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Assessing Situation of Inpatient Mental Health Screening and Suicide Prevention of Standard Operating Procedure (SOP)
Dongxiang Hu,
Meilin Fan,
Lilian Gao
Issue:
Volume 4, Issue 2, December 2020
Pages:
31-33
Received:
27 May 2020
Accepted:
10 June 2020
Published:
16 June 2020
Abstract: Objective: To assess situation of Inpatient mental health screening and suicide prevention of standard operating procedure (SOP). Methods: We invest 306 people to join our study from August 2017 to July 2019, the participants contain 128 patients, 128 healthy people and 50 medical workers. The information is collected by interview and questionnaire, that includes basic information of participants, depression assessment, anxiety assessment and medical workers’ suicide prevention cognition score. The questionnaires include simple questionnaire, Self-Rating Anxiety Scale (SAS) and Self-rating depression scale (SDS). Result: In SAS research and SDS research, patient group has higher score than that of healthy people group, that patients were more anxious and depressed than healthy people in this mental health research. And the situation between patient group and healthy people group have big different as the results are statistical significance (p<0.001). In medical workers' suicide prevention cognition test, the test accuracy rates only have approximately 60% in those 3 domains, so medical workers' knowledge of suicide prevention of standard operating procedure (SOP) is far from enough in hospitalization. In particular, suicide prevention measures part has better performance than that of basic knowledge of suicide part (7 out of 12 vs 5 out of 8). Conclusion: The suicide prevention is a serious problem in hospitalized patient, the inpatients have serious mental health problem and medical workers lack related knowledge and skills.
Abstract: Objective: To assess situation of Inpatient mental health screening and suicide prevention of standard operating procedure (SOP). Methods: We invest 306 people to join our study from August 2017 to July 2019, the participants contain 128 patients, 128 healthy people and 50 medical workers. The information is collected by interview and questionnaire...
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Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome
Farah Naaz Kazi,
Anurag Agarwal,
Prashant Kanni
Issue:
Volume 4, Issue 2, December 2020
Pages:
34-40
Received:
18 May 2020
Accepted:
20 June 2020
Published:
6 July 2020
Abstract: Irritable Bowel Syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by chronic abdominal pain, cramping, constipation, and diarrhea. Manning criteria, Kruis criteria and Rome IV criteria have shown that certain symptoms derived from a 15-items questionnaire differentiated patients with Irritable Bowel Syndrome (IBS) from patients with organic diseases. The purpose of the study is to find out the reliability and discriminatory value of the Manning criteria, Kruis criteria and Rome IV criteria in the differentiation of Irritable Bowel Syndrome (IBS) from organic diseases and to find out if the three criteria could be combined. The study is a prospective cross-sectional analytical study of one hundred and thirty patients who presented with Diarrhea or Constipation to the Department of Medicine, Department of Surgery, Department of Medical Gastroenterology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore between September- February, 2019-2020. After taking informed consent, patients were subjected to preformed questionnaire in the language best understood by them. Patient underwent diagnostic investigations like Complete blood count (CBC), Erythrocyte Sedimentation Rate (ESR), C- reactive protein, Serum albumin and Colonoscopy. A total of 130 patients were interviewed for the study. Manning criteria had the highest sensitivity (88%) compared to Kruis criteria (81%) and Rome IV criteria (80%). Kruis criteria had the highest specificity (91%) compared to Manning criteria (87%) and Rome IV criteria (86%). On combining the three criteria, while the sensitivity is 94.4%, the specificity fell drastically to 58%. Hence everything considered it is best to ply with the individual criteria for the diagnosis of irritable bowel syndrome.
Abstract: Irritable Bowel Syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by chronic abdominal pain, cramping, constipation, and diarrhea. Manning criteria, Kruis criteria and Rome IV criteria have shown that certain symptoms derived from a 15-items questionnaire differentiated patients with Irritable Bowel Syndrome (IBS) ...
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Patterson-Kelly Syndrome: A Single Centre Experience
Issue:
Volume 4, Issue 2, December 2020
Pages:
41-44
Received:
28 June 2020
Accepted:
16 July 2020
Published:
4 August 2020
Abstract: Background: Patterson Kelly syndrome is a rare entity, presenting with a triad of Iron deficiency anemia, Dysphagia and Esophageal webs. The syndrome is extremely rare and its incidence is decreasing probably due to improvements in nutritional standards. The syndrome is enigmatic in the sense that not all patients may be having anemia, the syndrome is associated with various autoimmune conditions, webs are located in post-cricoid region only and there is increased prevalence of upper gastrointestinal malignancies in these patients. The symptoms respond to iron replacement but many patients require rupture of web for relief of dysphagia. Savary dilators, TTS balloon, electro-cautery have been variably used to break the web. Objectives: 1. To study the profile of Patterson Kelly syndrome at our center; 2. To study if the endoscope itself can be used as effective dilator for rupturing the web; 3. To study the effect of iron replacement in these patients; 4. To study the occurrence of upper gastrointestinal malignancies in this condition. Material and methods: We report our experience of sixteen patients with Patterson Kelly syndrome over last fifteen years. This is a retrospective, single center, observational study. All patients had demonstrable web on endoscopy. The endoscope itself was used as a dilator to break the web in more than half of the patients. The endoscope being rigid instrument can easily break the thin web during diagnostic endoscopy itself. If the opening was too narrow, TTS balloon or Savary Guilard dilators were used. One patient had a perforation while using endoscope as the dilator. Five patients required more than one sitting of dilatation for achieving relief of dysphagia or for recurrent web formation. Most patients received intravenous iron supplementation. Ten patients had complete relief of dysphagia without recurrence. One patient had concomitant esophageal squamous cell carcinoma in lower esophagus which became evident when the scope was passed distally, post dilatation of the web. Conclusions: Although rare, Patterson Kelly syndrome continues to exist and can be effectively treated by iron replacement, dilatation and rupture of esophageal webs using various methods. The web can be ruptured by careful maneuvering of the endoscope itself. Intravenous iron replacement can be used prior to the procedure which can ameliorate the symptoms and reduce the need for the dilatation or can make it easier. Patients need surveillance for upper gastrointestinal malignancies however exact guidelines in this regard are lacking.
Abstract: Background: Patterson Kelly syndrome is a rare entity, presenting with a triad of Iron deficiency anemia, Dysphagia and Esophageal webs. The syndrome is extremely rare and its incidence is decreasing probably due to improvements in nutritional standards. The syndrome is enigmatic in the sense that not all patients may be having anemia, the syndrome...
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Diagnosis and Surgical Extraction of Large Gastric Trichobezoars: A Single Center Study of Two Cases
Tulika Saggar,
Varun Saggar
Issue:
Volume 4, Issue 2, December 2020
Pages:
45-49
Received:
5 July 2020
Accepted:
17 July 2020
Published:
4 August 2020
Abstract: Trichobezoars are compact mass of hair occupying the gastric cavity that if left untreated can cause developmental delay, malnutrition, obstruction or perforation. The treatment options include extraction by conventional laparotomy, laparoscopy, gastrotomy or endoscopy. Since they are almost always associated with trichotillomania and trichophagia or other psychiatric disorders, psychiatric consultation is necessary to prevent relapses. We reviewed the medical charts of two patients with trichobezoar who were treated at Lord Mahavir, Civil Hospital, Ludhiana. Both the cases, aged 14 and 19 years were females and presented at the hospital with a history of epigastric discomfort, pain and vomiting. Both the girls were lean, underweight and pale skinned. First patient had trichotillomania and trichophagia for 1 year prior to presentation. The parents were unaware of patient’s trichophagia but the girl revealed that she ate hair during the night. The second patient had no history of trichophagia and the bilateral loss of scalp hair indicated nocturnal involuntary eating of hair during sleep. The large palpable mass in both the cases was non-tender, hard, smooth and mobile on examination. The abdominal imaging with CT revealed the mass occupying most of the gastric cavity, and turned out to be trichobezoars. The masses were successfully extracted by laparotomy and gastrotomy. A trichobezoar represents a serious surgical condition. It is important to consider such diagnosis in face of suggestive symptoms, even if signs of trichotillomania are not present. Gastrotomy was found to be very successful for the surgical removal of trichobezoars. The behavioral assessment and psychiatric counselling also plays a useful role in patient management and prevention of recurrence.
Abstract: Trichobezoars are compact mass of hair occupying the gastric cavity that if left untreated can cause developmental delay, malnutrition, obstruction or perforation. The treatment options include extraction by conventional laparotomy, laparoscopy, gastrotomy or endoscopy. Since they are almost always associated with trichotillomania and trichophagia ...
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Helicobacter Pylori Infection as Coincidence in Gallbladder Disease: Is It Worth for Routine Testing
Fatima Al Harmoodi,
Meera Al Matrooshi,
Mohammed Al Suwaidi,
Katharina Kessler
Issue:
Volume 4, Issue 2, December 2020
Pages:
50-53
Received:
24 June 2020
Accepted:
25 July 2020
Published:
10 August 2020
Abstract: Background: Abdominal pain is one of the most common presented symptoms to the medical services, and some of them are assumed to be due to cholecystolithiasis. Helicobacter Pylori (H. pylori) gastritis can cause equal symptoms as cholecystolithiasis. A lot of researches in the field are trying to clarify the misdirection, as this will change the management for cholecystolithiasis patients. Methods: In this retrospective study from October 2018 till July 2019 at Al Ain Hospital, United Arab Emirates, a coincidence of having H. pylori infection in the presence of gallstones was investigated, and if a routine testing for H. pylori was done. Results: Total number of 159 cases from different nationalities, majority were United Arab Emirates locals were assembled and investigated. Although the majority of the studied group were not investigated for H.pylori, and around 30 patients were investigated, Results showed a 36% rate of positivity of H.pylori among the investigated people, which is similar to the other researches in this field. Majority of the H.pylori testing were done via antigen stool test analysis, as its inexpensive method, reliable and appropriate. Conclusion: Data showed that still Helicobacter testing is not routinely done, however a high infection rate similar like other studies detected. More awareness and further studies recommended.
Abstract: Background: Abdominal pain is one of the most common presented symptoms to the medical services, and some of them are assumed to be due to cholecystolithiasis. Helicobacter Pylori (H. pylori) gastritis can cause equal symptoms as cholecystolithiasis. A lot of researches in the field are trying to clarify the misdirection, as this will change the ma...
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A Randomized Clinical Trial Evaluating Mannitol, Lactitol, and Polyethylene Glycol Macrogol as Oral Solutions for Colonoscopy Preparation
Lourianne Nascimento Cavalcante,
Adriana Ribas,
Alexandre Pithon Lins,
Luciana Rodrigues Leal da Silva,
Flora Maria Lorenzo Fortes,
Valdeck Sodre Bispo Jr,
Marcus Vinicius Matos de Almeida,
Maira Cintra de Oliveira,
Camila Silveira,
Marcos Clarencio Batista,
Igelmar Barreto Paes
Issue:
Volume 4, Issue 2, December 2020
Pages:
54-62
Received:
11 August 2020
Accepted:
26 August 2020
Published:
23 September 2020
Abstract: Colonoscopy is an important tool for diagnosing and treating bowel injuries and reducing colorectal cancer incidence. Adequate bowel preparation is necessary to ensure the effectiveness of the procedure for detecting injuries. In this trial the aim was to compare effectiveness of lactitol, mannitol, and polyethylene glycol (PEG) oral solutions for bowel cleansing prior to colonoscopy. This is a randomized, blinded clinical trial. The primary endpoint was to evaluate the adequacy of colon cleansing according to the Boston Bowel Preparation Scale (BBPS). A total of 294 patients were randomized into three groups. The overall adequacy of bowel cleansing was achieved in 98.8% in the mannitol, followed by 93.5% in the lactitol and 92.3% in the PEG group. When comparing lactitol and mannitol, the efficacy to bowel preparation was greater in the mannitol group, but without statistical significance (P=0.164). The adequacy to bowel preparation was slightly better in the mannitol group than PEG (98.8% vs. 92.2%, respectively), but with P-value of 0.073. In adjusted analysis, the results were similar. The frequency of hypernatremia after bowel preparation was 25.3% in the mannitol group, followed by 7.3% and 5.2% in the PEG and lactitol, respectively. Considering tolerance for bowel preparation solution there was no difference between the mannitol and lactitol groups (P=0.07); but lactitol was better tolerated when compared to PEG (P=0.001). In conclusion, mannitol, lactitol and PEG are effective as intestinal cleansing solutions before colonoscopy, but adverse events, taste and tolerability must be considered before choosing.
Abstract: Colonoscopy is an important tool for diagnosing and treating bowel injuries and reducing colorectal cancer incidence. Adequate bowel preparation is necessary to ensure the effectiveness of the procedure for detecting injuries. In this trial the aim was to compare effectiveness of lactitol, mannitol, and polyethylene glycol (PEG) oral solutions for ...
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Evolution of Susceptibilities of Helicobacter pylori Strains Circulating in Cameroon to Usual Antibiotics: A Three-year Study
Eyoum Bille Bertrant,
Tali Nguefak Lionel Danny,
Fotso Chimi Serge,
Malongue Agnes,
Ateba Mbassa Roger,
Kuiate Jules Roger,
Kouitcheu Mabeku Laure Brigitte
Issue:
Volume 4, Issue 2, December 2020
Pages:
63-71
Received:
9 October 2020
Accepted:
22 October 2020
Published:
19 November 2020
Abstract: This study was conducted to estimate the evolution of antimicrobial susceptibilities of H. pylori strains isolated in Cameroon from 2014 to 2016 in relation to sociodemographic factors and clinical outcomes. A total of 278 H. pylori strains were isolated from patients with gastroduodenal disorders and tested for their susceptibility to nine antibiotics using the disc diffusion method. With time, a significant decreased of resistance was observed against clarithromycin (31.11 to 3.20%, p<0.0001), erythromycin (66.69 to 9.6%, p<0.0001) and metronidazole (86.67 to 69.6%, p<0.0001). Resistance to tetracycline (0 to 2.4%) and doxycycline (0 to 1.6%) slightly increase with time. Resistance to amoxicillin (95.5 to 94.4%), ciprofloxacin (4.44 to 4%) and levofloxacin (0 to 0.8%) was relatively constant. No resistance was detected against rifampicin with the time. A significant decrease of resistance was detected against metronidazole / clarithromycin (22.22 to 1.6%, p<0.0001) and amoxicillin / clarithromycin (26.67 to 3.2%, p<0.0001). Among the tested isolates, 0.92 and 2.4% elicited triple resistance to metronidazole / tetracycline / amoxicillin in 2015 and 2016, and 0.8% quadruple resistance to metronidazole / tetracycline / clarithromycin / amoxicillin in 2016. Higher resistance rate was noticed as age increase and among female compared to men. Our data showed evolution in the antimicrobial susceptibilities of H pylori strains circulating in our milieu with time. This finding highlights the need of monitoring periodically H. pylori resistance profile to antibiotics in order to determine the adapted treatment for this infection.
Abstract: This study was conducted to estimate the evolution of antimicrobial susceptibilities of H. pylori strains isolated in Cameroon from 2014 to 2016 in relation to sociodemographic factors and clinical outcomes. A total of 278 H. pylori strains were isolated from patients with gastroduodenal disorders and tested for their susceptibility to nine antibio...
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Colonoscopy: Early Experience in National Hospital Abuja Nigeria
Oluwole Olaomi,
Onyedika Okoye,
Oluwale Badejo
Issue:
Volume 4, Issue 2, December 2020
Pages:
72-76
Received:
2 December 2020
Accepted:
10 December 2020
Published:
31 December 2020
Abstract: Colonoscopy has become one of the most important modalities in the assessment of the lower gastrointestinal lesions. This study focused on our early experience with colonoscopy documenting the indications and outcome in the first five years of Colonoscopy in National Hospital, Abuja, Nigeria. This was a retrospective analysis of demographic data, indications for colonoscopy, agents used for bowel preparation, type of anaesthesia used, endoscopic findings, and extent of colon intubation from the endoscopy unit register of National Hospital, Abuja between July 2007 and June 2012. Patients whose data were incomplete or procedure abounded were excluded. Two hundred and eleven patients had colonoscopy during the 5 year period. Only 153 patients fulfilled the inclusion criteria and their data analysed. Males were 107 (69.9%) and 46 (30.1%) were females given a male/female ratio of 2.3:1 Age range was 2years to 90years with a Mean of 48.02. The commonest indications were bleeding per rectum (33.3%), haemorrhoids (24.8%) and suspicion of malignancy of the lower gastrointestinal tracts (24.3%). The most common findings on colonoscopy in our study were haemorrhoids (47.7%) and malignancies (24.2%) of various parts of the large bowel. 12.4% of the patients had normal study. Our Ceacal intubation rate was 75.8%. Majority of the lesions were found in the Anorectal region (69.9%) with only 17.7% in the rest of the Colon 24.2% of our findings were malignancies of lower intestinal tract. 97.3% of the malignancies were Adenocarcinoma. 83.8% of the malignancies were located in the left colon. Assessment of lower gastrointestinal symptom is incomplete without colonoscopy. Colonoscopy gives a good yield in well selected patients, it is safe and has low complication rate.
Abstract: Colonoscopy has become one of the most important modalities in the assessment of the lower gastrointestinal lesions. This study focused on our early experience with colonoscopy documenting the indications and outcome in the first five years of Colonoscopy in National Hospital, Abuja, Nigeria. This was a retrospective analysis of demographic data, i...
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