scholarly journals EFFECT OF CITRAKADI KSARA LĒPA IN THE MANAGEMENT OF SECOND-DEGREE INTERNAL HAEMORRHOIDS

2021 ◽  
Vol 9 (10) ◽  
pp. 2331-2338
Author(s):  
Basima A.P ◽  
Rejani H
Keyword(s):  
Anal Canal ◽  
Assessment Tools ◽  
Abnormal Growth ◽  
Key Words Haemorrhoids ◽  
Affected Person ◽  
Mucous Discharge ◽  
Preoperative Procedures ◽  
Mucosal Changes ◽  
Second Degree

Background and Objectives: Haemorrhoids are dilated veins within the anal canal in the sub-epithelial region formed by radicles of superior, middle, and inferior rectal veins. It hampers the routine life of an affected person. In India about 50% of the population would have haemorrhoids at some point in their life. Achārya Vāgbhata defines Arsas (haemorrhoids) as an abnormal growth which obstructs the anal canal and troubles continuously like an enemy The objective of the study is to assess the efficacy of citrakādi kṣāra lēpa in the management of second- degree internal haemorrhoids. The study also aims to find out an easy, effective and less complicated procedure for second-degree haemorrhoids. The 15 participants with second degree internal haemorrhoids were selected as per inclusion criteria. After doing all the preoperative procedures, the citrakādi kṣāra lēpa was done in a single sitting. The duration of the study was 30 days. The assessment of reduction of size of haemorrhoids, mucosal changes after the procedure and frequency of bleeding were done before the treatment, on 1st, 3rd, 5th, 7th, 15th, and 30th day using the required assessment tools. The symptoms, constipation and mucous discharge were assessed on the 0th and 30th days. The follow up was done on the 60th day. The statistical analysis of the results was done using non- parametric tests. On analysing, it was found that the Citrakādi kṣāra shows 86.11% of the efficacy in the reduction of both subjective and objective parameters. Key words: Haemorrhoids, Arsas, Citrakādi kṣāra

Anal Canal Duplication in Adults: Report of Five Cases

2016 ◽  
Vol 101 (1-2) ◽  
pp. 20-23
Author(s):  
Merter Gülen ◽  
Sezai Leventoğlu ◽  
Bahadir Ege ◽  
B.Bülent Menteş
Keyword(s):  
Anal Canal ◽  
Medical Records ◽  
Perianal Fistula ◽  
Surgical Excision ◽  
Complete Surgical Excision ◽  
Radiologic Imaging ◽  
Mucous Discharge ◽  
The Mean ◽  
Anal Canal Duplication

Anal canal duplications are very rare noncommunicating second anal orifices located posterior to the true anus. In this study, 5 adult cases of anal canal duplication are reported as extremely rare entities in the literature. The medical records of anal canal duplication patients treated from 2011 to 2014 were reviewed retrospectively. Five adult patients with symptoms of mucous discharge, anal pain, and or perianal fistula/abscess were admitted. Findings of physical examination and radiologic imaging (pelvic magnetic resonance, endoanal ultrasound, and or colonoscopy) suggested anal canal duplication. The mean age of patients was 40.4 ± 8.7 (range, 33–55), and the mean follow-up period was 18.4 ± 11.2 (range, 6–36) months. Histologic features of the removed samples confirmed anal canal duplication. All patients underwent complete surgical excision of the rudimentary anal canal. Anal canal duplication is a very rare congenital anomaly, and 5 additional adult cases are reported. Although this is a referral center, the recent accumulation of 5 adult cases of anal canal duplication suggests that this malformation might be more prevalent and frequently overlooked.

scholarly journals Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Afona Chernet ◽  
Nicole Probst-Hensch ◽  
Véronique Sydow ◽  
Daniel H. Paris ◽  
Niklaus D. Labhardt
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Assessment Tools ◽  
Migration Route ◽  
Post Traumatic Stress ◽  
Hazardous Alcohol Use ◽  
Hazardous Alcohol ◽  
One Year ◽  
The One

Abstract Objective Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. Results At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%).

Bowen’s Disease of the Anal Canal Treated with Radiation Therapy: A Case Report

2021 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
I. Mbarki Mbarki
Keyword(s):  
Anal Canal ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Intraepithelial Neoplasia ◽  
Bowen’S Disease ◽  
Bowen's Disease ◽  
Radiological Response ◽  
Slow Growing

Bowen’s disease, also known as intraepithelial neoplasia, is a very slow-growing carcinoma in situ. It can progress to an invasive squamous cell cancer and infiltrate mucosa or skin in 3 to 5% of cases. The anal localization of this disease is very rare. Surgical resection is the standard of treatment. Radiotherapy keeps its place in recurrent or unresectable cases. We report a case of Bowen’s anal canal disease in order to verify the effectiveness of Radiotherapy. He is a 59-years-old patient diagnosed with Bowen’s anal canal disease at the National Institute of Oncology in Rabat. He was treated with exclusive radiotherapy at a dose of 60 Gray in 30 fractions over 49 days. The evolution was marked by a complete clinical and radiological response and preservation of the anal sphincter with an 18 months follow-up.

Accuracy of endoanal ultrasound in the follow-up assessment for squamous cell carcinoma of the anal canal treated with radiochemotherapy

2008 ◽  
Vol 23 (5) ◽  
pp. 1054-1057 ◽  
Author(s):  
Jacopo Martellucci ◽  
Gabriele Naldini ◽  
Caterina Colosimo ◽  
Luca Cionini ◽  
Mauro Rossi
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Endoanal Ultrasound

scholarly journals Evaluating the Evaluators: Implementation of a Multi-Source Evaluation Program for Graduate Medical Education Program Directors

2016 ◽  
Vol 8 (4) ◽  
pp. 592-596 ◽  
Author(s):  
Mary Ellen J. Goldhamer ◽  
Keith Baker ◽  
Amy P. Cohen ◽  
Debra F. Weinstein
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Assessment Tools ◽  
Completion Rates ◽  
Source Evaluation ◽  
Graduate Medical ◽  
Medical Education Program ◽  
Academic Year

ABSTRACT Background Multi-source evaluation has demonstrated value for trainees, but is not generally provided to residency or fellowship program directors (PDs). Objective To develop, implement, and evaluate a PD multi-source evaluation process. Methods Tools were developed for PD evaluation by trainees, department chairs, and graduate medical education (GME) leadership. Evaluation questions were based on PD responsibilities, including Accreditation Council for Graduate Medical Education (ACGME) requirements. A follow-up survey assessed the process. Results Evaluation completion rates were as follows: trainees in academic year 2012–2013, 53% (958 of 1824), and in academic year 2013–2014, 42% (800 of 1898); GME directors in 2013–2014, 100% (95 of 95); and chairs/chiefs in 2013–2014, 92% (109 of 118). Results of a follow-up survey of PDs (66%, 59 of 90) and chairs (74%, 48 of 65) supports the evaluations' value, with 45% of responding PDs (25 of 56) and 50% of responding chairs (21 of 42) characterizing them as “extremely” or “quite” useful. Most indicated this was the first written evaluation they had received (PDs 78%, 46 of 59) or provided (chairs 69%, 33 of 48) regarding the PD role. More than 60% of PD (30 of 49) and chair respondents (24 of 40) indicated trainee feedback was “extremely” or “quite” useful, and nearly 50% of PDs (29 of 59) and 21% of chairs (10 of 48) planned changes based on the results. Trainee response rates improved in 2014–2015 (52%, 971 of 1872) and 2015–2016 (69%, 1276 of 1837). Conclusions In our institution, multi-source evaluation of PDs was sustained over 4 years with acceptable and improving evaluation completion rates. The process and assessment tools are potentially transferrable to other institutions.

scholarly journals Structural Assessment of Scars Using Optical Techniques

2020 ◽  
pp. 169-178
Author(s):  
L. van Haasterecht ◽  
Paul P. M. van Zuijlen ◽  
ML. Groot
Keyword(s):  
Second Harmonic ◽  
Objective Assessment ◽  
Assessment Tools ◽  
Optical Techniques ◽  
Second Harmonic Generation Microscopy ◽  
Treatment Benefits ◽  
Precise Quantification ◽  
Resolution Imaging

AbstractThe evaluation of scar treatment benefits from exact structural measurements. Accurate assessment of thickness, surface area, and relief is crucial in routine clinical follow-up. From an experimental perspective, precise visualization of the microstructural organization is necessary for a better understanding of the mechanisms underlying pathological scarring. Structural proteins in scars differ from healthy skin in terms of amount, type, and importantly, organization. The precise quantification of this extracellular matrix (ECM) organization was, until recently, limited to two-dimensional images from fixated and stained tissue. Advances in optical techniques now allow high-resolution imaging of these structures, in some cases in vivo. The enormous potential of these techniques as objective assessment tools is illustrated by a substantial increase in available devices. This chapter describes currently used devices and techniques used in the clinical follow-up of scar progression from a volumetric standpoint. Furthermore, some of the most powerful techniques for microstructural research are described including optical coherence tomography, nonlinear optical techniques such as second harmonic generation microscopy, and confocal microscopy.

scholarly journals Development of Skill Assessment Instrument Service Volly 6th Grade in Physical Education

2019 ◽  
Vol 2 (4) ◽  
pp. 634-641
Author(s):  
Moh. Noer ◽  
Ali Maksum ◽  
Anung Priambodo
Keyword(s):  
Large Scale ◽  
Assessment Tools ◽  
Assessment Instrument ◽  
Skill Assessment ◽  
Small Scale ◽  
Service Reliability ◽  
School Students ◽  
Assessment Guidelines ◽  
Initial Attitude

This research aims to develop instruments for assessing lower and upper service engineering skills in volleyball games for 6th-grade students in elementary schools. This research uses research and development methods, with the following development steps: (1) information gathering in the field, (2) analyze the information collected, (3) developing initial products, (4) expert validation and revision, (5) small-scale trials and revisions, (6) large-scale trials and revisions, (7) manufacturing of final products. The subject of this research is 6th-grade students of elementary students. Data analysis for the validity test was carried out with CVR (content validity ratio) and reliability using Alpha Cronbach. This research resulted in a handbook of instrument assessment tools for service techniques of lower and upper service in volleyball games for 6th-grade elementary school students, which contained instructions for use, student assignments sheets, assessment guidelines, assessment rubrics, and scoring tables, which have high validity. (1) And under service reliability initial attitude: r = 0.975, implementation: r = 0.961, follow-up motion: r = 0, 955. Upper Service for initial attitude: r = 0.961, implementation: r = 0.974, follow-up motion: r = 0.989.

scholarly journals INDICATIONS FOR INJECTION OF BULKING AGENTS FOR THE TREATMENT OF ANAL INCONTINENCE

2017 ◽  
pp. 43-48
Author(s):  
A. I. Nedozymovany ◽  
E. A. Dementeva ◽  
D. E. Popov ◽  
S. V. Vasiliev
Keyword(s):  
Comparative Analysis ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Bulking Agents ◽  
Study Objective ◽  
Relevant Today ◽  
Surgical Methods ◽  
The Mean ◽  
Methods Of Treatment

Despite of lots conservative and surgical methods of treatment, the problem of anal incontinence is relevant today and remains unresolved. Since the beginning of the 1990s attempts ofimplantation of bulking agents in order to increase the basal pressure in the anal canal were begun. Domestic product “ДАМ+” used in the study. OBJECTIVE. To determine the indications for injection of bulking agents for the treatment of anal incontinence. Research the possibility of using the drug “ДАМ+,” with assessment of treatment outcomes. During a period of 2014 to 2016 there were 30 patients with anal incontinence of various etiologies involved in research. The mean age was 47,5 ± 6,5 years. Injection of bulking agent “ДАМ+” were performed by the punction of submucosa of the anal canal in 3 points, andfollowed by a comparative analysis of the survey after treatment. Average follow-up was 12,1 ± 0,97 months. The study we have identified indications for the implementation of bulking agents for correction of anal incontinence, and the estimation results.

scholarly journals The reform of Italian forensic psychiatric hospitals and its impact on risk assessment and management

2018 ◽  
Author(s):  
Vittorio De Luca ◽  
Pieritalo Maria Pompili ◽  
Giovanna Paoletti ◽  
Valeria Bianchini ◽  
Federica Franchi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Treatment Plan ◽  
Psychiatric Hospitals ◽  
Assessment Tools ◽  
Residential Home ◽  
Security Measures ◽  
Lazio Region ◽  
History Of ◽  
Forensic Psychiatric

Italy has a consolidated history of de-institutionalization, and it was the first country to completely dismantle psychiatric hospitals, in order to create small psychiatric inwards closer to the community (i.e. in general hospitals). Nevertheless, it took the nation nearly 40 years to end the process from the beginning of de-institutionalization, definitely closing all of the forensic hospitals, which was not addressed by the first Italian psychiatric reform. This paper describes the establishment of new facilities substituting old forensic hospitals, called Residences for the Execution of Security Measures (REMS), which are a paradigm shift in terms of community-based residential home, and are mainly focused on treatment and risk assessment, rather than custodial practices. The use of modern assessment tools, such as the Aggressive Incident Scale (AIS) and the Hamilton Anatomy of Risk Management (HARM), is crucial in order to point out the focus and consistent instruments of the treatment plan. A preliminary analysis of data from the first 2 years of activity, considering severely ill patients who have been treated for more than 12 months, is then described for two REMSs in the Lazio region, close to Rome. Encouraging results suggest that further research is needed in order to assess clinical elements responsible for a better outcome, and to detect follow-up measures of violence or criminal relapse after discharge.

A systematic review of evidence-based aftercare for older adults following self-harm

2022 ◽  
pp. 000486742110671
Author(s):  
Anne PF Wand ◽  
Roisin Browne ◽  
Tiffany Jessop ◽  
Carmelle Peisah
Keyword(s):  
Older Adults ◽  
Qualitative Studies ◽  
Assessment Tools ◽  
Screening Tools ◽  
Safety Planning ◽  
Level Of Evidence ◽  
Heritage Foundation ◽  
Quality Ratings ◽  
Self Harm

Objective: Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. Methods: Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. Results: Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. Conclusion: Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches.

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