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Cystic fibrosis: An updated comprehensive review of literature with pediatric dentistry perspectives 囊性纤维化:从儿科牙科角度对文献的最新综述
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_301_22
Mohammad Khan
Cystic fibrosis (CF) is a genetic disorder, inherited in an autosomal recessive manner. It affects the multiple organs or organ systems of human body including mainly respiratory, digestive, and renal systems. CF patients may have various orodental problems either directly by the primary disease of CF or indirectly by comorbidities, its complications and by side effects of pharmacotherapies. The optimization of oral health by meticulous dental care is essential aspect and hence must be an integral part of the multidisciplinary management in such patients with CF. Thus, general and pediatric dentist need to remain updated with the pathophysiology of the disease, its medical treatment, and its adverse effects on oral health in order to manage such CF-affected individuals with best scientific evidence-based approach of dentistry. Therefore, the current article has comprehensively reviewed the existing current literature regarding CF to describe its pathophysiology (etiology), clinical features, screening/diagnostic modalities, and management strategies along with its detailed orodental implications of CF and dental management aspects. Moreover, an overview/outline of dental care of CF patients in age-wise manner has been illustrated in this article. The relevant and recent scientific literature for the comprehensive review has been searched using the suitable keywords or its combinations/Boolean operators in different electronic databases (PubMed-Medline, Web of Science, Scopus, and Google Scholar) and, thus, included the topic-related articles published in English literature till 2022. Furthermore, the articles related to orodental implications and the dental management of the CF with the perspectives of pediatric dentistry was also searched and included for review.
囊性纤维化(CF)是一种遗传性疾病,以常染色体隐性遗传方式遗传。它影响人体的多个器官或器官系统,主要包括呼吸系统、消化系统和肾脏系统。CF患者可能直接因CF的原发性疾病或间接因合并症、并发症和药物治疗的副作用而出现各种口腔问题。通过细致的牙科护理来优化口腔健康是一个重要方面,因此必须成为此类CF患者多学科管理的一个组成部分。因此,普通和儿科牙医需要了解该疾病的病理生理学、医学治疗、,以及其对口腔健康的不良影响,以便用最好的科学循证牙科方法来管理这些CF患者。因此,本文全面回顾了有关CF的现有文献,以描述其病理生理学(病因)、临床特征、筛查/诊断模式和管理策略,以及CF和牙齿管理方面的详细口腔影响。此外,本文还对CF患者的牙科护理进行了概述。综合综述的相关和最新科学文献已在不同的电子数据库(PubMed Medline、Web of Science、Scopus和Google Scholar)中使用合适的关键词或其组合/布尔运算符进行了搜索,因此,包括了截至2022年在英文文献中发表的主题相关文章。此外,还从儿童牙科的角度检索了与口腔牙科影响和CF的牙科管理相关的文章,并将其纳入综述。
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引用次数: 0
Efficacy of closed and open endotracheal suction on prevention of ventilator-associated pneumonia on patients admitted to critical care unit at tertiary care hospital 闭式和开放式气管吸引预防三级医院重症监护病房患者呼吸机相关性肺炎的疗效观察
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_618_22
Ruksar Mulla, V. Mohite
Background: Endotracheal suctioning is a method commonly used to clean airway secretions in patients under mechanical ventilation. This study aimed to compare the effects of open and closed suction methods on the occurrence of ventilator-associated pneumonia (VAP). In the open endotracheal suction, the approach necessitates the participation of two nurses and may result in a momentary interruption of ventilation and oxygen supply due to the patient's disconnection from the ventilation device during suctioning. In the closed endotracheal suction, the approach can be performed through connections in a closed suction set while the patient is ventilated without separating the patient from the ventilator. Objective: (1). To compare the close endotracheal suction with open endotracheal suction for the prevention of VAP. (2) To assess the incidence of VAP among intubated patients. Materials and Methods: The study was conducted among 60 patients who are on mechanical ventilator in the critical care unit in tertiary care hospital. For the study, simple random sampling technique is used for the selection of sample. Using a lottery method of sampling, one in the experimental group and one in the control group on the basis of inclusion criteria. Results: The study was done on patients who are on mechanical ventilators in the critical care unit in tertiary care hospitals. The data analysis was done using descriptive and inferential statistics. The study finding revealed that in VAP scoring of the patient's 1st and 2nd day in open endotracheal suction, there are no significant changes in open endotracheal suction then null hypothesis was accepted (t = 0.9, P = 0.37). VAP scoring of the patient's 2nd and 3rd day and 3rd and 1st day in open endotracheal suction, there are significant changes in open endotracheal suction method in null hypothesis was rejected (P < 0.05). VAP scoring of the patient's 1st and 2nd day and 2nd and 3rd day and 3rd and 1st day in closed endotracheal suction, there are significant changes in closed endotracheal suction then null hypothesis was rejected (P < 0.05). Conclusion: The study assessed the efficacy of open endotracheal suction versus closed endotracheal suction on age, sex, duration of hospital stays, return of mechanical ventilation, and mode of ventilation are not significant but the duration of mechanical ventilation is significant. The nurses play a vital role in assessing the cardiac monitor while doing suctioning to prevent cardiorespiratory complications.
背景:气管内抽吸是一种常用于机械通气患者气道分泌物清洁的方法。本研究旨在比较开放式和封闭式抽吸方法对呼吸机相关性肺炎(VAP)发生的影响。在开放式气管内抽吸中,该方法需要两名护士的参与,并且可能由于患者在抽吸过程中与通气装置断开而导致通气和氧气供应的瞬时中断。在封闭式气管内抽吸中,该方法可以通过封闭式抽吸装置中的连接来执行,同时在不将患者与呼吸机分离的情况下对患者进行通气。目的:(1)。比较闭式和开放式气管内抽吸预防VAP的效果。(2) 评估插管患者中VAP的发生率。材料与方法:对60例在三级甲等医院重症监护室使用机械通气机的患者进行研究。本研究采用简单的随机抽样技术进行样本选择。采用抽签抽样的方法,在纳入标准的基础上,实验组和对照组各一人。结果:这项研究是针对三级护理医院重症监护室使用机械呼吸机的患者进行的。数据分析采用描述性和推断统计学方法。研究发现,在患者开放式气管内抽吸第1天和第2天的VAP评分中,开放式气管吸引没有显著变化,然后接受零假设(t=0.9,P=0.37),无效假设下开放式气管内抽吸方法有显著变化(P<0.05),结论:本研究评估了开放式气管内抽吸与封闭式气管内抽吸器在年龄、性别、住院时间、机械通气恢复时间和通气方式方面的疗效并不显著,但机械通气的持续时间显著。护士在进行抽吸以预防心肺并发症的同时,在评估心脏监测仪方面发挥着至关重要的作用。
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引用次数: 0
An efficacy of intermittent subglottic irrigation with 3% NaCl on prevention of ventilator-associated pneumonia 3% NaCl间歇声门下冲洗预防呼吸机相关性肺炎的疗效观察
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_616_22
P. Jadhav, V. Mohite
Background: ventilator-associated pneumonia (VAP) is the leading cause of death associated with healthcare-associated infections, an important cause of morbidity and mortality despite advances in antimicrobial therapy and advanced supportive measures. The accumulation of subglottic secretions above the endotracheal tube (ETT) cuff, as these secretions may leak around the cuff of the ETT resulting in aspiration and an increased risk for infection of VAP. Objective: (1) To assess the efficacy of intermittent subglottic irrigation with 3% NaCl for the prevention of VAP. (2) To assess the association between VAP in the experimental and control group with demographic variables. Materials and Methods: A quantitative research approach and an experimental research design were used for the present study. Simple random sampling technique using a lottery method was used for the selection of the sample. Results: The study revealed that on comparison of VAP for the experimental and control group on days 2nd and 3rd, there is a significant association found. Second day P = 0.003Significant (S), 3rd day P < 0.0001(S). On 1st day, the experimental group revealed that there is a significant association (P = 0.003) between the duration of the mechanical ventilator and VAP, on the 2nd day, the control group shows the duration of the mechanical ventilator was associated with VAP (P < 0.0001). Conclusion: The conclusion drawn from the present study is intermittent subglottic irrigation with 3% NaCl was effective on the prevention of VAP.
背景:呼吸机相关性肺炎(VAP)是与卫生保健相关感染相关的主要死亡原因,尽管抗菌治疗和先进的支持措施取得了进展,但仍是发病率和死亡率的重要原因。声门下分泌物积聚在气管内管(ETT)袖口上方,因为这些分泌物可能会泄漏到ETT袖口周围,导致误吸和VAP感染的风险增加。目的:(1)评价3% NaCl间歇声门下冲洗预防VAP的疗效。(2)用人口学变量评价实验组和对照组VAP的相关性。材料与方法:本研究采用定量研究方法和实验研究设计。采用摇号法的简单随机抽样技术对样本进行选择。结果:研究发现,实验组与对照组在第2、3天的VAP有显著的相关性。第2天P = 0.003显著(S),第3天P < 0.0001(S)。第1天,试验组机械呼吸机使用时间与VAP存在显著相关性(P = 0.003),第2天,对照组机械呼吸机使用时间与VAP存在显著相关性(P < 0.0001)。结论:3% NaCl间歇声门下冲洗可有效预防VAP的发生。
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引用次数: 0
Exploring “Human Skills” through a cinemeducation workshop during a health professions education conference in India 在印度卫生专业教育会议期间,通过电影教育讲习班探索“人类技能”
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_198_23
P. Shankar, Anuradha Joshi, Juhi Kalra, A. Agarwal
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引用次数: 0
A rare case of cutis aplasia congenita in a newborn 新生儿先天性皮肤发育不全1例
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_664_22
Ashwini Lakra, H. Bhandekar, Ishani Arora, M. Lakra, A. Taksande
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引用次数: 0
Comparative study to assess the effect of cartoon watching and distraction card on physiologic parameters and fear level during inhalation therapy in children 观察卡通与分心卡对吸入治疗儿童生理参数及恐惧水平影响的比较研究
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_614_22
Supriya Jadhav, Harshavardhan Kevade, Harshad Kadam, Prakash Naregal, V. Mohite, Shivaji Pawar
Background: Children are the world's most valuable resource and its best hope for the future. Distraction is a very common way to distract a child's attention from a potentially unpleasant procedure, lessen their fear, and help them relax. Objective: The objective of this study was to assess the effectiveness of cartoon-watching and distraction cards on physiological parameters and fear levels during inhalation therapy in children. Materials and Methods: A quasi-experimental study design was used in this study to monitor 60 children between the ages of 3 and 6 years selected by a simple random sampling method. Each of the cartoon and distraction groups had 30 children. A self-structured demographic performa and a standard Children Fear Scale were used to collect data from children. An unpaired t-test was used to estimate the effectiveness of the cartoon and distraction group among participants receiving inhalation therapy. Using the Chi-square test, the researcher looked at the association between fear and sociodemographic variables. Results: The difference between the mean after intervention pulse rates and respiratory rate of both groups was evaluated and it was found statistically significant (P < 0.05). The difference between the mean fear score in the cartoon group and the distraction card group was found to be statistically significant after the inhalation therapy (P < 0.0001). Conclusion: It was observed that the cartoon-watching therapy was better than the distraction card therapy in reducing the fear level during inhalation therapy among children. However, cartoon-watching and distraction cards were more significant on physiologic parameters and fear in children during inhalation therapy.
背景:儿童是世界上最宝贵的资源,也是未来的最大希望。分散注意力是一种很常见的方法,可以将孩子的注意力从潜在的不愉快的过程中转移开,减轻他们的恐惧,帮助他们放松。目的:本研究的目的是评估卡通观看和分心卡对吸入治疗期间儿童生理参数和恐惧水平的影响。材料与方法:本研究采用准实验研究设计,采用简单随机抽样法对60名3 ~ 6岁儿童进行监测。每组有30名儿童。采用自结构人口统计表和标准儿童恐惧量表收集儿童数据。使用非配对t检验来估计卡通和分心组在接受吸入治疗的参与者中的有效性。通过卡方检验,研究人员研究了恐惧和社会人口变量之间的关系。结果:两组患者干预后平均脉搏率、呼吸率比较,差异有统计学意义(P < 0.05)。吸入治疗后,卡通组和分心卡组的平均恐惧评分差异有统计学意义(P < 0.0001)。结论:观察到卡通观看疗法在降低儿童吸入治疗中的恐惧水平方面优于分心卡片疗法。然而,卡通观看卡和分心卡对吸入治疗期间儿童的生理参数和恐惧的影响更为显著。
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引用次数: 0
Sputum culture conversion among patients with drug-resistant tuberculosis: A study of various predictors 耐药结核病患者的痰培养转化:各种预测因素的研究
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_50_23
S. Khan, S. Choudhary, Gaurang M Aurangabadkar, N. Bankar
Introduction: Conversion of a positive sputum culture to a negative culture is an important parameter in the management of drug-resistant tuberculosis (TB), as the failure to convert was related to dismal posttreatment outcomes and elevated mortality rates by almost eight times when compared to victims of multidrug-resistant TB (MDR-TB) who did so. In the patients of MDR-TB, it is an important sign of treatment success to have sputum culture converted from positive to negative, and helps in determining the duration of treatment. The goal of this study was to examine and compare the length of time it took to convert an initial sputum culture with predictors of treatment outcomes for patients with MDR-TB, as well as to pinpoint the variables that affected the length of time. Materials and Methods: The mixed method (records review and qualitative approach) was used to understand the patient's perspective for accepting the Programmatic Management of Drug-resistant TB (PMDT) services and the provider's perspective for rendering services in a public-private mix model setup. This study was undertaken as a retrospective analysis and studied the patients drug-resistant TB who were admitted to a tertiary care hospital in central India. This study was carried out on the patients of Rifampicin-Resistant TB (RR-TB) and MDR-TB (Resistant to both INH and Rifampicin) with positive baseline culture, pretreatment evaluation, and appropriate anti-MDR-TB treatment. As per the PMDT guidelines, sputum smear and culture reports were collected and analyzed. Results: In this study, the time and predictors to convert an initial positive sputum culture to negative and factors influencing treatment outcome were evaluated, compared, and identified. A total of 163 patients were evaluated and analyzed. Of these, 111 (68.09%) were rifampicin and INH-resistant (MDR-TB), whereas 52 (31.90%) were rifampicin resistant (RR-TB) only. Overall 68 (41.71%) patients with baseline positive culture were converted within 3 months. Conclusions: It was concluded that malnourishment, human immunodeficiency virus positivity, associated extra pulmonary TB, and bilateral cavitation were found to be significant predictors of longer time of sputum culture conversion and thereby treatment outcome.
引言:将阳性痰培养物转化为阴性痰培养物是耐药结核病(TB)治疗的一个重要参数,因为与多药耐药结核病(MDR-TB)患者相比,未能转化与治疗后惨淡的结果和近八倍的死亡率升高有关,痰培养由阳性转为阴性是治疗成功的重要标志,有助于确定治疗的持续时间。本研究的目的是检查和比较耐多药结核病患者转换初始痰培养所需的时间与治疗结果的预测因素,并确定影响时间长度的变量。材料和方法:使用混合方法(记录审查和定性方法)来了解患者接受耐药结核病(PMDT)计划管理服务的观点,以及提供者在公私混合模式设置中提供服务的观点。这项研究是一项回顾性分析,研究了印度中部一家三级护理医院收治的耐药结核病患者。本研究对耐利福平结核病(RR-TB)和耐多药结核病(INH和利福平均耐药)患者进行了阳性基线培养、预处理评估和适当的抗多药结核病治疗。根据PMDT指南,收集并分析痰涂片和培养报告。结果:在本研究中,评估、比较和确定了将初始阳性痰培养转化为阴性的时间和预测因素以及影响治疗结果的因素。共对163名患者进行了评估和分析。其中,111例(68.09%)对利福平和异烟肼耐药(耐多药结核病),而52例(31.90%)仅对利福平耐药(RR-TB)。总的来说,68名(41.71%)基线阳性培养的患者在3个月内转化。结论:营养不良、人类免疫缺陷病毒阳性、相关的肺外结核和双侧空洞是痰培养转化时间延长的重要预测因素,从而影响治疗效果。
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引用次数: 0
Comparative analysis of eye safety knowledge and practices among private and hospital dental practitioners in national capital region of India: A cross-sectional study 印度首都地区私人和医院牙科医生眼部安全知识和实践的比较分析:一项横断面研究
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_663_22
Simran Uppal, Aman Chowdhry, Priya Kapoor, Dhruv Dar
Introduction: Dentists are prone to ocular injuries from chemical, physical, or infectious agents. While most dentists wear masks, gloves, and gowns, eye protection continues to be neglected. Thus, this study was undertaken to identify these gaps in awareness and practices of eye safety among dentists. Aim: This study aims to evaluate and compare the knowledge and practices of hospital and private dental practitioners regarding eye protection in clinical practice. Methodology: A questionnaire designed to assess the eye safety knowledge and practices of dentists was validated and mailed to hospital dental practitioners and private dental practitioners (100 each), from the National Capital Region over 6 months. Data collected were subjected to Chi-square analysis for comparing knowledge and practices of the two groups. Results: Dentists were found to be lacking in their practices with 48.5% using eye protection sometimes and 5.5% never using it, although their knowledge however revealed otherwise. Sixty-eight percent of dentists never or rarely used eye protection for their patients. 40.5% dentists had at least one incident of ocular trauma due to inadequate eye protection while 26% had at least 5 such incidents. Conclusion: The study highlights the gaps in the knowledge and practices of dentists regarding eye protection thus, emphasizing the need for creating more awareness, more so in the coronavirus disease of 2019 era, to prevent further transmission of infections.
引言:牙医很容易受到化学、物理或传染因素的伤害。虽然大多数牙医都戴着口罩、手套和长袍,但眼睛保护仍然被忽视。因此,进行这项研究是为了确定牙医在眼睛安全意识和实践方面的这些差距。目的:本研究旨在评估和比较医院和私人牙科医生在临床实践中对眼睛保护的知识和实践。方法:对一份旨在评估牙医眼部安全知识和实践的问卷进行了验证,并在6个月内邮寄给来自国家首都地区的医院牙科医生和私人牙科医生(各100人)。收集的数据进行卡方分析,比较两组的知识和实践。结果:牙医们在实践中被发现缺乏,48.5%的人有时使用眼部保护,5.5%的人从未使用过,尽管他们的知识表明情况并非如此。68%的牙医从未或很少为患者使用眼部防护用品。40.5%的牙医至少有一次因眼部保护不足而造成的眼部创伤,26%的牙医至少发生过5次此类事件。结论:因此,该研究强调了牙医在眼睛保护方面的知识和实践差距,强调需要提高认识,尤其是在2019年的冠状病毒疾病中,以防止感染的进一步传播。
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引用次数: 0
International thymic malignancy interest group classification – The future of mediastinal mass evaluation using multidetector computed tomography 国际胸腺恶性肿瘤兴趣组分类-使用多探测器计算机断层扫描纵隔肿块评估的未来
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_24_23
Pratik J Bhansali, G. Mishra, P. Parihar, Bhavik S Unadkat, Ruchi Kabra
Background: The diagnosis of mediastinal masses is a demanding task as it is like Pandora's box with diverse masses. Multidetector computed tomography (MDCT), along with intravenous contrast, is the diagnostic technique of choice to diagnose mediastinal masses. Hence, the International Thymic Malignancy Interest Group (ITMIG) uses MDCT as a gold standard for defining mediastinal compartments. Aim and Objectives: The purpose of this study was to ascertain characteristics, the accurate extension of mediastinal masses, and its distribution according to classification by ITMIG and to correlate the fine-needle aspiration cytology/biopsy diagnosis to the findings of the computed tomography (CT) scan where ever possible. Materials and Methods: The present study was conducted at the Radiodiagnosis Department of AVBRH, a Teaching Hospital of DMIHER, Sawangi (Meghe) Wardha. It was a prospective cross-sectional study. A purposive convenience sampling method was used with a sample size of 100 participants needed for 2 years. Results: In the study population, the predominant (63%) participants were male, and the remaining 37 (37.00%) participants were female. Fifteen (15.00%) lesions were in prevascular, 55 (55.00%) were in visceral, 15 (15.00%) were in paravertebral, 8 (8.00%) involved Prevascular + Visceral, 7 (7.00%) lesions involved all three compartments, i.e., Prevascular + Visceral + Paravertebral localization. In the present study, in 94.73% of the masses, the same diagnosis was made by both CT and holoprosencephaly. In 5.27% of the masses, the diagnosis was different. The total diagnostic accuracy was 100% (95% confidence interval 93.73%–100%). Conclusion: CT has a cardinal part in the assessment of different masses in the mediastinum in regards to their characterization, distribution, and distinguishing malignant and benign lesions. The novel mediastinal division system introduced by ITMIG is intended to facilitate uniform communication between health-care professionals and radiologists at cross-sectional imaging.
背景:纵隔肿块的诊断是一项艰巨的任务,它就像潘多拉的盒子,肿块种类繁多。多探测器计算机断层扫描(MDCT),连同静脉造影,是诊断纵隔肿块的首选诊断技术。因此,国际胸腺恶性肿瘤研究小组(ITMIG)使用MDCT作为确定纵隔区室的金标准。目的和目的:本研究的目的是根据ITMIG分类确定纵隔肿块的特征、准确的范围和分布,并尽可能将细针穿刺细胞学/活检诊断与计算机断层扫描(CT)的结果联系起来。材料和方法:本研究在Sawangi (Meghe) Wardha DMIHER教学医院AVBRH放射诊断科进行。这是一项前瞻性横断面研究。采用有目的的方便抽样方法,样本量为100人,为期2年。结果:在研究人群中,男性占多数(63%),其余37名(37.00%)为女性。血管前病变15例(15.00%),内脏病变55例(55.00%),椎旁病变15例(15.00%),血管前+内脏病变8例(8.00%),三个腔室均病变7例(7.00%),即血管前+内脏+椎旁定位。在本研究中,94.73%的肿块CT和前脑无裂的诊断相同。5.27%的肿块诊断不一致。总诊断准确率为100%(95%置信区间93.73% ~ 100%)。结论:CT对纵隔不同肿物的特征、分布及良恶性病变的鉴别具有重要的评价作用。ITMIG引入的新型纵隔分割系统旨在促进保健专业人员和放射科医生在横断面成像方面的统一沟通。
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引用次数: 0
Publication of identifying information and protection of research participants 识别信息的发布和研究参与者的保护
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/jdmimsu.jdmimsu_290_20
Manoj Goyal, M. Bansal
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引用次数: 0
期刊
Journal of Datta Meghe Institute of Medical Sciences University
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