History and Development of TCM Case Report in a Real-World Setting

Objective. The medical record of Chinese medicine is a miniature of the theoretical system of traditional Chinese medicine (TCM), with a time-honored history in a real-world setting and a firm place in medicine. In modern times, people have emphasized the value and standardization of TCM cases. The aim of this study was to explore the historical origins and developments of TCM case records. Methods. A chronological narrative style was used to divide the development history of TCM case records into early (1600 BC–220 AD), middle (220–1911 AD), and modern periods (1912–till now). The historical context of the origin and development of TCM case records was analyzed through the evolution of the format and content of the case recording files with the specific documents and distinctive cases. Results. From the early to middle period, the development of TCM case record had experienced four periods: the budding, blossoming, maturity, and heyday. In modern times, they presented the following characteristics: A, the establishment and development of the discipline of TCM medical records; B, the standardization of the writing format of TCM medical records; C, a large number of books concentrating on recording and studying TCM medical records, especially those of prestigious veteran TCM doctors; D, the proliferation of TCM case reports published in journals; E, the establishment of TCM medical records databases and application platforms integrating computer programs and artificial intelligence; F, many reporting guidelines have been developed in order to improve the reporting quality of case report in TCM. Conclusions. The study analyzed and illustrated the characteristics of TCM case records of different dynasties in terms of writing content and format. TCM case record is a relatively young discipline in spite of its ancient origins. TCM case records still have far-reaching significance for the inheritance and development of TCM theory and clinical experience. From the wisdom of history, its positive impact has just been revalued to be validated and it will continue to develop.

Health Problems Among Forcibly Displaced Myanmar Nationals (FDMNs) Admitted To The Medicine Ward of Cox’s Bazar Medical College Hospital

Background Forcibly displaced Myanmar nationals (FDMNs) or Rohingya refugees are one of the vulnerable groups suffering from different kinds of health problems but have been less reported yet. Therefore, the study was designed to delineate the health problems among FDMNs admitted to Cox’s Bazar Medical College Hospital. Methods This hospital-based cross-sectional study was conducted at the Medicine ward, Cox’s Bazar Medical College Hospital, for a six-month period following approval. Rohingya refugees who were admitted during the study period were approached for inclusion. Informed written consent was ensured prior to participation. A structured questionnaire was used during data collection. Collected information was recorded in case record form. A total of 290 subjects were interviewed. Analysis was performed using the statistical package for social science (SPSS) version 20. Results The mean age of the participants was 48.76±18.67 years (range: 16-91), with a clear male predominance (60.7%). Family size ranged 6-8. All of the participants reported at least one of the illnesses. Of all, 29.66% patients reported disease of the respiratory system, and 26.9% reported disease of the gastrointestinal disease and hepatobiliary system. Accidental injury or injury due to electrocution or thin falls or snake bites was present in 10.4% of the cases. Among the single most common diseases, COPD (20%) was the most frequently observed, and the rest of them were chronic liver disease (13.1%), pulmonary TB (5.5%), ischemic stroke (5.5%), CAP (4.1%), acute coronary syndrome (3.4%), thalassaemia (3.4%) and hepatocellular carcinoma (3.4%). Among the top 6 reported diseases, PTB was more common in elderly individuals (p=0.29). The disease pattern was similar across the sexes among the refugees except community acquisition pneumonia (CAP), which was commonly observed among males (p=.004). Considering different age groups, genitourinary problems were more common in males aged >60 years, and rheumatology and musculoskeletal problems were equally affected in females aged between 40-60 years. Conclusion COPD, CLD and CAP were the most prevalent diseases in FDMN patients who attended the medicine ward of Cox’s Bazar Medical College Hospital. Further exploration is warranted before any policy making and comprehensive plan.

Deformation Characteristic of a Supported Deep Excavation System: A Case Study in Red Sandstone Stratum

A complete case record of a deep foundation pit with pile-anchor retaining structure excavated in red sandstone stratum is presented in this study. The horizontal displacement of pile top, the horizontal displacement at various depths, the axial force of anchor cable, and ground settlement during construction are measured. A three-dimensional numerical model is established to analyze the additional stress and deformation induced by the excavation and the accuracy of the FEM model is verified by comparing with field measured results. Both the measured and numerical simulation results show that the deformation of the pile-anchor supported deep excavation is significantly affected by the spatial effect. The results show that the deformation in the middle of the foundation pit is greater than the pit angle and that the deformation of the long side is greater than that of the short side and gradually decreases from the middle to the pit angle. The deformation and stress in the middle of the long side of the foundation pit are the largest, which is the most unfavorable part. With the increase of vertical excavation depth, the spatial effects tend to increase, and the influence scope of spatial effects is about five times the vertical excavation depth in the red sandstone stratum. The ground settlement outside the pit is mainly distributed in a groove shape, and the maximum settlement occurs about 8.5 m away from the pit edge. Finally, parametric studies of reinforcement parameters indicated that 1.5–2.0 times the initial elastic modulus and cohesive force of soil should be used for reinforcement. It is recommended that the ranges for pile diameter, pile spacing, anchor cable prestressing and inclination angle should be selected as 0.8–1.2 m, 1.4–2.0 m, 100–150 kN, and 10°–20°, respectively.

Outcomes of Dialysis in low Income Country – An Experience in a Tertiary Care Center of Bangladesh

Background: The widespread use of hemodialysis to prolong life of end-stage renal disease (ESRD) patients has been a remarkable achievement, preventing death from uremia in these patients. The aim of the study was to find out the outcomes of haemodialysis patients with end-stage renal disease (ESRD) in low Income County. Methods: A hospital based prospective observational study was performed in the of Department of Nephrology, Shaheed Suhrawardy Medical College. Total 189 patients who stated dialysis during study period were included. All patients were monthly followed up and appropriate investigation done. All data recorded in a case record form. Study protocol approved by Ethical committeeof institute. Data analyzed in SPSS software version 25. Results: Among 189 ESRD patients on MHD selected with mean age 49.16 years (15-82), male was 60.3% and female 39.7%.Eighty eight 46.5% patient died and 39.15%(74) patient discontinue dialysis due to lack of financial support or helping assistant or social support. Three (1.6%) patients underwent renal transplantation and five patients (2.6%) transfer to other dialysis center. Average life span in dialysis 256 day (16-786 days). Most of the paints was on twice weekly dialysis 84%. Vascular access of stating dialysis was 73.8% by catheter and only 32.2% stated with AV fistula. Conclusion: A large group of patients leave dialysis due to financial or helping personal or social supportwithin 3-4 months of stating dialysis. A significant number of patients died due to multiple risk factors within 8-9 months. Identification of risk factors for early mortalityis essential and appropriatemeasure should take to prevent discontinuation at community and national level. Bangladesh J Medicine July 2022; 33(1) : 52-56

Exploring the Potential of Implementing Managed Alcohol Programmes to Reduce Risk of COVID-19 Infection and Transmission, and Wider Harms, for People Experiencing Alcohol Dependency and Homelessness in Scotland

People who experience homelessness and alcohol dependency are more vulnerable than the general population to risks/harms relating to COVID-19. This mixed methods study explored stakeholder perspectives concerning the impact of COVID-19 and the potential utility of introducing managed alcohol programmes (MAPs) in Scotland as part of a wider health/social care response for this group. Data sources included: 12 case record reviews; 40 semi-structured qualitative interviews; and meeting notes from a practitioner-researcher group exploring implementation of MAPs within a third sector/not-for-profit organisation. A series of paintings were curated as a novel part of the research process to support knowledge translation. The case note review highlighted the complexity of health problems experienced, in addition to alcohol dependency, including polysubstance use, challenges related to alcohol access/use during lockdown, and complying with stay-at-home rules. Qualitative analysis generated five subthemes under the theme of ‘MAPs as a response to COVID-19′: changes to alcohol supply/use including polysubstance use; COVID-19-related changes to substance use/homelessness services; negative changes to services for people with alcohol problems; the potential for MAPs in the context of COVID-19; and fears and concerns about providing MAPs as a COVID-19 response. We conclude that MAPs have the potential to reduce a range of harms for this group, including COVID-19-related harms.

Health and Lifestyle, Safety, Relationship and Personality Factors Influence Gender, Sex and Sexuality Issues among Youth—A Case Record Analysis from Youth Mental Health Promotion Clinics in Karnataka, India

Promoting positive identity and seeking early support for gender, sex and sexuality (GSS) issues among youth is vital. Understanding and addressing factors associated withGSS among them is critical. We assessed four-year case records (January 2017–December 2020) of all first visit youth mental health promotion clinic (YMHPC) clients (15–35 years) for factors associated with GSS issues in Karnataka. Overall, prevalence of GSS issues was 1.8% (189/10,340). Increased risk of GSS issues was observed among clients reporting suicidality (AOR = 4.27, 95% CI = 2.70–6.74) and relationship issues (AOR = 3.63, 95% CI = 2.36–5.57), followed by issues of safety (AOR = 2.56, 95% CI = 1.72–3.81), personality (AOR = 2.48, 95% CI = 1.60–3.85), health and lifestyle (AOR = 2.27, 95% CI = 1.77–4.19), smokers (AOR = 2.30, 95% CI = 1.24–4.27), and those who felt depressed (AOR = 2.10, 95% CI = 1.43–3.09) and worthless (AOR = 2.08, 95% CI = 1.28–3.39). Clients aged 21–25 years (AOR = 1.80,95% CI = 1.27–2.54), male (AOR = 1.72, 95% CI = 1.20–2.46) and who had been married (AOR = 2.32, 95% CI = 1.51–3.57) had a higher risk of GSS issues than those aged 15–20 years and other counterparts, respectively. Clients who drank alcohol (AOR = 0.49, 95% CI = 0.30–0.81) had reduced risk of GSS issues. The findings re-iterate the importance of early recognition of factors (essential precursors) of GSS issues among youth. The study highlights the importance of promoting awareness and improving primordial prevention of possible GSS issues in later life. This study has important implications on youth mental health promotion programs, especially in countries like India.

Prevalence of depression, anxiety and Quality of life among North Indian Polycystic ovary syndrome Women: Evidence from a prospective observational study

Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous gynaecological endocrine disorder characterized by clinical features including oligo-amenorrhea/ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. PCOS increases the risk of depression and anxiety which leads to poor quality of life. Aim of the study were to determine the prevalence of anxiety and depression among women suffering from PCOS and to determine the quality of life (QOL) in PCOS women.Methods: The study was prospective, observational, non-interventional and questionnaire-based. 192 women with PCOS voluntarily helped in filling the questionnaires consisting of questions using PHQ-9 for depression, GAD-7 for anxiety, SF-12 for general health and PCOSQ-50 for disease-specific domains. All data were recorded in pre-designed case record forms and analysis of data was done using different statistical methods.Results: Majority of PCOS women were either overweight or obese. Based on PHQ-9 20% of women was suffering with major depression and based on GAD-7, 25% with major anxiety. It is found that psychosocial and emotional domain and coping domain of PCOSQ-50 is significant in patients with major depression and major anxiety. Significant effects were seen on their general health as per SF-12 domain. Lack of physical exercise was found in 83% of women.Conclusions: PCOS is a complex disease which decreases the overall quality of life. Therefore, treatment of PCOS women should include psychological counselling along-with with medication, especially in obese PCOS women. Women should be educated with the benefits of lifestyle modification in PCOS.

Modernism and Record Covers: Raising the Status of Jazz in Sweden

By introducing a wider understanding of the discourse of modernism at the time that record covers were introduced, this article investigates record covers as a means through which various actors in the Swedish jazz scene connected jazz with modernist art forms. In the 1950s, specific designs for record sleeves became integrated into the ways in which jazz was mediated in Sweden, which coincided with wider debates about whether jazz could be seen as an art form. The main question of this article is: How did the artwork on record covers influence the acceptance of jazz as an art form in Sweden? In responding to this question, the article aims to demonstrate that, in addition to written discourse, visual objects – in this case record covers – were of great importance to the rising status of jazz in Sweden in the 1950s and 1960s. More broadly, I argue that the visual elements in music cultures can be just as important, if not more so, than written forms of discourse, for negotiating the social status of music.