International Medical Journal

Journal ID : IMJ-25-03-2020-369

Total View : 122

Title : A review on the technique of procedural sedation and analgesia (PSA) in emergency medicine

Abstract : One of the proper clinical practices applied in emergency medicine departments is the medical technique of procedural sedation and analgesia (PSA). The sedation level should be modified somehow that patients be able to undergo undesirable medical conditions and also preserve normal consciousness and physiological reflexes while being able for considering and responding to tactile or/and verbal stimulations. In spite the fact that the most frequently applied drugs for procedural sedation are broadly safe, but improper dosing or monitoring would increase adverse side effects. It should be noted that applying the technique of procedural sedation in emergency medicine departments may bring risks along. Appropriate medical monitoring from one side, and providing proper accessibility to resuscitation possibilities with the presence of properly educated staffs of emergency units for immediate management of airway and supporting the life of patients in an advanced way from the other side, could decrease the harmful consequences of treatment. For proper screening of compatibility of procedural sedation and evaluation the main risk factors, preprocedural assessment should be done. Patients who have improper airway, are in full stomach condition or have considerable medical diseases should take higher levels of conscious sedation and also should consider alternatives to procedural sedation. The medical professional doctor which is responsible for carrying out procedural sedation must be educated properly from the point view of operation, dose, consequences, side effects and antitoxin of frequently applied sedative analgesics. The recent developed novel and advanced techniques are such as the chemical compound of Inhalational anesthetic, drug delivery system of transmucosal, target controlled sedation (TCS), patient-controlled sedation (PCS) and transnasal esophagoscopy. After procedural sedation process, all patients must be undergoing medical monitoring and also must be kept at the recovery room until they present all required criteria’s for being discharged.
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International Medical Journal

Journal ID : IMJ-25-03-2020-367

Total View : 154

Title : Caries experience and oxidative status among a group of diesel generator workers

Abstract : The highly use of generators creating an alarming level of pollution (air and noise) in all regions of the world. The soot which is impure carbon particles emitteddfrom diesel engines into environment during combustion process is to consider one of the dangerous pollutant due to its direct and broad impact on the respiratory organs and some polycyclic aromatic hydrocarbons known for their cancer properties are associated with it. Environmental conditionsshave many serious impacts on the general health of humans-as well as on dental status. The aim of the study was to evaluate caries experience and salivary oxidative stress biomarker (protein carbonyl) in relation to dental caries among a group of diesel generator workers. The sample for this study included 94 workers in diesel generators, their ages were between 20- 49 years. Collection of stimulated salivary samples was carried out under standardized conditions to determine the level of oxidative stress biomarker (protein carbonyl) while caries experience was determined by the Decayed- Missing – Filled Surface index by WHO 1997. The result revealed that caries experience (DMFS, DMFT, DS, MS) was relatively highest among the workers with longer duration and the most component of caries experience was the Missing surfaces (MS) followed by Decayed surface(DS) while the least one was the Filling surfaces (FS), furthermore, the salivary protein carbonyl level was increased approximately with increase duration of work in the field of generators. Saliva considered as a valid and convenient diagnostic biofluid for measurement of oxidant/antioxidants in patients. In this study there was changes in the oxidative stress in the biological systems among the workers with longer duration which can be produced by the exhaustion, of antioxidants and/or by an-overload of oxidants, as a result of this ,the antioxidant defense system become deficient that may,,be important in the inflammatory reactions, also caries experience was approximately,higher=among the=workers with longer duration ,therefore special oral, and general health,,preventive and educational programs are needed for them.
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International Medical Journal

Journal ID : IMJ-25-03-2020-366

Total View : 151

Title : DRUG COST ANALYSIS UNDER CAPITATION PAYMENT SYSTEM IN DAERAH ISTIMEWA YOGYAKARTA PROVINCE, INDONESIA

Abstract : This study aimed to analyze the capitation payment utilization and expenditure of drugcosts in public and private primary health care (PHC). This study was a cross-sectional study withquantitative approach of data collection that was done from January 2016 to December 2016 at 5 private and5 public PHC, evaluating utilization and expenditure data prescription cost in Yogyakarta city and Slemandistrict, Indonesia. We performed Mann-Whitney and Kruskal-Wallis analysis to determine differences inutilization and expenditure of drug cost between private and public PHC. The most prevalent diseases foundbased on the type of PHC was pulpitis (12.5%) while in private PHC was an acute upper respiratoryinfection (13.5%). Characteristic of patients visited was female (68%), 46-55 age group (17%). The costused in health services were IDR 16,093 (77%) for patient examination and services and IDR 5,097 (23%)for the drug. There were statistically difference for total cost of three diseases, includinghypercholesterolemia (p=0.008); acute upper respiratory infection (p= 0.023); and functional dyspepsia (p=0.015). The highest drug cost based on diseases was refractory anemia (IDR 18,885). The proportion of drugcost was about 23% of the total capitation fund received by PHCs. Drug costs in the capitation system at theprivate first level health facilities tend to be higher than in the public facilities. Moreover, it is lower than theinternational standard suggested by WHO. It is recommended to evaluate the capitation system especiallythe rational proportion of health expenditure to enhance the quality of care.
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International Medical Journal

Journal ID : IMJ-24-03-2020-365

Total View : 172

Title : Effectiveness of Basic Science Education on the Clinical Skills from the Viewpoint of the Medical Interns and Externs at Semnan University of Medical Sciences

Abstract : Among the educational programs, medical education is very important because of itsunique nature and high costs. Students, as the main elements of education, are the best source of informationneeded to determine the quality of education. Therefore, the present study aimed to evaluate theeffectiveness of basic science education on the clinical skills from the viewpoint of the medical interns andexterns at Semnan University of Medical Sciences. In this descriptive cross-sectional study, 102 30-itemquestionnaires were completed by medical students of Semnan University of Medical Sciences during 2017-2018. The questionnaire evaluated four indices of achievement of objectives, content of basic sciencecourses, educational planning and organization, and assessment of professors. The answers were based on a5-point Likert scale varying from undesirable to poor, average, good, and excellent. In this study, 51 femalesand 51 males medical inters and externs participated. From the viewpoint of students, the anatomy(3.42±1.038) and physiology (3.27±1.195) were considered as the most important and influential basicscience courses and physics (1.58±0.895) and biochemistry (1.44±0.752) were evaluated as the leastimportant basic science courses. Evaluation of the effectiveness of the three indices of achievement ofobjectives, educational planning and organization, and assessment of professors from the viewpoint ofstudents showed a mean and standard deviation of less than average. The results showed that clinical aspectsof basic science courses were received less attention, indicating the need to revise current methods of basicsciences in medical education.
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International Medical Journal

Journal ID : IMJ-24-03-2020-364

Total View : 184

Title : Molecular detection of Trypanosoma evansi in Camels (Camelus dromedaries) in Nyalal area.

Abstract : The aim of the current study was to investigate the T. evansi infection of dromedary camel, using the molecular tools in comparison to conventional methods. Jugular vein blood samples were randomly collected seasonally for three successive seasons from 500 camels in Nyala area (South Darfur State) and examined parasitologically by Giemsa stained blood smears (GSBS) for the presence of the trypanosomes, serologically for detection of anti-trypanosomal antibodies by card agglutination test (CATT) and molecularly for detection of the T. evansi amino- acid sequence through PCR by using T. brucei spp specific primers. Out of 500 samples 55(11%) were positive by smears, and 140(28%) were positives by CATT through anti-trypanosomal antibodies, while 200(40%) were positive by PCR. The obtained results showed that PCR have higher sensitivity and specificity (95%), while CATT and smears gave less sensitivity 70% and 32% respectively. These findings were useful in formulating strategic control programs, because this new molecular approach will make it possible to detect infections in the very early stages where microscopic examination is unclear and to monitor groups of animals after trypanocidal treatment. This will not only be beneficial for diagnosis also useful for epidemiological study and designing rational control program.
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International Medical Journal

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Submission Deadline ( Vol 30 , Issue 09 )
20 Sep 2023

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Publish On ( Vol 30 , Issue 07 )
31 Jul 2023