Rheumatoid arthritis onset after COVID-19 infection: a case report

At the end of 2019, coronavirus disease (COVID-19) outbreak is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Worldwide researchers and physician try to explore the mechanisms of damage induced by virus, they focus on the short-term and long-term immune-mediated consequences induced by the virus infection. Every day discover a new pathological condition induced by virus and new symptoms and disease may occur after recovery from disease. Our case report is 41 years old, Indian lady who presented to our primary health care centre complaining of multiple small hand joints pain, both elbows and knees pain with swelling of them and prolonged morning stiffness, diagnosed seropositive rheumatoid arthritis (RA) (arthritis, positive rheumatoid factor (RF), and X-ray changes) after 1 month recovery from COVID-19 infection. She did not have any joint pain and she had negative RF before COVID-19 infection with no family history of RA.

Innovativehealth education project in Al-Qassim region, Saudi Arabia

A pilot project was conducted with the aim of training and human resources development in health education, enhancing health education research, and establishing a health promotion and education centre in Al-Qassim region, Saudi Arabia. Health education programmes of three months for males [n = 14] and two to three weeks for females [n = 253] were offered. The work activities of such trained personnel were monitored and evaluated. It was concluded that through these programmes the targeted population could be trained to a satisfactory extent. Second, they would probably be able to convey basic health education concepts to the population at large, especially primary health care centre visitors

Differences in controlled versus uncontrolled arterial hypertension in a primary health care centre—a quality improvement cycle study

Background Cardiovascular diseases are the leading cause of death worldwide and uncontrolled Arterial Hypertension (AH) is the most important involved risk factor. An observational study published in 2019 found differences between controlled and uncontrolled AH patients, namely less frequent chronotherapy and family history health records. We aimed to study medical designed population based interventions to reach an increase in controlled AH defining a set of growth dynamics (Δ) ≥ +5 in AH prevalence of control defined for a value of 140/90 mmHg. Methods 2019 results were presented in small medical teams weekly periodic scientific meetings and upon such awareness strategies were developed for improving AH control, according to the best practice evidence available. Data were collected, 6 months later, in a randomized representative sample of AH patients in each Primary Care Health Unit for a confidence interval 95%, error margin of 5%. Descriptive and inferential analysis, for a P < 0.001 and growth dynamics (Δ) were calculated. Results In a n = 148 sample there was a significant improvement in the rate of controlled hypertension (43.9% to 67.9%, P < 0.001, Δ = +54.0). Chronotherapy improved from 29.0% to 66.2% (P < 0.001), Δ = +128.3) and family medical records also improved (88.1% to 100%, Δ + 11.9). Conclusions Significant rise in the prevalence of AH control was achieved after informative and formative intervention. Chronotherapy was significantly improved, allowing a 67.9% AH control. Family medical records also significantly improved. Healthcare professional’s knowledge and reflection about their clinical activity seem to be important tools to achieve better results and hopefully health outcomes, in Arterial Hypertension.

Pancreatic cancer in obstructive jaundice in unexpected age

Cancer of the pancreas is a highly lethal malignancy. It is considered as the fourth leading cause of cancer-related death in the United States and second only to colorectal cancer as a cause of digestive cancer-related death.It is hoped that detection of asymptomatic and early stage of disease is potentially curable pancreatic cancer and it will improve outcomes. Our case report is 45 years old female who presented at our primary health care centre with obstructive jaundice for only 2 weeks and no weight loss, vague abdominal pain. She had intermittent epigastric pain for past few months and diagnosed as gastroesophageal reflex. Also, she had chronic anemia and need blood transfusion in the past 3 years. No family history of pancreatic cancer and no other risk factor. Most articles reveal difficulty in diagnosing pancreatic cancer in early stage and young age group due to its resemblance to benign lesion. That’s why we prefer to do case report for documentation. Diagnosis of the tumor is important especially in early stages for improving prognosis.

THE AVAILABILITY OF ANTIHYPERTENSIVE DRUG IN ERA OF NHI: A STUDY IN THE PRIMARY HEALTH CARE CENTRE JAKARTA-INDONESIA

Objective: The study was carried out to observe the impact of NHI to availability, usage, stock of antihypertensive drug enrolled in a national formulary in one of the primary health care centre in Jakarta. Methods: A longitudinal time series design was performed retrospectively to analyse the availability, usage, and stock of antihypertensive drug. The data period was from January 2013 (1 y before NHI) to December 2015 (2 y after NHI). The Independent-Samples T or Mann-Whitney test was conducted to compare these parameters before and after NHI. Results: We found amlodipine 5 mg and 10 mg tablet, hydrochlorothiazide 25 mg tablet, captopril 12.5 mg and 25 mg tablet, nifedipine 10 mg tablet were available in Primary Health Care. These drug were generic and tablet dosage form. The most common drug used was captopril and Nifedipine, respectively. The highest availability was diuretic hydrochlorothiazide. The availability of amlodipine 5 mg and 10 mg tablet, captopril 12.5 mg tablet increased significantly (P<0.05) after NHI was implemented. Moreover, hydrochlorothiazide decreased (P<0.05) as well. The usage of amlodipine and hydrochlorothiazide risen (P<0.05) but the nifedipine decreased (P<0.05) after NHI. All stock of antihypertensive except captopril 25 mg different significantly (P<0.05) after the application of NHI. Conclusion: This study highlights the implementation of NHI impacted the availability, usage, and stock of antihypertensive drug enrolled in national formulary.