Australasian Medical Journal
Not a member yet
1482 research outputs found
Sort by
“Urgent Dental Care” – A preclinical patient case scenario as an aid to clinic preparation for treating a patient with urgent dental care needs
Get PDFBackgroundPre-clinical student competencies are usually assessed in only one specific area and not contextualized in a patient care scenario. Exposing preclinical students to a high fidelity simulated urgent care patient scenario will help the student develop critical thinking and intuitive dental treatment skills that will prepare them for actual urgent dental care (UDC) treatment in the clinic. AimsDental students, in the preclinical years, have difficulty in applying various disciplines of dentistry to an actual patient. The goal of this exercise is to contextualize several disciplines (diagnosis, material selection, oral pathology, electronic record keeping, patient interview and critical thinking) into a real patient case. The hypothesis is that providing a preclinical urgent care session in this manner will better prepare students for clinical UDC treatment.MethodsAn urgent care patient scenario was developed that integrated multiple disciplines and contextualized common urgent clinical situations that are encountered daily, focusing on interviewing skills, basic diagnostic skills, manipulation of electronic patient records, material selection and defence of selection, image and data procurement, prescription writing, critical decision making, oral medicine diagnosis, treatment planning for a focused need, and performance of dental treatment. Second year dental students are required to interview a first time (walk-in) urgent care patient to determine the chief complaint, diagnose the urgent problem (based on information obtained by interviewing the patient) and to make critical patient care decisions and self-assess their performance. Results Students generally completed the session on time and in a satisfactory fashion. Preparation for the session was key and faculty calibration was essential. ConclusionCompletion of this case scenario better prepared the students for the clinic as indicated by student self-assessment, post course satisfaction surveys, narrative comments, and faculty assessments
True ownership of traditional medicines in South Africa
No full textBackgroundLiterature postulates that traditional medicines form an important part of modern-day South African healthcare. The belief is that the traditional healer and traditional medicine is a close-knit unit, with the traditional healer as the true owner and manufacturer of traditional medicines. Various studies also postulate that the growth and development of South African traditional medicines are restricted by the pharmaceutical industries and other role players like the medical fraternity.AimsThe present study aimed to determine who holds the true ownership of traditional medicines in South Africa.Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the thinking and opinion on the true ownership of traditional medicines in South Africa. The findings are offered in narrative form.Results Many more role players are active in today’s traditional medicines manufacturing industry than merely the traditional healer and the traditional fraternity. The literature on traditional medicines fails to show the public the true meaning of traditional medicine in modern-day South Africa and to whom it really belongs. An in-depth analysis and understanding of the Regulations of the Traditional Health Practitioners Act (Act No 22, 2007), and of the definitions traditional philosophy and traditional medicines as reflected by the Act are totally missing from the literature. Such an investigation will aid in uncovering the true ownership of traditional medicines. ConclusionThere is a clear differentiation between the dominant (real) traditional medicines and the inferior pre-modern traditional products of the traditional healer. The title deed or card and transport of traditional medicine are held by various public and private institutions and other entities, not exclusively by the traditional healer fraternity
Clinical, molecular imaging and biomarker concordance in the diagnosis of Alzheimer’s disease and vascular dementia
No full textBackgroundThe CSF and plasma biomarkers may help clinicians in differentiating between Alzheimer and Vascular dementia. Apart from biopsy, FDG PET, MRI Brain and clinical examination gives a reliable diagnosis of AD and VaD.AimsTo evaluate the correlation of molecular imaging (FDG PET brain) with CSF Alzheimer profile and Plasma hemostatic biomarkers in Mild Cognitive Impairment (MCI), Alzheimer’s disease (AD) and Vascular dementia (VaD).Methods Neuropsychological assessment, MRI brain, FDG-PET brain, CSF biomarkers of AD (Aβ42 and total tau) and plasma hemostatic biomarkers (Fibrinogen and D dimer) were done for evaluation.Results FDG PET Brain, plasma fibrinogen and D dimer were done in 68 patients. CSF biomarkers were done in 46 patients. Clinical-PET discordance was found in 7 patients. One patient of MCI-VaSC had a normal PET study with elevated hemoststic biomarkers. Those with clinical diagnosis of Alzheimer’s disease either had normal hemostatic biomarkers and supporting Alzheimer profile CSF biomarkers where they were done. The discordant vascular group had elevated plasma hemostatic biomarker with normal CSF profile. Even those who were reported as FTD in PET imaging had Alzheimer profile and normal hemostatic factors.ConclusionFDG PET brain findings were concordant with the CSF biomarkers (CSF Aβ42, Total tau and Tau/Aβ42 ratio) in Alzheimer’s disease and Haemostatic biomarkers (Plasma Fibrinogen and D dimer) in vascular dementia. In clinical and molecular imaging discordance, biomarkers help in making a reliable diagnosis which favours the clinical assessment
Lifestyle of health sciences students at Majmaah University, Saudi Arabia
No full textBackgroundWe all want to live a long, happy and healthy life with an abundance of energy and vitality to perform well both mentally and physically. A healthy lifestyle is a valuable resource for reducing the incidence and impact of health problems, enabling you better to cope with life stressors, as well as improving your quality of life.AimsThe study was aimed to assess the lifestyle (eating habits and physical activity) of health sciences students studying at Majmaah University.Methods This cross-sectional institutional based study was conducted from 25th November 2014-3rd May 2015. A total of 450 students (370 males and 80 females) aged between 18–28 years were randomly chosen. Self-reported questionnaire was used for data collection from the College of Medicine, College of Applied Medical Sciences and College of Dentistry.Results Majority of the students, 62.4 per cent, were physically inactive. Students from the College of Medicine, 40.4 per cent, were the most physically active. The most common reason that restrained the students from being active was time limitation. In addition to that, many of the participants, 29.6 per cent, have never had breakfast at home. Also, most of the participants, 42.7 per cent, were not satisfied with their eating habits. Almost one quarter of students were consuming soft drinks more than four times a day.ConclusionThere is a high prevalence of sedentary lifestyle, physical inactivity and unhealthy dietary habits among health sciences students studying at Majmaah University. There is an urgent need for arranging health education programs for promoting healthy and active living among health sciences students of Majmaah University in Saudi Arabia
The lowest dose of corticosteroids, which stops the episodes of PFAPA syndrome
No full textBackgroundThe episodes of PFAPA syndrome with their exhausting periodic fever, annoying oral aphthae and sore throat, warrant treatment. Corticosteroids are the most efficacious.AimsProviding evidence that a weight-independent, minimal dose of betamethasone, the least ever used, can resolve symptoms of PFAPA syndrome, within few hours.Methods In a retrospective case-series analysis study, approved by the relevant ethical committees of Clalit Health Organization, we collected analysed and interpreted data from medical files of children who suffered from PFAPA syndrome, during 1998 until 2015, concerning the lowest effective betamethasone dose, they received and which had abated fever within few hours.Results We had diagnosed 132 children of our 2300 children community, as suffering from PFAPA syndrome (rate 6 per cent). Ninety eight per cent of the patients satisfactorily responded, within two-to-twelve hours, to treatment with a minimal one-time weight-independent dose of betamethasone in every flare. The rest of patients (2 per cent) needed an equal second dose to end their first flare during the following twelve hours. Three patients who were four to five-months-old at time of diagnosis, had received 0.1mg dose.ConclusionA dose of 0.5mg of betamethasone for children under 5 years of age and a dose of 1.0mg was prescribed for children >5, were effective for prompt resolution of PFAPA flares. We believe that as long as there is an effective lowest dose for treating PFAPA episodes, a great reduction of corticosteroid consumption will be exercisable globally
Is warfarin usage a risk factor for osteoporotic fractures? A cohort study in the emergency department
Get PDFBackgroundSeveral studies have examined the association between warfarin sodium use and risk of osteoporotic fractures with conflicting results. Our study addresses this question, for the first time regarding patients attending emergency department (ED).AimsThe aim of this study was to retrospectively detect whether there is higher rate of usage of warfarin sodium in patients with osteoporotic fractures attending an ED.Methods This is a retrospective study from patients' computerized charts. All individuals >65 years old who had an osteoporotic fracture and attended an ED in a tertiary hospital were compared with a similar group of elderly individuals >65 years old without an osteoporotic fracture who attended the ED for a cause other than an osteoporotic fracture.Results This study included 328 patients who were evaluated in the years 2005¬–2016. Overall, 164 individuals with a typical osteoporotic fracture (hip -66 patients (40 per cent), spine- 92 patients (56 per cent), humerus -4 patients (2 per cent), radius -13 patients (8 per cent)) were identified and compared with a matched group of elderly individuals who were evaluated in the ED for other complaints. Warfarin sodium was used in 61 individuals (19 per cent) in the entire cohort, 34 in the fracture group and 27 in the non-fracture group (p=0.324).ConclusionIn elderly patients, attending an ED, warfarin sodium use does not seem to be a risk factor for an osteoporotic fracture
Salivary gland scintigraphy with partial volume effects quantification: A phantom feasibility study
Get PDFBackgroundSalivary gland scintigraphy gives functional information on irradiated glands. Upon irradiation, their size may become less than 2–3 times the resolution of the gamma camera hence underestimation of the regional distribution of administered activity due to partial volume effects (PVEs) which hinder accurate quantification of their function. AimTo accurately quantify planar images of spheres mimicking irradiated parotid and submandibular glands with view of implementing salivary gland scintigraphy that involves quantification of PVEs.MethodsA hollow head and neck phantom was fitted with spheres (diameters: 20mm; 14mm; 12mm and 10mm) filled with technetium-99m solution of activity concentration of 300kBq/mL. The spheres mimicked irradiated parotid glands (right (RP) and left (LP)) and submandibular glands (right (RSM) and left (LSM)) respectively. The phantom was filled with technetium-99m solution of activity concentration 144kBq/mL.1 A planar image was acquired in 5 minutes using Siemens E-Cam dual head gamma camera detector positioned 5cm vertically above the phantom, on 128×128 matrix size following a thyroid protocol. The detector was fitted with low energy high resolution collimators. ImageJ software was used for quantification. ResultsThe image counts post PVEs quantification were: LP=252,690; LP=160,836; RSM=149,315; LSM=68,292. The percentage quantification errors were: 44 per cent, 48 per cent, 51 per cent and 75 per cent for the LP, RP, RSM and LSM glands respectively.ConclusionImageJ software improved quantitative accuracy of sphere images hence it provides a robust quantification tool for irradiated salivary glands
Elective freeze-all embryos: What is the scientific evidence?
Get PDFBackgroundWith the advancement in cryopreservation techniques, studies on freezing all survived embryos and frozen-thawed embryo transfer (FTET) in the next cycle have been conducted in assisted reproduction. AimTo review the theoretical backgrounds and clinical outcomes of freeze all embryos, followed by FTET, compared with conventional fresh embryo transfer (FET), and suggest future research direction for policy on this issue.MethodsA through literature search comparing clinical outcomes of FTET and FET was conducted in PubMed. The following keywords were used: ‘frozen-thawed embryo transfer’, ‘fresh embryo transfer’, ‘cryopreserved-thawed embryo transfer’, ‘freeze all policy’ from their inceptions through July 2017.ResultsClinical researches conducted before 2013 indicated better in vitro fertilization (IVF) results as well as obstetric and perinatal outcomes with FTET than with FET. However, the 2017 Cochrane systemic review including more recent studies showed no difference in the cumulative live birth rate per woman between the two methods. FTET was associated with fewer miscarriages and a higher birth weight of singleton babies, but also with an increased rate of pregnancy complications such as preeclampsia.Conclusions While theoretical evidence of FTET after electively freezing all embryos has been suggested to have good outcomes through basic and clinical research, more high-quality randomized clinical trial results with the same primary outcomes under the well-controlled conditions are needed in the future for the generalization of the elective freeze-all method
HeberFERON, formulation based on IFNs alpha2b and gamma for the treatment of non-melanoma skin cancer
No full textBackgroundSurgery remains the procedure of election for the treatment of non-melanoma skin cancer (NMSC). However, after recurrence, or under surgical complex scenarios, other therapeutic modalities have to be indicated. Immune suppression is associated to NMSC; thus, immunotherapy is a rational approach to treat the high spread form of skin tumour.AimsWe propose a summary of the most relevant clinical results with the combination of IFNs alpha2b and gamma in the treatment of non-melanoma skin cancer.Methods In several clinical trials (Open prospective trial; phase 2 double-blind randomized studies: InCarbacel-II and InCarbacel-III; retrospective study and ongoing phase IV trial, InCarbacel-IV) more than 200 patients with histological diagnostic of non-melanoma skin cancer were recruited to be treated with the combination of IFNs in Cuban health institutions at primary, secondary or tertiary care levels. All the studies were approved by institutional ethic committees and all the patients given their written informed consent. HeberFERON was administered, peri- or intralesionally, three times per week, during 3 weeks. Clinical and histological responses were evaluated by RECIST (1.0), three months after the end of treatment.Results HeberFERON promoted more rapid and higher number of CRs than separated IFNs (InCarbacel-II study). The open-label prospective study showed 46.7 per cent CR in locally advanced BCC after application of HeberFERON. Patients with periocular BCC or SCSC received benefits from HeberFERON treatment (71.4 per cent OR). Overall, HeberFERON has been administered to patients with non-melanoma skin cancer obtaining a 65 per cent of histological CR together with an excellent safety profile.ConclusionHeberFERON is a novel, non-surgical, effective and safe option to treat advanced, high risk or recurrent non-melanoma skin cancer
An unusual case of neonatal mastocytoma
Get PDFMastocytosis is a group of disorders characterized by the accumulation of mast cells in various tissues. In this article we report an interesting case of cutaneous mastocytoma in a 3-month-old infant. We describe two episodes characterized by an exacerbation of the skin lesion with the typical Darier’s sign. Both of them occurred after breastfeeding. In both episodes, the mother had eaten shrimps before the breastfeeding. This peculiar case, difficult to understand regarding its pathogenesis, was successful resolved just with dietary prescription given to the breast feeding mother