Case report: contrast imaging in the setting of venous thrombosis
Published on: 28th February, 2023
Disruption to contrast agent supply chains for radiology investigations has become an additional consequence of the COVID-19 pandemic. Various recommendations, including dose reductions and choices of alternative agents, have been made to help account for this limited availability. This case demonstrated how two separate CT venograms with different contrast agents, undertaken on the same day for the same patient, yielded different results; venous thromboses were more prominent in the subsequent scan. Although there was some evidence of venous sinus thrombosis on the first scan, repeat imaging was required to further characterize the lesions identified. The case exemplifies the notion that diagnostic imaging should always be guided by a detailed history and examination. It also raises the discussion point of whether more strict or uniform protocols should be developed to facilitate contrast administration for radiology investigations. It is important that appropriate doses are always administered to maximize diagnostic yield.
Atherogenic risk assessment of naive HIV-infected patients attending Infectious Diseases Service of Kinshasa University Teaching Hospital, Democratic Republic of the Congo (DRC)
Published on: 13th October, 2020
OCLC Number/Unique Identifier: 8689021635
Background and aim: Metabolic abnormalities are common in HIV/AIDS. Increasingly, lipid ratios are used as screening tools for dyslipidaemia in these medical conditions. The aim of this study was to assess the ability of 4 lipid ratios to predict cardiovascular risks.
Methods: This is a cross-sectional and analytical study included 105 HIV+ patients followed in Kinshasa University Teaching Hospital (KUTH). Four indices [Atherogenic Index of Plasma (AIP), Castelli Risk Index (CRI) I and II, Atherogenic coefficient (AC)] were compared. Statistical analyzis consisted of measuring frequencies and means, Student’s t-tests, ANOVA and Ficher’s exact test, and the calculation of the Kappa value.
Results: Lipid ratios predicted respectively the risk in 62% (AIP), 28.6% (CRI-I) and 23.8% (CRI-II). CRI-I and II were elevated, especially in women. The AIP appeared to be a better predictor than CRI-I and II to assess dyslipidaemia in general and the high-risk frequency. The cholesterol detected risk in 66.7% (Low HDL-C), 50% (High LDL-C), 38.9% (High TC and/or TG).
The atherogenic risk was higher with age, advanced WHO stage, HIV-TB, HBV-HCV co-infections, smoking and alcohol intake. Haemoglobin (Hb) and CD4 counts were low when the risk was high. Age ≥ 50 years, stage 4 (WHO), CD4s+ ≤ 200 cells/µL were independent factors associated with atherogenic risk.
Conclusion: Lipid ratios can be used as reliable tools for assessing cardiovascular risk of naïve HIV-infected patients who received HAART.
Intersecting Pathways: Examining Hildegard Peplau's and Rosemarie Parse's Nursing Theories through a Comparative Lens
Published on: 12th September, 2023
Background: Nursing theories are organized bodies of knowledge providing a way to define nursing as a unique discipline that is separate from other disciplines. As a profession, nursing is committed to recognizing its own unparalleled body of knowledge vital to nursing practice and science. Nursing is a science based on the theory of what nursing is, what nurses do, and why.Aim: This paper aims to elucidate the practical application of Hildegard Peplau's and Rosemarie Parse's nursing theories, individually and in synthesis, in modern nursing practice. Key points: These include a) Hildegard Peplau's Theory of Interpersonal Relations emphasizes the nurse-patient relationship, therapeutic communication, and the continuous search for improvement in patients, even those facing mental health challenges. b) Rosemarie Parse's Theory of Human Becoming underscores the uniqueness of each patient's lived experiences, the significance of "meaning" in health experiences, "rhythmicity" in patterns, and the potential for "transcendence" and growth. c) Integrating Peplau's and Parse's theories promotes holistic patient-centered care, compassionate and empathetic nursing, enhanced communication skills, patient autonomy, cultural competence, continuity of care, and a deep respect for human dignity. d) By embracing both theories, nurses can provide comprehensive, compassionate, and patient-centered care that respects each patient's individuality and capacity for growth.Conclusion: The synthesis of Hildegard Peplau's and Rosemarie Parse's nursing theories offers nurses a comprehensive framework for modern nursing practice. It guides nurses in providing high-quality, patient-centered care that preserves human dignity and recognizes the uniqueness of each patient. Drawing from multiple theoretical perspectives enhances nursing practice and ensures the well-being of patients in today's evolving healthcare landscape.
Femoral venous closure: A single-centre retrospective analysis in real world all comers with MynxGrip® vascular closure device
Published on: 18th June, 2020
OCLC Number/Unique Identifier: 8628667812
Background: Vascular closure devices (VCD) are routinely used to achieve haemostasis following percutaneous arterial procedures. The extravascular polyethylene-glycol based MynxGrip® device (Cardinal Health) received FDA approval for use in the closure of femoral veins, but so far limited data is available on its use, especially with concomitant use of anticoagulants.
Method: This is a retrospective analysis of data from a single-centre on the effectiveness and complication rates following the use of the MynxGrip® device for femoral venous closure in patients undergoing diagnostic/interventional (temporary pacing during balloon aortic valvuloplasty, or electrophysiology) procedures utilising 5-7F sheaths.
Results: 85 patients (mean age 74 years) underwent femoral venous closure with the MynxGrip® device. 51.8% were male. The rate of concomitant anticoagulant or antiplatelet use was 52.9%. Device deployment was 100% successful with full haemostasis in all cases. There were no major vascular complications (bleeding, thrombosis, or infections). There was one case of a minor small venous hematoma which did not require treatment. The mean length of stay was less than 1 day (67.1% patients discharged the same day) and overnight stay only indicated by interventional procedure.
Conclusion: These data support safety and efficacy of the MynxGrip® device for femoral venous closure with same-day discharge, even with concomitant aggressive antiplatelet and anticoagulant use. It has the potential for use in other large bore venous access sites.
Teledentistry and Digital Therapeutics (DTx) for dentistry
Published on: 5th August, 2022
Due to the global pandemic spread of COVID-19, the medical field has experienced many changes [1]. One of the main changes is the attention to Telemedicine (Digital Medicine), which is a part of Digital Health. The combination of ‘Digital’ and ‘Dentistry’ can be awkward because dental treatment is often conducted face-to-face with clinical treatment, but it is planned to proceed with the inevitable flow of the times [2,3]. In addition, Digital therapeutics (DTx), a part of digital dentistry, is a narrower concept and has an evidence-based effect on diseases. This article contains opinions on the concept and current status of Teledentistry and the application of DTx [4].
Chemical constituents and biological activities of Artocarpus heterophyllus lam (Jackfruit): A review
Published on: 20th January, 2021
OCLC Number/Unique Identifier: 8987258409
Artocarpus (Moraceae) is a deciduous tree with appreciable importance as a source of edible fruit and is widely used in folk medicines. The extracts and metabolites of Artocarpus heterophyllus particularly those from leaves, bark, stem and fruit possess several useful bioactive compounds. This review indents to compile various studies on A. heterophyllus and critically evaluates its ethnomedical and ethnopharmacological properties. Several pharmacological studies from A. heterophyllus have conclusively established their mode of action in anti-inflammatory, antimicrobial, antioxidant and anticancer activities. Based on the available data, it is concluded that Artocarpus as a promising source of useful products and opens up new avenues for novel therapeutics.
‘Life-Changing Bubbles’ – How carbonated water can relieve swallowing problems for many dysphagia sufferers worldwide
Published on: 15th March, 2023
Today, there are said to be some 590 million people of all ages around the world, who are suffering from a range of swallowing problems – probably about 4 million in the UK. Either living at home or as residents in some 20,000 Care Homes, with perhaps another 25,000 as patients in hospitals every day.Professor David Smithard, of the Lewisham and Greenwich NHS Trust, has been leading a national campaign for some years to raise general awareness of Dysphagia and to improve the treatment of patients with varying conditions. He and his team at the Queen Elizabeth Hospital have now completed a detailed Review of the use of carbonated water (CW) in the treatment of Dysphagia, which has just been published and can be accessed here: https://www.mdpi.com/2308-3417/8/1/6The Review concludes that further evidence-based research is essential before CW can be adopted as standard in clinical practice – but that although the amount of evidence is small, there is a suggestion that swallows are safer and that secretion management improves, and consequently until further studies are undertaken, Carbonated Water should be limited to individual patient use.My experience as a Dysphagia sufferer is that the use of CW has resulted in life-changing benefits, and this paper is devoted to describing how CW worked for me, and what the practical requirements are, so that many others may be able to benefit as I have done. The paper has three sections: My Personal Experience, Practical Considerations, and Conclusions.
A case of true hermaphroditism: presenting as congenital bilateral inguinal hernia
Published on: 20th March, 2023
True hermaphroditism (TH) is a cause of intersexuality in which both ovarian and testicular tissue is present in the same individual [1]. The gonadal distribution in cases of true hermaphroditism varies from [2]
The factors associated with mental health and the impact of COVID-19
Published on: 11th August, 2022
OCLC Number/Unique Identifier: 9591348162
The mental health impact caused by COVID-19 on adolescents was reviewed, and due to limited data, adult results were included, to support our assertion that additional mental health resources are needed for both adult and young people. Positive gains would include improved socio-emotional skills, a decrease in maladaptive behaviors contributing to the disruption in interpersonal relationships and lifetime achievements, suicide attempts and psychopathology, persistent mental health concerns found in the juvenile justice and foster care systems and substance use addiction later in adulthood (The American Psychological Association, 2019; Garber & Weersing, 2010; Office of Juvenile Justice and Delinquency Prevention, n.d.; Tomasello, 2018;). Geiger & Davis, 2019, found that 13% or 3.2 million United States (U.S.) teenagers aged 12 - 17 years old experienced at least one major depressive episode with the depression rate increasing 59% from 2007 to 2017. Therefore, we assert that developing programs to overcome barriers to mental health aid can reduce instances experienced in adolescence and adulthood.
Requirement for object-oriented database management systems in forensic science
Published on: 21st March, 2023
The complex requirements of a database system for recording regulated chemicals exceed the capabilities of a relational database system. Inheritance, which is part of object-oriented programming, must also be logically transferred to chemical objects. This issue is illustrated here by means of examples of the Chemical Weapons Convention (CWC) and the German version of the New Psychoactive Substances Law (NpSG).
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