Descriptive study of chest x-ray examination in mandatory annual health examinations at the workplace in Japan

The utility of chest x-ray examination (CXR) in mandatory annual health examinations for occupational health is debatable in Japan. This study aimed to provide basic data to consider future policies for mandatory annual health examinations in the workplace. A nationwide descriptive survey was performed to determine the rate of detection of tuberculosis, lung cancer, and other diseases through CXR in organizations associated with National Federation of Industrial Health Association. The rate of finding on CXR conducted during annual health examinations in FY2016 was evaluated. Data regarding diagnosis based on follow-up examination findings were obtained and compared with the national statistics. In addition, CXR findings were compared with the results of low-dose lung computed tomography performed at the Hitachi Health Care Center. From 121 surveyed institutions, 88 institutions with 8,669,403 workers were included. For all ages, 1.0% of examinees required follow-up examination. Among 4,764,985 workers with diagnosis data, the tuberculosis detection rate was 1.8–5.3 per 100,000 persons. For Lung cancer, 3,688,396 workers were surveyed, and 334 positive cases were detected. The lung cancer detection rate using CXR was 9.1–24.4 per 100,000 persons. From 164 cases with information regarding the clinical stage, 72 (43.9%) had Stage I lung cancer. From 40,045 workers who underwent low-dose computed tomography multiple times, 31 lung cancer cases, all with Stage I disease, were detected (detection rate: 77.4 per 100,000 persons). Our findings suggest that CXR plays a little role in the detection of active tuberculosis. With regard to LC screening, the detection rate of LC by CXR was lower, approximately 50%, than the expected rate (41.0 per 100,000 persons) of LC morbidity based on the age–sex distribution of this study population. However, the role of CXR for LC screening cannot be mentioned based on this result, because assessment of mortality reduction is essential to evaluate the role.

Preparation and Evaluation of Polymer-Based Ultrasound Gel and Its Application in Ultrasonography

Ultrasound imaging is a widely used technique in every health care center and hospital. Ultrasound gel is used as a coupling medium in all ultrasound procedures to replace air between the transducer and the patient’s skin, as ultrasound waves have trouble in traveling through air. This research was performed to formulate an inexpensive alternative to commercially available ultrasound gel as it is expensive and imported from other countries. Different formulations with different concentrations of carbopol 980 (CAR 980) and methylparaben were prepared with natural ingredients such as aloe vera gel and certain available chemicals that have no harmful effects on the skin. To justify the efficiency of the formulations; necessary physicochemical characteristics such as visual clarity, homogeneity, transparency, skin irritation, antibacterial activity, pH, stability, spreadability, conductivity, acoustic impedance, viscosity, and cost were evaluated. Moreover, a comparison study was also conducted with commercially available ultrasound gel that was utilized as a control. All samples showed excellent transparency and no microbial growth. S1 was the only formulation that met all of the requirements for commercial ultrasound gel and produced images that were similar to those produced by commercial ultrasound gel. So, this formulation could be used as an alternative to expensive commercial ultrasound gel for taking images in hospitals and medical centers.

Extrapulmonary Tuberculosis Manifests as Middle Ear Tuberculosis: A Rare Case Report from Secondary Health Care Center at Sub-Himalayan Region

Tuberculosis of ear is a rare entity. Early diagnosis and prompt treatment can prevent many serious complications. Here we report a case of 45 year old female with middle ear tuberculosis which was cured with mastoid exploration followed by anti tubercular treatment. Keywords: Tuberculosis, TB, Extrapulmonary Tuberculosis, Middle Ear Tuberculosis, Sub-Himalayan Region

Prevalence of Anemia and Morphological Variation in RBC among COPD Patients admitted at a Tertiary Health Care Center, Kathmandu, Nepal

Many studies have depicted that anemia is one of the most common co-morbidity among Chronic Obstructive Pulmonary Disease (COPD) patients. Therefore, its correction in those patients is an important aspect of the treatment protocol. Our study was designed to explore the prevalence of anemia and morphological alteration, if any, in RBC among COPD patients. The study was conducted from November 2020 to June 2021 among the COPD patients admitted in the Medical ward of Nepal Medical College Teaching Hospital. If hemoglobin level was <13gm/dl in males and <12gm/dl in females and/or hematocrit level was <39%, the patient was considered anemic. Anemia was morphologically classified following standardized procedure with RBC indices as a reference. Among the COPD patients (n=101), 40 (39.6%) were anemic, out of which 21(52.5%) was normocytic normochromic, 10 (25%) were microcytic hypochromic, 5 (12.5%) were normocytic hypochromic, 3 (7.5%) were microcytic normochromic and (2.5%) was macrocytic hyperchromic. Anisocytosis was commonly noted (25.7%) among the COPD patients with microcytosis (20.8%) and macrocytosis (4.9%) among them. Among the patients, 23.8% showed hypochromia while only 0.9% showed hyperchromia. Polycythemia was present in 24 (23.8%) of them. Inflammatory mediators and cytokines in COPD causes a compromised response of marrow cells to erythropoietin and shortens the survival of red blood cells.

Prevalence of partial edentulism among the patients visiting a Tertiary Health Care Center in the Western Region, Nepal

Introduction: Tooth loss causes impairment, functional limitation, physical, psychological, and social disability. Hence, the study of pattern of tooth loss can provide a rough information about the frequency, cause and magnitude of oral problems, its sequelae that eventually can act as mirror image of prosthodontic treatment needs. Objectives: To assess the prevalence of partial edentulism and its etiology, to determine its association with sociodemographic parameters, and to find out the motivational factor/s for replacement in willing patients. Methods: Total 417 patients with partial edentulism were examined intraorally on the basis of Kennedy’s classification with Applegate’s modification. The descriptive analysis was done using frequency distribution. Pearson Chi-square analysis test was used to determine the association between demographic variables and type of tooth loss where p-value ≤0.05 was considered statistically significant. Results: Partial edentulism was more prevalent in mandibular arch (41.7%) followed by both arches (30.9%). Kennedy’s Class III was the commonest and Kennedy’s class III modification 1 was second most common type of partial edentulism. Age and educational status had statistically significant association while gender had no association with various classes of partial edentulism. Dental caries (62.8%) followed by periodontitis (25.9%) were the major causes of tooth loss. Functional demand (46.8%) was the key motivational factor for the replacement among those who were willing (78.4%). Conclusions: This study can help in assessing the epidemiological features of partial edentulism of one community in a more classified form and can help gather information necessary to assess the treatment needs.

Socio-cultural Conceptions and HIV-related TB among Haitian Immigrants in Broward County, Florida: A Brief Historical Insight, 1995-2002

This study deals with tuberculosis (TB), human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Broward County, South Florida. Theoretically, it demonstrates the existing co-infection between TB and HIV that provokes HIV-related TB or AIDS. Additionally, it indicates that AIDS is provoked by HIV co-infection with all opportunistic infections. Nine (9) qualitative interviews and one focus group conducted with 12 Haitian patients and TB control program workers at Fort Lauderdale Health Care Center allowed to understand the connection between TB and HIV, and the patients’ socio-cultural conceptions about HIV-related TB. Then, the study reveals that the prevalence of TB and HIV-related TB has every year a dramatic increase among foreign-born individuals including Haitian residents. To determine this prevalence, the Broward County Health Department charts of 778 reported TB and HIV co-infection cases for the last 6 years were analyzed along with the qualitative interviews. Finally, the study shows that the indicated prevalence is due to both Haitian immigrants’ socio-cultural conceptions and reactions vis-à-vis the TB screening, prevention measures, and treatment.

Impact of different sources of noise exposure on hearing impairment: A cross- sectional study

Background: Mental health is integrated into PHC as a strategy of WHO to fill the gap in mental health treatment. Part of this strategy needs a level of task shifting so that mental health care is provided by different level of PHC workers and not only specialists such as psychiatrists and psychologists. Objectives: To assess the knowledge and attitudes of family doctors regarding the provision of psychological health in PHCC and if there is an association between the certificates of these family doctors and their Knowledge and attitudes to psychological health. Subjects and Methods: A cross-sectional descriptive study with analytic elements was conducted in 8 family health care centers in Baghdad city/Al-Karkh. Data was collected via questionnaire form which consists of three domains: Domain one includes sociodemographic data, domain two was about knowledge and consists of (7) questions and domain three consisted of (12) questions about the attitude of physicians regarding mental health. A convenient sample of (83) family health care physicians were included in the current study. Results: The mean age of participants was 42 years (range: 27 – 53). The results revealed that 22.9% of participants were male, 77.1% were female. The percentage of mental illness seen by the physicians daily in the health care center was (15.7%). Physicians with higher degree certificates obtained higher knowledge scores in comparison to residents or practitioners as well as the females reported a significantly higher score of knowledge in comparison to males. Moreover, higher scores of positive attitudes were found. Conclusion: Physicians with higher certificates had more knowledge and attitude than other certificates; therefore, raising the awareness among family physicians about mental health services through making workshops, symposiums, more training courses is recommended.

Socio-cultural Conceptions and HIV-related TB among Haitian Immigrants in Broward County, Florida: A Brief Historical Insight, 1995-2002

This study deals with tuberculosis (TB), human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Broward County, South Florida. Theoretically, it demonstrates the existing co-infection between TB and HIV that provokes HIV-related TB or AIDS. Additionally, it indicates that AIDS is provoked by HIV co-infection with all opportunistic infections. Nine (9) qualitative interviews and one focus group conducted with 12 Haitian patients and TB control program workers at Fort Lauderdale Health Care Center allowed to understand the connection between TB and HIV, and the patients’ socio-cultural conceptions about HIV-related TB. Then, the study reveals that the prevalence of TB and HIV-related TB has every year a dramatic increase among foreign-born individuals including Haitian residents. To determine this prevalence, the Broward County Health Department charts of 778 reported TB and HIV co-infection cases for the last 6 years were analyzed along with the qualitative interviews. Finally, the study shows that the indicated prevalence is due to both Haitian immigrants’ socio-cultural conceptions and reactions vis-à-vis the TB screening, prevention measures, and treatment.

Case report on fatal human rabies infection in central India

Rabies is a zoonotic disease that affects the central nervous system of mammals and has a high mortality rate. It is a viral disease that can be prevented by vaccination. Dogs are the leading cause of human rabies deaths, accounting for up to 99% of all human rabies transmissions. On 15th December 2019 an 8 years old male child was bitten by a stray dog outside of his house. The patient visited with his parents to a nearby primary health care center on same day where his wound was washed with water. He received first dose of anti-rabies vaccine and was referred to a tertiary care center for immunoglobulin because of a history of wound bleeding. They did not visit tertiary care center for immunoglobulin as advised. 15 days after exposure on 1st January 2021 the patient presented with unusual behavior like fear of water and tremor. On examination his pupils were found dilated and he was referred to isolation ward of tertiary care center. Based on the history of animal bites and clinical signs, the patient was diagnosed as probable case of rabies. The patient eventually died within 24 hours of admission. Such kind of incident shows that there is lack of awareness regarding rabies in community. In this case, if the patient had completed the anti-rabies vaccination schedule and visited a higher centre on time for immunoglobulin, death could have been avoided. Mortality due to rabies can be prevented by raising public awareness about immunization.