Παρασκευή 10 Ιουνίου 2016
Academy News – June PM&R Journal
As the primary medical society for the specialty of PM&R, your Academy is focused on moving the specialty and you forward. Academy membership supports initiatives to assist our members with:
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Wanting and Getting Help for Substance Problems on Both Sides of the US-Mexico Border
Abstract
The US-Mexico border presents potential cultural and logistic barriers to obtaining substance abuse treatment. We compare the prevalence and correlates of wanting and getting help between border and non-border residents in both the US and Mexico. Data come from the 2011 to 2012 US-Mexico Study on Alcohol and Related Conditions which surveyed 3214 border and 1582 non-border residents in the US and Mexico. Multivariate logistic regressions estimate the effect of border residence on desire for and receipt of help. In both countries, border substance users were about half as likely as nonborder substance users to have wanted or obtained any kind of help, independent of predisposing, need and enabling factors, including migration status. Among those desiring help, however, about half had obtained it, both on and off the border in both countries. While substantial proportions of those who need help do not get it either on or off the border, lower motivation for treatment may be more important than access in explaining border/non-border differences. Future research should investigate whether there are border-specific barriers to wanting help, and how to minimize them.
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Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001–2013
Abstract
Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African–American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.
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Overdoses now top killer of Americans
Seth Borenstein
Associated Press
WASHINGTON — Accidents are killing more Americans each year, increasingly from overdoses and falls.
A new report from the National Safety Council said that in 2014, more than 136,000 Americans died accidentally. That's up 4.2 percent from the year before and a jump of 15.5 percent over a decade. And the accident rate has risen despite a 22 percent plunge in car crash deaths since 2005.
Overdose and accidental poisonings are up 78 percent over a decade — pushing aside car crashes as the No. 1 accidental killer in the U.S. They killed 42,032 people, about 6,000 more than vehicle accidents. Opioid overdoses killed 13,486 people in 2014, the non-profit safety council reported.
Falls are up 63 percent over a decade, which experts said is a function of an aging society.
"It's all preventable. Every accident is preventable," said Ken Kolosh, the safety council's statistical manager said in a Thursday news conference. He said the point is not that people are accident prone, but that society is not doing enough to prevent people from dying by accident.
An American dies of accidental injury every four minutes. If you count people who do not die but need medical help, the rate increases to one every second, according to the safety council.
Where you live can more than double the rate of accidental deaths. Maryland, California and New York have the lowest accidental death rates — around 30 per 100,000 people. West Virginia — driven by overdoses, Kolosh said — has the highest accidental death rate at 75.2 per 100,000, followed by Oklahoma (64.3) and Montana (61.4). The national average is 41.3 accidental deaths per 100,000 people.
"Unintentional injuries are clearly a real public health issue," said George Gray, a George Washington University public health professor and expert on risk, who wasn't part of the report but praised it.
Car crashes have become less lethal, but the opioid and prescription drug abuse epidemic is growing more deadly, Gray said.
In 1999, overdoses, poisonings and falls accounted for one in four accidental deaths. Now, they are more half of them.
The 218-page annual Injury Facts report is based on federal death and injury statistics and other science studies, and gives a big picture look at what's really killing Americans and sending them to the hospitals. The three biggest killers remain diseases: heart disease, cancer, and lower respiratory diseases. But unintentional injury — the accidents at work, home and in vehicles that the report concentrates on — is the fourth leading killer, beating out stroke, Alzheimer's diabetes, flu and suicide.
People think murder is a big risk in America, but there are eight accidental deaths for every homicide. And there are more than two times as many suicides as murders, with suicides by gun steadily increasing.
In the past, accidents ranked as low as seventh leading killer of Americans, but the country has done a better job of reducing and preventing illness deaths than accidental ones.
The report notes the drop in motor vehicle deaths in 2014, down to 35,398 from a high of more than 53,000 in 1980.
"Far fewer teenagers and young adults are dying on the roads than they were in 1981," Kolosh said.
But even that good news isn't exactly good. It's partly a function of the economy and with a growing economy, preliminary 2015 data show that car crash fatalities are up 8 percent, Kolosh said.
The United States has higher car fatality rate than other developed countries, partly because drunk driving regulations and other safety rules are looser in America, Kolosh said.
The safety council report veers from the deadly to the strange: Toilet accidents sent 112,412 people to the emergency room in 2014, more than saws, hammers, or even trampolines and swimming pools but not nearly as much as carpets and floors. Slippery floors and rugs send nearly 1.6 million people to the emergency room a year.
"Bathrooms are a relatively dangerous place," Kolosh said, adding that it's mostly an issue of elderly people falling.
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Study of nutritional status of preschool children in areas of Kallur Primary Health Center, Kurnool District
2016-06-10T09-26-46Z
Source: International Journal of Medical Science and Public Health
Sreedevi Arepalli, Guthi Visweswara Rao.
Background: The level of undernutrition in children remains unacceptable throughout the world, with 90% of the developing worlds chronically undernourished (stunted) children living in Asia and Africa. Objective: To study the nutritional status and to reveal the factors influencing the nutritional status among preschool children. Materials and Methods: This was a community-based cross-sectional study conducted by carrying out a door-to-door survey among 330 preschool children of age between 0 and 6 years in Kallur primary health center area during March 2014 to September 2014. Weight for age was calculated and childs age, gender, mothers education, type of house, type of family, socioeconomic status (modified BG Prasad 2014), religion, and caste of the family were collected. Result: Most of children in the study area were suffering from grade 1 (34.5%) malnutrition followed by grade 2 malnutrition (33.1%), grade 3 malnutrition (6.1%) and grade 4 malnutrition (1.5%). Severe malnutrition constitutes 7.6%. Significant association was found between malnutrition and childs age, gender, mothers education, religion, type of house, and family. Conclusion: Severe degree of malnutrition was found only among children of the illiterate mothers. It was also found only among children of families with class 4 and class 5 socioeconomic statuses. Negative association was found between standard of housing and nutritional status.
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Exploring levels of Internet addiction among medical interns: a cross-sectional study
2016-06-10T09-26-46Z
Source: International Journal of Medical Science and Public Health
Rajeshree S Dhok, Kalpak S Kadarkar, Mohan K Doibale.
Background: Internet has invaded into our daily activities. There is rising concern over increased Internet usage especially among younger generation. Internet overusage affects them at various levels of academics, interpersonal relationship, and physical and health aspects. Medical definition of Internet addiction is based on compulsive act of using Internet despite ones best interest. Objective: To estimate the level of Internet addiction among medical interns and understand patterns of Internet usage among them. Materials and Methods: A cross-sectional study was conducted among interns of medical college in March 2016. Data were collected through self-administered questionnaire which contained sociodemographic, Internet usage pattern information and Youngs 20-item Internet addiction test (IAT). Severity of Internet addiction was graded as per the scale. Result: According to IAT, of 130 study participants, 70 (53.85%) were normal users, 41 (31.54%) showed mild, and 19 (14.61%) showed moderate levels of Internet addiction. Mean duration of Internet use/day was found to be 2.25 1.07 years. Majority [120 (92.31%)] of the study participants used smartphone. Males were more addicted to Internet than female subjects. Using 3G speed of Internet was significantly associated with Internet addition. Conclusion: Internet addiction is identified as a matter of concern among medical interns. Awareness needs to be created regarding Internet addiction/problematic Internet use and developing a healthy and safe Internet use. Preventive measures should be instituted promptly to forestall the possible influence of Internet addiction on students.
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EMS providers keep their cool
"IF" - a poem - by Rudyard Kipling seems an apt and appropriate description of EMTs and paramedics
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Ambulance station dance off
Three Illinois EMS providers show off their best dance moves with costumes, props and chroreography
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Firefighter/EMT or Paramedic - City of Delaware
DELAWARE, CITY OF 1 S. SANDUSKY STREET DELAWARE, OHIO 43015 Updated: May 31, 2016 Classification: Full-time and Part-time Firefighter/EMT/Paramedic The City of Delaware is currently building an eligibility list to fill full-time and part-time firefighter positions. The same hiring steps are required for both positions. Those hired for part-time positions can apply for full-time vacancies as they arise ...
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Fire Chief - Fauquier County Government
This is an exciting opportunity to lead a department that is committed to protecting & preserving the county & its citizens with Fire, Paramedic Emergency Medical, Rescue, Hazard Mitigation and Emergency Management Services. The selected candidate will be responsible for staffing, training, budgeting & all other administrative matters. A Bachelor's degree is required (Masters preferred) ...
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EMS providers keep their cool
"IF" - a poem - by Rudyard Kipling seems an apt and appropriate description of EMTs and paramedics
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Ambulance station dance off
Three Illinois EMS providers show off their best dance moves with costumes, props and chroreography
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EMS providers keep their cool
"IF" - a poem - by Rudyard Kipling seems an apt and appropriate description of EMTs and paramedics
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Ambulance station dance off
Three Illinois EMS providers show off their best dance moves with costumes, props and chroreography
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EMS providers keep their cool
"IF" - a poem - by Rudyard Kipling seems an apt and appropriate description of EMTs and paramedics
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Ambulance station dance off
Three Illinois EMS providers show off their best dance moves with costumes, props and chroreography
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EMS Artwork: Is there wheezing?
Wheezes, retractions, tachypnea and altered mental status lead to a quick assessment of asthma
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'Drug Round Game' teaches medication error prevention
The game gives players the opportunity to exchange ideas, participate in interactive discussions on medication safety and to practice drug calculations
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EMS Artwork: Is there wheezing?
This image was based on a call I did for a boy who was having an asthma attack. He was fine, but his father was distraught. His wife, the boys mother, had died a week prior from cancer. He said she used to deal with and handle these types of family matters. He told me he was really missing her and this just made it worse for him. The spirit is the boys mother still at her son's side.
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Mercedes driver blocks ambulance transporting patient
Police are investigating the driver's interference of a Slovakian ambulance
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Mercedes driver blocks ambulance transporting patient
Police are investigating the driver's interference of a Slovakian ambulance
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Mercedes driver blocks ambulance transporting patient
Police are investigating the driver's interference of a Slovakian ambulance
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Pattern of septic arthritis in a tertiary hospital in Northern Nigeria: A retrospective study
Mamuda Abdulrahman Alhaji, Atiku Mamuda, Bashir Bello, Mustapha Ibrahim Usman, Shamsudeen Muhammad
African Journal of Medical and Health Sciences 2016 15(1):36-40
Background: Septic arthritis remains one of the most rapidly destructive and potentially lethal forms of arthritis hence necessitating early and adequate treatments. Epidemiological data on septic arthritis are limited in Nigeria especially in the Northern region. This study was aimed to determine the pattern of distribution, presentation, treatment, and outcome of septic arthritis in a tertiary hospital in Northern Nigeria. Methods: A retrospective study of all patients that presented with septic arthritis at Aminu Kano Teaching Hospital, Nigeria over a 6-year period was carried out. The patient's case notes were retrieved from the medical record department. Information extracted and analyzed included demographic data; joints affected cultured organisms, treatment offered, and outcomes. Results: A total of 36 patient case files (23 males and 13 females) with septic arthritis involving 48 joints were studied. Patient's age ranged 3 months to 60 years with mean age of 4.5 years. The knee was the most commonly involved joint (58.5%) followed by hip (25%) and then shoulders (10.5%). The common presenting symptoms were joint pain, fever, joint swelling, limping, and joint trauma. Staphylococcus aureus was the most common (52.8%) organism involved. About 58.3% of the patients had arthrotomy with antibiotics and 27.8% patients had arthrocentesis with antibiotics while only 13.9% had antibiotic treatment alone. Complications of joint stiffness (31%) and fixed flexion deformity (19%) were recorded whereas 41.7% had a complete resolution in this study. Conclusion: From the result of this study, the outcome of septic arthritis management in our environment was unsatisfactory. It is recommended that prompt recognition, rapid, and adequate treatments are critical to restore normal function of affected joints and minimize complications.
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African Journal of Medical and Health Sciences 2016 15(1):36-40
Background: Septic arthritis remains one of the most rapidly destructive and potentially lethal forms of arthritis hence necessitating early and adequate treatments. Epidemiological data on septic arthritis are limited in Nigeria especially in the Northern region. This study was aimed to determine the pattern of distribution, presentation, treatment, and outcome of septic arthritis in a tertiary hospital in Northern Nigeria. Methods: A retrospective study of all patients that presented with septic arthritis at Aminu Kano Teaching Hospital, Nigeria over a 6-year period was carried out. The patient's case notes were retrieved from the medical record department. Information extracted and analyzed included demographic data; joints affected cultured organisms, treatment offered, and outcomes. Results: A total of 36 patient case files (23 males and 13 females) with septic arthritis involving 48 joints were studied. Patient's age ranged 3 months to 60 years with mean age of 4.5 years. The knee was the most commonly involved joint (58.5%) followed by hip (25%) and then shoulders (10.5%). The common presenting symptoms were joint pain, fever, joint swelling, limping, and joint trauma. Staphylococcus aureus was the most common (52.8%) organism involved. About 58.3% of the patients had arthrotomy with antibiotics and 27.8% patients had arthrocentesis with antibiotics while only 13.9% had antibiotic treatment alone. Complications of joint stiffness (31%) and fixed flexion deformity (19%) were recorded whereas 41.7% had a complete resolution in this study. Conclusion: From the result of this study, the outcome of septic arthritis management in our environment was unsatisfactory. It is recommended that prompt recognition, rapid, and adequate treatments are critical to restore normal function of affected joints and minimize complications.
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Enterocutaneous fistula: Role of early bowel diversion
Emmanuel A Sule, Gabriel Igberase
African Journal of Medical and Health Sciences 2016 15(1):58-61
Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging from 3 to 6 months postoffending surgery in a bid to forestall further bowel fistulae in a hostile abdomen. However, the role of early bowel diversion for source control of peritoneal fecal contamination in situations of overwhelming sepsis is illustrated with three postoperative enterocutaneous fistulas successfully managed with early bowel diversion.
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African Journal of Medical and Health Sciences 2016 15(1):58-61
Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging from 3 to 6 months postoffending surgery in a bid to forestall further bowel fistulae in a hostile abdomen. However, the role of early bowel diversion for source control of peritoneal fecal contamination in situations of overwhelming sepsis is illustrated with three postoperative enterocutaneous fistulas successfully managed with early bowel diversion.
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Work-related musculoskeletal disorders and ergonomic stressors among direct and nondirect contact health care workers from a Nigerian tertiary health facility
Olufemi O Oyewole, Emmanuel A Adeniyi, Babatunde F Ajayi, Adeyemi A Olajitan, Kolawole S Oritogun
African Journal of Medical and Health Sciences 2016 15(1):7-13
Background: Work-related musculoskeletal disorders (WRMDs) among health care workers have increased with little information on ergonomic stressors' exposure. Therefore, the exposure of health care workers to ergonomic stressors and the consequent WRMDs were investigated. Materials and Methods: The descriptive cross-sectional study involved 279 stratified participants from various departments of Olabisi Onabanjo University Teaching Hospital. Standardized Nordic and adapted European Foundation questionnaires were used to obtain data on musculoskeletal pain and ergonomic stressors. The data were analyzed with Statistical Package for the Social Sciences (SPSS) using descriptive and inferential statistics. Results: About 48% of the participants reported WRMDs in at least one part of the body during the 12 months preceding the study while 22.2% reported WRMDs in the last 7days. During the preceding 12 months and the last 7 days, the lower back was the most common site of disorders (29.4% and 9.7%, respectively) while the elbow joint was the least affected site. About 49.7% and 42.7% of the clinical staff and nonclinical staff, respectively, reported WRMDs in the last 12 months while 22.3% versus 22.0% reported WRMDs in the last 7 days. Female participants had a higher prevalence of WRMDs but significant gender difference existed for point prevalence only. A majority of the participants (65.8%) were exposed to 11 or more risk factors. There was a significant association between both 12-month and point prevalences of WRMDs on the one hand and exposure to painful tiring positions on the other. Conclusions: The prevalence of WRMDs was high among health care workers with the lower back being the most frequently affected body region. Work involving painful/tiring positions was the most common ergonomic risk factor associated with WRMDs.
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African Journal of Medical and Health Sciences 2016 15(1):7-13
Background: Work-related musculoskeletal disorders (WRMDs) among health care workers have increased with little information on ergonomic stressors' exposure. Therefore, the exposure of health care workers to ergonomic stressors and the consequent WRMDs were investigated. Materials and Methods: The descriptive cross-sectional study involved 279 stratified participants from various departments of Olabisi Onabanjo University Teaching Hospital. Standardized Nordic and adapted European Foundation questionnaires were used to obtain data on musculoskeletal pain and ergonomic stressors. The data were analyzed with Statistical Package for the Social Sciences (SPSS) using descriptive and inferential statistics. Results: About 48% of the participants reported WRMDs in at least one part of the body during the 12 months preceding the study while 22.2% reported WRMDs in the last 7days. During the preceding 12 months and the last 7 days, the lower back was the most common site of disorders (29.4% and 9.7%, respectively) while the elbow joint was the least affected site. About 49.7% and 42.7% of the clinical staff and nonclinical staff, respectively, reported WRMDs in the last 12 months while 22.3% versus 22.0% reported WRMDs in the last 7 days. Female participants had a higher prevalence of WRMDs but significant gender difference existed for point prevalence only. A majority of the participants (65.8%) were exposed to 11 or more risk factors. There was a significant association between both 12-month and point prevalences of WRMDs on the one hand and exposure to painful tiring positions on the other. Conclusions: The prevalence of WRMDs was high among health care workers with the lower back being the most frequently affected body region. Work involving painful/tiring positions was the most common ergonomic risk factor associated with WRMDs.
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Sociodemographic characteristics of pediatric human immunodeficiency virus-positive patients in Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
Nnamdi Benson Onyire, U Anyanwu Onyinye, OW Daniyan, C Onwe Ogah, ML Orji
African Journal of Medical and Health Sciences 2016 15(1):46-49
Introduction: Approximately 2.5 million children below 15 years are infected with the human immunodeficiency virus (HIV), with 90% in sub-Saharan Africa. The Federal Teaching Hospital Abakaliki has been a treatment center for HIV since 2006. Objective: The aim of this study was to analyze the sociodemographic and anthropometric characteristics of pediatric HIV-positive patients seen at this facility. Methods: This was a cross-sectional and descriptive study carried out from January to July 2014 of all HIV-positive children aged 0–18 years. The sociodemographic and anthropometric indices were obtained from the patients and/or their accompanying caregiver. Results: There were 89 children (mean age 7.12 ± 4.10 years; range 2–16 years), of which, 54 (60.7%) were male and 35 (39.3%) were female, with a male:female ratio of 1.5:1. Fifty-two children (58.4%) belonged to the lower socioeconomic class by Olusanya, of which, 25 (28.1%) orphans, 15 (16.9%) had stopped schooling whereas 66 (74.2%) were fully immunized according to National Programme on Immunization schedule. Maternal HIV-status was positive in 87 (97.8%) of the children whereas 33 (37.1%) of their fathers were HIV-positive. Paternal HIV-status was unknown in 32 (36.0%). Orphans were more likely to drop out of school. Conclusion: Most children with HIV are from parents of low socioeconomic status while a good number have been orphaned by acquired immunodeficiency syndrome. Vertical transmission was the means of acquiring the infection in most cases. Reinforcement of services for prevention of mother-to-child transmission of HIV is therefore recommended.
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African Journal of Medical and Health Sciences 2016 15(1):46-49
Introduction: Approximately 2.5 million children below 15 years are infected with the human immunodeficiency virus (HIV), with 90% in sub-Saharan Africa. The Federal Teaching Hospital Abakaliki has been a treatment center for HIV since 2006. Objective: The aim of this study was to analyze the sociodemographic and anthropometric characteristics of pediatric HIV-positive patients seen at this facility. Methods: This was a cross-sectional and descriptive study carried out from January to July 2014 of all HIV-positive children aged 0–18 years. The sociodemographic and anthropometric indices were obtained from the patients and/or their accompanying caregiver. Results: There were 89 children (mean age 7.12 ± 4.10 years; range 2–16 years), of which, 54 (60.7%) were male and 35 (39.3%) were female, with a male:female ratio of 1.5:1. Fifty-two children (58.4%) belonged to the lower socioeconomic class by Olusanya, of which, 25 (28.1%) orphans, 15 (16.9%) had stopped schooling whereas 66 (74.2%) were fully immunized according to National Programme on Immunization schedule. Maternal HIV-status was positive in 87 (97.8%) of the children whereas 33 (37.1%) of their fathers were HIV-positive. Paternal HIV-status was unknown in 32 (36.0%). Orphans were more likely to drop out of school. Conclusion: Most children with HIV are from parents of low socioeconomic status while a good number have been orphaned by acquired immunodeficiency syndrome. Vertical transmission was the means of acquiring the infection in most cases. Reinforcement of services for prevention of mother-to-child transmission of HIV is therefore recommended.
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Pattern of impacted mandibular third molars in Calabar, Nigeria
Otasowie D Osunde, Godwin O Bassey
African Journal of Medical and Health Sciences 2016 15(1):14-17
Background: The study examines the pattern of impacted lower third molars in Calabar, Southern Nigeria. Patients and Methods: A retrospective analysis of the medical record of all patients, who were treated for symptomatic impacted lower third molar at the Dental and Maxillofacial Surgery Clinic of our institution over a 3-year period was undertaken. Information obtained included patients' demographics, location, type of impaction, presence of caries in the second molar, and indication for extraction. Results: A total of 2,156 patients were seen at the Dental and Maxillofacial Surgery Clinic over the 3-year period of study and of these patients, 118 impacted mandibular third molars were surgically extracted in 97 patients and thus giving a prevalence of 4.7%. The patients' ages ranged 18-48 years, the mean (SD) age was 27.5 (5.60) years. Impaction of the lower third molar occurred equally in both gender with an approximate ratio of 1:1. Mesioangular impaction was the most common type (N = 53; 44.9%), followed by horizontal impaction (N = 34; 28.8%). About half of the impacted teeth were located on the left side (N = 51; 43.2%). There was bilateral location in 21 (17.8%) cases. Recurrent pericoronitis (N= 65; 55.1%) and apical periodontitis (N= 41; 34.7%) were the most common indications for extraction. Conclusion: The prevalence of impacted mandibular third molar in Calabar is lower than previous reports from other urban cities in Nigeria. Mesioangular impaction was the most common impaction type, but unlike previous reports, horizontal impactions constitute a great proportion of third molar impactions seen in this environment.
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African Journal of Medical and Health Sciences 2016 15(1):14-17
Background: The study examines the pattern of impacted lower third molars in Calabar, Southern Nigeria. Patients and Methods: A retrospective analysis of the medical record of all patients, who were treated for symptomatic impacted lower third molar at the Dental and Maxillofacial Surgery Clinic of our institution over a 3-year period was undertaken. Information obtained included patients' demographics, location, type of impaction, presence of caries in the second molar, and indication for extraction. Results: A total of 2,156 patients were seen at the Dental and Maxillofacial Surgery Clinic over the 3-year period of study and of these patients, 118 impacted mandibular third molars were surgically extracted in 97 patients and thus giving a prevalence of 4.7%. The patients' ages ranged 18-48 years, the mean (SD) age was 27.5 (5.60) years. Impaction of the lower third molar occurred equally in both gender with an approximate ratio of 1:1. Mesioangular impaction was the most common type (N = 53; 44.9%), followed by horizontal impaction (N = 34; 28.8%). About half of the impacted teeth were located on the left side (N = 51; 43.2%). There was bilateral location in 21 (17.8%) cases. Recurrent pericoronitis (N= 65; 55.1%) and apical periodontitis (N= 41; 34.7%) were the most common indications for extraction. Conclusion: The prevalence of impacted mandibular third molar in Calabar is lower than previous reports from other urban cities in Nigeria. Mesioangular impaction was the most common impaction type, but unlike previous reports, horizontal impactions constitute a great proportion of third molar impactions seen in this environment.
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Prevalence of neck pain in goldsmith workers
2016-06-10T07-42-30Z
Source: International Journal of Therapies and Rehabilitation Research
HARSHA DHANUKA, RITESH GAIGOLE.
: Goldsmith workers are working there for prolonged period of time in cross legged posture at semi confined workstation. This sustained posture increases the demand on the muscles, ligaments, soft tissues of musculoskeletal system. Sitting alters the normal curvature of the spine and puts pressure on the discs. With prolonged sitting this pressure can cause compression of the discs. Prolonged static load of long duration and repeated movements can result in neck pain, tension neck syndrome, muscle imbalance or cervical instability. There have been studies done on work related musculoskeletal disorders in Goldsmith workers, as Goldsmith workers work in very semi confined position hence the stress comes more on neck and upper back .80% of Goldsmith workers are more prone to the neck pain and there are limited studies done so as to show prevalence of neck pain,so we wanted to find out the prevalence of neck pain in Goldsmith workersThe study was observational study carried out on 100 goldsmith workers within Pimpri-Chinchwadarea,Pune for 6months.Inclusion criteria was goldsmith workers woking for more than 6 months age group of 20-60yrs.Subjects with any spinal fracture, spine deformity, trauma, surgery, any neurological involvement. were excluded.Statistical analysis was carried out based on the questionnaire provided to them From the study we can conclude that Goldsmith Workers often have neck pain which may be associated with improper position of neck and faulty posture while working. Keywords: Neck pain, Goldsmith workers, Prevalence INTRODUCTION Neck pain in the most common health problem in general population. Most of the people experience some degree of neck pain in their life time. (6) It has been seen that neck pain is the most common problem in Goldsmith workers. These industries are one of the wide spread small scale industries of India. Goldsmith workers are working there for prolonged period of time in cross legged posture at semi confined workstation. This sustained posture increases the demand on the muscles, ligaments, soft tissues of musculoskeletal system. Sitting alters the normal curvature of the spine and puts pressure on the discs. With prolonged sitting this pressure can cause compression of the discs. (6) Prolonged static load of long duration and repeated movements can result in neck pain, tension neck syndrome, muscle imbalance or cervical instability. (1) This may have lead to the development of different kinds of musculoskeletal disorders among them observed that poorly designed workstation promote unnecessary physical efforts, which reduce efficiency and productivity also. (6) According to study done by TirthankarGhosh(2010) concluded that prevalence of neck pain in Goldsmith workers in Karnataka region is 80%. (2) So, the purpose of the present study is to know the prevalence of neck pain in Goldsmith workers of Pune(PCMC) region
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Plasma fibrinogen correlates with lipid profile in Nigerian patients with hypertension and diabetes coexisting with hypertension
Nancy Ibeh, John Aneke, Okocha E Chide, Emeka Enemuo, Uche Chukwuemeka, Christain Ibeh
African Journal of Medical and Health Sciences 2016 15(1):1-6
Background: Established markers of cardiovascular risk have become important in the evaluation of patients with diabetes and hypertension. This study correlated plasma fibrinogen with indices of cardiovascular risk in patients with type 2 diabetes, hypertension, and diabetes coexisting with hypertension. Materials and Methods: This study was cross-sectional, carried out at the Medical Outpatient (MOP) clinic of our hospital, from May to August, 2014. Eighty subjects were enrolled and were categorized into three groups, according to the following diagnoses: Diabetics, hypertensives, and patients with diabetes coexisting with hypertension. Fasting lipid profile [total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglyceride] and fibrinogen level were estimated while body mass index (BMI) was calculated. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20. Results were presented as means (and standard deviations), percentages, and proportions, and variables were compared using the chi-square test, analysis of variance (ANOVA), and the Pearson's correlation coefficient. The level of significance was set at P = 0.05. Results: Plasma fibrinogen levels were significantly higher in patients with hypertension, diabetes, and diabetes coexisting with hypertension than in control subjects (469.15 ± 67.99 mg/dL, 440.10 ± 45.63 mg/dL, 473.75 ± 82.61 mg/dL vs. 378.95 ± 31.37 mg/dL, respectively, P = 0.001). The total cholesterol, LDL, HDL, and BMI were significantly different in all the patient groups compared to the controls; while HDL and triglyceride correlated significantly with plasma fibrinogen in those with hypertension and diabetes coexisting with hypertension. Conclusion: Plasma fibrinogen could serve as a marker of cardiovascular risk in patients with hypertension and diabetes coexisting with hypertension.
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African Journal of Medical and Health Sciences 2016 15(1):1-6
Background: Established markers of cardiovascular risk have become important in the evaluation of patients with diabetes and hypertension. This study correlated plasma fibrinogen with indices of cardiovascular risk in patients with type 2 diabetes, hypertension, and diabetes coexisting with hypertension. Materials and Methods: This study was cross-sectional, carried out at the Medical Outpatient (MOP) clinic of our hospital, from May to August, 2014. Eighty subjects were enrolled and were categorized into three groups, according to the following diagnoses: Diabetics, hypertensives, and patients with diabetes coexisting with hypertension. Fasting lipid profile [total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglyceride] and fibrinogen level were estimated while body mass index (BMI) was calculated. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20. Results were presented as means (and standard deviations), percentages, and proportions, and variables were compared using the chi-square test, analysis of variance (ANOVA), and the Pearson's correlation coefficient. The level of significance was set at P = 0.05. Results: Plasma fibrinogen levels were significantly higher in patients with hypertension, diabetes, and diabetes coexisting with hypertension than in control subjects (469.15 ± 67.99 mg/dL, 440.10 ± 45.63 mg/dL, 473.75 ± 82.61 mg/dL vs. 378.95 ± 31.37 mg/dL, respectively, P = 0.001). The total cholesterol, LDL, HDL, and BMI were significantly different in all the patient groups compared to the controls; while HDL and triglyceride correlated significantly with plasma fibrinogen in those with hypertension and diabetes coexisting with hypertension. Conclusion: Plasma fibrinogen could serve as a marker of cardiovascular risk in patients with hypertension and diabetes coexisting with hypertension.
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Level of awareness, and factors associated with willingness to participate in the National Health Insurance Scheme among traders in Abakaliki main market, Ebonyi State, Nigeria
Benedict Ndubueze Azuogu, Ugochukwu C Madubueze, Chihurumnanya Alo, Lawrence Ulu Ogbonnaya, Nnennaya A Ajayi
African Journal of Medical and Health Sciences 2016 15(1):18-23
Introduction: The National Health Insurance Scheme (NHIS) was introduced in Nigeria in 2005, and nine years after its inception only 3.5% of the population have been enrolled in three Sectors of the Scheme. Traders and others in the informal sector are not involvement in the scheme. This study was conducted to assess the level of awareness, and factors that could affect the willingness of traders in Abakaliki main market to participate in the National Health Insurance Scheme. Materials and Methods: A descriptive cross sectional study of 419 traders (53% males and 47% females) was carried out using a three stage sampling technique. Data was collected using interviewer administered semi-structured questionnaire, and was analyzed using SPSS (version 20) and Mathcad 7 Professional software. Frequencies and percentages were calculated, while Chi square test and Z-score were used to test for associations, with P < 0.05 set as level of significance. Results: Only 127 (30.3%) of the 419 traders were aware of NHIS, and significant majority (73.2%) of those aware of the scheme were willing to participate. No factor was significantly associated with willingness to participate. Conclusion: Awareness of NHIS was very poor among the traders, but majority of them were willing to participate in the scheme. Enlightenment campaigns should be embarked upon in the markets to increase awareness of the scheme among the traders, as this could influence their participation.
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African Journal of Medical and Health Sciences 2016 15(1):18-23
Introduction: The National Health Insurance Scheme (NHIS) was introduced in Nigeria in 2005, and nine years after its inception only 3.5% of the population have been enrolled in three Sectors of the Scheme. Traders and others in the informal sector are not involvement in the scheme. This study was conducted to assess the level of awareness, and factors that could affect the willingness of traders in Abakaliki main market to participate in the National Health Insurance Scheme. Materials and Methods: A descriptive cross sectional study of 419 traders (53% males and 47% females) was carried out using a three stage sampling technique. Data was collected using interviewer administered semi-structured questionnaire, and was analyzed using SPSS (version 20) and Mathcad 7 Professional software. Frequencies and percentages were calculated, while Chi square test and Z-score were used to test for associations, with P < 0.05 set as level of significance. Results: Only 127 (30.3%) of the 419 traders were aware of NHIS, and significant majority (73.2%) of those aware of the scheme were willing to participate. No factor was significantly associated with willingness to participate. Conclusion: Awareness of NHIS was very poor among the traders, but majority of them were willing to participate in the scheme. Enlightenment campaigns should be embarked upon in the markets to increase awareness of the scheme among the traders, as this could influence their participation.
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Identification and prereferral care for patients with chronic kidney disease by Nigerian family medicine trainee
Okwuonu Chimezie Godswill, Ugwelle Ogbonna, Chimezie Oluchi Justina, Ezeani Ignatius, Chukwuonye Innocent Ijezie, Oviasu Efosa
African Journal of Medical and Health Sciences 2016 15(1):41-45
Background: The family physician is usually the first contact between patients and the health care system at the tertiary level, and they play an important role in the screening for chronic kidney disease (CKD), treatment of reversible causes, and timely referral to the nephrologist. We do not know if the future family physician in Nigeria is prepared for this important role, prompting us to carry out this study. Materials and Methods: Self-administered questionnaires were given to family medicine trainees attending a nationally organized revision course. Results: Two hundred questionnaires were distributed and 172 were returned Guidelines for the management of CKD were correctly identified by only 18% of the participants. The screening methods that were identified for CKD included urinalysis (43.6%), serum creatinine alone (72.7%), estimation of glomerular filtration rate (70.3%), and renal ultrasound (30.5%). Less than 50% were aware of the recommended frequency of screening for diabetic and elderly patients while less than 25% were aware of coronary artery disease and stroke as complications of CKD. After a diagnosis of CKD, 40.4% would refer immediately to the nephrologist, while 33%, 13%, and 2% would use the serum creatinine level alone, estimated glomerular filtration rate (GFR), and clinical features, respectively, as guides in taking decisions on referral. Conclusion: A good number of the participants had poor knowledge in the aspects of identification of patients with CKD, initial evaluation of such patients and eventual referral to nephrologists. Concerted efforts are needed to improve this knowledge in the family physician trainees of Nigeria.
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African Journal of Medical and Health Sciences 2016 15(1):41-45
Background: The family physician is usually the first contact between patients and the health care system at the tertiary level, and they play an important role in the screening for chronic kidney disease (CKD), treatment of reversible causes, and timely referral to the nephrologist. We do not know if the future family physician in Nigeria is prepared for this important role, prompting us to carry out this study. Materials and Methods: Self-administered questionnaires were given to family medicine trainees attending a nationally organized revision course. Results: Two hundred questionnaires were distributed and 172 were returned Guidelines for the management of CKD were correctly identified by only 18% of the participants. The screening methods that were identified for CKD included urinalysis (43.6%), serum creatinine alone (72.7%), estimation of glomerular filtration rate (70.3%), and renal ultrasound (30.5%). Less than 50% were aware of the recommended frequency of screening for diabetic and elderly patients while less than 25% were aware of coronary artery disease and stroke as complications of CKD. After a diagnosis of CKD, 40.4% would refer immediately to the nephrologist, while 33%, 13%, and 2% would use the serum creatinine level alone, estimated glomerular filtration rate (GFR), and clinical features, respectively, as guides in taking decisions on referral. Conclusion: A good number of the participants had poor knowledge in the aspects of identification of patients with CKD, initial evaluation of such patients and eventual referral to nephrologists. Concerted efforts are needed to improve this knowledge in the family physician trainees of Nigeria.
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Seroprevalence of cytomegalovirus antibodies among antenatal clinic attendees in Abakaliki, Nigeria
Ogbonna Nlia Anuma, Odidika Ugochukwu Joannes Umeora
African Journal of Medical and Health Sciences 2016 15(1):24-29
Context: Cytomegalovirus infection is potentially neurotoxic to the fetus when it occurs during pregnancy. The prevalence is not known within our population. Aims: To determine the seroprevalence of Cytomegalovirus antibodies in pregnant Nigerian women at a tertiary health facility in Southeast Nigeria. Methods: This was a laboratory-based cross sectional descriptive study. Pregnant women who consented to the study were recruited from the antenatal clinics of the Teaching Hospital. Blood samples were collected from them and analysed using ELISA techniques. The relationships between positive CMV antibodies and socio-demographic variables were analysed using Chi square test and linear regression analysis. Results: Two hundred and four (204) serum samples were analysed. CMV seroprevalence was 96.08%. Two hundred and one (98.5%) participants were not aware of CMV infection. Lower socioeconomic class was associated with increased seroprevalence of Cytomegalovirus (P=0.004). Multiparous women were more likely to acquire CMV infection than primigravide women (P=0.009). There was a strong association between maternal place of residence and CMV seropositivity (P=0.023). The association between increasing maternal age and CMV seropositivity did not achieve statistical significance (P=0.246). Conclusion: Cytomegalovirus seroprevalence is high among participants and awareness of this disease is low. There is need to create further awareness of this disease.
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African Journal of Medical and Health Sciences 2016 15(1):24-29
Context: Cytomegalovirus infection is potentially neurotoxic to the fetus when it occurs during pregnancy. The prevalence is not known within our population. Aims: To determine the seroprevalence of Cytomegalovirus antibodies in pregnant Nigerian women at a tertiary health facility in Southeast Nigeria. Methods: This was a laboratory-based cross sectional descriptive study. Pregnant women who consented to the study were recruited from the antenatal clinics of the Teaching Hospital. Blood samples were collected from them and analysed using ELISA techniques. The relationships between positive CMV antibodies and socio-demographic variables were analysed using Chi square test and linear regression analysis. Results: Two hundred and four (204) serum samples were analysed. CMV seroprevalence was 96.08%. Two hundred and one (98.5%) participants were not aware of CMV infection. Lower socioeconomic class was associated with increased seroprevalence of Cytomegalovirus (P=0.004). Multiparous women were more likely to acquire CMV infection than primigravide women (P=0.009). There was a strong association between maternal place of residence and CMV seropositivity (P=0.023). The association between increasing maternal age and CMV seropositivity did not achieve statistical significance (P=0.246). Conclusion: Cytomegalovirus seroprevalence is high among participants and awareness of this disease is low. There is need to create further awareness of this disease.
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Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone: Long-Term Outcomes at a Single Center
Abstract
Background
Endoscopic papillary large balloon dilatation (EPLBD) without endoscopic sphincterotomy (EST) is an accepted, simplified endoscopic technique for large common bile duct (CBD) stone removal. However, little is known about the long-term outcomes of this technique. The purpose of this study was to evaluate the long-term outcomes of EPLBD without EST for the treatment of large CBD stones.
Methods
This retrospective study of EPLBD without EST for a large CBD stone was conducted between June 2005 and October 2010. A total of 128 patients with a large CBD stone were included. The primary outcome measurement was complete CBD stone removal after EPLBD. Clinical data obtained from medical records were analyzed.
Results
The overall complete stone removal rate was 94.5 %. Mechanical lithotripsy was needed in 18 (14.1 %) patients. Post-procedural pancreatitis and asymptomatic hyperamylasemia occurred in 1 (0.8 %) and 11 (8.6 %) patients, respectively. One (0.8 %) patient experienced minor bleeding. The rate of stone recurrence was 13.1 %, and median time to stone recurrence was 600 days (range 144–2284 days). Over a half (64.3 %) of stone recurrences occurred during the 2 years following stone removal. Recurrence tended to be more frequent in patients with a large CBD diameter and in patients requiring multiple endoscopic sessions for complete CBD stone retrieval.
Conclusion
EPLBD without EST may be safe and effective in patients with a large bile duct stone.
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Management of tooth mobility in the periodontology clinic: An overview and experience from a tertiary healthcare setting
Clement Chinedu Azodo, Paul Erhabor
African Journal of Medical and Health Sciences 2016 15(1):50-57
Background: Tooth mobility, considered as the extent of horizontal and vertical tooth displacement created by examiners force, is caused trauma and periodontal disease. It is a common presenting complaint in periodontal clinic and may result in occlusal instability, dietary restriction, masticatory disturbances, esthetic challenge, and impaired quality of life. The treatment of tooth mobility involves a combination of treatment of the etiology usually by nonsurgical and surgical periodontal treatment, occlusal adjustment, and splinting. This article reviewed occlusal adjustment and splinting in the management of tooth mobility and reported our experience in University of Benin Teaching Hospital, Benin City, Nigeria on tooth mobility managed with 0.5 mm hard stainless steel wire reinforced composite splint. Results: Composite splinting reinforced with 0.5 mm HSS wire facilitates healing of periodontally compromised teeth with mobility after they have been treated with nonsurgical periodontal therapy and occlusal adjustment. Conclusion: Splinting is a well-accepted integral part of holistic periodontal treatment which results in morale boost, improved patient comfort, and oral functions.
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African Journal of Medical and Health Sciences 2016 15(1):50-57
Background: Tooth mobility, considered as the extent of horizontal and vertical tooth displacement created by examiners force, is caused trauma and periodontal disease. It is a common presenting complaint in periodontal clinic and may result in occlusal instability, dietary restriction, masticatory disturbances, esthetic challenge, and impaired quality of life. The treatment of tooth mobility involves a combination of treatment of the etiology usually by nonsurgical and surgical periodontal treatment, occlusal adjustment, and splinting. This article reviewed occlusal adjustment and splinting in the management of tooth mobility and reported our experience in University of Benin Teaching Hospital, Benin City, Nigeria on tooth mobility managed with 0.5 mm hard stainless steel wire reinforced composite splint. Results: Composite splinting reinforced with 0.5 mm HSS wire facilitates healing of periodontally compromised teeth with mobility after they have been treated with nonsurgical periodontal therapy and occlusal adjustment. Conclusion: Splinting is a well-accepted integral part of holistic periodontal treatment which results in morale boost, improved patient comfort, and oral functions.
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Limb amputations in Abakaliki, South East Nigeria
Njoku Isaac Omoke, Chinedu Gregory Nwigwe
African Journal of Medical and Health Sciences 2016 15(1):30-35
Background: Limb amputation is a preventable and important public health concern in developing countries. We aimed at determining the pattern, indications, and outcome of limb amputations in our environment. Materials and Methods: A hospital-based retrospective review of the database of all limb amputations in Federal Teaching Hospital in Abakaliki, Ebonyi State, Nigeria from January 2002 to December 2012. Results: In 184 patients, there were 192 limb amputations; 141 (73.9%) of the amputations were major and 51 (26.1%) were minor. The male-to-female ratio was 3.5:1 and the mean age was 33.8 ± 1.95 years. The common indications for amputation were trauma (69.0%), diabetic foot gangrene (16.3%), and malignancy (7.1%). Lower limb was significantly more involved than the upper limb in all indications of amputation (P < 0.001). Wound infection (40.2%), severe anemia (11.4%), and wound dehiscence 9.2% were the three top complications observed. The mean and median lengths of hospital stay were 43.3 ± 3.1 and 36 days, respectively. The mortality rate was 8.7%; it was significantly higher in females than males (17.1% vs 6.3% P < 0.031) and in nontrauma-related amputations than trauma-related ones (15.8% vs 5.5% P < 0.022). The rate of successful prosthetic rehabilitation was 18.5%. Conclusion: In our environment, trauma and diabetic foot gangrene are common causes of limb amputation. The observed pattern of predominantly major amputations and the relatively high morbidity associated with amputation in our environment call for appropriate policy response aimed at prevention and optimum care.
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African Journal of Medical and Health Sciences 2016 15(1):30-35
Background: Limb amputation is a preventable and important public health concern in developing countries. We aimed at determining the pattern, indications, and outcome of limb amputations in our environment. Materials and Methods: A hospital-based retrospective review of the database of all limb amputations in Federal Teaching Hospital in Abakaliki, Ebonyi State, Nigeria from January 2002 to December 2012. Results: In 184 patients, there were 192 limb amputations; 141 (73.9%) of the amputations were major and 51 (26.1%) were minor. The male-to-female ratio was 3.5:1 and the mean age was 33.8 ± 1.95 years. The common indications for amputation were trauma (69.0%), diabetic foot gangrene (16.3%), and malignancy (7.1%). Lower limb was significantly more involved than the upper limb in all indications of amputation (P < 0.001). Wound infection (40.2%), severe anemia (11.4%), and wound dehiscence 9.2% were the three top complications observed. The mean and median lengths of hospital stay were 43.3 ± 3.1 and 36 days, respectively. The mortality rate was 8.7%; it was significantly higher in females than males (17.1% vs 6.3% P < 0.031) and in nontrauma-related amputations than trauma-related ones (15.8% vs 5.5% P < 0.022). The rate of successful prosthetic rehabilitation was 18.5%. Conclusion: In our environment, trauma and diabetic foot gangrene are common causes of limb amputation. The observed pattern of predominantly major amputations and the relatively high morbidity associated with amputation in our environment call for appropriate policy response aimed at prevention and optimum care.
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Origin, Clinical Characteristics and 30-Day Outcomes of Severe Hematochezia in Cirrhotics and Non-cirrhotics
Abstract
Background
The sites of origin, causes and outcomes of severe hematochezia have not been compared between cirrhotics and non-cirrhotics. In cirrhotics versus non-cirrhotics presenting with severe hematochezia, we aimed at (1) identifying the site and etiology of gastro-intestinal bleeding and independent predictors of bleeding from the upper gastrointestinal tract versus small bowel or the colon, (2) comparing 30-day clinical outcomes, and (3) proposing an algorithm for management of severe hematochezia.
Methods
In this cohort study from two university-based medical centers, 860 consecutive patients with severe hematochezia admitted from 1995 to 2011 were prospectively enrolled with 160 (18.6 %) cirrhotics. We studied (a) general clinical and laboratory characteristics of cirrhotics versus non-cirrhotics, (b) predictors of bleeding sites in each patient group by multiple variable regression analysis, and compared (c) 30-day outcomes, including rebleeding, surgery and deaths.
Results
Cirrhosis independently predicted an upper gastrointestinal source of bleeding (OR 3.47; 95 % CI 2.01–5.96) as well as history of hematemesis, melena in the past 30 days, positive nasogastric aspirate, prior upper gastrointestinal bleeding or use of aspirin or non-steroidal anti-inflammatory. The most prevalent diagnoses were esophageal varices (20 %) in cirrhotics and colon diverticular bleeding (27.1 %) in non-cirrhotics. Thirty-day rates of rebleeding, surgical interventions and deaths were 23.1 versus 15 % (P = 0.01), 14.4 versus 6.4 % (P < 0.001), and 17.5 versus 4.1 % (P < 0.001), in cirrhotics versus non-cirrhotics, respectively.
Conclusions
Cirrhosis predicted an upper gastrointestinal site of bleeding in patients presenting with severe hematochezia. The 30-day rates of rebleeding, surgery, and death were significantly higher in cirrhotics than in non-cirrhotics.
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Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman's disease) with systemic involvement
Viswanaths Sundaram
African Journal of Medical and Health Sciences 2016 15(1):62-64
Sinus Histiocytosis is rare benign lymphadenopathy. This has a recurrent course and at times requires cytotoxic therapy. Systemic involvement is very rare. Here a case with systemic involvement is described.
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African Journal of Medical and Health Sciences 2016 15(1):62-64
Sinus Histiocytosis is rare benign lymphadenopathy. This has a recurrent course and at times requires cytotoxic therapy. Systemic involvement is very rare. Here a case with systemic involvement is described.
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