scholarly journals Methods and tools of the rehabilitation process in a case of acute disseminated encephalomyelitis (ADEM) in the evolutionary age: continuity hospital - territory

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
G. Grippo ◽  
T. Bolgeo ◽  
G. Carpanese ◽  
C. Florio ◽  
A. Prosperi ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Acute Disseminated Encephalomyelitis ◽  
Positive Outcome ◽  
Practical Implementation ◽  
Second Phase ◽  
Care Hospital ◽  
Web Page ◽  
Organizational Models ◽  
Study Results ◽  
Good Individual

Background: An analysis of the situation of the Piedmont Region and Italy shows a lack of continuity of care due to the difficulties of communication, the fragmentation and incorrect timing of the interventions, the development of ultraspecialized skills and a lack of organizational models. However, program sharing and coordination of interventions are essential for the practical implementation of the rehabilitation, especially in pediatric physiotherapy. Purpose and Objective: Aim of the study is the continuity of care (hospital-territory) for children with acute disseminated encephalomyelitis, in order to achieve a good individual and family compliance in the rehabilitation programme and greater levels of autonomy. This study uses a figure to link the two realities and telerehabilitation. Methods: The project was divided into a first phase, the intensive hospitalization and a second phase, the return to the home withrehabilitation, trainingeducational and organizational interventions. The graduand student has been identified as a point of reference and a “bridge” between the two realities. A web page with “Google Forms” customized for children was created in order to increase compliance and motivation of patients and family. Questionnaires were administered to families, children and healthcare to check the methods and tools used in the study. Results: At the end of the study the rehabilitative intervention was assessed by scales and test scores, and improvements have been achieved. The organizational intervention (web page and hospital and communuty continuity mode), evaluated through questionnaires, has been postively assessed by those who took part in this project. Hospital-Territory continuity is a crucial and important moment for patients: having a physiotherapist who acts as a trait d’union is essential as is the use of telerehabilitation for monitoring and maintaining the autonomy of these children. Conclusions: Continuity of care is still operator-dependent; in rehabilitation this is a crucial and important time, as evidenced by the project. In order to support patients and their families and facilitate positive outcome it would be really important to have a reference organizational model and a referent physiotherapist who represents an interface between the various players in the socio-medical system The problem remains open and each route has its own story.

scholarly journals Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Functional Health ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Post Stroke ◽  
Self Rated Health ◽  
Modifying Factors ◽  
Study Results

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.

Total Population Estimate of Newborn Special-Care Bed Needs

PEDIATRICS ◽  
1985 ◽  
Vol 75 (6) ◽  
pp. 993-996
Author(s):  
August L. Jung ◽  
Nan Sherman Streeter
Keyword(s):  
Length Of Stay ◽  
Total Population ◽  
Average Length ◽  
Special Care ◽  
Care Hospital ◽  
Total Hospital ◽  
Live Births ◽  
Average Length Of Stay ◽  
Study Results ◽  
Hospital Days

In 1977, 7% of the 38,855 infants born in Utah were estimated to have required a total of 27,439 special-care hospital days. About half (53%) were mildly ill; their average length of stay was 4.6 days, or 24% of the total hospital-days. Another 20% of the infants had intermediate illness, with a 12-day average stay, or 23% of the total hospital-days. The remaining 27% of the infants required intensive care and used 53% of the total hospital-days; their average length of stay was 20 days. As a total population, the state's 38,855 births generated a need for two beds per 1,000 annual live births in special-care facilities. The estimated bed need was: mild illness (Level I), 0.5 beds per 1,000 annual live births; intermediate illness (Level II), 0.5 beds per 1,000 annual live births; and intense illness (Level III), one bed per 1,000 annual live births. Results are based on the assumption that nonstudy births, 30% of the total, have needs proportionate to study births. The following considerations are necessary to extrapolate these bed needs to other populations: (1) convalescence of intensely ill babies may require that up to 50% of their bed needs may be shifted to intermediate care; (2) compliance with criteria for transport to the next level of care may not be 100% as assumed in the study, thus redistributing bed needs; (3) census characteristically fluctuates in special-care nurseries (study results are reported for an unchanging daily census); and (4) the low birth rate of a population is intimately related to the bed needs.

Psychological Morbidity Among Post-COVID-19 Patients: A Cross-sectional Study from Chennai, South India

2021 ◽  
Vol 4 (01) ◽  
pp. 10-17
Author(s):  
D. Devi ◽  
V. Monica ◽  
Ravi Santhosh ◽  
Vijaya Raghavan ◽  
P. Poornachandrika
Keyword(s):  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Panic Attacks ◽  
Psychological Morbidity ◽  
Care Hospital ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Results

Background: The COVID-19 pandemic is a global health threat and is by far the largest outbreak of atypical pneumonia, since the SARS outbreak in 2003. A range of psychiatric morbidities such as persistent depression, anxiety, panic attacks, delirium and suicidality were observed in the post infectious state across the world. Hence, the aim of the study was to understand the psychological status of the patients affected by COVID during their post-COVID follow-up period and to examine the socio-demographic and clinical factors associated with high psychological morbidity. Materials and Methods: A cross sectional study conducted in the post-COVID follow up clinic, at a tertiary care hospital between the months of August - November 2020, using a semi structured proforma and rating scales such as Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) for depression, anxiety and insomnia, respectively. Results: The study results indicate that the prevalence of depression and anxiety among post-COVID-19 patients was 21.9% and 11.9%, respectively. Insomnia was observed among 21.7%Among various sociodemographic and clinical variables examined, it was observed that female gender, patients with ongoing stressors and patients with post-COVID-19 persistent physical symptoms were found to be associated with greater depression and anxiety among the study population. Conclusions: Persistent physical symptoms and ongoing life stressors are found to be associated with depression and anxiety among post-COVID-19 patients. Hence, periodic screening for individuals with persisting physical symptoms and care for the vulnerable population such as those with ongoing stressors will provide a significant advantage in the follow up of the mental health of the patients affected with COVID-19.

scholarly journals Halitosis: Its Aetiology and Psychosocial Impact- A Hospital Based Study

2021 ◽  
Vol 29 (2) ◽  
pp. 145-150
Author(s):  
Gopika Kalsotra ◽  
Monica Manhas ◽  
Sachin Gupta ◽  
Heemani Bhardwaj ◽  
Parmod Kalsotra ◽  
...  
Keyword(s):  
Social Life ◽  
Laryngopharyngeal Reflux ◽  
Systemic Disease ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Psychosocial Impact ◽  
Care Hospital ◽  
Female Ratio ◽  
Study Results ◽  
A Prospective Study

Introduction Halitosis means bad or unpleasant odour from oral cavity. It causes embarrassment to the patients and affects their social life and communication. This study aims to find the causes of halitosis and to assess its psychosocial impact. Materials and Methods A prospective study was conducted in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care hospital. It included 165 patients, presenting to the ENT OPD with chief complains of oral malodour for at least 3 months. The patients in the age above 15 years and below 75 years, irrespective of gender, were included in the study. Results The age of the patients ranged from 15 to 75 years with a mean age of 52.24 ± 15.67 with male: female ratio of 7:10. The most common cause of halitosis in the present study included chronic rhinosinusitis (38.7%), gingivitis/periodontitis (19.39%), tonsillitis (4.84%), laryngopharyngeal reflux (2%), deep neck space infections (1.2%). In 23.56%, the halitosis was a symptom of an underlying malignancy. Conclusion Halitosis from an extra oral origin can be the sign of an underlying systemic disease or malignancy. The consultation should be done with the periodontist, ENT specialist and a physician.

scholarly journals Poisoning trends in intensive care unit at secondary care hospital – a pilot study

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Sri Nanda G ◽  
Balaji S ◽  
Khayati Moudgil
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Small Scale ◽  
Hazardous Substance ◽  
Care Hospital ◽  
Global Issue ◽  
Study Results ◽  
Living Organisms ◽  
Collection Form

Poison is known as a toxic and hazardous substance that is capable of causing illness to the living organisms. It can lead to some fatal outcomes. Self-harming has become a global issue, which is a burden on society. Every year millions of people die due to the consumption of toxic compound and leaving their loved ones behind in grief. The prospective pilot study was performed on a small scale for a period of three months. Each type of poison case admitted to Intensive care unit for the three months from July 2018 to September 2018 were taken into consideration. The informed consent has been obtained from all the patients, whereas demographics details of the patient were obtained using a predesigned data collection form. During the study period, 37 cases of poisoning were reviewed. The incidence is found to be more in males 28 (75.6%) when compared to females 9 (24.3%). Our study results showed that pesticides are the major reason for poisoning with an intention of self- harming. Majority of the poisoning cases were seen in the age group of 21-30 where physical and mental stress is the major reason.

A CLINICAL STUDY OF ETIOLOGY, OUTCOME AND PROGNOSTIC FACTORS OF ACUTE KIDNEY INJURY AMONG ICU ADMISSIONS IN RURAL TERTIARY CARE HOSPITAL

2021 ◽  
pp. 201-204
Author(s):  
Shashikantha Shashikantha ◽  
Sohil Sharda. ◽  
Bernice Robert ◽  
Gangurde Bhushan Daulatrao
Keyword(s):  
Acute Kidney Injury ◽  
Prognostic Factors ◽  
Renal Disease ◽  
Tertiary Care Hospital ◽  
Chronic Renal Disease ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Care Hospital ◽  
Study Results

INTRODUCTION: Acute kidney injury is a common occurrence in ICU admissions causing increased morbidity and mortality. Present study aimed to determine the causes and prognostic factors of acute kidney injury in intensive care unit. MATERIAL AND METHODS: This Hospital based Cross sectional Study was conducted at a tertiary care Hospital and Research Center, including 100 patients aged >18 years with Acute Kidney Injury admitted in ICU from the period of October 2018 to June 2020. Patients with chronic renal disease, previous renal transplantation, congenital renal disease were excluded from the study. RESULTS: Most of the patients (63%) were aged above 50 years. Diabetes was found in 55% and hypertension in 26% of AKI cases. Most common cause identied were sepsis, CLD, renal, CNS and CVD. Hypotension occurred in 48% patients, while oliguria occurred in 45% patients. Ventilatory support was required by 43% patients, while 31% patients required haemodialysis. Mortality rate in AKI was 51%. Mortality was signicantly associated with advanced age, presence of Diabetes, and RIFLE criteria. Spot urine <40 meq/L, hyperkalemia, serum creatinine >4 mg/dl, blood urea >100 mg/dl and acidosis were associated with higher mortality. CONCLUSION: Continuous monitoring parameters like Spot Fe Na, Serum Potasium and pH especially in patients at risk, like elderly patients with diabetes, those with sepsis, can help in early identication and appropiate management, thus reduce the incidence or severity of AKI.

ORAL IRON VERSUS PARENTERAL IRON SUCROSE IN A RURAL TERTIARY CARE HOSPITAL OF SOUTHERN INDIA

2021 ◽  
pp. 48-50
Author(s):  
Ravindra S Pukale ◽  
Kavyashree H B
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cell Mass ◽  
Medical Science ◽  
Oral Iron ◽  
Iron Sucrose ◽  
P Value ◽  
Care Hospital ◽  
Study Results ◽  
Group B

Introduction: Nutritional iron deciency is one of the most common deciency disorders affecting more than one billion people, with pregnant women at particular risk. In pregnancy iron decit attributable due to increased iron demand of the feto-placental unit and an increase in maternal red cell mass. 30% of anaemic women have haemoglobin levels below 10g/dl above 10% below 8g/dl. Irrespective of mode of delivery blood loss can also be a contributing factor postnatal. Oral iron therapy and intravenous iron sucrose are the main therapy of iron deciency anaemia. The present study is aimed at comparing both their efcacy side effects. METHOD : Aprospective randomised control study was done from June 2019- September 2020, in the department of Obstetrics and gynaecology, Adichunchanagiri Institute of Medical Science, BG nagara. 253 women including antenatal women between 8-38 weeks gestational age were studied and postnatal women studied with no associated obstetrics and medical complication. They were divided into Group A (Oral) and Group B(Intravenous) by randomization. The two groups were monitored clinically, and for an improvement in laboratory parameters after four weeks on day 30 haemoglobin and haematocrit were repeated in both the groups. This study results were expressed as mean +/- standard deviation. And to test the signicance of difference between Oral and IVmode of treatment, student Ttest was done to verify the statistical signicance. RESULTS: Out of 253 patients in the study the mean age of ANC patients was 24.7+/- 4.4years. Mean age of PNC patients was 24.15+/- 3.5years. The peripheral smear showed Dimorphic anaemia in 9.1% and Microcytic Hypochromic picture in 90.9 % of the patients. Initial haemoglobin of ANC patients was 9.8+/- 0.3g/dl. The initial haemoglobin of PNC patients was 9.73+/- 0.91g/dl. 59.3% of the patient had a haemoglobin between 7.1 and 10.0g/dl. Final haemoglobin of an ANC patient was 11.68+/-0.98g/dl, PNC patients 11.69+/-0.99g/dl. There was a substantial increase in Group Ahaemoglobin (oral iron) raising from 10.2+/-7.2g/dl to 12.0+/-0.92g/dl with a T value of 9.25. as well as in Group B (iron sucrose) raising from 9.3+/-8.5g/dl to 11.3+/-0g/dl with T value of 5.65. In both cases this raise in haemoglobin after four weeks had a p value less than 0.01 which was highly statistically signicant. Conclusion:Intravenous iron sucrose is more effective than oral iron for correction of anaemia with lesser side-effect

The Effects of Combined Training of Web-Based Problem-Based Learning and Self-Regulated Learning

2011 ◽  
Vol 6 (2) ◽  
pp. 40-50
Author(s):  
Chia-Wen Tsai ◽  
Pei-Di Shen ◽  
Tsang-Hsiung Lee
Keyword(s):  
Course Design ◽  
Problem Based Learning ◽  
Web Page ◽  
Specific Context ◽  
Web Based ◽  
Combined Training ◽  
Self Regulated Learning ◽  
Low Achieving Students ◽  
Study Results ◽  
Regulated Learning

This study explored, via quasi-experiments, the effects of the combined training in web-based problem-based learning (PBL) and self-regulated learning (SRL) on low achieving students’ skill development. Two classes of 76 undergraduates in a one-semester course titled ‘Web Page Programming and Website Planning’ were chosen for this study. Results were generally positive, showing enhanced skills of website planning and higher levels of involvement. This study provided an illustration of a promising course design and its associated implementations in the specific context of low achieving students, for which there is lack of research in the current literature.

scholarly journals Effects of Short-Term Inhibition of Rho Kinase on Dromedary Camel Oocyte In Vitro Maturation

Animals ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 750
Author(s):  
Hammed A. Tukur ◽  
Riyadh S. Aljumaah ◽  
Ayman Abdel-Aziz Swelum ◽  
Abdullah N. Alowaimer ◽  
Mutassim Abdelrahman ◽  
...  
Keyword(s):  
In Vitro Maturation ◽  
Rho Kinase ◽  
Positive Outcome ◽  
Dromedary Camel ◽  
Second Phase ◽  
Short Term ◽  
Rock Inhibitor ◽  
Nuclear Maturation ◽  
Significant Difference

This is the first report on a biphasic in vitro maturation (IVM) approach with a meiotic inhibitor to improve dromedary camel IVM. Spontaneous meiotic resumption poses a major setback for in vitro matured oocytes. The overall objective of this study was to improve in vitro maturation of dromedary camel oocytes using ROCK inhibitor (Y-27632) in a biphasic IVM to prevent spontaneous meiotic resumption. In the first experiment, we cultured immature cumulus–oocyte complexes (COCs, n = 375) in a prematuration medium supplemented with ROCK inhibitor (RI) for 2 h, 4 h, 6 h, and 24 h before submission to normal in vitro maturation to complete 28 h. The control was cultured for 28 h in the absence of RI. In the first phase of experiment two, we cultured COCs (n = 480) in the presence or absence (control) of RI for 2 h, 4 h, 6 h, and 24 h, and conducted real-time relative quantitative PCR (qPCR) on selected mRNA transcripts. The same was done in the second phase, but qPCR was done after completion of normal IVM. Assessment of nuclear maturation showed that pre-IVM for 4 h yielded an increase in MII oocyte (54.67% vs. 26.6% of control; p < 0.05). As expected, the same group showed the highest degree (2) of cumulus expansion. In experiment 2, qPCR results showed significantly higher expression of ACTB and BCL2 in the RI group treated for 4 h when compared with the other groups. However, their relative quantification after biphasic IVM did not reveal any significant difference, except for the positive response of BCL2 and BAX/BCL2 ratio after 4 and 6 h biphasic IVM. In conclusion, RI prevents premature oocyte maturation and gave a significantly positive outcome during the 4 h treatment. This finding is a paradigm for future investigation on dromedary camel biphasic IVM and for improving the outcome of IVM in this species.

Multi-Vehicle Trajectory Design During Cooperative Adaptive Cruise Control Platoon Formation

2020 ◽  
Vol 2674 (4) ◽  
pp. 30-41 ◽  
Author(s):  
Qinzheng Wang ◽  
Xianfeng (Terry) Yang ◽  
Zhitong Huang ◽  
Yun Yuan
Keyword(s):  
Fuel Consumption ◽  
Adaptive Cruise Control ◽  
Second Phase ◽  
Trajectory Design ◽  
Cruise Control ◽  
Basic Scenario ◽  
Vehicle Trajectories ◽  
Cooperative Adaptive Cruise Control ◽  
Proposed Model ◽  
Study Results

Cooperative adaptive cruise control (CACC) organizes connected and automated vehicles (CAVs) in platoons to improve traffic flow and reduce fuel consumption. Platoon formation involves a very complex process, however, because lateral and longitudinal misbehavior of CAVs results in greater fuel consumption and risk of collision. This study aims to design optimal vehicle trajectories of CAVs during CACC platoon formation. First, a basic scenario and a destination-based protocol are described to determine vehicle sequence in the platoon. A space-time lattice based model is then formulated to construct vehicle trajectories considering boundary conditions of kinematic limits, vehicle-following safety, and lane-changing rules. The objective is to optimize the vehicle sequence and fuel consumption simultaneously. A two-phase algorithm is proposed to solve this model, where the first phase is a heuristic algorithm that determines vehicle sequence and in the second phase dynamic programming is adapted to optimize fuel consumption based on the determined sequence. To evaluate the effectiveness of the proposed model in designing CAV trajectories, extensive experimental tests have been conducted in this study. Results show that the proposed model and algorithm can effectively optimize CAV sequence in the platoon based on their destinations. After optimization, CAV fuel consumption was reduced by 42%, 46%, and 43%, respectively, in three different tested scenarios.

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