scholarly journals Accuracy of Heart Auscultation Examination by General Practitioners From Various Levels of Competency in Detection of Heart Abnormality in Basic School Children

2022 ◽  
Vol 6 (3) ◽  
pp. 1465-1474
Author(s):  
Annisa Permatasari ◽  
Deny Salverra Yosy ◽  
Achirul Bakri ◽  
Ria Nova

Background. Most of heart defects in children do not show typical clinical symptoms. Ten percent of the cases are late detected. Echocardiography is an examination with high sensitivity and specificity in detecting heart defects in children, but it cannot be performed by all health workers, expensive and not always available in hospitals. Auscultation is an important part of a physical examination that inexpensive, easy examination, and becomes a competency of all doctors. The aim of this study to determine the accuracy of the screening method by listening to murmurs on heart auscultation by various levels of physician competence. Methods. This is a diagnostic test of 250 elementary school children held in the pediatric ward of dr. Mohammad Hoesin Palembang from September to November 2019. The auscultation examination was performed by three pediatrics resident from three stages (i.e. junior, middle and senior), followed by echocardiography examinations by a pediatric cardiologist. Results. The highest sensitivity of auscultation was found in senior resident, 42.4%, while the lowest was found in junior resident, 12.1%. The results of the kappa analysis of the cardiac auscultation examination on the three examiners showed a poor level of agreement on junior stage  compared to senior resident (k = 0.189; CI = 0.033-0.346) and the level of agreement was sufficient in junior stage compared to middle stage resident (k = 0.297; CI = 0.134 -0.461) and middle stage compared to senior resident (k = 0.301; CI = 0.147-0.456). Conclusion. Experience and length of learning will affect the accuracy of the auscultation examination in detecting heart defects in children.

2019 ◽  
Vol 5 (2) ◽  
pp. 100-103
Author(s):  
Mestika Rija Helti ◽  
Suriani ◽  
Zakiah

Measles and rubella can have a negative impact on children's health in Indonesia, so the government has implemented an MR vaccination campaign (MMR VIS - Indonesia, 2012). The MR (Measles Rubella) vaccine provides benefits such as protecting children from disability and death due to complications of pneumonia, diarrhea , brain damage, deafness, blindness and congenital heart disease. There were 83 confirmed cases of CRS in 2015-2016 of which 77% suffered from heart defects, 67.5% suffered from cataracts and 47% suffered from deafness (Ditjen P2P, 2016). The research objective was the Effect of Promotion of Health Workers on the Improvement of Rubella Measles Immunization at the Bandar Khalipah Public Health Center in 2019. This type of research is descriptive analytic with a cross sectional approach with a sample size of 18, it is recommended to carry out promotions. The sampling technique is purposive sampling technique. The research instrument uses leaflet sheets. Univariate analysis using Microsoft Excel. The results showed that the total coverage of rubella measles immunization prior to promotion at the Bandar khalipah health center 2019 was 340 (7.8%) in the "decreased" category and after promotion the total coverage of rubella measles immunization at the Bandar khalipah puskesmas was 367 (8, 6%) are in the “increasing” category. So that there is an effect of promotion of health workers on increasing the provision of rubella measles immunization at the Bandar khalipah public health center in 2019. Conclusion in this study there is an effect of promotion of health workers on increasing rubella measles immunization, so that health workers can use promotion as an effort to support government programs, coverage of immunization rubella measles 95%.


2021 ◽  
Vol 3 (1) ◽  
pp. 23
Author(s):  
Inayah Hayati ◽  
Eka Nurdianty Anwar ◽  
Muhammad Yandi Syukri

Health Education in Efforts to Prevent Scabies at Islamic Boarding School of Harsallakum Madrasah Tsanawiyah Bengkulu Scabies is a skin disease caused by the Sarcoptes scabiei parasite that invades the skin of humans or animals. The high prevalence of scabies is generally found in environments with high population density and high interpersonal contacts such as prisons, Islamic boarding schools, and orphanages. There has been no research on the prevalence of scabies in the Harsallakum Islamic Boarding School, Bengkulu city. However, based on information from the school, there were several students who have been infected by skin disease with clinical symptoms of scabies. This community service program was aimed to provide education to students about preventing scabies infection. The service activities included delivering material about scabies, distributing leaflets, post-test and pre-test. This activity was attended by 65 participants. Evaluation included pre-test and post-test about the education carried out. The instrument to measure the level of students' understanding was the form of a questionnaire. The average value of the pre-test was 55.18 while the average value of the post-test was 80.26. It was concluded that this educational activity could increase the knowledge of the students of the Harsallakum Islamic Boarding School in Bengkulu about scabies disease. To optimize the prevention of scabies transmission, it is recommended to increase health education activities by involving health workers.


IKON ◽  
2009 ◽  
pp. 111-149
Author(s):  
Carlo Cristini ◽  
Marcello Cesa-Bianchi

- Increase aged produces more specific dangers about health and autonomy for many old people; it is possibile to see in aged a life dicotomy: from one side autonomies, creatives, enterprising, propositives old people, from other side old people present loose of physical and mental autonomy. There are many factors that may cause with years disabilities conditions: from changes of living organism in males and females climacteric, from loneliness to alienation, from illness to institutionalized. In old age happen traumatic events, more than other phases of life, as situations about (affective, social, professional and healthy loses) that may produce clinical pain, an affecctive and cognitive decline. In old age depression and dementia represent the more frequent mental and behavioral disturbances. Of course becomes more important to learn, to analyse knolewdge and communication, suffering aged and wih his family. The relationship especially with dement, requires attention, sensitiveness, the decodification of messages, of his identity and of social relationship. Some health workers mind always to some meanings in communication that are to be analysed especially in suffering aged, with dement. Communication and understanding of old people mean give opportunities of support, of changing, of relieving painful and of its clinical symptoms.


Author(s):  
Ralf Zeckay ◽  
Grzegorz Sliwinski ◽  
Christine Thiele ◽  
Wojtek Kufel ◽  
Bartłomiej Halat ◽  
...  

2013 ◽  
Vol 57 (1) ◽  
pp. 123-126 ◽  
Author(s):  
Urszula Pasławska ◽  
Agnieszka Noszczyk-Nowak ◽  
Adrian Janiszewski ◽  
Józef Nicpoń

Abstract The aim of the study was to estimate prevalence of tricuspid dysplasia (TD) in dogs with respect to breed, age, sex, clinical signs, and echocardiographic findings and to compare this data with literature. TD was found in 15 dogs (6.5% of congenital cardiac disease) of 215 dogs with congenital heart defects. All dogs had right heart enlargement on thoracic radiographs, echocardiography, and electrocardiography. Doppler echocardiography revealed tricuspid valve regurgitation. Seven dogs presented no clinical symptoms to date. TD took the form of Ebstein anomaly in all Labrador Retrievers, one Boxer, and one German Shepherd dog. TD predominated in males (11 males vs. three females). The body weight of the affected dogs, with the exception of the Miniature Schnauzer, exceeded 20 kg. Two dogs (Boxer and Bull Terrier) had additional congenital cardiac lesions in the form of mitral valve dysplasia. The most affected breeds in the study were the Labrador Retriever and Boxer.


2017 ◽  
Vol 7 (8) ◽  
pp. 794-800 ◽  
Author(s):  
Barrett S. Boody ◽  
Brett D. Rosenthal ◽  
Tyler J. Jenkins ◽  
Alpesh A. Patel ◽  
Jason W. Savage ◽  
...  

Study Design: Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center. Objectives: To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training. Methods: Twenty participants comprising senior medical students and orthopedic surgical residents. Participants were randomized to control (n = 9) or intervention (n = 11) groups controlling for level of experience (medical students, junior resident, or senior resident). The intervention group underwent a 40-minute bioskills training module, while the control group spent the same time with self-directed study. Pre- and posttest performance was self-reported by each participant (Physician Performance Diagnostic Inventory Scale [PPDIS]). Objective outcome scores were obtained from a blinded fellowship-trained attending orthopedic spine surgeon using Objective Structured Assessment of Technical Skills (OSATS) and Objective Decompression Score metrics. Results: When compared with the control group, the intervention group yielded a significant mean improvement in OSATS ( P = .022) and PPDIS ( P = .0001) scores. The Objective Decompression Scores improved in the intervention group with a trend toward significance ( P = .058). Conclusions: We conclude that a concise lumbar laminectomy bioskills training session can be a useful educational tool for to augment clinical education. Although no direct clinical correlation can be concluded from this study, the improvement in trainee’s technical and procedural skills suggests that Sawbones training modules can be an efficient and effective tool for teaching fundamental spine surgical skills outside of the operating room.


2021 ◽  
Vol 10 (16) ◽  
pp. 3547
Author(s):  
Michael Koch ◽  
Matti Sievert ◽  
Heinrich Iro ◽  
Konstantinos Mantsopoulos ◽  
Mirco Schapher

Background: Ultrasound is established as a diagnostic tool in salivary glands for obstructive diseases such as sialolithiasis and tumors. Concerning inflammatory diseases and in non-sialolithiasis-caused obstruction, much fewer data are available. In recent years, technical development has allowed a better assessment of the gland parenchyma, and knowledge about intraductal pathologies has increased considerably, which has provided new insights and a new interpretation of ultrasound findings. Objectives: To provide a comprehensive review of the literature that includes our own experiences and to point out the state of the art in ultrasound in the diagnostics of inflammatory and obstructive salivary gland diseases, taking adequate techniques and recent technical developments into consideration. Data sources and study eligibility criteria: A systematic literature search was performed in Pubmed using various specific key words. Results: According to the literature results, including our own experiences, ultrasound is of value in up to >90% of cases presenting with inflammatory and/or obstructive diseases. Technical developments (e.g., elastography) and the application of modified ultrasound techniques (e.g., transoral ultrasound) have contributed to these results. Today, ultrasound is considered a first-line diagnostic tool in these diseases. However, in some inflammatory diseases, the final diagnosis can be made only after inclusion of the anamnesis, clinical symptoms, serologic blood tests, or histopathologic investigation. Conclusions: Ultrasound can be considered as a first-line diagnostic tool in obstructive and inflammatory salivary gland diseases. In obstructive diseases, it may be sufficient for diagnostics in >90% of cases. In inflammatory diseases, ultrasound is at least an excellent screening method and can be used to establish the diagnosis in cases of an early suspicion. In all diseases ultrasound can contribute to better management and can be used for monitoring during follow-up.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Pavlicek ◽  
Eva Klaskova ◽  
Sabina Kapralova ◽  
Alzbeta Moravova Palatova ◽  
Alicja Piegzova ◽  
...  

Abstract Background Severe or critical congenital heart defects (CHDs) constitute one third of the heart defect cases detected only after birth. These prenatally unrecognised defects usually manifest as cyanotic or acyanotic lesions and are diagnosed postnatally at various times. The aim of the study was to identify their clinical symptoms and determine individual risk periods for CHD manifestation. Methods Data were assessed retrospectively based on a cohort of patients born between 2009 and 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was classified into: early neonatal (0–7 days), late neonatal (8–28 days), early infancy (1–6 months), or late infancy (6–12 months). The first symptom for which the child was referred to a paediatric cardiologist was defined as a symptom of CHD. Results There were 598 major CHDs diagnosed in the studied region, 91% of which were isolated anomalies. A concomitant genetic disorder was diagnosed in 6% of the cases, while 3% presented extracardiac pathology with a normal karyotype. In total, 47% (282/598) of all CHDs were not identified prenatally. Of these, 74% (210/282) were diagnosed as early neonates, 16% (44/282) as late neonates, and 10% (28/282) as infants. The most common symptoms leading to the diagnosis of CHD were heart murmur (51%, 145/282) and cyanosis (26%, 73/282). Diagnosis after discharge from the hospital occurred in 12% (72/598) of all major CHDs. Ventricular septal defect and coarctation of the aorta constituted the majority of delayed diagnoses. Conclusions In conclusion, murmur and cyanosis are the most common manifestations of prenatally undetected CHDs. Although most children with major CHDs are diagnosed as neonates, some patients are still discharged from the maternity hospital with an unidentified defect.


2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.


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