A. Pont, Fahmi Hafid, Kadar Ramadhan, Wedad M Al-Mutairi, Semuel Piter Irab, Ferry Efendi
Introduction: Considering the importance of birth registration for children, the government has been put a policy in place to provide legal recognition of a child’s identity. This study aims to examine the factors associated with birth registration among children aged one-four years in Indonesia. Methods: A cross-sectional design was applied in this study using data from the 2017 Indonesian demographic and health survey. A sample of 15,624 mothers with children aged one-four years were included in this research as the subjects. To examine the associated factors, Chi-square tests and binary logistic regression were used. Results: The prevalence of children’s birth registrations in Indonesia was 77.9%. Multivariate analysis showed that the mother variables, such as mothers aged between 35 and 39 years (odds ratio [OR]=1.69, 95% confidence interval [CI]=1.22-2.33), their higher education levels (OR=4.63, CI=2.93-7.30), their current marital status (OR=2.0, CI=1.48-2.66), the richest quintile (OR=5.04, CI=3.91-6.50), living in the west Indonesian region (OR=2.85, CI=2.29-3.55), were significantly associated with a higher possibility of registering the child’s birth. In the same vein, the variables of being born at a health facility (OR=1.23, CI=1.04-1.46), being assisted by a skilled birth attendant (OR=1.72, CI=1.39-2.15), female children (OR=1.28, CI=1.16-1.43), and children aged four years old (OR=8.07, CI=6.72-9.69), were the factors associated with birth registration in Indonesia. Conclusion: Our study showed that birth registrations related to the demographic, socioeconomic, and health services are given to the family, particularly mother and child. Structured policies to improve the birth registration rate for the less privileged or vulnerable groups, poor and limited access to health services should be considered in the long run.
{"title":"Factors associated with birth registrations in Indonesia","authors":"A. Pont, Fahmi Hafid, Kadar Ramadhan, Wedad M Al-Mutairi, Semuel Piter Irab, Ferry Efendi","doi":"10.29333/ejgm/12900","DOIUrl":"https://doi.org/10.29333/ejgm/12900","url":null,"abstract":"Introduction: Considering the importance of birth registration for children, the government has been put a policy in place to provide legal recognition of a child’s identity. This study aims to examine the factors associated with birth registration among children aged one-four years in Indonesia.\u0000Methods: A cross-sectional design was applied in this study using data from the 2017 Indonesian demographic and health survey. A sample of 15,624 mothers with children aged one-four years were included in this research as the subjects. To examine the associated factors, Chi-square tests and binary logistic regression were used.\u0000Results: The prevalence of children’s birth registrations in Indonesia was 77.9%. Multivariate analysis showed that the mother variables, such as mothers aged between 35 and 39 years (odds ratio [OR]=1.69, 95% confidence interval [CI]=1.22-2.33), their higher education levels (OR=4.63, CI=2.93-7.30), their current marital status (OR=2.0, CI=1.48-2.66), the richest quintile (OR=5.04, CI=3.91-6.50), living in the west Indonesian region (OR=2.85, CI=2.29-3.55), were significantly associated with a higher possibility of registering the child’s birth. In the same vein, the variables of being born at a health facility (OR=1.23, CI=1.04-1.46), being assisted by a skilled birth attendant (OR=1.72, CI=1.39-2.15), female children (OR=1.28, CI=1.16-1.43), and children aged four years old (OR=8.07, CI=6.72-9.69), were the factors associated with birth registration in Indonesia.\u0000Conclusion: Our study showed that birth registrations related to the demographic, socioeconomic, and health services are given to the family, particularly mother and child. Structured policies to improve the birth registration rate for the less privileged or vulnerable groups, poor and limited access to health services should be considered in the long run.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47016859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Alqatari, Manal Hasan, Raed Bukhari, Kawther Hadhiah, Abrar J Alwaheed, Fatimah Alabdrabalnabi, Fatimah Al Ohaid, Abdullah W Aldarwish
This case report represents a rare case of 14-year-old female who diagnosed with hypocompementemic urticarial vasculitis syndrome that presents with glomerulonephritis, diffuse alveolar hemorrhage, and acute disseminated encephalomyelitis. The progression of the symptoms explained in the text below in which the final diagnosis was reached after a challenging approach. Patient was managed properly and followed up after treating with rituximab, although she represents no sign of the disease after a total of two cycles.
{"title":"A young female with hypocomplementemic urticarial vasculitis associated with a rare CNS manifestation","authors":"S. Alqatari, Manal Hasan, Raed Bukhari, Kawther Hadhiah, Abrar J Alwaheed, Fatimah Alabdrabalnabi, Fatimah Al Ohaid, Abdullah W Aldarwish","doi":"10.29333/ejgm/12859","DOIUrl":"https://doi.org/10.29333/ejgm/12859","url":null,"abstract":"This case report represents a rare case of 14-year-old female who diagnosed with hypocompementemic urticarial vasculitis syndrome that presents with glomerulonephritis, diffuse alveolar hemorrhage, and acute disseminated encephalomyelitis. The progression of the symptoms explained in the text below in which the final diagnosis was reached after a challenging approach. Patient was managed properly and followed up after treating with rituximab, although she represents no sign of the disease after a total of two cycles.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47192233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aliya Meirmanova, Gulzhakhan Omarova, A. Kurmanova, Zhanara Begniyazova, A. Yuldasheva
Introduction: Prolapse can be fixed using a variety of surgical procedures. The goal of the present study was to examine the current literature on various surgical techniques for treating female genital organ prolapse. Methods: The PubMed and Medline databases were explored for pertinent literature up through August 2022 for this meta-analysis. The terms [surgery] AND [management] AND [genital prolapse OR gynaecological diseases] AND [randomised control studies OR randomised control trials] were used as search criteria. The studies that met the inclusion criteria were considered qualified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Cochrane handbook of “Systematic reviews of interventions” was used for risk of bias assessment. Results: The investigations found significant difference in the heterogeneity between the groups with a 76% I2 value (p<0.00001). There was little variability among the six trials that examined robotic and laparoscopic therapy of prolapse (I2=0%, p=0.94). In six investigations, the odd ratio revealed no statistically significant difference between groups (1.05; 95% CI, 0.52, 2.12). However, generally there were no appreciable differences between robotic and laparoscopic treatment of female prolapse. There was a low-risk bias among the selected studies. Conclusion: According to this meta-analysis study, laparoscopic surgery performed better job of managing prolapse than abdominal surgery.
{"title":"Surgical management of genital prolapse and combined gynecological pathologies in women: A meta-analysis","authors":"Aliya Meirmanova, Gulzhakhan Omarova, A. Kurmanova, Zhanara Begniyazova, A. Yuldasheva","doi":"10.29333/ejgm/12793","DOIUrl":"https://doi.org/10.29333/ejgm/12793","url":null,"abstract":"Introduction: Prolapse can be fixed using a variety of surgical procedures. The goal of the present study was to examine the current literature on various surgical techniques for treating female genital organ prolapse.\u0000Methods: The PubMed and Medline databases were explored for pertinent literature up through August 2022 for this meta-analysis. The terms [surgery] AND [management] AND [genital prolapse OR gynaecological diseases] AND [randomised control studies OR randomised control trials] were used as search criteria. The studies that met the inclusion criteria were considered qualified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Cochrane handbook of “Systematic reviews of interventions” was used for risk of bias assessment.\u0000Results: The investigations found significant difference in the heterogeneity between the groups with a 76% I2 value (p<0.00001). There was little variability among the six trials that examined robotic and laparoscopic therapy of prolapse (I2=0%, p=0.94). In six investigations, the odd ratio revealed no statistically significant difference between groups (1.05; 95% CI, 0.52, 2.12). However, generally there were no appreciable differences between robotic and laparoscopic treatment of female prolapse. There was a low-risk bias among the selected studies.\u0000Conclusion: According to this meta-analysis study, laparoscopic surgery performed better job of managing prolapse than abdominal surgery.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44313227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Recent research has demonstrated the possible relevance of bilirubin in metabolic and cardiovascular disorders. Lipid abnormalities are a major problem that is related with an increased risk of cardiovascular disease in diabetics. This study examined the relationship between serum bilirubin and direct bilirubin concentrations and atherogenic lipids in patients with type 2 diabetes (T2DM). Methods: This cross-sectional included 67 patients with type 2 diabetes and 39 matched healthy control. The lipid profile, including total cholesterol, HDL-C, and TG levels, fasting blood glucose, total bilirubin, direct bilirubin, ALT, AST, and ALP were measured using a dimension EXL clinical chemistry analyzer (Siemens Healthcare Diagnostics). Cholesterol in VLDL, LDL, and sdLDL were calculated from standard lipid assay results by the equations of Sampson et al. Results: Serum bilirubin was lower in non T2DM subjects nearly significant (p=0.0.51) whereas direct bilirubin concentrations were lower in T2DM (p=0.008). ALT, AST, and ALP levels were higher in T2DM groups. The mean values of LDL-C, sdLDL-C, non HDL-C and VLDL-C were significantly increased in T2DM group and lower HDL-C. An inverse relationship could be observed with increase in serum total bilirubin and serum levels of LDL-C (r2=0.139, p<0.005), sdLDL-C (r2=0.137, p<0.005), VLDL-C (r2=0.074, p<0.044), and non HDL-C (r2=0.166, p<0.002) in T2DM group. The same inverse relationship was observed with serum direct bilirubin and serum levels of LDL-C (r2=0.133, p<0.006), sdLDL-C (r2=0.172, p<0.001), VLDL-C (r2=0.118, p<0.01), and non HDL-C (r2=0.182, p<0.001) in T2DM group. Conclusions: A significant negative association was found between serum bilirubin levels and direct serum bilirubin with atherogenic lipids, suggesting that serum bilirubin may protect T2DM patients from development of cardiovascular disease. These findings indicate the need for additional research in a large cohort.
{"title":"Serum bilirubin levels are negatively associated with atherogenic lipids in Saudi subjects with type 2 diabetes: A pilot study","authors":"Sultan Alouffi","doi":"10.29333/ejgm/12777","DOIUrl":"https://doi.org/10.29333/ejgm/12777","url":null,"abstract":"Background: Recent research has demonstrated the possible relevance of bilirubin in metabolic and cardiovascular disorders. Lipid abnormalities are a major problem that is related with an increased risk of cardiovascular disease in diabetics. This study examined the relationship between serum bilirubin and direct bilirubin concentrations and atherogenic lipids in patients with type 2 diabetes (T2DM).\u0000Methods: This cross-sectional included 67 patients with type 2 diabetes and 39 matched healthy control. The lipid profile, including total cholesterol, HDL-C, and TG levels, fasting blood glucose, total bilirubin, direct bilirubin, ALT, AST, and ALP were measured using a dimension EXL clinical chemistry analyzer (Siemens Healthcare Diagnostics). Cholesterol in VLDL, LDL, and sdLDL were calculated from standard lipid assay results by the equations of Sampson et al.\u0000Results: Serum bilirubin was lower in non T2DM subjects nearly significant (p=0.0.51) whereas direct bilirubin concentrations were lower in T2DM (p=0.008). ALT, AST, and ALP levels were higher in T2DM groups. The mean values of LDL-C, sdLDL-C, non HDL-C and VLDL-C were significantly increased in T2DM group and lower HDL-C. An inverse relationship could be observed with increase in serum total bilirubin and serum levels of LDL-C (r2=0.139, p<0.005), sdLDL-C (r2=0.137, p<0.005), VLDL-C (r2=0.074, p<0.044), and non HDL-C (r2=0.166, p<0.002) in T2DM group. The same inverse relationship was observed with serum direct bilirubin and serum levels of LDL-C (r2=0.133, p<0.006), sdLDL-C (r2=0.172, p<0.001), VLDL-C (r2=0.118, p<0.01), and non HDL-C (r2=0.182, p<0.001) in T2DM group.\u0000Conclusions: A significant negative association was found between serum bilirubin levels and direct serum bilirubin with atherogenic lipids, suggesting that serum bilirubin may protect T2DM patients from development of cardiovascular disease. These findings indicate the need for additional research in a large cohort.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41741093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Gharaibeh, R. Alrashdan, Shaimaa Shamoun, R. A. Abu Farha
Objective: This is a descriptive qualitative study with the aim of examining experiences of women diagnosed with breast cancer. Methods: The semi-structured interviews were conducted in the oncology clinic in Al Basheer Hospital in Jordan and included 15 women. Results: Several themes were identified such as knowledge before and after diagnosis, side effects of treatment, social and economic problems, lockdown and financial challenges in corona pandemic, coping strategies, and disclosure issues. Appropriate knowledge concerning causes of breast cancer, and side effects of administered drugs were lacking. Additionally, women were not comfortable telling others about their breast cancer diagnosis and considered it a private issue. During the COVID-19 pandemic, they faced many difficulties reaching hospitals, financial struggles, and inability to meet with their loved ones during lockdown. Conclusion: This study revealed the diversity of personalities and unique disposition of women regarding all the topics covered in the interviews. These differences should be considered in the support provided to these patients.
{"title":"Women with breast cancer, listening to the unheard voices: A qualitative study","authors":"L. Gharaibeh, R. Alrashdan, Shaimaa Shamoun, R. A. Abu Farha","doi":"10.29333/ejgm/12895","DOIUrl":"https://doi.org/10.29333/ejgm/12895","url":null,"abstract":"Objective: This is a descriptive qualitative study with the aim of examining experiences of women diagnosed with breast cancer.\u0000Methods: The semi-structured interviews were conducted in the oncology clinic in Al Basheer Hospital in Jordan and included 15 women.\u0000Results: Several themes were identified such as knowledge before and after diagnosis, side effects of treatment, social and economic problems, lockdown and financial challenges in corona pandemic, coping strategies, and disclosure issues. Appropriate knowledge concerning causes of breast cancer, and side effects of administered drugs were lacking. Additionally, women were not comfortable telling others about their breast cancer diagnosis and considered it a private issue. During the COVID-19 pandemic, they faced many difficulties reaching hospitals, financial struggles, and inability to meet with their loved ones during lockdown.\u0000Conclusion: This study revealed the diversity of personalities and unique disposition of women regarding all the topics covered in the interviews. These differences should be considered in the support provided to these patients.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45457538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Patil, S. Toshniwal, Abhijit Acharya, G. Gondhali
Introduction: Cardiac dysfunction in pulmonary tuberculosis is relatively more common and underestimated due to lack of suspicion. We have studied prevalence of cardiac dysfunction in pulmonary tuberculosis with special emphasis on echocardiography, serum cortisol and its correlation in cases with unstable cardiorespiratory parameters. Methods: Prospective, observational, complete workup, and one year follow up study conducted during January 2016 to December 2020 included 800 cases of active pulmonary tuberculosis with specified inclusion criteria of disproportionate tachycardia, tachypnea with or without hypoxia and shock. Cases with known risk factor for cardiac disease and taking cardiac medicines, and cases with pericardial effusion were excluded from study. All study cases were undergone protocolized analysis such as chest radiograph, pulse oximetry, ECG, sputum examination, cardiac enzymes (CPK-MB, NT-Pro-BNP, and cardiac troponins), serum cortisol, and echocardiography at entry point, at two and six months of treatment with anti-tuberculosis medicines as per NTEP. Statistical analysis was carried out by Chi-square test. Observations and analysis: In a study of 800 pulmonary tuberculosis cases, 56.00% (448/800) cases were males, and 44.00% (352/800) cases were females. Cases with BMI<18 was 41.62% (333/800) and BMI>18 was 58.37% (467/800). Radiological patterns as unilateral disease in 33.62% (269/800) & bilateral disease in 66.37% (531/800). Hemoglobin less than 10 gm% were documented in 85.12% (681/800) and above 10 gm% were in 14.87% (119/800) cases. Serum albumin less than 3.5 gm% and more than 3.5 gm% were observed in 48.12% (385/800) and 51.12% (415/800) cases respectively. Hypoxia was documented 26.12% (209/800) cases and normal oxygen saturation in 73.87% (591/800) cases. cases with normal and abnormal serum cortisol were 61.37% (491/800) & 38.62% (309/800) respectively. Sputum examination for AFB observed in 30.00% (240/800) and gene Xpert MTB/RIF documented in 51.37% (411/800) cases respectively. Bronchoscopy guided techniques were used in 149 cases and BAL smear AFB in 44.96% (67/149) cases, gene Xpert MTB/RIF in 97.31% (145/149) cases and MGIT culture in four cases (positive in 100% cases subjected to MGIT culture). We have observed global hypokinesia is predominant cardiac dysfunction documented in 82.21% (171/208) cases, followed by left heart systolic dysfunction in 16.34% (34/208) cases and left heart diastolic dysfunction in 75% (156/208) cases. Right heart dysfunction as dilated right atrium and right ventricle documented in 52.88% (110/208) cases and pulmonary hypertension in 40.38% (84/208) cases. Covariates such as age, gender, hemoglobin, BMI, serum cortisol, serum albumin, oxygen saturation and radiological involvement has significant association with cardiac dysfunction. (p<0.00001) Response to treatment with antituberculosis medicines and steroids has documented as improved in 77.40% cases (161/208) cases, persisten
{"title":"Cardiac dysfunction in active pulmonary tuberculosis: Mysterious facts of TB’s pandora","authors":"S. Patil, S. Toshniwal, Abhijit Acharya, G. Gondhali","doi":"10.29333/ejgm/12834","DOIUrl":"https://doi.org/10.29333/ejgm/12834","url":null,"abstract":"Introduction: Cardiac dysfunction in pulmonary tuberculosis is relatively more common and underestimated due to lack of suspicion. We have studied prevalence of cardiac dysfunction in pulmonary tuberculosis with special emphasis on echocardiography, serum cortisol and its correlation in cases with unstable cardiorespiratory parameters.\u0000Methods: Prospective, observational, complete workup, and one year follow up study conducted during January 2016 to December 2020 included 800 cases of active pulmonary tuberculosis with specified inclusion criteria of disproportionate tachycardia, tachypnea with or without hypoxia and shock. Cases with known risk factor for cardiac disease and taking cardiac medicines, and cases with pericardial effusion were excluded from study. All study cases were undergone protocolized analysis such as chest radiograph, pulse oximetry, ECG, sputum examination, cardiac enzymes (CPK-MB, NT-Pro-BNP, and cardiac troponins), serum cortisol, and echocardiography at entry point, at two and six months of treatment with anti-tuberculosis medicines as per NTEP. Statistical analysis was carried out by Chi-square test.\u0000Observations and analysis: In a study of 800 pulmonary tuberculosis cases, 56.00% (448/800) cases were males, and 44.00% (352/800) cases were females. Cases with BMI<18 was 41.62% (333/800) and BMI>18 was 58.37% (467/800). Radiological patterns as unilateral disease in 33.62% (269/800) & bilateral disease in 66.37% (531/800). Hemoglobin less than 10 gm% were documented in 85.12% (681/800) and above 10 gm% were in 14.87% (119/800) cases. Serum albumin less than 3.5 gm% and more than 3.5 gm% were observed in 48.12% (385/800) and 51.12% (415/800) cases respectively. Hypoxia was documented 26.12% (209/800) cases and normal oxygen saturation in 73.87% (591/800) cases. cases with normal and abnormal serum cortisol were 61.37% (491/800) & 38.62% (309/800) respectively. Sputum examination for AFB observed in 30.00% (240/800) and gene Xpert MTB/RIF documented in 51.37% (411/800) cases respectively. Bronchoscopy guided techniques were used in 149 cases and BAL smear AFB in 44.96% (67/149) cases, gene Xpert MTB/RIF in 97.31% (145/149) cases and MGIT culture in four cases (positive in 100% cases subjected to MGIT culture). We have observed global hypokinesia is predominant cardiac dysfunction documented in 82.21% (171/208) cases, followed by left heart systolic dysfunction in 16.34% (34/208) cases and left heart diastolic dysfunction in 75% (156/208) cases. Right heart dysfunction as dilated right atrium and right ventricle documented in 52.88% (110/208) cases and pulmonary hypertension in 40.38% (84/208) cases. Covariates such as age, gender, hemoglobin, BMI, serum cortisol, serum albumin, oxygen saturation and radiological involvement has significant association with cardiac dysfunction. (p<0.00001) Response to treatment with antituberculosis medicines and steroids has documented as improved in 77.40% cases (161/208) cases, persisten","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47406954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Zawiah, Amer Hayat Khan, R. A. Abu Farha, Abubakar Usman, A. Sha’aban, K. Abu Hammour, Zahraa Almuhsen
Background: Establishing and implementing a gold standard criteria for diagnosing and treating stroke-associated pneumonia (SAP) would have a significant positive impact on stroke outcomes and antibiotic stewardship. This study aimed to qualitatively explore current diagnostic and treatment practice for SAP among clinicians. Methods: A qualitative study was employed to conduct semi-structured interviews at the tertiary-care Jordan University Hospital. A purposive sampling technique was employed to recruit the participants, including respiratory consultants (n=3) and residents (n=9) practicing in the internal medicine wards and intensive care unit, where stroke patients are treated. The interviews were audio-recorded, transcribed verbatim, translated, and analyzed thematically using framework analysis. Results: Clinicians expressed their experiences, which were organized into two themes and eight emerged sub-themes: Terminology and diagnostic approach of SAP involved; no definite terminology, reliance on both clinical evidence and X-ray findings to decide, reliance on clinical evidence alone to suspect SAP and initiate empirical therapy, and SAP overdiagnosis. The treatment strategies include early treatment of SAP, treating SAP the same as CAP/HAP, predominant anaerobes coverage, and SAP overtreatment. Conclusion: Our findings show a wide range of physician-based diagnostic and treatment approaches for SAP, with clinical criteria serving as the main driver for antibiotic initiation. Standard validated algorithmic-based criteria need to be established and implemented.
{"title":"Diagnosis and treatment of stroke associated pneumonia: Qualitative exploration of clinicians’ practice","authors":"M. Zawiah, Amer Hayat Khan, R. A. Abu Farha, Abubakar Usman, A. Sha’aban, K. Abu Hammour, Zahraa Almuhsen","doi":"10.29333/ejgm/12849","DOIUrl":"https://doi.org/10.29333/ejgm/12849","url":null,"abstract":"Background: Establishing and implementing a gold standard criteria for diagnosing and treating stroke-associated pneumonia (SAP) would have a significant positive impact on stroke outcomes and antibiotic stewardship. This study aimed to qualitatively explore current diagnostic and treatment practice for SAP among clinicians.\u0000Methods: A qualitative study was employed to conduct semi-structured interviews at the tertiary-care Jordan University Hospital. A purposive sampling technique was employed to recruit the participants, including respiratory consultants (n=3) and residents (n=9) practicing in the internal medicine wards and intensive care unit, where stroke patients are treated. The interviews were audio-recorded, transcribed verbatim, translated, and analyzed thematically using framework analysis.\u0000Results: Clinicians expressed their experiences, which were organized into two themes and eight emerged sub-themes: Terminology and diagnostic approach of SAP involved; no definite terminology, reliance on both clinical evidence and X-ray findings to decide, reliance on clinical evidence alone to suspect SAP and initiate empirical therapy, and SAP overdiagnosis. The treatment strategies include early treatment of SAP, treating SAP the same as CAP/HAP, predominant anaerobes coverage, and SAP overtreatment.\u0000Conclusion: Our findings show a wide range of physician-based diagnostic and treatment approaches for SAP, with clinical criteria serving as the main driver for antibiotic initiation. Standard validated algorithmic-based criteria need to be established and implemented.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44465589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Asyraf Ismail, M. N. Norhayati, Noraini Mohamad, Wan Noor Hasbee Wan Abdullah
Pemphigus foliaceus is a benign variety of pemphigus group. It is a rare autoimmune blistering disease that affects the skin without mucosal involvement. It can present in endemic and sporadic form; whereby endemic form is common in Brazil and Tunisia, known as fogo selvagem. There was no previous case reported in Malaysia. We report a case of a 43-year-old man, who presented with generalized extensive blisters and vesicles that form crust and scale. The full evaluation established the diagnosis of pemphigus foliaceous. Delay in diagnosis can lead to poor outcomes. Primary care practitioners should be aware of this since the condition can mimic eczema, specifically photodermatitis.
{"title":"Pemphigus foliaceus: A rare blistering skin lesion","authors":"Muhammad Asyraf Ismail, M. N. Norhayati, Noraini Mohamad, Wan Noor Hasbee Wan Abdullah","doi":"10.29333/ejgm/12831","DOIUrl":"https://doi.org/10.29333/ejgm/12831","url":null,"abstract":"Pemphigus foliaceus is a benign variety of pemphigus group. It is a rare autoimmune blistering disease that affects the skin without mucosal involvement. It can present in endemic and sporadic form; whereby endemic form is common in Brazil and Tunisia, known as fogo selvagem. There was no previous case reported in Malaysia. We report a case of a 43-year-old man, who presented with generalized extensive blisters and vesicles that form crust and scale. The full evaluation established the diagnosis of pemphigus foliaceous. Delay in diagnosis can lead to poor outcomes. Primary care practitioners should be aware of this since the condition can mimic eczema, specifically photodermatitis.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49141718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Suieubekov, A. Sepbayeva, A. Yeshmanova, A. Kusainov
Introduction: Acute kidney injury is a common complication following pediatric heart surgery, and it has been linked to an increased risk of morbidity and fatality. Methods: The PubMed and Medline databases were combed for relevant research until May 2022. The terms [Cardiac surgery] AND [acute renal injury] AND [newborns OR children OR neonates] AND [randomized control studies OR randomized control trials] were used as search criteria. The studies that met the inclusion criteria were considered qualified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Results: A total of 2,941 newborns or children were enrolled in 14 studies, with 931 developing acute renal damage. 2,095 of the enrolled infants and children received steroid, aminophylline, dexmedetomidine, and acetaminophen therapies. In seven studies, the odds ratio for steroids was not significantly different from control. In contrast, two studies comparing aminophylline to a control group found no statistically significant change. Two studies found no significant difference in dexmedetomidine therapy compared to control. Three trials, however, found a significant difference between the acetaminophen treatment and control groups. Conclusion: Acetaminophen was linked to a decreased risk of postoperative acute renal injury, while steroids had no benefit and aminophylline treatment could be justified.
{"title":"Cardiac surgery-associated acute kidney injury in newborns: A meta-analysis","authors":"B. Suieubekov, A. Sepbayeva, A. Yeshmanova, A. Kusainov","doi":"10.29333/ejgm/12805","DOIUrl":"https://doi.org/10.29333/ejgm/12805","url":null,"abstract":"Introduction: Acute kidney injury is a common complication following pediatric heart surgery, and it has been linked to an increased risk of morbidity and fatality.\u0000Methods: The PubMed and Medline databases were combed for relevant research until May 2022. The terms [Cardiac surgery] AND [acute renal injury] AND [newborns OR children OR neonates] AND [randomized control studies OR randomized control trials] were used as search criteria. The studies that met the inclusion criteria were considered qualified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.\u0000Results: A total of 2,941 newborns or children were enrolled in 14 studies, with 931 developing acute renal damage. 2,095 of the enrolled infants and children received steroid, aminophylline, dexmedetomidine, and acetaminophen therapies. In seven studies, the odds ratio for steroids was not significantly different from control. In contrast, two studies comparing aminophylline to a control group found no statistically significant change. Two studies found no significant difference in dexmedetomidine therapy compared to control. Three trials, however, found a significant difference between the acetaminophen treatment and control groups.\u0000Conclusion: Acetaminophen was linked to a decreased risk of postoperative acute renal injury, while steroids had no benefit and aminophylline treatment could be justified.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":"45 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69937683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Excess adiposity is an established risk factor for cardiovascular disease (CVD), therefore the early screening indies with predicted CVD risk is more useful for older adults. The current study evaluated the associations between anthropometric, body composition and dietary indices and elevated 10-year CVD risk in older people. Methods: This research, which involved 55 to 94-year-olds living in the community. Standard techniques were used to determine anthropometric factors and body composition indicators. The risk prediction chart created by World Health Organization and International Society of Hypertension was used to calculate the CVD risk score. Odds ratio (OR) and 95% confidence interval (CI) were determined. Results: CVD risk prediction was positively correlated with the anthropometric and body composition parameters. After controlling for confounding variables, the logistic regression analysis revealed that waist circumference (OR=16.34; 95% CI: 7.22, 36.98; p<0.001), systolic blood pressure (BP) (OR=9.53; 95% CI: 4.52, 20.07; p<0.001), and visceral adipose tissue percentage (OR=5.47; 95% CI: 2.98, 10.01; p<0.001) were correlated with cardiovascular risk prediction. Conclusions: Abdominal obesity and increase of systolic BP were associated to increased risk for CVD. Additionally, a positive association between the risk factors for CVD (%visceral adipose tissue) and diet (cholesterol consumption) was established.
{"title":"Association of abdominal obesity and systolic blood pressure indices with cardiovascular disease risk prediction among community-dwelling older adults","authors":"A. Duangjai, Naritsara Phanthurat, Wittawas Sajjapong, Atcharaporn Ontawong, Sirinat Pengnet, Atchariya Yosboonruang, Kamonwan Jongsomchai, Natthaphon Thatsanasuwan","doi":"10.29333/ejgm/12855","DOIUrl":"https://doi.org/10.29333/ejgm/12855","url":null,"abstract":"Background: Excess adiposity is an established risk factor for cardiovascular disease (CVD), therefore the early screening indies with predicted CVD risk is more useful for older adults. The current study evaluated the associations between anthropometric, body composition and dietary indices and elevated 10-year CVD risk in older people.\u0000Methods: This research, which involved 55 to 94-year-olds living in the community. Standard techniques were used to determine anthropometric factors and body composition indicators. The risk prediction chart created by World Health Organization and International Society of Hypertension was used to calculate the CVD risk score. Odds ratio (OR) and 95% confidence interval (CI) were determined.\u0000Results: CVD risk prediction was positively correlated with the anthropometric and body composition parameters. After controlling for confounding variables, the logistic regression analysis revealed that waist circumference (OR=16.34; 95% CI: 7.22, 36.98; p<0.001), systolic blood pressure (BP) (OR=9.53; 95% CI: 4.52, 20.07; p<0.001), and visceral adipose tissue percentage (OR=5.47; 95% CI: 2.98, 10.01; p<0.001) were correlated with cardiovascular risk prediction.\u0000Conclusions: Abdominal obesity and increase of systolic BP were associated to increased risk for CVD. Additionally, a positive association between the risk factors for CVD (%visceral adipose tissue) and diet (cholesterol consumption) was established.","PeriodicalId":44930,"journal":{"name":"Electronic Journal of General Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42641043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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