scholarly journals POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 921.2-922
Author(s):  
M. Yasmine ◽  
K. Maatallah ◽  
H. Ferjani ◽  
W. Triki ◽  
D. Ben Nsib ◽  
...  

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

Author(s):  
Roohi Abbas

Background: Ever since quality of services is gaining importance in every industry as it is the indicator of consumer/customer satisfaction, it is of utmost importance to measure service quality of educational institutes to determine the satisfaction of students. Thus, the study aimed to determine the important factors in service quality dimensions which contribute to the satisfaction of students. Methods: This was a Comparative Cross Sectional study in which final year department of physical therapy (DPT) students were included from three private and three public physiotherapy institutes. Results: The largest mean Positive Gap scores for Public Physiotherapy Institutes was 0.18 for accessibility and affordability 0.18. The largest negative mean gap score for Private Physiotherapy domain was “Accessibility and Affordability” found to be -1.96. Conclusion: Students were satisfied with service quality of private institutes in all domains except for the “Accessibility and Affordability” whereas, in Public Institutes largest negative quality gaps were found in “Empathy” and “Assurance”.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Solis-Pazmino ◽  
Jorge Salazar-Vega ◽  
Eddy Lincango-Naranjo ◽  
Cristhian Garcia ◽  
Gabriela Jaramillo Koupermann ◽  
...  

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Moreira de Sousa ◽  
L Lopes ◽  
P Costa ◽  
G Martins-Coelho ◽  
R Capucho

Abstract Background In 2017, the risk-weighted prevalence of alcohol consumption was the health indicator with a more negative impact on the Institute for Health Metrics and Evaluation Sustainable Development Goals Health Index Value in Portugal. According to data from 2012-14, the Alto Tâmega and Barroso (ATB) had the highest value of Years of potential life lost (YPLL) in North Portugal - 4570,1/10.000 people. Liver chronic disease was the specific cause of death that contributed to the value of YPLL - 465,4/10.000 people. Methods A cross-sectional study was conducted with data from the Northern Health Administration and the General Directorate for Intervention on Addictive Behaviours and Dependencies. We compared the number of patients with chronic alcohol consumption (CAC) in 2018, the leading causes of death between 2012-14, the main morbidity causes according to data from primary healthcare (PHC) physicians in 2018 and the number of patients in specialized treatment team (STT) for alcohol abuse treatment in 2018 in ATB. Results In 2018, 2643 patients of ATB had a diagnosis of CAC; only 178 were followed by an STT. Although CAC had a massive influence on YPLL, this was only the 11º cause of morbidity in ATB according to the data from PHC. The number of women with CAC was stable between 2012 (n = 284) and 2018 (n = 291). In the same period, there was an increase of 52,86% of CAC on men (n = 1523 to n = 2348). Even though 18,4% of YPLL due to chronic liver disease happen in women, only 11,2%of the patients with CAC in the PHC are women. Conclusions There is a need for the improvement of CAC diagnosis in PHC, and the improvement of referral of patients to STT and hospital care. Besides, to reach the SDG3, there is the need to work intensely on SDG 17 (partnership for the goals). The Public Health Unit of ATB is organizing Operation PROMETEU to improve communication, institutional collaboration, and monitoring of the existing health activities that are tackling CAC. Key messages The need to integrate data from different healthcare sources for a better analysis on health problems. The urgent need to tackle the alcohol abuse problem in ATB.


2015 ◽  
Vol 7 ◽  
pp. e2015038 ◽  
Author(s):  
Vincenzo De Sanctis

Objective: This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of  thalassaemia major(TM) patients with insulin dependent diabetes mellitus (IDDM). Τhis relation was not previously evaluated, despite the fact that both diseases co-exist  in the same patient. The  study   also  describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM.   Design: A population-based cross-sectional study.  Participants:The study  includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients without  IDDM who visited our out-patient clinics for an endocrine assessment Methods: An extensive medical history, with data on associated complications and current medications, was obtained. Blood samples were drawn in the morning after an overnight fast to measure the serum concentrations of IGF-1, glucose, fructosamine , free thyroxine (FT4), thyrotropin (TSH) and biochemical analysis . Serologic screening assays for hepatitis C virus seropositivity (HCVab and HCV-RNA) were also evaluated,  applying routine laboratory methods.Plasma total IGF-1 was measured by a chemiluminescent immunometric assay (CLIA) method. Ophthalmology evaluation was done by the same researcher using stereoscopic fundus biomicroscopy through dilated pupils. DR was graded using the scale developed by the Global Diabetic Retinopathy Group. Iron stores were assessed by direct and indirect methods. Results:Eighteen TM patients with IDDM (94.7 %) and 10 non-diabetic patients (32.2 %) had IGF-1 levels below the 2.5th percentile of the normal values for the Italian population. The mean serum IGF-1 concentrations were significantly lower in the diabetic versus the non-diabetic TM groups (p < 0.001). DR was present in in 4 (21 %) of 19 TM patients with IDDM and was associated with the main classical risk factors, namely inefficient glycemic control  and duration of disease but not  hypertension. Using the scale developed by the Global Diabetic Retinopathy Group, the DR in our patients was classified as non proliferative diabetic retinopathy (NPDR). Only few numbers of microaneurysms [1-3] were detected. Our data also confirm the strong association of IDDM in TM patients with other endocrine and non-endocrine complications.Conclusions: These results , although on a small number of patients, suggest a possible ‘protective’ role of low IGF-1 in the development of DR in TM patients 


2020 ◽  
Vol 26 (1) ◽  
pp. 6-9
Author(s):  
Soheila Sayad ◽  
Seyyed Ahmadi ◽  
Reza Nekouian ◽  
Mahshid Panahi ◽  
Khatereh Anbari

Background: Present study aimed to investigate immunohistochemical parameters in post-surgical cases of invasive breast cancer. Methods: In this single center cross-sectional study we investigated ethnicity, familial history, type of cancer, stage of cancer, lymph node positivity, bilateral involvement, metastasis and immunohistochemical parameters (estrogen and progesterone receptor, human epidermal growth factor receptor 2, as well as frequency of triple positive and triple negative patients merely based on immunohistochemical parameters). Results: Frequency of positive familial history was 27.42% (16.31-38.52%). Lymph node involvement was detected in 55.93% (43.26-68.60%) of the cases. Frequency of positive HER2 was 38.60% (25.96-51.23%). There were 17.54% (7.67-27.42%) of triple positive and 7.02% (0.39-13.65%) of triple negative cases. The most common stage at the time of diagnosis was stage 3 with 43.33% (30.79-55.87%) frequency. In Lur/Lak population higher frequency of positive HER2 cases was detected whereas in Mazani population frequency of positive HER2 cases was low (p=0.0291). Conclusions: These results could contribute to understanding of breast cancer patterns among different ethnicities. In order to draw clear conclusion future investigations have to be done in several health centers, for longer time periods and with larger number of patients.


Author(s):  
Vijay Kumar Manwani

Background: India being a country of agriculture, very little attention has been given to the occupational health problems of the agricultural workers; though the need of investigation and intervention towards their problems has repeatedly been mentioned. The objectives of the study were to find out the socio-demographic distribution of agricultural health hazards, to find out the personal protective measures being used by the agricultural workers and to give the necessary recommendations for the prevention of health hazards.Methods: It was a cross-sectional study conducted from September 2009 to December 2011. A pilot study was conducted on 50 patients. Data collection was done through asking questionnaire from the patients/relatives. Data was analyzed in the form of percentage (%) and presented in the tabular form. Chi- square (χ2) test was applied as a test of significance.Results: Out of total 926 cases maximum number of patients were males (549, 59.29%), followed by females (377, 40.71%). Majority of the respondents were primary educated (31.87%) followed by illiterate (29.48%). majority (44.60%) of the respondents belong to Class-IV (lower) socioeconomic status. Males (53.35%) were more addicted than females (10.26%). It was revealed that maximum number of the cases was not using (85.53%) PPE and only 14.47% were using any kind of PPE.Conclusions: Out of the total 926 cases, 549 (59.29%) were males, followed by females (377, 40.71%). Majority (63.61%) of the respondents have some kind of addiction. It was revealed that maximum number of the cases were not using (83.02%) any kind of PPE.


2021 ◽  
pp. 1-6
Author(s):  
Shivani Saini ◽  
◽  
Agarwal Shail ◽  
Jain Manish ◽  
Yadav Devendra ◽  
...  

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications


2020 ◽  
Vol 12 (6) ◽  
pp. 1776-1783
Author(s):  
Ze‐qing Huang ◽  
Fan‐yu Fu ◽  
Wen‐long Li ◽  
Biao Tan ◽  
Hai‐jun He ◽  
...  

2020 ◽  
Vol 29 (Sup3) ◽  
pp. S20-S28
Author(s):  
Stella Olivo ◽  
Cristina Canova ◽  
Angela Peghetti ◽  
Maurilio Rossi ◽  
Renzo Zanotti

Objective: The main aim of this study was to estimate the prevalence of pressure ulcers (PU) and related risk factors of PU development in hospitalised patients in Italy. Furthermore, the study investigated the association between risk factors for PU present on admission and the development during hospitalisation (hospital-acquired pressure ulcer, HAPU). Methods: A cross-sectional study, using two separate designs at two separate timepoints: 2010 and 2015. The methodology used to measure PU prevalence was that recommended by the European Pressure Ulcer Advisory Panel (EPUAP). Results: The total sample was 7681 hospitalised patients (3011 patients in 2010, 4670 in 2015). Prevalence of PU in hospital was 19.5% in 2010 and 17% in 2015. The number of patients with PU present on admission were 9.60% in 2010 and 9.42% in 2015. Patients with HAPU were 5.08% in 2010 and 5.87% in 2015. Older age and comorbidities, and a total Braden score of ≤16 were positively associated with PU present on admission and HAPU in hospitals (p<0.05). A longer length of stay appeared to correlate positively with a better clinical outcome for PU if there were already present on admission. Heterogeneous results emerged for length of stay of >30 days and being admitted to intensive care unit (ICU). Conclusion: Our results are comparable with other European and Italian studies. Most of the risk factors associated with PU development have been confirmed. However, further studies are needed to examine the effects of context on PU present on arrival and HAPU, especially regarding hospital length of stay.


2020 ◽  
Vol 18 (3) ◽  
pp. 365-371
Author(s):  
Carolina Matiello Souza ◽  
Jaqueline Martins ◽  
Thiele de Cássia Libardoni ◽  
Anamaria Siriani Oliveira

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