infection