Liaquat National Journal of Primary Care最新文献

{"title":"“It’s Not like This Back Home” Conversations and Conversation Analysis as a Tool to Consider the Family Medicine Consultation in India","authors":"K. Mohanna","doi":"10.37184/lnjpc.2707-3521.1.9","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.1.9","url":null,"abstract":"Introduction: This paper describes some of the features of family medicine consultations in one clinic in India. In the United Kingdom (UK) there is a significant difference in the success rate in the Royal College of General Practice postgraduate licensing assessment (MRCGP) between those doctors who graduated MBBS from overseas but who trained and work in the UK, and those who graduated in the UK. The reasons for this are not known, but are likely to be multifactorial. India is the country of origin of one of the largest groups of UK International Medical Graduates (IMGs) and some doctors from India feel that their difficulty in passing this exam is in part due to family medicine being performed differently in India. \u0000Methods: The reported experiences of family medicine trained doctors in India about contextual aspects of practice are explored through a thematic analysis of focus group and interviews. A conversation analysis of work done by talk-in-interaction in video recordings of actual family medicine consultations in India is also presented.\u0000Results and Discussion: The impact of family medicine training, or the lack of it, and Indian structural and societal norms in the practice of family medicine are considered. The Clinical Skills Assessment element of MRCGP (CSA) heavily emphasises talk as used in all three assessment domains - data gathering, clinical management and interpersonal skills. The phrase ‘interactional fluidity’ is coined for the marker of competence with talk that RCGP examiners seek. This has implications in a high-stakes, yet simulated, assessment for those consulting in a second language. Using a model that differentiates between ‘core business work talk’, ‘work-related talk’ and ‘small talk’, the talk from video-recorded real-life consultations in India will be analysed. The risk of UK examiners mistaking unfamiliar patterns of talk for lack of medical competence is discussed. \u0000Conclusion: The differential attainment of IMGs has been described for some time and this paper aims to move the discussion on to potential training interventions in response.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125876892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Spexin and Leptin in Obesity Among Male Pakistani Population","authors":"","doi":"10.37184/lnjpc.2707-3521.2.2","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.2.2","url":null,"abstract":"","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123796732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Vision Loss in a Young Patient with Pulmonary Hypertension, A Rare and Unusual Finding","authors":"","doi":"10.37184/lnjpc.2707-3521.2.11","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.2.11","url":null,"abstract":"Loss of vision associated with pulmonary hypertension in the pediatric age group has been rarely reported in the literature and often goes unnoticed for a long period. Pulmonary hypertension may manifest as shortness of breath limiting the activity of the individual, palpitation, headaches, easy fatiguability, dizziness been the most common symptoms encountered. However, primary pulmonary hypertension would not present itself instead secondary to other diseases like congenital heart disease, lung disease, connective tissue disorders or genetic diseases. Our case demonstrated a 17-year old individual with a primary complaint of progressive loss of vision in the left eye leading to complete vision loss. The patient experienced dyspnea two years back which exacerbated affecting his normal routine activity. His Echocardiography revealed severe pulmonary hypertension and was started on appropriate medications. His vision worsened and slit-lamp examination revealed multiple hemorrhages. Further investigations with FFA and OCT revealed significant hypoperfusion and significant elevation of the retina of the left eye. Anti-VEGF injections were given in an attempt to restore vision, but it resulted in no further improvement. Our case emphasizes the importance of prompt ophthalmologic examination in Pulmonary Hypertension.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115012485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uses of Antidepressant as Adjunct Treatment of Very Severe Atopic Dermatitis","authors":"Shamail Zia, Fazail Zia, Shraddha Panchal, Adeel Ahmad, Syeda Rabab Jaffer","doi":"10.37184/lnjpc.2707-3521.3.12","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.3.12","url":null,"abstract":"This is a case of severe atopic dermatitis in a young married male age 37 years. This patient was very anxious and frustrated. The patient was using all the standard treatments for severe atopic dermatitis for e.g azathioprine, cyclosporine, tab deltacortril, applying emollients with clobetasol in it but he was not getting better. By chance the patient's family dragged him to visit a psychiatrist and the patient was advised to start venlafaxine and within 15 days the patient started getting better miraculously. Atopic Dermatitis is a very frustrating disease and patients face severe depression and bouts of severe itching exacerbated by exposure to dust, stress, sweating, changing and wearing clothes, etc. The use of antidepressants is not common practice in treating atopic dermatitis. Most general practitioners and dermatologists don't pay attention to how much a patient is suffering not only physically but also mentally and because of this, they don't suggest antidepressants. The role of antidepressants as an anti-inflammatory is still needed to be educated among physicians. This is a vicious cycle. The stress causes the exacerbation of this disease in which patients start itching all over the body and because of itching, lesions all over the body start getting infected as during itching staphylococcus aureus which resides under the nail enter in the lesion and cause infection and because of infection patients have a fever, lethargy, and weakness. The use of antidepressants is a game-changer in the management of atopic eczema.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"665 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122965735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Manifestation of the Patients with Novel Wuhan Coronavirus Infection: A Clinical Summary on Patients in the First Month of Outbreak","authors":"","doi":"10.37184/lnjpc.2707-3521.1.15","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.1.15","url":null,"abstract":"","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129527925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compassion Fatigue, Compassion Satisfaction, Burnout and its Associated Factors among Nurses Working in Critical Care area of Tertiary Care Hospital, Karachi, Pakistan","authors":"","doi":"10.37184/lnjpc.2707-3521.5.13","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.5.13","url":null,"abstract":"Background: Compassion satisfaction and compassion fatigue is the element of professional quality of life which plays an integral role in compassionate care. Compassion fatigue can lead to poor job performance, high turnover rate, absenteeism, lack of interest in patients, and poor patient outcome. \u0000\u0000Objective: This study aimed to determine the burden of compassion fatigue and compassion satisfaction and burnout among nurses working in specialty-based critical care areas.\u0000\u0000Materials and Methods: A cross-sectional analytical study was accomplished at Dow University Hospital. A structured, and validated tool, ProQol was utilized for data collection. Data were entered and analyzed in SPSS version 24.0. Binary logistic regression was applied to establish the association between the variables. The level of significance was considered with a p-value ≤0.05.\u0000\u0000Results: A total of 140 nurses working in critical areas were approached and responded to this survey. The average means score was 40.77 ± 6.26 for compassion satisfaction, 22.47 ± 5.46 for burnout, and 26.14 ±6.20 for secondary traumatic stress was found. On multivariable regression analysis, the likelihood of average compassion satisfaction was significantly higher among nurses who had BSN degrees. Nurses with work experience of 6 months to <1 year, 1-3 years, and 4-6 years had higher average compassion satisfaction. None of the participants’ characteristics was associated with a burnout on univariate analysis. The risk of secondary traumatic stress was reported higher in single participants. \u0000\u0000Conclusion: The study findings indicated an average to a higher level of compassion satisfaction and a low to average level of compassion fatigue which is burnout and secondary traumatic stress among critical care nurses.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130509493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wandering Spleen: A Rare Condition with Splenic Torsion and Infarction in an Elderly Patient","authors":"","doi":"10.37184/lnjpc.2707-3521.6.10","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.6.10","url":null,"abstract":"Ectopic spleen or wandering spleen is an uncommon presentation in which the spleen's anatomical location is different from its fixed position in the left upper quadrant of the abdomen, due to the absence of the typical peritoneal attachments; the spleen is more mobile inside the abdomen. Congenital or acquired conditions are the cause of this anomaly, which could ultimately result in torsion and splenic infarction. Less than 0.2% of wandering spleen cases are reported annually, making it a rare clinical manifestation. Splenic vascular pedicle torsion can result in complications that can cause symptoms of an acute abdomen as a result of ischemic necrosis of the spleen. Computed tomography and ultrasonography with Doppler or CEUS are essential for accurate diagnosis due to the vague clinical signs and potential complications. This case involves a 70-year-old elderly woman who complained of extreme abdominal pain and vomiting for three days. On physical examination, a tense right lower quadrant lump was palpated, when she visited the emergency room. An urgent CT scan was done for the acute abdomen which revealed torsion of the splenic pedicle in a wandering spleen.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123980728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of the Literature on Patient Safety Culture","authors":"","doi":"10.37184/lnjpc.2707-3521.5.41","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.5.41","url":null,"abstract":"The prevention of errors and negative consequences on patients associated with health care is referred to as patient safety. Healthcare has become more complex as new technologies, drugs, and treatments have become more widely available. Every year, 134 million adverse events occur in hospitals in low- and middle-income countries (LMICs), resulting in 2.6 million deaths worldwide. Many medical practices and healthcare risks are emerging as critical issues for patient safety, significantly increasing the burden of harm caused by unsafe care. There are numerous predictors, including safety and risk management, medication errors, fall risks, unsafe surgical care procedures, diagnostic errors, hospital-acquired infections, and diagnostic errors, all of which pose a risk to patient safety measures. The role of a nurse surrounds the complete analysis of the solemn issue associated with the well-being and safety culture. Nurses contribute to patient safety by remaining at patients' bedsides and interacting with their families and other healthcare professionals.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121581475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections of an Earliest Established Screening and Testing Facility for COVID-19 in the Largest Metropolis, Pakistan","authors":"F. Kanwal, Karishma Lal, A. Qureshi","doi":"10.37184/lnjpc.2707-3521.3.5","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.3.5","url":null,"abstract":"As the world struggles to deal with the COVID-19 pandemic, this article talks about the experience and findings of the first COVID-19 screening facility in a tertiary care hospital in Karachi, Pakistan. Department of Family Medicine at Aga Khan University (AKU) took initiative where COVID-19 screening of stable patients first began in a dedicated area. Since testing kits were limited and community spread had not started, nurses would screen every walk-in patient based on the presence of fever, cough, travel history and exposure to COVID-19 positive patient in the last 14 days, and advise swab testing if indicated. Out of 742-screened patients, approximately 66% were males and 34% were females. 38% of patients reported fever and 54% of patients reported cough. 8% (65) patients checked all three screening criteria of cough, fever and international travel exposure whereas 35% were asymptomatic. The majority had clinical exposure (38.3%) followed by public exposure (33.4%) and international travel exposure (19.8%).","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122273253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Coaches’ Manuals for Teaching Professionalism in \u0000Problem Based Learning","authors":"","doi":"10.37184/lnjpc.2707-3521.2.15","DOIUrl":"https://doi.org/10.37184/lnjpc.2707-3521.2.15","url":null,"abstract":"The coaching is essential for elementary teaching and is even more compelling when applied to a field as complex as medicine. In any structured training program, there is a need for some instruc-tional material and references. These materials can be converted in the form of manuals as tools to be used for the facilitation of the process of teaching and learning. Therefore, this survey was de-signed to assess the perception of the coaches as regards the effectiveness of the coaches’ manual. A one-day workshop was conducted which involved brainstorming and different modalities of coaching in relationship with teaching professionalism and the effectiveness of the coaches’ manual were discussed. Results showed that the coaches who had no previous experience or training in coaching had benefited from the coaches’ manual. Sub-specialty of the faculty was found to have a significant (<0.05) effect on the use of manuals.","PeriodicalId":140679,"journal":{"name":"Liaquat National Journal of Primary Care","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128202080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}