Investigation of Anaemia in Geriatric patients Admitted to Norfolk & Norwich University teaching Hospital Old People’s Medicine/Geriatric Department

Aims To assess if anaemia detected in geriatric patients admitted to the Old Peoples Medicine Department at Norfolk and Norwich University Teaching Hospital was investigated with appropriate laboratory tests- haematinics and iron level tests. Also increase awareness among doctors of the high prevalence of anaemia in geriatric patients and the need to investigate to start treat if indicated. Target population or scope All patients aged 80 and above admitted under the care of NNUH OPM department on a given day incidentally found to have anaemia. Criteria All over 80 year olds admitted to hospital found incidentally to have low HB (anaemia) should be investigated by having elemental iron level and haematinic checks; Iron level check Vitamin B12 and folate check Ferritin Target population or scope All patients aged 80 and above admitted under the care of NNUH OPM department on a given day incidentally found to have anaemia.

New Onset Type-1 Diabetes Mellitus in a Toddler with Sars-Cov-2 Infection Presenting In Diabetic Ketoacidosis: A Case Report

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), though mostly sparing the lungs in children, has been found to affect other organs including the endocrine pancreas. Type 1 diabetes mellitus (T1DM) may occur through direct negative effects of the virus on beta-cell function leading to diminished insulin production. Diabetic ketoacidosis (DKA) is a known and life-threatening complication of T1DM. Case presentation: This is a case of a 3-year-old previously healthy male who presented with 4 days history of fever, with malaise and hyperpnea for one day. Review of systems was notable for increased thirst and urination, nausea, vomiting, fatigue, and visible weight loss for 4 days. Initial investigations done showed elevated blood glucose, ketonuria, increased anion gap metabolic acidosis, and positive SARS-CoV-2 polymerase chain reaction (PCR). He was immediately commenced on intravenous fluids and insulin with progressive improvement and was discharged on hospital day 6. Conclusion: Coronavirus disease-2019 (COVID-19) has impacted children most profoundly with the new post-infectious multi-inflammatory syndrome, however, it is important to remember that primary coronavirus infection is still a threat to pediatric patients, for example, and its cytotoxic effects on the pancreatic beta cells that may lead to T1DM. We, therefore, recommend that caregivers, parents, and medical professionals should have a high index of suspicion when children present with symptoms consistent with a diagnosis of T1DM during the COVID-19 pandemic so that diagnosis can be made promptly and therefore DKA prevented.

Covid Reinfection versus Asymptomatic Carrier State: A Case Report

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first discovered in China in December 2019, has been implicated in the current coronavirus disease 2019 (COVID-19) pandemic. Although much has been learned about the virus which peaked with the development of the vaccine, there is still a lot of unanswered questions. Maximum duration of positive SARS-CoV-2 real-time reverse transcriptase polymerase chain reaction (RT-PCR) from symptom onset may be up to 3 months [1], however it is not known if the continued detection of the viral genome implies prolonged infectivity or presence of a non-viable virus [2]. Most people with COVID-19 develop antibodies after resolution of acute infection [2]. The exact duration of these antibodies in the body is unknown, but some studies have shown that both memory T-cells and B-cells can persist up to 6 to 8 months after acute SARS-CoV-2 infection [3]. These SARS-CoV-2 antibodies may confer some immunity to the person after the acute infection and have been associated with protection against subsequent infection in nonhuman primates by the same viral strain during the early recovery phase [4]. In humans, however, it is unknown to what extent this immune response indicates a protective immunity to subsequent infection with SARS-CoV-2 [5]. Few cases of reinfection have been documented worldwide with varying symptom severity; the first case in the US was published in January 2021 (reinfection occurred in June 2020) [5]. None of the initial cases reported the presence of SARS-CoV-2 antibodies at the time of reinfection. We present a patient who tested positive to SARS-CoV-2 RT-PCR twice in 10 months (Table 1). At both times, she was asymptomatic and the second time, she had coexisting SARS-CoV-2 antibodies.

Chronic Pain – What is it?

The brain stem and brain are involved in chronic pain processing and sensation. This may involve changes in gene expression through epigenetic alterations [1]. Chronic pain is also a learned experience which involves the brain [2]. In chronic pain, thresholds to pain sensation decrease such that pain may be produced by nonpainful stimuli.

A Didactic Dilemma in Emerging Societies: Devaluing Journal Club in Medical Working out

A journal club is a scholastic conference in which a group of persons discuss issued articles, providing an opportunity for a shared effort to keep up with the current writings. The emphasis of journal clubs has supposedly shifted over the years. What was once a setting in which the world's recent literature was analyzed became a setting for talking over clinical issues raised by the writings and, most recently, a setup for learning critical reading abilities to physicians or other associated authorities. Nevertheless, so far there is no generally accepted definition of journal club, even though this academic method has been around for more than a century and has evolved basically during this period. In the present paper, conceptual and applied features of journal club, especially in developing countries, is surveyed, to discuss an apparent underrating of journal club in some medical departments, which could be due to misunderstanding of new philosophies, or to talk about the necessity of modification of an academic misconduct, which could be attributable to didactic unawareness.

Prevalence of Different Types of Leukemia and Associated Factors among Children in Children's Cancer Units at Al-Kuwait Hospital, Sana'a City: A Cross-Sectional Study

Introduction: Leukemia is a heterogeneous group of hematological disorders that is made up of several diverse and biologically distinct subgroups. Leukemia is the 11th and10th most common cause of cancer morbidity and mortality worldwide, respectively. There are insufficient data on the prevalence and associated factors of leukemia in Yemen, particularly in the study area. Aims: This cross-sectional study aims to determine the prevalence of different types of leukemia and associated factors among children with leukemia in the pediatric cancer units of Al-Kuwait Hospital, Sana'a City. Materials and Methods: A cross-sectional study was conducted on children with leukemia who were treated selectively in the pediatric leukemia units of Kuwait University Hospital in Sana'a. Group diagnostics and histopathological diagnoses were formed in line with the French, American and British classifications of leukemia in children in the pediatric leukemia units, over a period of 5 years. Factors associated with become infected with leukemia that were studied included ages, gender, and regarding outcomes. The association of death and recovery with different age groups and leukemia types was also studied through rates and calculation of OR, CI, chi-square test and p values ​​through probability tables. Results: 244 leukemia patients were diagnosed, treated and followed; there was association of leukemia with younger age group; 50% were in the age group 1-5 years and with mean ± SD age= 6.44 ± 3.7 years. There was significant association with male gender (66.7%). There was non-significant association between high mortality and the 6-10 year age group [(8/78; 10.2%), with OR = 2.6, p = 0.060, and with the AML [(4/38; 10.5%), OR = 2.1)]. Considering, the cure rates association with ages, roughly there were similar cure rates occurred in the different age groups. Also, there was high cure rate in the JCM (2/3; 66%), with OR = 2.9. And with the CML (7/11; 63.6%; OR = 2.60. Conclusion: In the current study an association between leukemia and younger age group, with males was found. An association between high mortality and the 6-10 year age group, with AML was found. Also, there was no association between ages and cure rate but a high cure rate occurred with JCM and CML.

Endogenous Endophthalmitis Associated with Pyogenic Liver Abscess Caused by Klebsiella Pneumoniae: A Case Report

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

Intergenerational Facility Alternatives: Transitioning Care Options for Aging Parents and Children with Autism

Purpose: The objective was twofold: 1) summarize research-informed environmental characteristics into Mostafa’s seven ASPECTSS™ criteria for people who are aging, and for children who have autism, and 2) apply those characteristics within the context of a Green House planned intergenerational facility providing support to adult child with autism, and their parent(s). Background: The rate of Autism Spectrum Disorder (ASD) diagnoses is increasing, making it important to design spaces for people with ASD. Approximately 85% of children with ASD live with their parents (Mykyta, 2012). Ahrentzen & Steele (2010) identified the need to develop housing options for people with ASD. Method: Design considerations from a literature review were organized into two tables: 1) aging adults and 2) people who have ASD. Shared characteristics were placed into a third table using Mostafa’s seven ASPECTSS™ criteria, and then applied to the intergenerational facility plan to demonstrate the effectiveness of intentional planning by caregivers and the design community. Results: When integrating Mostafa’s ASPECTSS™ framework, and the intergenerational Green House Model, the application of design choices within housing demonstrates that appropriately designed space can positively impact persons and families with autism, regardless of age. Conclusion: Findings show numerous overlapping design criteria for people with autism and aging adults that can lead to effective environmental solutions for both. This facility type has the potential to minimize family fracture since aging parents are supported in their ability to care for their child with autism.

Unindustrialized Nations and Migration of Work Force: Evaluation of Human Capital during Globalization Era

Among four essential features of globalization, which have been identified by the International Monetary Fund, immigration and leaving fatherland, has an important place, because it is about the human capital, which is the basis for social motion, organization, and evolution. During the last three decades of the 20th century, and continuing through the first two decades of the 21st century, there has been an increasing inflow of immigration to the world’s most highly developed countries. Parallel to the said move, brain drain, as well, is defined as the migration of educated workers in search of higher salaries, better standard of living and quality of life, access to advanced technology and more stable political circumstances in different places around the world. Limited career structures, poor intellectual stimulation, lack of research funding, threats of violence; and absence of good schooling are among the well-known motives for migration. By the way, brain drain has long been regarded as a serious restraint on the development of poor countries. While early literature supports the view that skilled migration is definitely damaging for those left behind, there are several recent studies that suggest that migration may in fact foster human capital formation and growth in sending countries. Before globalization, psychological problems of immigrants, like acculturation, had already a specific place in psychiatry. Now, while with increasing number of migrants, new accommodations and programs for responding to psychosocial complications of this huge number of refugees, outcasts, or valid émigrés seems more mandatory than before, the move toward universal measures, diagnoses and treatments of mental illness is inconsistent with the belief that mental distress is culturally and socially mediated. In the present article, the aforesaid circumstances, with reference to developing societies, have been surveyed from different perspectives.

Smart Care Business Uses the Internet of Things

It is important to increase the quality of health and medicine. A wearable system for continuous monitoring of the patient is important to overcome this issue. Thus, a patient with Arrhythmia due to its low cost and success in saving the life of the patient was the right option for the care partner. In addition, the device will provide a consumer with a smart smartphone application with accurate pulse beat and body temperature data in real-time. MAX 30100 and LM35 are primarily used for the detection of human heart and temperature. An arrhythmia algorithm in the esp32 segment generates the performance of these sensors.