Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

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Volume 7, Issue 3, May 2018

  • Authors: Juan Huang, Ting Sun, Ziping Huang, Zuoqin Liu

    Abstract: Chronic pain (CP) is a very common problem in elders, due to bodily degenerations, worldwide. Studies carried out in various countries have shown that CP is associated with the elders’ quality of life, significantly limiting their activities and hampering them to maintain an independence lifestyle. What’s worse, elderly suffering from CP mostly also experience mental problems. Yet, there have been only a few such research done and reported on this topic, concerning the elderly ethnic montagnards in the rural southwest Guangxi of China. This study aimed to explore the statement and self-management of rural dwelling elders with CP. First, cross-sectional surveys were conducted and then interviews were carried out. 150 elder people experiencing CP -- pain suffered at least 4 to 5 days a week during the past 3 months, according to the criteria of the international Association for the study of Pain (IASP) -- were enrolled in this study by convenience sampling. They were asked to fill in 3 questionnaires; the first related to participants’ mental status, the second related to participants’ perception of pain intensity, and the third related to pain’s impact on participants’ daily life. Following the completion of questionnaires, individual interviews were conducted, with the help of some students who are fluent in local native languages as well as in Chinese. The results show that CP significantly affected participants’ quality of life. The prevalence of suffering from multifocal CP was 90%. In the management of CP, 64% people mainly relied on paregoric means; a wide range self-management techniques were mentioned such as hot compress application for which some plant material was used, collected from the surrounding environment; only a few people went to seek professional treatment. Moreover, most of them said that they had reconciled to the pain or consider it as part of their fate. Encourage older people to seek different ways to manage their pain, not just traditional but complementary and professional approaches. In such severely lacking professional high-level medical resource environment, the elder people should change their cognition of CP and choose pertinence approaches and instruments based on their own condition.

    Received: May 8, 2018 Accepted: May 29, 2018 Published: Jun. 13, 2018

    DOI: 10.11648/j.cmr.20180703.11 View: Downloads:

  • Authors: Yuanqing Pan, Yanxu Yang, Yi Dong, Nan Li, Haiqian Liang, Qi Cui

    Abstract: Background: In the case of large heterogeneity, the data combination of randomized controlled trials will lead to the decrease of the reliability of systematic review and meta analysis, so we conducted the present study. Objectives: To explore sources of heterogeneity in studies on Tai Chi Chuan (TCC) as a complementary and alternative method for managing the overall quality of life of postoperative breast cancer patients. Methods: Randomized controlled trials were searched for in PubMed, EMBASE, Web of Science and the Cochrane Library through August 2017. The Cochrane Handbook 5.2 standards and Stata software version 10.0 were adopted for evaluating the quality of the included studies and the data was analyzed on overall quality of life of TCC. A separate univariate meta-regression analysis was performed on the study duration, sample size, cancer staging, prior breast cancer treatment, different types of TCC intervention group, different types of control group, intervention duration, mean age, and ethnicity to detect important factors leading to heterogeneity. Results: Significant heterogeneity was present in the included studies that used TCC to improve the overall quality of life of postoperative breast cancer patients from the retrieved literature (P < 0.05). The univariate meta-regression analysis indicated that the source of heterogeneity was not apparent in the analyzed factors within or between studies. Conclusions: A normative approach in studies evaluating the use of TCC for improving the overall quality of life of postoperative breast cancer patients was not sufficiently explored in the existing randomized controlled trials (RCTs). An insufficient number of RCTs in this field may be the reason that the effect size had unclear clinical significance. The existing evidence provided limited judgment on sources of heterogeneity between studies evaluating the use of TCC for improving overall quality of life in postoperative breast cancer patients.

    Received: May 12, 2018 Accepted: Jun. 4, 2018 Published: Jun. 15, 2018

    DOI: 10.11648/j.cmr.20180703.12 View: Downloads:

  • Authors: Dagim Assefa Kassaye, Haji Aman Deybasso, Godana Jarso Guto, Worku Dugassa Girsha

    Abstract: Reports are indicating increased rate of HIV related admissions despite high coverage of anti-retroviral drug usage. The aim of this study was to assess the magnitude of HIV related admission and associated factors among adult patients admitted to Medical ward of Adama Hospital Medical College in Ethiopia. An institution based cross sectional study design was conducted by using the formula to estimate a single population proportion (P) of 65% taken from HIV case hospital bed occupancy in Addis Ababa hospitals to select a total of 549 patients. Data were collected by an interviewer administered pre tested structured questionnaires. The 95% confidence intervals with p-value of less than 0.05 were considered statistically significant. Analysis was performed by using Statistical package for the social sciences (SPSS v 21) software program. A total of 538(97.9%) patients were involved in a study out of which, 120(22.3%) of them were HIV cases with various clinical manifestations. Toxoplasmosis was the commonest 32(26.7%) opportunistic infection. Patients who had divorced, widowed or separated were 2.6 (AOR 2.6, CI: 1.16, 6.00), Smear positive pulmonary tuberculosis were 4.6 times (AOR 4.6, CI, 1.52, 14.35), Bacterial pneumonia case were 37 times (AOR 37, CI:14.36, 99.68), those with disseminated tuberculosis were 56 times (AOR 56, CI=17.34, 85.84) and patients with neurological illnesses were 27 times (AOR 27, CI=14:00, 55.19) more likely to be admitted. Whereas, patients with age category of 45 to 54 years were less likely to be admitted to hospital by over 80% (AOR 0.18, CI: 0.06, 0.57) compared to age category of 15 to 24 years old. The prevalence of HIV related admission was lower compared to other studies. Age of the patients, respiratory system infections, Neurological infections and marital status of the patients were found to have significant association with HIV related admission.

    Received: Jan. 2, 2018 Accepted: May 30, 2018 Published: Jun. 25, 2018

    DOI: 10.11648/j.cmr.20180703.13 View: Downloads:

  • Authors: Xu Fei, Qiao Wanhai, Wang Liming

    Abstract: To study the expression and relationship of cyclooxygenase-2(COX-2) and peroxisome proliferators activated receptor-γ (PPARγ) in peripheral blood monouclear cells (PBMCs) of multiple organ dysfunction syndrome patients. In the emergency department and intensive care unit (ICU) of our hospital, 60 MODS patients were divided into three groups with 20 cases in each group. They were MODS1 group (APACHE II score 0-10 points), MODS 2 groups (APACHE II score 11-20 points), MODS 3 groups (APACHE II score> 20 points) and control groups of 20 healthy subjects. Venous blood were sampled 1d, 3d, 6d after diagnosis of MODS, reverse transcriptase -polymerase chain reaction (RT-PCR) were used to detect the expression of PPARγ, COX-2 in PBMCs. The expression of PPARγ, COX-2 in the same period were compared between the MODS groups and the healthy control group. The study fond that the expression of COX-2 and PPARγ were low in vehicle control group. In MODS1 group the expression of PPARγ and COX-2 was higher than in vehicle control group; during the treatment period, PPARγ was significantly increased (P <0.05), but the expression of COX-2 was significantly lower (P <0.05). PPARγ expression in MODS 2 group and MODS 3group was lower than that in vehicle control group, and its expression was progressively decreased during the treatment (P <0.05);in contrast, Expression of COX-2 in MODS2 and MODS3 group was higher than that in vehicle control group, and its level was progressively increased during the treatment (P <0.05). The study revealed a significant negative correlation between COX-2 and PPARγ in MODS1 group, MODS2 group and MODS3 group. (MODS1 group r=-0.761, P<0.01; MODS2 group: r=-0.782, P<0.01; MODS3 group: r=-0.791, P<0.01). There was no significant correlation in vehicle control group (r = -0.185, P >0.05). Thus, PPARγ may protect the MODS patients by repressing the expression of cox-2 therefore it can be used as an important indicator and potential target to determine the condition and treatment of MODS.

    Received: Jun. 5, 2018 Accepted: Jul. 12, 2018 Published: Aug. 8, 2018

    DOI: 10.11648/j.cmr.20180703.14 View: Downloads:

  • Author: Kassahun Dires

    Abstract: Hematological complications are documented as the second most common cause of morbidity and mortality in HIV/AIDS patients. Drugs for HIV/AIDS showed side effects on different hematological parameters. This study was aimed at assessing the changes in hematological profile of HIV infected pregnant women after initiation of highly active antiretroviral treatment. Retrospective cohort study was conducted to assess the hematological changes in HIV infected pregnant women after initiation of highly active antiretroviral (HAART) at ART clinic of Debremarkos hospital in Ethiopia from May to August 2017. Data available between May 2008 and August 2017 was collected from 380 patient cards of pregnant women. The data was entered into Excel spread sheet and was transported into STATA software for analysis. All data were presented as mean ± Standard error of the mean. Comparisons were made using the Paired T-test. A p-value of <0.05 was considered as a statistically significant difference. The result from the present study shows that the HAART initiation in pregnant women with HIV increases the CD4 cell count, the mean corpuscular hemoglobin concentration, white blood cell count, lymphocyte count and total mid cell count at ninety-five percent confidence interval. From the total of 380 patient cards with complete CD4 count, 200 patient cards were recorded with TDF/3TC/EFV ART regimen. The remaining 180 patient cards were documented with AZT/3TC/NVP regimen. Comparing the effect of the two Regimens on CD4 count, TDF/3TC/EFV increases the CD4 count significantly in pregnant women with HIV (p<0.0001). The other regimen (AZT/3TC/NVP) also increases the CD4 count from initial value but this increase in CD4 count after AZT/3TC/NVP initiation in pregnant women with HIV is not statistically significant (P>0.05). HAART initiation in pregnant women with HIV increases lymphocyte count, total mid cell count, red blood cell count, white blood cell count, total hemoglobin, hematocrit, mean cell volume and total platelet. On the contrary, the initial value of granulocyte count, mean cell hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width and mean platelet volume decreases after antiretroviral treatment in pregnant women with HIV.

    Received: Jun. 25, 2018 Accepted: Jul. 9, 2018 Published: Aug. 15, 2018

    DOI: 10.11648/j.cmr.20180703.15 View: Downloads:

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