Australasian Medical Journal
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A case of home care on an 103-year-old patient with Alzheimer's disease complicated with stage Ⅲ pressure ulcer
No full textThis paper reported a case of home care for a 103-year-old AD patient with stage III pressure ulcers. After ten weeks of professional home care, including the guidance for caregivers, such as posture putting, wound decompression, nutritional support, clinical nurse specialist come to home to give wound assessment and care, the ulcer was eventually healed. It is suggested that for the senior AD patients, intelligent auxiliary equipment can be introduced into the family in the future, it can help reduce the pressure of the affected side, reduce the burden on caregivers, meanwhile, wound specialist nurses came to the caregiver to give systemic instructions, prevent the occurrence and development of pressure ulcers
Asymmetrical Achilles tendon ossification and rare rear heel pain
No full textAchilles tendon ossification is not a frequent association of posterior heel pain in pain physicians’ daily practice. The condition has been reportedly common following rear heel trauma (repetitive heel stress injury), surgery (club foot surgery); however, some endocrino-metabolic, haematological disorders can also contribute to Achilles tendon ossification. Shape of ossified tendon mass varies from discrete (single/multiple) to extensive variety; and as per literature review, in bilateral cases they are alike. To be intriguing, here in this write-up, we demonstrate asymmetrical (in terms of clinical features and radio-imaging findings), bilateral Achilles tendon ossification in a 70-year-old retired farmer, first time in literature
Hypothyroidism in a 45, X phenotypic male with a Y/18 translocation
No full textThis is the first case report of a 45, X male with autoimmune thyroid disease. Chromosome analysis revealed that all cells were 45, X without chromosome Y. The entire short arm and the centromere of Y chromosome were translocated onto the short arm of chromosome 18. Fluorescence in situ hybridization revealed that the SRY gene was present in all cells. At the age of 3 years he was diagnosed with hypothyroidism, and treatment was initiated. In the rare event of 45, X karyotype in a male, hypothyroidism should be considered so that early treatment could be initiated
Quality of Life of Patients with Hypertension and Treatment Compliance
No full textBackgroundThe research was held within the framework of the program “Correction of the components of the metabolic syndrome by the method of biofeedback”. MethodThe study involved 90 patients, specifically 33 men and 57 women with Stages 1–3 hypertension as well as 25 healthy persons who live in various districts of Karaganda and are monitored on outpatient basis. We used analysis of variance, namely Fisher’s exact test, to gauge statistically significant differences in quality of life between the groups of treatment. ResultsThe results of survey using questionnaire SF-36 showed that while hypertension leads to the statistically significant reduction of all components of quality of life, three of the components - PF; RP and BP - are statistically significantly reduced in case of patient's low or no compliance with treatment. ConclusionThe research suggests that antihypertensive therapy as a whole is noted for a low level of compliance. This, in turn, leads to insufficient control of arterial hypertension and results in a decrease in quality of life
Are there 200,000 and more traditional healers practicing in South Africa?
No full textBackgroundThe promulgation of the Traditional Health Practitioners Act No 22 (2007) was guided to a great extent by the allegation that there were 200,000 and more traditional healers practicing in South Africa. This number had also reflected a great demand for their services. Regulation was thus in the early 2000s an immediate need to safeguard the public against malpractice of these practitioners.AimsThe aim of this study is to determine if the allegation that there are 200,000 and more traditional healers practicing in South Africa is true.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 opinions around the numbers of traditional health practitioners in South Africa. Findings are represented in narrative form.Results The Traditional Health Practitioners Act No 22 (2007) was promulgated without applicable and appropriate needs analysis of traditional healers as healthcare practitioners by the public. The true number of traditional healers, to make it a viable and sustainable healthcare profession in South Africa, was never determined. The alleged number of 200,000 and more traditional healers was the untested motivator for the promulgation of the Act in 2007.ConclusionThe allegation that there are 200,000 and more traditional healers practicing in South Africa could not be confirmed.The true number of bona fide traditional healers in present-day South Africa seems insignificant.It is of great importance that the official registration process of the South African traditional health practitioners is fully activated in 2017. Only then will clearance on the real number of traditional healers practicing in the country be obtained and can constructive decisions on the group’s future be taken
So much aDo the majority of South Africans regularly consult traditional healers?s 80% of South Africans regularly consult traditional healers: a true story?
No full textBackgroundThe statutory recognition of traditional healers as healthcare practitioners in South Africa in terms of the Traditional Health Practitioners Act 22 of 2007 is based on various assumptions, opinions and generalizations. One of the prominent views is that the majority of South Africans regularly consult traditional healers. It even has been alleged that this number can be as high as 80 per cent of the South African population. For medical doctors and other health practitioners registered with the Health Professions Council of South Africa (HPCSA), this new statutory status of traditional health practitioners, means the required presence of not only a healthcare competitor that can overstock the healthcare market with service lending, medical claims and healthcare costs, but also a competitor prone to malpractice.AimsThe study aimed to determine if the majority of South Africans regularly consult traditional healers.Methods This is an exploratory and descriptive study following the modern historical approach of investigation and literature review. The emphasis is on using current documentation like articles, books and newspapers, as primary sources to determine if the majority of South Africans regularly consult traditional healers. The findings are offered in narrative form.Results It is clear that there is no trustworthy statistics on the percentages of South Africans using traditional healers. A scientific survey is needed to determine the extent to which traditional healers are consulted. This will only be possible after the Traditional Health Practitioners Act No 22 has been fully enacted and traditional health practitioners have become fully active in the healthcare sector.ConclusionIn poorer, rural areas no more than 11.2 per cent of the South African population regularly consult traditional healers, while the figure for the total population seems to be no more than 1.4 per cent. The argument that the majority of South Africans regularly consult traditional healers is unsubstantiated
Unguided bronchoscopic biopsy: Does yield increase with operator experience
Get PDFBackgroundBronchoscopic Forceps biopsy (Endobronchial Biopsy (EBB) and Trans Bronchial Lung Biopsy (TBLB)) are commonly performed for diagnosis in patients with endobronchial abnormalities or diffuse parenchymal involvement. As the operator gains experience his yield of various diagnostic bronchoscopic biopsies is expected to increase, however, no studies on the subject are available in literature.AimsTo determine the effect of on- job experience on the yield of unguided bronchoscopic biopsies.Methods A total of 244 bronchoscopies were performed between Oct 2013 and Oct 2016. A retrospective analysis of all these bronchoscopies was undertaken. All patients who underwent biopsy were included in the study. Patients were divided into two groups with first group (Group A) comprising of biopsies done between Oct 2013 to Apr 2015 and second group comprising biopsies done between May 2015 to Oct 2016 (Group B). The diagnostic yield in two groups was compared.Results Total 71 bronchoscopic biopsies were performed during Oct 2013 to Oct 2016. 36 patients were included in group A and 35 patients were included in group B. The groups were matched in demographic profile, clinical diagnosis, bronchoscopic findings and type of biopsy undertaken. The biopsy was diagnostic in 31 patient (43.6 per cent) and non-diagnostic in 33 patients (46.4 per cent). There were 15 diagnostic biopsies in group A and 16 diagnostic biopsies in group B. The difference in the diagnostic biopsies between the two groups was not significant.ConclusionThere was no significant impact of on job experience on diagnostic yield of biopsies. This may be due to adequate exposure during training leading to a diagnostic plateau being reached
Thoracic mobilisation and periscapular soft tissue manipulations in the management of chronic Prolapsed Intervertebral Disc
Get PDFBackgroundThe most common cause of CLBP is discogenic lower back pain. Researches haveshown that connective tissue remodelling occurs in CLBP and thoracic spinal mobility and thoracolumbar mobility have higher correlations with LBP.AimsTo see the effect of upper back fascia and periscapular muscles stretching and thoracic mobilisation to reduce symptoms in subjects with CLBP due to lumbar disk herniation.Methods A total of 40 subjects with CLBP due to Prolapsed Intervertebral Disc (PIVD) were recruited and randomly distributed in two groups. Group 1 was given stretching of upper back fascia and periscapular muscles and thoracic mobilization along with conventional exercises (Cyriax listing correction -I followed by repeated McKenzie back extension exercise and Core muscle strengthening). Group 2 received only conventional exercises. Outcome Measures: visual analog scale, Oswestry Disability Index and Modified Schober's Test. Measurements were taken before and after three weeks of treatment, for 5 days/week.Results Overall results of the study, both Group 1 and Group 2 showed improvement in pain, function and lumbar Range of Motion (ROM) after three weeks of intervention. However, Group 1 improved significantly to a greater extent in pain, ROM and function than the Group 2.ConclusionStretching of periscapular muscles and fascia of the upper back and mobilisation of upper thoracic spine is found to be effective for the management of chronic low back pain due to PIVD
In rats with the polycystic ovary syndrome, the monoaminergic activity in the celiac superior mesenteric ganglion depends on the vagal innervation
No full textBackgroundOne of the mechanisms involved in the polycystic ovarian syndrome (PCOS) development is the hyperactivity of the sympathetic nervous system, which reaches the ovaries pathway the ovarian superior nerve (SON). The somas of the neurons originating the SON are located mainly in the celiac superior mesenteric ganglia (CSMG), which in turn receives innervation by the vagus nerve, suggesting that the neural information arriving to the CSMG through the vagus nerve may modulate the role played by the SON in the persistence of PCOS. AimsThe aim of the present study was to assess the participation of the vagus nerve in the regulation of the monoaminergic activity in the CSMG of rats with PCOS induced by estradiol valerate (EV-induced PCOS).Methods Ten-day old rats injected with EV dissolved in corn oil, at 24-days of age were submitted to unilateral or bilateral vagotomy. The animals were sacrificed at 90–92 days of age, after presenting vaginal oestrous smear preceded by a proestrus.Results In rats with EV-induced PCOS, unilateral or bilateral vagotomy resulted in lower noradrenaline (NA) levels; bilateral vagotomy yielded lower serotonine (5-HT) levels in the CSMG, and the dopamine (DA) levels were not modified by the vagotomy.ConclusionPresent result suggests that in rats with EV-induced PCOS the CSMG serves as communication channel between the vagus nerve and sympathetic innervation and this communication is related to the persistence of EV-induced PCOS
Prevalence of Rheumatic Heart Disease in North Madagascar: An echocardiographic screening in young and adult populations
Get PDFBackgroundRheumatic Heart Disease (RHD) prevalence in Madagascar is poorly known. Echocardiographic screening detects a higher prevalence of RHD than clinical examination.AimsWe aimed to describe RHD prevalence in children and adults in North Madagascar using the most updated World Heart Federation (WHF) criteria for RHD echocardiographic diagnosis.Methods Children aged 5–19 years (Group One) and adults aged more than 20 years (Group Two) underwent a four-steps visit: clinical questionnaire, physical examination, laboratory test - oropharyngeal swab for Group One and Anti-streptolysin O (ASO) titre for Group Two - and echocardiogram using a portable machine..Results Among 859 people (522 in Group One, 337 in Group Two) RHD prevalence was 2.1 per cent. Group Two had a higher risk of having RHD than Group One (OR 4.39, CI 1.39–13.9, p=0.004), while clinical findings were more frequent in Group One (children had a higher risk of heart murmur (O.R. 3.85 C.I. 1.08–13.72; p=0.029)). RHD prevalence was 1.34 per cent in children. Those positive to oropharyngeal swab had a higher risk of RHD (OR 14.5, CI 3.04–69.44, p=0.0024); children with history of fever and sore-throat had a higher risk of positive oropharyngeal swab (OR 15.97, CI 3.14–81.19, p=0.002). RHD prevalence was 3.3 per cent in adults. None of those had history of fever and throat-pain, positive ASO titre and cardiac murmur simultaneously. ConclusionThis is the first study describing prevalence of RHD in Madagascar. Our results, although preliminary, are important to enhance prevention programs in this country