Current Health Sciences Journal
vol. 40 no. 4, 2014
1. Participatory Hygiene and Sanitation Transformation (PHAST) in a Remote and Isolated Community in Samar Province, Philippines
View online - Abstract - Download PDF Participatory Hygiene and Sanitation Transformation (PHAST) in a Remote and Isolated Community in Samar Province, Philippines PDF
Diarrheal disease is one of the leading causes of death in children under five years old, most people who die from this disease actually die from severe dehydration and fluid loss. Moreover, 88% of its global diarrheal disease is attributed to unsafe water supply, inadequate sanitation, and hygiene. This investigation was developed to determine the effect of Participatory hygiene and sanitation transformation (PHAST) program in an isolated community of Mabini,Samar Province, Philippines. Longitudinal research design was used in order to determine the effect of the program one year was implemented in the community. A purposive sampling was utilized in this investigation which accounts a total of 39 households in Mabini community, Basey, Samar, without toilet facilities. The instrument used was the modified questionnaire of Philippine Red Cross in water and sanitation before and after the program was implemented. Results showed that there was improvement of knowledge on water and sanitation, handwashing practice, household waste practices drinking practices, defecation practices. Thus, program reaching the most isolated and difficult area experiencing the most detrimental effects which improve poor hygiene and sanitation, improving health, equality and social justice.
2. Polytrauma and Multiples Severity Scores
DANIELA CERNEA(1), M. NOVAC(1), P.O. DRAGOESCU(2), ANDREEA STANCULESCU(1), LUCICA DUCA(1), A.A. AL-ENEZY(2), NICOLETA ALICE DRAGOESCU(1)
View online - Abstract - Download PDF Polytrauma and Multiples Severity Scores PDF
The initial assessment and management of seriously injured patients is a challenging task and requires a rapid and systematic approach. Injuries causing this mortality occur in predictable patterns and recognition of these patterns led to the development of advanced trauma life support (ATLS) by the American College of Surgeons, and standardized protocol for trauma patient evaluation has been developed. Different systems of trauma scoring have been developed. This study was conducted out of the need for unified scale to assess polytrauma patients from the moment patient are admitted in, till when discharged from Intensive Care Unit (ICU), so we compared the accuracy of few scoring systems in predicting mortality rate in polytrauma patients, and then assessed the cost-effectiveness applying these methods, and how much are these applicable. Here we chose 3 scoring systems: Glasgow Coma scale (GCS), Revised Trauma score (RTS) and Acute Physiology and Chronic Health Evaluation II scales (APACHE II). APACHE II system proved to be helpful in giving primary impression about case prognosis, and overall it reflects the quality level provided in the facility which is providing the health care for the polytraumatized patients, and it can be used as unified scale to compare the healthcare results and outcomes in different hospitals. APACHE II can be considered to be a largely accurate and applicable system for the polytraumatized patients but the association between three of scores offers better results about predicting prognosis of these patients.
3. Determination of iNOS-2087A>G Polymorphism in Acute Pancreatitis Patients
V. PADUREANU(1), IOANA STREATA(1), M. IOANA(1), V. SURLIN(1), E.F. GEORGESCU(1), CRISTINA MARGINEAN(1), A. SAFTOIU(1)
View online - Abstract - Download PDF Determination of iNOS-2087A>G Polymorphism in Acute Pancreatitis Patients PDF
Purpose: To determine whether single nucleotide polymorphism (SNP) of inducible nitric oxide synthase (iNOS) is involved in susceptibility for acute pancreatitis. Material and Methods: Genomic DNA was extracted from blood samples collected from cases of acute pancreatitis (n=110) and normal population controls frequency matched for age and sex (n=232). iNOS – 2087A>G polymorphism was genotyped using TaqMan allelic discrimination assays. The association of the genetic polymorphism with clinical and pathological data of the patients was evaluated. Results: We have found no significant statistical association between this polymorphism and an increased risk of developing acute pancreatitis. Conclusion: In Romanian population, the risk of developing acute pancreatitis is not increased by the presence of iNOS-2087A>G polymorphism.
4. The Predictive Value of Scores Used in Intensive Care Unit for Burn Patients Prognostic
M. NOVAC(1), NICOLETA ALICE DRAGOESCU(1), ANDREEA STANCULESCU(2), LUCICA DUCA(2), DANIELA CERNEA(1)
View online - Abstract - Download PDF The Predictive Value of Scores Used in Intensive Care Unit for Burn Patients Prognostic PDF
Purpose: Statistical evaluation of the prognosis of burned patients based on the analysis of prognostic scores as quickly and easily obtainable that track the evolution of burned patient in ICU. Material / Methods: The prospective study included 92 patients were performed with severe burns on 35-67% body surface large area, aiming to establish a cut-off score for each studied and statistically significant prognostic parameter for assessing the risk of mortality. The control group was represented by 20 patients with burns on the body surface of <10%. Results: The death rate was not statistically significant on burned (p> 0.05) sex (male / female), but we had p <0.001 when we referred to the total body surface area, and p <0.05 when we took into account the degree burns, acute respiratory distress syndrome and age. For each index / prognostic score studied by making ROC curve when they take different values, we set a cut-off. Quantification of variables by calculating the area under the ROC curve (AUC), sensitivity and sensitivity, positive predictive value (PPV) and negative predictive value (NPV), allowed a better appreciation of these prognostic scores. Conclusions: These systems applicable to the burned patient scores, making a cut-off of each index / mortality probability score, he can manifest usefulness in medical decision making process and strategy to reduce the risk of death in patients with severe burns.
5. Dental Anxiety and its Association with Behavioral Factors in Children
SANDA MIHAELA POPESCU(1), IONELA TEODORA DASCALU(2), MONICA SCRIECIU(3), VERONICA MERCUT(3), IREN MORARU(4), MIHAELA JANA TUCULINA(4)
View online - Abstract - Download PDF Dental Anxiety and its Association with Behavioral Factors in Children PDF
Background: Dental anxiety is a condition that causes a decrease in population addressability to the dentist with adverse consequences for long-term oral health. Assessment of behavioral factors that correlate with dental anxiety is important for accurate evaluation of dental fear. Its diagnosis in childhood is important for establishing therapeutic management strategies to reduce anxiety and promote oral health. Objective: To determine the prevalence of dental anxiety in a group of Romanian schoolchildren, and assess its correlation with behavioral factors. Methods: This cross-sectional survey included a number of 650 schoolchildren attending public schools, randomly chosen. Data were collected from September 2013 to October 2013. 485 children aged 6–12 years responded the questionnaires and were included in the study (248 female, 237 male). Each subject was asked to independently complete a questionnaire including Dental Anxiety Scale (DAS) and other questions about children behavior towards dental health education and practice. Children having a score of 13 and above were included in the anxious group while those scoring under 13 were placed in the non anxious group. The data collected was processed and analyzed using the SPSS statistical software. Results: The overall prevalence of dental anxiety was 22.68% amongst subjects included in the study. No significant differences in dental anxiety scores between boys and girls were found in this study. Dental anxiety scores decreased with increasing age. Dental anxiety correlated positively with chewing gum use and sweet consumption frequency and negatively with age and dental health education. Conclusions: Prevalence of dental anxiety in the 6–12 year old children of this study was 22.68%. Factors like chewing gum use, sweet consumption frequency, age and dental health education were correlated with dental anxiety.
6. Pharmacokinetic profile evaluation of di-μ-hydroxo-bis (quercetinatooxovanadium(IV)) complex
B.S. VELESCU(1), VALENTINA UIVAROSI(1), ANCA BUZESCU(1), I. SARBU(1), ECATERINA IONESCU(2), VALENTINA ANUTA(1)
View online - Abstract - Download PDF Pharmacokinetic profile evaluation of di-μ-hydroxo-bis (quercetinatooxovanadium(IV)) complex PDF
The present study was designed to evaluate the pharmacokinetic (PK) properties of di-μ-hydroxo-bis(quercetinatooxovanadium(IV) (HOBQOV) complex, with hypoglycemic and hypolipidemic properties, in rats after a single i.p. dose of 100 mg/kg b.w. The HOBQOV complex pharmacokinetics is described by a bicompartmental model and the plasma concentration decrease is described by two phases that might be correlated to the distribution and elimination processes. The obtained results suggest a PK profile of the complex suitable for a profound distribution in the animal organism with possibility of interaction with the cytosolic enzymes.
7. Comparative Study between the Quality Management Indicators, Marker of Major Psychiatric Disorders in Evolution
D. BONDARI(1), SIMONA BONDARI(1), IOANA GHEONEA(1), ANDREEA ANDRONACHE(1)
View online - Abstract - Download PDF Comparative Study between the Quality Management Indicators, Marker of Major Psychiatric Disorders in Evolution PDF
Indicators of quality management are represented by: accounting hospitalization days (duration of stay); mortality rate; the rate of nosocomial infections; patients readmitted in 30 days; the percentage patients transferred; inconsistent diagnoses. The hospitalization period is a marker of evolution. The present study reflects comparative data between duration and the number of hospitalisations in patients with major psychiatric disorders. Introduction. Medical Psychiatry as a discipline has developed a specialized approach in the treatment of mental diseases, a phenomenon linked to the progress of knowledge ofpsychopathology and the increasing complexity of methods of diagnosis and treatment. The history of psychiatric patients reflects not only changes in scientific understanding of mental disorder, but also the beliefs of political, social and economic interests of that period [1,2]. Objectives. We analised the duration and number of hospitalisation in patients with schizophrenia, psychotic disorders compared to those with bipolar disorder and major depressive disorder in Psychiatric clinic from Craiova between 2006-2010. Method. Retrospective study during 2006-2010 took into account 8234 patients aged between 20-65 years from the Psychiatric Clinic Craiova constituting four groups: group N1=989 patients belonging to the schizophrenia group; group N2=1222 patients with psychotic disorders, group N3=918 patients with bipolar disorder and group N4=5101 with major depressive disorder.For data processing we used Microsoft Excel (Microsoft Corp., Redmond, WA, USA), together with the suite for MS Excel XLSTAT (Addinsoft SARL, Paris, France) and IBM SPSS Statistics programme 20.0 (IBM Corporation, Armonk, NY, USA). Results. Schizophrenia being defined as a chronic disease was noted that 85.4 % of the patients from the first group received at least two admissions during the trial. Females have better prognosis, having a lower share in the group with multiple hospital adm
8. Lung Involvement in Multiple Myeloma - Case Study
MIMI NITU(1), EMILIA CRISAN(1), M. OLTEANU(1), CRISTINA CALARASU(2), MADALINA OLTEANU(1), M.R. POPESCU(1)
View online - Abstract - Download PDF Lung Involvement in Multiple Myeloma - Case Study PDF
Introduction: Mutiple mieloma (MM) cells are rarely found in extramedullary sites. The sites of extramedullary dissemination reported in the literature are spleen, liver, lymph nodes, kidneys, thyroid gland, adrenal gland, ovary, tests, lung, pleura, pericardium, intestinal tract and skin. We report a case in which the myeloma was diagnosed after we discovered the presence of monoclonal plasma cells in the bronchoalveolar lavage fluid (BAL). Matherial and method: a case in which diagnosis was established from bronchoalveolar lavage (BAL) fluid demonstrating the presence of monoclonal plasma cells in Craiova Pneumology Departament. Results: Analysis of BAL fluid for the presence of plasma cells and for cytoplasmic immunoglobulin DNA provides a noninvasive means of establishing the diagnosis. Conclusions: Pulmonary parenchyma is an uncommon site of extramedullary involvement in multiple myeloma. Interstitial lung disease as pulmonary manifestation of multiple myeloma is even rarer; only isolated cases with histological proofs have been reported in the literature.
9. Face Basosquamous Carcinoma, a Case Report
R. MERCUT(1), CLAUDIA GEORGESCU(2), SANDA MIHAELA POPESCU(3), M. CIUREA(1), MONICA SCRIECIU(3), C.C. GEORGESCU(4)
View online - Abstract - Download PDF Face Basosquamous Carcinoma, a Case Report PDF
Face basosquamous or metatypical carcinoma is a rare and controversial form of skin cancer. It is characterized by increased incidence of recurrence and distant metastases. We present the case of a patient of 71 years with an ulcerative lesion of 3/4 cm in the nasal pyramid. The injury occurred due to trauma to the nasal pyramid, produced 13 years ago. After investigation, which included ORL examination, imaging and oncology exam, surgery was decided to completely ablate tumor formation. The resulted defect of 4/5 cm was covered by mobilizing a forehead flap based on right supratrohleare artery pedicle. Histopathological examination revealed the diagnosis of basosquamous or metatypical carcinoma. The patient was referred to the oncology service for treatment.
10. Corpuscular Haemolytic Anaemias - Lepore Haemoglobinopathy
IULIA TUDORASCU(1), SIMONA NEAMTU(1), LILIANA STANCA(1), MIRELA SIMINEL(1), LORENA DIJMARESCU(1), MAGDALENA MANOLEA(1), LILIANA NOVAC(1), ELIS PIRGARU(2), SUZANA DANOIU(1)
View online - Abstract - Download PDF Corpuscular Haemolytic Anaemias - Lepore Haemoglobinopathy PDF
Haemoglobinopathies are hereditary conditions in which the fundamental lesion affects the synthesis rate or the structure of the globin in normal hemoglobin. The synthesis of the polypeptide chains in globin is genetically coded. Clinically, haemoglobinopathies manifest most commonly in the form of hemolytic anemia and, more rarely, cyanosis and polyglobulia. They differ from “acquired haemoglobinopathies”, such as methemoglobinemia, in which hemoglobin is usually compromised due to the action of toxic substances. The clinical aspects are in close relationship to the nature and level of the structural anomaly of the Hb molecule. The heterozygous form of the Lepore syndrome is hematologically characterized by a similar pattern to minor β-thalassemia and electrophoretically by abnormal Hb D fractions at a rate of 5-10% and a decreased percentage of HbA. In homozygous forms, Lepore Hb represents 10-20% on electrophoresis, the rest consisting of HbF; HbA and HbA2 are completely absent. From a clinical point of view, Hb Lepore heterozygotes are similar to those with minor β – thalassemia.
11. TNFα inhibitor induced lupus-like syndrome (TAILS) in a patient with IBD
A. LUPU(1), C. TIERANU(1), C.L. CONSTANTINESCU(2), M. DICULESCU(1)
View online - Abstract - Download PDF TNFα inhibitor induced lupus-like syndrome (TAILS) in a patient with IBD PDF
Background: In patients with autoimmune diseases like inflammatory bowel diseases there has been reported a drug-induced lupus like syndrome secondary to TNFα inhibitors. Objective: clinical case presentation and literature review of patients who develop lupus-like syndrome in relation to TNFα antagonists and their future therapeutic options. Materials and methods: we report the case of a 27-year old woman with colonic Crohn s disease on combo-therapy (infliximab+azathioprine) for nearly two years who developed peripheral arthritis and malar rash in the context of TAILS. Results: our patient had positive anti-nuclear antibody, arthritis, malar rash, anemia and leukopenia. Her symptomes remited after discontinuation of infliximab and subsequently she started adalimumab for her Crohn s colitis; more than a year after switching between TNFα inhibitor molecules and stopping azathioprine she is feeling very well. TAILS is a rare condition described in the literature that can affect 0.5-1% of individuals, more often in association with etanercept and infliximab. Several pathogenic routes have been incriminated in the apparition of this syndrome there is still no definite mechanism up to date. Management options include discontinuation of the drug, corticosteroids, hydroxycloroquine sulfate and switching for other immunosupressives. Conclusions: TAILS can appear even a long time after first exposure to TNFα antagonists. In our case, the association with azathioprine was not a primary prophylactic solution.
12. A Case of Bilateral Aseptic Necrosis of the Femoral Head
DIANA KAMAL(1), RODICA TRAISTARU(2), C.K. KAMAL(1), D.O. ALEXANDRU(3), L. MOGOANTA(4), D. GRECU(5)
View online - Abstract - Download PDF A Case of Bilateral Aseptic Necrosis of the Femoral Head PDF
Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment.
13. Musculoskeletal Ultrasound Diagnosis in Calcium Pyrophosphate Dihydrate Crystal Deposition Disease
ANCA EMANUELA MUSETESCU(1), PAULINA CIUREA(1), ANCA ROSU(1)
View online - Abstract - Download PDF Musculoskeletal Ultrasound Diagnosis in Calcium Pyrophosphate Dihydrate Crystal Deposition Disease PDF
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is extremely versatile. We present the case of a 52 years old patient referred for inflammatory pain of the left knee and ankle of recent onset with intense inflammatory syndrome that mimics rheumatoid arthritis. Musculoskeletal ultrasound was able to detect effusion, hyperechoic crystals within the cartilage and fibrocartilage, inside tendons, suggestive for CPPD disease and to guide fluid aspiration as well as in sustaining a rapid diagnosis corroborating images suggestive for CPPD disease to biological data – hypercalcemia and hyperparathyroidism in finding the predisposing condition, the parathyroid adenoma.
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