British Journal of Healthcare and Medical Research

Therapeutic Effect of Polyherbal Formulation in The Management of Tamaka Śwāsa (Bronchial Asthma)

Rigom Pegu — 2023-05-09

Tamaka Śwāsa is one among the 5 different respiratory disorders described elaborately in classics of Ayurveda having close resemblance to Bronchial Asthma. With time several polyherbal formulation modalities are found to be well-accepted, safe and effective in asthma due to multiple blocking and homeostasis of very complex, interdependent cellular, mediator networks supporting and involved in the inflammatory process. An open clinical trial was conducted with polyherbal formulation on 100 patients at Government Ayurvedic College & Hospital, Guwahati, Assam-781014,India to assist the therapeutic effect in the management of Tamaka Śwāsa (Bronchial Asthma). The therapeutic effect showed statistically extremely satisfactory relief symptomatically along with improvement in Peak Expiratory Flow Rate, Breath Holding Time to be statistically highly significant suggestive of bronchodilator effect and statistically reduction in ESR, AEC showed anti-allergic, anti-inflammatory effect. During the course of the clinical study of the trial drug no adverse reaction or side effect was observed in any of the patients and overall therapeutic response was encouraging. Thus, it is found that the polyherbal formulation is safe and ideal in the management of Tamaka Śwāsa (Bronchial Asthma).

Ethical Generational Marketing Approach for Dental Patients

V Sergi — 2023-05-09

Dental marketing is one of the most challenging fields of marketing in the health field, due to the combination of dentistry science and business administration. Dentists, despite their medical occupation, are the leaders of their business and to succeed, they should use ethical marketing strategies avoiding patient’s deception. This narrative review analyses the current possible marketing strategies by identifying and exploiting existing opportunities; it also aims to demonstrate new approaches in dental marketing, which can be used to cope with the effects of the economic crisis, inflation, and after-Covid-19 market’s competition. In addition, it mentions the marketing techniques and the ways to approach every specific generation of dental patients to get maximum results. Generational marketing is not considered a complete strategy, but it’s relevant for marketers to understand their costumer’s perspectives. At the stage of planning, dentists should take into consideration the characteristics of the target generation and integrate the relevant method of approach into their marketing strategy. According to the generation features, there are specific techniques of ethical and legal approach, that can be included in marketing strategy to maximize efficiency. Moreover, dentists should never debase those characteristics, such as honesty and integrity, which are considered indisputable by people across all generations.

The livelihood of Rickshaw Pullers in Dhaka City During Covid-19 Pandemic: A Social Review

Md. Towhidul Islam Talukder — 2023-05-09

Introduction: A rickshaw puller is a worker who makes a living by pulling rickshaws. A rickshaw puller's main task is to transport passengers and goods from one location to another. Their lives are fraught with difficulties. Because of the epidemic condition, the majority of Dhaka's rickshaw pullers are experiencing unemployment and joblessness. The majority of rickshaw pullers are the primary breadwinners in their families. They spend their lives based on their daily earnings; thus, they must pull their rickshaw. Aim of the study: The study aimed to observe the lifestyle of rickshaw pullers during the Covid-19 pandemic, focusing on their livelihood. Methods: This cross-sectional quantitative analytical study was conducted targeting rickshaw pullers of dhaka city only. The study was conducted in a 1-year period, from february 2021 to january 2022, with a total of 200 rickshaw pullers from 3 places in dhaka city, badda, mirpur, and Bashundhara. Result: 55% of the participants were the sole earner in the family, 90% had been married, and only 12% had owned their rickshaws. 96% of participants lived in financial deficiency, 70% had been living in debt, and only 1% had savings. The average work day was 8-10 hours long for the majority (61%) of participants, 89% did not have a habit of wearing a facemask. Among the 178 participants who did not wear face masks, 91.01% cited difficulty in breathing during rickshaw pulling as the cause, while 7.87% said that masks were costly. 96% of participants had a significant decrease in their income. Conclusion: during the statewide shutdown induced by the covid-19 epidemic, the income of rickshaw pullers in the capital decreased. Rickshaw drivers live hand to mouth. They endure regular challenges at work due to limits on their operations such as harassment from passengers and traffic cops.

We Were Physcians

García-Solis Eduardo — 2023-05-13

We were physicians, persons who prepared ourselves to give our best, to relieve the sick, not only physically but sometimes emotionally. At the present it has been written, conferences have been given, in relation to the dehumanization of medicine. The medicine trade. Physicians who charge $1500.00 (66 dollars) per consultation while the minimum wage is $172.87 (8 dollars), perhaps a medicine for the rich? That is why when we treat a patient, we are not satisfied with just making a good diagnosis and a timely treatment, let us do something more; like in a give and take, where the patient and the physician are amalgamated, let us shake hands with the patient and together let us walk the path with a deep human sense full of love and understanding for our patient. Our patient who is a human being who sometimes requires only a few words of encouragement. There is much more to do. This is where we are, we need the complicity and support of many other colleagues who, like me, miss being physicians in the true sense of the word. It is everyone's responsibility, especially medical educators, not to say we were physician but that we are physicians.

Relationship Between Drinkers’ Motivation Before Therapy and Propensity to Relapse After Therapy Among Undergraduates with Substance Use Disorders in Nigerian University

Samuel Adedotun Ajiboye — 2023-05-13

Relapse cases after alcohol use disorder treatments have been a great challenge to individuals suffering from addiction, their families, and mental health professionals. This study examined influence of drinkers' readiness to change on their propensity to relapse after therapies. It also examined other factors that could be responsible for propensity to relapse after therapies among undergraduates in Ekiti State University. 24 students, male (n=19) and female(n=5), who scored 7 and above in Alcohol Use Disorder Identification Test and showed interest in therapy during baseline survey and were randomly assigned into three treatment groups and one control group. Drinkers’ motivation was tested before therapy and while propensity to relapse was assessed after therapy. The research shows that all stages of drinkers’ motivation to change jointly predict propensity to relapse [F (3, 20) = 3.19, p = .046, R²= .32]; meanwhile, only ambivalence (lack of motivation) significantly predict propensity to relapse [β=6.73, p = .006]. Propensity to relapse is significantly higher among male (mean = 100.89) than female (mean = 67.80); t(22) = 3.41, p<.01; meanwhile there is no significant sex difference in readiness to change among participants. It is clear from this study that lack of motivation among drinkers significantly predict higher propensity to relapse. In addition, gender related issues should be considered during therapies to prevent relapse. It is pertinent therefore, that therapists in Substance use disorder/addiction treatment centers should ensure drinkers’ motivation to quit alcohol use before therapies and conduct pretreatment assessment to identify individual factors that may engender relapse after therapies.

Assessment of Factors Influencing Utilization of Maternal and Child Health Services in The Federal Capital Territory (FCT), Abuja, Nigeria

F. B. Oguntimehin — 2023-05-13

Background: Although Nigeria has made progress in attaining the third sustainable development goal, maternal and child mortality remains a challenge to attaining universal health coverage. Utilization of maternal and child health services (MCH) is not uniform in the country, with the southern region outperforming the northern region, and within the northern region, the north central is outperforming the North West and east. Even in the north central, majority of state lag behind the federal capital territory (FCT), Abuja, in the uptake of MCH services. This study aimed to understand the determinants of maternal and child health service uptake in FCT. The evidence generated should help expand MCH services delivery in the FCT and other similar settings in Nigeria and beyond. Methodology: The research adopted a cross-sectional, mixed methods design in Bwari and Kuje Area Councils of Abuja, using a synthesis of the Ensor and Cooper demand and supply paradigm of health service uptake and the Andersen and Newman Behavioural Model for health service utilization. Qualitative data was obtained through Key Informant Interviews, In-Depth Interviews, and Focus group discussions with parents of under-five year children, pregnant women, health workers, program managers and community leaders. Quantitative data was collected through a household survey of women of childbearing age, using modified WHO Health Access and Use household survey questionnaire. Thematic analysis of the qualitative data was done to determine patterns relevant study objectives using Dedoose software. Quantitative analysis involved univariate descriptive analysis of respondents’ socio-demographics and multivariate logistic regression to determine the predictive value and relative importance of the predisposing, enabling, and needs determinants of MCH uptake. Result: Factors that favoured the uptake of MCH services included service availability, affordable cost of care, accessibility and proximity of health facilities, and perceived good knowledge and capacity of health workers. No religious or cultural barrier to MCH service uptake was reported. Education and employment status were statistically significant determinants of ANC uptake. Religion, level of education, and employment were statistically significant predisposing determinants of having skilled birth attendance (SBA). Also, employment and educational status were statistically significant predisposing factors of immunization uptake. Financial barriers, poor knowledge of availability services, previous negative experience with service utilization, poor perception on the value of MCH services were factors limiting uptake of MCH services. Conclusion: The study concludes that both demand and supply determinants of MCH services utilization were functionally demonstrated in the study area. However, the lack of health insurance scheme is a key limitation for universal coverage of MCH services in the study area. We recommend continuous improvement in health facility infrastructure and human resources capacity building by public authorities, to sustain and improve the current level of MCHs services delivery in the area. Furthermore, government should scale up the roll out of its national health insurance scheme to cover more enrollees.

Malaria Multifocal Study Shows the Preference of Orthodox Medicine for Malaria Treatment in Idu, Abuja.

Mercy N. Ezeunala — 2023-05-13

The purpose of this study is to examine the preference for orthodox medicine for malaria treatment among clients attending the Institute of Human Virology center in the National Institute for Pharmaceutical Research and Development (NIPRD), Abuja. To accomplish the purpose of the study, two specific objectives and two corresponding research questions guided the study. A simple random sampling technique was employed to select respondents from the study population majorly focusing on clients who came for their routine health checkups between April and August 2022. 176 clients were randomly selected to participate in the study. Closed-ended questions were used to get accurate and useful information from the respondents. The data collected were analyzed using frequency tables. The findings of this study revealed that insecticides and mosquito nets were mainly used as malaria preventive measures. The majority of the study participants tested positive for malaria infection and among the positive cases, a higher number of them preferred the use of orthodox medicine for treatment.

The Biophysical Modelling of the Equilibrium Receptors

Janos Vincze — 2023-05-13

The receiver or the analyser’s peripheral segment, the afferent pathway which takes the excitation to the cerebral cortex and the cortical segment. The simplest equilibrium takes place then two forces of equal size and directly opposed act simultaneously. If several forces act on different directions on an object, the object can be in equilibrium only if the effect of one is cancelled by the others. The equilibrium analyser is situated in the internal ear. The receptors of the macula are stimulated mechanically by the otolithes. Their stimulation takes place in static and dynamic conditions. This way, correcting motor reaction of the position of body and head are triggered at the level of the nervous centres, in order to maintain the equilibrium for the entire duration of movement. The vestibular sense is not a proper equilibrium sense, but an important component of the mechanisms which contribute to the adjustment of equilibrium, next to the kinaesthetic, visual, tactile analysers and cerebellum. The relative change of the stimulus is proportional with the relative change of the stimulus. They found that the so-called method of amplitude estimation resulted in values with very dispersed intervals, therefore, they applied the correlation of the analyzers.

Perforation Peritonitis: Clinical Insights from a Three-Year Experience

Rohit Kumar Singh — 2023-05-13

Background: Peritonitis caused by gastrointestinal perforation is a frequent surgical emergency globally. Early detection and treatment are vital in reducing complications and death. Surgical intervention and good perioperative care improve outcomes. A clinical trial assessed the outcome of perforation peritonitis at a tertiary healthcare institute to identify factors contributing to morbidity and mortality. Materials and Methods: The study conducted at IMS, BHU, was a Prospective Observational Study for 3 years. Patients of all ages presenting with acute abdominal pain and gas under the diaphragm were enrolled. After examination through different methods, after resuscitation, Laparotomy was performed in all patients, followed by thorough peritoneal lavage. The site, size, type, and number of perforations were documented, and biopsy was taken from the edge of the perforation when necessary. Results: The study showed that duodenal ulcer perforation was the leading cause of gastrointestinal perforation, followed by appendicitis, typhoid perforation, and malignancy. Primary closure was the most common surgical procedure, followed by appendectomy, gut resection, and exteriorization. Mortality rate was , and observed morbidity included wound infection, fever, respiratory complications, residual abscess, electrolyte imbalances, burst abdomen, sepsis, cardiac complications, and anastomotic disruption. Conclusion: Gastrointestinal perforation is a common complication of acid peptic disease and typhoid. To control acid peptic disease, NSAIDs and triple therapy for H. pylori eradication can be used. Early and primary treatment for typhoid should be prioritized on a larger scale, and common practitioners should be educated to increase awareness about the disease.

Comparison of Conventional versus Molecular Methods to Identify Escherichia coli Isolated from Stool Samples

Ebidor Lawani-Luwaj — 2023-05-13

The contemporary means of identifying bacteria are mainly phenotypic tests. Nevertheless, phenotypic tests have their likely characteristic problems. Studies on bacteria isolates have progressed from cultural characterisation, serological, antibiotic resistance profiling, and molecular and genetic engineering to sequencing. This study compared traditional culture algorithms with molecular techniques to identify and characterise Escherichia coli isolated from 50 stool samples. The bacterial isolates were analysed with standard conventional methods, and the 16S rRNA gene was amplified using Polymerase Chain Reaction (PCR). Out of the 50 samples. 15(45.5%) were conventionally identified as Escherichia coli. Representative E.coIi isolates were then sequenced, and the genotypic identification showed that one of the isolates was Enterobacter cloacae, not Escherichia coli. Molecular biology techniques can avoid misidentification with the conventional method across various microorganisms.

Digital Health Inclusion: A Pilot Study of Health Services Deployment Using Communications Satellite for the Underserved in Nigeria

Lasisi Salami Lawal — 2023-05-21

Health service delivery in Nigeria is constrained by: brain drain, insufficient infrastructure and technology, poor and inadequate medical facilities and paucity of medical specialists in rural and remote regions - thus leading to a high rate of “medical tourism”. With increasing mobile phone ownership in Nigeria, mobile technology-based telemedicine has the potential to improve Nigeria’s healthcare delivery with enabling infrastructural facilities. In this paper, a pilot study that uses Nigeria’s communication satellite system for virtual Telemedicine connection between health practitioners and underserved communities using the “one2one” mobile telemedicine application is reported. This pilot study aimed to deploy Nigeria’s communication satellite system to enable virtual telemedicine connection between health practitioners and underserved communities using the “one2one” mobile telemedicine app. Successful deployment of a 1.8m VSAT dish at the pilot clinic and testing showed robust internet connectivity with a time delay of 250ms per hop. Furthermore, the One2one app was successfully installed on health practitioners’ tablets/phone and patients’ phone/tablets. Over 100 patients were treated using the one2one app connected through the satellite internet. The one2one app was highly rated by patients and healthcare providers in terms of usability with the highest score being ease of use 87%. This study shows that Nigeria’s communications satellite can be deployed to support mobile telemedicine as part of the effort to increase access to doctors and specialists in medically underserved areas of Nigeria.

AntiCOVID-19 Vaccines for Children

Giulio Tarro — 2023-05-27

Emergency use authorization of the COVID-19 vaccine to prevent coronavirus disease 2019 is reported from the Medical Letter on Drugs and Therapeutics as well as from the contradictions presented by the drug producers to FDA and CDC for the messanger RNA vaccines to be approved or authorized. According to the knowledge of the first SARS and of the MERS, the children were not exposed to the civet and to the camels as the adults. The children are infected by the virus whitout suffering a serious illness, but they are an important source of infection. There is no COVID-19 emergency among children: there is no increase in mortality. The risks of hospitalization for COVID-19 in children are very low and often concern children with other pathologies. The children’s detection of the congenital defect of the MTHFR mutation makes them hypersensitive to the vaccine for thrombotic manifestations. One myocarditis every 10.000 inoculations for young people means risking much more for the vaccine than for the virus.

Knowledge of Antimicrobial Stewardship Actions Among Out Patients at The Maitama District Hospital, Maitama, Abuja, Nigeria

Lucy O. Idoko — 2023-05-27

Background: Antimicrobial stewardship programs primarily aim identify solutions to curb antimicrobial resistance (AMR). It helps to optimize antimicrobial use to improve patient outcomes, ensure cost-effective therapy, and reduce adverse sequel of antimicrobial use (including antimicrobial resistance) among residents, hospitalized patients, the public, and agricultural professionals. This study aims to assess the knowledge of antimicrobial stewardship actions among outpatients attending Maitama General Hospital, Abuja.Nigeria Methods: This was a descriptive cross-sectional study done between June and November, 2022 among 423 outpatients using Multistage sample technique. Data was collected using interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics committee, Jos, Plateau State. Results: The level of knowledge about solutions to curb AMR (Antimicrobial stewardship) between male and female respondents showed 179 (44.75%) of female respondents had good knowledge, 28 (7.0%) had fair knowledge and 21 (5.25%) had poor knowledge. Of all the male respondents, 132 (33.0%) had good knowledge,12 ( 3.00)% had fair knowledge and 28 (7.00%) had poor knowledge. Summarily, 311 (77.75%) had good knowledge of antimicrobial stewardship, 40 (10.00%) had fair knowledge of antimicrobial stewardship and 49 (12.25%) had poor knowledge of antimicrobial stewardship. Conclusion: Majority of clients had good knowledge of antimicrobial stewardship actions, but this can be improved by planning and implementing more antimicrobial stewardship (AMS) sensitization activities in communities and among patients in the hospitals. Health care workers should have continuous professional development (CPD) training on AMS.

Knowledge of Antimicrobial Drug Resistance (AMR) Among Patients in a General Outpatient Clinic in Abuja Municipal Area Council (AMAC), Federal Capital Territory, Nigeria

Lucy O. Idoko — 2023-05-27

Background: Antimicrobial resistance (AMR) is currently prevalent and has the potential to affect everyone, of any age, in any country. In humans, animals, and the environment, antimicrobial-resistant microbes are quickly emerging and spreading. This study aims to assess the knowledge of Antimicrobial Drug Resistance (AMR) among patients in a General Outpatient Clinic in Abuja Municipal Area Council (AMAC), Federal Capital Territory, Nigeria. Methods: This was a descriptive cross-sectional study among 400 clients in district hospital done in 2022. A multistage sampling technique was adopted for this study. Data was collected using self-administered structured questionnaire and analyzed and presented as tables, proportions, and percentages using the IBM SPSS 28 (Statistical Package for the Social Sciences) computer software (IBM SPSS Inc. 2021) Ethical approval was granted by Bingham University Teaching Hospital Ethical Research Committee, Jos, Plateau State. Results: The study revealed that the knowledge of antimicrobial resistance between male and female respondents. 8.5% of female respondents had good knowledge, 20.75% had fair knowledge while 27.75% had poor knowledge. Of all the male respondents, 8.5% had good knowledge, 13% had fair knowledge and 21.5% had poor knowledge. Summarily, only 68 (17.0%) of participants had good knowledge of antimicrobial resistance, 135 (33.75%) had fair knowledge of antimicrobial resistance, while 197 (49.25%) had poor knowledge of antimicrobial resistance. Test of association between knowledge of antimicrobial resistance and Sociodemographic showed that Marital Status (χ²_{(2, N=400)} = 44.28, p < 0.045), Education (χ²_{(2, N=400)}= 123.80, p < 0.001) and Age (χ²_{(2, N=400)}= 112.95, p < 0.001) were statistically significant. Conclusion: The Federal, State, and Local governments, health care providers, and community health workers should focus on increasing awareness of AMR risk factors through health campaigns and program that will aid behavioural change.