bluuebunny/crossref_metadata_2025 huggingface dataset:
Thực trạng việc kê đơn thuốc điều trị ngoại trú cho bệnh nhân tại Bệnh viện Trung ương Quân đội 108
Authors: Thọ Phạm Đình , Vân Vũ Hồng , Hà Nguyễn Hải , Đức Nguyễn Nhật
Published: December 2021

Mục tiêu: Đánh giá các chỉ số kê đơn của đơn thuốc ngoại trú và tính hợp lệ của đơn thuốc ngoại trú theo quy định của Bộ Y tế. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang 1200 đơn thuốc được lấy từ 10 phòng khám thuộc các chuyên khoa khác nhau tại Khoa Khám bệnh đa khoa - Bệnh viện Trung ương Quân đội 108 tháng 3 năm 2021. Đánh giá các chỉ số trong đơn thuốc như số lượng thuốc, kháng sinh, vitamin và khoáng chất, thực phẩm chức năng đồng thời đối chiếu đơn thuốc với các quy định của Bộ Y tế về kê đơn thuốc ngoại trú. Kết quả:  Số thuốc trung bình trong một đơn thuốc là 3,89 thuốc. Số đơn thuốc sử dụng từ 5 - 8 thuốc là 69,75 %, số đơn có sử dụng kháng sinh 43,5%, tỷ lệ sử dụng vitamin và khoáng chất chiếm 71,4%. Các đơn thuốc đều kê đúng theo quy định của Bộ Y tế. Kết luận: Số thuốc trong một đơn thuốc vẫn còn khá cao và tỷ lệ sử dụng vitamin và khoáng chất vẫn còn phổ biến. Các đơn thuốc đều đã thực hiện đúng quy định của Bộ Y tế.
Đánh giá đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân sốt xuất huyết đến khám tại Trung tâm Kiểm soát bệnh tật tỉnh Khánh Hòa năm 2020
Authors: Cương Lê Duy , Trung Vũ Hoàng , Giang Vũ , Nghĩa Vũ Xuân
Published: December 2021

Mục tiêu: Đánh giá đặc điểm lâm sàng, cận lâm sàng bệnh nhân sốt xuất huyết Dengue (SXHD) đến khám tại Trung tâm Kiểm soát bệnh tật tỉnh Khánh Hòa năm 2020. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang trên 102 bệnh nhân được chẩn đoán SXHD từ tháng 3 đến tháng 8/2020. Bệnh nhân được phỏng vấn trực tiếp, khám lâm sàng và làm xét nghiệm. Kết quả: Nam chiếm tỷ lệ 60,8%, độ tuổi trung bình là 31,1 ± 20,03 năm. Triệu chứng lâm sàng hay gặp nhất là sốt (92,2%), nghiệm pháp dây thắt (+) (52,0%), đau cơ (34,3%), đau khớp (34,3%), chân tay lạnh (18,6%), xuất huyết dưới da (16,7%), mạch nhanh (15,7%). Các triệu chứng ít gặp hơn là xuất huyết niêm mạc (6,9%), li bì chiếm 3,0% và vật vã chiếm 2,0%. Tỷ lệ tiểu cầu giảm chiếm 28,4%, hematocrite giảm nhẹ chiếm 27,5%, bạch cầu giảm chiếm 9,8% hồng cầu giảm nhẹ chiếm 13,7%. Men gan tăng nhẹ gồm: SGOT chiếm 18,6% cao hơn so với SGPT là 12,7%. Kết luận: Các bệnh nhân đều ở thể SXHD nhẹ, các triệu chứng lâm sàng và cận lâm sàng phong phú nhưng hay gặp nhất là sốt, nghiệm pháp dây thắt (+), đau cơ, đau khớp, chân tay lạnh, hạ huyết áp, xuất huyết dưới da, tiểu cầu giảm nhẹ, hematocrite tăng nhẹ, hồng cầu giảm nhẹ. Tỷ lệ men gan SGOT tăng cao hơn so với SGPT cho thấy cần chú ý tổn thương cơ trong quá trình bệnh SXHD.
Đánh giá kết quả điều trị bảo tồn vỡ lách trong chấn thương bụng kín tại Bệnh viện Trung ương Quân đội 108
Authors: Quang Vũ Văn , Thành Lê Văn , Anh Nguyễn Hoàng Ngọc
Published: December 2021

Mục tiêu: Đánh giá kết quả điều trị bảo tồn vỡ lách trong chấn thương bụng kín. Đối tượng và phương pháp: Nghiên cứu hồi cứu, tiến cứu và mô tả không có nhóm chứng các trường hợp vỡ lách trong chấn thương bụng kín được điều trị bảo tồn, từ tháng 06 năm 2015 đến tháng 01 năm 2021, tại Bệnh viện Trung ương Quân đội 108. Kết quả: Có 161 bệnh nhân vỡ lách do chấn thương bụng kín nhập viện, trong đó: 142 (88,2%) bệnh nhân được điều trị bảo tồn và 19 (11,8%) bệnh nhân phải mổ cắt lách cấp cứu. Tuổi trung bình là 37,42 ± 14,83 tuổi, tỷ lệ nam/nữ là 3,3; tai nạn giao thông là nguyên nhân chính gây ra vỡ lách (73,95%). Các triệu chứng lâm sàng: Đau bụng (100%), chướng bụng (73,24%), sây sát thành bụng (58,45%) và cảm ứng phúc mạc (13,38%); tổn thương phối hợp hay gặp nhất là chấn thương ngực kín (12,97%). Siêu âm: Dịch ổ bụng (92,96%), tổn thương nhu mô (69,01%). Chụp cắt lớp vi tính: Dịch ổ bụng (96,48%), vị trí đường vỡ lách (78,87%), tụ máu trong lách (53,52%), tụ máu dưới bao (10,56%) và thoát chất cản quang (2,82%); vỡ lách độ II và III chiếm phần lớn với tỷ lệ lần lượt là: 26,76% và 59,86%. Điều trị bảo tồn thành công: 140 (98,59%) bệnh nhân và 02 (1,41%) bệnh nhân thất bại phải chuyển mổ cắt lách. Tỷ lệ bệnh nhân cần truyền máu (29,58%). Thời gian nằm viện trung bình: 8,47 ± 3,97 ngày. Kết luận: Điều trị bảo tồn vỡ lách do chấn thương bụng kín là an toàn và hiệu quả với tỷ lệ thành công cao.
Các dấu hiệu hình ảnh tổn thương đám rối thần kinh cánh tay do chấn thương trên cắt lớp vi tính tủy cổ cản quang
Authors: Hằng Tống Thị Thu , Đoàn Lê Văn , Toản Thân Trọng , Quyết Nguyễn Văn , Hải Nguyễn Duy , Khánh Lâm
Published: December 2021

Mục tiêu: Nghiên cứu các dấu hiệu hình ảnh trên cắt lớp vi tính tủy cổ cản quang ở các bệnh nhân tổn thương đám rối thần kinh cánh tay do chấn thương. Đối tượng và phương pháp: Tiến hành trên 179 bệnh nhân có tiền sử chấn thương, lâm sàng chẩn đoán tổn thương đám rối thần kinh cánh tay, được chụp cắt lớp vi tính tủy cổ cản quang và được phẫu thuật tại Viện Chấn thương Chỉnh hình, Bệnh viện Trung ương Quân đội 108, từ tháng 05 năm 2015 đến tháng 05 năm 2019. Phương pháp nghiên cứu là tiến cứu, mô tả cắt ngang. Kết quả: Dấu hiệu tổn thương rễ trước và rễ sau chiếm tỷ lệ cao ở hầu hết các vị trí từ C5-T1. Có đồng thời 2 hoặc 3 dấu hiệu tổn thương chiếm tỷ lệ cao ở tất cả các vị trí rễ, 2 dấu hiệu xuất hiệu cùng nhau nhiều nhất là tổn thương rễ trước-rễ sau, 3 dấu hiệu xuất hiện cùng nhau nhiều nhất là tổn thương rễ trước-rễ sau-giả thoát vị màng tủy. Tổn thương nhổ rễ hoàn toàn mức độ A3 chiếm tỷ lệ cao (cao nhất tại vị trí C6 là 45,8%), sau đó đến tổn thương mức độ A2 và tổn thương mức độ M theo phân loại Nagano. Kết luận: Cắt lớp vi tính tủy cổ cản quang có thể phát hiện các dấu hiệu chi tiết nhổ rễ trên bệnh nhân tổn thương đám rối thần kinh cánh tay do chấn thương.
Emotional Intelligence among Nurses working in a Tertiary Care Hospital, Kerala, South India
Authors: Kundayi Ravi Ramya , Paul Suma , Jose Neethu
Published: December 2021

The nursing profession is labor intensive and nurses needs to regulate their emotions for the sake of their patients, their families and health care team member’s needs. The aim of the present study was to determine the level of emotional intelligence among nurses working in a selected tertiary care private hospital. A quantitative cross-sectional survey method, data was collected using a self-reported-questionnaires developed by Schutte from 717 registered nurses working in a tertiary care private hospital. A convnininece sampling technique was used to recruit the study participants. Data was analyzed using SPSS Version 24. The mean age of participants was 31.26±4.86 years; 93.4% (670) were females and 6.6% (47) were males. The total EI score ranged from 46 to 155 with a mean of 127.2311±10.1. Out of all, only 12% of the participants had above average, 3.5% had less than average and the remaining 84% had moderate levels of levels of EI levels. A statistically significant relationship was found between emotional intelligence and type of educational qualification and the total years of professional experience in the current area of work at 0.01 level. The moderate level of EI among majority of the participants revealed in the present study necessitates the need for conscious effort, education and training to improve the EI levels among nurses.
A Descriptive Study to assess the knowledge regarding Good Touch and Bad Touch among children (9-12 years) in a selected school of Ludhiana, Punjab
Authors: Keshni Keshni
Published: December 2021

A study was conducted to assess the knowledge regarding good touch and bad touch among children (9-12years) in a selected school of Ludhiana, Punjab. A Descriptive approach and purposive sampling technique was used on 100 students of S.K.S.S. International Sen. Sec. Public School Sarabha, Ludhiana, Punjab. Data was collected by using self structured questionnaire to assess the knowledge regarding good and bad touch. The results showed that 76% of students were having excellent knowledge, 23% were having good knowledge and 1% were having fair knowledge regarding good touch and bad touch.
Assess the Level of Practice regarding Prevention of Pressure Ulcer in bedridden patients among Nurses
Authors: Kuriakose Juby Rose , Sebastian Akku Maria , Jose Mary Annem , Zacharia Ashly , Chodon Dhundup , Kim Manlian , Jojo Silpamol , Alex Jaimol
Published: December 2021

Background: Pressure ulcers are the common conditions among patients hospitalized in acute and chronic care facilities and impose significant burden on patients, their relatives and caregivers. Now days, pressure ulcers are recognized worldwide as one of the five most common causes of harm to patients and preventable patient safety problem. It is also increasingly described as an indicator of the quality of care provided by health care organization. However, pressure ulcers are largely preventable. All patients who are identified as being at risk should have a management plan to prevent development of pressure ulcer, optimize healing, and prevent complications of existing pressure ulcer. Objectives: 1. To assess the level of practice regarding prevention of pressure ulcer in bedridden patients among nurses. 2. To determine the association between pre-test practice scores of nurses regarding prevention of pressure ulcer in bedridden patients with selected sample characteristics. Methodology: The research design used for this study was non – experimental descriptive design. The study was conducted at a tertiary hospital in Bengaluru, Karnataka, India. Population comprises of nurses (staff nurses and student nurses) working in a selected hospital. The sample size selected for this study consists of 60 nurses (staff nurses -24 and student nurses -36) who were working in medical, surgical wards and Intensive Care Units (ICUs). Nurses providing care to the patients who are bed ridden for more than 48 hours were included in the study. Non – probability purposive sampling technique was used to select the samples. The tool used in this study was socio-demographic profile of nurses (separate tool for staff nurses and student nurses) and observational checklist to assess the practice. Result: The overall practice scores of the 60 nurses revealed that 40(66.67%) had good practice, whereas 20(33.33%) samples had average practice and none of them had poor practice. Among of 24 staff nurses; 20(83.33%) had good practice, whereas 4(16.67%) had average practice and none of them had poor practice. Out of 36 student nurses; 20(55.56%) had good practice, whereas 16(44.44%) samples had average practice and none of them had poor practice. It was found that among socio-demographic variables none had association with the practice of staff nurses and student nurses too. Conclusion: The study concluded that continuing education programmes are needed to improve the practices of nurses. Nurses must be motivated to provide back care and position change every second hourly in bedridden patients.
Curriculum Evaluation - A Cross-Sectional Study under selected Nursing College of KUHS
Authors: George Betcy , N. A Sheela Shenai
Published: December 2021

Aim: A cross-sectional design (analytic) was adopted for the study and the aim of this study was to discover whether the curriculum is fulfilling its purpose and whether students are actually learning. Background: According to the history of education, the term ‘curriculum’ was originally related to the concept of a course of studies followed by a pupil in a teaching institution. Curriculum is a set of specific knowledge, skills and activities for students and it may be defined as planned activities to foster teachers' teaching and student's learning1. The term curriculum refers to the lessons and academic content taught in a school or in a specific course or program. Curriculum evaluation is an essential phase of curriculum development. Through evaluation a faculty discovers whether a curriculum is fulfilling its purpose and whether students are actually learning. Curriculum evaluation is crucial to measuring curriculum effectiveness in any educational setting2. Methods: A cross-sectional design (analytic) was adopted for the study. Eighty two graduates were selected by total enumerative sampling technique. Results: The data was analyzed using descriptive statistics. The various categories of the curriculum evaluation tool were summarized using frequency and percentage, separately for B.Sc and PB.BSc graduates. Conclusion: Out of six areas evaluated, 100% satisfaction was ensured in all areas except in assessment of organization of teacher’s materials, which concluded that 20% of graduates asked for improvement in special facilities and equipments for the curriculum updation.
Evaluate Breathing Exercises on Improvement in Respiratory Status among Patients with Respiratory Diseases
Authors: Kalita Gitima , Dutta Nabajani
Published: December 2021

Background: Respiratory diseases are typical issue of the airway that hampers the normal airflow and leads to airway inflammation. The impacts of breathing exercises on respiratory diseases have been concentrated to discover its role on improvement of respiratory status. Objective: To estimate breathing exercises on improvement in respiratory status among patients with respiratory diseases. Material and method: A pre experimental, one group pre-test post-test design was adopted on 50 samples with respiratory diseases selected by convenient sampling technique from Medicine (male and female), Pulmonary Medicine, CTVS ward of Guwahati Medical College and Hospital, Assam. Data collected through structured interview schedule for demographic and clinical variables and “modified respiratory status scale” for assessing respiratory status. The group received intervention for 3 minutes one time daily for 7 days. Post-test was done on 7th day. In this study, deep breathing exercise and pursed lip breathing exercise were used. Data were analyzed by using the software package SPSS 2.0 version. Results: the pre-test respiratory status mean was 7.6 and post-test respiratory status mean was 4.98 mean difference was 2.62. The difference in mean scores shows a significant improvement of Respiratory status among patients with Respiratory Diseases. The t’ value of the breathing capacity by using modified respiratory status scale (13.55) was much higher than the ‘p’ value at 0. 05 level of significance. So, Breathing Exercises (Deep Breathing Exercise and Pursed Lip Breathing Exercise) was effective which improve the respiratory status among Respiratory Disease patients. Respiratory status is associated with Gender, History of previous hospitalization and no association with clinical variables. Conclusion: The study concluded that breathing exercises is effective in improvement of respiratory status among patients with respiratory diseases.
Neglected Concerns of Nurses and Their Unheard Voices; A Blind Spot in our Health System
Authors: Baby Priya , Dhandapani Manju , Gopichandran L
Published: December 2021

The current scenario of nursing in India forces us to introspect if the nurses are equipped enough to bring out their best contribution towards the health of our country and if their voices are well heard in the healthcare system. Despite being highly skilled professionals, nurses are neither facilitated nor rewarded enough to sustain their motivation and inputs. To understand the struggles faced by nurses in India, we reviewed literature that addresses Indian nurses’ concerns and brainstormed about the major challenges that nurses encounter with key nursing personnel from nursing education, clinical services and administration from selected hospitals of India. The major challenges that negatively affect the contribution of nurses are shortage of nurses, poor working conditions and career opportunity, ineffective leadership roles, poor educational quality, low salary and state neglect. The COVID-19 pandemic has proven the vast contribution and sacrifice of nurses. The competency of nurses has gone up with specialization, and advanced nursing degrees. Enhancing nurses’ involvement in collaborative healthcare research would be a hallmark in improving the quality patient care. To efficiently utilize the contribution of the nurses in healthcare system, the society and state have to recognize the potentials and vulnerabilities of nurses, appreciate their strengths and reciprocate responsibilities to their neglected concerns.
UK Variant COVID-19
Authors: Kumar Balai Manish
Published: December 2021

Virus has a nature of antigenic drift and shift so over time their genetic make-up changes through the mutation and emerged a new strain of virus. Six type of coronavirus are known to infect the human being till now. The latest one and seventh number coronavirus is COVID-19. Diseases caused by coronavirus ranging from common cold to severe acute respiratory syndrome (SARS-CoV). One more strain or mutant COVID-19 identified at UK in September 2020 and this strain is fast and quick spreading that is 70% more transmissible than the old strain. The first “Variant Under Investigation” in December -2020 in which most significant mutation known as N501Y change the protein spike (S) of the virus that is the receptor binding domain, used to bind the human ACE2 receptors. Five alarming warning signs of new strain of coronavirus are Breathing problem, Confusion, Persistent chest pain, Tired and unable to stay awake, Bluish lips or face. RT-PCR and genetic sequencing still reliable diagnostic method for new variant of corona. Control and prevention need to follow all guidelines which are following previously and till now many vaccines developed but scientist need more research and data for its efficacy on new variant of corona.
Ung thư biểu mô tế bào thận dạng sarcoma di căn xương sườn: Báo cáo ca bệnh và hồi cứu y văn
Authors: Mạnh Phạm Thuần , Trần Minh , Nguyễn Quỳnh
Published: December 2021

Ung thư biểu mô tế bào thận dạng sarcoma (sRCC) là típ ung thư biểu mô mất biệt hóa hiếm gặp với tỷ lệ di căn cao và tiên lượng xấu. Các vị trí di căn thường gặp bao gồm hạch bạch huyết, phổi, gan và xương. Chúng tôi báo cáo một trường hợp sRCC di căn đến vị trí không thường gặp là xương sườn. Bệnh nhân nam, 52 tuổi, vào viện vì đau vùng vai phải. Chụp cắt lớp vi tính (CLVT) hệ tiết niệu thấy 1/3 giữa thận phải có khối kích thước 36 x 37mm; chụp CLVT lồng ngực thấy ổ tổn thương tiêu xương cung bên xương sườn 6 bên phải. Bệnh nhân được sinh thiết xương sườn và sinh thiết thận với chẩn đoán là sRCC di căn xương, sau đó bệnh nhân đã được cắt bỏ toàn bộ thận phải. Hình ảnh vi thể cho thấy mô u gồm thành phần ung thư biểu mô tế bào thận típ tế bào sáng kết hợp thành phần dạng sarcoma với các tế bào hình thoi ác tính. Chẩn đoán sau mổ: Ung thư biểu mô tế bào thận típ tế bào sáng có thành phần dạng sarcoma, độ IV, di căn xương sườn. SRCC là thể hiếm gặp, có tiên lượng xấu. U được cấu tạo bởi hai thành phần mô học là biểu mô và dạng sarcom, có thể gây khó khăn cho chẩn đoán trên sinh thiết trước phẫu thuật nếu mô u chỉ có một trong hai thành phần này.
Ca lâm sàng hạ đường huyết do hội chứng kháng Insulin tự miễn
Authors: Vũ Nga , Nguyễn Hương , Trần Hải
Published: December 2021

Hội chứng kháng Insulin tự miễn đặc trưng bằng tình trạng hạ đường huyết do tăng Insulin trong máu, tăng hiệu giá tự kháng thể kháng Insulin (IAA), không sử dụng Insulin ngoại sinh trước đó và không có bất cứ tổn thương bệnh lý nào của đảo tụy. Đây là nguyên nhân gây hạ đường huyết hiếm gặp, thường được báo cáo nhiều hơn ở các nước châu Á. Ca lâm sàng về trường hợp bệnh nhân được khám và điều trị tại Bệnh viện Đại học Y Hà Nội tháng 12 năm 2020. Bệnh nhân nam 58 tuổi, được chẩn đoán hạ đường huyết do hội chứng kháng Insulin tự miễn. Bệnh nhân nhập viện vì hôn mê do hạ đường huyết, xét nghiệm Insulin và C-peptid máu tăng cao. Tổn thương ở eo tụy theo dõi Insulinoma trên phim MRI dẫn đến sai lầm của các thầy thuốc lâm sàng tại bệnh viện trong chẩn đoán nguyên nhân gây hạ đường huyết. Vì vậy, tình trạng hạ đường huyết, nồng độ Insulin và C-peptid không cải thiện sau phẫu thuật cắt bỏ phần tụy chứa tổn thương. Cuối cùng bệnh nhân được chẩn đoán là hội chứng kháng Insulin tự miễn và được điều trị thành công bằng Glucocorticoid kết hợp chế độ ăn hạn chế tinh bột, chia nhỏ bữa.
Chẩn đoán căn nguyên nốt đơn độc ở phổi tại Bệnh viện Đại học Y Hà Nội
Authors: Hoàn Lê , Giáp Vũ Văn , Hồng Đinh Thị Thanh , Quỳnh Nguyễn Thị  Như , Chi Trần Khánh , Hằng Lê Minh
Published: December 2021

Nốt đơn độc ở phổi được định nghĩa là tổn thương đơn độc trên X quang phổi với kích thước ≤ 3cm, xung quanh là nhu mô phổi lành không gây xẹp phổi, không kèm hạch trung thất hay tràn dịch màng phổi. Đây là dạng tổn thương phổi khá thường gặp, có thể do nhiều nguyên nhân gây nên. Các nguyên nhân lành tính bao gồm: u lao, harmatoma, hạch lympho tại phổi, sarcoidosis, u nấm. Các căn nguyên ác tính gồm: ung thư phổi, ung thư di căn phổi, u lympho… Nghiên cứu của chúng tôi được thực hiện nhằm mô tả các đặc điểm về lâm sàng, cận lâm sàng và căn nguyên nốt đơn độc ở phổi, từ đó giúp các bác sỹ lâm sàng có thêm kinh nghiệm trong việc đưa ra các quyết định quản lý theo dõi các tổn thương này nhằm chẩn đoán và điều trị kịp thời các nốt phổi gợi ý ác tính và tránh những can thiệp không cần thiết đối với các nốt phổi đơn độc có tính chất lành tính. Nghiên cứu mô tả với 50 bệnh nhân nốt phổi đơn độc. Vị trí tổn thương thường gặp là thuỳ trên phổi với 44% là ung thư phổi và 10% viêm lao. Với căn nguyên ung thư phổi, 40% bệnh nhân có kích thước nốt từ 2 đến 3 cm, trong đó 54% là tổn thương dạng nốt đặc.
Tình trạng dinh dưỡng và đặc điểm kiểu gen của người bệnh ung thư dạ dày tại 4 bệnh viện ở Hà Nội
Authors: Nguyễn Thị Ngọc Lan , Tạ Thành Văn , Đặng Thị Ngọc Dung , Vũ Văn Quý , Nguyễn Thùy Linh , Nguyễn Thị Thu Liễu
Published: December 2021

Tình trạng dinh dưỡng ở bệnh nhân ung thư dạ dày là một trong những yếu tố quan trọng ảnh hưởng đến hiệu quả điều trị cũng như chất lượng cuộc sống của bệnh nhân. Nghiên cứu mô tả cắt ngang được tiến hành trên 302 bệnh nhân ung thư dạ dày nhằm đánh giá tính trạng dinh dưỡng cũng như mối liên quan giữa đặc điểm lâm sàng và kiểu gen đến tình trạng dinh dưỡng ở những bệnh nhân ung thư dạ dày. Kết quả của nghiên cứu này cho thấy độ tuổi trung bình của đối tượng tham gia nghiên cứu là 63,55 ± 11,98, nhóm tuổi thường gặp là 60-69, chiếm 33,44%. Tỷ lệ nam/nữ trong nghien cứu là 2,25/1. 143 (47,4%) bệnh nhân ung thư dạ dày có hút thuốc lá. 135 (44,7%) bệnh nhân ung thư dạ dày sử dụng đồ uống có cồn ở mức độ nguy cơ. Tỉ lệ người bệnh có nguy cơ suy dinh dưỡng mức độ vừa và nặng (PG-SGA B và C) là 39,7%. Về đặc điểm kiểu gen, đa hình đơn nucleotid rs4072037 - MUC1 kiểu gen AA chiếm chủ yếu với 49,34% trong khi với đa hình đơn nucleotid rs2070803 - MUC1 kiểu gen GG chiếm chủ yếu với 45,7%. Chưa nhận thấy chưa có mối liên hệ có ý nghĩa thống kê giữa tuổi, giới, type mô bệnh học, tiền sử hút thuốc lá, tiền sử uống rượu,bia và các SNP rs4072037, rs2070803 của gen MUC1 với tình trạng dinh dưỡng của bệnh nhân ung thư dạ dày.
Cơ cấu bệnh tật tại khoa cấp cứu Bệnh viện Đại học Y Hà Nội năm 2019
Authors: Hùng Vũ Đình , Hoa Kiều Thị , Hải Hoàng Bùi
Published: December 2021

Nghiên cứu mô tả cắt ngang nhằm mô tả mô hình bệnh tật và phân bố thời gian của bệnh nhân được khám và điều trị tại khoa Cấp cứu Bệnh viện Đại học Y Hà Nội năm 2019. Trong số 22.385 bệnh nhân được cấp cứu năm 2019 có 50,98% là nữ, 56,4% ở nhóm tuổi lao động (từ 18 đến 50 tuổi). Ba nhóm bệnh thường gặp nhất là tiêu hóa: 34,69%; nhiễm khuẩn: 12,76% và chấn thương: 11,84%. Cơ cấu bệnh tật tại Khoa Cấp cứu cho thấy tỷ lệ bệnh truyền nhiễm còn cao, tiếp đến là bệnh không lây nhiễm và chấn thương. Nghiên cứu cho thấy số lượng bệnh nhân đa dạng quanh năm với số lượng bệnh nhân cao nhất trong quý III, cao hơn nhiều so với quý I năm 2019. Cơ cấu bệnh tật cho thấy tính chất đa dạng của bệnh cấp cứu. Phân bố các nhóm bệnh khá cân bằng, trong đó nhóm bệnh truyền nhiễm, bệnh không lây nhiễm và bệnh chấn thương là bệnh phổ biến nhất.
A comparative study of attitudes towards COVID-19 vaccination in the rural and urban population of Uttarakhand, India
Authors: Sharma Rakesh , Jelly Prasuna , AS Vishwas , Chadha Lisa , Saxena Vartika , Mohan Latika
Published: December 2021

Background

The public is hesitant about getting vaccinated for COVID-19, and a few people are still avoiding it. The aim of this study was to evaluate the attitude towards COVID-19 vaccination among rural and urban populations of the Dehradun district in Uttarakhand, India.

Materials and methods

A cross-sectional survey was conducted from April to June 2021 in selected urban and rural areas of the Dehradun district, yielding 770 responses (385 from both rural and urban areas). The attitudes towards COVID-19 vaccination were collected via questionnaire and analysed using descriptive and inferential statistics.

Results

There were no rural-urban differences in the mean score of attitude towards COVID-19 vaccination (49.22±12.89 vs 50.01 ±11.88; P=0.379). The majority of participants had a neutral to positive attitude, and very few had a negative attitude towards COVID-19 vaccination, equally in the rural and urban population. A significant positive association was found between attitude scores with COVID-19 vaccination and mortality among participant’s relatives and friends in rural areas, while participant occupation and number of family members in the urban area were associated with a more positive attitude.

Conclusion

These results suggest mainly neutral attitude among the rural and urban populations towards COVID-19 vaccination. Therefore, it is important to design and implement innovative and efficient communication strategies to influence the neutral and offset the negative attitudes regarding vaccination drive to facilitate immunisation outreach and coverage.
Pissing it away
Authors: Joy Mike , Chapple Simon
Published: December 2021

If you want to know why swimming in rivers of New Zealand is a bad idea, or why our groundwater is less safe for drinking than it was three decades ago, blame that cow and her many, many friends.
The Muslim Minority and Communal Harmony in India: A Study of the Views of Wahiduddin Khan
Authors: Ahmad Khalil
Published: December 2021

The partition of the Indian subcontinent placed her religious harmony at stake. In postindependence India, one of the most crucial issues was to maintain communal harmony between the Muslim minority and non-Muslim majority. Renowned Muslim Scholars and organisations came forward and expressed their concerns on the issue. However, Wahiduddin Khan (1925-2021) suggested a different methodology, contrary to his contemporaries. Through the application of descriptive and content analytical methods, this study investigates Khan’s ideas of communal harmony in post-independence India. The study found that Khan emphasised da’wah and peace activism. Contrary to his preceding views, he blamed the Muslim populace for communal disharmony in the country. Further, based on his reading of the Treaty of Ḥudaibiyyah, he recommended Muslims take a unilateral and passive step to establish communal harmony in the country and assumed it to be the only possible way for the Muslim minority. This study observes that Khan’s understanding of Ḥudaibiyyah is questionable as he ignored all other significant incidents of the sīrah. Nevertheless, his views on the unity of religion remains significant.
Declarations of Independence: Sovereignty, Identity, and the Constitution of the “Other”
Authors: Carleton Alexandra L.
Published: December 2021

With the rise of Indigenous awareness, the formation of groups to argue for native title, and the global diaspora coming together in their pursuit of landed recognition, claiming sovereignty takes many forms: declaration, contestation, governance, land reclamation, and enterprise formation. These forms, examined as a collective whole, may be seen as the first pragmatic steps in self-determination for, often Indigenous, minorities. More importantly, they may be seen as a stage in the evolution of expressing spiritual and cultural ontology of the “other.” Not only is this expression, the seeking of an acknowledgement of a changing cast of actors in the global regime for self-determination, spiritual, and ontological recognition, but also underlies the need for recognizing a plurality of thought that one system of jurisprudence may not be able to defend.
A. B. Original's “Dumb Things”: Decolonizing the Postcolonial Australian Dream
Authors: Miller Benjamin
Published: December 2021

In 2016, Aboriginal hip-hop duo A. B. Original joined Paul Kelly live on radio to cover his iconic song “Dumb Things” (1987). Kelly's original version presented a critique of nationalist rhetoric in the lead up to the Australian bicentenary celebrations. Kelly's development of an itinerant counter-dreamer as a voice against nationalism, however, fashioned a brand of innocent, postcolonial whiteness and, thereby, remained complicit with colonial domination of Indigenous people. This article explores A. B. Original's commentary on institutional, systemic, and discursive racism, and their criticism of postcolonial whiteness through a close reading and contextualization of their music output in 2016. With particular emphasis on “Dumb Things” in its original context and its most recent context, this article argues that A. B. Original issues a call for, and demonstrates, the decolonization of postcolonial narratives of the Australian dream.
Combatting Stereotypes: The Media's View versus Personal Experiences in Pakistan and the United States
Authors: Ali Shinwari Rizwan , LeBlond Ken
Published: December 2021

Pakistan and US media often negatively portray the opposite side. The media's propagation of negative imagery that two friends (one American and one Pakistani) both consumed in their early lives did not prevent them from being curious and open-minded about each other's countries. This article addresses how one American and one Paskistani had their views shaped by American and Pakistani media and how their personal experiences contradicted those media images.
Epidemiological profile of myasthenia gravis patients at the Neuromuscular Diseases Service of the Hospital de Clínicas of the Federal University of Paraná
Authors: Moreira Isabelle Caroline Fasolo Normandia , Maglioni Rie Tiba , Prá Ducci Renata Dal- , Kay Cláudia Suemi Kamoi , Fustes Otto Jesus Hernandez , Werneck Lineu César , Lorenzoni Paulo José , Scola Rosana Hermínia
Published: December 2021

Background: Myasthenia Gravis (MG) is an autoimmune disease of the neuromuscular junction. In Brazil, epidemiological data regarding MG and its clinical aspects are limited. Objectives: The aim of this study was to describe the clinical and epidemiological profile of patients with MG at a referral center. Design and setting: Cross-sectional observational study performed on patients with Myasthenia Gravis age 18 years and older at Federal University of Paraná. Methods: Data were obtained through clinical evaluation and medical records. Results: The sample comprised 100 patients (67 females and 33 males). The median age at last appointment was 49.5 years (IQR 37-61). AntiAchR antibody was positive in 79 patients. Anti-MuSK antibody was positive in 6 positive patients. The Repetitive Nerve Stimulation (RNS) test presented abnormal result in 89 individuals. The main comorbidities reported were systemic arterial hypertension (SAH) (35%), mental health disorders (23%), diabetes mellitus (DM) (21%), dyslipidemia (18%), and hypothyroidism (13%). During the study period, the patients were on the following medications: pyridostigmine (88%), prednisone (42%), azathioprine (45%), cyclosporine (13%), and mycophenolate (6%). Thymectomy was performed in 30 patients, of whom 6 had a pathological diagnosis of thymoma, and five a pathological diagnosis of thymic hyperplasia. Conclusion: The patient profile as well as the prevalence of comorbidities in our MG sample were similar to previous studies. We also found that our sample presented a higher incidence of SAH, DM, mental health disorders and hypothyroidism compared with the general population.
Increased incidence of stroke in postCovid patients: a literature review
Authors: Nascimento Andressa Schmidt do , Souza Letícia Karen Rodrigues de , Miranda Ana Maria Ramos , Maia Jade Menezes , Rizziolli Daniele Sutherland W. , Silva Mara Iza Alves , Desteffani Karine Gomes Bandeira , Lima Cristiane dos Santos , Fecury Priscylla Celeste Milhomem Silva , Diniz Lilian Coelho Heringer
Published: December 2021

Background: Stroke causes severe damage to the brain, with prevalence in the elderly. Experts realized that infection by COVID-19 causes neurological problems, with cases of individuals diagnosed with stroke having also tested positive for Sars-CoV2, under 50 years of age. Objectives: To assess the increased incidence of stroke in post-covid-19 patients. Methods: This is a literature review, covering results on COVID-19 and stroke, from the last 2 years, with the descriptors “Coronavirus infections” and “Stroke.” 10 articles were selected in English and Portuguese from SCIELO and PUBMED. Results: There was an increase in the incidence of stroke in POST-COVID patients, pointing out that while a single health system identified five cases of these in a period of two weeks, in patients under 50 years of age; in other periods before the pandemic, approximately 0.7 strokes occurred over a twoweek interval in individuals under 50 years old, strengthening this hypothesis. Conclusions: Therefore, coronavirus infection causes neurological complications such as stroke. Thus, the performance of a multiprofessional team attentive to clinical and laboratory manifestations minimizes the risks of stroke.
Tuberculous Meningitis: Literature Review
Authors: Freijanes Loise Maria de Souza , Ueda Elisa Yuki Kurosawa , Lemaitre Paola Restum Antonio , Prado Isabela Pierotti
Published: December 2021

Background: Tuberculous meningitis is the most severe form of M.tuberculosis infection, and occurs when there is an invasion of the membranes and cerebrospinal fluid by the bacteria. It develops as a complication of primary infection and reactivation in immunosuppressed. Objectives: This study aims to characterize tuberculous meningitis and bring updates. Design and setting: This is a literature review from the Escola de Medicina Souza Marques‘s students, Brazil. Methods: The used articles were published between 2012 and 2021, from the UpToDate, Scielo, PubMed, and Google Scholar databases. Results: Relevant epidemiological factors, such as HIV, and the absence of the Tuberculosis vaccine could raise the diagnosis hypothesis for the disease. Furthermore, clinical features as headaches, myalgia, fever, emesis, and sudden mood swings are also red flags. Patients should always be tested for HIV infection since mortality in these cases is about 60%. Tuberculous meningitis has a high lethality due to the delay in diagnosis and, in the absence of therapeutics, it worsens the prognosis. The complications are hydrocephalus, cranial nerve paralysis, strabismus, and coma. The diagnostic methods include CSF examination, computed tomography, magnetic resonance imaging, and GeneXpert. The treatment consists of antituberculosis therapy with glucocorticoids. Conclusions: It is essential to identify the disease and start immediate treatment, in addition to emphasizing the BCG vaccine and HIV prevention to reduce cases.
Sexual dysfunction associated with neurological disorders in men aged 19 to 44 years
Authors: Borges Matheus Araújo , Menezes Isabel Cristina Borges de , Bessa Isabela Garcia , Correia Gabrielly de Souza , Dib Maria Clara Rocha Elias , Falcão Rafaela Joy , Moraes Leslivan Ubiratan
Published: December 2021

Introduction: Male sexual dysfunction (DSM) is characterized by changes in qualitative or quantitative sexual capacity, manifested by changes in ejaculation, erection, and/or orgasm, in addition to the presence of pain or discomfort in sexual relations, and the main one of these is erectile dysfunction (ED). Objective: Review the literature on sexual dysfunction caused by neurological disorders, in men aged 19 to 44 years. Methodology: This is a narrative literature review. The collection of information about the theme was carried out through a search for scientific articles in the PubMed databases. The descriptions used in the search were “sexual dysfunction AND neurological disorders in men”, articles published in the last 5 years were considered. Results: Several neurological diseases with a very high correlation with DSM were found, such as: multiple sclerosis, ED being the main problem reported by patients, depression and its respective treatment, epilepsy, mainly associated with anxiety and depression, Parkinson’s disease, spinal cord injury, spina bifida, stroke and traumatic brain injury, especially when associated with diabetic neuropathy. Conclusion: DS is a very frequent problem in neurological diseases, therefore, there is a need for this theme not to be neglected by health professionals, emphasizing the importance of multidisciplinary treatment. Mersh Terms: Impotence, Male Sexual Impotence, Nervous System Disease.
Diethylene glycol poisoning: report of two cases due to brewery contamination
Authors: Seraidarian Marina Buldrini Filogônio , Tavares Daniel Vasconcelos de Pinho , Freitas Tassila Oliveira Nery de , Magalhães Paolla Giovanna Rossito de , Silva Gabriella Braga da Cunha , Paixao Barbara Oliveira , Aspahan Maíra Cardoso , Gomez Rodrigo Santiago
Published: December 2021

Context: Diethylene glycol (DEG) is an alcohol used as industrial antifreeze. Poisoning is usually accidental and involves contamination of food and beverage. We report two cases of DEG poisoning (DEGP) resulting from ingestion of beer in 2020. Case report: ACMO, male, 57 year-old, admitted with bilateral visual turbidity complaint. Laboratory showed renal dysfunction (Cr 11 mg/dl, Ur 202 mg/dl), increased anion GAP (AG) and metabolic acidosis. He evolved with amaurosis, facial diplegia, tetraparesis and areflexia. He was discharged after prolonged hospitalization with severe motor impairment, bilateral amaurosis and under dialysis therapy. RJB, 75 year-old alcoholic male patient, reported 600 ml/day ingestion of high-risk beer in the month preceding his hospitalization. He was admitted with nausea, abdominal pain, renal failure (Cr 11 mg/dl, Ur 177 mg/dl), metabolic acidosis and AG 21. He developed bilateral papilla edema, flaccid tetraparesis, areflexia, dysautonomy, respiratory failure and death. Conclusions: DEG metabolites primarily target kidneys and nervous system. Patients shortly develop nephroneural syndrome characterized by acute oligoanuric renal injury with metabolic acidosis and increased AG, associated with peripheral polyneuropathy with involvement of cranial nerves, in addition to optic neuropathy. Due to the poorly available serum dosage, rapid recognition of DEGP is essential to institute early treatment and identification of the source of the intoxication in order to prevent mass poisoning.
Clinical overview and therapeutic management of the cognitive and behavorial aspects of Huntington’s disease
Authors: Innocencio Giovanna de Camargo , Rosa Juliana de Souza , Lopes Patrick de Abreu Cunha , Hernandes Júnior Paulo Roberto , Feitosa Jhoney Francieis
Published: December 2021

Background: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disease classified among chorea that, in addition to motor symptoms, is characterized by neuropsychiatric disorders. Objectives: to analyze the cognitive and behavioral clinical aspects of Huntington’s disease and the therapeutic management of these symptoms. Methods: a literature review was carried out from the Scielo and PubMed database, using “Huntington’s disease”, “Cognition”, “Behavior” and “Treatment” as descriptors, where 11 articles were selected between 2001 and 2018. Results: the nature of cognitive and behavioral symptoms in HD are very dynamic, and cognitive dysfunctions are present prior to diagnosis. The most common clinical challenges include executive dysfunction, mainly slow thinking and attention disorders, apathy, depression and irritability. One study used data from the European Huntington’s Disease Network and evaluated almost 2.000 carriers of the mutation, in which 47.4% reported apathy, while depression and irritability occurred in 42.1%, and aggression and psychosis occurred in 38.6%. Other studies have confirmed apathy as an early manifestation related to its progression. For the therapeutic management of chorea, tetrabenazine is used, while antidepressants can be effective in mood symptoms. On the other hand, antipsychotics can lead to the advance and rapid progress of the disease. Small controlled studies with atomoxetine, donepezil and rivastigmine have found no positive effects on patients’ cognition. Recent publications have shown that circulating levels of brain-derived neutrotrophic factors in HD correlate with mood, cognition and motor function and can serve as markers of treatment success, while growth factor I is associated with cognitive decline and can provide biomarker targets for treatment validation. Conclusion: cognitive and behavioral symptoms in HD are very diversified and some strategies may have potential therapies and/or deleterious ones.
Camptocormia and genetic Parkinson’s disease caused by the mutation of the LRRK2 gene. Case report.
Authors: Brooks Joseph Bruno Bidin , Prosdócimi Fábio César , Granzotto Lara Fenley , Mariani Matheus Garcez Jorge
Published: December 2021

Context: Parkinsonism is a clinical syndrome characterized by bradykinesia, tremor at rest, muscle stiffness and postural instability. Parkinson’s disease is the most common cause of parkinsonism. Pathogenic mutations in the leucine- rich repeat kinase 2 gene (LRRK2) have been identified in PARK8-linked autosomal dominant parkinsonism. This mutation is the most common and explains about 1–7% of family cases of parkinsonism of European and American origin and 1–3% of sporadic PD. This case report was approved by the Ethics Committee of Universidade Metropolitana de Santos. Case Report: The present case relates to a 40-year-old, white man, who presented insidious and progressive parkinsonism for 6 years, akinetic-rigid and asymmetric (Hoehn Yahr 2.5 scale) associated with early camptocormia and non-motor symptoms and partial response to levodopa. The classic phenotype of late-onset parkinsonism was found on the paternal side of the patient’s family, suggesting family inheritance. Exome sequencing showed heterozygous mutation PARK8 LRRK2 (Gly2019Ser). Conclusions: The presentation of this case was aimed at alerting to Parkinson’s genetic disease in adults with family inheritance associated with early camptocormia. The presentation of this case was aimed at alerting to Parkinson’s genetic disease in adults with family inheritance associated with early camptocormia.
Bilingual aphasia after stroke. Case report
Authors: Brooks Joseph Bruno Bidin , Prosdócimi Fábio César
Published: December 2021

Context: With the largest number of bilingual individuals in the world, there is a growing need for understanding and studying language in different populations. In cases of bilingual aphasia, patterns of language recovery can vary. Parallel, or simultaneous, recovery in both languages is the most common type of language recovery, followed by differential recovery, where there is an improvement in one language compared to another. This case report was approved by the Ethics Committee of Universidade Metropolitana de Santos. Case Report: The present case refers to a male patient, 52 years old, righthanded, born in Arkansas-United States of America and resident for 20 years in the city of Santos, São Paulo. The patient is bilingual fluent in English and Portuguese and had a sudden deficit in strength and sensitivity in the right hemibody, associated with language disorders. Imaging exams showed a hemorrhagic lesion in the topography of the left lenticular nucleus. In the neurological evaluation, hemiparesis and proportioned and complete hemiparesis were shown on the right. In the language assessment, he presented an important impairment of fluency, compression and repetition in the Portuguese language and relative preservation, with slight dysfunction in fluency in the English language. Conclusions: Symptomatic treatment was instituted and after 12 months he had partial improvement of motor symptoms and complete aphasia.
Cerebrovascular diseases: the importance of recognizing them
Authors: Martins Karine Felipe , Teles Flávia Pascoal , Balestra Amanda Fernandes de Sousa Oliveira , Maia Isadora Rosa
Published: December 2021

Background: Until the 70s, cerebrovascular diseases (CVDs) were neglected to the lack of resources. However, due to the advancement of technology, several imaging tests have appeared, such as magnetic resonance and computed tomography, which facilitated the diagnosis and the understanding of the pathophysiology of each disease. Objectives: The objective of this work is to identify the main CVDs signs and symptoms. Methods: An integrative literature review was carried out based on selected articles from Google Scholar, PubMed and SciELO, using the terms headache, cerebrovascular disease, neurology. Results: CVDs are characterized by causing damage to brain vessels, due to changes in blood flow momentarily or permanently in an area of the brain, allowing them to be classified as ischemic or hemorrhagic. In ischemic there is a blockage of blood flow and, consequently, of oxygen to areas of the brain, in hemorrhagic rupture of a vessel occurs and, with this, blood leakage. Therefore, it is necessary to recognize the signs and symptoms early, in order to prevent loss of neurological function, movements on one side of the body and the presence or absence of headaches in both patients, with ischemic CVD and hemorrhagic CVD prevent rapid loss of consciousness accompanied by severe headache. Such signs and symptoms associated with the patient’s family history and lifestyle can help in the diagnosis of this disease. Conclusion: Therefore, it is important to recognize the signs and symptoms of CVDs, in order to determine the treatment and advise the patient, which will guarantee a better prognosis.
The main impacts of COVID-19 on parkinson’s disease patients
Authors: Regadas Mariana Silva , Costa Guilherme Albuquerque de Araújo , Sampaio Myrela Murad
Published: December 2021

Background: COVID-19 patients with chronic diseases and comorbidities are more susceptible to the severe form of the infection. Neurological symptoms are reported by some patients infected by the virus and research seeks the relationship between the virus and neurological diseases, such as Parkinson’s Disease (PD). Objectives: To understand how COVID-19 and its effects affect patients with PD. Methods: Integrative review with search on Google Scholar, Scielo, PubMed and Science Direct platforms through an online scenario, selected articles from the years 2020 and 2021. Results: SARS-CoV-2 frequently undergo mutations, causes damage and inflammation. There are reports of symptoms such as anosmia, ageusia and headache. Anosmia stands out for its relationship with one initial symptom of PD, hyposmia. As the majority of PD patients are elderly and have comorbidities, there is a higher risk of being infected. Some patients with PD infected by the virus report worsening in motor and non-motor symptoms and such worsening can occur due to systemic inflammation, stress and the measures to contain the pandemic. Conclusions: PD is not a risk factor for COVID-19, however patients may experience worsening symptoms due to comorbidities, old age and stress caused by the pandemic. Strategies that reduce stress are options for maintaining the health of patients with PD.