Pilot study on the effectiveness of telemedicine in improving the quality of diabetes care of the rural Nepal

AbstractThe use of telecommunication in the field of medicine is very limited in Nepal. Despite huge potential of improving access of the sub-urban and rural communities with the urban-based health care professionals for expert consultation, the use of the telecommunication technology remains largely unexplored. In light of the facts, a comparative study was conducted at a rural community in Makwanpur. In total 40 patients (20 in each group) were selected for the study with an objective to test the feasibility and effectiveness of telemedicine in improving the quality of diabetes care in an experimental group and control group in Makwanpur district. In the intervention group, diabetes care was provided with tele-consultation for diabetes care mediated via local doctor. The outcome was compared with a control group based in an urban community with treatment as usual in their community. The study results showed that the use of telemedicine is a feasible alternative to provide diabetes care in rural Nepal. Overall fasting blood sugar was better controlled in the control group whereas there was significant improvements in micro albumin were observed in the interventional group. Similarly, the knowledge of the respondents on various aspects of the disease was also found to be better in the interventional group than in the control group. Majority of the respondents (90%) felt telemedicine service is less expensive than the service they had taken before.

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Hysteroscopic management of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial

QJM ◽

10.1093/qjmed/hcab115.005 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hatem Hussein El-Gamal ◽

Walid El-Basuony Mohammad ◽

Ahmed Samir Mohamed Zeerban

Keyword(s):

Quality Of Life ◽

Caesarean Section ◽

Controlled Trial ◽

Intervention Group ◽

Expectant Management ◽

Control Group ◽

Randomised Controlled ◽

Caesarean Scar Defect ◽

Interventional Group

Abstract Background Long-term complaints after caesarean section, such as postmenstrual spotting, dysmenorrhea, dyspareunia, or chronic pelvic pain, are frequently described in relation to the presence of a niche. A post-caesarean niche is defined as an indentation in the myometrium at the site of the uterine scar. Two independent prospective cohort studies reported that the presence of a niche after caesarean section increases the risk of postmenstrual spotting for more than 2 days from 15 to 30%. Postmenstrual spotting may be caused by a mechanical outflow problem, with the retention of menstrual blood in a niche, or by the accumulation of blood because of impaired uterine contractions at the site of the niche. Additionally, newly formed fragile vessels in the niche may play a role in the formation of blood or fluid in the niche and uterine cavity. Objective The aim of this study was to compare the effectiveness of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting and a uterine caesarean scar defect. Methods This trial is a randomised controlled trial that provides evidence for the (cost) effectiveness of hysteroscopic resection of a niche versus expectant management in women with niche related postmenstrual spotting. It was carried out on 28 cases divided into two equal group. The study was conducted at Ain Shams University on the women reporting postmenstrual spotting after a caesarean section. The primary outcome was the number of days of postmenstrual spotting 6 months after randomization. Secondary outcomes were spotting at the end of menstruation, intermenstrual spotting, dysuria, sonographic niche measurements, quality of life, women’s satisfaction, sexual function, and additional therapy. Outcomes were measured at 3 months and, also at 6 months after randomization. Results The results of this study show a significant improvement in interventional group after 3 months more than the control group in bleeding micturition characteristics which includes total days of spotting, spotting end of menstruation, intermenstral spotting, discomfort from spotting, dysmenorrhea and daily pain during micturition, after 6 months the two group improved but the interventional group was significantly higher than control group. Regarding the radiological assessment it was found that there was a significant improvement in intervention group more than the control group after 3 months, also the control group improved after 6 months also, but the intervention groups was significantly higher than the control group. The quality of life show a significant increasing in intervention group more than the control group after 3 months of intervention, at the end of follow up the intervention group was significantly higher in quality of life more than the control group. Conclusion A hysteroscopic niche resection reduces postmenstrual spotting, and the discomfort from spotting, compared with expectant management after 3 months of follow-up in women with a niche with a residual myometrium of at least 3 mm.

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The Effect of Jazar Supplement on Quality of Life and Sexual Function in Postmenopausal Women: A Double-Blind, Randomized, Placebo-Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/8854182 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Sousan Hafizi ◽

Alireza Abbassian ◽

Malihe Tabarrai

Keyword(s):

Quality Of Life ◽

Sexual Function ◽

Postmenopausal Women ◽

Hormone Replacement ◽

Intervention Group ◽

Control Group ◽

Vaginal Atrophy ◽

Vaginal Ph ◽

Study Results

Background. Menopause is one of the most critical stages of a woman’s life and is accompanied by symptoms including hot flashes, night sweats, mood swings, sexual dysfunction, mucus atrophy, and vaginal dryness. Women tend to use complementary and alternative medicine such as herbs rather than hormone replacement therapy to alleviate these symptoms. The purpose of this study is to examine the effects of Jazar supplement (herbal supplement comprising Vitex, fennel, and carrot seeds) on sexual function, quality of life, and vaginal atrophy in postmenopausal women. Methods. This study was a randomized clinical trial conducted on ninety postmenopausal women. Participants were randomized to intervention/control groups using block randomization. The intervention group received four Jazar capsules (500 mg each) daily, while the control group received a placebo for eight weeks. Data were gathered using a socio-demographic questionnaire, the Female Sexual Function Index (FSFI), and the Menopause-Specific Quality of Life (MENQOL) before the intervention and at weeks 4, 8, and 10. Vaginal pH and vaginal maturation index (VMI) were measured before and at the end of the study. Results. Eighty-four women completed the trial, and six women withdrew. There were no remarkable differences between the two groups in terms of quality of life, sexual function, VMI, and vaginal pH at baseline. At the end of the study, participants in the intervention group had a significantly lower score in terms of quality of life P < 0.001 and vaginal pH P = 0.001 , and a higher FSFI P < 0.001 and VMI P = 0.030 score compared to the control group. Conclusion. Based on the findings of the present study on menopausal women, the Jazar supplement significantly improved quality of life and sexual function and prevented or delayed vaginal atrophy.

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Program Lifts The Quality of Diabetes Care

Family Practice News ◽

10.1016/s0300-7073(10)70920-8 ◽

2010 ◽

Vol 40 (14) ◽

pp. 58-59

Author(s):

MICHELE G. SULLIVAN

Keyword(s):

Diabetes Care ◽

Quality Of Diabetes Care

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Penatalaksanaan IMD pada Ibu Postpartum Sectio Caesarea Mempengaruhi Status Gizi dan Kecepatan Produksi ASI

Jurnal Bidan Cerdas (JBC) ◽

10.33860/jbc.v2i2.68 ◽

2020 ◽

Vol 2 (2) ◽

pp. 112-120

Author(s):

Nursari Abdul Syukur ◽

Susi Purwanti

Keyword(s):

Breast Milk ◽

Nutritional Status ◽

Milk Production ◽

Quantitative Research ◽

Milk Protein ◽

Sectio Caesarea ◽

Control Group ◽

P Value ◽

Study Results

Many mothers who give birth to Sectio Caesarea (SC) do not Initiate Early Breastfeeding (IMD), which fails exclusive breastfeeding. This study aimed to determine the effect of IMD management in postpartum SC mothers on nutritional status, speed of milk production, and quality of breast milk protein. Method: quantitative research with quasi approach experiment. The research design used was a pre-post-test control non-equivalent control group. A sampling of this study used the Consecutive method sampling with a sample of 20 mothers who gave birth by cesarean section (SC). Hypothesis testing uses the independent t-test and the Mann-Whitney test. The study results showed an influence on the management of IMD in postpartum SC mothers on the speed of ASI production (p-value=0.004) and nutritional status (p-value=0.028). There was no effect of IMD management on postpartum SC mothers on the quality of breast milk protein (p-value = 0.543). This study recommends that the hospital implement an IMD promotion program before the abdominal wall is closed as a form of intervention to increase milk production and maternal nutritional status

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Understanding the quality of diabetes care in Japan: a systematic review of the literature

Diabetology International ◽

10.1007/s13340-021-00497-3 ◽

2021 ◽

Author(s):

Joanna Mitri ◽

Takehiro Sugiyama ◽

Hirokazu Tanaka ◽

Mitsuru Ohsugi ◽

Robert A. Gabbay

Keyword(s):

Systematic Review ◽

Diabetes Care ◽

Review Of The Literature ◽

Quality Of Diabetes Care

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Physical Activity and Sport for Acquired Brain Injury (PASABI): A Non-Randomized Controlled Trial

Medicina ◽

10.3390/medicina57020122 ◽

2021 ◽

Vol 57 (2) ◽

pp. 122

Author(s):

Marta Pérez-Rodríguez ◽

Saleky García-Gómez ◽

Javier Coterón ◽

Juan José García-Hernández ◽

Javier Pérez-Tejero

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Brain Injury ◽

Functional Capacity ◽

Intervention Group ◽

Chronic Phase ◽

Acquired Brain Injury ◽

Control Group ◽

Wide Range

Background and objectives: Acquired brain injury (ABI) is the first cause of disability and physical activity (PA) is a key element in functional recovery and health-related quality of life (HRQoL) during the subacute and chronic phases. However, it is necessary to develop PA programs that respond to the heterogeneity and needs of this population. The aim of this study was to assess the effectiveness of a PA program on the HRQoL in this population. Materials and Methods: With regard to recruitment, after baseline evaluations, participants were assigned to either the intervention group (IG, n = 38) or the control group (CG, n = 35). Functional capacity, mood, quality of life and depression were measured pre- and post-intervention. The IG underwent the “Physical Activity and Sport for Acquired Brain Injury” (PASABI) program, which was designed to improve HRQoL (1-h sessions, two to four sessions/week for 18 weeks). The CG underwent a standard rehabilitation program without PA. Results: Results for the IG indicated significant differences and large effect sizes for the physical and mental dimensions of quality of life, as well as mood and functional capacity, indicating an increase in HRQoL. No significant differences were found for the CG across any variables. Conclusions: The PASABI program was feasible and beneficial for improving physiological and functionality variables in the IG. The wide range of the activities of the PASABI program allow its application to a large number of people with ABI, promoting health through PA, especially in the chronic phase.

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The quality of diabetes care among cancer survivors: a retrospective cohort study

Diabetic Medicine ◽

10.1111/dme.14538 ◽

2021 ◽

Author(s):

Xinyun Liang ◽

Jacob Etches ◽

Bogdan Pinzaru ◽

Karen Tu ◽

Liisa Jaakkimainen ◽

...

Keyword(s):

Cohort Study ◽

Cancer Survivors ◽

Diabetes Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Quality Of Diabetes Care

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Implementation and effectiveness of a multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres

Scientific Reports ◽

10.1038/s41598-021-83408-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pei Ern Mary Ng ◽

Sean Olivia Nicholas ◽

Shiou Liang Wee ◽

Teng Yan Yau ◽

Alvin Chan ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

At Risk ◽

Cognitive Impairment ◽

Mobile Application ◽

Intervention Group ◽

Blood Parameters ◽

Attrition Rate ◽

Control Group

AbstractTo address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.

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A randomized trial of the effect of peer education on the sexual quality of life in patients with myocardial infarction

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2019-0204 ◽

2020 ◽

Vol 17 (3) ◽

Author(s):

Ali Abbasi ◽

Hossein Ebrahimi ◽

Hossein Bagheri ◽

Mohammad Hasan Basirinezhad ◽

Seyedmohammad Mirhosseini ◽

...

Keyword(s):

Quality Of Life ◽

Myocardial Infarction ◽

Health Care Professionals ◽

Peer Education ◽

Intervention Group ◽

Control Group ◽

Controlled Clinical Trial ◽

Sexual Quality Of Life ◽

Significant Difference

AbstractBackgroundOne of the factors associated with readmission is inappropriate sexual activity after myocardial infarction (MI). This study aimed to assess the effect of peer education on the sexual quality of life (SQOL) in patients with MI.MethodsIn this randomized controlled clinical trial, 70 patients with MI meeting the inclusion criteria were assigned to experimental or control groups using block randomization. Peer education for the intervention group was provided on the third day after MI. Education sessions lasted from 90 to 120 minutes. Data were collected using demographic, sexual quality of life-female (SQOL-F), and sexual quality of life-male (SQOL-M) questionnaires during the fourth week after MI.ResultsThere was no significant difference between the two groups before the intervention in terms of demographic and SQOL. The mean of SQOL in the peer education group was significantly higher than the control group at the 4-week follow-up.ConclusionsAccording to the results, using peer education is recommended for the sexual health care professionals.

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