Australasian Medical Journal
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Epidemiological study of fatal road traffic accidents in Ecuador
No full textBackgroundTraffic accidents represent a priority for public health since they are responsible for high mortality tolls, elevated economic costs and a significant social impact. Ecuador ranks as the seventh country in the World with a higher mortality rate.AimsTo describe the main epidemiologic characteristics of deaths caused by traffic accidents from a time and space perspective.Methods Transversal and descriptive study was conducted using the data from National Transit Agency. The data includes all deaths due to traffic accidents in Ecuador registered from January to December 2016. An analysis of percentages and frequencies of the traffic accident fatalities was performed based on demographic, temporal and geographic components. In addition, Gross Mortality Rates (x100,000) and adjusted (x1,000) per province were calculated.ResultsFrom 1,976 fatalities registered in Ecuador in 2016, 81.1 per cent corresponded to men and 18 per cent to women. Mortality Rate resulted as 13.6 per 100,000 inhabitants. With respect to men, the major portion of deaths correspond to drivers (52.1 per cent), when as for women, it correspond to passengers (51 per cent). Saturdays (21 per cent) and Sundays (23.1 per cent) correspond to the days with greater percentage of deaths. The incidence was greater in highways of Guayas (23.3 per cent) and Pichincha (17.1 per cent). Selected by type, cause and implicated vehicles, the accidents that outstand are frontal side collision (28.5 per cent) and pedestrian-motor vehicle collision (22.6 per cent), in addition to traffic law violations (46.9 per cent) and motorcycle incidents (29.55) respectively.ConclusionThe current study provides us, for the first time, a global perspective of the epidemiologic characteristics of fatal car accidents in Ecuador, contributing with better information for the design of national road safety regulations
Knowledge and attitudes toward HPV vaccination among healthcare givers: First multicentre survey in Malaysia
No full textBackgroundCervical cancer is an important public health concern worldwide, and in both developed and developing countries. In Malaysia, cervical cancer is the second most common cancer in women after breast cancer and colorectal cancer. The relation between cervical cancer and oncogenic human papillomavirus (HPV) infection has been well-established and it has been reported that almost all cervical cancers are correlated to oncogenic HPV DNA. Worldwide around 70 per cent of cervical cancer cases are caused by HPV type 16 and HPV type 18 and responsible for 90 per cent of penile and anal cancer in men. However, HPV type 6 and 11 cause over 90 per cent of genital warts in both men and women.AimsThe objective was to assess the knowledge and attitude level among health givers and to compare among the groups.Methods This was a cross-sectional multi-centre study. Simple random sampling was adopted to collect the data. A questionnaire has been developed and it was pretested. Medical doctors and nurses of Malaysian health service were the study population. The data was evaluated with the necessary statistical tests as applicable. P-values < 0.05 was considered statistically significant. Results Total participants of this study were 629. They mainly doctor and nurses. The average age was 31.68±7.20 years. Regarding HPV vaccination, their mean knowledge and attitude scores (SD) were 13.32±2.30 and 9.38±1.45 respectively.ConclusionMedical doctors have statistically significantly higher knowledge and attitude scores than paramedical staff. Knowledge level was statistically significantly correlated with attitude. More in-depth prospection interventional research has been advocated to safeguard the Malaysian population from the atrocities of cervical cancer
Micronutrients in Chilean Inflammatory Bowel disease patients: Cross sectional study
No full textBackgroundInflammatory Bowel Disease (IBD) patients often present with nutritional disorders that affect both macronutrient and micronutrient levels. Vitamin and mineral deficiencies are typically more frequent in Crohn's disease (CD) patients than other IBD patients. However, some studies have shown that these deficiencies can also be present in ulcerative colitis (UC) patients, even in those in remission.AimsTo describe the prevalence of micronutrient deficiencies in patients diagnosed with IBD and to correlate these micronutrient deficiencies with demographic, clinical and disease characteristics.Methods A cross-sectional study of patients in the IBD program who were 18 years and older was completed. Clinical characteristics and disease activity indexes were assessed. Body Mass Index (BMI), haematocrit, serum albumin, serum iron profile, serum 25(OH) D, vitamin B12, folate, zinc and copper were measured.Results Ninety-one patients with IBD were included: 46 patients (50.5 per cent) with UC and 45 patients (49.5 per cent) with CD. At least one micronutrient deficiency was found in 39.5 per cent of patients, 35.1 per cent had two deficiencies, and 12 per cent had three or more deficiencies. Iron, zinc, copper, and vitamin B12 deficiencies were found in 33 per cent, 22 per cent, 11 per cent and 10 per cent of patients, respectively. No folate deficiencies were found. Low levels of serum 25(OH) D were detected in 76 per cent of patients. The mean BMI was 24.3 (SD 3.4), and the mean serum albumin level was 4.0g/l (SD 0.4).ConclusionMicronutrient deficiencies were frequent in our study cohort and did not correlate with macronutrient status. Measurement of macronutrients and micronutrients should become a routine assessment in IBD patients to improve patient care and to avoid negative repercussions on disease activity
Consumption of herbal products: a study of urban community survey
No full textBackgroundFormulation of herbs into dosage forms promotes their marketing and usage. However, if these herbal products are being taken in an unhealthy trend, they may pose risks to consumers.AimsThe present study aimed to investigate herbal product consumption trends (n=550) among adults in the main cities of Malaysia.Methods A questionnaire-based, six-week cross-sectional study was conducted. Respondents were randomly selected in Shah Alam, Klang, Subang, and Kuala Lumpur. Descriptive statistics were used for data analysis and Chi-square test was applied where appropriate. Results Out of the 550 survey instruments distributed, 453(82.4 per cent) responded. The prevalence rate of herbal products use among the adult population in the past 12 months was 71.5 per cent. Regarding the consumption profile; the consumers were mostly female (73.4 per cent), age 25–44 (72.8), and educated at tertiary level (74.8 per cent). The majority of respondents perceived that herbal products helped reduce severity of illness and improve health related quality of life, while (16.4 per cent) consumed the herbal products for the treatment of menstrual problem, 71.7 per cent without the recommendation of health care professionals and 85.0 per cent of them purchased through over-the-counter retail sales. The herbal products most commonly consume were Labisia pumila (Kacip Fatimah) (32.4 per cent), Camellia sinensis (Green Tea) (32.1 per cent), Panax ginseng (Ginseng) (23.8 per cent), and Eurycoma longifolia (Tongkat Ali) (22.5 per cent).ConclusionThis study highlights an unhealthy trend in self-prescription of herbal product consumption without healthcare professionals’ recommendation. Hence, there is an urgent need for healthcare professionals to monitor herbal product consumption
Inhibition of cryoglobulin synthesis as an effective method of positive influence on spermogram indices
Get PDFBackgroundClinical signs of cryoglobulinemia syndrome depend on localization of affected vessels, and vascular pathology is a frequent cause of sexual disorders. Thus, the article presents correlation between cryoglobulinemia and spermatogenesis impairment.AimsThe aim of our investigation was to study reference between cryoglobulinemia and spermatogenesis impairment. The method of intradermal autoleukocyte immunization was used for inhibition of cryoglobulin synthesis.Methods The research involved patients with idiopathic oligoasthenoteratozoospermia and various severe forms of infertility, when cryoglobulinemia of the 2nd and 3rd types was detected. Leukocytes for immunization were isolated from plasma of a patient’s heparinized venous blood by centrifuging at 400g for 8 minutes, after that the residue was resuspended in 1–1.5ml of own blood serum and injected intradermally in 0.1ml dose into the back. Spermogram indices were compared before and in 10–15 days after immunization. Results In most patients (75.0 per cent) with idiopathic oligoasthenoteratozoospermia and cryoglobulinemia, spermogram indices completely returned to norm due to inhibition of cryoglobulin synthesis. In men with severe forms of infertility, elimination of cryoglobulins also had a positive impact on spermatogenesis (100 per cent), which resulted in normalization of spermogram indices and improved the conditions for assisted reproductive technologies.ConclusionThe results of investigation indicate that a considerable reduction of cryoglobulinemia has a positive impact on spermatogenesis. Therefore, it is expedient to include the method for detection of cryoglobulins into methodical recommendations/instructions for examination of patients with impairment of male fertility. Immunization with own leukocytes is recommended for inhibition of cryoglobulin synthesis
Protocol for differentiated thyroid cancer management
Get PDFBackgroundEffective screening procedures and advances in medical imaging technologies have seen increased detection of the differentiated thyroid cancers (DTC). However, management of DTC patients still remains controversial owing to differences in opinion on the extent of surgery (thyroid lobectomy or total thyroidectomy) and the need of radioiodine ablation (RIA) post-surgery. AimThis study was aimed to establish a local protocol for DTC management at Dr George Mukhari Academic Hospital (DGMAH). The protocol emphasizes on multidisciplinary management whereby, the nuclear medicine physicians, endocrinologists and surgeons decide on the extent of thyroid resection. The protocol emphasizes on total thyroidectomy for all DTC patients since it reduces morbidity and also optimizes the management of patients for further radioiodine treatment.Methods A search of scholar articles for various protocols on management of DTC was conducted using Google search engine, Science Direct and Medline. Abstracts and full texts were reviewed. Results The proposed local protocol for DGMAH emphasizes on a multidisciplinary management approach for DTC patients. Furthermore, only patients who have undergone total thyroidectomy should be managed with radioiodine.ConclusionTotal thyroidectomy reduces morbidity and also optimizes the management of patient for further radioiodine treatment
Health behaviors affecting academic performance among university students in Riyadh, Saudi Arabia: KSU female students as an example
Get PDFAimsTo determine whether there is an effect of healthy behaviours (diet, physical activity, sleep pattern and coping with stress strategies) on academic performance among King Saud University (KSU) female students who study in different academic fields.Methods A self-administered questionnaire was distributed among 14342 female students aged from 18-25 from different colleges fields, these colleges are Medical Colleges, Sciences Colleges and Humanities Colleges. We distributed the questionnaires through the students’ official emails and only 310 students who completed them.Results The study results show, there was a very weak, positive monotonic correlation between GPA and family income (rs=0.105, n=310, p > 0.001) while, there was a very weak, negative monotonic correlation between GPA and the number of family members, marital status, and with whom they live (p < 0.001). Regarding the health behaviours; Physical activity seems to be related to academic performance among students of sciences colleges (X2=174.34, and p < 0.001) while, sleep pattern and stress are related to academic performance for medical students, (X2=297.470, X2=120.7 respectively and p < 0.001).ConclusionThe medical students are the most affected group by the health behaviours where sleep pattern and cope with stress are found to be the most health behaviours affecting their academic performance
Effectiveness of two kind of medicine on non-obstructive azoospermia
Get PDFObjectiveTo assess the effectiveness of medicine on non-obstructive azoospermia (NOA). Cases32 male patients were enrolled from March 2012 to March 2016, with age range of 23–41 years old and infertility time of 1–3 years.Methods According to “WHO Human Semen Detection and Processing Experiment Manual";;;;;; fifth edition, semen routine was based on manual detection and serum hormones based on chemiluminescence detection, semen volume, sperm density, forward moving sperm ratio. If sperm was detected in semen for more than two consecutive times, the treatment was considered effective and was included into the statistical analysis. The detection parameters took the first test data and the last test data. Treatment Andriol and tamoxifen were used for idiopathic NOA while aescuven forte and aspirin used for NOA with varicocele (including two varicocelectomy). The time was four months.ResultsOf the 32 patients, 13 underwent testicular biopsy, pathological results showed six patients (46 per cent) with hypospermatogenesis, five patients (39 per cent) with maturation arrest, and two patients (15 per cent) with sertoli cell syndrome. Nine patients (28 per cent) had varicocele; two patients (6 per cent) underwent surgical treatment. After treatment, sperm was detected in 20 patients (63 per cent), seven of them (22 per cent) had detectable sperm in semen after one month of treatment; five (19 per cent) had sperm after two months of treatment; eight (25 per cent) had sperm after three months of treatment. Among the 23 patients with idiopathic azoospermia, 13 patients had detectable sperm in semen after treatment (56 per cent). The level of hormone gradually increased in 15 patients, rapidly increased in four patients, but four patients had no obvious change of hormone level. Among the nine patients with varicocele, three persons (including one patient undergoing surgery) had normal sperm density after 3–4 months of treatment, continuing the treatment for another 2–3 months, wife of the patients gained pregnancies. After treatment, seven patients had gradually decreasing serum level of FSH, LH and T while two patients had increased serum level of hormones. Excluding the three pregnancy patients, it was showed that the sperm density increased (t=-3.342, p=0.004) after treatment, so did the forward moving sperm ratio (t=-4.037, p=0.001), but semen volume had no significant changes (t=-1.698, p=0.109). ConclusionThe treatment of varococele is important for the NOA with varicocele while andriol and tamoxifen is other method for the treatment of idiopathic NOA
Studying the effect of medial open wedge high tibial osteotomy on the posterior slope of tibia among patients with Genu varum
Get PDFBackgroundA slight change in the posterior slope of tibia results in complications such as limited movement of knee joint and higher risks of Osteoarthritis.AimsThe present research seeks to study levels of tibia’s posterior slope change and limited movement of knee joint and knee stability following medial open wedge osteotomy used to treat patients with genu varum.Methods The present research is a clinical trial conducted in the form of a before and after study on patients with genu varum resorting to Imam Reza (PBUH), Khanevade, and Fajr hospitals from 2009 to 2012. As many as 40 knees (32 patients) were studied and the posterior slope of tibia before and after medial open wedge high tibial osteotomy was measured by someone totally unaware of the research using true lateral radiography. Movement limitation and stability of the knee was measured before and after the operation using scope of motion and Lachman and Drawer test. Paired sample test was used in this research and SPSS was used to analyse the data.Results The average posterior slope of tibia before the operation was 9.912, while this value changed to 11.625 after the operation signifying a significant increase. In terms of limited knee joint movement, 7 patients were diagnosed with grade 5 Extension LAG after operation, while the remaining 33 patients had a normal motion range (Extension LAG=0).ConclusionMedial open wedge osteotomy above tibia can help increase the posterior slope of tibia
Impact of case-based radiology education on first-year medical students knowledge, perceptions, and interests in the field of radiology
No full textMedical training institutions utilize a variety of approaches to present specialty educational material such as radiology. Typically, this material is introduced during the latter years of medical school and includes interactive modules, individual contexts, and case-based learning. This is a quasi-experimental study designed to evaluate the effectiveness of case-based radiology education presented to first-year medical students. Pre- and post-surveys were administered to measure changes in knowledge, perceptions of, and career interest in radiology. The results suggest that the use of case-based learning may improve medical students’ perceived knowledge of radiology and perceived importance of radiologists in the patient care process