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Knowledge and Attitude of Doctors in Primary Care Settings Towards Thyroid Disorders: An Interventional Study
Nora Nabil Hussien,
Rasha Mohammed Bahaa Eldin
Issue:
Volume 9, Issue 2, March 2021
Pages:
36-42
Received:
11 February 2021
Accepted:
1 March 2021
Published:
10 March 2021
Abstract: Thyroid disorders are important and growing health problems worldwide. However, considering real life, assessment of knowledge and attitudes of physicians towards thyroid diseases in primary care is lacking. The study aimed to determine the difference in knowledge and attitudes of Family physicians (FPs), General Practitioners (GPs) and internists in primary care settings of Ministry of Health and Population (MOHP) towards Hypo and hyperthyroidism before and after medical education. This study is a pre-post interventional study done in primary health care facilities on 70 physicians from the three medical disciplines. Doctors were interviewed at their work place with a questionnaire consisting of personal data of the doctor and twenty questions about knowledge and attitudes towards thyroid disorders then they were handled the ideal answers according to the guidelines and the interview was repeated after two months. This study revealed that the mean age of physicians was 34±7.8, the mean duration of work was 6.8±5 years. The pre- interventional knowledge of internists was superior to family physicians and general practitioners. There was a highly significant change of physician knowledge (from 4.1±1.4 to 8±1.6) after intervention and there was a weakly significant change in attitude (from 3.1±0.9 to 3.2±0.9 and from 3.1±1.5 to 3.3±1.6 respectively) among general practitioners and family physicians after intervention. It was concluded that doctors from the three medical disciplines had a significant change in their responses to knowledge questions after intervention. So, it’s a must to train doctors in primary care how-to pick-up cases of thyroid disorders and how to manage them according to the guidelines and when they need to refer these cases.
Abstract: Thyroid disorders are important and growing health problems worldwide. However, considering real life, assessment of knowledge and attitudes of physicians towards thyroid diseases in primary care is lacking. The study aimed to determine the difference in knowledge and attitudes of Family physicians (FPs), General Practitioners (GPs) and internists ...
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Kampung Sungai to Kerala: A Deadly Zoonotic Trail Encroaching Diverse Geography
S. M. Rashed Ul Islam,
Munira Jahan
Issue:
Volume 9, Issue 2, March 2021
Pages:
43-48
Received:
31 December 2020
Accepted:
11 January 2021
Published:
26 March 2021
Abstract: Nipah virus is an emerging zoonotic virus which causes fatal encephalitis in the South-East Asia region since 1999. Thereafter, it is prevalent almost every year in the different parts of Bangladesh and India. The aims of this analysis to describe the epidemiological patterns of the Nipah infection and also to highlight the factors for the recurrent outbreak in this region. Intensive web searching was done for documents and journals on Nipah Virus infection and Nipah outbreak from 1999 to 2019. A total of 279 research documents were found and about 40 papers, especially the PubMed indexed sources and newsletters distributed by different public health agencies were selected for the meta-analysis. Information gathered from the selected journals and documents were described in text and figures. The analysis revealed that fruit bats of the Pteropus genus are the natural hosts of the virus. After documentation of the only outbreak in Malaysia in 1999, Nipah virus struck in 2001 for the first time in Meherpur of Bangladesh and thereby, creating a public health issue for every year. In 2018, this deadly zoonotic virus caused a fatality in Kerala, India which is far away from its usual prevalent region. This infection starts with the ingestion of Nipah infected raw date palm sap and direct contact with the infected person. Early diagnosis and strict isolation of the infected persons are the mainstays to prevent an outbreak. Presently, Nipah virus infection is now one of the ten priority diseases listed by the World Health Organization considering its high fatality rate. However, effective health education and infection control practice is still considered as the mainstay of prevention of future Nipah outbreak.
Abstract: Nipah virus is an emerging zoonotic virus which causes fatal encephalitis in the South-East Asia region since 1999. Thereafter, it is prevalent almost every year in the different parts of Bangladesh and India. The aims of this analysis to describe the epidemiological patterns of the Nipah infection and also to highlight the factors for the recurren...
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Clinical Perspectives on the Use of Different Peripheral Intravenous Catheters with the Implementation of Volume-based Procurement in China
Jian Ming,
Hsing Jung Li,
Yu Wang,
Yunfan Ge,
Jun Liu,
Shanlian Hu
Issue:
Volume 9, Issue 2, March 2021
Pages:
49-56
Received:
27 February 2021
Accepted:
12 March 2021
Published:
26 March 2021
Abstract: China introduced a “volume-based procurement (VoBP)” policy for medical products to contain healthcare costs and improve patient access to cost-effective products recently. The VoBP of peripheral intravenous catheters (PIVCs) was piloted in Jiangsu, Shandong and Jiangxi provinces in late 2019. The bidding of PIVCs mainly focused on their prices, while the evaluation standard on clinical performance of PIVCs was less emphasized. In this study, we aim to understand the clinical impacts associated with the utilization of different PIVCs influenced by the implementation of VoBP policy in China. Semi-structured interviews were conducted with nurses in Nanjing and Linyi, the pilot cities implementing VoBP. A total of 27 nurses who used a leading multinational corporation’s (MNC’s) PIVCs before VoBP and changed to China local brands’ PIVCs after VoBP were included as informants. In the first 15 interviews, all domains (PIVC placement, complications, product issues, and training) and corresponding concepts listed in conceptual framework were mentioned, indicating that sample size was sufficient. After the change from the MNC’s PIVCs to local brands, PIVCs used per patient increased from 2.0 to 3.5 and the average indwelling time decreased from 3.7 days to 2.1 days. Compared with the MNC’s PIVCs, those from local brands were associated with a 0.9-minute increase in PIVC insertion time and a 9% relative decrease in first stick success rate. Furthermore, increased complication rate, quality issues and hard catheter materials, and reduced product training after PIVC change were also mentioned by nurses. This study discloses that PIVC product change following the implementation of VoBP may result in unexpected issues. Therefore, establishing quality evaluation criteria and strengthening product monitoring mechanism are recommended for VoBP policy optimization on medical consumables.
Abstract: China introduced a “volume-based procurement (VoBP)” policy for medical products to contain healthcare costs and improve patient access to cost-effective products recently. The VoBP of peripheral intravenous catheters (PIVCs) was piloted in Jiangsu, Shandong and Jiangxi provinces in late 2019. The bidding of PIVCs mainly focused on their prices, wh...
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The Looming COVID-19 Housing and Health Crisis in the US: Results from a National and Four-City Survey
Mary Findling,
Robert Blendon,
John Benson,
Carolyn Miller
Issue:
Volume 9, Issue 2, March 2021
Pages:
57-63
Received:
3 March 2021
Accepted:
13 March 2021
Published:
26 March 2021
Abstract: Affordable housing is a key determinant of health, and it has become a major issue for millions of vulnerable households during the COVID-19 pandemic. Little is known about Americans’ financial burdens in paying for housing costs during the COVID-19 pandemic, particularly after federal aid was initially distributed. In a randomized, representative survey of households nationally and in the four largest U.S. cities during the COVID-19 pandemic (n=3,454), we found widespread, serious burdens reported with paying for housing costs (including rent, mortgage, and utilities). Nationally, forty percent of households with employment disruptions (40%) reported serious financial problems paying their housing costs, including half or more in New York (50%), Los Angeles (50%), and Houston (60%). More than one-third of renters nationally (38%) and in the four largest U.S. cities (Houston – 59%, Los Angeles – 50%, New York City – 38%, Chicago – 37%) reported serious problems paying housing costs during this time. Serious cost burdens were concentrated among renters, Black and Hispanic households, and households with recent job or wage losses. The federal government earmarked limited funding specifically toward improving housing stability in December 2020, but it was a fraction of what is believed necessary to provide stability to the housing market for vulnerable groups. A patchwork of housing and financial protection programs are set to expire in 2021 with limited ongoing mechanisms to cover back rent or utility payments, widely placing vulnerable households at risk for health and economic problems unless further policy action is taken.
Abstract: Affordable housing is a key determinant of health, and it has become a major issue for millions of vulnerable households during the COVID-19 pandemic. Little is known about Americans’ financial burdens in paying for housing costs during the COVID-19 pandemic, particularly after federal aid was initially distributed. In a randomized, representative ...
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Correlation Analysis of Th17/Treg Cells and PTPN22 Gene Polymorphism in HT Patients with Different Iodine Nutritional Status
Wang Cuicui,
Mu Zhaoxin,
Hou Zhenjiang,
Chen Yunxia,
Liu Jianfeng,
Ma Jinqun,
Liu Chunyan
Issue:
Volume 9, Issue 2, March 2021
Pages:
64-71
Received:
8 March 2021
Published:
26 April 2021
Abstract: Background: The incidence of Hashimoto's thyroiditis (HT) may be related to environmental, immune, and genetic factors. Different iodine nutritional status can affect thyroid function. Th17/Treg cell imbalance is involved in the pathogenesis of autoimmune thyroid diseases, and PTPN22 is an important susceptibility gene related to autoimmune diseases. To study the relationship between Th17/Treg cells and cytokines and PTPN22 gene polymorphism in HT patients with different iodine nutritional status is to determine the role of immune and genetic factors in the pathogenesis of HT. Objective: To investigate the correlation between Th17/Treg cells and factors protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene-1123G>C site (rs2488457) polymorphism in peripheral blood mononuclear cells (PBMC) of Hashimoto's thyroiditis (HT) patients with different iodine nutritional status. Methods: 100 HT patients and 60 healthy subjects in Cang Zhou are selected from 2019 to 2020. Flow cytometry and real-time fluorescent quantitative PCR are used to detecting the proportion and ratio of Th17 and Treg cells in PBMC, as well as retinoic acid-related orphan receptor-γt (ROR-γt) and fork head/winged spiral transcription factor 3 (Foxp3) mRNA expression levels. Single allele-specific primer-polymerase chain reaction (SASP-PCR) technology is taken to sequence PTPN gene promoter-1123SNP leading to calculate the gene Type and allele frequency. Results: Th17 and Treg cells and factors in the PBMC of HT patients have a certain correlation with the-1123G>C locus of PTPN22 gene (rs2488457). The distribution frequency of rs2488457 genotype is consistent with Hardy Weinberg's law of genetic equilibrium. The distribution frequencies of various genotypes and alleles are significantly different between HT patients and the control group (P<0.05). PTPN22 gene-1123G>C site C/G, C/C genotype can increase of the risk of HT, while G/G genotype can decrease of the risk of HT. In Conclusion: The polymorphism of rs2488457 is related to susceptibility to HT. Carrying C/G and C/C genotypes may be risk factors for HT, and G/G genotypes may be protective factors for HT, but it has nothing to do with iodine nutrition status.
Abstract: Background: The incidence of Hashimoto's thyroiditis (HT) may be related to environmental, immune, and genetic factors. Different iodine nutritional status can affect thyroid function. Th17/Treg cell imbalance is involved in the pathogenesis of autoimmune thyroid diseases, and PTPN22 is an important susceptibility gene related to autoimmune disease...
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