101 research outputs found
Designing a mobile interface for a deaf user
My MA thesis is a collaborative research and design project about designing a mobile application to bridge the communication gap between Deaf people and healthcare professionals in South Africa. It explores health knowledge transfer problems faced by the Deaf community during a health consultation and aims to solve them by the means of a mobile application interface designed to aid communication.
Healthcare, a basic human right, is violated when healthcare professionals don't find the means to communicate health information to Deaf people in a medium that they understand. This communication problem is due to a language barrier between the Deaf and the hearing world. A Deaf person uses sign language as his or her primary form of communication, yet there is a lack of sign language interpreters at healthcare centers. Sign language is the first language of Deaf people because of which a number of Deaf communities all over the world are only able to use a very basic level of written or spoken language. Moreover, medical information is complex and the factors mentioned above make it difficult to transfer health knowledge between healthcare professionals and Deaf patients, leading to poor health conditions of the latter.
In order to solve this problem, my thesis explores ways of transferring medical knowledge using visual methods of communication as opposed to text based communication, via a mobile application. Since health knowledge is a vast topic, for my project I focus on only one medical condition, Diabetes type 2. This choice is determined by the fact that Diabetes is a lifelong condition that requires regular hospital visits and timely communication and treatment. A core aspect of my research is finding ways to design interactive interfaces that better suit the requirements of the Deaf user than they do at present, using a process of benchmarking, co-creation, interviews and usability testing. My project documents insights from desk and field research which are used to design and test a prototype of the mobile application with Deaf users in South Africa
Tracheal Resection and Anastomosis for Postintubation Tracheal Stenosis
Introduction: Tracheal stenosis is one of the dreaded complication of tracheal intubation. Tracheal resection and anastomosis is an established definitive treatment for stenosis more than one cm. Here, we present a case of postintubation tracheal stenosis managed by resection and anastomosis, first of its kind in our centre.
Case Report: We present a case of 26-year female who underwent tracheal intubation during her treatment of tubercular meningitis. Two weeks later, she returned with respiratory difficulty. A diagnosis of post-intubation tracheal stenosis was made. Tracheal resection and anastomosis was done. Recovery was uneventful and she was discharged on 14th post-operative day.
Conclusion: Post-intubation tracheal stenosis is still a dreaded complication even after the introduction of high volume low pressure cuff. They can be successfully managed. Care personnel in intensive care unit (ICU) should perform to prevent this complication
Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis
Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period.
Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November 2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed.
Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD.
Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis
Osteonecrosis of the jaws and bisphosphonates : report of fifteen cases: therapeutic recommendations
Recently there have been reports of osteonecrosis of the jaw (ONJ) in patients with chronic therapy with bisphosphonates (Bps). So far three drugs have been linked: Pamidronate of disodium, Zoledronic acid and Alendronate of sodium. It is due to a non detected side effect in clinical trials before commercialization, and reverberates significantly in the quality of life of these patients. Most of the cases are seen in oncology patients that have received long term concurrent antineoplasic therapy and were treated sporadically with steroids, together with Bps endovenous, for treatment of cancer and its symptoms. Among these cases we find the reported by R.E. Marx (1), S.L. Ruggiero (2) and J. V. Bagán (3). In this report fifteen cases diagnosed, treated and followed up at the author´s surgery department are presented and some suggestions are given in order to reduce the incidence in patients with cancer who are going to receive Bps, as well as in patients with established ONJ being treated with these drugs who may need a surgical intervention
Complications of Percutaneous Nephrolithotomy and their Management
Introduction: Increasing global prevalence of nephrolithiasis has resulted in the development of new minimally invasive techniques and has also led to the resurgence of established methods such as percutaneous nephrolithotomy (PCNL). This procedure is now recommended as the first option for the treatment of single large or multiple renal stones and those in the inferior calyx. This study was done to assess the complications of PCNL and their management, in our centre.
Methods: Medical records of 144 patients who underwent PCNL at Lumbini Medical College Teaching Hospital, during the last one year were reviewed. The demographic data, size, tract number and location of the calculi, and intraoperative and postoperative complications were evaluated. The various parameters of the calculi were evaluated. Descriptive analysis with frequencies was done.
Results: Complications occurred in 13 (9.02%) patients. Post operative bleeding occurred in seven (4.8%) patients, out of which one patient developed pseudoaneurysms and the other developed arteriovenous fistula. One patient developed hypovolemic shock immediately after surgery. Frequent blockage of urine, excessive drainage of urine from the drain site, hemothorax and colonic perforation was seen in one patient each. One patient had mortality due to post operative bleeding. Complications increased with the number and size of stones and number and site of the tracts.
Conclusion: Percutaneous nephrolithotomy has low complication rate in experienced hands and complications depend upon stone size, history of open stone surgery, tract number, and tract location
Incidence of Carcinoma Prostate in Transurethral Resection Specimen in a Teaching Hospital of Nepal
Introduction: As suggested through several autopsy studies there is a high prevalence of latent prostate cancer in the population. A much smaller proportion of prostate cancer is detected because of clinical symptoms. This study was done to identify the rates of incidentally detected prostate cancer in patients undergoing surgical management of Benign Prostatic Hyperplasia (BPH) in our centre.
Methods: A retrospective review was done on all transurethral resections of the prostate (TURP) cases from May 2014 to May 2015 at a single tertiary care institution. One hundred and three men, aged 40 to 88 year, underwent TURP and their specimens were sent for the histopathological analysis.
Results: Five (4.85%) patients were diagnosed with the prostate cancer. All the five patients had Gleason score of seven or more. Two patients had moderately differentiated adenocarcinoma with Gleason score of seven. Three patients had poorly differentiated adenocarcinoma with Gleason score of eight or above. The Prostate cancer was seen only in the age group above 65 years but it was not statistically significant.
Conclusion: Our series demonstrated that 4.85% of patients had latent prostate cancer. It occurs mainly in men above 65 years of age though this was not statistically significant
Obesity and Respiratory Hospitalizations During Influenza Seasons in Ontario, Canada: A Cohort Study
Evidence from the 2009 H1N1 pandemic suggests that severe obesity was a risk factor for serious complications from influenza infection. Our study identifies severe obesity as a risk factor for respiratory hospitalizations during seasonal influenza epidemics
Modeling of longitudinal polytomous outcome from complex survey data - application to investigate an association between mental distress and non-malignant respiratory diseases
<p>Abstract</p> <p>Background</p> <p>The data from longitudinal complex surveys based on multi-stage sampling designs contain cross-sectional dependencies among units due to clustered nature of the data and within-subject dependencies due to repeated measurements. Special statistical methods are required to analyze longitudinal complex survey data.</p> <p>Methods</p> <p>Statistics Canada's longitudinal National Population Health Survey (NPHS) dataset from the first five cycles (1994/1995 to 2002/2003) was used to investigate the effects of demographic, social, life-style, and health-related factors on the longitudinal changes of mental distress scores among the NPHS participants who self-reported physician diagnosed respiratory diseases, specifically asthma and chronic bronchitis. The NPHS longitudinal sample includes 17,276 persons of all ages. In this report, participants 15 years and older (n = 14,713) were considered for statistical analysis. Mental distress, an ordinal outcome variable (categories: no/low, moderate, and high) was examined. Ordered logistic regression models based on the weighted generalized estimating equations approach were fitted to investigate the association between respiratory diseases and mental distress adjusting for other covariates of interest. Variance estimates of regression coefficients were computed by using bootstrap methods. The final model was used to predict the probabilities of prevalence of no/low, moderate or high mental distress scores.</p> <p>Results</p> <p>Accounting for design effects does not vary the significance of the coefficients of the model. Participants suffering with chronic bronchitis were significantly at a higher risk (OR<sub>adj </sub>= 1.37; 95% CI: 1.12-1.66) of reporting high levels of mental distress compared to those who did not self-report chronic bronchitis. There was no significant association between asthma and mental distress. There was a significant interaction between sex and self-perceived general health status indicating a dose-response relationship. Among females, the risk of mental distress increases with increasing deteriorating (from excellent to very poor) self-perceived general health.</p> <p>Conclusions</p> <p>A positive association was observed between the physician diagnosed self-reported chronic bronchitis and an increased prevalence of mental distress when adjusted for important covariates. Variance estimates of regression coefficients obtained from the sandwich estimator (i.e. not accounting for design effects) were similar to bootstrap variance estimates (i.e. accounting for design effects). Even though these two sets of variance estimates are similar, it is more appropriate to use bootstrap variance estimates.</p
The Effect of Universal Influenza Immunization on Mortality and Health Care Use
Comparing influenza-related mortality and health care use between Ontario and other Canadian provinces, Jeffrey Kwong and colleagues find evidence that Ontario's universal vaccination program has reduced the burden of influenza
Major Depression Is a Risk Factor for Shorter Time to First Cigarette Irrespective of the Number of Cigarettes Smoked Per Day: Evidence From a National Population Health Survey
Article deposited according to Oxford Open Self-Archiving policy: http://www.oxfordjournals.org/oxfordopen/policies.html, January 12, 2012.YesFunding provided by the Open Access Authors Fund
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