Objective: To investigate the laxative effect of reducing the number of daily doses of magnesium oxide (MgO), while maintaining the total daily dose of MgO in patients with good bowel movements. Patients and Methods: The retrospective analysis involved 11 patients with regular bowel movements who were prescribed MgO for constipation upon admission to a nursing care facility accompanied by home visits by a pharmacist. This investigation was conducted before and after reducing the number of daily doses from three to two, or from two to one, over a two-week period. Results: The number of bowel movements was 7.6 ± 3.4 and 6.6 ± 4.0 times for two weeks before and after the change in dosage frequency, respectively. The difference was not statistically significant (P=0.09). The Bristol Stool Form Scale was 3.9 ± 0.9 and 4.0 ± 0.9 two weeks before and after the change, respectively, which was not significant (P=0.93). Two weeks after the change, the MgO regimen remained unchanged and no on-demand laxatives were administered. Conclusions: The results suggest that reducing the number of daily doses of MgO does not affect its laxative action.
{"title":"Effect of reduced daily magnesium oxide doses on laxative effect: a single-center retrospective study.","authors":"Norio Watanabe, Akira Itano, Motozumi Ando, Masami Kawahara","doi":"10.2185/jrm.2023-038","DOIUrl":"10.2185/jrm.2023-038","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the laxative effect of reducing the number of daily doses of magnesium oxide (MgO), while maintaining the total daily dose of MgO in patients with good bowel movements. <b>Patients and Methods:</b> The retrospective analysis involved 11 patients with regular bowel movements who were prescribed MgO for constipation upon admission to a nursing care facility accompanied by home visits by a pharmacist. This investigation was conducted before and after reducing the number of daily doses from three to two, or from two to one, over a two-week period. <b>Results:</b> The number of bowel movements was 7.6 ± 3.4 and 6.6 ± 4.0 times for two weeks before and after the change in dosage frequency, respectively. The difference was not statistically significant (<i>P</i>=0.09). The Bristol Stool Form Scale was 3.9 ± 0.9 and 4.0 ± 0.9 two weeks before and after the change, respectively, which was not significant (<i>P</i>=0.93). Two weeks after the change, the MgO regimen remained unchanged and no on-demand laxatives were administered. <b>Conclusions:</b> The results suggest that reducing the number of daily doses of MgO does not affect its laxative action.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 3","pages":"192-195"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Rapid bone development in growing children causes excessive tension in the lower extremities' muscles and tendons, leading to reduced flexibility and increased musculoskeletal disorder risk. Further, lack of exercise causes obesity. Therefore, we created a stretching exercise protocol to prevent musculoskeletal disorders in elementary school (middle and upper grades) children during their growth period, when rapid bone development begins. Patients and Methods: We examined the effects on pain, injury, and flexibility. Fifty-three (boys: 34, girls: 19) students in grades 3-5 (ages 9-11) performed the stretching exercises at school thrice a week for one year, and we compared the results before and a year after the intervention. Results: A three-minute stretching exercise routine achieved an intensity of 4.6-4.9 metabolic equivalents (METs; equivalent to brisk walking). Obesity (P=1.000), flexibility problems (inability to bend forward [P=0.754] or squat problems [P=1.000]), bone/joint pain (P=1.000), and injury (P=1.000) did not significantly increase. Conclusion: Stretching exercises during the growth period may help prevent childhood musculoskeletal disorders, obesity, and flexibility loss.
{"title":"Stretching exercises for growing children: evaluation of obesity, flexibility, pain and injury of musculoskeletal organs before and one year later.","authors":"Maiko Ohtaka, Masayo Saito, Yukiko Ito","doi":"10.2185/jrm.2023-051","DOIUrl":"10.2185/jrm.2023-051","url":null,"abstract":"<p><p><b>Objective:</b> Rapid bone development in growing children causes excessive tension in the lower extremities' muscles and tendons, leading to reduced flexibility and increased musculoskeletal disorder risk. Further, lack of exercise causes obesity. Therefore, we created a stretching exercise protocol to prevent musculoskeletal disorders in elementary school (middle and upper grades) children during their growth period, when rapid bone development begins. <b>Patients and Methods:</b> We examined the effects on pain, injury, and flexibility. Fifty-three (boys: 34, girls: 19) students in grades 3-5 (ages 9-11) performed the stretching exercises at school thrice a week for one year, and we compared the results before and a year after the intervention. <b>Results:</b> A three-minute stretching exercise routine achieved an intensity of 4.6-4.9 metabolic equivalents (METs; equivalent to brisk walking). Obesity (<i>P</i>=1.000), flexibility problems (inability to bend forward [<i>P</i>=0.754] or squat problems [<i>P</i>=1.000]), bone/joint pain (<i>P</i>=1.000), and injury (<i>P</i>=1.000) did not significantly increase. <b>Conclusion:</b> Stretching exercises during the growth period may help prevent childhood musculoskeletal disorders, obesity, and flexibility loss.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 3","pages":"150-157"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Identifying the peripheral biomarkers related to the prevention or modification of unhealthy mental conditions in older adults is extremely beneficial. This study aimed to evaluate the serum levels of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), a soluble form of an innate immune receptor expressed on microglia, in older adults living in a rural community, and their association with cognitive function. Materials and Methods: This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged ≥65 years. Blood samples were collected from the participants for serum sTREM2 level analysis using a peptide enzyme immunoassay. The participants underwent cognitive function assessments, including the Mini-Mental State Examination, Clinical Dementia Rating, and Frontal Assessment Battery. Therefore, we examined the association between serum sTREM2 levels and cognitive function. Results: Of the 95 participants, 25 were men and 70 were women with a mean age 78.24 ± 3.85 years and 77.96 ± 5.52 years, respectively. Serum sTREM2 levels were negatively associated with Frontal Assessment Battery scores, even after adjusting for age, sex, years of education, and serum high-sensitivity C-reactive protein levels. Conclusion: Serum sTREM2 levels may be associated with frontal lobe function in adults aged ≥65 years.
{"title":"Association between sTREM2, an immune biomarker of microglial activation, and frontal lobe function in community-dwelling older adults: a cross-sectional study.","authors":"Ryuzo Orihashi, Yoshiomi Imamura, Yoshito Mizoguchi","doi":"10.2185/jrm.2024-018","DOIUrl":"10.2185/jrm.2024-018","url":null,"abstract":"<p><p><b>Objective:</b> Identifying the peripheral biomarkers related to the prevention or modification of unhealthy mental conditions in older adults is extremely beneficial. This study aimed to evaluate the serum levels of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), a soluble form of an innate immune receptor expressed on microglia, in older adults living in a rural community, and their association with cognitive function. <b>Materials and Methods:</b> This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged ≥65 years. Blood samples were collected from the participants for serum sTREM2 level analysis using a peptide enzyme immunoassay. The participants underwent cognitive function assessments, including the Mini-Mental State Examination, Clinical Dementia Rating, and Frontal Assessment Battery. Therefore, we examined the association between serum sTREM2 levels and cognitive function. <b>Results:</b> Of the 95 participants, 25 were men and 70 were women with a mean age 78.24 ± 3.85 years and 77.96 ± 5.52 years, respectively. Serum sTREM2 levels were negatively associated with Frontal Assessment Battery scores, even after adjusting for age, sex, years of education, and serum high-sensitivity C-reactive protein levels. <b>Conclusion:</b> Serum sTREM2 levels may be associated with frontal lobe function in adults aged ≥65 years.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 3","pages":"186-191"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Histological differences in cartilage layer growth in Achilles tendon (AT), quadriceps tendon (QT), patellar tendon (PT), and anterior cruciate ligament (ACL) insertion are unclear. Therefore, this study aimed to investigate the differences in cartilage layer growth in AT, QT, PT, and ACL insertions. Materials and Methods: Forty-eight male Japanese white rabbits were used. Six animals were euthanized at different stages (day 1 and 1, 2, 4, 6, 8, 12, and 24 weeks). Safranin O-stained glycosaminoglycan (GAG) production area, chondrocyte count, and insertion width were investigated. Results: A two-way analysis of variance (ANOVA) revealed a significant difference in the main effects of time and insertion for all parameters. In addition, the time × insertion interaction was significant. Multiple comparisons showed a significant difference between the ACL insertion and all other variables; however, the GAG production area was not significantly different for the QT, PT, and AT insertions. AT insertions were significantly different from all other groups; however, the number of chondrocytes and insertion width were not significantly different for ACL, QT, and PT insertions. Conclusion: Cartilage layer growth differed between the AT, QT, PT, and ACL insertions. The differences between the insertions may also be due to the differences in their structures, locations, and mechanical environments.
{"title":"Histological differences in cartilage layer growth at various tendon and ligament insertions in rabbits.","authors":"Hirotaka Mutsuzaki, Hiromi Nakajima","doi":"10.2185/jrm.2024-009","DOIUrl":"10.2185/jrm.2024-009","url":null,"abstract":"<p><p><b>Objectives:</b> Histological differences in cartilage layer growth in Achilles tendon (AT), quadriceps tendon (QT), patellar tendon (PT), and anterior cruciate ligament (ACL) insertion are unclear. Therefore, this study aimed to investigate the differences in cartilage layer growth in AT, QT, PT, and ACL insertions. <b>Materials and Methods:</b> Forty-eight male Japanese white rabbits were used. Six animals were euthanized at different stages (day 1 and 1, 2, 4, 6, 8, 12, and 24 weeks). Safranin O-stained glycosaminoglycan (GAG) production area, chondrocyte count, and insertion width were investigated. <b>Results:</b> A two-way analysis of variance (ANOVA) revealed a significant difference in the main effects of time and insertion for all parameters. In addition, the time × insertion interaction was significant. Multiple comparisons showed a significant difference between the ACL insertion and all other variables; however, the GAG production area was not significantly different for the QT, PT, and AT insertions. AT insertions were significantly different from all other groups; however, the number of chondrocytes and insertion width were not significantly different for ACL, QT, and PT insertions. <b>Conclusion:</b> Cartilage layer growth differed between the AT, QT, PT, and ACL insertions. The differences between the insertions may also be due to the differences in their structures, locations, and mechanical environments.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 3","pages":"181-185"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. Material and Methods: A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Results: Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21–47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09–51.52], illiterate [OR= 6.25, 95% CI 2.84–13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54–7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70–18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52–19.42]. Conclusion: The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.
目标：常见精神障碍（CMDs），包括抑郁症、焦虑症和躯体形式障碍，影响人生的各个阶段，并对个人、家庭和社区造成影响。本研究旨在确定印度北部一个农村地区成年人中常见精神障碍的严重程度及其社会人口学决定因素。材料和方法：采用多阶段随机抽样技术，对印度北部哈里亚纳邦一个农村街区的成年居民进行了一项横断面定量社区研究。研究使用印地语版《一般健康问卷》（GHQ-12）这一经过充分验证的工具来筛查参与者是否患有慢性阻塞性肺病。得分在 4 分或以上者表示患有慢性阻塞性肺病。对 CMD 与社会人口学特征之间的关系进行了双变量分析。研究结果在被选中进行研究的 180 名居民中，大多数为女性（60.0%），年龄在 31 至 50 岁之间（52.3%）。研究人群中出现 CMDs 症状的比例为 20.0%。60 岁或以上[OR=12.33，95% CI 3.21-47.38]、丧偶、离婚或分居[OR=7.50，95% CI 1.09-51.52]、文盲[OR=6.25，95% CI 2.84-13.77]、家庭月收入低于 10,000 印度卢比[OR=3.33，95% CI 1.54-7.20]、有任何慢性身体疾病[OR=8.28，95% CI 3.70-18.56]、有任何精神病家族史[OR=5.56，95% CI 1.52-19.42]。结论北印度农村地区成年人的慢性精神疾病负担相当高。CMD的存在与社会人口特征密切相关。基层医疗机构和社区需要筛查、诊断和管理慢性阻塞性肺病，以解决这一日益严重的问题。
{"title":"Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India","authors":"MD. Abu Bashar, A. Mehra, Arun Kumar Aggarwal","doi":"10.2185/jrm.2023-013","DOIUrl":"https://doi.org/10.2185/jrm.2023-013","url":null,"abstract":"Objectives: Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. Material and Methods: A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Results: Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21–47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09–51.52], illiterate [OR= 6.25, 95% CI 2.84–13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54–7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70–18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52–19.42]. Conclusion: The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"68 8","pages":"49 - 56"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759088","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}
Yusuke Yamada, T. Abe, Rina Tanohata, Hidenobu Ochiai
Objective Little is known about the coagulation activity of factor XIII (FXIII) during resuscitation for hemorrhagic shock and the effects of plasma transfusions. We performed a single-center observational study to evaluate the changes in FXIII activity during resuscitation for hemorrhagic shock. Patient and Methods Twenty-three adult patients with hemorrhagic shock were enrolled in this study. Blood samples were drawn upon arrival (T1), at the time of hemostasis completion (T2), and on day 2 (T3). Baseline and changes in FXIII activity and the proportion of patients with adequate levels of FXIII activity (FXIII activity >70%) were evaluated. The effects of plasma transfusion on these parameters were also investigated. Results At T1, the median (interquartile range) FXIII activity was 53% (47–85%), which did not increase (T1 vs. T3: 53% [47–85%] vs. 63% [52–70%], P=0.8766). The proportion of patients with adequate FXIII activity decreased throughout the resuscitation period (T1, T2, and T3: 30, 34, and 21%, respectively). Plasma transfusion did not affect FXIII activity (T1 vs. T2, 66.4% [23.4] vs. 70.0% [16.2%], P=0.3956; T2 vs. T3, 72.0% [19.5] vs. 63.5% [8.6%], P=0.1161) or the proportion of adequate levels of FXIII activity at 44% at T2 and 27% at T3. Conclusion FXIII activity is low during the early phase of a hemorrhagic shock. Even with plasma transfusion, FXIII levels were not adequately maintained throughout resuscitation.
目的 对失血性休克复苏期间因子 XIII（FXIII）的凝血活性以及输血浆的影响知之甚少。我们进行了一项单中心观察性研究，以评估失血性休克复苏期间 FXIII 活性的变化。患者和方法 23 名失血性休克成人患者参与了这项研究。分别在患者到达时（T1）、止血完成时（T2）和第 2 天（T3）抽取血样。对 FXIII 活性的基线和变化以及 FXIII 活性达到足够水平（FXIII 活性大于 70%）的患者比例进行了评估。此外，还研究了输血对这些参数的影响。结果 在 T1 期，FXIII 活性的中位数（四分位数间距）为 53% (47-85%)，没有增加（T1 vs. T3：53% [47-85%] vs. 63% [52-70%]，P=0.8766）。在整个复苏期间，FXIII 活性充足的患者比例有所下降（T1、T2 和 T3：分别为 30%、34% 和 21%）。输血浆不会影响 FXIII 活性（T1 vs. T2，66.4% [23.4] vs. 70.0% [16.2%]，P=0.3956；T2 vs. T3，72.0% [19.5] vs. 63.5% [8.6%]，P=0.1161）或 FXIII 活性充足水平的比例（T2 为 44%，T3 为 27%）。结论 在失血性休克的早期阶段，FXIII 活性较低。即使输注了血浆，FXIII 的水平在整个复苏过程中也无法得到充分维持。
{"title":"Changes in coagulation factor XIII activity during resuscitation for hemorrhagic shock","authors":"Yusuke Yamada, T. Abe, Rina Tanohata, Hidenobu Ochiai","doi":"10.2185/jrm.2023-028","DOIUrl":"https://doi.org/10.2185/jrm.2023-028","url":null,"abstract":"Objective Little is known about the coagulation activity of factor XIII (FXIII) during resuscitation for hemorrhagic shock and the effects of plasma transfusions. We performed a single-center observational study to evaluate the changes in FXIII activity during resuscitation for hemorrhagic shock. Patient and Methods Twenty-three adult patients with hemorrhagic shock were enrolled in this study. Blood samples were drawn upon arrival (T1), at the time of hemostasis completion (T2), and on day 2 (T3). Baseline and changes in FXIII activity and the proportion of patients with adequate levels of FXIII activity (FXIII activity >70%) were evaluated. The effects of plasma transfusion on these parameters were also investigated. Results At T1, the median (interquartile range) FXIII activity was 53% (47–85%), which did not increase (T1 vs. T3: 53% [47–85%] vs. 63% [52–70%], P=0.8766). The proportion of patients with adequate FXIII activity decreased throughout the resuscitation period (T1, T2, and T3: 30, 34, and 21%, respectively). Plasma transfusion did not affect FXIII activity (T1 vs. T2, 66.4% [23.4] vs. 70.0% [16.2%], P=0.3956; T2 vs. T3, 72.0% [19.5] vs. 63.5% [8.6%], P=0.1161) or the proportion of adequate levels of FXIII activity at 44% at T2 and 27% at T3. Conclusion FXIII activity is low during the early phase of a hemorrhagic shock. Even with plasma transfusion, FXIII levels were not adequately maintained throughout resuscitation.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"64 ","pages":"76 - 82"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796969","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}
Keisuke Kubo, T. Abe, Hideki Nagoshi, Hidenobu Ochiai
Objective Blunt cardiac rupture is a life-threatening injury that requires surgical repair by cardiovascular or trauma surgeons. We report a case of blunt cardiac rupture in a rural area in which emergency physicians performed emergency department thoracotomy and surgical repair to save the patient’s life. Patient and Methods This case involved an 18-year-old female who was injured in a traffic accident and underwent emergency thoracotomy and surgical repair. Results The patient’s left thorax was deformed, and sonographic assessment revealed pericardial effusion. She experienced cardiopulmonary arrest 13 min after hospital arrival. An emergency physician performed an emergency department thoracotomy. The clots were removed from the surface of the left ventricle, followed by wound compression to control bleeding from the ruptured left ventricular wall. After the recovery of spontaneous circulation, the emergency physician sutured the ruptured heart. The patient survived with good neurological function. Conclusion In rural areas, blunt cardiac rupture may require emergency department thoracotomy and cardiac repair by emergency physicians. The establishment of educational systems that include continuous education on trauma surgical procedures and consensus guidelines is needed to assist rural emergency physicians in performing surgical procedures.
{"title":"Should an emergency physician be a “surgeon” in a rural area? A case of blunt cardiac rupture successfully treated by an emergency physician","authors":"Keisuke Kubo, T. Abe, Hideki Nagoshi, Hidenobu Ochiai","doi":"10.2185/jrm.2023-009","DOIUrl":"https://doi.org/10.2185/jrm.2023-009","url":null,"abstract":"Objective Blunt cardiac rupture is a life-threatening injury that requires surgical repair by cardiovascular or trauma surgeons. We report a case of blunt cardiac rupture in a rural area in which emergency physicians performed emergency department thoracotomy and surgical repair to save the patient’s life. Patient and Methods This case involved an 18-year-old female who was injured in a traffic accident and underwent emergency thoracotomy and surgical repair. Results The patient’s left thorax was deformed, and sonographic assessment revealed pericardial effusion. She experienced cardiopulmonary arrest 13 min after hospital arrival. An emergency physician performed an emergency department thoracotomy. The clots were removed from the surface of the left ventricle, followed by wound compression to control bleeding from the ruptured left ventricular wall. After the recovery of spontaneous circulation, the emergency physician sutured the ruptured heart. The patient survived with good neurological function. Conclusion In rural areas, blunt cardiac rupture may require emergency department thoracotomy and cardiac repair by emergency physicians. The establishment of educational systems that include continuous education on trauma surgical procedures and consensus guidelines is needed to assist rural emergency physicians in performing surgical procedures.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"402 1","pages":"114 - 118"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778619","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}
Fekri Dureab, T. Al-Mahbashi, R. Sheikh, Ola El Hajj Hassan, Elvis Safary, Yasmin Al-Qadasi
Objectives Many developing countries utilize the services of community health volunteers (CHVs) to enhance healthcare services in underserved regions. Evaluating client satisfaction with CHVs’ performance is crucial for ensuring the effective utilization of their services. This study aims to assess clients’ satisfaction with the provision of basic reproductive health services by CHVs in the governorates of Ibb and Al Mahweet, Yemen. Materials and Methods A cross-sectional study was conducted, collecting data via structured questionnaires administered by trained data collectors to clients of CHVs. A total of 510 households were interviewed, with 255 from each governorate, distributed across 30 clusters (villages). Each governorate comprised 15 clusters in 12 districts (six districts in Ibb and five in Al Mahweet, excluding one district for security reasons). Within each cluster, 17 households were randomly selected for interviews. Descriptive analysis was performed using the SPSS version 22. Results The majority of the clients were female (84.7%), most were aged 20–39 years (55.7%), and more than half of them had received at least primary education (54.2%). The study findings indicate that a significant proportion of respondents were highly satisfied with CHVs’ performance (93%). Almost all respondents confirmed that CHVs resided in their villages (94%) and were easily accessible for consultation (99%). Most of the respondents (97%) expressed trust in the CHVs, stating that they were helpful to all villagers and treated them well. Additionally, nearly all the respondents reported easy access to services (98.6%), although a considerable percentage experienced a gap of three months or more since their last interaction with a CHV (39.1%). Conclusion The CHVs contribute to the well-being of the rural populations in Yemen by delivering satisfactory services, particularly regarding family planning. However, ensuring the sustainability of the CHV programs remains a challenge, which requires attention from the program managers and decision makers in the Yemeni healthcare sector.
{"title":"Community health volunteers’ performance in rural areas of Yemen: a community-based satisfaction survey","authors":"Fekri Dureab, T. Al-Mahbashi, R. Sheikh, Ola El Hajj Hassan, Elvis Safary, Yasmin Al-Qadasi","doi":"10.2185/jrm.2023-027","DOIUrl":"https://doi.org/10.2185/jrm.2023-027","url":null,"abstract":"Objectives Many developing countries utilize the services of community health volunteers (CHVs) to enhance healthcare services in underserved regions. Evaluating client satisfaction with CHVs’ performance is crucial for ensuring the effective utilization of their services. This study aims to assess clients’ satisfaction with the provision of basic reproductive health services by CHVs in the governorates of Ibb and Al Mahweet, Yemen. Materials and Methods A cross-sectional study was conducted, collecting data via structured questionnaires administered by trained data collectors to clients of CHVs. A total of 510 households were interviewed, with 255 from each governorate, distributed across 30 clusters (villages). Each governorate comprised 15 clusters in 12 districts (six districts in Ibb and five in Al Mahweet, excluding one district for security reasons). Within each cluster, 17 households were randomly selected for interviews. Descriptive analysis was performed using the SPSS version 22. Results The majority of the clients were female (84.7%), most were aged 20–39 years (55.7%), and more than half of them had received at least primary education (54.2%). The study findings indicate that a significant proportion of respondents were highly satisfied with CHVs’ performance (93%). Almost all respondents confirmed that CHVs resided in their villages (94%) and were easily accessible for consultation (99%). Most of the respondents (97%) expressed trust in the CHVs, stating that they were helpful to all villagers and treated them well. Additionally, nearly all the respondents reported easy access to services (98.6%), although a considerable percentage experienced a gap of three months or more since their last interaction with a CHV (39.1%). Conclusion The CHVs contribute to the well-being of the rural populations in Yemen by delivering satisfactory services, particularly regarding family planning. However, ensuring the sustainability of the CHV programs remains a challenge, which requires attention from the program managers and decision makers in the Yemeni healthcare sector.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"199 ","pages":"66 - 75"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765105","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}
Objective To clarify the association between dementia knowledge and attitudes, lifestyle backgrounds, and practical training experiences of nursing students, and examine the basic nursing education for dementia. Participants and Methods A total of 412 first-to-fourth-year students at Nursing College A participated in the study. A cross-sectional survey was conducted regarding knowledge (15 questions) and attitudes (15 questions) related to dementia. Results Consent was obtained from 158 individuals (The response rate was 38.3%). Significant items regarding dementia attitudes and cohabitation experiences were identified. Additionally, significant items regarding attitude toward dementia and care providing experiences were identified. Conclusion Associations among attitude toward dementia, cohabitation experiences, and care providing experiences were determined. Knowledge and attitudes regarding dementia improved with practical training experience.
{"title":"Dementia knowledge and attitudes of nursing undergraduate students—association between lifestyle background and practical training experience—","authors":"Hirohito Nanbu, Kouhei Hayashi, F. Tanji, Yuki Tsuruta, Kazuki Awaji, Noriko Nakai","doi":"10.2185/jrm.2023-042","DOIUrl":"https://doi.org/10.2185/jrm.2023-042","url":null,"abstract":"Objective To clarify the association between dementia knowledge and attitudes, lifestyle backgrounds, and practical training experiences of nursing students, and examine the basic nursing education for dementia. Participants and Methods A total of 412 first-to-fourth-year students at Nursing College A participated in the study. A cross-sectional survey was conducted regarding knowledge (15 questions) and attitudes (15 questions) related to dementia. Results Consent was obtained from 158 individuals (The response rate was 38.3%). Significant items regarding dementia attitudes and cohabitation experiences were identified. Additionally, significant items regarding attitude toward dementia and care providing experiences were identified. Conclusion Associations among attitude toward dementia, cohabitation experiences, and care providing experiences were determined. Knowledge and attitudes regarding dementia improved with practical training experience.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"347 ","pages":"83 - 91"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778210","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}
Hiroyasu Sakai, Hironao Ichikawa, Jun Takada, Masaya Kubota, T. Ibuka, Y. Shirakami, Masahito Shimizu
Objective Colonoscopy is useful in diagnosing intestinal tuberculosis. However, the terminal ileum is generally not examined during routine colonoscopy. Therefore, even with colonoscopy, the diagnosis can be missed in patients with lesions confined to the terminal ileum. Herein, we report the case of an asymptomatic patient with intestinal tuberculosis, in whom a colonoscope insertion into the terminal ileum led to the diagnosis. Patient An asymptomatic 71-year-old man visited our hospital for a colonoscopy after a positive fecal occult blood test. Results Colonoscopy revealed diffuse edematous and erosive mucosa in the terminal ileum. Mycobacterium tuberculosis was detected by polymerase chain reaction and culture of biopsy specimens from the erosions, leading to the diagnosis of intestinal tuberculosis. The patient was treated with antitubercular agents for 6 months, and a follow-up colonoscopy revealed healing of the lesions. Conclusion Asymptomatic intestinal tuberculosis may occasionally be detected on colonoscopy following a positive fecal occult blood test and is sometimes confined to the terminal ileum. Therefore, clinicians should consider intestinal tuberculosis in the differential diagnosis of the causes of positive fecal occult blood test results and perform colonoscopies, including observation of the terminal ileum.
{"title":"Asymptomatic intestinal tuberculosis of the terminal ileum diagnosed on colonoscopy: a case report and literature review","authors":"Hiroyasu Sakai, Hironao Ichikawa, Jun Takada, Masaya Kubota, T. Ibuka, Y. Shirakami, Masahito Shimizu","doi":"10.2185/jrm.2023-045","DOIUrl":"https://doi.org/10.2185/jrm.2023-045","url":null,"abstract":"Objective Colonoscopy is useful in diagnosing intestinal tuberculosis. However, the terminal ileum is generally not examined during routine colonoscopy. Therefore, even with colonoscopy, the diagnosis can be missed in patients with lesions confined to the terminal ileum. Herein, we report the case of an asymptomatic patient with intestinal tuberculosis, in whom a colonoscope insertion into the terminal ileum led to the diagnosis. Patient An asymptomatic 71-year-old man visited our hospital for a colonoscopy after a positive fecal occult blood test. Results Colonoscopy revealed diffuse edematous and erosive mucosa in the terminal ileum. Mycobacterium tuberculosis was detected by polymerase chain reaction and culture of biopsy specimens from the erosions, leading to the diagnosis of intestinal tuberculosis. The patient was treated with antitubercular agents for 6 months, and a follow-up colonoscopy revealed healing of the lesions. Conclusion Asymptomatic intestinal tuberculosis may occasionally be detected on colonoscopy following a positive fecal occult blood test and is sometimes confined to the terminal ileum. Therefore, clinicians should consider intestinal tuberculosis in the differential diagnosis of the causes of positive fecal occult blood test results and perform colonoscopies, including observation of the terminal ileum.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"30 3","pages":"119 - 125"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772570","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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