Clinical Medicine Research

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

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Volume 10, Issue 2, March 2021

  • Authors: Elisabeth Brogren, Pernilla Vikstrom, Stefan Johansson, Nyaradzai Dangarembizi-Munambah, Theodora Chikwanha, Faith Chengetayi Muchemwa, Pat McKee, Tingadini Nyoni, Midion Mapfumo Chidzonga, Lars Bertil Dahlin

    Abstract: Background: Scaling-up surgical care is one of the most important goals in improving global health and long-term development, where specific attention is directed towards diagnosis and treatment of traumatic injuries, as well as to certain conditions, with varying frequencies between continents and countries. Successful outcome after surgery depends also on safe, efficient and widespread rehabilitation, including both short- and long-term engagement of physiotherapists and occupational therapists. However, relatively little attention has been paid to rehabilitation after trauma and surgery for injuries and various conditions in a global perspective. In fact, the access to rehabilitation in low- and middle-income countries (LMIC) is believed to be enormous. Objective: Through a shared project between two University Hospitals in Zimbabwe and Sweden, our objective was to create an academic partnership with the goal of improving rehabilitation after hand injuries in Zimbabwe. Results: Except geographical, political and patient-related factors, we found that prolonged or inadequate immobilisation after hand injuries and poor teamwork between surgeons and therapists were important factors that complicated the patient care. We give examples on how educational programs in rehabilitation could be organized with focus on creating a close alliance between surgeons and therapists. Conclusion: Creating academic partnerships between universities and hospitals can be of mutual benefit and may be a model for spreading knowledge and strengthen health care systems. Collaboration between therapists and surgeons can be strengthened through integrated courses adapted to existing local circumstances, exchange programs and on-line education, which can be organized between specific departments in different countries. We launch the concept of Global Rehabilitation and give examples of how teaching posttraumatic and postoperative management of hand surgical injuries and common conditions could be structured.

    Received: Aug. 31, 2020 Accepted: Mar. 8, 2021 Published: Mar. 30, 2021

    DOI: 10.11648/j.cmr.20211002.11 View: Downloads:

  • Authors: Vyacheslav Semionovich Lukyanchikov, Alim Nasimovich Scharapov

    Abstract: Low blood glucose is a dangerous violation of homeostasis, especially for infants, children and adolescents, in whom hypoglycemia is often observed, which is explained by immaturity and insufficient efficiency of adaptation reactions, primarily imperfection of hormonal regulators and instability of enzyme systems of glucose metabolism and alternative energy sources, in the form of free fatty acids, ketones, lactate, etc. The special danger of hypoglycemia in children is that glucose, although not single, but a priority source of energy for the nervous structures, therefore the lack of glucose leads to a delay in intellectual development and even to brain damage. At the same time, the lack of stability and clarity of reactions from the central nervous system, somatic and autonomic divisions of the nervous systems characteristic of these age groups, makes it extremely difficult to recognize the hypoglycemic syndrome (HS), and the etiological and pathogenetic diversity of the HS makes its clarifying diagnosis an extremely difficult task. In this regard, the issues of prevention, timely diagnosis, urgent and subsequent therapy of hypoglycemia in newborns, children and adolescents are very relevant. Fulfilled critical analysis of thematic literature over many years, as well as analysis own clinical and research experience. The article discusses the typology of HS from the standpoint of the causes and mechanisms of development, establishes anamnestic and obstetric-gynecological features of the course of pregnancy and childbirth, which predispose to hypoglycemia, clarifies the anthropological and clinical stigmas of HS in the fetus and newborn, which suggests the possibility of hypoglycemia in a child, shows the features clinical manifestations of HS in children of different ages. For clinical practice, an etiological and pathogenetic classification of HS, an algorithm for the treatment of hypoglycemic coma (HC), a scheme for the pathogenetic diagnosis of HS is proposed. Hypoglycemia in infants, children and adolescents is a common syndrome that poses a great danger to the health and development of the child and requires timely and qualified assistance.

    Received: Jan. 15, 2021 Accepted: Jan. 23, 2021 Published: Apr. 7, 2021

    DOI: 10.11648/j.cmr.20211002.12 View: Downloads:

  • Authors: Chatuthanai Savigamin, Jedsadakorn Jitwimungsanon, Thanapoom Rattananupong, Chanchai Sittipunt, Thitiwat Sriprasart

    Abstract: Background: Electronic cigarette (E-cigarette) has gained popularity internationally. It was claimed to be a novel way of smoking cessation. Previous reports regarding E-cigarette in Thai college student were limited. We investigated the prevalence, characteristics, and risk factors of e-cigarette smoking in Thai college students. Method: This is a descriptive cross-sectional study of prevalence, characteristics and risk factors of E-cigarette user in college students in Bangkok in January 2018. We used simple random sampling method and self-interviewed anonymous online questionnaire. The primary outcome was the prevalence of E-cigarette user. Secondary outcome were the characteristics and risk factors of E-cigarette users. Result: There were 1302 college students which 535 students (41.1%) were male, and 767 students (58.9%) were female. 289 students (22.2%) were E-cigarette users. 223 students had history of both cigarette and E-cigarette used. History of cigarette used in 30 days, history of cigarette used not in 30 days, water pipe user, marijuana user and male were risk factors of using E-cigarette by adjusted odds ratio 24.59 (95% CI 13.31- 45.43), 15.12 (95% CI 9.06 – 25.23), 10.08 (95% CI 6.38 – 15.92), 11.59 (95% CI 4.61 – 29.14), 1.90 (95% CI 1.25 – 2.90) respectively. Studying in non-health faculties was the risk factor for E-cigarette used with adjusted odds ratio of 2.07 (95% CI 1.05 – 4.10). Conclusion: Prevalence of E-cigarette users in Thai college student was high. Risk factors included male, history of cigarette smoking, marijuana use, water pipe and studying in non-health associated faculty. Effective control and education are needed.

    Received: Mar. 19, 2021 Accepted: Apr. 1, 2021 Published: Apr. 12, 2021

    DOI: 10.11648/j.cmr.20211002.13 View: Downloads:

  • Authors: Vaijanti Jain, Arti Yadav, Ashwini Chauhan

    Abstract: Aim: To find the effectiveness of Occupational therapy intervention in post operative mandibular fracture patients. Objective: To improve mouth opening and reduce jaw deviations (temporomandibular joint mobility). Study design: A Retrospective study. Study setting: OPD of Occupational Therapy Department In Seth G. S. Medical College, KEM Hospital, Parel, Mumbai -400012, India. Methodology: Data was retrieved from Occupational therapy department records for the last one and half years i.e from july 2019 to jan 2021. In the said period around 33 operated mandibular fractures patients had been referred to Occupational therapy dept for therapy. Out of which only 20 patients followed up. Data of these 20 mandibular fractures patients were analysed. Inclusion criteria, Both males and females, Age group 20-60 years, Operated for mandibular fractures in period July 2019 – January 2021 who were referred to occupational therapy department for therapeutic intervention. Exclusion criteria: Incomplete data, Patients who have not followed up for second visit also. Outcome measures – Mouth opening with a tape measure at 1st, 3rd and 5th week respectively. All these data was already available in Occupationa therapy department records and there was no patient contact at all. Hence waiver of consent was asked for. Results: Statistical analysis (paired t-test) was used to assess the significance of difference. The calculated t value for mouth opening measurements was 17.1850 which was much much higher than the tabular t value at P=0.001, which means the increase in post treatment mouth opening measurements is just not by chance but it’s extremely significant at p= 0.001. The pre and post photograph of the patients showed a difference in jaw deviation angle too while opening mouth. The above results showed the treatment proved to be effective. Conclusion: The Occupation therapy intervention in post-operative mandibular fracture patients proved to be effective in improving mouth opening measurements and jaw deviations.

    Received: Mar. 29, 2021 Accepted: Apr. 14, 2021 Published: Apr. 26, 2021

    DOI: 10.11648/j.cmr.20211002.14 View: Downloads:

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