http://www.intarchmed.com The latest research articles published by International Archives of Medicine 2012-05-04T00:00:00Z Background: Medication administration errors in patient care have been shown to be frequent and serious. Such errors are particularly prevalent in highly technical specialties such as the intensive care unit (ICU). In Ethiopia, the prevalence of medication administration errors in the ICU is notstudied.ObjectiveTo assess medication administration errors in the intensive care unit of Jimma University Specialized Hospital (JUSH), Southwest Ethiopia. Methods: Prospective observation based cross-sectional study was conducted in the ICU of JUSH from February 7 to March 24, 2011. All medication interventions administered by the nurses to all patients admitted to the ICU during the study period were included in the study. Data were collected by directly observing drug administration by the nurses supplemented with review of medication charts. Data was edited, coded and entered in to SPSS for windows version16.0. Descriptive statistics was used to measure the magnitude and type of the problem under study. Results: Prevalence of medication administration errors in the ICU of JUSH was 621 (51.8 %).Common administration errors were attributed to wrong timing (30.3 %), omission due to unavailability (29.0 %) and missed doses (18.3 %) among others. Errors associated with antibiotics took the lion's share in medication administration errors (36.7 %). Conclusion: Medication errors at the administration phase were highly prevalent in the ICU of Jimma University Specialized Hospital. Supervision to the nurses administering medications by more experienced ICU nurses or other relevant professionals in regular intervals is helpful inensuring that medication errors don't occur as frequently as observed in this study. http://www.intarchmed.com/content/5/1/15 Asrat Agalu Yemane Ayele Worku Bedada Mirkuzie Woldie International Archives of Medicine 2012, null:15 2012-05-04T00:00:00Z doi:10.1186/1755-7682-5-15 /content/figures/1755-7682-5-15-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 15 2012-05-04T00:00:00Z PDF Background: Non-communicable lifestyle diseases are a growing public health concern globally. Obesity is a risk factor for premature mortality from cardiovascular diseases and diabetes as well as all-cause mortality. The objective of the study was to estimate the prevalence and associated factors for obesity among Zambian adults in Lusaka district. Methods: A community-based study was done among adults in Zambia. Descriptive and co-relational analyses were conducted to estimate the prevalence of being obese as well as identify associated factors. Results: A total of 1,928 individuals participated in the survey, of which 33.0% were males. About half of the participants were aged 25-34 years (53.2%), and about two-thirds had attended at least secondary level of education (63.9%). Overall, 14.2% of the participants (5.1% of males, and 18.6% of females) were obese. Significant factors associated with obesity were sex, age, education, cigarette smoking and blood pressure. Male participants were 55% (AOR=0.45; 95% CI [0.29, 0.69]) less likely to be obese compared to female participants. Compared to participants who were of age 45 years or older, participants of age 25-34 years were 61% (AOR=0.39 (95% CI [0.23, 0.67]) less likely to be obese. Compared to participants who attained college or university level of education, participants who had no formal education were 63% (AOR=0.37; 95% CI [0.15, 0.91]) less likely to be obese; and participants who had attained secondary level of education were 2.22 (95% CI [1.21, 4.07]) times more likely to be obese. Participants who smoked cigarettes were 67% (AOR=0.33; 95% CI [0.12, 0.95]) less likely to be obese compared to participants who did not smoke cigarettes. Compared to participants who had severe hypertension, participants who had moderate hypertension were 3.46 (95% CI [1.34, 8.95]) times more likely to be obese. Conclusions: The findings from this study indicate that Zambian women are more at risk of being obese. Prevention and control measures are needed to address high prevalence and gender inequalities in risks for non-communicable diseases in Zambia. Such measures should include policies that support gender specific approaches for the promotion of health behavior changes. http://www.intarchmed.com/content/5/1/14 Emmanuel Rudatsikira Adamson Muula David Mulenga Seter Siziya International Archives of Medicine 2012, null:14 2012-05-02T00:00:00Z doi:10.1186/1755-7682-5-14 /content/figures/1755-7682-5-14-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 14 2012-05-02T00:00:00Z PDF Background: In 2009, there was an influenza pandemic in South Korea. The aim of this study was to evaluate the epidemiological, clinical and laboratory characteristics of this infection in children and adults. Methods: We evaluated the epidemiologic characteristics of patients infected with the 2009 H1N1 influenza A virus (4,463 patients, age range from 2 mo to 86 y), and the clinical and laboratory findings of 373 inpatients (80/217 children, ≤ 15 y, had pneumonia and 36/156 adults, > 16 y, had pneumonia) in a single hospital during the epidemic. Results: The majority of infected patients (94%) were less than 40 y, and greater than 90% of cases occurred during a two-month period. The rates of admission and pneumonia were 8.4% (373/4,463) and 2.5% (116/4,463), respectively. The rates of admission and pneumonia, total duration of fever, the frequency of underlying diseases, and the values of C-reactive protein and erythrocyte sedimentation rate tended to increase as age increased; highest rates were found in the ≥ 65 y group. Pneumonia was founded more boys than girls in children, but more female than male in adults. The adult patients with pneumonia had higher leukocyte counts with lower lymphocyte differentials than the group without pneumonia, as shown in children group. Conclusion: Our results suggest that the immunologic reaction to viral insults may be associated with age, sex and underlying diseases, and that unknown herd immunity may affect populations. The patients with underlying diseases, especially in older patients may have immunologic insufficiency that is associated with immunologic consumption by the underlying diseases. http://www.intarchmed.com/content/5/1/13 Jung-Woo Rhim Eun-Ji Go Kyung-Yil Lee You-Sook Youn Myung-Sook Kim Sun-Hee Park Ji-Chang Kim Jin-Han Kang International Archives of Medicine 2012, null:13 2012-03-26T00:00:00Z doi:10.1186/1755-7682-5-13 /content/figures/1755-7682-5-13-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 13 2012-03-26T00:00:00Z XML Background: The burden of malaria is a key challenge to both human and economic development in malaria endemic countries. The impact of malaria can be categorized from three dimensions, namely: health, social and economic. The objective of this study was to estimate the impact of malaria morbidity on gross domestic product (GDP) of Uganda. Methods: The impact of malaria morbidity on GDP of Uganda was estimated using double-log econometric model. The 1997-2003 time series macro-data used in the analysis were for 28 quarters, i.e. 7 years times 4 quarters per year. It was obtained from national and international secondary sources. Results: The slope coefficient for Malaria Index (M) was 0.00767; which indicates that when malaria morbidity increases by one unit, while holding all other explanatory variables constant, per capita GDP decreases by US$0.00767 per year. In 2003 Uganda lost US$ 49,825,003 of GDP due to malaria morbidity. Dividing the total loss of US$49.8 million by a population of 25,827,000 yields a loss in GDP of US$1.93 per person in Uganda in 2003. Conclusion: Malaria morbidity results in a substantive loss in GDP of Uganda. The high burden of malaria leads to decreased long-term economic growth, and works against poverty eradication efforts and socioeconomic development of the country. http://www.intarchmed.com/content/5/1/12 Juliet Orem Joses Kirigia Robert Azairwe Ibrahim Kasirye Oladapo Walker International Archives of Medicine 2012, null:12 2012-03-22T00:00:00Z doi:10.1186/1755-7682-5-12 /content/figures/1755-7682-5-12-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 12 2012-03-22T00:00:00Z PDF Sinus arrest rarely occurs during acute myocardial infarction involving the right coronary artery (RCA) and sinus node (SN) artery. We report a rare case of sinus arrest caused by SN artery occlusion following RCA stenting. A 56-year-old woman with a significant history of RCA stenosis with prior bare metal stenting, presented to the emergency department with anginal chest pain. Initial work up showed significant elevation of cardiac troponin T with T-wave inversion in the inferior leads on electrocardiogram (ECG). Coronary angiography revealed a 90% stenosis of midportion of the RCA, mild occlusion in the left anterior descending coronary and left circumflex coronary arteries. Stenting was performed on the RCA lesion. Immediately after undergoing those interventions, thrombosis developed and occluded SN artery. Electrocardiogram showed junctional escape rhythm without P waves at a heart rate of 30 beats per minute, suggesting sinus arrest. The clot in the SN artery was identified and thrombectomy was performed. Neither symptoms nor hypotension were identified during this arrhythmia. Six days later, normal sinus rhythm began to appear on EKG with improving heart rate, and patient still remained completely hemodynamically stable. Pre-discharge exercise stress test had shown 50% predicted heart rate without ST segment change. Sinus node dysfunction is commonly related to degenerative processes, and rarely caused by thrombosis in the SN artery. In our case, we emphasize the potential complication of sinus arrest after RCA stent implantation. http://www.intarchmed.com/content/5/1/11 Peerawut Deeprasertkul Ranjan Thakur International Archives of Medicine 2012, null:11 2012-03-20T00:00:00Z doi:10.1186/1755-7682-5-11 /content/figures/1755-7682-5-11-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 11 2012-03-20T00:00:00Z XML Background: Left ventricular non-compaction (LVNC) is a recently recognized rare disorder. Magnetic resonance imaging (MRI) may help to clarify the uncertainties related to this genetic cardiomyopathy. Despite the fact that many articles have been published concerning the use of MRI in the study of LVNC, there is a lack of data describing the disease in the North African population. The aim of our study is to clarify MRI findings of LVNC in North African patients. Methods: In our retrospective cohort, twelve patients (7 male, mean age 53 ± 8 years) underwent MRI for suspected LVNC. Correlations were investigated between the number of non-compacted segments per patient and left ventricular ejection fraction (LVEF), then between the number of non-compacted segments and left ventricular end diastolic diameter. The presence or absence of late gadolinium enhancement (LGE) was qualitatively determined for each left ventricular myocardial segment. Results: Non-compaction was more commonly observed at the apex, the anterior and the lateral walls, especially on their apical and mid-cavity segments. 83% of patients had impaired LVEF. There was no correlation between the number of non-compacted segments per patient and LVEF (r = -0.361; p = 0.263), nor between the number of non-compacted segments per patient and left ventricular end diastolic diameter (r = 0.280; p = 0.377). LGE was observed in 22 left ventricular segments. No association was found between the pattern of fibrosis and non-compaction distribution (OR = 2.2, CI [0.91-5.55], p = 0.076). Conclusion: The distribution of LVNC in North African patients does not differ from other populations. Ventricular dysfunction is independent from the number of non-compacted segments. Myocardial fibrosis is not limited to non-compacted areas but can extend to compacted segments. http://www.intarchmed.com/content/5/1/10 Amal Lachhab Nawal Doghmi Youssef Elfakir Omar Taoussi Aatef Benyass Laila Haddour Jamila Zarzur Rhizlane Cherradi Ibtissam Fellat Aicha Aouad Fedoua Ellouali Ilyas Asfalou Amin Elmajhad Mohamed Cherti International Archives of Medicine 2012, null:10 2012-03-09T00:00:00Z doi:10.1186/1755-7682-5-10 /content/figures/1755-7682-5-10-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 10 2012-03-09T00:00:00Z XML Background: Catching an object is a complex movement that involves not only programming but also effective motor coordination. Such behavior is related to the activation and recruitment of cortical regions that participates in the sensorimotor integration process. This study aimed to elucidate the cortical mechanisms involved in anticipatory actions when performing a task of catching an object in free fall. Methods: Quantitative electroencephalography (qEEG) was recorded using a 20-channel EEG system in 20 healthy right-handed participants performed the catching ball task. We used the EEG coherence analysis to investigate subdivisions of alpha (8-12 Hz) and beta (12-30 Hz) bands, which are related to cognitive processing and sensory-motor integration. Results: Notwithstanding, we found the main effects for the factor block; for alpha-1, coherence decreased from the first to sixth block, and the opposite effect occurred for alpha-2 and beta-2, with coherence increasing along the blocks. Conclusion: It was concluded that to perform successfully our task, which involved anticipatory processes (i.e. feedback mechanisms), subjects exhibited a great involvement of sensory-motor and associative areas, possibly due to organization of information to process visuospatial parameters and further catch the falling object. http://www.intarchmed.com/content/5/1/9 Farmy Silva Oscar Arias-Carrion Silmar Teixeira Bruna Velasques Caroline Peressutti Flavia Paes Luis Basile Manuel Menendez-Gonzalez Eric Murillo-Rodriguez Mauricio Cagy Roberto Piedade Antonio Nardi Sergio Machado Pedro Ribeiro International Archives of Medicine 2012, null:9 2012-02-24T00:00:00Z doi:10.1186/1755-7682-5-9 /content/figures/1755-7682-5-9-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 9 2012-02-24T00:00:00Z XML Background: Hydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecaluteínicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report.MethodDescription of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, São Paulo, from July 1994 to August 2011. Results: The cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection. Conclusion: The incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition. http://www.intarchmed.com/content/5/1/8 Jefferson Drezzet Flavia Kurobe Cecilia Nobumoto Daniela Pedroso Marcia Blake Vitor Valenti Luiz Carlos Vanderlei Fernando Adami Franciele Vanderlei Sandra Moraes Maria Auxiliadora Vertamatti Alberto Reis Renata Rossi Carlos Monteiro Luiz Carlos de Abreu International Archives of Medicine 2012, null:8 2012-02-21T00:00:00Z doi:10.1186/1755-7682-5-8 /content/figures/1755-7682-5-8-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 8 2012-02-21T00:00:00Z XML Background: The anti-TNFα therapy has been since its approval by the FDA, along with nonsteroidal antiinflammatory drugs (NSAIDs), one of the most important therapies for control of spondyloarthritis (SpA). The onset of Lupus Like Syndrome (LLS) has been described in patients with rheumatoid arthritis (RA) treated with anti-TNFα therapy but there is little literature on the occurrence of this entity in patients with SpA. Methods: We studied 57 patients with SpA who received more than 1 year of anti-TNFα therapy (infliximab, adalimumab or etanercept). Patients were analyzed for the development of LLS, in addition to measuring ANA levels ≥ 1:160 and Anti-dsDNA (measured by IIF). Results: In total, 7.01% of patients treated with anti-TNFα had titers of ANA ≥ 1:160, whereas 3.5% of patients had serum levels of dsDNA. However, only one patient (1.75%; n = 1) experienced clinical symptoms of LLS; this was a female patient with a history of psoriatic arthritis. Conclusions: The presence of LLS secondary to anti-TNFα therapy in patients with SpA is observed less frequently compared with patients with RA. LLS was only detected in a patient with a history of psoriasis since youth, who developed psoriatic arthritis after 27 years of age and had received anti-TNFα therapy for > 2 years. This may be because LLS is an entity clearly associated with innate immunity, with little central role of B and T cells. http://www.intarchmed.com/content/5/1/7 Luis Arturo Gutierrez Gonzalez Miriam Azocar Elaudi Rodriguez International Archives of Medicine 2012, null:7 2012-02-15T00:00:00Z doi:10.1186/1755-7682-5-7 /content/figures/1755-7682-5-7-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 7 2012-02-15T00:00:00Z XML Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia. http://www.intarchmed.com/content/5/1/6 Amira Hamzaoui Rim Klii Randa Salem Ines Kochteli Mondher Golli Silvia Mahjoub International Archives of Medicine 2012, null:6 2012-02-09T00:00:00Z doi:10.1186/1755-7682-5-6 /content/figures/1755-7682-5-6-toc.gif International Archives of Medicine 1755-7682 ${item.volume} 6 2012-02-09T00:00:00Z XML