Advances in Clinical Medical Research and Healthcare Delivery最新文献

{"title":"Obesity in Women of Reproductive Age","authors":"Dilafruzhon Ravshanovna Maksudova, Khurshidakhon Kudratullayevna Nasyrova","doi":"10.48112/acmr.v3i3.35","DOIUrl":"https://doi.org/10.48112/acmr.v3i3.35","url":null,"abstract":"This article provides information about the relationship between obesity and disorders of the reproductive system. Lifestyle factors are changeable habits and lifestyles that can greatly affect overall health and well-being, including fertility. Overweight contributes to menstrual cycle disorders, infertility, miscarriage, unfavorable pregnancy outcome, deterioration of fetal well-being and diabetes mellitus.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88800480","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":"A Case of Intractable Hyperhidrosis in Spinal Cord Injury: Role of Stellate Ganglion Block","authors":"S. Sheen, Hemant Kalia, Victoria Kung","doi":"10.53785/2769-2779.1104","DOIUrl":"https://doi.org/10.53785/2769-2779.1104","url":null,"abstract":"Abstract Objective: Autonomic dysreflexia (AD) in spinal cord injury (SCI) can present as hyperhidrosis due to sudomotor dysfunction. Hyperhidrosis can also occur without an identifiable etiology. There are no standard treatment guidelines for refractory hyperhidrosis in the setting of persistent noxious stimulation. Stellate ganglion blockade may prevent hyperhidrosis by inhibiting profound sympathetic surge and vasoconstriction. Case: 58-year-old female with C7 ASIA-A quadriplegia was admitted to the hospital for episodes of profuse sweating in the setting of autonomic dysreflexia secondary to underlying T7-8 discitis. Despite conservative treatment of discitis, patient continued experience 50-60 episodes of profuse sweating daily. Stellate ganglion block was performed under ultrasound guidance to reduce sympathetic surge. Patient underwent serial stellate ganglion blocks under ultrasound guidance with >75% improvement in her hyperhidrosis episodes. Discussion: Stellate ganglion block is a safe interventional which can be considered for sympathetically mediated refractory hyperhidrosis. It may also be used as a treatment alternative in certain cases of refractory AD in SCI patients. Abstract Objective : Autonomic dysre fl exia (AD) in spinal cord injury (SCI) can present as hyperhidrosis due to sudomotor dysfunction. Hyperhidrosis can also occur without an identi fi able etiology. There are no standard treatment guidelines for refractory hyperhidrosis in the setting of persistent noxious stimulation. Stellate ganglion blockade may prevent hyperhidrosis by inhibiting profound sympathetic surge and vasoconstriction. Case : 58-year-old female with C7 ASIA-A quadriplegia was admitted to the hospital for episodes of profuse sweating in the setting of autonomic dysre fl exia secondary to underlying T7-8 discitis. Despite conservative treatment of discitis, patient continued experience 50 e 60 episodes of profuse sweating daily. Stellate ganglion block was performed under ultrasound guidance to reduce sympathetic surge. Patient underwent serial stellate ganglion blocks under ultrasound guidance with > 75% improvement in her hyperhidrosis episodes. Discussion : Stellate ganglion block is a safe interventional which can be considered for sympathetically mediated refractory hyperhidrosis. It may also be used as a treatment alternative in certain cases of refractory AD in SCI patients.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84566205","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":"Obesity and COVID-19 Outcomes in a Primarily Black Population","authors":"Raj K. Dangol, O. Lurye, Sadaf Mustafa, L. Camire, Krupa Patel, E. Tefera, David S. Weisman","doi":"10.53785/2769-2779.1098","DOIUrl":"https://doi.org/10.53785/2769-2779.1098","url":null,"abstract":"Abstract ABSTRACT Background: Studies have noted higher COVID-19 mortality with more severe obesity in populations that included a small percentage of Black patients. Methods: We retrospectively analyzed COVID-19 outcomes associated with obesity in our largely African American patient population. A total of 1101 symptomatic patients with a positive COVID-19 laboratory test March 5 to June 3, 2020, were categorized into weight groups based on body mass index (BMI). Of these patients, 679 (61.7%) were Black. A total of 355 (32.2%) patients had overweight and 516 (46.9%) had obesity. Results: BMI was an independent risk factor for intubation and an independent predictor for ICU length of stay and intubation days. An unexpected observation was favorable outcomes in mild obesity compared with normal weight and more severe obesity, likely a result of older age and higher Charlson comorbidity index in patients with normal BMI compared with patients with mild obesity. Conclusions: Abstract Background : Studies have noted higher COVID-19 mortality with more severe obesity in populations that included a small percentage of Black patients. Methods : We retrospectively analyzed COVID-19 outcomes associated with obesity in our largely African American patient population. A total of 1101 symptomatic patients with a positive COVID-19 laboratory test March 5 to June 3, 2020, were categorized into weight groups based on body mass index (BMI). Of these patients, 679 (61.7%) were Black. A total of 355 (32.2%) patients had overweight and 516 (46.9%) had obesity. Results : BMI was an independent risk factor for intubation and an independent predictor for ICU length of stay and intubation days. An unexpected observation was favorable outcomes in mild obesity compared with normal weight and more severe obesity, likely a result of older age and higher Charlson comorbidity index in patients with normal BMI compared with patients with mild obesity. Conclusions : In a diverse primarily Black population, comorbidities were a concern for adverse COVID-19 outcomes and COVID-19 outcomes were signi fi cantly worse with moderate and severe obesity.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77330247","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":"Journal Club Review of Diabetic Foot Infections","authors":"Dustin Moyer, Benjamin Heddy, Brady Webb, Zak Oddone","doi":"10.53785/2769-2779.1124","DOIUrl":"https://doi.org/10.53785/2769-2779.1124","url":null,"abstract":"Abstract The general purpose of this journal club is to review foundational articles in the diagnostic and surgical treatment of diabetic foot infections and osteomyelitis. These articles help form the basis for clinical decision making and best treatment practices involving outpatient and inpatient care for diabetic foot infections. Abstract The general purpose of this journal club is to review foundational articles in the diagnostic and surgical treatment of diabetic foot infections and osteomyelitis. These articles help form the basis for clinical decision making and best treatment practices involving outpatient and inpatient care for diabetic foot infections.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90423455","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":"Public Health Liberation – An Emerging Transdiscipline to Elucidate and Transform the Public Health Economy","authors":"Christopher D Williams, Joy Birungi, Melody Brown, J. Deutsch, Felecia S. Williams, P.S. Perkins, P. Bishop, Dena Walker, E. Moody, Rhonda Hamilton, J. El-Bayoumi","doi":"10.53785/2769-2779.1120","DOIUrl":"https://doi.org/10.53785/2769-2779.1120","url":null,"abstract":"","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"134 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77389066","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":"Stones, Bones, and Groans with Cancerous Overtones - A Rare Case of Diffuse Large B Cell Lymphoma Presenting as Hypercalcemia","authors":"Evan Becker, Caitlyn Moss, Steve Chung","doi":"10.53785/2769-2779.1106","DOIUrl":"https://doi.org/10.53785/2769-2779.1106","url":null,"abstract":"Abstract Diffuse large B cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma that can present in a variety of ways including fever, weight loss, weakness, and drenching night sweats. Uncommonly, hypercalcemia of malignancy can be associated with DLBCL through multiple mechanisms that include synthesis of parathyroid hormone related peptide (PTHrP) or elevated calcitriol levels. It is estimated that hypercalcemia in the setting of DLBCL is present in 18% of newly diagnosed cases. This report details a case of an 80-year-old man with history of chronic anemia and CKD stage 3b that presented with weakness, decreased oral intake, and self-reported weight loss. Initial labs showed a corrected calcium of 14.1 mg/dL and normal phosphorous and alkaline phosphatase levels. PTH was decreased at 4 pg/mL. Serum protein electrophoresis and skeletal survey were unremarkable. A continued anemia of 8.1 g/dL in the setting of hypercalcemia prompted further investigation with endoscopy and colonoscopy which showed a large malignant-appearing mass in the mid gastric body. Pathology identified the mass as DLBCL germinal center type. Labs taken after endoscopy reported elevated 1,25-dihydroxyvitamin D levels, consistent with vitamin-D induced hypercalcemia seen in DLBCL. This case report highlights an uncommon yet important presentation of DLBCL. It is imperative that a differential diagnosis for undifferentiated hypercalcemia in an older patient should include malignancies such as DLBCL and workup should include extrarenal causes of hypercalcemia such as PTHrP production and calcitriol levels. Abstract Diffuse large B cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma that can present in a variety of ways including fever, weight loss, weakness, and drenching night sweats. Uncommonly, hypercalcemia of malignancy can be associated with DLBCL through multiple mechanisms that include synthesis of parathyroid hormone related peptide (PTHrP) or elevated calcitriol levels. It is estimated that hypercalcemia in the setting of DLBCL is present in 18% of newly diagnosed cases. This report details a case of an 80-year-old man with history of chronic anemia and CKD stage 3b that presented with weakness, decreased oral intake, and self-reported weight loss. Initial labs showed a corrected calcium of 14.1 mg/dL and normal phosphorous and alkaline phosphatase levels. PTH was decreased at 4 pg/mL. Serum protein electrophoresis and skeletal survey were unremarkable. A continued anemia of 8.1 g/dL in the setting of hypercalcemia prompted further investigation with endoscopy and colonoscopy which showed a large malignant-appearing mass in the mid gastric body. Pathology identi fi ed the mass as DLBCL germinal center type. Labs taken after endoscopy reported elevated 1,25-dihydroxyvitamin D levels, consistent with vitamin-D induced hypercalcemia seen in DLBCL. This case report highlights an uncommon yet important presentation of DLBCL. It is imperative that a differential diagn","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81986151","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":"Features of Thyroid Function in Patients with Metabolic Syndrome","authors":"Z. Djuraeva, A. Davranova","doi":"10.48112/acmr.v3i2.33","DOIUrl":"https://doi.org/10.48112/acmr.v3i2.33","url":null,"abstract":"According to the results of the largest epidemiological studies, the prevalence of hypothyroidism in women is 4-21% and 3-16% in men and is characterized by a significant increase in its frequency among older people. In this connection, the study of the relationship of these diseases is relevant in order to improve diagnosis and treatment. We came to the conclusion that in patients suffering from MS average TSH level is higher than in people of the same age without metabolic syndrome, and with an increase in the number of MS components, a decrease in the functional activity of the thyroid gland occurs.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87450203","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":"Efficiency of Monoclonal Antibodies Application against Covid-19","authors":"Amonov Erkin, Bazarova Sayyora, Saatov Ziyovuddin","doi":"10.48112/acmr.v3i2.34","DOIUrl":"https://doi.org/10.48112/acmr.v3i2.34","url":null,"abstract":"Despite the 20 years history of pathogenic coronavirus infection, methods of prevention and treatment of diseases caused by this infection were not developed yet. One of the reasons could be the features of pathogenesis and a quick spread of the pandemic which may have made researches more complicated. As an inflammatory process develops, a generalization of infection also develops. A cytokine secretion becomes rockets up, Interferon-γ (IFN-y), interleukin-1(IL-1), interleukin-6 (IL-6), interleukin-12 (IL-12), concentration increases. To put it in other words, the primary inflammatory reaction enters a new phase — the cytokine storm phase. In this regard, adequate therapy aimed at stopping the uncontrolled process induced not so much by viremia as by the inflammation associated with it becomes crucial. Therefore, the aim of our research was to study the impact of monoclonal antibodies, in particular the drug \"Kazirivimab + Imdevimab\" — a combination of recombinant monoclonal antibodies aimed against S-protein on the clinical course and laboratory data in patients with a new coronavirus infection – Covid-19.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79190628","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 Use of Leukotriene Inhibitors as Basic Therapy in Children with Bronchial Asthma","authors":"Zebo Norboboevna Sherova, KamolaYuldashevna Normatova, Kamala Shakhamdamovna Shaabidova","doi":"10.48112/acmr.v3i2.31","DOIUrl":"https://doi.org/10.48112/acmr.v3i2.31","url":null,"abstract":"In the pharmacotherapy of bronchial asthma, a \"step-by-step\" approach is recommended, which includes an increase or decrease in the volume of therapy, depending on the severity of clinical symptoms. In complex therapy, it is possible to use non-drug methods of treatment, although the effectiveness of some of them is debatable and needs further study. To achieve this goal, children over the age of 3 years (the group of patients consisted of 26 children) with different forms and degrees of severity of bronchial asthma were included in the study. Patients of the main group took L-Montus (montelukast), children of the ketotifen comparison group. Leukotriene receptor antagonists (montelukast, zafirlukast) are the first mediator-specific therapy of AD and represent a new therapeutic class of drugs in the treatment of the disease. The effectiveness of leukotriene receptor antagonists has been proven in randomized clinical trials among adults and children with bronchial asthma. Leukotriene receptor blockers, in particular L-Montus relieves the symptoms of AD and is a drug for the basic therapy of this disease, leads to a significant improvement in control, reduces the frequency of exacerbations of AD caused by viral infection in children aged 3-5 years. It has an anti-inflammatory effect, complementary to the action of glucocorticosteroids.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90637273","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":"Knowledge and Attitude towards Psychiatry among Nursing Staffs in Tertiary Health Care Hospital","authors":"Z. Djuraeva, G. Togaeva, A. Davranova","doi":"10.48112/acmr.v3i2.32","DOIUrl":"https://doi.org/10.48112/acmr.v3i2.32","url":null,"abstract":"Type 2 diabetes mellitus (DM) is one of the most common noncommunicable diseases on the globe. If at present the number of patients with diabetes in the world is 347 million people, then by 2025, according to scientists, this figure will reach at least 592 million, of which 90% will be in diabetes. Global trends in the incidence of type 2 diabetes are also observed in Uzbekistan. The total number of patients with diabetes in Uzbekistan amounted to 230610 (706.24 per 100 thousand people), of which type 1 diabetes – 18349 (56.2 per 100 thousand people), type 2 diabetes – 212261 (650,0 per 100 thousand people). As a percentage, patients with type 1 diabetes of the total number of patients with diabetes is 8.0%, patients with type 2 diabetes are 92.0%. Maintaining a constantly normal or near normal concentration of glucose in the blood slows down the onset and progression of late complications of type 2 diabetes. In the absence of achieving the target glycemic values against the background of the use of a rational combination of oral hypoglycemic drugs, it is shown that baseline action is added to insulin treatment to suppress liver gluconeogenesis and normalize fasting glucose. The combination of sulfonylurea derivatives (PSM) and basal insulin has been well studied and has proven. In addition, the combined use of metformin and insulin was widely used in the treatment of patients with type 2 diabetes mellitus (T2DM), however, at present there is no evidence base in favor of their joint appointment.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90551127","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}