Medical ethics is a system of moral principles that applies values to the practice of clinical medicine and to scientific research. They are based on a set of values that professionals can refer to in the event that they are in conflict or are confused. The values include: beneficence, non-maleficence, autonomy, justice, veracity, dignity. The code of ethics is based on the understanding of the goals of medicine dating back to the 5th century B.C. and Hippocrates. By 1847, the code of ethics was based greatly on Thomas Percival's work. He was an English physician-philosopher and wrote a code of medical ethics for hospitals in 1803.
{"title":"Meaning in Medical Ethics","authors":"Richard Boudreau","doi":"10.31579/2639-4162/007","DOIUrl":"https://doi.org/10.31579/2639-4162/007","url":null,"abstract":"Medical ethics is a system of moral principles that applies values to the practice of clinical medicine and to scientific research. They are based on a set of values that professionals can refer to in the event that they are in conflict or are confused. The values include: beneficence, non-maleficence, autonomy, justice, veracity, dignity. The code of ethics is based on the understanding of the goals of medicine dating back to the 5th century B.C. and Hippocrates. By 1847, the code of ethics was based greatly on Thomas Percival's work. He was an English physician-philosopher and wrote a code of medical ethics for hospitals in 1803.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45208361","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}
Malnutrition is common among hospitalized bed ridden patients. Nutritional management of hospitalized patients is a necessity in order to improve their nutritional status and disease conditions. The objectives of nutritional management of malnourished bedridden patient diagnosed with deep vein thrombosis and pulmonary embolism were to improve nutritional status of the patient through gradual provision of calorie and protein intake, to improve body protein status and control muscle wasting. Nutritional status was assessed by anthropometric, biochemical, clinical and dietary information. SGA was used to assess the malnutrition status of the patient. Since the patient was severely malnourished, she was fed with NG feeds followed by PEG feeds by gradually increasing calorie and protein up to the target level mainly through nutritional supplements for the one and half months of hospital stay. Patient’s serum protein, albumin levels and muscle mass were improved. According to the SGA, the patient was at normal/ well-nourished condition after nutrition management. Dietary management incorporating nutrition supplements indicated improvement of nutritional status of severely malnourished bedridden patient.
{"title":"Improving Nutritional Status of Malnourished Bedridden Patient Diagnosed with Deep Vein Thrombosis and Pulmonary Embolism: A Case Study Approach","authors":"Adikari Amnt","doi":"10.31579/2639-4162/001","DOIUrl":"https://doi.org/10.31579/2639-4162/001","url":null,"abstract":"Malnutrition is common among hospitalized bed ridden patients. Nutritional management of hospitalized patients is a necessity in order to improve their nutritional status and disease conditions. The objectives of nutritional management of malnourished bedridden patient diagnosed with deep vein thrombosis and pulmonary embolism were to improve nutritional status of the patient through gradual provision of calorie and protein intake, to improve body protein status and control muscle wasting. Nutritional status was assessed by anthropometric, biochemical, clinical and dietary information. SGA was used to assess the malnutrition status of the patient. Since the patient was severely malnourished, she was fed with NG feeds followed by PEG feeds by gradually increasing calorie and protein up to the target level mainly through nutritional supplements for the one and half months of hospital stay. Patient’s serum protein, albumin levels and muscle mass were improved. According to the SGA, the patient was at normal/ well-nourished condition after nutrition management. Dietary management incorporating nutrition supplements indicated improvement of nutritional status of severely malnourished bedridden patient.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42118014","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}
Hypereosinophilic syndrome (HES) is a rare systemic disease in which cardiac manifestations are the leading cause of morbidity and mortality. HES involvement of the heart can often clinically mimic acute coronary syndrome (ACS) with the patient undergoing repeat cardiac catheterizations when no conclusive diagnosis is arrived at, and no effective treatment is suggested to alleviate recurrent symptoms of chest discomfort. Here we present an elusive case of eosinophilic myocarditis (EM) and advocate that a detailed review of history as well as obtaining all medical records be done to avoid unnecessary and repeated invasive investigations in order to provide safe, cost effective, and efficient care for our patients.
{"title":"The Underrecognized Cardiac Manifestation of Hypereosinophilic Syndrome","authors":"A. Malhotra","doi":"10.31579/2639-4162/002","DOIUrl":"https://doi.org/10.31579/2639-4162/002","url":null,"abstract":"Hypereosinophilic syndrome (HES) is a rare systemic disease in which cardiac manifestations are the leading cause of morbidity and mortality. HES involvement of the heart can often clinically mimic acute coronary syndrome (ACS) with the patient undergoing repeat cardiac catheterizations when no conclusive diagnosis is arrived at, and no effective treatment is suggested to alleviate recurrent symptoms of chest discomfort. Here we present an elusive case of eosinophilic myocarditis (EM) and advocate that a detailed review of history as well as obtaining all medical records be done to avoid unnecessary and repeated invasive investigations in order to provide safe, cost effective, and efficient care for our patients.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42708146","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}
Over many years, laboratory testing of platelet aggregability have been carried out in attempts to develop drugs that would prevent thrombosis in arteries. The problems encountered included the question of methodology. Blood samples have to be anticoagulated in order to study the platelets. Anti-coagulation with citrate and tests on derived platelet rich plasma did not correlate at all well with thrombus growth in the stenosed coronary arteries of experimental animals and citrate removes the calcium ions which are vital for platelet function. Anticoagulation with heparin also interfered with platelet function, so that now, hirudins are the preferred anticoagulant. However it was observed that if, instead of stimulating platelet aggregation with adrenaline or ADP, serotonin was applied to the preparation, very little aggregation took place in spite of serotonin 5HT2A antagonists being the most potent inhibitors of thrombus growth in experimental animals. Another indicator that primary platelet agggregation is not a predictor of in vivo efficacy was the finding that 5HT2A antagonism inhibited aggregate growth. In a stenosed artery the platelets are activated by increased shear stress and blood turbulence with release of platelet serotonin causing positive feedback activation of more platelets. At present, there does not seem to be a bench in vitro test that accurately predicts in vivo efficacy in stenosed artery occlusive thrombosis.
{"title":"Are Platelet Aggregation Tests the Best Way to Assess New Drugs for Arterial Disease","authors":"Mark I. M. Noble","doi":"10.31579/2639-4162/003","DOIUrl":"https://doi.org/10.31579/2639-4162/003","url":null,"abstract":"Over many years, laboratory testing of platelet aggregability have been carried out in attempts to develop drugs that would prevent thrombosis in arteries. The problems encountered included the question of methodology. Blood samples have to be anticoagulated in order to study the platelets. Anti-coagulation with citrate and tests on derived platelet rich plasma did not correlate at all well with thrombus growth in the stenosed coronary arteries of experimental animals and citrate removes the calcium ions which are vital for platelet function. Anticoagulation with heparin also interfered with platelet function, so that now, hirudins are the preferred anticoagulant. However it was observed that if, instead of stimulating platelet aggregation with adrenaline or ADP, serotonin was applied to the preparation, very little aggregation took place in spite of serotonin 5HT2A antagonists being the most potent inhibitors of thrombus growth in experimental animals. Another indicator that primary platelet agggregation is not a predictor of in vivo efficacy was the finding that 5HT2A antagonism inhibited aggregate growth. In a stenosed artery the platelets are activated by increased shear stress and blood turbulence with release of platelet serotonin causing positive feedback activation of more platelets. At present, there does not seem to be a bench in vitro test that accurately predicts in vivo efficacy in stenosed artery occlusive thrombosis.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70017618","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}
Introduction: Celiac disease (CD) is an autoimmune disease that typically occurs in childhood and young age. Late-onset forms (after 60 years) are rare and often underestimated in current medical practice, as is joint damage during this disease. We report an original case of CD in an elderly patient revealed by acute polyarthritis. Observation: A 62-year-old patient with no significant pathological history was explored for acute polyarthritis of both large and small joints. The physical examination noted synovitis of the hands and wrists without articular deformities, and a marked mucocutaneous pallor. The biology revealed a microcytic anemia at 8 g/dl with stigmas of malabsorption (low cholesterol and hypocalcemia). No inflammatory syndrome was noted. Joint X-rays were without abnormalities. Immunological tests for chronic inflammatory rheumatisms were negative. Gastroduodenal fibroscopy was performed and histological examination of duodenal biopsies showed diffuse villous atrophy with marked inflammatory infiltrate. Anti- endomysium and anti-transglutaminase antibodies were positive confirming the diagnosis of CD. Under gluten-free diet, the evolution was favorable with totally disappearance of articular signs. Conclusion: Joint manifestations during CD are rare. The revealing forms are exceptional and can make a differential diagnosis with chronic inflammatory rheumatism, in particular that associations with CD was described. CD deserves to be evoked in front of any unexplained arthritis of the elderly, even without any specific digestive symptomatology of this disease.
{"title":"Acute polyarthritis revealing celiac disease of the elderly","authors":"Bouomrani S","doi":"10.31579/2639-4162/004","DOIUrl":"https://doi.org/10.31579/2639-4162/004","url":null,"abstract":"Introduction: Celiac disease (CD) is an autoimmune disease that typically occurs in childhood and young age. Late-onset forms (after 60 years) are rare and often underestimated in current medical practice, as is joint damage during this disease. We report an original case of CD in an elderly patient revealed by acute polyarthritis. Observation: A 62-year-old patient with no significant pathological history was explored for acute polyarthritis of both large and small joints. The physical examination noted synovitis of the hands and wrists without articular deformities, and a marked mucocutaneous pallor. The biology revealed a microcytic anemia at 8 g/dl with stigmas of malabsorption (low cholesterol and hypocalcemia). No inflammatory syndrome was noted. Joint X-rays were without abnormalities. Immunological tests for chronic inflammatory rheumatisms were negative. Gastroduodenal fibroscopy was performed and histological examination of duodenal biopsies showed diffuse villous atrophy with marked inflammatory infiltrate. Anti- endomysium and anti-transglutaminase antibodies were positive confirming the diagnosis of CD. Under gluten-free diet, the evolution was favorable with totally disappearance of articular signs. Conclusion: Joint manifestations during CD are rare. The revealing forms are exceptional and can make a differential diagnosis with chronic inflammatory rheumatism, in particular that associations with CD was described. CD deserves to be evoked in front of any unexplained arthritis of the elderly, even without any specific digestive symptomatology of this disease.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43628601","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}
A 30-year-old housewife with past history of acute lymphoblastic leukemia 12 years back, still in remission, was admitted with polyarthritis of 2 months duration. She was evaluated and found to have SLE with positive ANA and Anti ds DNA which were strongly positive.
{"title":"Case Report: A rare association between SLE and Acute Lymphatic Leukemia","authors":"P. Sasidharan","doi":"10.31579/2639-4162/011","DOIUrl":"https://doi.org/10.31579/2639-4162/011","url":null,"abstract":"A 30-year-old housewife with past history of acute lymphoblastic leukemia 12 years back, still in remission, was admitted with polyarthritis of 2 months duration. She was evaluated and found to have SLE with positive ANA and Anti ds DNA which were strongly positive.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42436440","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}
This paper focuses on what the primary care team – physicians and praxis nurses – can do to prevent the most common non-communicable diseases, particularly cancer. The most basic concepts underlying the preventive practice in primary care are summarized.
{"title":"Prevention of cancer in primary care: principles and practices","authors":"L. Döbrőssy","doi":"10.31579/2639-4162/010","DOIUrl":"https://doi.org/10.31579/2639-4162/010","url":null,"abstract":"This paper focuses on what the primary care team – physicians and praxis nurses – can do to prevent the most common non-communicable diseases, particularly cancer. The most basic concepts underlying the preventive practice in primary care are summarized.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41916085","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: Considering the respiratory health risk of exposure to biomass cooking fuel emissions, this study was conducted to elucidate the relationship between cooking fuel choices and declined pulmonary function in rural and urban population in the Copperbelt Province of Zambia. Methods: We carried out a cross-sectional study of 1,170 healthy nonsmoking pregnant women from Masaiti and Ndola predominantly using biomass fuel for cooking. Questionnaire based data was acquired along with standardized measures of lung function. MIR Spirobank G (Italy) was used in spirometry based on American Thoracic Standards. Results: The present study found that over two thirds (69.2%) of pregnant women in the study population use biomass for cooking and only 12.4 % use electricity only. Declined lung function was found to be statistically significantly associated with cooking fuel choices (p – value 0.005) and a weak association was observed with gravida at a p-value of 0.056. Pregnant women using crop residues as cooking fuel were two times more likely to have a declined lung function [AOR 2.33 (1.27, 4.30)] compared with pregnant women using mixed fuel type (biomass and electricity) and those using electricity only were 57% less likely to have a declined lung function [AOD 0.43 (0.26, 0.69)]. Conclusion: Use of biomass for cooking among pregnant women is a strong determinant of declined lung function. Interventions to improve maternal respiratory health outcomes in Zambia and other countries in sub-Saharan Africa should involve making cleaner cooking fuel energy options available and accessible by ordinary women from both rural and urban areas.
{"title":"Research Article: Impact of Cooking Fuel Choices on Maternal Lung Functions in Selected Rural and Urban Areas of Copperbelt Province, Zambia","authors":"David Mulenga","doi":"10.31579/2639-4162/012","DOIUrl":"https://doi.org/10.31579/2639-4162/012","url":null,"abstract":"Background: Considering the respiratory health risk of exposure to biomass cooking fuel emissions, this study was conducted to elucidate the relationship between cooking fuel choices and declined pulmonary function in rural and urban population in the Copperbelt Province of Zambia. Methods: We carried out a cross-sectional study of 1,170 healthy nonsmoking pregnant women from Masaiti and Ndola predominantly using biomass fuel for cooking. Questionnaire based data was acquired along with standardized measures of lung function. MIR Spirobank G (Italy) was used in spirometry based on American Thoracic Standards. Results: The present study found that over two thirds (69.2%) of pregnant women in the study population use biomass for cooking and only 12.4 % use electricity only. Declined lung function was found to be statistically significantly associated with cooking fuel choices (p – value 0.005) and a weak association was observed with gravida at a p-value of 0.056. Pregnant women using crop residues as cooking fuel were two times more likely to have a declined lung function [AOR 2.33 (1.27, 4.30)] compared with pregnant women using mixed fuel type (biomass and electricity) and those using electricity only were 57% less likely to have a declined lung function [AOD 0.43 (0.26, 0.69)]. Conclusion: Use of biomass for cooking among pregnant women is a strong determinant of declined lung function. Interventions to improve maternal respiratory health outcomes in Zambia and other countries in sub-Saharan Africa should involve making cleaner cooking fuel energy options available and accessible by ordinary women from both rural and urban areas.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43168028","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}
Modern societies tend to ignore emotion, especially the emotion of shame. But for that reason, shame especially may become important to understand. Beginning with Norbert Elias and Helen B.
{"title":"Hiding Shame in Science and Scholarship","authors":"T. Scheff","doi":"10.23880/pprij-16000148","DOIUrl":"https://doi.org/10.23880/pprij-16000148","url":null,"abstract":"Modern societies tend to ignore emotion, especially the emotion of shame. But for that reason, shame especially may become important to understand. Beginning with Norbert Elias and Helen B.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43116185","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}
Primary care physicians (PCP) needs to plan, organize, implement, and evaluate as care director and coordinator. In primary care there is need to implement leadership model in health sector and medicine. Transformational leadership can be described as style of leadership which is appropriate for health sector. It is alike to the approach which is patient centered. Case management must be well organized, prepared, arranged and described as per needs of patient. The same must be agreed and implemented with suitable individual roles. Leaders are required to do numerous aspects linked to management, managerial and decision making process to carry out the requisite actions. Same process and procedures are also required be completed by Primary care physicians for achievement of patient’s targeted administration, supervision and management. Such happenings and actions contain from preparation, planning, development till structuring networks. Primary care physicians are anticipated to possess transformational leadership capabilities and to assist their performance in role of care coordinators. This all can be attained through integrated, holistic, continuous, comprehensive approach and by building relations with all stakeholders.
{"title":"Short Communication: Role of Leadership in Doctor-Patient Relationship & Execution on Patient’s Case Management in Primary Care","authors":"S. Naeem","doi":"10.31579/2639-4162/013","DOIUrl":"https://doi.org/10.31579/2639-4162/013","url":null,"abstract":"Primary care physicians (PCP) needs to plan, organize, implement, and evaluate as care director and coordinator. In primary care there is need to implement leadership model in health sector and medicine. Transformational leadership can be described as style of leadership which is appropriate for health sector. It is alike to the approach which is patient centered. Case management must be well organized, prepared, arranged and described as per needs of patient. The same must be agreed and implemented with suitable individual roles. Leaders are required to do numerous aspects linked to management, managerial and decision making process to carry out the requisite actions. Same process and procedures are also required be completed by Primary care physicians for achievement of patient’s targeted administration, supervision and management. Such happenings and actions contain from preparation, planning, development till structuring networks. Primary care physicians are anticipated to possess transformational leadership capabilities and to assist their performance in role of care coordinators. This all can be attained through integrated, holistic, continuous, comprehensive approach and by building relations with all stakeholders.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43913914","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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