临床医学国际期刊(英文)最新文献

{"title":"Enablers and Barriers to Respectful Maternity Care in Low and Middle-Income Countries: A Literature Review of Qualitative Research","authors":"F. Mgawadere, U. Shuaibu","doi":"10.4236/IJCM.2021.125021","DOIUrl":"https://doi.org/10.4236/IJCM.2021.125021","url":null,"abstract":"Background: Low and Middle-Income Countries (LMIC) account for 94% of maternal deaths annually. Interventions to reduce these deaths include; access to Emergency Obstetric Care (EmOC) and Skilled Birth Attendant (SBA) at childbirth. However, evidence indicates increasing access to EmOC, and SBA only does not translate into positive maternal and newborn outcome due to disrespectful care faced by women during labour. World Health Organization (WHO) guidelines emphasize on positive birth experience through Respectful Maternity Care (RMC). Therefore, this review aims to explore enablers and barriers to respectful maternity care in low and middle-income countries. Methods: We conducted an exhaustive literature search for studies that reported on enablers and barriers to respectful maternity care. Qualitative studies done in low and middle-income countries, published in English Language from the year 2000 to June 2020 were included in this study. Articles were screened by two researchers for eligibility and critical appraisal skills programme checklist was used to appraise the quality. The themes and quotes from the studies were extracted and synthesized using thematic synthesis. Results: The search strategy generated 14,190 articles and 54 studies met the inclusion criteria. Two main themes: interpersonal relationship and support, and privacy and confidential care were reported as both enablers and barriers to respectful maternity care. Strategies to promote RMC were: health education to pregnant women on care expected during labour, good communication between maternity staff and women, capacity building of staff on RMC and staff motivation. Conclusion: Respectful maternity care plays a big role in promoting health-seeking behaviours among pregnant women. However, women experience barriers ranging from provider behaviour, work environment and health system challenges. Ensuring a dignified and respectful working environment could contribute to an increase in health seeking-behaviours and consequently reduction of maternal mortality.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43662769","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":"Vaccination Coverage and the Risk of Hepatitis B Virus Infection amongst Medical and Paramedical Students Practicing at the Bamenda Regional Hospital in Cameroon Sub-Saharan Africa","authors":"M. Asanghanwa, Menji B. Nyuykighan, Odelia Kwende-Tanjong, E. Agbor","doi":"10.4236/IJCM.2021.125020","DOIUrl":"https://doi.org/10.4236/IJCM.2021.125020","url":null,"abstract":"Introduction: The endemic nature of hepatitis B virus (HBV) in Sub-Saharan Africa is a significant public health problem that places health care providers (medical students inclusive) at increased risk of occupational exposure. However, vaccination against HBV is not systematic among medical students in Cameroon. Thus, we sought to evaluate awareness and HBV vaccine coverage amongst medical students in Cameroon. Aim: The present study was aimed at determining the proportion of Medical and Paramedical students on internship at the Bamenda Regional Hospital (BRH) who are vaccinated and immune to hepatitis B virus (HBV). Methods: This was a hospital-based cross sectional study carried out at the BRH in Cameroon. Questionnaires were administered to 120 participants who signed an informed consent form and venous blood samples collected in dry tubes for the HBV-5 PANEL test. Data were collected within a period of two weeks. HBV vaccine status was defined as complete (3 doses), partial (1 or 2 doses), and unvaccinated. Results: Of 120 participants (87 females and 33 males), 56 (46.7%) were vaccinated at least once against HBV; 15 (12.5%) were partially vaccinated and 41 (34.2%) completely vaccinated. Out of the 56 vaccinated individuals, only 13 (23.2%) were confirmed immunized against HBV by testing positive for hepatitis B surface antibodies. Only 3 (5.4%) students had done post-vaccination serologic test to confirm their immunized status. There was high exposure to potentially infected body fluids like blood (97.5%) and urine (87.5%). There was equally poor practice of adequate preventive measures like regular hand washing and the proper use of personal protective equipment. A prevalence of 3.1% of HBV amongst the unvaccinated group was recorded. Conclusion: Only 1 in 3 medical students had completed the HBV vaccination series and only 26.8% of this cohort was confirmed immunized against HBV. This highlights the need for improved health policies aimed at increasing access and coverage of HBV immunization in high risk groups such as health workers.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45902334","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":"Vegetarian Diets in Children—Some Thoughts on Restricted Diets and Allergy","authors":"H. Kalhoff, M. Kersting, Lennart Lücke, T. Lücke","doi":"10.4236/IJCM.2021.122007","DOIUrl":"https://doi.org/10.4236/IJCM.2021.122007","url":null,"abstract":"Vegetarianism is a common diet worldwide. For a large proportion of people, meat or fish is not available at all or not regularly as a meal. But also in the industrialised countries, vegetarian nutrition is becoming more and more popular for various reasons. Many vegetarian parents also want a suitable diet for their children. But are restrictive diets beneficial or potentially harmful in certain situations, such as a predisposition to severe atopy? Are vegetarian diets equally suitable for pregnant women, nursing mothers, infants, children, and adolescents? What critical nutrients should parents, children, pediatricians, and nutritionists pay particular attention to? This article is focused on questions like these and discusses scientifically based concepts of nutrition. Main findings are that exposure to a variety of food antigens during early life may play a role in the development of healthy eating habits and that restrictive diets have not been found in studies to prevent allergic disease.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47386860","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":"Tigecycline Use in Surgical Intensive Care Unit for the Treatment of Complicated Intra-Abdominal Infections: A Real-World Study","authors":"Y. Nie, F. Pei, Luhao Wang, X. Si, X. Guan","doi":"10.4236/IJCM.2021.121001","DOIUrl":"https://doi.org/10.4236/IJCM.2021.121001","url":null,"abstract":"OBJECTIVES: To describe real-world use of tigecycline in cIAIs patients. METHODS: A retrospective, observational study enrolled cIAIs patients hospitalized in The First Affiliated Hospital, Sun Yat-sen University from January 1, 2013 to June 30, 2017 was conducted. Patients’ data were collected and matched based on age, gender, and Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score according to receiving first-line, later-line, or no tigecycline during hospitalization. RESULTS: Data were collected for 52 patients. 82.6% were male. Mean age was 57.8 years and APACHE II score was 14.8. The incidence of both extended-spectrum beta-lactamase producing and carbapenem-resistant pathogens was high on initial culture; however, few patients received first-line tigecycline. No significant difference in mortality rate was identified among first-line, later-line and no tigecycline users. Of surviving patients, shorter hospital length of stay was observed for patients receiving first- vs later-line or no tigecycline, respectively. ICU length-of-stay was shorter in patients receiving first- vs later-line or no tigecycline. CONCLUSIONS: First-line tigecycline use was rare in our surgical intensive care unit. Resistant organisms were commonly cultured from initial specimens. Although these results are limited by small patient numbers and single center, our results suggest that early tigecycline use may have significant benefits with similar mortality. Further research is warranted to demonstrate the values of early tigecycline use in cIAIs patients.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42622989","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":"Well Controlled Blood Pressure in Turkish Patients: How Many Drugs Are Required to Attain and Maintain the Blood Pressure Goal?","authors":"M. Temizel, Ugur Dilek Calap, M. Cit, Mansur Azermir, Y. Arman","doi":"10.4236/IJCM.2021.121004","DOIUrl":"https://doi.org/10.4236/IJCM.2021.121004","url":null,"abstract":"Background: This study aimed to determine the number of antihypertensive agents required to achieve optimal blood pressure (BP) in Turkish hypertensive patients. Material and Methods: Totally 400 hypertensive patients (114 males and 286 females) were enrolled. BP was measured by patients at home twice a day. The patients were called for controlling in every four weeks, and those who had BP 140/90 drug, doses were increased or another antihypertensive drug added and the patients were continued to be followed-up. Results: In the first follow-up (on the 4th week), 152 (38%) patients, including 35 (31%) men and 117 (41%) women, attained the goal BP. The mean duration of hypertension in single, double, triple, and quadruple treatment groups was 6.2 ± 5.0, 6.8 ± 5.9, 8.8 ± 5.4, and 10.4 ± 6.6 years, respectively. In the beginning, the median number of agents used for each patient was 2.17. When the follow-up was concluded, the median of agents used for each patient was 2.72. Conclusion: Thirty-eight percent of participants had controlled hypertension in the first follow-up. Women had better BP control. The median number of agents required for attaining and maintaining BP goal was 2.72. More drugs are needed when hypertension gets longer.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42422123","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":"Transcatheter Aortic Valve Dislocation in Left Ventricular Outflow Tract with Successful Repositioning Using “Double Snare” Technique","authors":"M. Bunc, L. Vitez, S. Terseglav, T. Zlahtic, G. Ussia","doi":"10.4236/IJCM.2021.121002","DOIUrl":"https://doi.org/10.4236/IJCM.2021.121002","url":null,"abstract":"Background: Transcatheter aortic valve implantation (TAVI) is a widely used treatment of severe aortic stenosis. Implantation of a self-expanding valve into a dense calcified aortic annulus can be challenging and may result in device malposition and malfunction. Aim: The aim of our case report is to present a novel technique of transcatheter aortic valve dislocation treatment. Case presentation: An 86-year-old woman with severely calcified aortic valve underwent TAVI using a 27-mm self-expanding Portico valve (Abbott Vasc, USA). In the last phase of implantation, the valve dislocated deep into the left ventricular outflow tract resulting in significant paravalvular regurgitation and patient instability. Repositioning of the valve with a single snare was ineffective because of severe aortic ring calcifications. A novel “double snare” technique was applied and the valve was successfully repositioned upward with an excellent anatomic and haemodynamic result. Conclusion: “Double snare” technique can be an effective strategy for repositioning of deeply implanted self-expanding transcatheter aortic valves. It represents an efficient bailout strategy in case of single snare approach failure, especially in cases of severe aortic ring calcifications.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42778338","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":"Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India","authors":"Darshi M Desai, E. Khan, Dinesh M Rathod","doi":"10.4236/ijcm.2021.1212048","DOIUrl":"https://doi.org/10.4236/ijcm.2021.1212048","url":null,"abstract":"Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itch-ing/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915]; p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424]; p < 0.001) for second-ary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733]; p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887]; p = - 3.146] for vaginal and cervical; AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 -1.180]; p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose in-terventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower so-cio-economic sections of the society.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70629876","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":"Early Hyperglycemia in Diabetics as a Predictor of Disease Severity in COVID-19","authors":"N. Shaikh, Arshee Khan, A. Shah, Rubina Inamdar, Rania Abosalama, Rafeh Jamal","doi":"10.4236/ijcm.2021.1212047","DOIUrl":"https://doi.org/10.4236/ijcm.2021.1212047","url":null,"abstract":"Background: Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. Method: Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl; was studied with mortality, requirement of ICU stay and prognostic markers. Results: Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR; 48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR; 26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group; 24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. Conclusion: Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70629583","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":"Saudi Consensus for Low-Premixed Insulin Analogues in Type 2 Diabetes: Consensus Report","authors":"A. Alshaikh, Mohammed S Aljamal, Saud Alsifri, A. Alrumaih, S. Bokhari, Mohammed Almuzaini, K. Alyahya, Abdulaziz Bin Shaikh, T. Alharbi, Rashid Aljuwair, Fahad Alsabaan, Emad R. Issak","doi":"10.4236/IJCM.2021.124016","DOIUrl":"https://doi.org/10.4236/IJCM.2021.124016","url":null,"abstract":"We learned from the literature that premixed insulins are short-acting insulin or rapid-acting insulin analogue mixed with intermediate-acting insulin in a fixed ratio, addressing FBG and PPBG in one injection. There are two categories; high-mix and low-mix premixed insulins. We, a Saudi task force, gathered to develop an explicit, evidence-based consensus for the use of the low-mix premixed insulin for better glycemic control. The treatment with premixed aspart 30 was non-inferior to treatment with premixed","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70630049","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":"Faster Healing Process by Sparing Intramural Myoma’s Pseudocapsule during Laparoscopic Myomectomy Compared with Removing It during Open Myomectomy","authors":"A. Zikopoulos, Y. Prapas, M. Paraskevaidi, C. Siristatidis, A. Galani, O. Tsonis, M. Paschopoulos, K. Zikopoulos, E. Kolibianakis","doi":"10.4236/ijcm.2021.1210038","DOIUrl":"https://doi.org/10.4236/ijcm.2021.1210038","url":null,"abstract":"","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70629530","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}