Australasian Medical Journal
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Doctor awareness of radiation doses
No full textBackground The large number of diagnostic procedures undertaken in emergency departments (ED) is vital to the early diagnosis and treatment of patients. The use of ionising radiation in diagnosis adds a lifetime attributable risk (LAR) of cancer depending on the region imaged, the frequency of imaging, and dose per exposure. Aims This pilot study aims to assess the degree of radiation awareness amongst ED doctors at major metropolitan and regional health services in Australia, in terms of the dose and risks associated with common imaging. Secondary aims were to provide a template to practically evaluate ED doctor radiation awareness, identify factors impacting upon radiation awareness (e.g., location, seniority of doctor), and to suggest practical means to improve radiation awareness. Methods Physicians in the EDs of two major health services (one regional and one metropolitan) in Australia were surveyed and asked to compare the radiation dose from each procedure to what the general population is exposed to naturally from background radiation. Additionally, the physicians were asked to estimate the LAR of cancer from each diagnostic procedure. These estimates were compared to literature-sourced values to assess the accuracy of physician responses. Results Results showed that there was significant variance with regard to knowledge of dose and risk, and that respondents tended to greatly overexaggerate the radiation levels and risk associated with diagnostic imaging. Despite failing to attribute correct values, in many cases, respondents ranked scans correctly. Responses comparing differences amongst the two health services and amongst different levels of medical hierarchy largely overlapped with no clear difference between these factors. Conclusion Physicians reported low confidence in their knowledge of radiation awareness and indicated the need for additional education, which would assist them in communicating the risks to patients. Furthermore, such education would assist physicians in tailoring their diagnostic imaging requests so as to minimise radiation levels in patients
Attitudes toward the use of baby walkers among healthcare personnel
Get PDFBackgroundBaby walkers (BW) are commonly used among the population in Kuwait with high incidence of injuries and without awareness of their harms.AimsThe aim of the study is to identify the attitudes of healthcare personnel in Kuwait towards the use of BW.MethodsSelf-administered questionnaires were distributed among 144 health workers of different specialties in hospitals in the State of Kuwait to find out the perceived benefits and associated risks of BWs.Results108 participants had children and 36 did not. Of those, who had children, 87 (80.6 per cent) have used a BW. The most common reasons for using a BW were: to promote early walking (60.9 per cent), to give the child freedom (44.8 per cent), and to keep the child safe (43.7 per cent) and entertained (43.7 per cent). 20 participants reported injuries sustained from the BW (23.0 per cent). The majority of participants (52.8 per cent), mostly paediatricians and physiotherapists acknowledged the risks of BWs, but most participants also believed that BWs increase a child’s motor activity levels (64.6 per cent).ConclusionHealthcare personnel commonly think highly of BWs and believe that it benefits the child
Acute Surgical Unit: The consultant experience
Get PDFBackgroundEstablishment of the Acute Surgical Unit (ASU) has redefined the approach to emergency surgery in Australia with quantitative data showing improvement in patient outcomes. However, as qualitative data regarding the ASU remains scarce, we sought to determine the impact of the ASU on overall surgeon job satisfaction.AimsThe aim of this paper was to specifically address the impact of the ASU on consultant surgeons overall job satisfaction.Methods We designed a 34 – item questionnaire with consultant general surgeons addressing important aspects of the ASU. Themes included on – call rostering and workload, academic pursuits, surgical training, work – life balance and overall job satisfaction.Results We received responses from 88 surgeons currently working on ASU units, responding correctly and in full to the survey. Overall, our surveyed cohort reported better on – call rostering, improved surgical training and higher levels of job satisfaction and overall work – life balance with ASU implementation.ConclusionPreliminary qualitative results indicate that the ASU may improve on – call rostering, work – life balance and overall job satisfaction
Development of a Novel Steerable Bougie
Get PDFBackgroundThis paper describes the development of a new airway access device that will improve the speed and safety associated with bougie assisted endotracheal intubation in anaesthesia and critical care. Case of need, design specification and fabrication of the steerable bougie mechanism is discussed.AimsIdentify the need for a novel Steerable Bougie whilst considering technology readiness levels associated with medical device design. Analyse and produce suitable mechanisms, utilising smart materials to increase device functionality ensuring successful patient intubation procedures.MethodsThis work describes the total design activity that contributes to the successful design and manufacture of medical devices through research and development, from case of need research to smart material actuation mechanisms. Research focuses on identifying a suitable control mechanism to allow a steerable tip to be integrated into a bougie with a control device attached to the laryngoscope.ResultsData collected from a user group survey supported the development of a novel bougie, with better shape retention, variable rigidity within the tip, and an integrated steerable function. Analysis of several mechanisms, artificial muscles and smart materials identified a cost effective steerable mechanism that can be incorporated into a steerable bougie.ConclusionUsers have defined a need for a new steerable bougie for endotracheal intubation. Controlling smart materials and mechanisms within the predefined dimensions identified strengths and weaknesses associated with steerable functions. The performance of the selected mechanism for incorporation in the steerable bougie requires a high level of control to accurately steer a device within the human airway
Association between anti-Toxoplasma gondii antibodies and schizophrenia and psychotic bipolar in patients hospitalized in the psychiatric ward
Get PDFBackgroundToxoplasmosis is caused by an intracellular parasite and is a worldwide disease. In laboratory, a mouse has been observed with the presence of this parasite in the brain which increased the level of dopamine in the brain. The evidence showed that dopamine releasing in the nucleus accumbens by activating the retro hippocampal region can disrupt the fornix section of brain as evolve to develop a psychosis in human.MethodsThis retrospective case-control study was conducted in patients with schizophrenia and psychotic bipolar referred to psychiatric clinic in Amir Kabir hospital, Arak. After psychiatric diagnosis of patients with schizophrenia and bipolar disorder, 2ml of blood samples were acquired from 76 patients and 75 controls without any psychotic illness or bipolar disorder and other mental illnesses with safety issues. The serum of samples was separated in laboratory and was kept until the day of testing at -20˚C. After collecting all the samples; Anti-Toxoplasma lgG on the case and control samples were analysed by ELISA. Results were analysed by SPSS software version 16 and were calculated by χ2 tests.Results55.26 per cent of patients (42 persons) were infected with Toxoplasma gondii and in the control group 36 per cent (27 patients) were infected, that the different between them was significant (p < 0/05). Toxoplasmosis in psychotic men was more than psychotic women significantly (p < 0/05). Toxoplasma gondii infection in patients with schizophrenia with psychotic bipolar patients showed no significant difference.ConclusionPatients with schizophrenia and bipolar disorder showed significantly higher rate than healthy people against Toxoplasma gondii infection. Prevention of infection with this parasite is effective in reducing the risk of psychosis
Unsaid new practice rights of the traditional health practitioner, as guided by Act No 22 (2007) of South Africa
No full textBackgroundIn 2007, a practice directive was issued for the new legal entity traditional health practitioner with the promulgation of the Traditional Health Practitioners Act (No 22 of 2007) in the Republic of South Africa. Although the Act describes this new pathway in terms of various definitions, the future practice rights and impact on healthcare were left undefined and unwritten. To date the negative legal implications and career consequences that the Act has for the regulated health practitioners, have gone unnoticed. The derogation and degrading of their work domains and rights, seem of no concern.1 AimsThe aim of the present study is to determine and describe the unwritten new practice rights of the traditional health practitioner.Methods This is an exploratory and descriptive study in line with the modern historical approach of investigation by means of a literature review. The emphasis is on using documentation such as articles, books and newspapers as primary resources to reflect on the traditional health practitioner’s new unsaid and unwritten future practice rights.Results The future practice and services of traditional health practitioners seem to incorporate many new unwritten practice rights and activities, which is contrary to the Act’s written intentions.ConclusionThe new traditional health practitioner‘s future practice rights are legally comprehensive and masked. It holds serious consequences for the practices of the established healthcare professions
How hypothyroidism affects the ovaries
No full textA 15-year-old girl who was previously diagnosed to have primary hypothyroidism presented to the outpatient department in our tertiary care centre in Southern India with abdominal distension and pedal oedema. On evaluation, she was found to have elevated lactate dehydrogenase (LDH) and CA 125 levels, enlarged multicystic ovaries, ascites, and pleural and pericardial effusions. A diagnosis of spontaneous ovarian hyperstimulation syndrome (SOHSS) was made based on the characteristic soap bubble-like imaging appearance of ovaries in the background of hypothyroidism and she was started on thyroxine. At her three-month follow-up, the patient’s biochemical parameters normalised with reduced ovarian volume and resolution of other imaging findings. SOHSS needs to be considered in patients with hypothyroidism and characteristic multicystic ovarian enlargement