Community Mental Health Services in Developing Countries, Time to Think Outside the Box
Sadat Muzammil, MBBS, MRCGP, FRCP (Glasg), CCFP and Georgina Lopes, MSc
Article Type: Review Article | First Published: January 20, 2020
Developing countries are struggling to provide adequate mental health care to its citizens. One of the main reasons is the serious shortage of psychiatrists and trained Mental Health Nurses (MHNs). In many countries the quality of mental health nursing is less than satisfactory. Some Western countries have devised nurse led care models under the supervision of psychiatrists, which have shown improvement in patient waiting times and care delivery as compared to low-income countries. Nurses with prescribing privileges have received mixed opinions but it has been shown to have benefits to a certa...
A Rare Form of Dermoid Cyst: A Fetiform Teratoma
Erciyestepe SG, Turan H and Kahramanoglu I
Article Type: Case Report | First Published: January 24, 2020
Thirty three-years-old patient presented with abdominal distention and intermittent abdominal pain. She gave vaginal birth 2 times; last one three years ago. She didn’t have history of any abdominal operation, family history, or comorbidities. Her menstrual periods were regular. Review of the systems were unremarkable. In the pelvic examination, a 10 cm abdominal mass palpated which deviated to the left side. The pelvic mass had a soft consistency and free mobility. In the ultrasonography, 80*80*70 mm measured complex lesion that resembles dermoid cyst was visualised at the right ovary. The ...
Patient Reported Outcomes of Balloon Dilation for Eustachian Tube Dysfunction Using the SNOT-22 Survey
Zahrah M Taufique, MD, MBA, Steven A Gordon, MD, MPH, Janine M Rotsides, MD, Jamie R Oliver, BA and Lisa A Liberatore, MD
Article Type: Original Resear ch | First Published: January 15, 2020
Eustachian tube dysfunction is a common medical condition affecting approximately 1% of the adult population. Previous studies have evaluated eustachian balloon tuboplasty using tympanometry, ability to perform Valsalva maneuver and subjective improvement in symptoms to measure effectiveness. In this study, we propose using the Sino-Nasal Outcome Test (SNOT-22) to measure outcomes following eustachian tube balloon dilation, with a focus on ear-specific symptoms within the survey....
Case of Preslip Capital Femoral Epiphysis: A Visual Vignette
Mai Adnan Banjar, MBBS, EDiR, Premilla Pillay, MD, FRCR and Salil Babla Singbal, MBBS, FRCR
Article Type: Short Commentary | First Published: January 23, 2020
9-year-old presented with left thigh pain for several weeks. Physical assessment of gait noted external rotation of the left hip. Anteroposterior and lateral radiographs of the hip demonstrated normal alignment. No fractures or dislocation. In particular, no femoral epiphysis slip was noted. The lateral view first interpreted as normal, although in hindsight there might have been subtle alignment irregularity. MRI was performed which showed high T2/STIR signal intensity with slight widening of the physeal line of the left hip with no slippage or subluxation of...
Reconstruction of Subacute Pectoralis Major Tendon Rupture from CrossFit Injury: Case Report and Literature Review
William H Miears, BS, Christian Douthit, MD and Mimi Zumwalt, MD
Article Type: Case Report | First Published: January 18, 2020
Pectoralis major tendon ruptures are uncommon injuries that are most commonly seen in active males between 20-40 years of age. While the most frequently cited mechanism of injury is during bench press, other causes from activities such as contact sports have also been reported. With the rise in popularity of CrossFit, or high intensity variable functional training, practitioners may begin to notice an increase in other mechanisms of injury. In this clinical case we present a patient who ruptured his pectoralis major tendon while performing a CrossFit workout as a coach....
Chronic Fatigue Syndrome (CFS): An Imprecisely Defined Infectious Disease Caused by Stealth Adapted Viruses
W John Martin
Article Type: Commentary | First Published: January 20, 2020
Much of the research on the chronic fatigue syndrome (CFS) is misguided for two major reasons. First, it is falsely assumed that CFS is a distinct, definable illness, which can be reliably differentiated from other neurological and psychiatric illnesses. Second, in spite of compelling evidence to the contrary, CFS is not generally regarded as an infectious illness. This review addresses these two issues and is followed by a brief discussion on stealth adapted viruses and the alternative cellular energy (ACE) pathway....
Pilot Study on Frequency in Schoolchildren with Parasitism
Osvaldo Batista Rojas, MSc
Article Type: Research Ar ticle | First Published: January 15, 2020
Among infectious diseases, those produced by intestinal parasites are an important health problem for man. To characterize intestinal parasitism clinically and epidemiologically in young patients. An observational, descriptive and cross-sectional study was carried out in the Clinic 11 of the Finlay Polyclinic with schoolchildren diagnosed with intestinal parasitisms from the Hermanos Montalvo Primary School January-May 2019. There was a predominance of the male sex with 91%, with the age group most affected being 17 to 22 years for 60.7%. 19.6% of the patients came from primary school. Abdomin...
Relationship between BMI at Discharge and ADL Ability in Integrated Community Care Ward
Article Type: Research Article | First Published: January 22, 2020
Low BMI is a poor prognostic factor. Previous studies have reported that daily body activity (ADL) ability is difficult to improve if the body mass index (BMI) at admission is low, but the relationship between BMI at discharge and ADL ability has not been clarified. Therefore, we aimed to clarify that ADL ability is low when BMI at discharge is low. A cross-sectional study of patients who were admitted to an integrated community care ward and underwent rehabilitation. Patient information was investigated from medical records. BMI: Less than 20 kg/m2 was defined as a low BMI group, and more th...
Incidence, Microbiological Spectrum and Outcomes of Infective Peritonitis in Chronic Peritoneal Dialysis Patients
Vivek Sood, Vivek Kumar, Raja Ramachandran, Shefali Gupta, Vikas Gautam, Manish Rathi, HS Kohli1 and KL Gupta
Article Type: Original Article | First Published: January 20, 2020
Peritoneal dialysis related peritonitis is a major risk factor for drop-out of patients on continuous ambulatory peritoneal dialysis. Data on factors affecting outcome of chronic peritoneal dialysis related peritonitis and microbiology is limited. In this regard, a retrospective, observational study was conducted at Post Graduate Institute of Medical Education and Research, Chandigarh, India, wherein we reviewed medical records of chronic peritoneal dialysis patients for 3 years between 01 July 2015 and 30 June 2018. We abstracted data pertaining to social, demographic and clinical characteris...
Mucoepidermoid Carcinoma of the Parotid Gland in a Patient with Duchenne Muscular Dystrophy: A Case Report
Geun-Jeon Kim, MD, Dong-Hyun Lee, MD, Chul-Woo Yang, MD, PhD and Dong-Il Sun, MD, PhD
Article Type: Case Report | First Published: January 22, 2020
We report the co-occurrence of Duchenne muscular dystrophy (DMD) and mucoepidermoid carcinoma (MEC) of the parotid gland. A 33-year-old male presented with a parotid gland tumor of benign appearance. After surgery, the patient’s serum creatine kinase level exceeded 20,000 IU/L (normal, 50-200 IU/L); his potassium level was also high (7.2 mEq/L), as were his aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase levels. Genetic testing revealed the deletion of exons 10-29 on chromosome Xp21, and the patient was diagnosed with DMD. The resected specimen revealed eviden...