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51.
C Dilip R Saraswathi PN Krishnan AK Azeem Abdul azeez Jaywin jose 《Asian Pacific journal of tropical medicine》2010,3(6):443-447
ObjectiveTo identify the chikungunya outbreaks in both indoor and outdoor patients in some selected hospitals in our locality and the burden and magnitude of the disease, to compare different system of medicines (allopathic, Ayurvedic, homeopathy etc) and to explore the knowledge, attitude and practices of pharmacists and other health care professionals in the treatment of chikungunya.MethodsA six-month study was carried out. Detailed history was taken from the case history, personal interview of doctors and suspected cases. Personal data such as name age, sex, location, date of onset of illness, medical history, general/systemic examination features, drugs used (allopathy, Ayurveda, homeopathy, or traditional) for the treatment, etc. were noted down. A simple questionnaire was prepared and distributed to various doctors practicing various systems of medicines.ResultsA total of 209 suspected cases were identified from July to December, 2009. People in the age group of 20–40 years were more affected. The study revealed that females were more affected than males. The Grade-III (58.73%) population was more prone to chikungunya than Grade-II (38.75%) and Grade-I (2.87%). It showed that fever, pain in muscles, and sleeping disturbances were the intense symptoms of chikungunya. Myocarditis and arthritis were concomitant diseases which worsened chikungunya symptoms. It also indicated the effective medicine for compliance is nonsteroidal antiinflammatory drugs (NSAIDS).ConclusionsFrom our study we found that in some places there is no proper documentation, even though there are proper guidelines framed by the relevant authorities. It can be concluded from the study that all the systems of medicine are equally important for the management of chikungunya. Additional effort in promoting the guidelines at local level and proper documentation helps to achieve the goal of curbing the chikungunya. It is high time to increase our effort and promote these messages at grassroot level which benefits the society/community as a whole. 相似文献
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MJ Armstrong DD Houlihan IA Rowe WHO Clausen B Elbrønd SCL Gough JW Tomlinson PN Newsome 《Lancet》2013
BackgroundFatty liver disease has reached epidemic proportions in type 2 diabetes. Glucagon-like peptide-1 (GLP-1) analogues are licensed for treatment of type 2 diabetes, yet little data exist on efficacy and safety in liver injury. We aimed to assess the safety and efficacy of 26 weeks' liraglutide on liver function compared with an active placebo.MethodsIndividual patient data meta-analysis was done with patient level data combined from six 26-week, phase 3, double-blind randomised controlled trials on type 2 diabetes, which comprise the Liraglutide Effect and Action in Diabetes (LEAD) programme. In addition, the LEAD-2 sub-study was analysed to assess the effect on CT-measured hepatic steatosis.FindingsOf 4442 patients analysed, 2241 (50·8%) had an abnormal alanine aminotransferase (ALT) at baseline (mean 33·8 IU/L [SD 14·9] in female participants; 47·3 [18·3] in male participants). Liraglutide 1·8 mg reduced ALT in these patients compared with placebo (?8·20 vs ?5·01 IU/L, p=0·003), and was dose dependent (no significant differences vs placebo with liraglutide 0·6 or 1·2 mg). This effect was lost after adjustment for liraglutide's effect on reduction of weight (corrected mean ALT difference vs placebo ?1·41 IU/L, p=0·21) and HbA1c (corrected mean ALT difference vs placebo 0·57 IU/L, p=0·63). Adverse effects with 1·8 mg liraglutide were similar between patients with and without baseline abnormal ALT. In the LEAD-2 sub-study, liraglutide 1·8 mg (26 weeks) improved hepatic steatosis (CT-measured liver:spleen attenuation ratio) from baseline (0·10, p=0·001) and showed a trend towards improvement compared with placebo (0.10 vs 0·00, p=0·07).Interpretation26 weeks of liraglutide (1·8 mg) is safe, well tolerated, and improves liver enzymes compared with placebo in patients with type 2 diabetes.FundingWellcome Trust. 相似文献
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S Huber-Wagner R Lefering MV Kay J Stegmaier PN Khalil AO Paul P Biberthaler W Mutschler K-G Kanz the Working Group on Polytrauma of the German Trauma Society 《European journal of medical research》2009,14(12):532-540
Background
Hospitals have a critically important role in the management of mass causality incidents (MCI), yet there is little information to assist emergency planners. A significantly limiting factor of a hospital''s capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations.Methods
The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission.Results
From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%), pelvic injuries (11.5%), thoracic injuries (5.0%) and major amputations (3.1%). The mean cut to suture time was 130 min (IQR 65-165 min). Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00), ISS ≥ 35 (OR 2,94), hemoglobin level ≤ 8 mg/dL (OR 1,40), pulse rate on hospital admission < 40 or > 120/min (OR 1,39), blood pressure on hospital admission < 90 mmHg (OR 1,35), prehospital infusion volume ≥ 2000 ml (OR 1,34), GCS ≤ 8 (OR 1,32) and anisocoria (OR 1,28) on-scene.Conclusions
The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI. 相似文献56.
Robinson PN, Mundlos S. The Human Phenotype Ontology. A standardized, controlled vocabulary allows phenotypic information to be described in an unambiguous fashion in medical publications and databases. The Human Phenotype Ontology (HPO) is being developed in an effort to provide such a vocabulary. The use of an ontology to capture phenotypic information allows the use of computational algorithms that exploit semantic similarity between related phenotypic abnormalities to define phenotypic similarity metrics, which can be used to perform database searches for clinical diagnostics or as a basis for incorporating the human phenome into large‐scale computational analysis of gene expression patterns and other cellular phenomena associated with human disease. The HPO is freely available at http://www.human‐phenotype‐ontology.org . 相似文献
57.
ML Kwan L Shen JR Munneke EK Tam PN Partee M André SE Kutner CP Somkin LM Ackerson SR Thiadens 《Breast cancer research and treatment》2012,135(2):591-602
Breast cancer patients have voiced dissatisfaction regarding their education on breast cancer-related lymphedema risk and risk reduction strategies from their clinicians. Informing patients about lymphedema can contribute to decrease their risk of developing the condition, or among those already affected, prevent it from progressing further. In this cross-sectional study, a lymphedema awareness score was calculated based on responses to a brief telephone interview conducted among 389 women diagnosed with invasive breast cancer at Kaiser Permanente Northern California from 2000 to 2008 and had a previous record of a lymphedema-related diagnosis or procedure in their electronic medical record. During the telephone interview, women self-reported a lymphedema clinical diagnosis, lymphedema symptoms but no lymphedema diagnosis, or neither a diagnosis nor symptoms, and responded to questions on lymphedema education and support services as well as health knowledge. Multivariable logistic regression [odds ratio (OR) and 95 % confidence interval (CI)] was used to determine the associations of selected sociodemographic and clinical factors with the odds of having lymphedema awareness (adequate vs. inadequate). The median (range) of the lymphedema awareness score was 4 (0–7). Compared with patients <50 years of age, patients 70+ years of age at breast cancer diagnosis had lower odds of adequate lymphedema awareness (OR 0.25; 95 % CI 0.07, 0.89), while patients 50–59 and 60–69 years had greater odds of adequate awareness although not statistically significant (OR 2.05; 95 % CI 0.88, 4.78 and OR 1.55; 95 % CI 0.60, 4.02, respectively; p for trend = 0.09). Higher educational level and greater health literacy were suggestive of adequate awareness yet were not significant. These results can help inform educational interventions to strengthen patient knowledge of lymphedema risk and risk reduction practices, particularly in an integrated health care delivery setting. With the growing population of breast cancer survivors, increasing patient awareness and education about lymphedema risk reduction and care after cancer diagnosis is warranted. 相似文献
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59.
Jerry ME Kovoor PN Jayakumar SG Srikanth B Indira M Gayatri Devi 《Journal of Medical Imaging and Radiation Oncology》2002,46(1):65-68
Although known, histologically proven pulmonary metastasis from a benign intracranial meningioma is exceedingly rare. We report a case of meningiothelial meningioma producing a solitary pulmonary deposit. 相似文献
60.
Fetal iron status in maternal anemia 总被引:2,自引:0,他引:2
PN Singla M Tyagi R Shankar D Dash A Kumar 《Acta paediatrica (Oslo, Norway : 1992)》1996,85(11):1327-1330
Hemoglobin, serum iron, transferrin saturation and ferritin were measured on paired maternal and cord blood samples in 54 anemic (hemoglobin < 110 g/L) and 22 non-anemic (hemoglobin ≥ 110 g/L) pregnant women at term gestation. The levels of hemoglobin, serum iron, transferrin saturation and ferritin were significantly low in the cord blood of anemic women, suggesting that iron supply to the fetus was reduced in maternal anemia. The linear relationships of these parameters with both maternal hemoglobin and maternal serum ferritin indicated that the fetus extracted iron in amounts proportional to the levels available in the mother. Infants of mothers with moderate and severe anemia had significantly lower cord serum ferritin levels and hence poor iron stores at birth. It is concluded that iron deficiency anemia during pregnancy adversely affects the iron endowment of the infant at birth. 相似文献