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Table of Contents
April-June 2015
Volume 10 | Issue 2
Page Nos. 45-71
Online since Thursday, July 16, 2015
Accessed 8,471 times.
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ORIGINAL ARTICLES
A study of acute ST elevation myocardial infarction in young patients from government teaching hospital
p. 45
Chirayu Vijaykumar Vaidya, Drusty Krishnasevak Majmudar
DOI
:10.4103/1858-5000.160939
Context:
Myocardial infarction (MI) is being recognized in a younger age group in recent years. MI in the young adult may differ from that in the elderly by virtue of its greater incidence of risk factors and atherosclerotic etiology, the heavy preponderance of male patients.
Aims:
The aim of this study was to study clinical profile, risk factors, complications, infarct type, management, and outcome in patients 45 years or younger (young) admitted with acute ST elevation MI at a Government teaching hospital in Gandhinagar, Gujarat.
Subjects and
Methods:
This is a retrospective study of all new young patients managed for acute ST elevation MI in ICCU of GMERS Medical College and Hospital, Gandhinagar, Gujarat from January 1, 2012 to December 31, 2013. Data were analyzed with SPSS version 21 software.
Results:
The mean age of 40.95 years with (89%) males and, (11%) females and male to female ratio was 8.1:1. Most patients (58.9%) were from 41 to 45 years age. The most common clinical presentation was chest pain and sweating (97.3% vs. 11%). Most patients (65.8%) arrived in hospital within 6 h from the onset of symptoms. The most common area of infarction was anterior wall and inferior (61.3% vs. 22.7%). The most common risk factor was smoking (40.7%) followed by hypertension (20.3%) and dyslipidemia (15.3%). The most common complication was arrhythmias (24.65%) followed by recurrent ischemia (12.3%). Most (78.7%) received thrombolysis. In hospital, death was 9.3%.
Conclusion:
In young acute ST elevation myocardial infarction, smoking is the most important risk factor. These patients have better outcome and prognosis.
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Hand-washing practices and techniques among clinical students of Bayero University Kano, Nigeria
p. 51
Abdulsalam Mohammed, Ibrahim Aliyu
DOI
:10.4103/1858-5000.160942
Background:
Hand-washing is an important and a single most cost-effective and practical measure that reduces the incidence of infection and cross infection among health-care providers and patients. However, compliance of health-care workers to hand hygiene guidelines are reportedly poor. It is important, therefore, to instill adequate knowledge and good attitudes and practices at the time of primary training of future health-care workers.
Materials
and
Methods:
This was a descriptive cross-sectional study carried out among randomly selected clinical students of Bayero University Kano. The questionnaires were administered to the students during their daily ward rounds and clinic sessions.
Results:
One hundred and thirty-seven medical and nursing students of Bayero University Kano, who were on clinical posting were studied. Sixty-three (46%) students were aware of the Global Hand-washing day (
χ
2
= 5.989, df = 2,
P
= 0.050). Only 16 (11.7%) students were able to state correctly the Global Hand-washing date. One hundred and thirty-one (96%) students believe that hand-washing if correctly done can reduce the risk of infection. One hundred and fourteen (83.2%) students were taught hand-washing technique (
χ
2
= 6.862, df = 1,
P
= 0.009). One hundred and twenty-two (89.1%) of the students use soap and water or hand rubs in washing their hands. One hundred and two (74.5%) students are not aware of the World Health Organization five moments of hand-washing hygiene. Only 13 (9.5%) students were able to mention the steps of hand-washing correctly (
χ
2
= 10.285, df = 2,
P
= 0.006). Eighty-six (62.8%) students adhere to the principles of hand-washing in their clinical postings (
χ
2
= 4.404, df = 1,
P
= 0.036). Seventy-two (52.6%) students wash their hands before handling patients (
χ
2
= 7.575, df = 1,
P
= 0.006), but the majority 130 (94.9%) of them wash their hands after handling patients.
Conclusion:
There is a need for continuous teaching of medical and nursing students on the correct hand-washing techniques and to inculcate in them the habit of hand-washing before and after touching patients. This will greatly improve the safety of the potential health-care providers and patients.
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The centre for professional development, the national university-Sudan: Evaluating the achievements
p. 57
Wisal OI Gameel, Asim QM Ali
DOI
:10.4103/1858-5000.160945
Background:
The National University-Sudan is a private university, in Sudan that has been established in 2005. It consists of eight colleges: Medicine, pharmacy, dentistry, nursing, medical laboratories, physiotherapy, and administrative sciences. The Centre for Professional Development (CPD) was established in 2010. The aim was to provide and organize training for academic, administrative, and information technology staff. The plan was to have a basic phase focusing on the provision of basic concepts and skills. With the basic phase coming to an end, this paper is a review of both the achievements of the center and the setbacks, in the period between 2011 and 2013.
Methodology:
Data were collected from the needs assessment forms, meetings, activity evaluation forms filled by participants by the end of each activity, attendance sheets, the annual CPD reports, and discussion with different faculty members. The collected data were analyzed using Excel program.
Results:
On comparing the faculty attendance per college in 2011-2012 and 2012-2013, a decline in the attendance was found in radiography (from 59.09% to 28.48%) and in medicine (from 28.52% to 15.8%). On the other hand, the faculty attendance from dentistry rose from 20.91% to 33.3%. The same trend was found in pharmacology with a rise from 21.43% to 36.67%. In nursing and physiotherapy, there was an increase in the percentage of trained staff to 6.75% and 1.25%, respectively. In both years, participation from the faculty of administrative sciences was weak.
Conclusion:
There was an increase in the total percentage of faculty members attending from 2011 to 2013. Yet, the details of academic staff attendance show a lot of variation between the 2 years with some faculties attending more activities while others have a declining attendance. While the use of attendance records was useful in reflecting the response of the academic staff to the CPD activities, it did not reflect the actual role played by the CPD as an advisory body to individual faculties or staff members.
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Topical phenytoin for managing various ulcers: A meta-analysis
p. 63
Pugazhenthan Thangaraju, T Tamilselvan, Sajitha Venkatesan, T Eswaran, Hosanna Singh, VC Giri, MK Showkath Ali
DOI
:10.4103/1858-5000.160951
Objective:
The aim of this meta-analysis was to evaluate the efficacy of topical phenytoin in the treatment of ulcers of different origin compared with other standard topical treatment.
Methods:
Randomized controlled trials were identified by searching PubMed, Embase, Medline, and Web of Science. Outcomes were complete wound healing rate and reduction in wound volume or surface area.
Results:
Thirteen studies with 980 patients were included. Topical phenytoin were associated with a statistically significant improvement of complete wound healing rate compared with other line of management in 11 randomized control trial of 815 patients (odds ratio = 3.03, 95% confidence interval 2.23-4.10, Z = 7.14,
P
< 0.00001). No publication bias exists in this meta-analysis. Three studies from India also confirmed that the topical phenytoin was associated with a statistically significant percent reduction in wound volume compared with the other dressing (mean difference 23.56, 95% confidence interval 19.48-27.64, Z = 11.32,
P
< 0.00001).
Conclusion:
The existent evidence shows that topical phenytoin is more effective for ulcer treatment.
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CASE REPORT
Congenital bilateral anophthalmia: A case report and review of the literature
p. 69
Ibrahim Aliyu, Safiya Gambo, Peter David Igoche
DOI
:10.4103/1858-5000.160954
Anophthalmia is congenital absence of the eyes; it may be unilateral or bilateral. Though rare, it occurs worldwide. It usually occurs in association with other systemic malformations particularly cardiac, musculoskeletal and central nervous system abnormalities. Therefore, the case of a female child delivered in our facility who was subsequently admitted into the special care baby unit on account of respiratory distress and bilaterally absent eyes is reported. She had ocular and brain computer tomography scan that showed under development of both globes and hypogyria; chest X-ray showed bilateral patchy opacities only, electrocardiography and abdominal ultrasound scan were normal while echocardiography revealed trivial tricuspid regurgitation with shunt lesions: Perimembranous ventricular septal defect of 5.4 mm and a secundum atrial septal defect of 5 mm. She is followed-up in both the ophthalmology and pediatric cardiology clinics.
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