scholarly journals Caso Clínico: Cirugía Reconstructiva de Tobillo

2018 ◽  
Vol 10 (2) ◽  
pp. 170-174
Author(s):  
Fulvio Enrique Zuñiga Cabrera ◽  
Jaime Santiago Clavijo Jaramillo ◽  
Adriana Abigail Guzmán Villa
Keyword(s):  
Diabetes Mellitus ◽  
Reverse Flow ◽  
Public Health Problem ◽  
Lower Limbs ◽  
World Health ◽  
Major Public Health Problem ◽  
Sural Flap ◽  
Advantages And Disadvantages ◽  
Left Ankle ◽  
Osteosynthesis Material

BACKGROUND: Diabetes mellitus is a major public health problem, according to the World Health Organization, 422 million adults worldwide in 2014. In 2012, it caused 1.5 million deaths worldwide. Diabetes is the leading cause of non-traumatic amputation in lower limbs and foot infections occur with high frequency in poorly controlled patients. This case shows the reconstruction of soft tissue defects in the lower third leg, heel, malleoli and foot through the description of the reverse sural flap. In this study the advantages and disadvantages of the use of this technique are discussed. CASE REPORT: A 56-year-old female patient with a poorly controlled history of Diabetes Mellitus type 2, who suffered a fracture of the left ankle treated with osteosynthesis, and who during the postoperative period attended emergency orthopedics and traumatology, due to severe pain in the left ankle, fever, dehiscence of surgical wound, accompanied by serous secretion. EVOLUTION: The patient, after several surgical cleanings and changes in closure therapy assisted by negative pressure, manages to control the infection, with persistence of the bone coverage defect and the osteosynthesis material. There were additional complications such as joint stiffness, muscle atrophy; it was decided to reconstruct the distal third of the foot using a reverse flow sural fasciocutaneous flap, which evolved satisfactorily, managing to cover the defect with biological tissue. CONCLUSIONS: The sural flap of reverse flow is a reproducible technique that allows to cover coverage defects in the distal third of the leg and ankle; shorten hospitalization times, especially when there is bone exposure or osteosynthesis material.

scholarly journals Prevalence of anemia among pregnant women in rural Koppal: a study from teaching hospital, Koppal, India

2017 ◽  
Vol 6 (9) ◽  
pp. 3792 ◽  
Author(s):  
Seema B. N.
Keyword(s):  
Pregnant Women ◽  
Public Health Problem ◽  
Peripheral Blood Smear ◽  
Poverty Line ◽  
World Health ◽  
Major Public Health Problem ◽  
Severe Anemia ◽  
Mild Anemia ◽  
High Prevalence ◽  
Prevalence Of Anemia

Background: Anemia is the nutritional deficiency disorder and 56% of all women living in developing countries are anaemic according to World Health Organization. India has the highest prevalence of anaemia and 20% of total maternal deaths are due to anemia. To determine the prevalence of anemia and factors influencing its causation among pregnant women.           Methods: This is the study of 1769 pregnant women which was conducted in a rural population of Koppal district, Karnataka, India, from June 2016 to November 2016 i.e. a period of 6 months. This longitudinal prospective observational study was conducted in the district hospital of Koppal. Anemia was classified as per the Indian Council of Medical Research (ICMR) criteria. The diagnosis of anemia was undertaken by peripheral blood smear examination and standard hemoglobin estimation by shale’s method.Results: The average age of pregnant women was 23.5 years, ranging between 18 and 40 years. Most of the women belonged to below poverty line (BPL) families (84.6%) and Hindu religion (98%). Regarding education, 28.9% were illiterates. The mean haemoglobin level was found to be 8.95. Prevalence of anemia was 96.5% among the pregnant females in this region of rural Koppal. Out of these 22.47% had mild anemia, 56.30% had moderate anemia, 14.98% had severe anemia and 2.73% very severe anemia according to ICMR classification of anemia.Conclusions: High prevalence of anemia among pregnant women indicates anemia to be a major public health problem in the rural community and indicates strict implementation of National Nutrition Anemia prophylaxis programme. Factors such as socioeconomic status, education, birth interval, and gravida contribute to this high prevalence.

Severity and costs associated with hospitalization for dengue in public and private hospitals of Surat city, Gujarat, India, 2017–2018

2019 ◽  
Vol 113 (11) ◽  
pp. 661-669 ◽  
Author(s):  
Viral R Bajwala ◽  
Denny John ◽  
T Daniel Rajasekar ◽  
Manoj V Murhekar
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Warning Signs ◽  
World Health ◽  
Severe Dengue ◽  
Major Public Health Problem ◽  
Private Hospitals ◽  
Government Hospitals ◽  
The Cost

Abstract Background Dengue is major public health problem in India, especially in urban areas. We conducted a study to estimate the severity and costs of treatment among hospitalized dengue patients in Surat city, Gujarat, India. Methods We reviewed the medical records of dengue patients hospitalized in five tertiary care facilities (private [n=2], semi-government [n=2] and government [n=1]) between April 2017 and March 2018. We used the World Health Organization 2009 classification to classify the severity of dengue. A resource utilization approach was used to estimate the cost of illness in US dollars (US$) (inflation adjusted to 2018) from a quasi-societal perspective (excluding non-medical cost) for dengue hospitalization. Results Of the 732 hospitalized dengue patients, 44.7% had no warning symptoms, 39.5% had warning signs and 15.8% had severe dengue. The mean cost of hospitalization was US$86.9±170.7. The cost of hospitalization was 28.8 times higher in private hospitals compared with government hospitals. Consultant charges in private hospitals, laboratory investigations in semi-government hospitals and registration with admission charges in government hospitals accounted for 27.3%, 39.4% and 53% of the direct cost in these facilities, respectively. Conclusions A better triage system for hospitalization, subsidizing costs in the public sector and cost capping in the private sector can help to reduce the cost of hospitalization due to dengue so as to ensure affordability for larger portion of the society for universal health coverage.

scholarly journals A study on validity of Indian Diabetes Risk Score for screening of diabetes mellitus among rural adult population at Rural Health Training Centre, Bhouri, under Department of Community Medicine

2018 ◽  
Vol 5 (12) ◽  
pp. 5295
Author(s):  
Garima Namdev ◽  
Vinod Narkhede
Keyword(s):  
Diabetes Mellitus ◽  
Rural Health ◽  
Risk Score ◽  
Screening Tool ◽  
Public Health Problem ◽  
Diabetes Risk ◽  
Major Public Health Problem ◽  
Training Centre ◽  
Health Training ◽  
Diabetes Risk Score

Background: Diabetes mellitus is a major public health problem in India and many of them remain undetected throughout years. This scenario becomes worse in rural setup where limited heath care facilities are available. So, to detect risk of diabetes earlier, Indian diabetes risk score (IDRS) is to be used. There is also various socio demographic and anthropometric factors associated with the risk of occurring diabetes. The aims and objectives of the study were to study the validity of IDRS method as a screening tool in community as well as to determine the association of IDRS with socio demographic factors and body mass index (BMI).Methods: A cross sectional study was conducted on 270 study participants at rural health training centre (RHTC) for a period of around 7 months. All of them were being measured weight, height, waist circumference and calculated BMI. Along with it, they were categorized by applying IDRS method and measured blood sugar by glucometer also.Results: Out of 270 study subjects, 29% found to have high score. By applying IDRS, at score > 60, we found 32% sensitivity and 97% specificity. A statistically significant association of IDRS with age, gender, religion, socioeconomic status (SES), education, occupation and BMI was seen.Conclusions: In present study, IDRS method proved to be a good screening tool for detecting diabetes mellitus at rural set up with minimum cost.

scholarly journals Trajectories and Determinants of Physical Activity during COVID-19 Pandemic: A Population-Based Study of Middle-Aged and Elderly Individuals in The Netherlands

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3832
Author(s):  
Amy Hofman ◽  
Marlou A. M. Limpens ◽  
Tosca O. E. de Crom ◽  
Mohammad Arfan Ikram ◽  
Annemarie I. Luik ◽  
...  
Keyword(s):  
Physical Activity ◽  
The Netherlands ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Public Health Problem ◽  
Population Based ◽  
World Health ◽  
Major Public Health Problem ◽  
Middle Aged ◽  
Health Organization

Physical inactivity is a major public health problem, and there are concerns this might have increased during the COVID-19 pandemic. We aimed to identify distinct trajectories of physical activity over a 6-week period after the first restrictive measures and to explore determinants of these trajectories in a population-based cohort of middle-aged and elderly in the Netherlands (n = 5777). We observed that at least 59% of participants did not meet the World Health Organization recommendations for physical activity. Using latent class trajectory analyses over three time points, we identified five distinct trajectories, including four steady trajectories at different levels (very low, low, medium and high) and one increasing trajectory. Using multinomial logistic regression analyses, we observed that, compared to the ‘steadily high’ trajectory, participants in the ‘steadily very low’ trajectory were more often older, lower educated, reporting poorer physical health, more depressive symptoms, consuming a less healthy diet, smoking, and lower alcohol use, and were less often retired. A similar pattern of determinants was seen for those in the increasing trajectory, albeit with smaller effect sizes. Concluding, we observed low levels of physical activity that generally remained during the pandemic. The determinants we described can help identify groups that require additional preventive interventions.

Antidepressants

2012 ◽  
pp. 1185-1198
Author(s):  
Zubin Bhagwagar ◽  
George R. Heninger
Keyword(s):  
Burden Of Disease ◽  
Antidepressant Drugs ◽  
Public Health Problem ◽  
Premature Mortality ◽  
Primary Treatment ◽  
World Health ◽  
Years Of Life Lost ◽  
Major Public Health Problem ◽  
Treatment Of Depression ◽  
Health Organization

Major depressive disorder is a serious, recurrent illness which levies a crippling toll on individuals, families, and society in general. The importance of depression as a major public health problem is emphasized by findings from the World Health Organization Global Burden of Disease survey in showing that in 1990 it was the fourth largest cause of burden of disease (i.e. years of life lost due either to premature mortality or to years lived with a disability). It has been estimated that by the year 2020 it is expected to be the second largest cause of burden of disease. Depression is underdiagnosed and frequently under-treated, and depressed individuals have a much higher risk for suicide. The primary treatment for depression involves the use of antidepressant drugs, and it is therefore important that clinicians become familiar with and adept in utilizing this important group of compounds. Although primarily used for the treatment of depression, drugs within this category also have a number of other important uses. A thorough understanding of the pharmacology of antidepressants will aid the clinician in the selective use of these drugs for patients with depression as well as patients with a number of other disorders.

scholarly journals Incidence and Risk Factors for Severe Pneumonia in Children Hospitalized with Pneumonia in Ujjain, India

2020 ◽  
Vol 17 (13) ◽  
pp. 4637
Author(s):  
Sunil Kumar Kasundriya ◽  
Mamta Dhaneria ◽  
Aditya Mathur ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Public Health Problem ◽  
Severe Pneumonia ◽  
World Health ◽  
Major Public Health Problem ◽  
Open Defecation ◽  
History Of ◽  
Poor Ventilation ◽  
Acyanotic Congenital Heart Disease ◽  
Health Organization

Childhood pneumonia is a major public health problem. The aim of this prospective hospital-based study is to determine the incidence and risk factors for community-acquired severe pneumonia in children in Ujjain, India. The study includes 270 children, 161 (60%) boys and 109 (40%) girls, aged between 2 months and 5 years with World Health Organization defined and radiologically confirmed severe pneumonia. Considering the 270 children, 64% (95% confidence interval (CI) 57.9–69.4) have severe pneumonia. The following are identified as risk factors for severe pneumonia from the generalized logistic regression model: Born premature (adjusted odds ratio (AOR) 7.50; 95% CI 2.22–25.31; p = 0.001); history of measles (AOR 6.35; 95% CI 1.73–23.30; p = 0.005); incomplete vaccination (AOR 2.66; 95% CI 1.09–6.48; p = 0.031); acyanotic congenital heart disease (AOR 9.21; 95% CI 2.29–36.99; p = 0.002); home treatment tried (AOR 3.84; 95% CI 1.42–10.39; p = 0.008); living in a kuchha house (AOR 3.89; 95% CI 1.51–10.01; p = 0.027); overcrowding (AOR 4.50; 95% CI 1.75–11.51; p = 0.002);poor ventilation in living area (AOR 16.37; 95% CI 4.67–57.38; p < 0.001); and practicing open defecation (AOR 16.92; 95% CI 4.95–57.85; p < 0.001). Awareness of these risk factors can reduce mortality due to severe pneumonia.

scholarly journals The SGLT-2 Inhibitors in Personalized Therapy of Diabetes Mellitus Patients

2021 ◽  
Vol 11 (12) ◽  
pp. 1249
Author(s):  
Mariana Cornelia Tilinca ◽  
Robert Aurelian Tiuca ◽  
Ioan Tilea ◽  
Andreea Varga
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Blood Pressure Reduction ◽  
Public Health Problem ◽  
Diabetic Patients ◽  
Major Public Health Problem ◽  
Patient Centered ◽  
Oral Antihyperglycemic Agents ◽  
Modern Drug

Diabetes mellitus (DM) represents a major public health problem, with yearly increasing prevalence. DM is considered a progressive vascular disease that develops macro and microvascular complications, with a great impact on the quality of life of diabetic patients. Over time, DM has become one of the most studied diseases; indeed, finding new pharmacological ways to control it is the main purpose of the research involved in this issue. Sodium–glucose cotransporter 2 inhibitors (SGLT-2i) are a modern drug class of glucose-lowering agents, whose use in DM patients has increased in the past few years. Besides the positive outcomes regarding glycemic control and cardiovascular protection in DM patients, SGLT-2i have also been associated with metabolic benefits, blood pressure reduction, and improved kidney function. The recent perception and understanding of SGLT-2i pathophysiological pathways place this class of drugs towards a particularized patient-centered approach, moving away from the well-known glycemic control strategy. SGLT-2i have been shown not only to reduce death from cardiovascular causes, but also to reduce the risk of stroke and heart failure hospitalization. This article aims to review and highlight the existing literature on the effects of SGLT-2i, emphasizing their role as oral antihyperglycemic agents in type 2 DM, with important cardiovascular and metabolic benefits.

scholarly journals Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap

2011 ◽  
Vol 6 (03) ◽  
pp. 234-241 ◽  
Author(s):  
Abdirahman Sheikh Mahamud ◽  
Jamal A Ahmed ◽  
Raymond Nyoka ◽  
Erick Auko ◽  
Vincet Kahi ◽  
...  
Keyword(s):  
Water Storage ◽  
Public Health Problem ◽  
Refugee Camp ◽  
Case Definition ◽  
World Health ◽  
Major Public Health Problem ◽  
Potential Risk Factors ◽  
Storage Containers ◽  
Health Organization ◽  
Hospital Registry

Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009. Methodology: We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls. Results: From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital.  Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42%) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p < 0.01), while presence of dirty water storage containers was a risk factor (AOR=4.39[1.12-17.14]; p=0.03). Conclusion:  Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera.

scholarly journals Actual problems of measles

2017 ◽  
Vol 8 (3) ◽  
pp. 120-129 ◽  
Author(s):  
Vladimir N Timchenko ◽  
Tatyana A Kaplina ◽  
Olga A Leonicheva ◽  
Oksana V Bulina ◽  
Jean-Claude Hakizimana ◽  
...  
Keyword(s):  
Developing Countries ◽  
Parvovirus B19 ◽  
Public Health Problem ◽  
Childhood Mortality ◽  
World Health ◽  
Symptomatic Therapy ◽  
Major Public Health Problem ◽  
Duration Of Treatment ◽  
Recombinant Interferon ◽  
The World

Measles is still an major public health problem in many countries. According to the World Health Organization, up to 3 million measles cases were recorded annually. Measles was one of the main causes of death among young children in the pre-vaccine period. More than 10 million children died of measles every year throughout the world. In 2014, on a global scale, there were 114 900 deaths from measles almost 314 deaths per day or 13 deaths per hour. The main cause of death from measles are complications from the respiratory tract (pneumonia), the central nervous system (meningitis, encephalitis, meningoencephalitis, encephalomyelitis), gastrointestinal tract (diarrhea). Between 2000 and 2014, mass measles vaccination reduced global measles mortality rate by 79%, and about 17.1 million children's lives were saved. However, measles still remains endemic and, one of the leading causes of childhood mortality in developing countries as a result of lack of immunization policies. Up to 98% of measles mortality are registered in developing countries, such India, Bangladesh, Nigeria, RDC, etc. If in the pre-vaccine period, measles affected predominantly children aged less than five years, the global immunization era led to a change in the measles-age-category pattern. The increase measles occurency in adults is due to the loss of protective antibodies, that last generally for 10 to 15 years after vaccination in only 36% of the vaccinees. Complications due to measles in adolescents and adults are most likely than in children. However, immunocompetent individuals may have repeated measles infections. The possibility of transplacental transmission of the disease: measles in pregnant women leads to a higher risk of premature birth, spontaneous abortion, congenital malformations, and with a woman at the end of pregnancy intrauterine infection and the birth of a child with signs of measles. In the absence of specific anti-measles antibodies in the mother, the child may become ill in theantenatal period. Differential diagnosis of measles is carried out with infections that occur with exanthema syndrome (parvovirus B19, sudden exanthema, etc.). Etiotropic therapy is carried out with preparations of recombinant interferon (viferon, etc.). Doses of drugs and the duration of treatment are determined by the severity of the disease. Pathogenetic and symptomatic therapy is strongly recommended.

scholarly journals Correlation of CRP level with glycemic control in diabetic foot patients and its sequelae

2017 ◽  
Vol 4 (12) ◽  
pp. 4006
Author(s):  
Anand A. ◽  
Maragathamani .
Keyword(s):  
Blood Sugar ◽  
Diabetic Foot ◽  
Public Health Problem ◽  
Positive Association ◽  
Final Analysis ◽  
Lower Limbs ◽  
P Value ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Study Population

Background:Diabetes mellitus is a major public health problem globally and in Indian population and diabetic foot is reported as the most common cause of non-traumatic amputation of the lower limbs in India. There is renewed interest in various inflammatory markers and their association with various chronic complications of diabetes mellitus. There is a scarcity of data on the subject in Indian population.Methods: The current study was a cross sectional study of 100 patients admitted to a Diabetic foot in Department of General Surgery, Stanley medical college and Hospital between January 2012-November 2012. The CRP level and fasting and plasma glucose levels were considered as the relevant variables for statistical analysis.Results:A total of 100 patients were included in the final analysis. The proportion of subjects with Wagners, grade 1, grade 2, 3, 4 and 5 ulcers were 48%, 27%, 16%, 3% and 6% respectively. Among the study population, 73% of patients had CRP value greater than 40 and 27% patients had CRP value less than 40. The proportion of subjects with Higher CRP level (>40) showed increasing trend with increasing level of fasting blood sugar and post prandial blood sugar in the study population. The proportion of people who underwent amputation was 27.5% in people with CRP value >40 and it was only 6.85% of people with CRP value <40, the association between CRP values and amputation was statistically significant. (P value 0.046).Conclusions:The study has established a strong positive association between poor blood sugar control and elevated CRP levels in the study population. The study has also documented a positive association between higher CRP levels and amputation.

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