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Dengue Fever in Adults, a Retrospective Study
Mohammed Salah Debes,
Mohamed Al Tayeb,
Momen Faysal Nassani,
Ahmed Abdullah Basaeed,
Anas Dwaima,
Moahmmed Khaldoun Alsaadi,
Hassan Odah
Issue:
Volume 4, Issue 6, November 2016
Pages:
93-100
Received:
8 April 2016
Accepted:
19 July 2016
Published:
10 November 2016
Abstract: Background: Dengue fever is a very common viral infection with potential serious complications and is one of the WHO challenges to limit its spread especially in view of lacking specific treatment or approved vaccine. We noticed over long time frequent cases of dengue fever with some characteristic laboratory findings particularly leukopenia, thrombocytopenia and elevated liver enzymes. These findings sometimes give concerns about safety of the patients so admission and sometimes isolation that could be unnecessary for some patients. Objectives: To present our data about variable clinical presentations and laboratory changes associated with dengue fever infection in adults and complications encountered in our institute in Saudi Arabia. So that we can give recommendations about the diagnosis, management and protection. Methods: We included all dengue fever positive cases starting September 2007 till end of December 2014. The data gathered through tracking the records of patients requested for Dengue fever serology in the main laboratory of the International Medical Centre (IMC). Data for analysis: Age, gender, characteristic laboratory changes, clinical manifestations and complications. Results: Dengue fever is a self-limiting viral infection in the majority of cases. Incidence of dengue infection in males: females is 2:1. Dengue fever manifestations in order of frequency: Fever, body aches, gastro intestinal symptoms, headache, and skin rash and chest symptoms. Incidence of complications in our study was 5.5%.
Abstract: Background: Dengue fever is a very common viral infection with potential serious complications and is one of the WHO challenges to limit its spread especially in view of lacking specific treatment or approved vaccine. We noticed over long time frequent cases of dengue fever with some characteristic laboratory findings particularly leukopenia, throm...
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Health Care Maintenance of HIV Infected Women at a Tertiary Care Center
Mohamed Ali Elkarouri,
Muneerah Mohammed Albugami,
Magid A. Halim Mohamed,
Munirah Abdulrahman Bin Dahham,
Yasmin Ahmed Al Twaijri
Issue:
Volume 4, Issue 6, November 2016
Pages:
101-106
Received:
1 October 2016
Accepted:
26 October 2016
Published:
19 November 2016
Abstract: Introduction: HIV care should change from HIV focused approach to one which addresses chronic diseases, counseling, screening of non-AIDS related malignancies and immunization. Our objectives are to review standard of health maintenance services (screening, counselling and immunization) among HIV infected women and to find the prevalence of co-morbid conditions. Methodology: Retrospective cohort study to review HIV infected women in HIV clinic at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia (KFSH&RC) from January 2008 to December 2012. Results: Among 103 HIV infected women, dyslipidemia accounts for 31.07%, hypertension 16.5%, diabetes mellitus 14.6%, patients who have more than two co-morbid conditions were 24.5%. Vitamin D level was requested for 93.20%. HIV viral load wasn’t detectable in 63.11% and antiretroviral therapy was prescribed for 99.02%. The median latest CD4 lymphocyte count was 725 cells/ µmol. Tuberculin screening test (TST) was done for 5.88%. Screening mammography and Pap smear were done for 37.25%, 13.73% respectively. Colorectal cancer screening was not done in 96.11%. Bone densitometry screening was done for 36.36%. Mental status evaluation was performed for 63.73%. Influenza, pneumococcal, hepatitis B virus and Human Papilloma Virus (HPV) vaccination were received by 93.20%, 49.51%, 17.47% and 1.94% respectively. Counseling for condom use was provided to 64.79% and hormonal contraception/obstetrics referral were done for 49.02%. Conclusion: Our HIV clinic is providing a standard HIV focused patient care. Screening for tuberculosis, malignancies, counseling for hormonal contraception and immunization were deficient. There is high prevalence of cardiovascular risk factors among our patients. There is an urgent need to improve delivery of preventive health care to HIV-infected women.
Abstract: Introduction: HIV care should change from HIV focused approach to one which addresses chronic diseases, counseling, screening of non-AIDS related malignancies and immunization. Our objectives are to review standard of health maintenance services (screening, counselling and immunization) among HIV infected women and to find the prevalence of co-morb...
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Computerized Clinical Pharmacy Management System Improves Prescribing Quality and Rational Antimicribial Use
Xianhua Ren,
Quansheng Ren
Issue:
Volume 4, Issue 6, November 2016
Pages:
107-112
Received:
22 November 2016
Published:
24 November 2016
Abstract: To introduce the increased efficiency and improved health care provision brought by incorporating a certified clinical pharmacy management (CPM) system into an existing hospital information system. Evaluate the appropriateness rate of prescriptions or orders, the rational use of antimicrobial use, and the workflow of clinical pharmacist before and after the adoption of the CPM system. The adoption of the CPM system markedly increased the appropriateness rate of prescriptions and orders by 89% in 2011 as compared to that of 2010. The CPMS decrease the antimicrobial use both in outpatients and inpatients by 47.0% and 51.9 respectively in December 2011 as compared to that of January 2011. The CPMS also streamlined the clinical pharmacist’s workflow and help disseminate medication use knowledge and policies within the hospital.
Abstract: To introduce the increased efficiency and improved health care provision brought by incorporating a certified clinical pharmacy management (CPM) system into an existing hospital information system. Evaluate the appropriateness rate of prescriptions or orders, the rational use of antimicrobial use, and the workflow of clinical pharmacist before and ...
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Left Atrial Size and Risk of Stroke in Patients with Sinus Rhythm and Normal Left Ventricular Systolic Function
Hanan K. Altalhi,
Asgad A. Abdalgbar,
Ali Areef Fadhlullah
Issue:
Volume 4, Issue 6, November 2016
Pages:
113-116
Received:
21 October 2016
Accepted:
2 November 2016
Published:
25 November 2016
Abstract: Increased left atrial (L A) size associated with poor cardiovascular outcome such as development of heart failure, atrial fibrillation (AF) and stroke in the elderly. Objective: The present study was conducted to reevaluate the relationship between la size and stroke in subjects of all ages, not just the elderly who presented with preserved left ventricular systolic function (lvsf) and sinus rhythm (sr). Patients and Methods: This is case control study of 52 patients admitted to the hospital 26 with diagnosis of ischemic stroke (case subject), and 26 patients without ischemic stroke were included as (control subject). The diagnosis of Cerebral infarction was confirmed by a new computer Tomography of Brain All participant underwent the standard examination and testing as well as Echocardiography (measurement of left atrial dimension, Ejection Fraction,Mitral inflow, LV mass), patients with valvular heart disease, atrial fibrillation or coronary disease were excluded. Result: The mean age was 69 ± 18 years in the stroke group and 66 ± 17 years in control group. The LA dimension of stroke group (3.38 ± 0.50 cm) was significantly greater than that of the control group (3.56 ± 0.44cm); P< 0.0001) E&A Velocity showed no significant relation with Stroke (p=NS) Left ventricular mass, left ventricular mass / height and left ventricular mass index were significantly related to stroke (p<0.0001, p= 0.001, p = 0.001, respectively). Conclusion: Echocardiographic left atrial enlargement has prognostic value in identifying a subset of persons at increased risk of stroke.
Abstract: Increased left atrial (L A) size associated with poor cardiovascular outcome such as development of heart failure, atrial fibrillation (AF) and stroke in the elderly. Objective: The present study was conducted to reevaluate the relationship between la size and stroke in subjects of all ages, not just the elderly who presented with preserved left ve...
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Non Rheumatic Atrial Fibrillation as Risk of Stroke
Ali Areef Fadhlullah,
Asgad A. Abdalgbar,
Hanan K. Altalhi
Issue:
Volume 4, Issue 6, November 2016
Pages:
117-119
Received:
21 October 2016
Accepted:
1 November 2016
Published:
25 November 2016
Abstract: Atrial fibrillation (AF) is one of the main risk factor for ischemic stroke. The reason for an increased stroke risk in AF has always been claimed to be the occurrence of left atrial thrombosis causing arterial embolism. In patients with Rheumatic heart disease especially mitral valve stenosis with AF, the frequency of atrial thrombosis has found to be 30 - 42% (Keren G et al. 1987), and the prevalence of left atrial thrombosis in NRAF are higher than in control 13-27% (Petersen P et al. 1988). Objectives: We investigated if there are any differences in risk factors or atherosclerotic manifestations between ischemic brain infarction patients with and without AF? Are the brain lesions characteristics in these patients similar?Patients and Methods: This is a case- control study of 26 patients with acute ischemic stroke and NRAF (case subjects) a and 26 patients with acute ischemic stroke and sinus rhythm. (control subjects). The patients admitted to the hospital; the diagnosis of cerebral infarction was confirmed by new CT of the brain. All the participants underwent the standard examination and testing as well as ECG and ECHO. Result: Patient with NRAF had higher mortality 30% than in control (SR) 7% (P<0.001). NRAF patients had positive brain CT finding 68% compared to 23% of the SR Patients (P<0.001). Conclusion: Brain infarction in non-Rheumatic AF group are more serious than other and therefor make up a (high risk) group for which acute treatment would be specially indicated and primary prophylaxis with anticoagulants might therefore be considered.
Abstract: Atrial fibrillation (AF) is one of the main risk factor for ischemic stroke. The reason for an increased stroke risk in AF has always been claimed to be the occurrence of left atrial thrombosis causing arterial embolism. In patients with Rheumatic heart disease especially mitral valve stenosis with AF, the frequency of atrial thrombosis has found t...
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Theraputic Plasmapheresis in Neurological Disorders, Baghdad/Iraq
Basim Hanoon Jabar,
Bahaa A. Hassan
Issue:
Volume 4, Issue 6, November 2016
Pages:
120-123
Received:
26 October 2016
Accepted:
10 November 2016
Published:
16 December 2016
Abstract: Background: plasma exchange (PE) involves the separation and removal of plasma from corpuscular blood and the replacement of it with various fluids, while plasmapheresis only refers to the removal of plasma. AIM OF STUDY: To study our experience with PE in our 487 patients of different neurological disorders, determined most referring diseases. Materials and Methods: Retrospective study of PE procedures done during a period of 36 months, from January 2013to January 2016 in a neurosciences hospital in Baghdad/Iraq. Data analysis is used SPSS 20. Results: The main indication for PE was CIDP (339 patients; 69.20%). Age of patients ranged from 8-85 (mean = 46.22 years). Up to our knowledge is largeset number of patients used in that period, no mortality found. Conclusion: The analysis of 487 cases of PE done in our department shows that PF is usually well tolerated. Possible adverse reactions mainly relate to vascular access.
Abstract: Background: plasma exchange (PE) involves the separation and removal of plasma from corpuscular blood and the replacement of it with various fluids, while plasmapheresis only refers to the removal of plasma. AIM OF STUDY: To study our experience with PE in our 487 patients of different neurological disorders, determined most referring diseases. Ma...
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A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease
Joyce Akwe,
Scott Steinbach,
Julie Jackson Murphy
Issue:
Volume 4, Issue 6, November 2016
Pages:
131-147
Received:
24 December 2016
Accepted:
7 January 2017
Published:
1 February 2017
Abstract: Over the years, the management of chronic obstructive pulmonary disease has evolved, but given the high mortality and morbidity of COPD, much work still needs to be done. To date, none of the existing pharmacological therapies for COPD has been shown conclusively to modify the long-term decline in lung function. Several trials have been completed to evaluate options that can improve patient symptoms and quality of life. Optimal management of COPD requires both pharmacologic and non-pharmacologic interventions. Some of the non-pharmacologic options for the management of COPD like Oxygen therapy have proven reduction in mortality and mortality, and an improvement in the quality of life. Lung transplant is the only treatment that can stop the decline in lung function. Smoking cessation is the non-pharmacologic intervention with the greatest capacity to influence the natural course of COPD. Pulmonary rehabilitation programs are evidence based, multidisciplinary and comprehensive interventions for patients with COPD. These programs involve patient assessment, exercise training, education, nutrition and psychosocial support. Pulmonary rehabilitation programs are designed to reduce symptoms, optimize functional status, increase participation and reduce health care cost through stabilizing or reversing systemic manifestations of the disease. This article discusses the most used non pharmacologic management of COPD and their usefulness in relieving symptoms and improving the quality of life for patients with severe COPD. These treatment options are used in addition to optimal pharmacologic therapy.
Abstract: Over the years, the management of chronic obstructive pulmonary disease has evolved, but given the high mortality and morbidity of COPD, much work still needs to be done. To date, none of the existing pharmacological therapies for COPD has been shown conclusively to modify the long-term decline in lung function. Several trials have been completed t...
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Pattern of Acute Arthritis in Seventeen Patients with Sarcoidosis
