The use of tele-audiology in ototoxicity monitoring: A scoping review

Introduction Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. Methods The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. Results and discussion While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.

Recurrent urinary tract infections in adults: a practical guide

Recurrent urinary tract infections are a common problem faced by clinicians across many specialities. For the patient, recurrent urinary tract infections can be burdensome and detrimental to their quality of life. For the clinician, they can be challenging to manage, and the socioeconomic burden on healthcare systems can also be substantial. Investigations serve to rule out any underlying structural or pathological abnormalities. In conjunction with behavioural prevention methods, treatment strategies include antibiotic and non-antibiotic approaches and holistic management approaches. This article provides an overview of the investigation and treatment of urinary tract infections and includes algorithms which can be used in daily clinical practice.

Call for action: incorporating wellness practices into a holistic management plan for rheumatoid arthritis—going beyond treat to target

This expert opinion article explores the strategy of adopting a holistic approach to the management of rheumatoid arthritis (RA) by incorporating the wellness practices of exercise, optimised sleep, optimised nutrition, mindfulness, social connectedness and positive emotions into the management plan. The aim is to attain optimal health for each patient beyond that achievable by limiting disease management to pharmacological treatment to attain the lowest achievable composite scores of disease activity, as recommended with the current treat-to-target approach, and addressing the recent recognition of pain control as a key patient-reported outcome. Incorporating wellness practices into a busy clinical setting requires creativity and customisation based on the individual practice setting and the individual needs of each patient. Such practices can help people living with RA to achieve optimum wellness through the introduction of measures—according to individual need—designed to improve the aspects of life most impacted for that person, thereby complementing treat-to-target and pain control strategies with pharmacological agents. Clinicians must consider wellness practices in addition to treat-to-target pharmacological agents for the holistic management of people with RA.

Rare and Complex Epilepsies from Childhood to Adulthood: Requirements for Separate Management or Scope for a Lifespan Holistic Approach?

Purpose In this descriptive review, we describe current models of transition in rare and complex epilepsy syndromes and propose alternative approaches for more holistic management based on disease biology. Recent Findings Previously published guidance and recommendations on transition strategies in individuals with epilepsy have not been systematically and uniformly applied. There is significant heterogeneity in models of transition/transfer of care across countries and even within the same country. Summary We provide examples of the most severe epilepsy and related syndromes and emphasise the limited data on their outcome in adulthood. Rare and complex epilepsy syndromes have unique presentations and require high levels of expertise and multidisciplinary approach. Lifespan clinics, with no transition, but instead continuity of care from childhood to adulthood with highly specialised input from healthcare providers, may represent an alternative effective approach. Effectiveness should be measured by evaluation of quality of life for both patients and their families/caregivers.

The Ergonomic Holistic Management Strategy against the Covid-19 Pandemic

Ergonomics or Human Factors are natural laws of human activities that involve physicals and mental (spirituality). As an applied science, ergonomics is multidisciplinary and interdisciplinary with other sciences. Therefore, to solve human problems, ergonomics uses other science. Such as strategic management, which in the business benefits the economy and the environment sustainably. However, environmental damage by human activity causes the Coronavirus out of its origins and establishes humans as their new host. When COVID-19 spread globally and caused many casualties, the pandemic occurred. After more than one year, it seems humans have not yet learned from the pandemic. Whereas, the public behaviour and selfishly against pandemic caused blundering solutions of the government and experts. Even applying synthetic herd immunity needs years. Observing these situations and conditions required an ergonomic holistic approach. The goal of a holistic strategy is to solve the problem from various aspects. It leads to the public-awareness response of critical conditions and situations. Therefore, self-leadership must be intensified to safety the self, family, and society by raising the body’s immunity. Besides mass vaccination, it would be nice if immunity was formed naturally by food and a healthy lifestyle, and practicing Yoga. For that reason, people should return to the old values and use natural resources for life.

A 40-year-old Woman with Hypercalcemia Crisis Caused by Bone Metastasis in Stage IV Breast Cancer

Breast cancer is still global burden especially for woman with 2.3 million cases every year dan 15% mortality among cancer diseases. In developing countries, most of the cases are diagnosed at terminal stage when metastasis already found. Bone metastasis is the highest among other metastasis sites such as: lung, liver and brain. Bone metastasis will cause hypercalcemia and bone pain as complications. Both will gradually decrease patient’s quality of life. Comprehensive and holistic management for these complications will reduce deterioration and hopefully increase patient’s quality of life even they were at terminal stage. We describe a 40-year-old woman who got hypercalcemia crisis. Hypercalcemia usually manifest as a consequence of other diseases. Epidemiologically, majority come from metastasis, but can be other diseases, such as multiple myeloma. Interestingly, during medical investigation through her medical history, and physical examination, and laboratory examinations, we conclude that her hypercalcemia crisis was caused by bone metastasis from breast cancer.

Bahrain’s Environmental Legal Tools for Giving Effect to Sustainable Development Goals: An Assessment

Sustainable development in Bahrain is considered one of the national core objectives in the Government Action Plan. Bahrain has enacted environmental legislation and adopted the National Environment Strategy. This study examines the appropriateness of the current environmental legislations in the context of SDGs. To achieve this goal, a scoping review was conducted to assess their compatibility. The study revealed that the successful integration of SDGs with the current environmental legislations can be carried out by recognising the challenges highlighted in the 2030 Agenda. This study suggests the quick-updating of the current environmental legislations in line with SDGs. There is still room for improvement, and more comprehensive and sustainable approaches need to be developed in the environment dimension to stay on track to reach the SDGs. The policies should factor in the possible linkage opportunities to develop a holistic management approach in the implementation, considering the international conventions’ obligations. The study can be deemed as the first attempt to examine the consistency of the SDGs with the national environmental legal framework, which can be employed to enhance the sustainable practices. Moreover, the study develops a simple framework that can assist in review, keep the legislations and strategy consistent with the SDGs.

Ayurvedic Successful Management of Nodular Episcleritis with Prolonged Period Follow Up-A Case Report

Episcleritis, an acute unilateral or bilateral inflammation, usually idiopathic or autoimmune condition with or without underlying systemic condition is a troublesome manifestation of red eye reported. It manifests as red or pinkeye, varied mild pain to foreign body sensation, tender discomfort on touch, commonly recurs. As an acute condition patient seeks medical assistance. Ayurveda recognised this either as Sirajala, Siraharsha, Sirajapidika and a Shuklabhagaroga. Here a young lady with painful repeated manifestation of episcleritis is reported seeking Ayurveda for holistic management of the condition after repeatedly trying other systems in vain. Patient was treated with suitable Shodhana, Kriyakalpa followed by necessary Dinacharya and Rasayana ensuring non recurrence; Deepan pachana, Anulomana, Kriyakalpa, Rasyana chosen were all Chakshushyadravyas. To add up to synchronize the effect of yoga therapies advised, to achieve non recurrence of symptoms. Trikatu, Trivrt, Triphala, Yashtimadhu, Madhu, Ghrta known Chakshushyadravya having vitamins and trace elements known to be highly beneficial to the eye and all sense organs was advocated, Kriyakalpa play a major role in immediate mitigation of symptoms and also prevents recurrence. Seka is most accepted Kriyakapla for enhancing quick relief, non recurrence, cost effective Ayurveda management reported after a prolonged period of follow up for a year. Yoga therapy included Suryanamaskar, Anulomaviloma pranayama and Trataka, Ayurveda and yoga when added to management ensured non recurrence.