Do economic conditions and in-kind benefits make needy patients bond together? Insights from cross-section data on clusters of co-located patients in Vietnam

Needy patients in Vietnam have been facing risks of destitution and decreasing quality of life. The problem appears to have been persistent due largely to undeveloped healthcare and health financing systems, especially for patients from rural areas or those suffering from chronic diseases. To cope with harsh realities of life during their medical treatments, an increasing number of Vietnamese patients have chosen to live together in voluntary co-location clusters where they seek to support one another in reducing burdens and sharing resources, apart from information needs. By living together, patients in need hope for some improvement in quality of life, which is a crucial part constituting quality of healthcare during their long-term treatment.

Synthesis and Structural Properties Characterization of Ap/Mgo Nanocomposites for Biomedical Applications

A novel method was used to produce a nanostructured composite consisting of hydroxyapatite and MgO by varying the temperature. The structure and morphology of the synthesized nanocomposite were characterized. From x-ray diffraction (XRD) analysis, an increase in crystallite size and degree of crystallinity with an increase in the temperature was observed.

The XRD investigation confirms that the grain size of the synthesized nanocomposites is in the range 4-11 nm. The grain size increases when the temperature is increased due to the agglomeration of nanoparticles. The fourier transform infrared spectroscopy (FTIR) studies confirm the presence of PO4 3-, CO3 2- and Mg2+, and oh-  groups. The UV-VIS spectroscopy measurements show the reduction in the band-gap upon the temperature. Transmission electron microscope (TEM) images ascertained that nano HAp /MgO at 250°C and 300°C composite shows flakes like morphology.

A rare presentation of herpes zoster induced osteonecrosis of jaw in an immunocompetent individual

Herpes Zoster (HZ) or Shingles presents as a cutaneous vesicular eruption in the area innervated by the affected sensory nerve, usually associated with severe pain. Oral manifestations of HZ appear when the mandibular or maxillary divisions of the trigeminal nerve are affected. Osteonecrosis of Jaw Bones (ONJ) is one of the rare complications associated with it. This paper will discuss about a case of HZ with subsequent osteonecrosis of maxillary bone as one of the complication.

Preferences and Expectations of the Older Adult Care

The WHO defines the care services such as the provision of health services by formal or informal caregivers, at home, with the aim of promoting to restore or maintain the highest degree of comfort, functionality and health, including efforts to dignify death.
To comply with such a definition is of the utmost importance to know the real needs and problems in the elderly, as well as their real preferences and expectations and feelings about health care in general and before the death, so as to be able to adapt our interventions to meet these expectations, providing quality health care and a dignified death.

A cross-sectional study was conducted in adults older than 60 years who live in the community, municipality of Santa Catarina, Nuevo León, Mexico. During the months from January to May of 2017. Demographic data were collected and a survey was conducted of the preferences and expectations of the older adult about your medical care, which was applied directly by students of Community Medicine in the homes; the survey is made up of a total of 20 items, being 12 items relating to medical care in general and 8 items to medical care prior to death. The data were analyzed with the statistical program SPSS 20.0 (SPSS Inc.).

Evolution of uncontrolled severe asthma under Omalizumab and specialized care unit treatment

Bronchial asthma is one of the most frequent respiratory disorders, affecting 5% of the adult Spanish population, although its prevalence appears to be levelling off among adolescents. The management of asthmatic patients is widespread among general practitioners, allergists and pneumologists, although the most severe forms prove challenging for professionals due to the associated disability, reduced quality of life and treatment Costs. The prevalence of severe uncontrolled asthma is not negligible; a recent study that recorded information from 164 hospital units in Spain over 6 months, showed that 666 (65.9%) patients among 36,649 adult asthmatics, met criteria for uncontrolled severe chronic asthma according to GINA criteria. For this and other reasons, the creation of specific asthma units has led to improved assistance, a rational use of medical resources and the use of specific biologic therapies for this disease.

Exercise during pregnancy activates cardioprotective genes without a further increase in pregnancy-induced cardiac hypertrophy

Pregnancy and exercise promote cardiovascular remodeling: pregnancy is associated with prolonged, but reversible, cardiac volume overload secondary to increased blood volume and significant hormonal changes that together result in cardiac hypertrophy. During pregnancy, cardiac output increases gradually and reaches a peak from the second trimester through term. This increase in cardiac output is achieved by either gradual and substantial increases in heart rate and stroke volume or a fall in vascular resistance. In addition to hemodynamic alterations during pregnancy, the levels of circulating progesterone gradually increase with advancing gestational age, which contributes to pregnancy induced cardiac hypertrophy.

How Often Should Surgical Instruments Be Sterilized?

Proper and timely sterilization of surgical instruments is crucial for achieving desirable postoperative outcomes. Though the methods of sterilization have long been standardized, standardization of the specific time period after which they should be repeated, is yet to be achieved. A recent study regarding the same illustrated that surgical instruments remain sterile up to 6 hours after the sterilization procedure, after which the bacterial colonies begin to develop. It is hence recommended to re-sterilize surgical instruments after 6 hours of use. This newfound information specifically correspond to replacing surgical instruments after 6 hours of commencement of surgery, especially in those extensively lengthy multiple surgical regimes.

Effect of structured patient education program on the knowledge level of mothers regarding childhood gastroenteritis and pneumonia at El-Raml Pediatric Hospital

Diarrhea and pneumonia are leading childhood killers; together, they are responsible for almost one quarter of all deaths in children under 5. There is nothing new or exotic about these two diseases. In fact they are some of the oldest and most common in the world; most children contract pneumonia and diarrhea at some point during childhood. Globally more than 1.4 million children die every year, from diarrhea and pneumonia, particularly in settings with limited access to health services, nutritious foods, basic sanitation and hygiene.

New Onset Diabetes after Liver Transplantation (NODAT): Myths and Facts

NODAT is considered as one of the crucial factors that limit the real time therapeutic efficacy of patients who undergo liver transplantation. While family history of Diabetes Mellitus, immunosuppressive treatment regimen used, obesity, and etiology of CLD are considered as chief contributors towards development of post-surgical NODAT in majority of liver transplantation cases, recent study results indicate otherwise. Most cases of NODAT are transient in nature i.e. the patients recover within six months to one year. Furthermore, the total percentage of people NODAT has also declined significantly in the recent past. Hence, a multifactorial and extended analysis of NODAT is crucial to accessing the real time therapeutic efficiency of the surgical procedure.

Fistulous communication between the circumflex artery and right atrium: Diagnostic imaging and surgical repair

Coronary artery fistulas are rare anatomic anomalies that may be congenital or acquired. The most commonly affected vessel is the right coronary artery while origination from the left circumflex is rare. A coronary fistula creates a left-to-right shunt eventually leading to ventricular overload and congestive heart failure. Due to the low incidence of coronary fistulas, data is limited with regards to treatment strategies. We report the successful treatment of a large fistulous communication between the circumflex artery and the right atrium by proximal and distal ligation of the circumflex artery and selective revascularization of the excluded marginal branch.

Correlation between high mobility group box 1 protein, tumor necrosis factor-α, and acute coronary syndrome

Acute Coronary Syndrome (ACS) is characterized by a complex multi factorial pathogenesis, which involves an inflammatory response, immune damage, and the activation of the blood clotting function. Thus far, researchers studying the fundamental mechanism of ACS have suggested that inflammation causes coronary atherosclerotic plaque instability and leads to the activation of endothelial cells, which results in the rupture of plaques and thrombus formation. In addition, the progression of thrombus formation is associated with inflammation, and the pro-inflammatory state appears to increase the risk of coronary artery thrombosis, which suggests that the inflammatory response plays an important role in the onset of ACS.

Study and development of algorithm of different skin diseases analysis using image processing method

Tele-dermatology is a system in the medical field of dermatology where telecommunication technologies are used to exchange information concerning skin conditions over a distance. The advantage of tele-dermatology is that the patients need not to be physically present in consultation room of doctor(s). We have collected (i) eczema, scabies, pyoderma, ringworm, psoriasis, MRSA skin disease images from the American Academy of Dermatology website. 

Our study found that Feature Extraction is an important aspect to aid the doctors or Automatic decisions making by computer algorithm to find the diseases of the skin amongst the all possible skin diseases. Our approach was Artificial intelligence based computer algorithm that would be able to make diagnostic decision to a good degree of accuracy. We found features namely, contrast, correlation, energy, maximum probability, entropy, smoothness, homogeneity based on STATISCAL THEORY. We computed the features from the digital images of skin. We found many of the above mentioned features do vary with good degree of margin for Different Skin diseases, but few of them are barely indistinguishable.

Deep vein thrombosis: A rare complication of varicella zoster infection

Chickenpox (varicella) is a benign illness caused by varicella zoster virus which occurs predominantly in childhood. The incidence in young adults is 90/100,000 population and falls steadily with age. The varicella-Zoster virus is a double-stranded DNA virus of the Herpes viridae family. It affects only humans and the primary route of spread is via the respiratory tract. The incubation period from contact to appearance of the rash is 10- 20 days. Complications include pneumonitis, encephalitis, rare neurological sequelae including optic neuritis and transverse myelitis. Hematological complications of thrombocytopenia and purpura fulminans myocarditis, pericarditis, pancreatitis and orchitis have all been reported.

Prevalence and risk factors of new onset diabetes after liver transplantation (NODAT): A single Egyptian center experience

To estimate the prevalence of New Onset Diabetes after Liver Transplantation (NODAT) and to investigate the possible risk factors. Methods: This retrospective study comprises 213 patients subjected to living donor liver transplantation (LDLT). Patients’ data were collected from medical registry files for a period of two years after transplant. Results: Of the total 213 recipients, complete data for the whole study period were available for 164 recipients who were enrolled in this study. Fifty one 51 (31.1%) patients were already diabetic prior to transplantation. 

The prevalence of NODAT was 27.43% (31/113). Eight of NODAT cases (25.8%) were transient with recovery within 6-months period in 5/8 cases while the other 3 cases recovered in more than 6 months to a year. The only drug that showed statistically significant difference was tacrolimus (p=0.02). Interestingly, three pre-transplant diabetics (3/51, 5.9%) recovered after liver transplant with elimination of their anti-diabetic therapy. Conclusion: NODAT is a common medical complication that occurs in 27.4% of liver transplant recipients. 

Microbial dysbiosis and disease pathogenesis of endometriosis, could there be a link?

Endometriosis is an estrogen-dependent inflammatory condition in women that is characterised by the ectopic growth of endometrial glands and stroma outside of the uterine cavity. Although there exists many theories for the pathogenesis of endometriosis, none has been successively confirmed as a direct cause for disease development. The human body comprises a diverse micro flora across all tissues that can have fundamental roles in health and disease.

The microbial flora in a healthy individual can vary remarkably between anatomical sites due to the physical and chemical properties of specific tissues. This includes the female reproductive tract, notably the vagina, which harbours a micro biota dominated byLactobacilli species. In addition, a core unique micro biome has been defined for the endometrium that also includes Lactobacilli spp. In this review we examine the possibility that endometriosis could result from microbial dysbiosis, whereby significant changes to the natural micro flora within the endometrium could reduce mucosal immune regulation in this tissue with concomitant expansion of pathogenic bacteria that trigger local tissue inflammation that could perpetuate the development of endometrial disease.

Take On the Colon Cancer

Colon cancer is the third most common cancer in incidence and mortality worldwide (Fearon et al., 1990), and one of the few cancers that can be prevented. Fortunately, this disease often starts from the beginning with abdominal pain and symptoms. 

Less than 10% of patients in stage I disease recurrence and does not benefit for whom adjuvant chemotherapy, 20% of patients in stage II disease have a recurrence and for whom adjuvant chemotherapy minimal benefit (Marshall, 2010) because in the early stages of colon cancer (stages I and II) tumor engulfed all the inner walls of the colon. In stage III colon cancer there are regional lymph node metastases and the administration of adjuvant chemotherapy have been seen a significant increase in survival (Meyerhardt et al., 2005). In stage IV colon cancer patients are with distant metastases, tougher regimes in the process of receiving treatment that is not common treatments (Boland et al., 2016).

Literature review on Bio degradable Nano spheres for Oral and Targeted Drug Delivery

Nano sphere systems have great potentials, being able to convert poorly soluble, poorly absorbed and labile biologically active substance into promising deliverable drugs. The core of this system can enclose a variety of drugs, enzymes, genes and is characterized by a long circulation time due to the hydrophilic shell which prevents recognition by the reticular-endothelial system. To optimize this drug delivery system, greater understanding of the different mechanisms of biological interactions, and particle engineering, is still required. Further advances are needed in order to turn the concept of nanoparticles technology into a realistic practical application as the next generation of drug delivery system.

Training the? Blind? Otolaryngologist: Can OSATS Help?

Training in surgery is entirely different to medical training as it involves acquisition of skills, operating competence and cutting experience within a defined time frame. As a result,some training programmes end up producing less competent and less experienced surgeons owing to the decreased training time. Considering the fact that each trainee surgeon has a different learning curve, a question is posed; whether some surgeons complete their training at a lower point, than anticipated, on their learning curve1.