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@#Introduction: Fragility fracture from osteoporosis is a major challenging health problem in aging population in developing countries. In order to reduce the risk of development of osteoporotic fragility fractures authors made a study with high risk individuals, divided into two groups and a comprehensive management protocol had been offered in one group where as conventional management protocol had been offered in other to see the efficacy of such comprehensive management protocol to reduce the risk of occurring fragility fracture over at least three months period among the patients, attended in orthopaedic out patient department of state medical college, West Bengal. Methods: The authors selected 30 diagnosed osteoporosis clients of 50 to 90 years age as per inclusion and exclusion criteria, who attended in orthopaedic OPD in SSKM Hospital, Kolkata, West Bengal, India from 2021April to July2021, carrying highest risk factors of developing osteoporosis. Results: In experimental group, mean post test BMD score is higher than the mean pre test BMD, which is statistically significant as calculated t value is 3.666 at 14 df at 0.05 (p<0.05) level of significances. It indicates that comprehensive management protocol is effective to increase the bone strength. Conclusion: The study of comparison of mean difference values of two groups conclude that comprehensive management protocol can reduce the risk of osteoporotic fracture much efficiently in compared to standard pharmaceutical treatment in a short span of time which is applicable for long term management of osteoporosis.
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Las arbovirosis por Dengue (VD), Zika (VZIK) y Chikungunya (VCHIK), transmitidas por vectores del género Aedes, tienen alta prevalencia en países tropicales, especialmente en Ecuador donde se les considera problemas de salud pública. Se realizó un estudio descriptivo para identificar el nivel de cumplimiento de la estrategia de gestión integrada (EGI) para prevención y control de VD y otros arbovirus en Ambato, Tungurahua - Ecuador. Se realizó perfil comunitario a partir de fuentes oficiales y secundarias, se evaluó componentes del ambiente mediante lista de verificación y se evaluó cumplimiento de EGI mediante encuesta al personal del sector salud. Datos consultados señalan que en la provincia existe 36% y 10% de pobreza y pobreza extrema, respectivamente; además adecuado servicio de agua potable, recepción de agua por tubería, gestión de residuos sólidos y servicio de electricidad en ambas zonas, urbana y rural. Se constató que más del 50% de la población rural presenta condiciones óptimas de salud ambiental: aire limpio (90,28%) y agua potable (66,94%); en la población urbana destaca higiene de alimentos (63,89%) y microambiente doméstico (69,44%), con deficiencia en recolección de residuos sólidos (33,89%). La EGI tuvo un nivel de cumplimiento de 100% en parroquias urbanas en componentes laboratorio, atención al paciente, promoción y comunicación, mientras que en parroquias rurales, salud ambiental tuvo 63% e investigación y capacitación menor nivel (47,78%); siendo necesario mejorar sistemas de desechos sólidos en la población urbana y promover el conocimiento y capacitación epidemiológica en la rural, para reducir el riesgo de transmisión por arbovirus(AU)
Dengue (DV), Zika (ZIKV) and Chikungunya (CHIKV) arboviruses, transmitted by vectors of the Aedes genus, have a high prevalence in tropical countries, especially in Ecuador where they are considered public health problems. A descriptive study was carried out to identify the level of compliance with the integrated management strategy (EGI) for prevention and control of DV and other arboviruses in Ambato, Tungurahua - Ecuador. A community profile was made from official and secondary sources, components of the environment were evaluated by means of a checklist and compliance with EGI was evaluated by means of a survey of health sector personnel. Consulted data indicate that in the province there is 36% and 10% of poverty and extreme poverty, respectively; In addition, adequate drinking water service, receiving water through pipes, solid waste management and electricity service in both urban and rural areas. It was found that more than 50% of the rural population presents optimal environmental health conditions: clean air (90.28%) and drinking water (66.94%); In the urban population, food hygiene (63.89%) and domestic microenvironment (69.44%) stand out, with a deficiency in solid waste collection (33.89%). The EGI had a compliance level of 100% in urban parishes in laboratory, patient care, promotion and communication components, while in rural parishes, environmental health had 63% and research and training lower level (47.78%); being necessary to improve solid waste systems in the urban population and promote epidemiological knowledge and training in rural areas, to reduce the risk of transmission by arbovirus(AU)
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Humans , Male , Female , Arbovirus Infections/prevention & control , Communicable Disease Control , Dengue/prevention & control , Public Health Surveillance , Chikungunya Fever/prevention & control , Zika Virus , Rural Population , Urban Population , Environmental Health , Surveys and Questionnaires , Ecuador/epidemiologyABSTRACT
Rare bleeding disorders (RBD) are autosomal recessive inherited diseases caused by one or more coagulation factor defects, including the deficiency of fibrinogen (FG), prothrombin, factor (F)V, Ⅶ, Ⅹ，Ⅺ, Ⅷ and so on. Due to the low prevalence of RBD, and lack of large-scale randomized controlled studies in the world, where are great challenges to clinicians in diagnosis and treatment of this series of diseases. Facing in the heterogeneity of clinical phenotype and laboratory characteristics, it is more necessary to strengthen the communication and cooperation between the clinical and laboratory, realizing comprehensive management.
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BACKGROUND@#Mortality of lung cancer can be decreased by early screening effectively. However, consistent and proficient standards & methods have not been established in China. This study was based on pulmonary nodules/lung cancer comprehensive management platform established by West China Hospital, Sichuan University. Early screening of pulmonary nodules was integrated into standard healthcare of lung cancer system, aiming to improve survivals of lung cancer patients.@*METHODS@#Three cohorts were established: healthy populations, pulmonary nodules cohort and lung cancer patients cohort, and related clinical data will be collected and analyzed. Preliminary plan includes verifying effect of pulmonary nodules screening module.@*RESULTS@#Pulmonary nodules screening was performed in 2,836 employers (>40 years old) of West China Hospital. Lung cancers were diagnosed in 66 participants, all receiving surgery to remove the lesions. 65 of them were with early stage diseases, 1 with lung cancer and brain metastasis.@*CONCLUSIONS@#Proficient screening, follow-up and healthcare can be achieved via pulmonary nodules/lung cancer comprehensive management mode, which will be extended all over west China region in future.
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Objective To investigate the effect of comprehensive management mode intervention in elderly patients with moderate/severe chronic obstructive pulmonary disease at stable stage. Methods A total of 150 elderly patients with stable-stage COPD were randomly divided into two groups, 75 in each group. The control group received routine medication, while the observation group was given comprehensive management mode intervention, including health education,rational medication, pulmonary rehabilitation training and psychological guidance. Both groups were treated for 12 months. Differences in lung function parameters, modified Medical Research Council (mMRC) dyspnea scale, COPD assessment test (CAT), 6-minute walk test (6MWT), and frequency of acute exacerbation of COPD (AECOPD) were compared between the two groups. Results: After treatment, FEV1/FVC and FEV1%pred of observation group（57.65±11.62%、61.83±13.50%）were higher than control group（52.38±13.24%、53.42±13.93%）(P0.05). Within 12 months of treatment, the frequency of AECOPD in the observation group was less than that in the control group (P<0.05). Conclusions: In the treatment of elderly patients with moderate/severe chronic obstructive pulmonary disease, comprehensive management mode intervention can help delay the deterioration of lung function, correct the difficulty of breathing, improve the quality of life, and reduce the number of AECOPD.
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Children diabetes is a rare chronic disease, recent data on the incidence of childhood diabetes show both types of diabetes are increasing worldwide.How to implement individualization on the basis of the principle of comprehensive management of diabetes mellitus, and ultimately make blood sugar achieve optimal control and reduce complications is the goal of treatment.In order to correctly treat and utilize new insulin dosage forms and new blood sugar monitoring technology in children, it is necessary to integrate all aspects of information and make comprehensive decisions.Now, how to realize individualization on the basis of comprehensive management of diabetes mellitus was elaborated.
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Children are a special group, which have unique physiological characteristics and are still in the period of physical and mental growth and development, thus the prevention and treatment of scar in children are different from that in adults. Scar management in children is a complex and multifaceted system engineering. The grade of scar in children needs to be adjusted according to the age, period, and severity. Corresponding method needs to be chosen for the treatment of scar in children according to the classification of the scar. The compliance of children is poor, and the key to scar treatment is the persistence and cooperation of the parents, so doctors should strengthen propaganda and education to the parents of children with scar. For children with scar, individualized and comprehensive treatment should be used according to the characteristics of children to achieve good results.
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There are an increasing number of women with CHD seeking to bear children,and once pregnant,the risk of heart and maternal and fetal complications increases,and heart function is furhter damaged.The risk depends on the type of congenital heart disease,degree of hemodynamic impairment,and potential complications.Strengthening the comprehensive management of such patients,conducting careful individual and multidisciplinary risk assessment,and formulating detailed plans for follow-up during pregnancy,delivery and postpartum treatment can reduce the risk and improve perinatal outcomes,which has important significance for reducing maternal mortality.
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Children diabetes is a rare chronic disease,recent data on the incidence of childhood diabetes show both types of diabetes are increasing worldwide.How to implement individualization on the basis of the principle of comprehensive management of diabetes mellitus,and ultimately make blood sugar achieve optimal control and reduce complications is the goal of treatment.In order to correctly treat and utilize new insulin dosage forms and new blood sugar monitoring technology in children,it is necessary to integrate all aspects of information and make comprehensive decisions.Now,how to realize individualization on the basis of comprehensive management of diabetes mellitus was elaborated.
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Objective To evaluate the effectiveness of a comprehensive hypertension management. Methods Hypertensive patients aged≥35 years in the Zhengfei community of Zhengzhou were selected. The patients were randomly assigned to the intervention and control groups. Those in intervention group received comprehensive hypertension management from October 2015 to September 2016,whereas those in the control group received the original management mode. Scales to assess blood pressure control, biochemical indexes, unhealthy lifestyle, and cardiovascular disease associated risk level were used to evaluate the effectiveness of the management modes.Results Each study groups had 1 051 patients.There were no significant differences in the baseline data of the two groups (P>0.05). At the end of 1 year of receiving the respective hypertension management modes, each group had 941 patients. Findings revealed that after receiving the comprehensive hypertension management mode, the systolic and diastolic blood pressure in the intervention group decreased by(9.87±7.38)mmHg(1 mmHg=0.133 kPa)and(6.33±4.14) mmHg,respectively.Those in the control group decreased by(7.01±6.02)mmHg and(4.52±3.59)mmHg, respectively,statistically significant differences in the extent of reduction of blood pressure between the two groups (P<0.05). Further, the fasting plasma glucose, postprandial blood glucose, low density lipoprotein, serum creatinine,and microalbuminuria levels in the intervention group were significantly lower than those in the control group(all P<0.05).However,the intervention group exhibited a significant increase in the high density lipoprotein level as compared to the control group(P<0.05).There were no significant differences in the total cholesterol,triglyceride,urinary creatinine levels,and body mass index between the two groups(P>0.05), although they had decreased in both groups. After the 1-year management, these proportions of smoking,heavy drinking,high salt diet and need to exercise were 10.0%,3.7%,20.1%,and 48.9% in the intervention group, and 15.3%, 10.0%, 29.0%, and 54.3% in the control group. The proportions were significantly different between the two groups (P<0.05). After the 1-year management, these proportions of low,moderate,and high risk of cardiovascular disease were 13.3%,33.5%,and 53.2% in the intervention group, and 11.2%, 30.1%, and 58.8% in the control group, respectively, with statistically significant differences between the two groups (P< 0.05). After the 1-year management, the proportion of treated, controlled, and control-treated hypertension using medication was 100%, 65.1%, and 75.3% in the intervention group, and 39.5%, 60.3%, and 70.0% in the control group, respectively, with statistically significant differences between the two groups (P< 0.05). Conclusion The comprehensive hypertension management mode was effective in significantly improving the blood pressure and health condition of hypertensive patients.
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Cataract is still the main blinding eye disease,and it is a major goal of fighting blindness in China.In the past years,the diagnosis,treatment technology and equipment have made great progress.With the further understanding of this disease and increasing requirement of patients for the quality of life,the standardization,safety and efficacy of the clinical diagnosis and surgical outcomes of cataract have become much more important.So the relative clinical examination approaches,modified operating skills,new surgery development and application as well as novel type of functional IOLs design advance rapidly,which provide an expensive space for the selection of the treatment for cataract.High quality of cataract surgery depends on preoperative precise biometry,reasonable operating scheme targeting at personality,suitable functional IOL,less intra-or post-operative complications,effectively avoiding treatment risk and correctly processing disadvantageous factors affecting postoperative visual quality.Therefore,the management of cataract surgery is a systemic procedure.The issue of improving ophthalmic examination,new cataract surgical technique and new IOL emerges as the time requires.How to make up individual-based treatment options for patients,better improve postoperative visual quality,enhance the safety of operative procedure,reduce operative complications is the challenges and unremitting goal for the ophthalmologists.
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Objective To evaluate the effect of comprehensive management of patients with early diabetic nephropathy in community . Methods A randomized controlled trial was adopted and 201 patients with early diabetic nephropathy in a community were randomized into two groups:intervention group(n=101) and control group(n=100).The intervention group received comprehensive intervention and standardized management , while the control group received routine medical services of diabetes mellitus.The changes of related indicators were compared between the patients in two groups before and after twelve months of intervention . Results After twelve months of intervention , the patients in the intervention group showed greater improvement in cognition , attitude and self-management behavior for the disease compared with the patients in the control group .The values of disease-related knowledge and attitude in the intervention group increased by 1 .20 points and 0 .52 points significantly more than those in the control group .Medication compliance , weekly exercise time , communication between doctors and patients in the intervention group increased by 0.19 points, 0.74 times/week and 0.44 points significantly more than those in the control group ( all P <0 .05 ) .Two-hour postprandial blood glucose , glycosylated hemoglobin decreased by 1.13 mmol/L and 0.42%respectively , significantly more than those in the control group.Urinary albumin/urine creatinine, systolic blood pressure decreased by 26.81 mg/g and 3 mmHg respectively, significantly more than those in the control group (all P<0.05). Conclusion Compared with the routine medical services of diabetic nephropathy, the comprehensive intervention and standardized management of early diabetic nephropathy in community is more effective on the improvement in disease-related cognition, attitude and self-management behavior , as well as the biological indexes such as urine albumin/urine creatinine , postprandial blood glucose and blood pressure .
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Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavior disorder in children characterized by attention deficit, overactivity and impulsivity, which may persist into adolescence and adulthood. It is often complicated with multiple comorbid disorders which when undiagnosed or untreated significantly affects the children on aspects like academic skills, peer relationship, social life and difficulty in leading productive lives. This report presents a case of 12 year old male child with attention deficit and poor academic performance, diagnosed and treated for ADHD with a complex array of coexisting disorders untreated. An attempt is made to highlight the differential diagnosis for attention deficit in children, comorbid disorders, and the necessity for a multiprofessional approach in complete evaluation and comprehensive management of the same.
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[Summary] Treatment of type 2 diabetes which is characterized by the progressive β-cell dysfunction currently faces various challenges.A new generation of drug need to protect β-cell function in early stage of the disease.Liraglutide is a glucagon-like peptide 1 analogue and provides a new therapeutic option due to its unique clinical efficacy.Early and long-term usage of liraglutide improves glycemic control,reduces body weight and systolic blood pressure,as well as protects β-cell function for the patients with diabetes.
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Objective To enhance the quality and efficiency of the outpatient cashier service.Methods A comprehensive outpatient cashier management system based on RFID was developed and put into use.Results The system could be used in outpatient cashier department for attendance checking,schedule management,bonus distribution,personnel management,data statistics and report printing.Conclusion The comprehensive outpatient cashier management system can improve the efficiency of the outpatient department.
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Objective To evaluate the application effect of workload statistic software.Methods According to the actual workflow of the hospital and concrete management index sign,the workload of statistics procedure was designed using Dephi7.0.Results "Comprehensive Management System in Medical Imaging Department" run stable and accurate.What's more,its functions greatly facilitated workload statistics.Conclusion The system plays an important role in excellent workflow,exaltation of work efficiency,reasonable allotment of manpower and material resources,etc.