A Review of Type 1 Diabetes (T1D)

The diagnosis of Type 1 Diabetes (T1D) will come as an unwelcome surprise to most people. Within a short period of time, the person will have to come to understand and manage this chronic illness. The terminology associated with the T1D condition will also be totally new to the person: diabetes mellitus, pancreas, hyperglycaemia (hyper), hypoglycaemia (hypo), bolus (fast acting insulin), basal (slow acting insulin), ketones and blood glucose levels. The purpose of this article is to assist newly diagnosed patients' understanding of T1D, people who are already living with T1D, carers of people with T1D, partners and family members of someone with T1D, work colleagues, and friends who participate in the same sporting activities or go on holiday with a person who has T1D. In addition, this article reviews how people living with T1D can still enjoy exercise and maintain the best quality of life possible; whilst controlling the blood glucose levels in their body for the rest of their lives to prevent the onset of complications associated with diabetes.

A Study on Lifetime Enhancement and Reliability in Wearable Wireless Body Area Networks

The wireless body area network (WBAN) which consists of wearable or implantable sensor nodes, is a technology that enables pervasive observing and delivery of health related information and services. The radio-enabled implantable medical devices offer a revolutionary set of applications among which we can point to precision drug distribution, smart endoscope capsules, glucose level observers and eye pressure detecting systems. Devices with WBAN are generally battery powered due to sensitivity and criticality of the data carried and handled by WBAN, reliability becomes a critical issues. WBAN loads a high degree of reliability as it openly affects the quality of patient observing. Undetected life-threatening circumstances can lead to death. A main requirement is that the health care professionals receive the monitored data correctly in emergency situations. The major objective is to achieve a reliable network with minimum delay and maximum throughput while considering power consumption by reducing unnecessary communication.

Online Communities. Benefits and Risks

This article reviews empirical studies from 2008 to 2017 on the effects of participating in online communities. The review uses three databases: PubMed, Scopus and ScienceDirect. The criteria are: (1) online community aimed to provide support by and for people with a common problem; (2) the content of the sessions was determined by users; (3) members met via the Internet; (4) online community was available 24/7; (5) online community access was free and open to everyone with an Internet connection. Of the articles, 13 of 105 met the inclusion criteria. Seven studies reported positive changes: informational and emotional support, increased sense of belonging, less isolation, better medical understanding. Six articles also considered risks: the rise of the level of stress because of successes or failures of other users, the addiction to the forum and the consequent isolation from real relationships.

Manufacturers Should Consider Older Consumers' Diverse Needs and Develop a Diverse Set of Walking Aids

Manufacturers worldwide could help many elderly people within society, maintain their independence and meet the demands of their environment with more ease and functionality, if they would consider the needs of elderly more carefully and involve them in development.

A Case of Spontaneous Esophageo-Pleural Fistula

Spontaneous esophageal-pleural fistula is a rare entity. The authors describe a case of 60-year-old male who presented with cough with expectoration, severe retrosternal chest pain and shortness of breath and vomiting. Computed tomography with oral contrast showed right esophageal-pleural fistula and hydro pneumothorax. He was managed conservatively keeping the chest tube drainage and nasogastric tube feeding.

Feasibility of Hospital-at-Home for Older Patients With an Acute Medical Illness

Out-of-hospital-treatment in the form of a hospital at home has been suggested as a potential alternative to hospital admission. The objectives of the study were to address the feasibility of a hospital at home supported by telemedicine for older patients requiring admission. Of 601 patients screened, seven were eligible and willing to participate in the intervention. Poor health status and skepticism towards the technology was the main reasons for ineligibility and declining to take part. Patients admitted to the scheme at home felt safe and were positive regarding several aspects of the scheme. Health care professionals found that the intervention gave an opportunity to create a patient-centred treatment. However, the intervention was not successfully integrated because of the few cases. The economic evaluation found the cost of home admission depended on the turnover of patients. Hospital at home was not feasible in this setup and do not justify proceeding to a randomised controlled trial.

Early Intervention and Health Promotion in the Management of Chronic Liver Disease

Liver disease is prevalent and a major public health concern. It has predominantly spread in the UK and worldwide, causing liver-related morbidity and mortality rates for the under 65s since 1970. This article aims to highlight the role of early intervention and health promotion in the management of chronic liver disease (CLD). The objective is to critically analyse an issue like CLD, and further employ principles, ethical theories to health promotion practice. Since 2015, there is no one single drug that treats NALFD, a dietary plan and lifestyle modifications can be added in management of the disease. Educating patients perhaps is a form of regimen, and a coping mechanism as set by the health belief model to understand the disease. Additional studies need to be formed to understand the exact contributions health care professionals are likely to make, and of those that are new clinicians.

Abnormal Uterine Bleeding (AUB) and Thyroid Function in Chhattisgarh

Abnormal function of thyroid gland is associated with a disturbance in the menstrual cycle. However, in clinical practice, thyroid dysfunction is frequently overlooked as a possible etiology and therefore, the importance to investigate thyroid function in asymptomatic cases is under- recognized in India. Treating thyroid dysfunction in such cases can reverse the menstrual abnormality, thus avoiding unnecessary hormonal therapy or in long term, hysterectomy. This article is intended to determine the prevalence of overt and subclinical forms of hypothyroidism/hyperthyroidism among women with abnormal uterine bleeding (AUB) in a known iodine-deficient state of India, Chhattisgarh. Moreover, the aims included to characterize the types of menstrual abnormality with thyroid dysfunction in study participants. The present study found a prevalence of thyroid dysfunction in one out of five cases of menstrual abnormality, most common dysfunction being hypothyroidism. An appreciable proportion of thyroid disorder was found in patients with menorrhagia, oligomenorrhea, polymenorrhea and amenorrhea.

Survival Fight of a Teen With Polytrauma, Severe Head Injury, Gr-V Liver Injury Followed By ARDS, Managed in a Rural Hospital of Andaman, India

This article describes how the liver is one of the most commonly injured organs in the abdomen, especially in road traffic accidents. Patients do present with polytrauma and those who are hemodynamically unstable have a high morbidity and mortality, even in advanced hospital settings. Following is the case report of a 17-yr. old boy, who was involved in a road traffic accident with polytrauma, presented to a tertiary care hospital in a remote island, with Grade IV-V liver injury and developed ARDS in post-operative period. The patient was managed successfully and discharged.

Uncertainty in Clinical Knowledge

This article explores the ways in which uncertainty can be incorporated into the understanding of better performance approaches, and is thus proposed as an enabling dimension of performance. The enabling characteristic of uncertainty is of special interest to designing educational programs for providers in assistance to the amelioration of care through the application of available knowledge, be that from data relating processes to outcomes, or based on feedback providers get from patients and families about their expectations from the care. Tracing the keystone definitions of uncertainty from Hippocrates to Osler, the discussion addresses the dimensions of decision - making appropriateness, its timeliness, the expected and actual value of the care services, and the role of systematic communication between providers of care as well as with patients. The crucial role of Health Information Technology is emphasized, and a unifying model is proposed where the inclusion of uncertainty as a dimension of performance promotes an encompassing evaluation of the quality of health care services. Evaluation, influenced by tradition and precedent, is discussed as requiring the inclusion of health care and caring services.