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Observed Adverse Effects of Sinopharm COVID-19 Vaccine in Healthcare Workers 在医护人员中观察到的国药集团 COVID-19 疫苗不良反应
Pub Date : 2024-03-11 DOI: 10.21089/njhs.91.0015
Khadija Muneer, Nimra Tufail, Muhammad Imran Hassan Khan, Sadia Inam, S. Ayub
Abstract: Background: Covid-19 was first identified in Wuhan China in December 2019, and rapidly spread world over. Vaccine was always thought as first line defence against viral infections, and Covid was no exception. Although developed through different technologies, Pakistan got its share of Sinopharm from China and vaccination started in February 2021, with priority for Healthcare workers. There were lot of myths and hesitancy related with the adverse effects and urgency in approving these vaccines. Addressing adverse effects in post vaccinated population hence, became an important matter. Objective: Aim of this study was to observe the adverse effects of this vaccine in Pakistani population, to assess safety and develop confidence in Healthcare Workers. Materials and Methods: A cross-sectional Observation study was carried out in vaccinated Healthcare Professional through Non-probability purposive sampling over a period of one month. A team collected data directly, as well as on the telephone call. A Google form was also generated and sent. Information was collected and analysed on IBM-SPSS 23.0 Result: Majority of the participants were less than 55 years with female dominance. Among co-morbidities, hypertension was most common, followed by diabetes. In local and systemic adverse effects, pain and fatigue were most common, followed by muscle weakness, fever and headache respectively. These effects were also more common after first injection. Conclusion: Results favor that people should be more careful after the first dose as more adverse effects were felt after that. This vaccine has a good safety profile as no major adverse effects were noticed. It was also considered safe for patients with co-morbidities.
摘要:背景:Covid-19 于 2019 年 12 月在中国武汉首次发现,并迅速在全球传播。疫苗一直被认为是抵御病毒感染的第一道防线,Covid 也不例外。虽然是通过不同的技术开发的,但巴基斯坦还是从中国获得了国药集团的份额,并于 2021 年 2 月开始接种,优先接种对象是医护人员。对于这些疫苗的不良反应和批准的紧迫性,人们有很多误解和犹豫。因此,解决接种后人群的不良反应问题就变得非常重要。研究目的本研究旨在观察该疫苗在巴基斯坦人群中的不良反应,评估其安全性并增强医护人员的信心。材料与方法:通过非概率目的性抽样,对接种过疫苗的医护人员进行了为期一个月的横断面观察研究。一个小组直接收集数据,并通过电话收集数据。此外,还制作并发送了一份谷歌表格。收集的信息通过 IBM-SPSS 23.0 进行分析:大多数参与者年龄在 55 岁以下,女性居多。在并发症中,高血压最为常见,其次是糖尿病。在局部和全身不良反应中,疼痛和疲劳最常见,其次分别是肌无力、发烧和头痛。这些不良反应在首次注射后也更为常见。结论结果表明,人们在注射第一针后应更加小心,因为在注射第一针后会出现更多不良反应。这种疫苗的安全性较好,没有发现重大不良反应。它还被认为对合并疾病的患者是安全的。
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引用次数: 0
The Faces of Deceptive Healers: A Scoping Review of Titles and Traits Associated with Quacks across Regions 欺骗性医者的面孔:对各地区庸医相关头衔和特征的范围审查
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0203
Ghulam Yaseen Veesar, A. Akhlaq, Ahson Qavi Siddiqi
Abstract: Background: The progress in medical science and the increased accessibility of digital resources have enhanced the convenience for individuals in accessing appropriate treatments. Despite these advancements, quackery continues to persist as a global concern. Throughout history, people have been intrigued by miraculous treatments rooted in faith and trust theories. In ancient times, distinguishing between scientifically approved and unapproved medical practices posed challenges. Ever since medical practices have been taking place, service providers took advantage of people’s unawareness, exploiting patients for personal gain. Over time, in certain cultures and societies, their intentions became apparent, and they earned a reputation as deceivers in the medical field. The current research seeks to uncover the various traits utilized by quacks across different times and locations worldwide, aiming to expose their fraudulent practices. Methodology: In this scoping review, the focus was on investigating various characteristics displayed by quacks during their practices. The study involved a comprehensive examination of 3740 published research articles and 400 pieces of gray literature such as websites of regulatory authorities, Acts, Laws. News items and reports which encompassed regulatory authority websites, news articles, and reports. From this extensive pool of sources, 45 articles and 4 excerpts were carefully chosen for in-depth analysis. Result: The current study highlighted 90 terms used for quacks to define their characteristics. The data was analyzed and developed five different themes defining various traits according to the near association. The main theme covered the moral values of these practitioners followed by Modern quackery under complementary and alternative healthcare services, sorcery and mystic, ignorant of science, and contract to law. Conclusion: Quackery, with its long-standing history, remains an ongoing health threat. Embracing modern technology, it utilizes the Internet and social media to propagate deceptive claims. Gaining insights into the traits of quacks is crucial for policymakers to address this issue effectively. Combating quackery necessitates heightened awareness, robust regulations, dissemination of authentic information and evidence-based healthcare involving all stakeholders.
摘要: 背景:医学科学的进步和数字资源的日益普及为个人获得适当的治疗提供了更多便利。尽管取得了这些进步,庸医仍然是全球关注的问题。纵观历史,人们一直对植根于信仰和信任理论的神奇疗法充满好奇。在古代,区分科学认可的医疗方法和未经认可的医疗方法是一项挑战。自从有了医疗行为,服务提供者就利用人们的无知,剥削病人以谋取私利。随着时间的推移,在某些文化和社会中,他们的意图变得显而易见,并赢得了医疗领域骗子的美誉。本研究试图揭示庸医在全球不同时期、不同地点所利用的各种特征,旨在揭露他们的欺诈行为。研究方法:在这项范围审查中,重点是调查庸医在行医过程中表现出的各种特征。研究涉及对 3740 篇已发表的研究文章和 400 篇灰色文献(如监管机构网站、法案、法律)的全面审查。新闻项目和报告包括监管机构网站、新闻文章和报告。从这些广泛的资料中,我们精心挑选了 45 篇文章和 4 篇摘录进行深入分析。结果:本研究强调了 90 个用于界定庸医特征的术语。对数据进行分析后,形成了五个不同的主题,根据近似关联定义了各种特征。主要主题包括这些从业者的道德价值观,其次是补充和替代医疗服务下的现代庸医、巫术和神秘主义、对科学的无知以及与法律的契约。结论:庸医由来已久,仍然是一个持续的健康威胁。庸医利用现代技术,利用互联网和社交媒体宣传欺骗性的说法。了解庸医的特征对于政策制定者有效解决这一问题至关重要。要打击庸医,就必须提高人们的认识,制定健全的法规,传播真实的信息,并让所有利益相关者参与到循证医疗保健中来。
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引用次数: 0
Clinical Relationship of Blood Vitamin-C Levels and Age Related Cataract 血液中维生素 C 水平与老年性白内障的临床关系
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0174
Fehmina Nazir, Hafiz Muhammad Jahan Zaib, Nida Armoghan Khan, Mariam Noor, Amina Khalid
Abstract: Background: Cataract is an extremely important and ground source of the curable blindness around the globe. Lenticular Vitamin C is actual important ultraviolet filter and antioxidant that decreases entry of the light rays into lens and therefore preventing the lens from oxidative damage. Keeping this in sight, higher intake of the vitamin c and by consuming the diet rich in vitamin c can prevent the age-related cataract. The motive of this study is to analyze if high vitamin C levels can lead to decrease in the percentage of cataract in patients. Objective: To determine occurrence of the senile cataract among Vitamin C deficient subjects and compare mean vitamin C levels among senile cataract and controls. Materials and Methods: This comparative cross-sectional study was conducted at The Department of Ophthalmology, PIMS (Pakistan Institute of Medical Sciences), Islamabad, Pakistan, after being accepted by Ethical review Committee. Individuals were selected, in the age range between 45 to 75 years of age from the patients who visited Eye OPD, PIMS, and Islamabad. All participants undergone detailed ophthalmic examination that included visual acuity assessment through the Snellen’s chart, anterior segment examination on the slit lamp. Blood vitamin C level was assessed in both cases and controls. Information was recorded in the designated Proforma and data was analyzed using SPSS 23.0 version. Results: We enrolled 100 patients 50 in each group. Average age of our individuals in our case set was 60.96±9.57 years and in control set remained 59.66±8.92 years. In study group 25(50.0%) remained male and 25(50.0%) remained female. similarly, in control group 19(38.0%) were male and 31(62.0%) were female. The mean value of level of serum vitamin C in study group was 0.55±0.06 mg/dl and average value of level of the serum vitamin C in control group was 0.87±0.07 mg/dl. There was significant difference as p value is less than level of implication (p < 0.05). In cataractous individuals the level of the serum vitamin C was low as compared to control set. Conclusion: In this study, researchers determined that blood vitamin C may be a preventive component towards cataract development that is likely influenced by vitamin C consumption.
摘要: 背景:白内障是全球可治愈性失明的一个极其重要的根源。晶状体维生素 C 是一种重要的紫外线过滤器和抗氧化剂,可减少进入晶状体的光线,从而防止晶状体受到氧化损伤。有鉴于此,摄入更多的维生素 c 和摄入富含维生素 c 的饮食可以预防老年性白内障。本研究的目的是分析高水平的维生素 C 是否能降低白内障患者的比例。研究目的确定缺乏维生素 C 的受试者中老年性白内障的发生率,并比较老年性白内障和对照组的平均维生素 C 水平。材料与方法:这项横断面比较研究是在巴基斯坦伊斯兰堡的巴基斯坦医学科学研究所(PIMS)眼科部进行的。研究人员从前往伊斯兰堡巴基斯坦医学科学研究所眼科门诊就诊的患者中选取了年龄在 45 岁至 75 岁之间的患者。所有参与者都接受了详细的眼科检查,包括通过斯奈伦视力表评估视力、裂隙灯检查前段。对病例和对照组的血液维生素 C 水平进行了评估。信息记录在指定的表格中,并使用 SPSS 23.0 版本对数据进行分析。结果我们共招募了 100 名患者,每组 50 人。病例组患者的平均年龄为(60.96±9.57)岁,对照组患者的平均年龄为(59.66±8.92)岁。同样,对照组中有 19 人(38.0%)为男性,31 人(62.0%)为女性。研究组的血清维生素 C 平均值为 0.55±0.06 mg/dl,对照组的血清维生素 C 平均值为 0.87±0.07 mg/dl。由于 P 值小于暗示水平(P < 0.05),因此存在明显差异。与对照组相比,白内障患者的血清维生素 C 水平较低。结论在这项研究中,研究人员发现血液中的维生素 C 可预防白内障的发生,而维生素 C 的摄入量很可能会影响白内障的发生。
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引用次数: 0
Gender Based Comparison of Mean Arterial Pressure and Pulse Pressure after Stress Induction in Healthy Adults 健康成年人压力诱导后平均动脉压和脉压的性别比较
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0185
Syed Shahmeer Raza, Attaullah Shah, Umema Zafar, Tooba Khan, Dureshahwar Ali, Farhan Ullah
Abstract: Background: Mean Arterial Pressure (MAP) and Pulse Pressure (PP) are both key parameters to diagnose and manage cardiovascular diseases and hypertension, a leading cause of mortality and morbidity globally. Men and women are physically different from each other. Objective: Is to evaluate gender-based comparison of MAP and PP of healthy adults after stress induction. Material and Methods: This cross-sectional study was designed and conducted in the Institute of Basic Medical Sciences (IBMS) at Khyber Medical University (KMU) from January 2022 to April 2022. A total of fifty-two participants including twenty-six males and twenty-six females were selected using convenience sampling. Sample size estimation was carried out using G*Power. Healthy adults between the age of 18-40 years were included in the study. Blood Pressure (BP) and Heart Rate (HR) were checked both before and after the stress induction. MAP and PP were calculated using the formulas obtained from the literature i.e., MAP = DP + 1/3 (PP) and PP = SBP-DBP. Result: The mean age of males was 27.16 ± 4.28 years and that of females was 23.15 ± 2.86 years. Both pre and post stress comparison of mean difference between healthy adult males and females, revealed no significant difference between MAP (Post-Stress p=0.97 and Pre-Stress p=0.61), PP (Post-Stress p=0.18 and Pre-Stress p=0.05) and HR (Post-Stress p=0.11 and Pre-Stress p=0.57). Males had a higher PP than females in both pre and post stress phase. Females had a slightly higher MAP than males in the pre stress phase. In the post stress phase, MAP showed a positive correlation with HR and PP. While in the pre stress phase, all the variables (MAP, PP and HR) showed no correlation with each other. Conclusion: MAP and PP show no significant difference between healthy adult males and females, after stress induction.
摘要:背景:平均动脉压(MAP)和脉压(PP)都是诊断和管理心血管疾病和高血压的关键参数。男性和女性在生理上存在差异。目的评估健康成年人在压力诱导后的 MAP 和 PP 的性别比较。材料和方法:这项横断面研究于 2022 年 1 月至 2022 年 4 月在开伯尔医科大学基础医学研究所(IBMS)设计和实施。研究采用便利抽样法,共选取了 52 名参与者,其中包括 26 名男性和 26 名女性。使用 G*Power 对样本量进行了估算。研究对象为 18-40 岁的健康成年人。在压力诱导前后均检查了血压(BP)和心率(HR)。使用从文献中获得的公式计算 MAP 和 PP,即 MAP = DP + 1/3 (PP),PP = SBP-DBP。结果男性的平均年龄为(27.16 ± 4.28)岁,女性的平均年龄为(23.15 ± 2.86)岁。健康成年男性和女性在压力前后的平均差异比较显示,MAP(压力后 p=0.97,压力前 p=0.61)、PP(压力后 p=0.18,压力前 p=0.05)和 HR(压力后 p=0.11,压力前 p=0.57)之间没有显著差异。在应激前和应激后阶段,男性的 PP 均高于女性。在应激前阶段,女性的 MAP 略高于男性。在应激后阶段,MAP 与 HR 和 PP 呈正相关。而在应激前阶段,所有变量(MAP、PP 和 HR)之间均无相关性。结论应激诱导后,健康成年男性和女性的 MAP 和 PP 没有明显差异。
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引用次数: 0
Factors Affecting the Implementation of Nursing Care Plans in Patient Care 影响在病人护理中实施护理计划的因素
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0189
Imran Iqbal, Saima Kouser, Sadia Samreen, Gideon Victor
Abstract: Background: Nursing Care Plan (NCP) is used in practice as a systematic and scientific problem-solving method to determining the care needs of individuals. There is lack of research on factors affecting regarding utilization of nursing care plan in patient care. Objective: The objective of this study were to evaluate the implementation of the nursing process and to determine the factors that may influence the implementation of the nursing process. Materials and Methods: A cross-sectional survey was conducted at a private hospital during February to June, 2023. The study protocol was reviewed and approved. Permission from institutional heads was sought. Informed consent was obtained before data collection. Simple random sampling method was employed. The data were collected with structured questionnaires whose responses were rated on Likert scale. Data were coded and analyzed using SPSS v25.0. Result: A total 108 nurses participated in the study. Study findings revealed 89% of the nurses were female nurses and 82% possessed diploma in nursing. The knowledge 50.5%, confidence 50.9% and willingness 54.2%, were at borderline good level. Whereas, assessment and diagnosis, planning, implementation, evaluation, and nurses’ views about nursing care planning implementation were at < 50% as poor. There was a moderate positive correlation between knowledge and implementation R-Value 0.312 and confidence and evaluation R-Value 0.246. Barrier to implement nursing process included uncooperative patients, lack of awareness about nursing process, lack of preparedness, low satisfaction level, lack of in-service training, lack of time, and high patient flow. Conclusion: Study’s findings revealed knowledge, confidence and willingness of the nurses determine the use of nursing process in their nursing practice.
摘要:背景:护理计划(NCP)作为一种系统、科学的解决问题的方法,用于确定个人的护理需求。目前还缺乏对影响在患者护理中使用护理计划的因素的研究。研究目的本研究旨在评估护理流程的实施情况,并确定可能影响护理流程实施的因素。材料与方法:于 2023 年 2 月至 6 月在一家私立医院进行了横断面调查。研究方案已通过审查和批准。已征得机构负责人的许可。数据收集前已获得知情同意。采用简单随机抽样法。通过结构化问卷收集数据,问卷回答采用李克特量表评分。数据使用 SPSS v25.0 进行编码和分析。结果共有 108 名护士参与了研究。研究结果显示,89% 的护士为女性,82% 的护士拥有护理文凭。50.5%的护士的知识水平、50.9%的护士的信心水平和 54.2%的护士的意愿水平处于良好边缘。而评估和诊断、计划、实施、评价以及护士对护理计划实施的看法均小于 50%,为差。知识与实施的 R 值为 0.312,信心与评价的 R 值为 0.246,两者之间呈中度正相关。实施护理程序的障碍包括病人不合作、缺乏对护理程序的认识、缺乏准备、满意度低、缺乏在职培训、缺乏时间和病人流量大。结论研究结果表明,护士在护理实践中使用护理程序的知识、信心和意愿。
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引用次数: 0
Assessment of Depression, Anxiety, and Stress among Health Care Professionals due to Covid - 19 评估医护人员因 Covid 而产生的抑郁、焦虑和压力 - 19
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0179
Irfan Ali, S. A. Rizvi, Khadijah Abid, Nida Shoaib, Haya Ul Batool Abbasi
Abstract: Background: The emergence of an undisclosed pneumonia outbreak in Wuhan, China, in December 2019 led to the global spread of Corona virus Disease (COVID-19), declared a pandemic by the WHO on March 12, 2020. Healthcare workers (HCPs) faced unprecedented challenges, with studies revealing elevated stress, depression, and anxiety. Despite differing roles, direct health care providers reported higher psychological distress. The absence of a definitive treatment compounded fears, resulting in anxiety, depression, and stress among patients, Healthcare professionals and normal subject. Objective: To identify the level of anxiety, depression, and stress among health care professionals due to the wave of Covid- 19. Materials and Methods: Analytical cross-sectional survey was done among health care workers who were working in a tertiary care hospitals, Sohail Trust Hospital Korangi Industrial Area, Karachi, and Medicare Cardiac and Dental Hospital, Tariq Road, Karachi from January 2022 to April 2022 in the third wave of Covid-19. The Depression, Anxiety, and Stress Scale-21 Items (DASS-21) self reporting scale based questionnaire was used to examine mental health. During data analysis, descriptive and inferential statistics were calculated in SPSS. Result: Out of 416 participants, 56% were females and 56.2% were single. The mean age of the respondents was 29.36 years (± 5.5). The symptoms of anxiety were reported by 47%, depression by 35% and stress was reported by 21% of participants. The level of anxiety, depression, and stress was higher in male technicians, frontline workers, HCP with chronic illnesses, and those who got covid-19 infection. Based on the results, it was identified that male had higher odds of developing anxiety while female, HCPs belonging to age groups of above 25 years and those with work experience lesser than 5 years showed to have greater odds of having stress. Conclusion: COVID-19 has caused Anxiety, Depression, and Stress among Pakistani healthcare workers. Early intervention with focused strategies and psychological therapies could help to prevent more serious problems.
摘要:背景:2019年12月,中国武汉出现了一起未公开的肺炎疫情,导致科罗娜病毒病(COVID-19)在全球蔓延,世卫组织于2020年3月12日宣布该病为大流行病。医护人员(HCPs)面临着前所未有的挑战,研究显示他们的压力、抑郁和焦虑都有所上升。尽管角色不同,但直接医护人员的心理压力更大。缺乏明确的治疗方法加剧了人们的恐惧,导致患者、医护人员和正常人产生焦虑、抑郁和压力。研究目的确定医护人员因 Covid- 19 浪潮而产生的焦虑、抑郁和压力水平。材料和方法:在 Covid-19 第三波调查中,对 2022 年 1 月至 2022 年 4 月期间在卡拉奇 Korangi 工业区 Sohail Trust 医院和卡拉奇 Tariq 路 Medicare 心脏和牙科医院这两家三级医院工作的医护人员进行了横断面分析调查。采用抑郁、焦虑和压力量表-21 项(DASS-21)自我报告量表为基础的问卷调查心理健康情况。在数据分析过程中,使用 SPSS 计算了描述性和推论性统计数据。结果在 416 名参与者中,56% 为女性,56.2% 为单身。受访者的平均年龄为 29.36 岁(± 5.5)。47%的受访者有焦虑症状,35%的受访者有抑郁症状,21%的受访者有压力症状。男性技术人员、一线工人、患有慢性病的卫生保健人员和感染了 covid-19 的人员的焦虑、抑郁和压力水平较高。研究结果表明,男性患焦虑症的几率更高,而女性、25 岁以上和工作经验少于 5 年的高级保健人员患压力症的几率更高。结论COVID-19 在巴基斯坦医护人员中引发了焦虑、抑郁和压力。通过有针对性的策略和心理疗法进行早期干预,有助于防止出现更严重的问题。
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引用次数: 0
Gender-Based Violence and its Effect on Mother, Fetus and Newborn Baby: A Systematic Review 性别暴力及其对母亲、胎儿和新生儿的影响:系统回顾
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0195
Sameera Rizvi, Sana Tariq, Amira M. Ali, Tazeen Saeed Ali
Abstract: Gender-based violence (GBV) is a major public health concern resulting in physical, psychological, sexual, and social issues. GBV during pregnancy may results in complicated and grave consequences for mother and unborn child. The prevalence of GBV was reportedly higher in developing countries, indicating higher maternal and child mortalities. Effect of GBV on pregnancy has been reported to enhance the chances of prolonged labor, obstructed labor and in severe injuries higher incidents of miscarriages and abortions are also been reported. Moreover, fetal respiratory distress, diarrhea, small for gestaional age and Intra Uterine Growth Retardation (IUGR) have also been reported. This review aims to present a systematic view of genderbased violence and its association with adverse pregnancy outcomes and to contribute by filling the existing information gap. Review assessed the effect of GBV during pregnancy on fetal health, reporting infant diarrhea more frequently, along with fever, vomiting, and respiratory distress. The significant association between adverse maternal and fetal outcomes and gender-based violence has been evaluated extensively.
摘要:基于性别的暴力(GBV)是一个重大的公共健康问题,会导致生理、心理、性和社会问题。孕期性别暴力可能会给母亲和胎儿带来复杂而严重的后果。据报道,在发展中国家,基于性别的暴力的发生率更高,这表明母婴死亡率更高。据报道,基于性别的暴力对妊娠的影响会增加产程延长、难产的几率,在严重受伤的情况下,流产和堕胎的几率也会增加。此外,胎儿呼吸窘迫、腹泻、胎龄偏小和宫内发育迟缓(IUGR)也有报道。本综述旨在对基于性别的暴力及其与不良妊娠结局的关联进行系统性分析,并填补现有的信息空白。综述评估了孕期性别暴力对胎儿健康的影响,报告显示婴儿腹泻、发烧、呕吐和呼吸窘迫的发生率较高。孕产妇和胎儿的不良后果与性别暴力之间的重要关联已得到广泛评估。
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引用次数: 0
Non Alcoholic Fatty Liver Disease (NAFLD) – An Emerging Challenge 非酒精性脂肪肝(NAFLD)--新出现的挑战
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0140
Shahid Kamal
A rapidly emerging cause of Chronic Liver Disease (CLD) is Non-alcoholic Fatty Liver Disease (NAFLD). In the West, the prevalence of NAFLD is as high as 30% and it is postulated that it may affect one-third of the population by 2030 [1]. Various studies have shown that the prevalence of NAFLD in Pakistan ranges from 14% to 47% [2]. The spectrum of liver damage in NAFLD is wide-ranging and essentially involves non-alcoholic causes of fat accumulation in the cells of the liver. This can also occur in other conditions where there is more than 5% steatosis. These conditions include chronic liver disease (CLD) caused by drugs (such as Methotrexate, Amiodarone, Tamoxifen etc.) or viruses (such as HCV), exposure to environmental toxins, malnutrition, hemochromatosis, Wilson’s disease, and any autoimmune disease triggering 5% steatosis [3]. There is a strong association of NAFLD with obesity (in more than 40% of patients) [4], hypertriglyceridemia (in 20% or more), diabetes mellitus (in 20% or more), and insulin resistance – all components of the metabolic syndrome [5]. Over the last two decades, rising trends of DM, obesity and insulin resistance have gone hand in hand with increasing prevalence of NAFLD [6]. Pakistan has a 17.1% incidence of Type-2 diabetes and a 14% incidence of NAFLD. There is a 32% incidence of NAFLD in Pakistani type 2 diabetics [7]. The National Health Survey of Pakistan conducted way back in 2006 depicted an incidence of obesity in 25% of the Pakistani population, and since then, numbers have continued to rise.
非酒精性脂肪肝(NAFLD)是慢性肝病(CLD)的一个新病因。在西方,非酒精性脂肪肝的发病率高达 30%,据推测,到 2030 年,三分之一的人口可能会受到非酒精性脂肪肝的影响 [1]。多项研究表明,非酒精性脂肪肝在巴基斯坦的发病率从 14% 到 47% 不等 [2]。非酒精性脂肪肝的肝损伤范围很广,主要包括非酒精性原因导致的肝细胞脂肪堆积。非酒精性脂肪肝也可能发生在脂肪变性超过 5% 的其他情况下。这些疾病包括由药物(如甲氨蝶呤、胺碘酮、他莫昔芬等)或病毒(如丙型肝炎病毒)引起的慢性肝病(CLD)、暴露于环境毒素、营养不良、血色素沉着病、威尔逊氏病以及任何引发5%脂肪变性的自身免疫性疾病[3]。非酒精性脂肪肝与肥胖(40% 以上的患者)[4]、高甘油三酯血症(20% 或以上)、糖尿病(20% 或以上)和胰岛素抵抗密切相关,这些都是代谢综合征的组成部分[5]。在过去二十年中,糖尿病、肥胖症和胰岛素抵抗呈上升趋势,同时非酒精性脂肪肝的发病率也在上升[6]。巴基斯坦的 2 型糖尿病发病率为 17.1%,非酒精性脂肪肝发病率为 14%。在巴基斯坦的 2 型糖尿病患者中,非酒精性脂肪肝的发病率为 32%[7]。早在2006年进行的巴基斯坦全国健康调查显示,25%的巴基斯坦人患有肥胖症,此后,肥胖人数持续上升。
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引用次数: 0
The Experiences of Smokers Admitted to a Smoking Cessation Center in Samsun Regarding their Addiction: A Qualitative Study 萨姆松戒烟中心收治的吸烟者的戒烟经历:定性研究
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0144
B. Yalcin, Gokce Celik Kara, Muge Ustaoglu
Abstract: Background: Primary care physicians have a vital opportunity to help their patients quit smoking. They need to provide an individualized approach to them while in the cessation process in order to help them understand. Objective: The aim of this study is to investigate the individualized interacting factors and principles of starting, maintaining, quitting, and relapse of tobacco addiction among smokers. Materials and Methods: This qualitative research performed between March and December 2015 involved 331 smokers who had applied to the Ondokuz Mayis University, Medical Faculty Family Medicine Cessation Clinic, Türkiye. In the first meeting, a workshop (lasting approximately 1 hour) was held for all the participants (31) and recorded. In this workshop the participants discussed how they started smoking and why they wanted to quit. They reported examples of successful quitting with which they were familiar, together with any precautions they took in order to protect themselves and the people around them. Every workshop was decoded and analyzed by the researchers. Result: One hundred nineteen (35.7%) of the participants were women, and the mean age of the study group was 37.75 ± 12.41 years. Most of the participants (n=280, 85%) began smoking under the age of 18, with a close friend providing the cigarettes in the majority of cases (n=212, 64%). The main motivation differed between younger and older participants. In order to protect themselves, participants used external tar filters, smoked ‘light’ cigarettes, and refrained from smoking after eating or before sleeping. They also tended to smoke in the kitchen or on the balcony to protect other household members from their smoke. In addition, the participants increased their physical activity levels, requested more laboratory or screening tests from their physicians, and consumed healthier diets (honey, vitamin pills, and water). Conclusion: The addiction dynamics of cigarette addicts differ very widely.
摘要: 背景:初级保健医生拥有帮助患者戒烟的重要机会。在戒烟过程中,他们需要为患者提供个性化的方法,以帮助他们理解。研究目的本研究旨在调查吸烟者开始吸烟、维持吸烟、戒烟和烟瘾复发的个体化交互因素和原则。材料与方法:这项定性研究于 2015 年 3 月至 12 月间进行,共有 331 名吸烟者向土耳其翁多库兹马伊斯大学医学院家庭医学戒烟门诊提出申请。在第一次会议上,为所有参与者(31 人)举办了一场研讨会(持续约 1 小时),并进行了记录。在研讨会上,与会者讨论了他们是如何开始吸烟以及为什么想要戒烟。他们报告了自己熟悉的成功戒烟的例子,以及为保护自己和周围人而采取的预防措施。研究人员对每个研讨会进行了解码和分析。结果如下119 名参与者(35.7%)为女性,研究小组的平均年龄为 37.75±12.41 岁。大多数参与者(280 人,占 85%)在 18 岁以下开始吸烟,其中大多数(212 人,占 64%)由亲密朋友提供香烟。年轻人和老年人吸烟的主要动机有所不同。为了保护自己,参与者使用外置焦油过滤嘴,吸 "淡味 "香烟,饭后和睡前不吸烟。他们还倾向于在厨房或阳台吸烟,以保护其他家庭成员免受烟雾的影响。此外,参与者还增加了体育锻炼,要求医生进行更多的化验或筛查,并摄入更健康的饮食(蜂蜜、维生素丸和水)。结论吸烟成瘾者的成瘾动态差异很大。
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引用次数: 0
Nephrotic Syndrome Secondary to Primary Membranoproliferative Glomerulonephritis in a 27 Years Old Nigerian Male 一名 27 岁尼日利亚男性继发于原发性膜增生性肾小球肾炎的肾病综合征
Pub Date : 2023-12-28 DOI: 10.21089/njhs.84.0212
Peter K. Uduagbamen, G. Ano-Edward, Sandra O. Idris, Tochukwu P. Ogbonna, Solomon Kadiri, Ayodeji Arije
Abstract: Membranoproliferative glomerulonephritis (MPGN) is not a common cause of nephrotic syndrome (NS) in adults unlike in children. It is commonly steroid-resistant in adults unlike in children. Tissue diagnosis needed for effective management could be unavailable due to cost, particularly in resource poor settings. Patient was examined, had urine analysis, serum biochemistry assay, kidney scan and a kidney biopsy for histological diagnosis. The patient had generalized oedema, with ascites, elevated blood pressure (156/90 mmHg) and massive proteinuria (4.6 g/day). The haemogram showed haematocrit of 32%, with absolute lymphocytosis (72%). Fasting lipids showed hypercholesterolemia (533 mg/dl), elevated LDL (274 mg/dl), low HDL (27 mg/dl) and hypertriglyceridemia (302 mg/dl). Ultrasound showed enlarged kidneys. Histological findings were mesangial hypercellularity, double-contour formation along the glomerular capillary wall (tram track appearance) and endocapillary proliferation. He was managed with intravenous methylprednisolone, (followed by gradually reducing oral doses), frusemide, atorvastatin, antibiotics and had daily weighing. He responded well to treatment. He was counselled on good compliance and has been on follow-up visits. His clinical and laboratory parameters have been normal. Nephrotic syndrome from MPGN should be looked out for in adults presenting with NS and their treatment with steroids could be very beneficial.
摘要:与儿童不同,膜增生性肾小球肾炎(MPGN)不是成人肾病综合征(NS)的常见病因。与儿童肾病综合征不同,成人肾病综合征通常对类固醇具有耐药性。有效治疗所需的组织诊断可能因费用问题而无法获得,尤其是在资源匮乏的环境中。对患者进行了检查、尿液分析、血清生化检测、肾脏扫描和肾脏活检,以进行组织学诊断。患者全身水肿,伴有腹水,血压升高(156/90 毫米汞柱),大量蛋白尿(4.6 克/天)。血象图显示血细胞比容为 32%,绝对淋巴细胞增多(72%)。空腹血脂显示高胆固醇血症(533 毫克/分升)、低密度脂蛋白升高(274 毫克/分升)、高密度脂蛋白低(27 毫克/分升)和高甘油三酯血症(302 毫克/分升)。超声波检查显示肾脏增大。组织学检查结果显示,肾小球系膜细胞增生,沿肾小球毛细血管壁形成双轮廓(电车轨道外观),毛细血管内膜增生。他接受了甲基强的松龙静脉注射(随后逐渐减少口服剂量)、氟塞米特、阿托伐他汀和抗生素治疗,并每天称重。他对治疗反应良好。他接受了良好依从性辅导,并一直接受随访。他的临床和实验室指标一直正常。在成人 NS 患者中,应警惕 MPGN 肾病综合征,使用类固醇治疗对他们非常有益。
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引用次数: 0
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National Journal of Health Sciences
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