scholarly journals Adherence in elderly patients with NCDs: Which is the best, educational or social support? A comparative study in Ecuador

2019 ◽  
Author(s):  
Elizabeth Elena Aguirre Céspedes ◽  
Angela Faydé Alfonso Florido ◽  
Edgar León Segovia ◽  
Patricia Ortiz Solórzano ◽  
Sergio Minué Lorenzo ◽  
...  

Abstract Background: Adherence to treatment is one of the mainstays of non-communicable diseases adequate control. Non – adherence can affect several aspects to both the patient and the health system. For this reason, it is important to have intervention strategies available to prevent detachment and improve adherence to treatment. The objective of this study is to evaluate the effectiveness of the educational strategy compared with the social and family support for the improvement of adherence in patients with chronic noncommunicable diseases. Methods: A quasi-experimental study was conducted in 159 participants with diagnosis of arterial hypertension or/and diabetes mellitus type 2 plus polypharmacy. Participants were divided in two groups and strategies: Group A: educational (n = 79) and Group B social/family support (n = 80), follow up three months for each group. For group "A", informative group workshops were assigned; while for group "B" therapeutic agreements were established. Adherence to treatment pre- and post-intervention were evaluated using the four item Morisky Green Levine scale of public domain. At the end of the intervention period, an intra and intergroup analysis were performed and a Z test for difference in proportions was applied; the RR was used as a measure of association, and Chi2 as a measure of significance. Results: A total of 152 patients complete the intervention. In group A, pre-intervention non-adherence was 58.2%, post-intervention of 45.3% and final reduction of the failure was 12.9% (p<0,001). In group B, pre-intervention non-adherence was 55%, post-intervention 46.8%, and final reduction of adherence failure of 8.2%, (p> 0.05). Statistically significant difference was obtained between the decrease in the failure reached after the application of the educational strategy compared to social / family support strategy (p = 0.001). Conclusions: Educational strategy is more effective than social/family support strategy, to reduce the failure of therapeutic adherence. There was not association of sociodemographic factors and adherence to treatment.

2021 ◽  
Vol 11 (7) ◽  
pp. 265-271
Author(s):  
Abhinav Salve ◽  
Sachin Maghade ◽  
Sneha Katke

Background: Respiratory PNF technique is a proprioceptive and tactile stimulus that alters the depth and rate of breathing. Intercostal stretch enhances the chest wall elevation and increase chest expansion and diaphragm excursion to improve intra-thoracic lung volume which contributes to improvement in flow rate percentage. Vertebral pressure is another respiratory PNF where there is increased epigastric abdominal excursion over T2-T4. Objective: To find out the effect of Vertebral pressure and Intercostal stretch technique on respiratory rate, tidal volume, SpO2 & heart rate among organophosphorus poisoning patients Method: Data was collected from 24 ICU patients who were on mechanical ventilator. Subjects were divided in two groups. Intercostal stretch technique was given to group A and vertebral pressure technique was given to group B, changes HR, RR, SpO2, tidal volume was noted and data analysis was done. Result: There was significant difference between pre intervention and post intervention readings for both the groups A and B at heart rate, respiratory rate, SpO2 and tidal volume related (p<0.001). It thus proved that respiratory stimulation improves TV, Decrease in RR and HR and increase in SpO2 for both groups. Conclusion: Proprioceptive Neuromuscular Facilitation techniques are effective in improving HR, RR, lung capacity and Oxygen saturation in patients with OP poisoning. There was significant difference between pre intervention and post intervention readings for both the groups A and B at heart rate, respiratory rate, SpO2 and tidal volume. Key words: Organophosphorus poisoning, Mechanical ventilator, intercostal stretch, Vertebral pressure, Respiratory PNF.


2021 ◽  
Vol 15 (6) ◽  
pp. 1876-1878
Author(s):  
Muhammad Hassan ◽  
Sajid Rashid ◽  
Rehan Ramzan Khan ◽  
Muhammad Usman Khalid ◽  
Haroon Mansha ◽  
...  

Objective: To evaluate the effects of structured resistance exercises on cognition level among patients with mild cognitive impairment. Methods: A quasi experimental trial was conducted on thirty patients with mild cognitive impairment (MCI) from September 2020 to February 2021 at Ibn e Siena hospital, Multan. The total sample was randomly divided into two equal groups containing fifteen patients each; Group-A (Conventional pharmacological treatment) and Group-B (Resisted exercises). Group-A participants were treated with conventional pharmacological treatment cholinesterase inhibitors along with regular physical exercise while Group-B participants were treated with resistance exercises along with conventional pharmacological treatment. The standardized tools were used for data collection including Standardized mini mental state examination (SMMSE), Montreal cognitive assessment (MOCA), Trial making test A (TMT-A) and Trial making test B (TMT-B). Data was entered and analyzed by using SPSS 21. Results: Independent samples T-test showed statistically significant difference after intervention for measures of cognitive performance. There was significant difference (p<0.01) between pre and post intervention score of SMMSE (20.60 ± 1.75 and 23.20 ± 1.69) and MOCA (17.60 ± 1.35 and 21.93 ± 1.57). There was also significant difference between (p<0.01) pre and post intervention score of TMT-A (1.47 ± 0.34 & 1.23 ± 0.04) and TMT-B (2.51 ± 0.04 and 2.08 ± 0.04). Conclusion: Resistance exercises increases the cognitive levels of Mild Cognitive impairment patients. Key Words: Cognitive dysfunction, Exercises, Dementia.


2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Chen Qiu ◽  
Xiao-Feng Qiu ◽  
Jing-Jing Liu ◽  
Yi-Xin Wang ◽  
Li Gui

Abstract Background Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide. However, few Chinese military medics know the proper first aid procedures for snakebites. Therefore, this study aimed to explore the impact of the Standard Operation Procedure (SOP) and checklist on Chinese military medics’ ability to manage snakebite first aid. Methods This study was a prospective single-blind randomized controlled trial conducted in a military medical university of China from May to June 2017. A questionnaire-based survey was performed to collect the participants’ socio-demographic profiles before the baseline measurement. During the baseline measurement, participants were requested to provide corresponding first aid that was responsive to the simulative situation portrayed by the SPs (standardized patients) and the evaluators then scored their performances according to a checklist for snakebite first aid scoring table. After the baseline measurement, they were randomly assigned to one of three intervention groups after stratification according to their baseline performance scores: group A received a self-learning course with textbooks (n = 27), group B received a self-learning training on the SOP and checklist (n = 27) and group C was engaged in an interactive discussion panel regarding the SOP and checklist (n = 26). After the interventions, participants received outcome measurements about snakebite first aid key points capability from the same evaluator and SP for each group to avoid observational error. The reviewers were blinded about the grouping in the trial. Results The baseline measurement yielded no significant difference (H = 1.647, P = 0.439) among the three groups. The post-intervention scores were higher than the pre-intervention scores for all three (A, B and C) groups (P = 0.008, P < 0.001 and P < 0.001, respectively). There was significant difference of the post-intervention scores among the three groups (F = 8.841, P < 0.001). Both post-intervention scores of group B and group C were higher than that of group A (P < 0.001 and P = 0.001, respectively), but no difference was found between group B and C (P = 0.695). The acceptance questionnaire score of SOP and checklist was mostly very satisfied, as the final scores of group B and group C were 4.62 ± 0.61 and 4.82 ± 0.45, respectively. Conclusions In this study, the implementation of an SOP and checklist for snakebite first aid was shown to update and improve first aid treatment concepts in military medics. These intervention methods played an important role in improving the medics’ cognition and understanding of snakebite first aid. Therefore, this finding suggests that SOP and checklist training should be further implemented in Chinese troops for snakebite care.


Author(s):  
S Anu ◽  
N Uwaraja ◽  
R Somaskandan ◽  
R Vairapraveena ◽  
K Jeyashree ◽  
...  

Introduction: Mentally Guided Imagery (MGI) has successfully been applied in sports for skill acquisition and performance enhancement. Despite the fact that athletes often use mental imagery as a part of their preparation, it has not been extensively explored as a learning technique in medical education. Few studies had highlighted mental imagery as a way to review and practice surgical skills efficiently. The present study aimed to assess the efficiency of intubation skills acquired through mental imagery in medical interns. Aim: To assess and compare the effect of Guided mental imagery and physical practice using mannequins on intubation technique among 40 medical Interns after seven days of training. Materials and Methods: The study was conducted in the Department of Emergency Medicine, Velammal Medical College and Hospital, Madurai over a period of seven days. Forty house surgeons were randomly divided into two groups. Group A (n=20) practiced MGI on intubation technique and Group B (n=20) practiced on mannequins one hour everyday for seven days. The performance of the students was assessed using a graded Objective Structured Clinical Examination (OSCE). Results: Results of Group A and Group B were analysed and compared statistically using paired and unpaired t-test. Though there was significant difference between the pre and post values in the MGI group (p<0.001), there was no statistically significant difference (p=0.216) in the post-intervention scores between the Mentally Guided Imagery (MGI) and physical practice group. Conclusion: Guided mental imagery was as effective as additional physical practice for medical students learning to perform intubation.


Author(s):  
Mustak M. Makarani ◽  
Prakruti P. Patel ◽  
Anuradha M. Gandhi ◽  
Chetna K. Desai ◽  
Mira K. Desai

Background: Inadequate understanding and performance of drug administration using metered-dose inhaler (MDI) in paediatric population affects therapeutic outcome. Hence, this study aimed to evaluate the impact of two educational interventional methods for usage of MDI in paediatric patients of bronchial asthma.Methods: This prospective, interventional study was done in paediatric asthma patients who were prescribed drugs with (MDI) with/without spacer at outpatient department of pediatrics. Patients were divided in group A (video) or group B (leaflet) as per random table method and method to use MDI was assessed by using checklist as per WHO guide to good prescribing at baseline. Investigator taught the technique by a video (group A) and leaflet (group B) to the selected population. Patients were followed up after 15 days and assessed for use of MDI using the same checklist. Data were analysed by using paired and unpaired ‘t’-test.Results: A total of 100 pediatric asthma patients were included in study group A (50) and group B (50). The average no. of steps (WHO checklist) followed was significantly improved at post intervention in both group A (with spacer, p<0.0001) as well as B (without spacer, p<0.05). Although average no. of steps followed were more in group A, no significant difference was found between two groups after intervention.Conclusions: As video is an audio-visual method of demonstration, and hence help us memorise the step of inhalational technique in pediatric patients. Repeated demonstration/education to patients/caregivers may improve the method of MDI usage.


2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.


2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.


Author(s):  
Rajendra Joshi ◽  
N. B. Mashetti ◽  
Rakesh Kumar Gujar

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.


Author(s):  
Patil Aniket ◽  
Dindore Pallavi ◽  
Arbar Aziz ◽  
Kadam Avinash ◽  
Saroch Vikas

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.


Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.


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