Medical encounters, cardiac arrests and deaths during a 109 km community-based mass-participation cycling event: a 3-year study in 102 251 race starters—SAFER IX

2019 ◽  
Vol 54 (10) ◽  
pp. 605-611 ◽  
Author(s):  
Jannelene Killops ◽  
Martin Schwellnus ◽  
Dina Christina Janse van Rensburg ◽  
Sonja Swanevelder ◽  
Esme Jordaan
Keyword(s):  
Sudden Cardiac Arrest ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
Community Based ◽  
International Consensus ◽  
Cross Sectional ◽  
Life Threatening ◽  
Cycling Event ◽  
Few Data ◽  
Mass Participation

BackgroundThere are few data on medical encounters, including deaths during mass-participation cycling events.ObjectiveTo determine the incidence and nature of medical encounters during a community-based mass-participation cycling event.DesignCross-sectional study across three annual events.Setting2012–2014 Cape Town Cycle Tour (109 km), South Africa.Participants102 251 race starters (male=80 354, female=21 897).MethodsMedical encounters (moderate, serious life-threatening, sudden cardiac arrest/death), using the 2019 international consensus definitions, were recorded on race day for 3 years as incidence rates (IR per 1000 starters; 95% CI). Overall illness-related (by organ system) or injury-related (by anatomical region) encounters, and severity were recorded.ResultsWe recorded 539 medical encounters (IR 5.3; 4.8 to 5.7). The IR was 3.2 for injuries (2.9 to 3.6), 2.1 for illnesses (1.0 to 2.4) and 0.5 for serious life-threatening medical encounters (0.4 to 0.7). In the 3-year study, we encountered three cardiac arrests and one death (2.9 and 1.0 per 100 000 starters, respectively). Injury IRs included upper limb (1.9; 1.6 to 2.1), lower limb (1.0; 0.8 to 1.0) and head/neck (0.8; 0.6 to 1.0). Illness IRs included fluid/electrolyte abnormalities (0.6; 0.5 to 0.8) and the cardiovascular system (0.5; 0.4 to 0.6).ConclusionIn a 109 km community-based mass-participation cycling event, medical encounters (moderate to severe) occurred in about 1 in 200 cyclists. Injury-related (1/300 cyclists) encounters were higher than illness-related medical encounters (1 in about 500). Serious life-threatening medical encounters occurred in 1/2000 cyclists. These data allow race organisers to anticipate the medical services required and the approximate extent of demand.

scholarly journals Senile Cataract in Patients with Diabetes with and Without Diabetic Retinopathy: A Community-Based Comparative Study

2021 ◽  
Author(s):  
Khalid Mohammad Alabdulwahhab
Keyword(s):  
Diabetic Retinopathy ◽  
Age Of Onset ◽  
Glycosylated Hemoglobin ◽  
Diabetes Type 2 ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
Community Based ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Onset Of Diabetes

Abstract Aim We compare the incidence rates of cataract in persons with diabetes with and without diabetic retinopathy in Saudi Arabia, for the first time. In addition, we explored the role of new factor, diabetes age of onset and several other known factors. Methods In a community-based cross-sectional study, 334 persons with diabetes type 2 were randomly selected from a diabetic register. Detailed history and comprehensive ophthalmic examination was done at an eye clinic. Body Mass Index, blood pressure and glycosylated hemoglobin were also recorded. Results In 668 eyes, cataract and diabetic retinopathy were present in 35.5% and 32.2%, respectively. Diabetic retinopathy, age, duration of diabetes and systolic BP were found to be independent risk factors for cataract. Whereas, gender, BMI, HbA1c use of insulin and diastolic BP have no significant association with cataract. Persons with cataract had significantly higher age of onset of diabetes. Most of the cataracts were cortical followed by PSC, while minority were nuclear. Conclusion DR is an independent risk factor of developing cataract in persons with diabetes. Others are age, duration of DM and hypertension. Age-of-onset of DM is a new factor we report it to be significantly associated with cataract.

scholarly journals Awareness of Adult Basic Life Support among Graduates in a Medical College of Kathmandu

2020 ◽  
Vol 4 (2) ◽  
pp. 73-77
Author(s):  
Siddharth Dixit ◽  
Sirjana Dahal ◽  
Punam Basnet Dixit ◽  
Geshu Lama
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Medical Curriculum ◽  
Sudden Cardiac Arrest ◽  
Medical Personnel ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Ethical Approval ◽  
Life Threatening

 Introduction: Survival after sudden cardiac arrest depends upon early intervention, quality of cardiopulmonary resuscitation (CPR) and time of defibrillation. So, it is very important that at least the medical personnel know about Basic Life Support (BLS) as they are frequently facing the life threatening situations. Objective: To assess the level of awareness regarding adult basic life support among graduates in a medical college of Kathmandu. Methods: A descriptive cross-sectional study was conducted after ethical approval in Kathmandu Medical College and Teaching Hospital from April to September 2018 among 150 medical and dental graduates including interns and dental/medical officers. A structured self-administered questionnaire was used to assess their awareness regarding Adult BLS. Data were entered and analysed in Microsoft Excel Sheet. Mean, standard deviation, frequency, and percentage were calculated. Results: Most of the graduates surveyed (122, 81.3%) had heard about Adult BLS and felt the need to know about it (142, 94.7%). They felt the necessity including BLS training as a part of medical curriculum (144, 96%). Some of them (58, 38.7%) had seen BLS being done. However, very few (2, 1.3%) had actually done BLS on a patient. Some (54, 36%) had attended workshop on BLS. Conclusion: The findings of the study concluded that although most of the medical and dental graduates felt the need, very few had attended workshop for BLS. The BLS training should be included in the medical curriculum so that the graduates would be able to effectively manage the life-threatening emergencies.

scholarly journals Impact of COVID-19 pandemic on rare diseases- A case study on thalassaemia patients in Bangladesh

2021 ◽  
Author(s):  
Mohammad Sorowar Hossain ◽  
Farhana Runa ◽  
Abdullah Al Mosabbir
Keyword(s):  
Blood Transfusion ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Median Number ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Life Threatening ◽  
The Impact

Objectives Thalassaemia is a life-threatening rare disease, which requires regular blood transfusion and medical care. The information on how thalassaemia patients are affected during the unprecedented COVID-19 crisis is scarce. This study aimed to assess the impact of the COVID-19 pandemic on the blood transfusion and healthcare access of thalassaemia patients at the community level in Bangladesh. Methods A cross-sectional study was conducted among thalassaemia patients registered in a community-based thalassaemia registry in Jamapur, Bangladesh. Results As compared to pre-COVID-19 time, the number of blood transfusions among patients under the thalassaemia registry was significantly reduced during COVID-19 pandemic (190 units versus 81 units). In addition, the median number of red cell transfusions per patient was dropped significantly from 4 units to one unit. Over 80% of patient had no access to healthcare services at all during the early phase of the pandemic. Conclusion Emergency response with appropriate mitigative measures must be a priority for addressing an acute shortage of blood supply in situations like COVID-19 pandemic.

Lipophilic Statin Use and Suicidal Ideation in a Sample of Adults With Mood Disorders

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 278-282 ◽  
Author(s):  
Karen M. Davison ◽  
Bonnie J. Kaplan
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorders ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptom Scores ◽  
Unit Increase ◽  
Predominantly Female ◽  
Lipophilic Statin

Background: Mood disorders are associated with a high risk of suicide. Statin therapy has been implicated in this relationship. Aims: To further clarify reported associations between suicide and cholesterol in mental health conditions, we conducted an analysis of dietary, clinical, and suicidal ideation measures in community-living adults with mood disorders. Method: Data were used from a cross-sectional study of a randomly selected community-based sample (> 18 years; n = 97) with verified mood disorders. Dietary (e.g., fat, iron, vitamin intakes), clinical (e.g., current depression and mania symptoms, medications), and sociodemographic (age, sex, and income) measures were analyzed using bivariate statistics and Poisson regression with robust variance. Results: Participants were predominantly female (71.1%) with bipolar disorder (59.8%); almost one-third (28.9%) were taking lipophilic statins. The prevalence of suicidal ideation was more than 2.5 times in those taking statins, PR = 2.59, 95% CI 1.27–5.31, p < .05. The prevalence ratio for suicidal ideation was 1.10, 95% CI 1.06–1.15, p < .001, for each unit increase in mania symptom scores. No associations between suicidal ideation and dietary intake measures were identified. Conclusion: Individuals with mood disorders may be susceptible to neuropsychiatric effects of cholesterol-lowering drugs, which warrants further research.

Breastfeeding practices among mothers of infants in Peringara Panchayat in Pathanamthitta District

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Aswathy S. ◽  
Lakshmi M. K.
Keyword(s):  
Exclusive Breastfeeding ◽  
Cross Sectional Study ◽  
Community Based ◽  
Chi Square ◽  
Cross Sectional ◽  
Breastfeeding Practices ◽  
Chi Square Test ◽  
Type Of Delivery ◽  
Initiation Of Breastfeeding

The study was aimed to assess the breastfeeding practices among mothers of infants in Peringara Gramapanchayat in Kerala. Study was a community based cross-sectional study among mothers of infants in Peringara gramapanchayat using a pretested questionnaire. 142 breastfeeding mothers of infants in Peringara gramapanchayat were studied and mothers who were not present at home during the study were excluded from the study. Study period consisted of 18 days between December 2015 and January 2016. Study variables includes type of delivery, initiation of breastfeeding, breastfeeding practices and role of ASHAs in promoting good breastfeeding practices. Statistical analysis was done using Pearson’s Chi-square test and T test. The study found that exclusive breastfeeding has been done by 68.3% of mothers. There is no practice of giving pre-lacteal feed, 95.8% of mothers have given colostrum to the new born. Statistically significant association was found between the type of delivery and time of initiation of breastfeeding (p less than 0.05). Time of initiation of breastfeeding was prolonged in case of Caesarean section. 49.3% of mothers have breastfed the baby within one hour. 55.6% of mothers were informed about importance of breastfeeding by ASHAs and only 20.4% of mothers were informed about period of exclusive breastfeeding and period of complimentary feeding by ASHAs.

Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

2020 ◽  
Author(s):  
Mohammad Alakchar ◽  
Abdisamad M. Ibrahim ◽  
Mohsin Salih ◽  
Mukul Bhattarai ◽  
Nitin Tandan ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Correlation Coefficient ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resident Attitudes ◽  
Internal Medicine Residents ◽  
Life Threatening ◽  
Degree Of Participation ◽  
Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

scholarly journals Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  
Keyword(s):  
Physical Examination ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Medical Interview ◽  
Sectional Study ◽  
University Hospitals ◽  
Community Based ◽  
Cross Sectional ◽  
Clinical Competencies ◽  
Clinical Procedures

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”

scholarly journals Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Mbusa Kambale ◽  
Gaylord Amani Ngaboyeka ◽  
Joe Bwija Kasengi ◽  
Sarah Niyitegeka ◽  
Boss Rutakaza Cinkenye ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Wide Range ◽  
South Kivu

Abstract Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu.

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