Traditional medicinal plants used by tribal communities in Tonk district, Rajasthan

Rajasthan is the third largest state of India. About 80% of the population live in the villages. The main tribes of Rajasthan are Bhil, Meena, Garasia, Saharia, Damor and Kathoudi. The study area comprises of Tonk district of Rajasthan, India which has seven divisions Deoli, Malpura, Todaraisingh, Uniara, Peeplu, Tonk and Newai. Survey method was followed covering five villages of each division. The data were collected through direct interviews with local people, priests, local physician and gardeners. A detailed questionnaire was designed and written in Hindi for the baseline study following standardised procedures. The tribal communities use plants and plant products in their day to day life, however there is a gap in knowledge in the younger generation. A total of 147 species belonging to 62 vascular plant families are reported. From these 145 species were reported to be used for medicinal applications, 135 species of which were used to treat more than one disease and remaining 8 species were used to treat only one disease. The most widely used plant part is leaves (95 species) and the, most common mode of application is oral (39.65%). The traditional knowledge about the plants can be used to produce to new products for medicinal use, food and fodder.

Introducing physiology of diabetes to American Asian middle school and high school students

Diabetes, a chronic condition that impacts millions, is a complex disease. Understanding the disease can contribute to increasing awareness about this debilitating condition and preventing occurrences. Furthermore, inculcation of physiology knowledge may lead to an increased likelihood of career goals that align with this area of study. In pursuit of these goals, we set out to educate middle and high school students about diabetes. Thirty (16 high school; 14 middle school) students from a Sunday school program at an urban religious center completed a 10-question pretest as a way to measure initial knowledge about diabetes. Following completion of the survey, a 1-h education session was presented by a local physician who also brought a glucometer and insulin syringes for students to have a hands-on experience with some disease-specific tools. A posttest was administered following the presentation. The posttest consisted of 11 questions, where all but 2 questions were the same as for the pretest, measuring improvement of prior knowledge and engagement in the presentation. The overall posttest average score increased by approximately two correct responses, which was a significant improvement ( P < 0.0001), suggesting that the students were motivated to and did learn diabetes concepts. This study also suggests that exposing students to educational activities related to physiology is beneficial and may lead to an increase in interest in physiology, an awareness of diabetes, and perhaps the development of healthy habits.

COMBINATION OF DISEASES OF THE ORAL MUCOSA, RED BORDER WITH SOMATIC PATHOLOGY AND LOCAL FACTORS OF THE ORAL CAVITY OF GERONTOLOGICAL PATIENTS

Background. In this article, we have studied the frequency of the combination of diseases of the oral mucosa with somatic pathology and local factors of the oral cavity of gerontological patients. A clinical dental examination of the elderly and old people who addressed to the Department of Therapeutic Dentistry in Omsk State Medical University on the basis of Omsk dental polyclinics No. 1 was carried out. Objectives ― to study the frequency of combinations of diseases of the oral mucosa with somatic pathology and local oral factors. Methods. 120 patients aged 55―85 with periodontal diseases, the oral mucosa and red border were examined. Out of those 120 people 96 ones (80 %) were women; 24 (20 %) were men. Informed consent was obtained from all patients for examination, treatment, observation and «health questionnaires» were filled out. The analysis of the personalized advisory conclusions of the local therapist is carried out. An analysis was made of the oral hygiene index, galvanic current indicators, and the indications of gerontological patients in prosthetic treatment were fulfilled. Results. An analysis of the personalized advisory conclusions by the local physician showed that diseases of the oral mucosa of gerontological patients were combined with somatic pathology. The analysis of the hygiene index revealed unsatisfactory hygiene in 72 % cases. Galvanic currents were found in the oral cavity of gerontological patients in 52.2 % cases. Conclusions. In 100 % cases, somatic pathology was combined with diseases of the oral mucosa of gerontological patients. Local unfavourable factors: poor hygiene, galvanosis, irrational denture exacerbated the course of diseases of the oral mucosa and worsened the quality of life of gerontological patients.

What Is the Impact on Rural Area Residents When the Local Physician Leaves?

Background and Objectives: Scarce evidence exists in the medical literature describing the attitudes of rural community residents about the impact of losing their local physician. This pilot study explores aspects of access to care, both within and outside of primary care settings, that result from loss of a rural family physician. Methods: We selected study participants through convenience and snowball sampling, and we conducted in-person interviews of up to 60 minutes. We audio recorded and transcribed the interviews (May to August, 2018), then analyzed transcripts using immersion crystallization and managed within Atlas.ti 7.0 software (Berlin, Germany). Results: We interviewed 18 participants, some of whom interviewed as pairs. Our analysis revealed three significant themes: rurally-specific access to care concerns, relationships valued for being both community and care based, and loss felt specific to the integrated community leadership roles occupied by family physicians. In addition, participants identified social challenges they associated with losing their “country doctor,” such as withering community cohesion. Conclusions: Our findings suggest that rural physicians offer tremendous value to their communities, both inside and beyond their clinic walls. Issues of social cohesion and local health leadership affected by physician loss should be addressed by policy makers and educators charged with designing patient-centered solutions to improve health outcomes in rural communities. Current health and medical education reforms would benefit from greater focused attention on these issues.

Public Spillovers from Private Insurance Contracting: Physician Responses to Managed Care

Managed care is rebounding as more emphasis is placed on cost containment. These efforts may benefit consumers but challenge providers; however, empirical evidence on how supply-side managed care influences physicians is incomplete. We leverage a quasi-experiment3 in which a commercial insurer imposed a new contract regime on behavioral health providers in response to recent policy shifts. We demonstrate spillovers in the form of negative effects on local physician supply and positive effects on Medicare and Medicaid participation in areas where the insurer has market power. Commercially insured patients are also not obviously harmed but receive less intense services in some settings. (JEL G22, I11, I13, I18, I38, J22, J44)

Best practices for EHR implementation: A BC First Nations community’s experience

First Nations and other health leaders are looking to Electronic Health Records (EHRs) to improve the quality of health information, efficiency of health services, and health outcomes for Indigenous people in Canada. This study used qualitative and quantitative methods to identify the success factors in an EHR implementation at a First Nations health centre in British Columbia, Canada. The Best Practices EHR Implementation Framework (EHRIF) was used to analyze the success factor data and found that all of the success factors from the planning and implementation phases in the framework were important. Provincial and federal government commitment and collaboration with key stakeholders including a local physician champion were also critically important for the electronic medical record implementation to proceed. This study suggests the EHRIF can be used to promote successful EHR implementations in Aboriginal communities and can contribute to building health informatics expertise and capacity in First Nations communities.

A National Model for Tactical Emergency Medical Support in Finland

Introduction:Tactical Emergency Medical Response (TEMS) originated in the 1990s in Finland. It is a nationally standardized joint-effort with EMS and police special units, such as SWAT.Aim:To describe a national system of TEMS in Finland.Methods:In Finland, TEMS is a national response system of specially trained paramedics and pre-hospital doctors, working normally in HEMS or a local physician staffed rapid response car. There is a two-tier selection to get accepted in the basic course. The police run background checks for all participants before they are accepted to the course. The course itself is four days and it covers the basics of police tactics, protective gear, penetrating wounds, evacuation, etc. After graduating from the basic course, the paramedic/doctor is qualified to participate in missions. Although healthcare professionals are involved, a TEMS mission is under the police command and is used as one of the police’s special teams to operate in areas where normal EMS cannot be allowed for safety reasons. TEMS does not carry any weapons. The Police provide the teams with the same protective equipment that the SWAT/CTU has. After some years, there is a three-day refresher course for active TEMS service. In this course, the main training points are working in austere environments, such as helicopters, boats, and in urban environments wearing civilian clothing. Police pay for the usage of TEMS in missions, but they do not pay for training days.Results:TEMS has good national coverage. In 2017, there were 131 TEMS activations. The normal response to a mission is a team of one or two TEMS operators.Discussion:TEMS has achieved good national coverage and is deployed often. TEMS has also channeled information and training, such as TECC, to normal EMS personnel and raised their preparedness as well.

Uterine Didelphys with Pregnancy Outcomes: A Case Report

A didelphys uterus also known as a “double uterus” is one of the least common Mullerian duct anomalies. Uterine didelphys is a congenital malformation that result from complete failure of fusion of the ipsilateral Mullerian duct during embryonic development. Ideally, diagnosis should be made before pregnancy and labour to prevent adverse outcomes. Here reporting a case who was a 19 years old, 4thgravida, Para: 0+3 (Spontaneous abortion) referred to Bangabandhu Memorial Hospital (BBMH) USTC, Chittagong at 35 weeks of pregnancy with severe abdominal pain by local physician from Raozan, Chittagong. On vaginal examination a longitudinal vaginal septum and two vagina were found. Uterine Didelphys was confirmed during emergency caesarean section and delivered 1.5 kg male baby with APGAR score 7/10 and was referred to Neonatal Intensive Care Unit (NICU). Post operative recovery of the mother was uneventful. The baby was also discharged at the age of seven days with establishment of breast feeding. To avoid delayed diagnosis and associated adverse outcome clinicians should have high index of suspicion of uterine anomaly when assessing cases of dysfunctional labour. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 53-55

Understanding Men’s Perceptions of Human Papillomavirus and Cervical Cancer Screening in Kampala, Uganda

Purpose This preliminary study explores Ugandan men’s knowledge and attitudes about human papillomavirus (HPV), cervical cancer, and screening. Methods A local physician led an education session about cervical cancer for 62 men in Kisenyi, Kampala in Uganda. Trained nurse midwives administered surveys to assess knowledge and attitudes before and after the education session. Results From the pre-education survey, only 24.6% of men had heard of HPV previously, and 59% of men had heard of cervical cancer. Posteducation, 54.5% of men believed only women could be infected with HPV and 32.7% of men believed antibiotics could cure HPV. Despite their limited knowledge, 98.2% of men stated they would support their partners to receive screening for cervical cancer, and 100% of men surveyed stated they would encourage their daughter to get the HPV vaccine if available. Conclusions Knowledge of HPV and cervical cancer among Ugandan men is low. Even after targeted education, confusion remained about disease transmission and treatment. Ongoing education programs geared toward men and interventions to encourage spousal communication about reproductive health and shared decision making may improve awareness of cervical cancer prevention strategies.