scholarly journals Difficulties in breastfeeding: ways to solve the problem

2021 ◽  
pp. 7-13
Author(s):  
E. Z. Polyanina
Keyword(s):  
Medical Personnel ◽  
First Year ◽  
Mixed Feeding ◽  
Herbal Tea ◽  
Lactation Disorders ◽  
Early Postpartum ◽  
Nursing Mothers ◽  
Long Time ◽  
Perinatal Center ◽  
Group 2

Introduction. Practical assistance of medical personnel to nursing women with difficulties in breastfeeding, joint search for solutions to the problem of hypogalactia contributes to the preservation of breastfeeding throughout the first year of a baby’s life.Purpose of the study. The frequency and nature of lactation disorders in women in the first weeks and months of breastfeeding were studied.Materials and methods. The attitude of women to various, including non-drug, methods of maintaining lactation was analyzed. The study was conducted following a survey of 58 women – patients of the perinatal center in the early postpartum period, 28 women whose children received breastfeeding/mixed feeding in the 1st year of life and 16 female employees of neonatological departments, whose children were also breastfed/mixed feeding in the 1st year of life. With women in groups 1 and 2 in the obstetric facility, there were talks about the benefits of breastfeeding and instructions on how to properly latch on the newborn to the breast. The respondents participated in the study only voluntarily.Results and discussion. Revealed approximately the same nature of lactation disorders in all groups. The predominance of women with hypogalactia after preterm birth was noted; breastfeeding up to one and a half to two years was observed in 4% of young women without chronic somatic pathology after the first spontaneous birth. Respondents of groups 1 and 3 showed high awareness and greater adherence to non-drug correction of hypogalactia in the form of the use of herbal tea. At the same time, some of the respondents in group 2 showed low motivation to maintain breastfeeding and were skeptical about any way to maintain lactation. Among the surveyed respondents, 47% (48 women out of 102) used herbal tea for a long time (3–6 weeks or more). All of them characterized as an effective lactogonic agent, and also noted a calmer behavior of the child, a decrease in intestinal colic and an improvement in the quality of night sleep.Conclusions. A data analysis of the survey of nursing mothers and women who had a breastfeeding experience showed that there is approximately the same pattern of lactation disorders regardless of the woman’s age, high or low awareness of breastfeeding issues.

HEALTHCARE CHALLENGES IN GILGIT BALTISTAN: THE WAY FORWARD

1970 ◽  
Vol 7 (2) ◽  
pp. 113-116
Author(s):  
Amimah Fatima Asif
Keyword(s):  
Health Care ◽  
Healthcare Delivery ◽  
Medical Personnel ◽  
Political Regime ◽  
Quality Healthcare ◽  
Accident And Emergency ◽  
Long Time ◽  
The Common ◽  
Gilgit Baltistan ◽  
And Child Health

Quality healthcare delivery is the bedrock to exponentially accelerate the development of a country. Unfortunately, in Pakistan healthcare has been neglected since a long time, with the common man bearing the brunt of this acute situation. There are critical challenges in health care, with paucity of trained human resource and deficit of regulated infrastructure and service delivery being the predominant dilemmas. Primary and secondary healthcare are in an unseemly state, to say the least. Maternal and child health care, accident, and emergency departments and mental health are among the most undermined and forsaken areas of healthcare, primarily in the far flung Gilgit Baltistan region of Pakistan. The only way forward is if the political regime, administration and the medical personnel work in concurrence to revise the health infrastructure of the country.

scholarly journals (P1-67) Collaboration of Military and Civil EMS during Russian Georgian War 2008

2011 ◽  
Vol 26 (S1) ◽  
pp. s120-s120
Author(s):  
K. Chikhradze ◽  
T. Kereselidze ◽  
T. Zhorzholiani ◽  
D. Oshkhereli ◽  
Z. Utiashvili ◽  
...  
Keyword(s):  
Emergency Care ◽  
Medical Personnel ◽  
Disaster Medicine ◽  
Military Hospital ◽  
Emergency Medical Care ◽  
Field Hospital ◽  
Occupied Territory ◽  
Long Time ◽  
The Military ◽  
The Village

IntroductionDuring 2008 Russian Federation realized major aggression against its direct neighbor, the sovereign republic of Georgia. It was Russia's attempt to crown its long time aggressive politics by force, using military forces. EMS physicians from Tbilisi went to the Gori district on August 8 at first light, 14 brigades were sent. At noontime of August 8, their number was increased up to 40. 6 brigades of disaster medicine experts joined them as well.ResultsDestination site for the beginning was the village Tkviavi, where a military field hospital was assembled and a Military Hospital in Gori. Later 6 brigades were withdrawn towards the village Avnevi. During fighting, wounded victims were evacuated from the battlefield, where initial triage was done. Evacuated victims were brought to the military hospital where the medical triage, emergency medical care and transportation to Gori military hospital or to Tbilisi hospitals was done. A portion of the wounded was directly taken to Gori military hospital and later to different civil hospitals in Tbilisi. Corpses were transported to Gori morgue as well. On August 9, the emergency care brigades and field hospital left Tkviavi and moved to the village Karaleti, then to Gori. On August 12, the occupied territory was totally evacuated by civil and military medical personnel. Although withdrawal of wounded was done on following days. Up to 2232 military and civil persons were assisted by EMS brigades during war period (8–12 August), from them 721 patients were transported among which 120 were severely injured.ConclusionClose collaboration between military and civil EMS gave the system opportunity to work in an organized manner. On the battlefield prepared military rescuers were active taking out wounded victims to the field or front-line hospitals from which civil emergency care brigades transported them to Tbilisi hospitals. Only 3 fatalities occurred during transportation.

scholarly journals Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Aylin Karalezli ◽  
Sema Kaderli ◽  
Ahmet Kaderli ◽  
Cansu Kaya ◽  
Sabahattin Sul
Keyword(s):  
First Year ◽  
Intravitreal Ranibizumab ◽  
Retinal Layers ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

scholarly journals Emergency Management Missing from the Pandemic?

2020 ◽  
Vol 18 (7) ◽  
pp. 149-150
Author(s):  
Attila J. Hertelendy, PhD ◽  
William L. Waugh, Jr., PhD
Keyword(s):  
United States ◽  
Emergency Management ◽  
Task Force ◽  
Medical Personnel ◽  
The United States ◽  
First Year ◽  
Protective Equipment ◽  
Protective Measures ◽  
White House ◽  
Pandemic Response

The change in presidential administrations in the United States promises new approaches to deal with the COVID-19 pandemic. The first year of the pandemic response in the United States has been characterized by a lack of national leadership. Moreover, the message from the White House Coronavirus Task Force has been muddled at best. There have been great inconsistencies in how the States have chosen to address spreading infections and increased stress on individual Americans who are trying to protect themselves and their families. The same pattern can be found with the distribution of vaccines and management of vaccinations. Politics has often conflicted with public health concerns. The States have been left to provide personal protective equipment (PPE) to medical personnel and first responders and to formulate their own guidance for protective measures.

scholarly journals THE EFFECT OF ARTISTIC GYMNASTICS AND STEP AEROBICS ON PHYSICAL PERFORMANCE IN FIRST-YEAR FEMALE UNIVERSITY STUDENTS NOT RELATED TO SPORT

2019 ◽  
Vol 19 (3) ◽  
pp. 66-73 ◽  
Author(s):  
M Avdeeva ◽  
T Belicheva
Keyword(s):  
Oxygen Consumption ◽  
University Students ◽  
Physical Performance ◽  
First Year ◽  
Maximum Oxygen Consumption ◽  
Standing Long Jump ◽  
Long Jump ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Aim. The article deals with establishing the effect of step aerobics and artistic gymnastics on physical performance in first year female university students. Materials and methods. 80 full-time female university students participated in the study. The first group practiced artistic gymnastics (Group 1, n = 40), the second group (Group 2, n = 40) – step aerobics. The mean age was 18.35 ± 0.04 years. In September and December 2017, their physical development, physical fitness, physical performance, respiratory and cardiovascular systems were assessed based on standard procedures using the data of maximum oxygen consumption and the step test. Results. At the beginning of the experiments, there were no statistically significant differences between Group 1 and Group 2. The mean maximum oxygen consumption values corresponded to satisfactory performance (39.85 ± 0.37 – Group 1, 38.92 ± 0.42 – Group 2, р = 0.1). At the end of the experiment, there were statistically significant differences in terms of the mean maximum oxygen consumption: 40.73 ± 0.21 – Group 1 and 41.61 ± 0.21 – Group 2. The results of the ranking showed that the majority of participants demonstrated an increase in physical performance. Group 1 showed an increase in the standing long jump, Group 2 improved 2000 m running time and the standing long jump. Group 2 also demonstrated a decrease in heart rate and an increase in adaptation capacities. Conclusion. The lessons of artistic gymnastics during a semester do not influence significantly physical performance but improve speed-strength characteristics. Step aerobics influences positively physical performance, speed-strength characteristics, and the cardio­vascular system in first-year female university students not related to sport.

scholarly journals Growth and mortality of black bass, Micropterus salmoides (Pisces, Centrachidae; Lacapède, 1802) in a reservoir in southern Brazil

2005 ◽  
Vol 65 (2) ◽  
pp. 363-369 ◽  
Author(s):  
U. H. Schulz ◽  
M. E. Leal
Keyword(s):  
Micropterus Salmoides ◽  
Scientific Information ◽  
Fish Fauna ◽  
Fish Diversity ◽  
First Year ◽  
Southern Brazil ◽  
Small Reservoir ◽  
Long Time ◽  
Black Bass ◽  
Aquaculture Facilities

The black bass, Micropterus salmoides, was introduced to Brazil from North America in 1922. Since then the species has been reared in aquaculture facilities intended to stock reservoirs as additions to native stocks available for angling. At present no scientific information on the biology of black bass in Brazilian waters is available. Since black bass dispersion may cause severe impacts on native Brazilian fish fauna, information on the basic biological parameters of this species is necessary. The objective of the present study is to provide information on the growth, age structure, and mortality of the species in a small reservoir in southern Brazil, where the species reproduces regularly. Based on scale readings, the von Bertalanffy growth curve was calculated and compared to the length-frequency distribution of the population. Both methods showed similar results. Maximum length was about 44 cm. The mean length at the end of the first year was 23.1 cm (s.d. = 13.88); at that of the second, 37.3 cm (s.d. = 12.52); and 41.4 cm (s.d. = 9.92) at the third. Oldest fish were three years old. The growth performance index ø' was 3.28 cm year-1. Mortality increased from 0.16 year-1 between the first and the second cohort, to 0.8 year-1 between the second and third. The results show that black bass in Brazil grows faster than in its area of origin, but longevity is shorter and body shape, stouter. The cause of high mortality at a relatively early age may be connected with the loss of genetic diversity due to inbreeding of the Brazilian stocks, which originated from few introduced individuals a long time ago. The fact that black bass reproduces in reservoirs and grows rapidly may be considered a threat to conserving fish diversity in Brazilian ecosystems.

scholarly journals Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

2021 ◽  
Vol 17 (16) ◽  
pp. 26-30
Author(s):  
Yu.A. Kucheryavy ◽  
◽  
P.R. Movtaeva ◽  
D.N. Andreev ◽  
R.I. Shaburov ◽  
...  
Keyword(s):  
Comparative Study ◽  
Underlying Disease ◽  
On Demand ◽  
Long Time ◽  
Prospective Comparative Study ◽  
Group 2 ◽  
Significant Regression ◽  
Risk Of Relapse ◽  
Group 1

Objective: to evaluate the effectiveness of an esophagoprotector in reducing the risk of recurrent symptoms of gastroesophageal reflux disease (GERD) in patients who requiring temporary cancellation of therapy with proton pump inhibitors (PPIs). Material and methods. For the prospective comparative study there were selectively chose patients who had been taking PPIs for a long time (at least one month) for the underlying disease and who required temporary discontinuation of antisecretory therapy due to objective medical reasons. The study included patients with endoscopically and/or pH-metrically verified GERD, as well as histologically verified Barrett's esophagus. In the process of randomization of patients, two equal groups were formed, depending on the therapy received at the time of PPI withdrawal: group 1 received antacids on demand, group 2 received antacids on demand, as well as the esophagoprotector Alfasoxx at a dose of 10 ml four times a day (after each meal and at night). The follow-up period was two weeks. The patients recorded episodes of heartburn in their personal diaries. Results. The study included 60 patients (28 men and 32 women). The average age of the examined patients was 43.1 ± 5.3 years. By the end of the two-week follow-up period, the frequency of recurrent symptoms in group 1 was 36.7%, while in group 2 it was 13.3%. The use of the esophagoprotector Alfasoxx contributed to the significant regression of the risk of heartburn recurrence (odds ratio 0.2657; 95% confidence interval (CI) 0.07328-0.9637; p = 0.0438) in comparison with the group of patients who received only antacids in the on-demand mode. When analyzing the population of patients who had relapsed symptoms, it was demonstrated that the average number of heartburn episodes in group 1 was 6.18 (95% CI 4,1930-8,1706), and in group 2 – 4.50 (95% CI 0,7121-8,2879). Conclusion. This prospective comparative study demonstrated that the use of the esophagoprotector Alfasoxx helps to reduce the risk of relapse of GERD symptoms in patients requiring temporary cancellation of PPI therapy.

Sociodemographic characteristics of vaccine-refusing families and reasons for refusal

2021 ◽  
Vol 19 (1) ◽  
pp. 124-130
Author(s):  
O.A. Senkevich ◽  
◽  
Z.A. Plotonenko ◽  
V.P. Molochniy ◽  
O.V. Kaplieva ◽  
...  
Keyword(s):  
Maternity Hospital ◽  
Sociodemographic Characteristics ◽  
City Hospital ◽  
Young Mothers ◽  
Cross Sectional ◽  
First Child ◽  
Perinatal Center ◽  
Public Health Institutions ◽  
Group 2 ◽  
High Level

Vaccination is a reliable way to prevent many infectious diseases. Reduced vaccination coverage along with increased migration, high population density, and high risk of epidemic outbreaks makes the issue of vaccine commitment among parents and the problem of vaccine refusal highly relevant. Objective. To analyze sociodemographic characteristics of vaccine-refusing families and reasons underlying their refusal. Patients and methods. We have conducted a blind, consecutive, cross-sectional, cohort study that included 2 groups of respondents: Group 1 included 80 mothers of newborns followed-up at the Perinatal Center, whereas Group 2 comprised 135 mothers of children aged 2–3 years followed-up at the Children's Polyclinic No 2, Children's City Hospital No 9 of Khabarovsk. Data collection was performed between January and September 2018 and included the survey of mothers. The questionnaire was aimed to assess sociodemographic characteristics of the respondents and reasons for refusing vaccination. Results. We have analyzed sociodemographic characteristics of vaccine-refusing families and identified the differences in the social status of mothers of newborns and children aged 2–3 years. In the maternity hospital, young mothers (74.2%) who are officially married (57.5%) with 2 or more children, with secondary or specialized secondary education (58%) were most likely to refuse vaccination. Young mothers of the first child with higher education (65%) (48.5% with higher medical education), with an average income (60%) most frequently refused previous vaccinations of children aged 2–3 ages. In more than half of the cases, there was one child in the family (65.5%); these were primarily two-parent, socially advantaged families. We observed a prior role of a pediatrician as a source of information about vaccination of children and a high level of trust in public health institutions in terms of vaccination. Conclusion. Our findings indicate that the attitude to vaccines is generally positive. However, some parents, whose children may be a reserve for increasing the number of timely vaccinated children, realize the importance of vaccination, but due to some objective reasons (such as medical contraindications) or without substantial reasons postpone it indefinitely. Key words: vaccination, children, refusal, adherence

Survival of Patients with High-Risk Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

2021 ◽  
Vol 104 (6) ◽  
pp. 895-901
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Congenital Heart ◽  
First Year ◽  
Pulmonary Arterial ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD) with uncorrected left-to-right shunts. Currently, no consensus guideline exists on the management of PAH-CHD in children, especially those who do not meet operability criteria. Objective: To compare survival between three groups of high-risk PAH-CHD, group 1: total correction including both surgical and percutaneous intervention, group 2: palliative treatment, and group 3: conservative with medical treatment group. Materials and Methods: All pediatric patients with PAH-CHD that underwent cardiac catheterization between January 1, 2008 and December 31, 2017 were retrospectively reviewed. Inclusion criteria were high risk PAH-CHD patients who had pulmonary vascular resistance (PVR) greater than 6 Wood unit·m² and PVR-to-SVR ratio greater than 0.3 evaluated in room air. Exclusion criteria were younger than three months of age, severe left side heart disease with pulmonary capillary wedge pressure greater than 15 mmHg, obstructive total pulmonary venous return, and single ventricle physiology. The Kaplan-Meier analysis was performed from the date of PAH diagnosis to the date of all-cause mortality or to censored date at last follow-up. Results: Seventy-six patients with a median age at diagnosis of 27.5 months (IQR 14.5 to 69.0 months) were included in this study. The patients were divided into three subgroups and included 38 patients (50.0%) in group 1, six patients (7.9%) in group 2, and 32 patients (42.1%) in group 3. The median follow-up time was 554 days (IQR 103 to 2,133 days). The overall mortality was 21.7%. One-year survival in patients with simple lesion in group 1 and 3 were 79.5% and 87.5% and patients with complex lesions in group 1, 2, and 3 were 93.8%, 83.3%, and 73.1%, respectively. The results showed that most mortalities occurred in the first year. There were no statistically significant differences in survival among difference types of treatment (log rank test, p=0.522). Conclusion: The mortality of high-risk PAH-CHD patients were not different among those who underwent corrective surgery, palliative, or conservative treatment. The mortality was high in the first year after PAH diagnosis and remain stable afterward. Management decision for an individual with high-risk PAH-CHD patients requires comprehensive clinical assessment to balance the risks and benefits before making individualized clinical judgment. Keywords: Pulmonary hypertension; Congenital heart disease; High-risk patients

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