சுகாதார கல்வி ஆராய்ச்சி மற்றும் மேம்பாட்டு இதழ்

Objective

The purpose of the study was to identify knowledge and perception of medical students regarding complementary and alternative medicine therapy (CAM).

Background

Complementary and alternative medicine (CAM) is growing field in medicine, which can be a useful resource to improve the quality of life. Medical students should be aware of these modalities available freely for the patient as over the counter medicine.

Methods

A cross- sectional survey based study carried out on 6th and 7th year medical students (clinical years). Data was collected on self-administered questionnaire in which core elements were divided-Knowledge and Perception about CAM and Knowledge regarding Herbs used as Pain Killer. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). Data were expressed in frequencies, mean and percentages.

Results

Less than a half (44.9%) of the participants were 7th year and (55.1%) were 6th year students. Majority of the students (80.5%) were Omani 53 (45%) of study participants were below 25 years in age and 101 (85.6%) were female. No difference was observed between 6th and 7th year students (p-0.516, 95% CI-1.74-3.31), significant difference (p-0.009, 95% CI 1.25-8.44). Significant difference was observed (p-0.009, 95% CI-7.45-1.08) between Omani and non-Omani participants. Students possess adequate knowledge about CAM and positive approach in clinical practice but overall they have poor knowledge about herb as pain killer.

Conclusion

Students in clinical years have positive approach towards CAM and their knowledge is adequate in general but they have poor knowledge regarding herbs used as pain killer.

A survey was carried out to study the common menstrual problems faced by women during their menstural period. 210 individuals of Allithurai and Lalgudi areas of Tiruchirappalli district were interviewed personally with a standard questionnaire. The statistical analysis was performed using SPPS software. The level of significance was analyzed using chi-square test where the results emphasized that 31.4% had their first menses at the age of 14, maximum number of respondents (68.6%) experiences pain and 68% showed medium bleeding. Most of them experienced psychological problems which affects their routine life. The most prevalent psychological symptom is anger (35.7%). Of the individuals surveyed most of them (92.9%) had a regular menstrual cycle with less abnormality. Marriage has a significant effect on bleeding, bleeding in between two successive periods, days of menses, pain, fatigue, increased appetite, fainting, indigestion and forgetfulness. Area also had a significant effect on many of the symptoms surveyed. The women residing in Allithurai area had shown significantly higher irregular periods.

Aim

Comparison between intraluminal and subintimal angioplasty with review of technique, factors affecting the success and complications with special emphasis on factors that could predict the wire route meanwhile using simple techniques.

Methods

This is a non-randomized study with prospectively collected data that included 159 patients presented from 2011 to 2014 to the vascular surgery department with critical chronic lower limb ischemia due to atherosclerotic femoropopliteal occlusive disease for whom percutaneous angioplasty was done. Patients presenting with non-salvageable limbs requiring primary major amputation and non-atherosclerotic causes of CLI were excluded.

Results

75.5% of the lesionswere crossed transluminally while 19.5% of the lesions were crossed subintimally. In 8 cases (5%) the lesion could not be passed. The overall technical success to pass the lesion was 95%. On 24 months follow up, 1ry patency, 2ry patency, limb salvage in intraluminal group are 56.8%, 60.2% and 66.1% respectively while in subintimal group 46.7%, 46.7% and 60% respectively. Subintimal was more in the TASC D, lesion more than 10 cm and in contralateral access (P value was<0.05). There were no statistically significant differences between intraluminal and subintimal angioplasty regarding the outcome (Patency and limb salvage).

Conclusions

The passage of the wire is affected by length of the lesion, the TASC II classification of the lesion and access site with the subintimal passage was more in Lesion more than 10 cm, TASC D lesions and in contralateral access. These factors can be used prospectively as predictors for passage of the wire whether intraluminal or subintimal. In spite of the technical differences between the intraluminal and subintimal passage, yet they show no significant statistical differences regarding the outcome (patency and limb salvage). Hence both should be used as part of vascular armamentarium for revascularization in such frail patients.

The food environment at school plays an important role in promoting healthy food choices in students. In our previous study, classroom teachers were concerned about some of the meal options offered at their school cafeteria and wanted a school cafeteria component as part of a successful nutrition education program. In response, our first objective was to evaluate the nutritional quality of school meals at Oregon elementary schools. We learned that unless students ate the recommended amount of fruits and vegetables from the salad bar, school menus did not meet the nutrition standards for fruits (99%) and vegetables (100%). As the second objective, we asked Oregon elementary school foodservice personnel (SFP) in a cross-sectional, anonymous mail survey if and how they should be involved in nutrition education programs. Of the 59 SFP who responded, all perceived that nutrition education in elementary schools is somewhat to very important and 76% perceived that they should be involved in a successful nutrition education program. They were interested in nutrition education training (75%) but noted multiple barriers for incorporating the school cafeteria into nutrition education programs, the primary were cost (66%), time (58%), and potential teaching commitments. SFP wanted to be involved in nutrition education through nutrition posters in the cafeteria (58%) and new recipes and food items (56%). In conclusion, SFP are highly motivated to participate in nutrition education programs through activities in the school cafeteria that do not involve teaching. Renewed focus should be on developing and implementing nutrition education programs that provide SFP with training and new recipes and food items that are nutritious, affordable, easy and quick to prepare, and appealing to students so that nutrition information delivered in the classroom can be reinforced in the school cafeteria.

Object

Improve the diagnosis and treatment of calcified renal masses.

Method

We respectively reviewed 3 cases of abnormally calcified renal masses admitted to our hospital. We evaluated the clinical manifestations in the patients we treated and reviewed the literature regarding the diagnosis and treatment of calcified renal masses. Case 1, a 21 year old male, was evaluated for a right renal space-occupying lesion found incidentally on physical examination. CT imaging revealed a space-occupying lesion in the middle lower pole of the right kidney with peripheral circular calcifications and irregular calcifications. The lesion was low density on CT. Case 2, a 44 year old male, presented with right flank swelling pain and discomfort for 10 days. KUB and CT imaging demonstrated an abnormal round calcification in the dorsal midpole of the left kidney. Case 3, a 53 year old female, presented with dull left flank pain for more than 2 years. KUB and CT showed a round calcified lesion in the upper pole of the left kidney.

Results

The diagnosis of renal cancer was made before surgery in patient 1 and radical nephrectomy was carried out. The pathological diagnosis was papillary renal cell carcinoma. The patient was followed for 27 months and was free of recurrence and metastases. The preoperative diagnosis of patient 2 was benign renal tumor. The patient underwent enucleation of the renal tumor. Pathologic examination revealed clear cell renal carcinoma. A radical nephrectomy was then performed. The patient was followed for 37 months and was free of recurrence and metastases. The preoperative diagnosis in patient 3 was left renal calyceal stones. The patient underwent wedge resection of left renal parenchyma. Pathologic examination revealed an abnormal left renal calcification with inflammatory cell infiltration. The patient was followed for 39 months and remained in good health.

Conclusion

Calcified renal masses are rare manifestations of renal cancer. It is difficult to make the diagnosis before surgery, but the prognosis is favorable. Nephron sparing surgery (NSS) is the choice of treatment.

Background

Breast cancer mortality rate is increasing among women in developing countries a condition that might be brought about by lack of knowledge of fundamental elements necessary for cancer prevention.

Purpose

To ascertain level of breast cancer knowledge across some socio-demographic variables among women in Ebonyi State Nigeria

Method

A total sample of 1,845 women was used for the study selected through multistage sampling technique. A 40-items questionnaire eliciting answers on knowledge of cancer symptoms, risk factors, prevention methods and cancer treatment options was used for the study. Descriptive statistics of frequency and percentage were used to answer the research question while Chi-square statistic was used to test the hypotheses at an alpha level of 0.05.

Results

Knowledge of breast cancer was found to be on the average (48.72%); differed by age with younger women (35-44 yrs/56.43%) displayed higher knowledge of breast cancer than the older ones (45-54/46.03%); women with post-secondary education (67.66%) had higher knowledge than those with secondary (60.16%), primary (49.03%) and non-formal education (39.01%); urban women (55.61%) were more knowledgeable than rural women (47.81%). Chi-square analysis indicated that difference in knowledge was significant for educational attainment, age and location of residence.

Conclusion

Breast cancer knowledge of women in Ebonyi State is on the average and differed significantly by education, age and location of women. Consequent it is recommended that breast cancer education should be used to improve their knowledge of the disease, especially for those with non-formal education, older women and those in the rural areas through interventions by government and non-governmental agencies and through curriculum revision for schools.

Background: Due to advances in cancer diagnosis and treatment, the number of prostate cancer survivors are increasing. Yet, with this expanding cohort of patients, very little has been done to develop services.

Objective: A systematic review was conducted to explore prostate cancer survivorship issues. This analysis will inform development of interventions. Design/setting: A systematic review was conducted using the following databases from 2000 to Decembers 2013: CINAHL and MEDLINE (NHS Evidence), Cochrane, AMed, BNI, EMBASE, Health Business Elite, HMIC, PschINFO. The papers were retrieved and a quality assessment was conducted using a new tool for survivorship care standards. Participants/Interventions/ Outcome measurements/

results: 76 papers met the criteria for inclusion. These specified papers must be on primary research, related to prostate cancer AND Survivorship OR any one of the categories of nutrition, exercise therapy, psychology, treatment outcomes.

Discussion: The literature is reviewed and the way forward for survivorship discussed. We also identify possible themes for research. Patient summary: Based on these results, we develop a prostate cancer survivorship care assessment tool and identify areas of practice that can be targeting for further research.

To prevent kindergarten teacher’s resignation due to workplace stress, and to maintain better education, we established the stress evaluation method based on the measurement of the autonomic nervous system’s activity (ANSA) by M-BIT, and we applied it to evaluate and decrease workplace stress. We proposed the method of detecting the subject with large stress and remains stress by the distribution of epoch values of sympathetic nervous system’s activity (SNSA) during awake and sleep, respectively.

We also proposed the method to evaluate the degree of chronic unhealthy of ANSA, normal, incoordination of ANSA or depressed state based on epoch values of coefficients of variation of RR intervals (CVRR) during awake, and co-use of Self-Rating Scale increases the accuracy of evaluation. Furthermore, we proposed that status of ANSA, normal, incoordination of ANSA and depressed state can be evaluated by the CVRR and SNSA values measured by 120 seconds stress application measurement.

We found that the chronic continuation of large SNSA does not always lead to chronic unhealthy state of ANSA. Hence, we proposed two dimensional evaluation of SNSA with CVRR, and separation of stress to passive stress and active stress.