Personalized Health Monitoring System for Managing Well-Being in Rural Areas

Rural India lacks easy access to health practitioners and medical centers, depending instead on community health workers. In these areas, common ailments that are easy to manage with medicines, often lead to medical escalations and even fatalities due to lack of awareness and delayed diagnosis. The introduction of wearable health devices has made it easier to monitor health conditions and to connect doctors and patients in urban areas. However, existing initiatives have not succeeded in providing adequate health monitoring to rural and low-literate patients, as current methods are expensive, require consistent connectivity and expect literate users. Our design considerations address these concerns by providing low-cost medical devices connected to a low-cost health platform, along with personalized guidance based on patient physiological parameters in local languages, and alerts to medical practitioners in case of emergencies. This patient-centric integrated healthcare system is designed to manage the overall health of villagers with real-time health monitoring of patients, to offer guidance on preventive care, and to increase health awareness and self-monitoring at an affordable price. This personalized health monitoring system addresses the health-related needs in remote and rural areas by (1) empowering health workers in monitoring of basic health conditions for rural patients in order to prevent escalations, (2) personalized feedback regarding nutrition, exercise, diet, preventive Ayurveda care and yoga postures based on vital parameters and (3) reporting of patient data to the patient’s health center with emergency alerts to doctor and patient. The system supports community health workers in the diagnostic procedure, management, and reporting of rural patients, and functions well even with only intermittent access to Internet.     

Treatment of seborrheic dermatitis: comparison of sertaconazole 2 % cream versus pimecrolimus 1 % cream

Objective

Seborrheic dermatitis (SD) is an inflammatory skin disorder affecting the scalp, face, and trunk. The treatment of SD is an important issue in dermatology. This study aimed at comparing the efficacy of sertaconazole 2 % cream versus pimecrolimus 1 % cream in the treatment of SD.

Methods

In this clinical trial study, 60 patients suffering from SD were studied. Thirty patients received local sertaconazole 2 % cream and in control group, 30 patients received pimecrolimus 1 % cream. Patients were recommended to use the cream twice a day for 4 weeks. At the beginning of referring and also 2 and 4 weeks after first visit, the patients were examined by a dermatologist to control improvement of clinical symptoms.

Results

The mean age of members of the sertaconazole and pimecrolimus groups was 30.12 ± 12.56 and 34.67 ± 10.98 years, respectively. The highest level of satisfaction (90 %) was observed 28 days after sertaconazole application since it was 80 % in pimecrolimus group. The relationship between patients’ satisfaction and receipt of sertaconazole cream (on the 28th day) was statistically significant (P = 0.006).

Conclusion

Sertaconazole 2 % cream may be an excellent alternative therapeutic modality for treating SD.     

Hepatoprotective effects of ethanol extracts from Folium Syringae against acetaminophen-induced hepatotoxicity in vitro and in vivo

Background

The leaves of Folium Syringae (FS) have been long used as a traditional Chinese folk medicine for their anti-inflammatory effect, utilized as an antibacterial and antiviral treatment. The purpose of this study was to investigate the potential hepatoprotective effects of FS on acetaminophen-induced hepatic injury in primary hepatocytes and mice.

Renal transplantation delays major adverse cardiac events (MACEs) in patients with end-stage renal disease: A nationwide population-based study

Background

Whether renal transplantation (RT) influences the risk of cardiovascular events remains controversial.

Embolization of arterial gastrointestinal hemorrhage with Fuaile medical adhesive

Background

To investigate the safety and effectiveness of Fuaile medical adhesive (FAL) with superselective catheterization in endovascular embolotherapy for the treatment of gastrointestinal hemorrhage (GIH) that was unresponsive to internal medicine treatment and gastroscopy management.

Audit on breast ultrasound in women under 25 years

Background

Women younger than 30 years with a focal breast finding have a low incidence of malignancy. Targeted ultrasound is an accurate primary imaging test.

Materials and methods

All breast ultrasounds performed from July 1, 2011 to September 30, 2011 were reviewed. All ultrasounds in patients under 25 years were reviewed with regard to indication, imaging findings, and pathology results.

Results

Over a 3-month period, 855 breast ultrasounds were performed; 4.1 % breast ultrasounds were performed in a patient under 25 years. Twenty patients had imaging features consistent with a fibroadenoma. Pathology confirmed the diagnosis of fibroadenomas in 15 of the patients. Five patients did not have biopsies performed due to young age or presence of bilateral fibroadenoma.

Conclusion

A breast nodule in a patient under the age of 25 years with benign clinical findings and imaging features consistent with a fibroadenoma does not require biopsy.     

Nullification of Electromagnetic Radiation: 50 Hz Artifact During Electroencephalogram Recording

This paper discusses the 50-Hz artifact observed during EEG recording of three patients, using Mindset24 equipment in a biomedical laboratory along with other instruments. The artifact at 50 Hz is created due to electromagnetic (EM) radiation from the environment. Perhaps, the nullification of 50 Hz artifact occurs by the three important means such as (a) grounding of far-field EM current when the patient touches the equipment metal casing, (b) connecting the electrodes in a sequence to obtain differential potentials with suppressed near-field EM radiation potentials of the scalp, and (c) destructive interferences of the EM waves.     

Retrograde Intussusception 5 years after Roux-en-Y gastric bypass for morbid obesity

Introduction

Small bowel obstruction secondary to intussusception is a rare but important consequence of Roux-en-Y gastric bypass (RYGB).

Case report

A 37-year old female presented to the emergency department with abdominal pain. She had undergone RYGB 5-years previously for obesity. CT revealed a retrograde jejuno-jejunal intussusception. The intussusceptum was the common jejunal channel and the intussuscepiens was the jejunojejunostomy resulting in obstruction of both the alimentary and biliary limbs. The patient underwent laparotomy, small bowel resection and refashioning of the jejunojejunal anastamosis.

Conclusion

We report this case as it highlights both how a delay in diagnosis can occur and the importance of including this complication early in the differential diagnoses of any patient presenting with acute or chronic abdominal pain with a history of bariatric surgery. Retrograde intussusception is more common than previously thought and the incidence may increase as bariatric surgery is performed more frequently worldwide.     

The potential of targeting Toll-like receptor 2 in autoimmune and inflammatory diseases

The last decade has revealed interesting insights into the initiation and pathophysiology of the innate immune system. Toll-like receptors are of key importance for this process and they are a family of receptors expressed mainly on leukocytes that recognize a variety of microbial products derived from bacteria, viruses, protozoa and fungi. As key players of innate immunity, TLRs and downstream signalling components are important target candidates for drug development. In this review, we focus on TLR2, which recognizes bacterial lipopeptide. TLR2 forms dimers with TLR1 or TLR6. The TLR2/TLR1 dimer recognizes triacylated lipopeptides, whilst the TLR2/TLR6 dimer recognizes diacylated lipopeptides. TLR2 has been implicated in several auto-immune and inflammatory conditions, and its role in disease pathogenesis has been supported by numerous reports of TLR2 polymorphisms in humans linked to disease. Here we discuss the potential of TLR2 as a drug target in autoimmune and inflammatory disease.     

What has happened to people affected by thalidomide 50 years on?

Introduction  

There have been reports of thalidomide-affected people suffering a deterioration in their disability over time [1, 2]. This study assessed changes in disabilities among thalidomide-affected people in the Irish population.     

The impact of open to collaborative care model in cardiovascular surgical unit

Background

When compared with open care model, a closed one improves patient care in intensive care units (ICUs), mixed ICUs, surgical ICUs and trauma centers. We wanted to evaluate the benefit of a collaborative care model in highly specialized cardiovascular care unit.

Evaluation of the effect of intra-operative intravenous fluid on post-operative pain and pulmonary function: a randomized trial comparing 10 and 30 ml kg−1 of crystalloid

Background

Existing evidence suggests that administration of intravenous fluids has been shown to improve outcomes including pain in gynecological laparoscopic surgery but the optimum fluid dose has not been determined.

Aims

To determine the effect of administration of intravenous fluids on post-operative pain and pulmonary function after gynecological laparoscopy.

Methods

In a prospective randomized double-blinded study 100 ASA 1 and 2 elective patients undergoing gynecological laparoscopy were randomized to receive intravenous compound sodium lactate 10 ml kg^?1 (CSL10-restrictive) or 30 ml kg^?1 (CSL30-liberal) administered intra-operatively. The primary outcome measure was the post-operative pain score at 24, 48 and 72 h, assessed by 0–10 verbal rating scale (VRS). Pulmonary function (FEV1, FVC, PEFR) and oxygen saturation were also measured.

Results

Patients who received CSL 30 had lower post-operative pain scores than CSL 10 (ANCOVA—mean difference = 0.47, 95 % CI 0.11–0.83, P = 0.01). Post-operative pain VRS was lower in CSL30 than CSL10 at 48 h (mean difference 0.56, 95 % CI 0.04–1.09, P = 0.036). Patients in CSL30 reported shoulder tip pain less frequently than those in CSL10 (30.4 vs. 43.9 % of assessments, P = 0.03, OR 0.58) but reported wound pain more frequently 39.0 vs. 24.2 %, P = 0.01, OR 2.0). Indices of pulmonary function did not differ between groups at any time.

Conclusions

Liberal compared to restrictive administration of i.v. crystalloid is associated with a clinical modest reduction in pain. Pulmonary dysfunction was not increased with liberal fluid administration.     

Hyperemesis gravidarum is not a negative contributing factor for postpartum bone mineral density

Background

Hyperemesis gravidarum (HG), related to protracted vomiting and nausea, is a common cause of hospitalization during the first trimester of pregnancy. It can be accompanied by ketonuria, dehydration, and weight loss. Our aim was to investigate bone loss in patients with HG.

Predicting Major Adverse Kidney Events among Critically Ill Adults Using the Electronic Health Record

Prediction of major adverse kidney events in critically ill patients may help target therapy, allow risk adjustment, and facilitate the conduct of clinical trials. In a cohort comprised of all critically ill adults admitted to five intensive care units at a single tertiary care center over one year, we developed a logistic regression model for the outcome of Major Adverse Kidney Events within 30 days (MAKE30), the composite of persistent renal dysfunction, new renal replacement therapy (RRT), and in-hospital mortality. Proposed risk factors for the MAKE30 outcome were selected a priori and included age, race, gender, University Health System Consortium (UHC) expected mortality, baseline creatinine, volume of isotonic crystalloid fluid received in the prior 24 h, admission service, intensive care unit (ICU), source of admission, mechanical ventilation or receipt of vasopressors within 24 h of ICU admission, renal replacement therapy prior to ICU admission, acute kidney injury, chronic kidney disease as defined by baseline creatinine value, and renal failure as defined by the Elixhauser index. Among 10,983 patients in the study population, 1489 patients (13.6%) met the MAKE30 endpoint. The strongest independent predictors of MAKE30 were UHC expected mortality (OR 2.32 [95%CI 2.06–2.61]) and presence of acute kidney injury at ICU admission (OR 4.98 [95%CI 4.12–6.03]). The model had strong predictive properties including excellent discrimination with a bootstrap-corrected area-under-the-curve (AUC) of 0.903, and high precision of calibration with a mean absolute error prediction of 1.7%. The MAKE30 composite outcome can be reliably predicted from factors present within 24 h of ICU admission using data derived from the electronic health record.