Archive : Volume - 8, Issue - 1, Month - January
1 Sleep disorder breathing in obese preschool children: case series and review of literatures
- Abdullah Khayat*
- Abstract
- Show Article
- Download : 246
- Google Citation
- Journal DOI : 10.46624/bjmhr.2021.v8.i1.001
- Certificate
Abstract : Background: Obstructive sleep apnea (OSA) is a common problem estimated at 2-5% in the school-aged children. As obesity prevalence is increasing universally, OSA is estimated to be higher than their lean children. Obesity related OSA is increasing in all age groups including younger children. The aim of this study is to focus on the importance of OSA among obese preschool children and to determine what risk factors are associated with OSA.
Methods: A retrospective chart review for children ≤6 years is identified from tertiary centre in Saudi Arabia who had a polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age. OSA was diagnosed if the obstructive apnea hypopnea index (OAHI) was greater than 1 event per hour.
Results: There were 4 children identified; the mean age was 4.5 years meaning BMI was 28(SD ± 1.2). the prevalence of OSA in those children was high.
Conclusion: Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness should facilitate referral for a PSG, especially in resource-limited settings.
Keyword : _Obesity. Obstructive sleep apnea. Sleep-disordered breathing. Pediatrics_
2 SPLEENIC ABCESS: RARE SPECTRUM OF DIAGNOSIS IN IMMUNOCOMPETENT PATIENT WITH URINARY TRACT INFECTION
- ANUBHAV GUPTA* ,
- JAGRATI GUPTA ,
- HAKIMUDDIN PARDAWALA
- Abstract
- Show Article
- Download : 252
- Google Citation
- Journal DOI : 10.46624/bjmhr.2021.v8.i1.002
- Certificate
Abstract : Spleenic abscess is a rare entity, with a reported frequency of 0.05-0.7%.Its reported mortality is still high, up to 47%, and has the potential to reach 100% among patients who do not receive antibiotic treatment. It is more common in the presence of infection at different primary sites, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Immunosuppression and trauma are well-known risk factors. Recently, intravenous drug abusers and alcoholics have shown an increased incidence compared to other high-risk groups. However, encountering this entity in general population is uncommon. Clinical examination and laboratory findings are not constant; thus, imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. If untreated, the mortality reaches almost 100%. Treatment includes conservative measures and surgical interventions. Spleenectomy has been the preferred approach in most centers. More recent studies have suggested the use of advanced and alternative options, including laparoscopic surgical and percutaneous interventions. Changing trends, in view of the importance of immunological role of spleen, have emphasized more on spleen preserving protocols, especially in children and young patients, and in cases of solitary abscess with a thick wall. Conducted a literature review by analysis of various high-risk groups, presentation, diagnosis and treatment of splenic abscess and have presented a case report here.
Spleenic abscess is an infrequent clinical entity and carries a very high mortality in the untreated cases. Pathognomic clinical features of left hypochondrial pain, splenomegaly, fever and leucocytosis are present in only one - third of the cases. Diagnosis is mostly done by imaging, either Abdominal Sonography or CT Scan. So far no prospective study has been done to rationalize the management, probably due to paucity of cases. Antibiotics alone or with percutaneous drainage under imaging control are successful in many cases. Failed aspirations and splenic abscesses with concomitant pathologies need spleenectomy. Spleenectomy and complete removal of the source of the infection is still the mainstay of treatment. Detailed review of the available literature of the clinical problem and various methods of treatment of spleenic abscesses are discussed in this article.
Keyword : spleenic abcess , urinary tract infection , immunocompetent
3 Clinical reasoning skills of medical students, Faculty of Medicine Alzaiem Alazhari University Khartoum Sudan Measured by Diagnostic Thinking Inventory (DTI)
- Wisal Omer Mohamed Nabag* ,
- Abdelmoniem Sahal Elmardi
- Abstract
- Show Article
- Download : 234
- Google Citation
- Journal DOI : 10.46624/bjmhr.2021.v8.i1.003
- Certificate
Abstract : ABSTRACT
Clinical reasoning skills are considered as essential domain needed to be acquired to become a good physician The Diagnostic Thinking Inventory (DTI) is a tool used for measuring critical thinking skills namely flexibility in thinking and evidence for Structure in memory. To measure the clinical reasoning skills among medical students in Alzaiem Alazhari University.. It is cross-section study which was conducted at the Faculty of Medicine, Alzaiem Alazhari University (AAU) Khartoum,to measure clinical reasoning skills using the diagnostic thinking inventory(DTI) of 5th(92),9th(63) semester & the newly graduate (62) a total of 181students . The study population (74%) were under graduate (in 5th&9th.Semester), while the remainder were newly graduate (26%),all were scored high levels .Tests of correlation, for the 3 subgroups, for DTI scores the flexibility of thinking & Structure of Knowledge and the standard of Bordage, Grant & Marsden in 1990 (81.6& 87.4) for the students in 5th. Semester were 0.004 &0.000 for the 9th Semester students were, 0.001 & 0.000while for the newly graduate students were 0.424&,0.003 which were significant at P>0.05 using one sample t test &Nonparametric test ( Wilcoxon Signed Rank Test) was used when the data distribution was not normal. The correlation, for the 3 subgroups using one-way ANOVA was not significant (0.893& 0.680). DTI is an appropriate instrument for a comparative survey of self-assessed clinical reasoning among students at different semesters. The curriculum of AAU faculty of medicine is integrating basic and clinical sciences in solving community, family and individual health problems according to known methods of problem solving. In addition started teaching clinical reasoning skills earlier so, DTI scores were found to be high in all subgroups 5th, 9th & the newly graduate. There is Conclusive evidence that critical thinking skills and abilities can be taught, so medical curriculum should be integrated & based in problem based learning so as to graduate student with Critical thinking & good clinical reasoning skills.
Keywords: Clinical reasoning skills,, Medical students, DTI, Curriculum
Keyword : Clinical reasoning skills,, Medical students, DTI, Curriculum
4 application of RUSH(rapid ultrasound in shock and hypotension)protocol on patients presenting in emergency with Shock
- ANSHUL JAIN ,
- ANSHUL JAIN* ,
- DIWAKAR VERMA ,
- Shatrughan Pareek ,
- BINOD KRISHNA GOUDA
- Abstract
- Show Article
- Download : 256
- Google Citation
- Journal DOI : 10.46624/bjmhr.2021.v8.i1.004
- Certificate
Abstract : Background: Emergency ultrasound examinations should be done for a clearly defined emergency condition. RUSH (Rapid ultrasound in shock and hypotension) protocol in an emergency setting can play a vital role. The present study was conducted with the aim of applying RUSH protocol on patients with shock in the emergency department. Materials and methods: The present cross-sectional clinical observational study was conducted in the Emergency department. Only 57 samples were selected by non-random sampling method in this study. We performed an early bedside sonographic examination for participants based on RUSH protocol. Patients received all needed standard therapeutic and diagnostic interventions without delay and were followed to document their final diagnosis. The data analysis was done with help of SPSS 18. Results: Our study had overall sensitivity of 93% and specificity of 96% with kappa index of 0.85 which shows good agreement (85%) of our RUSH protocol with the final diagnosis. In addition, distributive shock showed the highest degree of agreement with the final diagnosis (kappa index=1) followed by hypovolemic (kappa index=0.91), cardiogenic (kappa index=0.83) and obstructive (kappa index=0.71). While, mixed variety of shock had the lowest agreement (kappa=0.70) with the final diagnosis. Conclusion: The RUSH protocol is significantly effective in making a rapid diagnosis of shock etiology, especially in ruling out obstructive, cardiogenic, and hypovolemic types. Moreover, the protocol can be helpful in minimizing morbidity and mortality among shock patients in the emergency department.
Keyword : RUSH protocol, Emergency department, Rapid ultrasound in shock, Shock patient
Login
Loading....
Author Guideline
Copyright Form
News Update
Archive List
- Volume-11
- January 2024 Issue 1
- February 2024 Issue 2
- February 2024 Issue 2
- March 2024 Issue 3
- April 2024 Issue 4
- May 2024 Issue 5
- May 2024 Issue 5
- June 2024 Issue 6
- July 2024 Issue 7
- July 2024 Issue 7
- August 2024 Issue 8
- September 2024 Issue 9
- September 2024 Issue 9
- October 2024 Issue 10
- November 2024 Issue 11
- Volume-10
- January 2023 Issue 1
- January 2023 Issue 1
- February 2023 Issue 2
- March 2023 Issue 3
- March 2023 Issue 3
- April 2023 Issue 4
- April 2023 Issue 4
- May 2023 Issue 5
- May 2023 Issue 5
- May 2023 Issue 5
- June 2023 Issue 6
- June 2023 Issue 6
- July 2023 Issue 7
- July 2023 Issue 7
- August 2023 Issue 8
- August 2023 Issue 8
- September 2023 Issue 9
- October 2023 Issue 10
- November 2023 Issue 11
- December 2023 Issue 12
- Volume-9
- January 2022 Issue 1
- February 2022 Issue 2
- March 2022 Issue 3
- April 2022 Issue 4
- May 2022 Issue 5
- June 2022 Issue 6
- July 2022 Issue 7
- July 2022 Issue 7
- July 2022 Issue 7
- July 2022 Issue 7
- August 2022 Issue 8
- September 2022 Issue 9
- October 2022 Issue 10
- October 2022 Issue 10
- November 2022 Issue 11
- November 2022 Issue 11
- November 2022 Issue 11
- December 2022 Issue 12
- Volume-8
- January 2021 Issue 1
- February 2021 Issue 2
- February 2021 Issue 2
- March 2021 Issue 3
- April 2021 Issue 4
- May 2021 Issue 5
- June 2021 Issue 6
- June 2021 Issue 6
- June 2021 Issue 6
- July 2021 Issue 7
- August 2021 Issue 8
- September 2021 Issue 9
- October 2021 Issue 10
- November 2021 Issue 11
- December 2021 Issue 12
- Volume-7
- January 2020 Issue 1
- January 2020 Issue 1
- February 2020 Issue 2
- March 2020 Issue 3
- March 2020 Issue 3
- March 2020 Issue 3
- April 2020 Issue 4
- April 2020 Issue 4
- May 2020 Issue 5
- May 2020 Issue 5
- May 2020 Issue 5
- June 2020 Issue 6
- June 2020 Issue 6
- June 2020 Issue 6
- July 2020 Issue 7
- August 2020 Issue 8
- September 2020 Issue 9
- October 2020 Issue 10
- November 2020 Issue 11
- December 2020 Issue 12
- December 2020 Issue 12
- Volume-6
- January 2019 Issue 1
- February 2019 Issue 2
- March 2019 Issue 3
- April 2019 Issue 4
- April 2019 Issue 4
- May 2019 Issue 5
- May 2019 Issue 5
- June 2019 Issue 6
- June 2019 Issue 6
- July 2019 Issue 7
- July 2019 Issue 7
- August 2019 Issue 8
- September 2019 Issue 9
- September 2019 Issue 9
- September 2019 Issue 9
- October 2019 Issue 10
- November 2019 Issue 11
- November 2019 Issue 11
- November 2019 Issue 11
- December 2019 Issue 12
- Volume-5
- January 2018 Issue 1
- January 2018 Issue 1
- February 2018 Issue 2
- March 2018 Issue 3
- April 2018 Issue 4
- May 2018 Issue 5
- June 2018 Issue 6
- July 2018 Issue 7
- August 2018 Issue 8
- September 2018 Issue 9
- September 2018 Issue 9
- October 2018 Issue 10
- October 2018 Issue 10
- November 2018 Issue 11
- December 2018 Issue 12
- December 2018 Issue 12
- Volume-4
- January 2017 Issue 1
- February 2017 Issue 2
- February 2017 Issue 2
- March 2017 Issue 3
- April 2017 Issue 4
- April 2017 Issue 4
- May 2017 Issue 5
- June 2017 Issue 6
- June 2017 Issue 6
- June 2017 Issue 6
- June 2017 Issue 6
- July 2017 Issue 7
- August 2017 Issue 8
- August 2017 Issue 8
- September 2017 Issue 9
- October 2017 Issue 10
- November 2017 Issue 11
- December 2017 Issue 12
- December 2017 Issue 12
- December 2017 Issue 12
- Volume-3
- January 2016 Issue 1
- February 2016 Issue 2
- March 2016 Issue 3
- April 2016 Issue 4
- May 2016 Issue 5
- June 2016 Issue 6
- June 2016 Issue 6
- July 2016 Issue 7
- July 2016 Issue 7
- July 2016 Issue 7
- August 2016 Issue 8
- September 2016 Issue 9
- October 2016 Issue 10
- October 2016 Issue 10
- November 2016 Issue 11
- November 2016 Issue 11
- December 2016 Issue 12
- Volume-2
- Volume-1
Statastics
Download of Articles
131,259