Australasian Medical Journal
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Definitive treatment of a basal cell carcinoma on the upper lip through the oral administration of Vismodegib
Get PDFBasal cell carcinoma is the most common malignant neoplasm of the skin of the face in old, caucasian humans. The tumour growth slow and rarely has metastases. The clinical presentation is different. The main method for treating is radical surgical excision, but if the tumour is very big or there are metastases, there is a very effective target therapy with the peroral capsules Vismodegib 150mg. In this case we introduce a patient whit cancer of upper lip of preoperative target therapy whit Vismodegib 150mg, which destroy the tumour cells and help us to make cosmetic surgical excision
Bilateral ankyloblepharon filiforme adnatum associated with cardiac defects
Get PDFAnkyloblepharon filiforme adnatum (AFA) is a rare congenital anomaly and its presentation always indicates the possibility of other important anomalies. AFA is classified into four subgroups based on the associated abnormalities. Here we report a case of AFA associated with cardiac defects happened to a vitro fertilization (IVF) female baby whose mother is elderly parturient (more than 43- year-old), and the baby was treated one day after birth
Pituicytoma. Case report and literature review
Get PDFPituicytoma is a rare glial tumour located in the sellar and/or suprasellar region of the brain, it originates from pituicytes, and they were included in the World Health Organization (WHO) Classification of Central Nervous System Tumours in 2017. As mentioned above it originates from pituicytes cells in the posterior pituitary near the infundibulum. Histological characteristics permits classification and identification among other central nervous system tumours localized in the posterior pituitary or infundibulum. WHO classification describes them as grades such as grade I tumour which has a differentiated structure composed of spindle-shaped cells presumably derived from pituicytes. We report the case of a 37-year-old woman who developed a suprasellar tumour and that it was discovered following a past medical history of amenorrhoea and migraines. Once the lesion was detected in images, the patient rejected surgical treatment even when she developed galactorrhea and preferred medical treatment with cabergoline. However, two years later she developed visual defects due to increase in size by that time accepting surgical treatment. A review of the literature including most common clinical and radiological features of this entity as well as treatment protocols proposed are discussed
Sinus histiocytosis with massive lymphadenopathy, (Rosai-Dorfman Disease) with cholastatic jaundice in an HIV positive patient
Get PDFIntroductionSinus histiocytosis with massive lymphadenopathy is a rare histiocytic disease first described by Rosai and Dorfman in 1969. The typical presentation is that of cervical and often widespread painless lymphadenopathy.Case reportWe present a 33-year-old gentleman, with one-month history of pruritus, abdominal pain, jaundice and dark urine, jaundice, scratch marks, large inguinal lymph nodes, an enlarged liver and spleen. CT scan confirmed ultrasound findings and suggested that splenic lesions were micro-abscesses. Biopsy of the lymph nodes revealed features in keeping with sinus histiocytosis with dermatophatic lymphadenopathy.DiscussionThis is our second case of sinus histiocytosis in two years
Pulmonary rehabilitation in moderate pulmonary hypertension
Get PDFIntroductionPulmonary Rehabilitation has been used in Chronic Obstructive Pulmonary Disease, becoming an essential strategy in its treatment; however, in pathologies such as Pulmonary Hypertension, the benefits in the quality of life and tolerance to the effort are still discussed. Therefore, the aim of this case report is to evaluate the effect of an integral pulmonary rehabilitation intervention in a patient with moderate pulmonary hypertension secondary to respiratory disease.Case detailsA patient with moderate pulmonary hypertension secondary to lung disease, who attended an integral pulmonary rehabilitation program during 8 weeks of muscle training, aerobic exercise, breathing exercises, individualized education and psychological/ nutritional counselling were performed.ResultsSignificant improvement in tolerance to effort, reduction of symptoms and health-related quality of life after the intervention was achieved.ConclusionPulmonary rehabilitation in moderate pulmonary hypertension generated beneficial changes in terms of symptoms and functionality in the patient reported
The effectiveness of trauma-focused cognitive-behavioural therapy in the treatment of depression of divorced women
Get PDFBackgroundDivorce and disintegration of the family centre is a social problem having consequences considered as the main problems of current societies.AimsTherefore, the aim of this study was to determine the effectiveness of trauma-based cognitive-behavioural therapy in the treatment of depressed divorced women.MethodsThe experimental method was a pretest-posttest design control group with a three-month follow up. The statistical population of this study was a total of 103 women who referred to Mehravar Consulting Centre and Psychotherapy Centre in Tehran. After the initial stages of evaluation, 77 divorced women had the highest mean score in Beck Depression Inventory and 30 were selected and randomly divided into two groups of experimental (15 women), and control (15 women). The experimental group received weekly group intervention in 8 sessions of 90 minutes. Data were analysed using repeated measure ANOVA.ResultsThe findings showed a significant difference between the performance of the two experimental and control groups in depression (F=22.23, p=0.001) in the post-test and after three months of follow-up.ConclusionThe results indicated that trauma-based cognitive-behavioural therapy reduced depression symptoms in divorced women. Therefore, it is recommended to use this therapeutic approach to improve reconciliation, interpersonal relationships, and the promotion of quality of life after divorce in divorced women
Interns’ knowledge of, and attitudes and practices towards malnutrition and hydration
Get PDFBackgroundMalnutrition and inappropriate hydration can result in adverse clinical consequences for patients in acute tertiary-care hospitals. Interns have an important role in ensuring optimal patient nutrition and hydration care.AimsTo determine the knowledge of, and attitudes and practices towards, the assessment and management of malnutrition and hydration of interns working in an Australian acute tertiary-care hospital.MethodsEighty-four interns completed a purpose-designed questionnaire.ResultsThe mean percentage of correct responses for knowledge questions was 53.4 per cent for malnutrition and 56.0 per cent for hydration. Most participants did not undertake assessment of nutritional status as part of their medical examination (n=55 [65 per cent]) whereas the majority did assess hydration status (n=78 [92 per cent]). A minority believed they had adequate knowledge to identify patients at risk of malnutrition (n=14 [16 per cent]) or manage a patient with malnutrition (n=13 [15 per cent]) whereas a majority believed they had adequate knowledge to manage patient hydration (n=61 [72 per cent]). The majority of participants indicated that further training on malnutrition (n=76 [90 per cent]) and hydration (n=74 [88 per cent]) would be beneficial.ConclusionParticipants demonstrated poor knowledge of the core principles of malnutrition and hydration and acknowledged the need for further education. Given the detrimental impact of malnutrition and inappropriate fluid management on patient outcomes and healthcare costs, medical schools and hospitals need to collaborate and explore effective education strategies for interns
Screening of attention deficit hyperactivity disorder in children aged 3 to 6 years and 11 month olds
Get PDFBackgroundADHD (Attention deficit hyperactivity disorder) is a multifactorial disorder, defined by hyperactivity, impulsivity and attention deficits. Symptoms of ADHD begins during early childhood and negatively affects functionality at various levels.AimsThis descriptive and cross-sectional study was conducted in 2016 to screen for Attention Deficit Hyperactivity Disorder in children aged 3 to 6 years, 11 months olds of Tabriz in Iran.MethodsA total of 737 children aged 36 months to 6 years, 11 months in Tabriz were randomly selected from kindergarten and preschool centres. Both the Conners Early Childhood-Parent and -Teacher forms were used to estimate the prevalence of ADHD.ResultsThe results indicated that the prevalence of ADHD was 337 (45.7 per cent) based on Conners EC-Parent, 416 (56.4 per cent) according to Conners EC-Teacher, and 225 (30.5 per cent) based on the both Conners EC-Teacher & Parent scales. The results of Fischer's exact test showed that the prevalence of ADHD in boys (n=117, 35.3 per cent) was significantly higher than that of the girls (n=108, 26.6 per cent) (p=0.01, X2=6.57). The results of Chi-square test indicated that there was no difference among different age groups in terms of the prevalence of ADHD (X2=2.86, p=0.41).ConclusionADHD screening based on the Conners EC-Teacher & Parent forms was estimated to be 30.5 per cent. The regional prevalence of ADHD appears to be greater among children under the age of 7, although the use of the new Conners EC tool in this study could have possibly affected the ADHD prevalence estimates
Lid abscess: An unusual presentation of melioidosis
Get PDFMelioidosis caused by Burkholderia pseudomallei (B. pseudomallei), is an emerging infection in India. Clinical manifestation of melioidosis is variable ranging from localized benign infection to fulminant septicemia. Ocular presentation of melioidosis is rare. However, cases of endophthalmitis, keratitis and orbital infections have been reported. We report the isolation of B. pseudomallei in a 40 year old male, presenting with fever and lid abscess. The patient was treated with meropenem during the acute phase and switched to trimethoprim/sulfamethoxazole for eradication phase
Make learning fun to increase nursing students’ success: Formative feedback in communication learning
No full textBackgroundCommunication skills are taught in most Bachelor of Nursing programs; however, student performance is often not monitored or tested until the final exam. Audience Response System (ARS) technology enables the collection of feedback from students during lectures to improve their quality of learning.AimsWe assessed the efficacy of ARS technology in promoting the understanding of communication skills among nursing students.Methods Questions were integrated into 14 lectures using the ARS platform Learning Catalytics (LC; Pearson UK, London, UK). Students answered the questions using their own web-enabled mobile devices. One hundred and twenty second-year nursing students participated in this study. Their answers were pooled and prompt formative feedback was provided in the classroom. A questionnaire was distributed to evaluate their perceptions of ARS use.Results All students reported that they enjoyed ARS use: 92 per cent stated that it helped to identify their learning needs and 87 per cent agreed that it promoted the integration of key concepts. The most common theme within the feedback was that of identifying their own learning needs. Repeated questioning produced a significant increase (p < 0.05) in students’ knowledge of specific concepts.ConclusionThe use of ARS technology to provide prompt feedback promoted teaching and learning among undergraduate nursing students. ARS use enabled the identification of individual learning needs and aided revision before summative exams. It also improved students’ confidence and understanding of key concepts. Moreover, students of different educational levels and learning styles were identified, tracked and given support through the use of ARS technology