Journal of general practice (Los Angeles, Calif.)最新文献

{"title":"A Case Report of Severe Anemia in a North Indian Surrogate Mother","authors":"A. Mani","doi":"10.4172/2329-9126.1000326","DOIUrl":"https://doi.org/10.4172/2329-9126.1000326","url":null,"abstract":"Recently, our unit tackled a case of severe anemia in a surrogate mother during the third trimester of a twin \u0000 pregnancy. Her hemoglobin was just 5 g/dl, whereas the normal range should ideally be within the range of 12 g/dl \u0000 to 14 g/dl. Due to timely intervention, we managed to avoid complications. However, it is important to discuss this \u0000 case, as it is found that in the Assisted Reproductive Technology (ART) centers worldwide, multiple embryo transfers \u0000 is preferred over single embryo transfers, which often result in higher morbidity and mortality in mothers and infants.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45946963","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":"How do Family Doctors Cure, Resolve, and Treat?","authors":"J. Turabián","doi":"10.4172/2329-9126.1000E118","DOIUrl":"https://doi.org/10.4172/2329-9126.1000E118","url":null,"abstract":"The usual biomedical approach to \"cure\" is to consider that the family doctor does it by means of drugs, usually has a quantitative meaning (\"90% cases are resolved ...\"), and it is considered dichotomous (cure-yes/no). But, the sense of healing/resolution is qualitative and occurs in a non-dichotomous continuum. Many diseases in Family Medicine are self-limited or have no cure, so it can be assumed that many of the medical pharmacological treatments are useless. The concept of healing or resolution should be seen in Family Medicine as facilitating the unlocking of a situation, change or move from one setting to another. It is the result of the action that gives rise to a new scenario. Healing takes place through the encounter of a person with other people (healing is a \"relational\" concept, of adjustment or change in the matrix of relationships or connections), rather than through interventions in the body or mind of the individual isolated. Healing involves in one way or another return of the part to the whole.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000E118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49611622","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 Need for Clearance in Relaxation Therapy: Development of the Relaxation Clearance Tool for Practitioners","authors":"Mavis Asare, S. Danquah","doi":"10.4172/2329-9126.1000324","DOIUrl":"https://doi.org/10.4172/2329-9126.1000324","url":null,"abstract":"Relaxation therapy is one of the widely used therapies conducted in clinical psychology practice. The purpose of relaxation is to reduce tension in the various muscles in the body system. Relaxation therapy is considered a noninvasive intervention and is effective in treating a number of stress-related conditions. Both young people and adults benefit from relaxation therapies. Though this intervention is non-invasive, there is a need for proper screening of patients especially elderly clients and people with special conditions before relaxation therapies are conducted. Failure to screen individuals may result in some complications for the client in treatment. A clinical tool has therefore been developed to guide and help practitioners adequately screen their clients for relaxation therapy. At the end of the tool is an agreement section to be signed by the client and therapist before the relaxation therapy procedure.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42556753","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":"Ultrasound Value in the Early Diagnosis and Exclusion of Idiopathic Hypertrophic Pyloric Stenosis: 10 Years Experience at Babylon Governorate","authors":"Ahmed. S. Resheed","doi":"10.4172/2329-9126.1000323","DOIUrl":"https://doi.org/10.4172/2329-9126.1000323","url":null,"abstract":"Background: Idiopathic Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical conditions of early infancy, presenting in 1.5 to 4 per 1000 live births. Despite this high prevalence, the precise etiology remains poorly understood. The diagnosis is made primarily with history and physical examination. Projectile, non-bilious vomiting is the classic presentation of an infant with IHPS. The typical physical exam findings include visible peristaltic waves and palpation of the olive mass in the upper abdomen. In the absence of a palpable mass, an upper gastrointestinal (UGI) barium study or ultrasonographic evaluation will usually make the diagnosis. Ultrasound is the preferred modality to diagnose IHPS. Demonstration of pyloric muscle thickness of 3.5 mm to 4 mm or more and pyloric channel length of 16 mm or more increases the specificity of the ultrasound to 100%. \u0000Objectives: This prospective study aims to evaluate the ultrasonographic accuracy in the diagnosis and exclusion of Idiopathic Hypertrophic Pyloric Stenosis in infants presenting with non-bilious vomiting and no palpable pyloric mass, suspected to have IHPS. \u0000Patients and Methods: Prospective study carried out between June 2006 and June 2016 at Babylon Maternity and Pediatric Teaching Hospital. One hundred forty-six (146) infants suspected of having IHPS presenting with nonbilious vomiting and no palpable pyloric (olive) mass were enrolled in this study. All infants sent for abdominal ultrasound examination. The sonographic findings categorized as positive and negative IHPS. Surgery done for patients as indicated according to diagnostic positive criteria and the operative findings compared to ultrasound findings. \u0000Results: Sixty-nine (69) infants with positive ultrasound criteria underwent surgery and the diagnosis was confirmed intra-operatively for (67) patients, while negative for (2) infants. In (77) infants with negative ultrasound criteria, the diagnosis of IHPS excluded for (75) patients, and all observed and treated conservatively as pylorospasm or chalasia (Gastro-esophageal reflux), only 2 patients then need pyloromyotomy. About 88% of patients with positive ultrasound criteria (69) diagnosed from third to sixth week of age and about 12% of patients in this study were diagnosed later. Sensitivity and the Specificity of ultrasound to confirm the diagnosis of (IHPS) in this study were 97.1% and 97.4% respectively. \u0000Conclusion: Ultrasonography is the investigation of choice for early diagnosis of IHPS before significant fluid and electrolyte imbalance occur. It is cost effective, rapid, harmless, non-invasive procedure mostly available and easy to perform. It’s the method of choice for both diagnosis and exclusion of pyloric stenosis. Indication for surgical interference could safely be based on positive ultrasound result.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47446209","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 Cyclist's Heart","authors":"G. C. Newell","doi":"10.4172/2329-9126.1000325","DOIUrl":"https://doi.org/10.4172/2329-9126.1000325","url":null,"abstract":"I started to notice when I would begin a ride a burning sensation in my throat and a deep ache in the palm of my hands. I thought at first that the throat burning was due to the recent sanding of the floors in my house and that the hand ache was that my cycling gloves were too tight. I offhandedly told my wife I was having these symptoms. She said get a stress test. I thought she was wrong-so I went to my Chief of Medicine who said “Glenn you are the healthiest guy I know, but when the wife says get a stress test then get one”!","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48404904","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":"How Serious is ADHD","authors":"R. Eme","doi":"10.4172/2329-9126.1000321","DOIUrl":"https://doi.org/10.4172/2329-9126.1000321","url":null,"abstract":"Even though there are well over 20,000 studies of Attention-Deficit/Hyperactivity Disorder (ADHD), it is still viewed with skepticism by some and often remains stigmatized by the media. Hence, given the continuing challenges to the validity of ADHD, this article provided a concise overview of the evidence that establishes ADHD as brain disorder associated with a set of well-defined symptoms that causes serious impairment in many life activities.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44117994","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":"How to Reach Effective Health Service Delivery","authors":"Ann-Christine Andersson","doi":"10.4172/2329-9126.1000320","DOIUrl":"https://doi.org/10.4172/2329-9126.1000320","url":null,"abstract":"This means that health care need to get back to a more holistic view on what care is. It also includes more co-production [1], not only between care givers and their patient, but also between different caregivers across organizational boundaries. The biggest challenge to health care and social services today is how to produce the best and most effective and efficient care to all people in need. Public organizations are put under hard finical pressure, and new technology is good, but costly. Therefore, it would be even more important to cooperate in the future.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44739700","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":"Left Ventricular Rupture in Transmural Myocardial Infarction WithoutEnzymatic or Electric Disturbances: Medico-legal Implications","authors":"M. A. Mesrati, Marwa Boussaid, Y. Mahjoub, M. Sahnoun, M. Boughattas, A. Chadly, A. Aissaoui","doi":"10.4172/2329-9126.1000319","DOIUrl":"https://doi.org/10.4172/2329-9126.1000319","url":null,"abstract":"Background: The early and accurate diagnosis of acute myocardial infarction may be a challenging task for doctors in the emergency room. The patient’s history, electrocardiographic and cardiac markers data are sometimes non diagnostic and misleading which may lead to death. In this case, physician’s responsibility may be engaged. Case report: A 48-year-old man was admitted in the Emergency Department because of chest pain. Exploration (Percritical ECG, enzymatic levels and transthoracic echocardiogram) did not show any abnormality. He received a symptomatic treatment and was allowed to return home. The patient was confined to bed during his stay at home because of persisting chest pain. Two days later, he presented syncope and arrived dead to hospital. At autopsy, an abundant hemopericardium made by coagulated blood was noted, associated with an obstruction of the circumflex of about 90% of its light. A rupture of the myocardium was repaired in the lateral wall of left ventricle, surrounded by a semi recent infarction. Discussion: The peculiarity of this case is the difficulty of the diagnosis of the myocardial infarction because of the normality of the enzymatic assessment and the absence of electric modifications during the crisis and two hours later. Misdiagnosed cases can lead health professionals to legal suits. The claims about diagnostic error can be usually subject to trials in both of penal judgment and compensation trial.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47681045","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 New-born with Severe Hydrocephalus and Myelomeningocele Associated with Maternal Antiepileptic Medication: A Case Report","authors":"Juyoung Lee, Soo Kyung Nam, Y. Jun","doi":"10.4172/2329-9126.1000318","DOIUrl":"https://doi.org/10.4172/2329-9126.1000318","url":null,"abstract":"The possible teratogenic effects of maternal antiepileptic drugs (AEDs) on the development of the fetus are of major concern. The fetal risks imposed by these drugs must be weighed against the risks associated with untreated maternal epilepsy not being treated. Here, we describe an infant with a neural tube defect caused by AEDs prescribed to the mother during her pregnancy. A female infant was delivered by means of cesarean section after 37+6 weeks of gestation. Her 21-year-old mother had been diagnosed with epilepsy at 2 years of age, following brain surgery performed for a traffic accident injury. Since the age of 6 years, the mother had been medicated with lamotrigine (Lamictal®), levetiracetam (Keppra®), and valproate (Depakote®). At birth, the baby exhibited pallor, severe macrocephaly, a large anterior fontanelle (4 cm × 4 cm), and sutural widening. On her lower back, there was a 3 cm open spinal dysraphism exposing nervous tissue. On the 11th postnatal day, a ventriculo-peritoneal shunt was placed and a myelomeningocele removal operation was performed. After this operation, the head circumference decreased from 44.0 cm to 35.8 cm, and the post-operative period was uneventful. The patient was discharged on the 24th day. Several case reports and studies have reported that valproate or multi-antiepileptic medication that contains valproate increased the risk of neural tube defects in the offspring. For women of childbearing age who use AEDs, clinicians should review pregnancy risk regularly and consider adjusting medication whenever possible. Additionally, while examing newborns with neural tube defects, clinicians should review prenatal maternal medication history thoroughly.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46247748","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":"Co-medication with Cannabidiol May Slow Down the Progression of Motor Neuron Disease: A Case Report","authors":"G. Nahler","doi":"10.4172/2329-9126.1000316","DOIUrl":"https://doi.org/10.4172/2329-9126.1000316","url":null,"abstract":"Amyotrophic lateral sclerosis (ALS, also called Charcot disease, Lou Gehrig disease), is a progressive, neurodegenerative disease caused by the degeneration of motor neurons in the brain and spinal cord. There is no cure. This report describes a case of motor neuron disease with typical weakness in one leg, one hand and the tongue. Despite of treatment with riluzole, symptoms progressed relatively fast. Therefore, the patient decided to take cannabidiol (CBD, 2 × 200 mg/day) as co-medication, which was started 8 weeks after riluzole, and increased to a daily dose of 2 × 300 mg. Within 6 weeks, the impaired function of the right hand and foot reversed almost completely and dysphagia partially. Improvement was maintained for about 10 weeks, when again a slow progression of dysarthria and dysphagia was observed. Eighteen months after onset, speech is almost completely lost, and dysphagia also progressed. However, symptoms of the limbs (weakness, fasciculation, atrophy) worsened much less. It is concluded, that Co-medication with CBD may be able to slow down the progression of some but not all symptoms of motor neuron disease.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"2017 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70285376","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}