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Biomarker: Trolox equivalent antioxidant capacity and telomere length of Thai elderly people with frailty
Get PDFIntroduction: Thailand has a rapidly aging population; assessing frailty earlier with biochemical markers could identify many adverse outcomes such as disability, hospitalization, and death. We aimed to examine the correlation between Trolox equivalent antioxidant capacity (TEAC), thiobarbituric acid reactive substances (TBARS), and telomere length and frailty for elderly people in Northern Thailand.
Methods: A cross-sectional study was performed between May 2017 and March 2018 with a total of 350 elderly aged 60 and older for frailty phenotype assessment by five frailty criteria including unintentional weight loss, exhaustion, slowness, low physical activities, and grip strength weakness. Twenty-eight subjects in both the frailty and non-frailty groups were analyzed for basic clinical parameters, including plasma TEAC, TBARS, and telomere length.
Results: Alanine aminotransferase activity, albumin concentration, cholesterol level, and telomere length were significantly low in the frailty group. The albumin level, TEAC, and telomere length were significantly higher between the ages of 60 and 75 years compared to those with non-frailty over 75 years of age. Likewise, albumin and cholesterol levels were significantly higher in the frailty group aged 60–75 years. Albumin concentration, cholesterol level, TEAC, and telomere length were significantly higher in the non-frailty group when compared to the frailty group aged 60–75 years, but no significant difference was found among these biochemical parameters of frailty and non-frailty whose age was above 75 years.
Conclusion: The reduction of albumin concentration, cholesterol level, TEAC, and telomere length supports the underlying mechanism of frailty screened by the frailty phenotype tool in a specific age range. However, further analyses with multi-parameters must be validated before the application in clinical diagnosis for frailty
Canal cholesteatoma in canal stenosis: a case report
No full textIntroduction: We present the a-12-year old female with canal stenosis and canal cholesteatoma. We discuss the clinical, radiological and treatment option for canal cholesteatoma in canal stenosis
Discussion: Congenital canal atresia is a failure of the development of the external auditory canal which comprises anomalies of variable severity involving pinna, external acoustic canal, middle ear structures and rarely inner ear leading to hearing impairment. Congenital canal stenosis is considered to be a subset of congenital canal atresia. This malformation results in mild to severe conductive hearing loss. Furthermore, the risk of cholesteatoma increased when it is associated with the stenotic ear. Radiological evaluation in the form of an HRCT scan of temporal bones should always be done in these patients during their initial presentation and surgery should be planned accordingly. Their presence should be rule out prior to any corrective surgery.
Conclusion: Although the incidence of canal cholesteatoma is rare in congenital canal stenosis, all patients presenting with canal atresia or stenosis should be evaluated thoroughly due to their potential to develop cholesteatoma as it may be challenging to treat at an advanced stage in view of morbid complications. 
Road to healthcare professional’s burnout: poor empathy and impaired work ability, are they cause or effect?
Get PDFIntroduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators results in the reduced working capacity of healthcare professionals.
Material and methods: Assessing working conditions of 100 healthcare professionals regarding stress impact on empathy and workability was the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability.
Results: In the research group “intensive care units”, significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research groups named “other departments”.
Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of healthcare professionals. 
The free maternal health policy: acceptability and satisfaction with quality of maternal health services during pregnancy in rural Northern Ghana
Get PDFIntroduction: Ghana introduced a maternal health policy in July 2008 to provide free of cost health services to women. However, the utilization of services does not depend on affordability alone but acceptability as well. Acceptability includes attitudes and behaviors of providers and satisfaction with the quality of care. The study explored women’s views and perceptions about attitudes and behaviors of providers and satisfaction with the quality of services under the free maternal health policy in Ghana. In addition, the views and perceptions of providers were examined.
Methods: A convergent parallel mixed-methods study was conducted. The study was carried out in the Kassena-Nankana Municipality in Ghana. A structured questionnaire was distributed among women (n=406) who utilized health facilities during pregnancy. Further, focus group discussions (FGDs) with women (n=10) and in-depth interviews with midwives and nurses (n=25) were held. Quantitative data were analyzed using descriptive statistics, while the qualitative data were recorded, transcribed, read, and coded thematically.
Results: Women perceived facilities to be clean, especially the smaller ones. Ninety-eight percent of women (n=313/320) perceived providers to be respectful or friendly, and this was mostly confirmed in the FGDs. More than two-thirds of the women (74%, n=300) were also very satisfied or satisfied with the quality of care due to the respect accorded them by providers. Equally, midwives and nurses were satisfied with the quality of care they provided. Nonetheless, providers believed that the unavailability of drugs and supplies, laboratory services, accommodation, and transportation for emergencies reduced women’s satisfaction with services and the quality of care they could provide.
Conclusion: The services provided to women during pregnancy were acceptable under the free maternal health policy. There remain challenges in addressing a lack of infrastructure and commodities that affects the quality of care
The Osgood-Schlatter\u27s Syndrome (OSD) and Involvement of Children of Young Age in Sports
Get PDFIntroduction: Two findings can be highlighted from recent medical research, first children of a young age are involved in organized sports activities more frequently than ever and second the first symptoms of Osgood-Schlatter disease (OSD) have been reported in children at the age of 5.5 years. The latest research has shown that children from ages 10 to 12 years have already been actively involved in sports activities for 5–7 years. In recent years, the practice of young children training to master sports has become a trend. Said exposes young children who are training intensively to various external risk factors such as social isolation, addiction, frequent injuries, and syndrome of overload. Enablers of this behavior are commonly parents and coaches who notice the child’s abilities stand out from those of other children in the group and find that such talent requires intensive sport-specific training. The purpose of this study was to determine the average age of the patients and the average age when the first symptoms of the disease appeared as well as to provide an analysis of the average duration of children being actively involved in sports activities before the first symptoms of OSD appeared.
Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups each containing 100 patients, first group –aerobic sports (football and basketball) and the second group –anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. The study was prospective, clinical, comparative, analytical, and descriptive. The research was conducted in Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA).
Results: The average age when the patients started with intensive training was highest with basketball players (7.8 years) following with karate trainees (6.8 years). Basketball players had statistically the lowest duration of being actively involved in sports activities before the first symptoms of OSD appeared (5.4 years). No statistically significant difference in the average duration of training was discovered between the test groups. The average age when knee pain or swelling under the knee first appeared was at the age of 11.4 years with players of aerobic sports and 11.8 years with players of anaerobic sports. Furthermore, no statistically significant difference was found between test groups and subgroups. Before the first appearance of knee pain, the taekwondo patients had been in training the longest (4.7 years) and basketball players the least amount of time (3.4 years).
Conclusion: By conducting retrospective analysis, it has been concluded that children had started training at the age of 3 or 4 years and had encountered the first symptoms of OSD at the ages of 4 years (football) and 6 years (taekwondo). Research showed that the early involvement of children in sports and their early specialization in sports are both external risk factors that have a dominant influence on OSD development
Transient coma as Percheron’s artery stroke
Get PDFThe artery of Percheron is a rare anatomic variation in the brain vascularization, in which a single arterial trunk arises from the posterior cerebral artery to supply both sides of brain structures, i.e., the thalamus and midbrain. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report the case of a Caucasian woman who completely recovers after transient coma due to Percheron artery infarction
Atypical presentation of Hand foot mouth disease (HFMD) caused by enterovirus serotype Coxsackievirus A6, in India
Get PDFA 27-year-old male presented in the OPD of Naval Hospital in Port Blair, Andaman Islands, India, in 2011 with a history of low-grade fever associated with malaise and a pruritic skin rash. Case 2 – A 17-year-old male student reported to the OPD at Naval Hospital, Kochi Kerala, India, in August 2015. He presented with eruptions on both the palm and soles with a history of high-grade fever for the past 3–4 days. Clinically, both the cases were diagnosed as hand, foot, and mouth disease (HFMD). Both samples were tested against measles virus and varicella-zoster IgM antibodies by enzyme immunoassay and found negative. Stool sample (case 1) and lesion swab (case 2) were processed by enterovirus reverse transcription polymerase chain reaction and phylogenetic analysis, and both were positive for enterovirus human coxsackievirus A6 (CVA6) (untranslated region [UTR]). Phylogenetic analysis also confirmed that both the CVA6 etiology belonged to the genotype F. HFMD in adults often asymptomatic and very few patients get atypical symptoms. Clinical diagnosis is often troublesome to identify HFMD in such cases. An epidemiological surveillance/vigilance is essential to document these atypical cases in near future in developing countries like India
Medication Adherence to Type 2 Diabetic Patients Hospitalized at a Tertiary Care Hospital in Bangladesh: Diabetic Medication Adherence
No full textIntroduction: Diabetes Mellitus (DM) has been a global epidemic in the new millennium and the majority of all diabetic patients constitute Type 2 diabetes mellitus. Medication adherence to prescribed treatments is a key determinant to achieve therapeutic success reduces diabetic complications. The aim of the study was to examine the level of medication adherence to Type 2 diabetic patients hospitalized at tertiary care hospital in Bangladesh.
Methods: The study was descriptive cross-sectional design. A total of 112 Type 2 diabetic patients were conveniently recruited from tertiary care hospital in Bangladesh.
Results: The mean age of the participants was 57.46 (SD=11.65) years. More than half of the patients (60.7%) were male and majority of them (94.6%) were married. The mean score of diabetic medication adherence was calculated as 26.46 (SD=1.58). Adherence to diabetic medications was significantly associated with age (p=.01), occupation (p=.003), duration of DM (p=.003), oral hypoglycemic agents (p=.02), HbA1c (p=< .01) and Fasting Blood Sugar (p=< .01). Medication non-adherence significantly found in patients with presence of diabetic retinopathy (p=<.01), microalbuminuria (p=.01), dyslipidemia (p=.006), hypertension (p=.01) and other chronic diseases (p=.01).
Conclusion: The level of medication adherence among Type 2 diabetic patients was found to be suboptimal. Good adherence has beneficial effects on HbA1c and FBS. For improving adherence particular focus should pay to diabetic patients with different age groups and the presence of comorbidities.
 
The Algorithm for overload syndrome prevention: Osgood-Schlatter\u27s syndrome (OSD) as an overload syndrome caused by early inclusion of children in sports and excessive physical activity (sports and recreation)
Get PDFIntroduction: Osgood-Schlatter’s syndrome (Osgood-Schlatter disease [OSD]) is caused by an accumulation of repeated microtraumas and is classified as a type of chronic injury called “overload syndrome“. It is considered that the root causes of OSD are accelerated growth as well as excessive sports and recreational activity. Currently, more than 50% of children of school age are involved in sports activities. In this study, 40 external risk factors were analyzed. Considering that frequent medical examinations, expensive rehabilitation, time-consuming sports activities, and school obligations result in major socio-economic and financial consequences, a need to work on a preventive program was recognized. The aim of this study was to determine external risk factors and to develop an algorithm for the prevention of injuries caused by overload syndrome through a detailed analysis of Osgood-Schlatter’s syndrome concerning aerobic and anaerobic sports (football, basketball, karate, and taekwondo).
Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups, each containing 100 patients, first group – aerobic sports (football and basketball) and the second group – anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. This clinical study was prospective, comparative, analytical, and descriptive. The research was conducted in the Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA).
Results: Patients experienced the first symptoms of OSD at 4 years (football) and 6 years (taekwondo). About 60% of patients who trained in anaerobic sports and 38% of patients who trained in aerobic sports trained other sports more often as well. The research showed that a higher percentage of patients who trained anaerobic sports trained multiple sports at the same time (karate 88%, and taekwondo 82%) compared to patients who trained aerobic sports (football 68%, and basketball 76%). Patients who trained in anaerobic sports were also more likely to engage in recreational activities (58.3%) compared to patients who trained in aerobic sports (41.7%). On average, the number of hours per week which patients spent actively training (primary sport, additional sports activity, and recreational sport) was 17.2 h for basketball players, 16.8 h for taekwondo trainees, 16.7 h for caratists, and 15.7 h in case of football players. About 32% of football players, 24% of basketball players, 12% of karate trainees, and 18% of taekwondo trainees did not engage in additional sports or recreational activities. Only 36% of patients who trained in aerobic sports and 37% of patients who trained anaerobic sports respected the planned rest days, and in both groups, some subjects trained for 12 months.
Conclusion: The research showed that patients who trained in anaerobic sports more frequently trained more than one sport at the same time and spent more hours doing recreational activities compared to patients who trained in aerobic sports. By analyzing weekly physical activity, it was concluded that the rest is limited. Future research aims to identify risk factors so that children, parents, and trainers can be educated to work on prevention through teamwork
The Defensive Practices of Nurses
No full textIntroduction: Through the developments in science and technology, in health-care services, roles and responsibilities of nurses are changing, and nurses are frequently faced with risky circumstances in terms of malpractice. In this case, it is thought that nurses may be inclined to exhibit defensive practices.
Methods: This study was carried out in a descriptive type to determine the defensive practice status of nurses. The population of the study consists of the nurses working at a university and private hospital, and the sample comprises 345 nurses working at inpatient departments in hospitals. This study was approved by the ethical board of Istanbul Medipol University. Data were analyzed using SPSS 21.00.
Results: About 91.9% of the nurses who were included within the scope of the research are female, and the mean age is 35.67 ± 8.89. It was found that 60.9% of the nurses, who were included within the scope of the research, sometimes had concerns about making a mistake in nursing care, 60.9% of them never administered any drug he/she thought to be unnecessary, 55.7% of them never kept away from the patients who are more likely to file a lawsuit to protect themselves, 48.7% of them sometimes explained nursing practices in more detail to protect themselves from the allegations of malpractice, 44.1% of them never avoided practices with high complications to guard themselves against malpractice lawsuits, 65.5% of them always kept the records in a more detailed way to protect themselves from allegations of malpractice, and 52.2% of them considered there was a high risk of encountering with a malpractice case at any time according to the conditions of the environment.
Conclusion: The data obtained have indicated that nurses sometimes perform defensive practices. Thus, it is necessary to develop and implement strategies to prevent nurses from performing defensive practice