Hilal Al Shamsi, Abdullah Al Mutairi, Sulaiman Al Mashrafi,
52912 Views
Objectives: Language barriers pose challenges in terms of achieving high levels of satisfaction among medical professionals and patients, providing high- quality healthcare and maintaining patient safety. To address these challenges, many larger healthcare institutions offer interpreter services to improve healthcare access, patient satisfaction, and communication. However, these services increase the cost and duration of treatment. The purpose of this review is to investigate the impact of language barriers on healthcare and to suggest solutions to address the challenges. Methods: We identified published studies on the implications of language barriers in healthcare using two databases: PubMed and Medline. We included 14 studies that met the selection criteria. These studies were conducted in various countries, both developed and developing, though most came from the US. The 14 studies included 300 918 total participants, with participation in each study ranging from 21 to 22 353 people. Results: We found that language barriers in healthcare lead to miscommunication between the medical professional and patient, reducing both parties’ satisfaction and decreasing the quality of healthcare delivery and patient safety. In addition, the review found that interpreter services contribute indirectly to increased cost and the length of treatment visits. One study reported the implementation of online translation tools such as Google Translate and MediBabble in hospitals, which increased the satisfaction of both medical providers and patients (to 92%) and improved the quality of healthcare delivery and patient safety. Language barriers are responsible for reducing the satisfaction of medical providers and patients, as well as the quality of healthcare delivery and patient safety. Many healthcare institutions use interpreter services that increase the cost and length of treatment visits. Conclusions: The results of our review suggest that implementing online translation tools such as Google Translate and MediBabble may improve the quality of healthcare and the level of satisfaction among both medical providers and patients.
Keywords: Communication Barriers; Patient Satisfaction; Limited English Proficiency; Quality
of Health Care.
Abdulfatai B. Olokoba, Olusegun A. Obateru, Lateefat B. Olokoba,
49685 Views
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Type 2 Diabetes Mellitus: A Review of Current Trends
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Abdulfatai B. Olokoba,1* Olusegun A. Obateru,2 Lateefat B. Olokoba3
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DOI 10.5001/omj.2012.68 |
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1Division of Gastroenterology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria. 2Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria. 3Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Nigeria. Received: 10 Mar 2012 Accepted: 08 May 2012 *Address correspondence and reprints request to: Abdulfatai B. Olokoba, Division of Gastroenterology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria. E-mail: drabolokoba@yahoo.com |
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Abstract
Type 2 diabetes mellitus (DM) is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO) and American Diabetes Association (ADA) criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.
Keywords: Type 2 diabetes mellitus; Diagnosis; Management; Newer drugs.
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Abdulaziz Al-Sawai,
44859 Views
Rashid Al-Abri, Amina Al-Balushi ,
32424 Views
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Patient Satisfaction Survey as a Tool Towards Quality Improvement
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Rashid Al-Abri* and Amina Al-Balushi
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DOI 10.5001/omj.2014.02 |
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ENT Division, Surgery Department, Sultan Qaboos University Hospital, Sultanate of Oman. Received: 30 Aug 2013 Accepted: 23 Oct 2013 *Address correspondence and reprints request to: Rashid Al-Abri, ENT Division, Surgery Department, Sultan Qaboos University Hospital, Sultanate of Oman. E-mail: ralabri@gmail.com |
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Abstract
Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there are very few published studies reporting of the improvements resulting from feedback information of patient satisfaction surveys, and in most cases, these studies are contradictory in their findings. This article investigates in-depth a number of research studies that critically discuss the relationship of dependent and independent influential attributes towards overall patient satisfaction in addition to its impact on the quality improvement process of healthcare organizations.
Keywords: Patient satisfaction; Quality improvement; Healthcare.
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Beena Jimmy, Jimmy Jose,
27105 Views
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Patient Medication Adherence: Measures in Daily Practice
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Beena Jimmy, Jimmy Jose*
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DOI 10.5001/omj.2011.38 |
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Department of Pharmacy, Practice School of Pharmacy, College of Pharmacy and Nursing, University of Nizwa, Birkat Al Mouz, Nizwa-616, Sultanate of Oman Received: 03 Feb 2011 Accepted: 09 Apr 2011 *Address correspondence and reprints request to: Dr. Jimmy Jose, Department of Pharmacy, Practice School of Pharmacy, College of Pharmacy and Nursing, University of Nizwa, Birkat Al Mouz, Nizwa-616, Sultanate of Oman. E-mail: jimmy_jose2001@yahoo.com, jimmy.jose@unizwa.edu.om
Abstract
Adherence to therapies is a primary determinant of treatment success. Failure to adherence is a serious problem which not only affects the patient but also the health care system. Medication non adherence in patients leads to substantial worsening of disease, death and increased health care costs. A variety of factors are likely to affect adherence. Barriers to adherence could be addressed as patient, provider and health system factors, with interactions among them. Identifying specific barriers for each patient and adopting suitable techniques to overcome them will be necessary to improve medication adherence. Health care professionals such as physicians, pharmacists and nurses have significant role in their daily practice to improve patient medication adherence.
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Ajay Krishnan, Sumit Kar,
26806 Views
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Scrotal Dermatitis - Can we Consider it as a Separate Entity?
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Ajay Krishnan* and Sumit Kar
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DOI 10.5001/omj.2013.91 |
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Department of Dermatology, Venereology and Leprosy, MGIMS, Sewagram, Wardha, Maharashtra-442012, India. Received: 22 Jun 2013 Accepted: 16 Aug 2013 *Address correspondence and reprints request to: Ajay Krishnan, Department of Dermatology, Venereology and Leprosy, MGIMS, Sewagram, Wardha, Maharashtra-442012, India. E-mail: akof2k@yahoo.com |
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Abstract
Scrotal dermatitis is a very common condition that has been easily overlooked by most dermatologists and treating physicians. The condition is easily mistaken for the common skin disorders affecting the area, like fungal infections. Scrotal dermatitis is not considered a separate disease entity and is usually considered a condition similar to the contact dermatitis occurring elsewhere. This article attempts to classify the condition as a separate disease entity and explains the various etiological factors and the pathogenesis of the condition. The various stages of the condition are also explained in detail. Newer treatment modalities like the use of narrow band UVB for the management of scrotal dermatitis is also highlighted in this article.
Keywords: Dermatitis; Scrotum; Narrow band.
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Rabia Bushra, Nousheen Aslam, Arshad Yar Khan,
24131 Views
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Food-Drug Interactions |
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Rabia Bushra,1 Nousheen Aslam,1 Arshad Yar Khan2 |
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DOI 10.5001/omj.2011.21 |
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From 1Department of Pharmacy, College of Pharmacy, Ziauddin college of Pharmacy, Ziauddin University, Karachi, Pakistan; 2Department of Chemistry University of Karachi, Pakistan. Received: 17 Oct 2010Accepted: 09 Dec 2010 Address correspondence and reprints request to: Ms. Rabia Bushra, Department of Pharmacy, College of Pharmacy, Ziauddin college of Pharmacy, Ziauddin University, Karachi, Pakistan. E-mail: rabia_pharmacist@hotmail.com
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Abstract
The effect of drug on a person may be different than expected because that drug interacts with another drug the person is taking (drug-drug interaction), food, beverages, dietary supplements the person is consuming (drug-nutrient/food interaction) or another disease the person has (drug-disease interaction). A drug interaction is a situation in which a substance affects the activity of a drug, i.e. the effects are increased or decreased, or they produce a new effect that neither produces on its own. These interactions may occur out of accidental misuse or due to lack of knowledge about the active ingredients involved in the relevant substances. Regarding food-drug interactions physicians and pharmacists recognize that some foods and drugs, when taken simultaneously, can alter the body's ability to utilize a particular food or drug, or cause serious side effects. Clinically significant drug interactions, which pose potential harm to the patient, may result from changes in pharmaceutical, pharmacokinetic, or pharmacodynamic properties. Some may be taken advantage of, to the benefit of patients, but more commonly drug interactions result in adverse drug events. Therefore it is advisable for patients to follow the physician and doctors instructions to obtain maximum benefits with least fooddrug interactions. The literature survey was conducted by extracting data from different review and original articles on general or specific drug interactions with food. This review gives information about various interactions between different foods and drugs and will help physicians and pharmacists prescribe drugs cautiously with only suitable food supplement to get maximum benefit for the patient.
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Athar Abdul Samad Majeed, Mea`ad Kadhum Hassan,
18559 Views
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Risk Factors for Type 1 Diabetes Mellitus among Children and Adolescents in Basrah
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Athar Abdul Samad Majeed1, Mea`ad Kadhum Hassan2*
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DOI 10.5001/omj.2011.46 |
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1Basrah Maternity and Children Hospital 2Department of Pediatrics College of Medicine, University of Basrah Received: 07 Jan 2011 Accepted: 15 Mar 2011 *Address correspondence and reprints request to: Mea`ad Kadhum Hassan, Department of Pediatrics, College of Medicine, University of Basrah. E-mail: drmk_hassan@yahoo.com
Abstract
Objectives: Environmental factors play an important role in the pathogenesis of type 1 diabetes mellitus, many of these factors have been uncovered despite much research. A case-control study was carried out to determine the potential maternal, neonatal and early childhood risk factors for type 1 diabetes mellitus in children and adolescents in Basrah.
Methods: A total of 96 diabetic patients who have been admitted to the pediatric wards at 3 main hospitals in Basrah, and those who have visited primary health care centers over the period from the 4th of November 2006 to the end of May 2007 were recruited. In addition, 299 non-diabetic children were included, their age ranged from 18 months to 17 years.
Results: Family history of type 1 diabetes mellitus and thyroid diseases in first and second degree relatives was found to be an independent risk factor for type 1 diabetes mellitus, (p<0.001). Regarding maternal habits and illnesses during pregnancy, the study has revealed that tea drinking during pregnancy is a risk factor for type 1 diabetes mellitus in their offspring, (p<0.05). In addition, maternal pre-eclampsia and infections were found to be significant risk factor for type 1 diabetes mellitus, (p<0.001). Neonatal infections, eczema and rhinitis during infancy were also significantly associated with development of type 1 diabetes mellitus. Moreover, the results revealed that duration of <6 months breast feeding is an important trigger of type 1 diabetes mellitus.
Conclusion: Exposure to environmental risk factors during pregnancy (tea drinking, pre-eclampsia, and infectious diseases), neonatal period (respiratory distress, jaundice and infections) and early infancy are thought to play an important role in triggering the immune process leading to B-cell destruction and the development of type 1 diabetes mellitus.
Keywords: Type 1 Diabetes Mellitus; Risk factors; Children; Adolescents.
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Shibani Shetty, Gokul S.,
17713 Views
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Keratinization and its Disorders
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Shibani Shetty,1 Gokul S.2
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DOI 10.5001/omj.2012.90 |
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1Senior Lecturer, Dept. of Oral Pathology and Microbiology, M. R AmbedkarDental College and hospital, Bangalore- 560005Karnataka, India2Lecturer, Dept. of Oral Pathology and Microbiology, YMT Dental College andHospital, Institutional area, Sector-4, Kharghar, Navi Mumbai-410210, India..
Received: 03 May 2012 Accepted: 08 July 2012 *Address correspondence and reprints request to: Gokul S. Lecturer, Dept. of Oral Pathology and Microbiology, YMT Dental College andHospital, Institutional area, Sector-4, Kharghar, Navi Mumbai-410210, India.E-mail: drgokuls@gmail.com |
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Abstract
Keratins are a diverse group of structural proteins that form thei ntermediate filament network responsible for maintaining the structural integrity of keratinocytes. In humans, there are around 30 keratin families divided into two groups, namely, acidic and basic keratins, which are arranged in pairs. They are expressed in a highly specific pattern related to the epithelial type and stage of cellular differentiation. A total of 54 functional genes exist which codes for these keratin families. The expression of specific keratin genes is regulated by the differentiation of epithelial cells within the stratifying squamous epithelium. Mutations in most of these genes are now associated with specific tissue fragility disorders which may manifest both in skin and mucosa depending on the expression pattern. The keratins and keratin-associated proteins are useful as differentiation markers because their expression is both region specific and differentiation specific. Antibodies to keratin are considered as important tissue differentiation markers and therefore are an integral aid in diagnostic pathology. The present review discusses the structure of keratin, the various types of keratin and their distribution and the disorders associated with keratinization with special emphasis on the disorders of the oralcavity. A brief note on the clinical significance of keratin is also mentioned.
Keywords: Keratinization; Keratins; Distribution; Keratinization disorders; Keratin antibodies.
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Sudhir M. Naik, Sarika S. Naik,
17327 Views
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Tonsillo-Styloidectomy for Eagle’s Syndrome: A Review of 15 Cases in KVG Medical College Sullia |
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Sudhir M. Naik,1 Sarika S. Naik2 |
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DOI 10.5001/omj.2011.30 |
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From the 1Department of ENT, Head and Neck Surgery KVG Medical College, Sullia, India; 2Department of Anesthesia KVG Medical College, Sullia, India. Received: 13 Dec 2010 Accepted: 24 Jan 2011 Address correspondence and reprints request to: Dr. Sudhir M Naik, Department of ENT, Head and Neck Surgery KVG Medical College, Sullia, India. E-mail: sud223@gmail.com
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Abstract
Elongated styloid process causing Eagle's Syndrome is a rare clinical entity and the diagnosis is often difficult as a result of its vague symptomatology. However, palpation of tonsillar fossa with radiological demonstration of the elongated styloid process confirms the diagnosis. This is a report of a retrospective study conducted at the KVG Medical College, Hospital, Sullia, Karnataka, India where 15 patients who were surgically treated for Eagle’s syndrome in the ENT department were retrospectively studied. Fourteen patients became symptom free after surgery within three months of follow up. Tonsillo-styloidectomy is the treatment of choice for Eagle’s syndrome with a high success rate.
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Firdous Jahan, Kashmira Nanji, Waris Qidwai, Rizwan Qasim,
17304 Views
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Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management
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Firdous Jahan,1 Kashmira Nanji,2 Waris Qidwai,2 Rizwan Qasim1
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DOI 10.5001/omj.2012.44 |
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1Family Medicine Department, Oman Medical College, Sohar, Sultanate of Oman.2Family vMedicine Dept. Stadium Road Aga Khan University Hospital, Karachi, Pakistan. Received: 15 Feb 2012 Accepted: 28 Apr 2012 *Address correspondence and reprints request to: Dr. Firdous Jah, Family Medicine Department, Oman Medical College, Sohar, Sultanate of Oman. E-mail: Firdous@omc.edu.om |
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Abstract
Fibromyalgia Syndrome (FMS) is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. It is also characterized by restless sleep, tiredness, fatigue, anxiety, depression, and disturbances in bowel functions. The etiology of fibromyalgia remains unknown, but recent advances and discoveries have helped to unravel some of the mysteries of this disease. Research highlights some of the biochemical, metabolic, and immunoregulatory abnormalities associated with fibromyalgia. Management of FMS at the present time is very difficult as it has multiple etiological factors and psychological predispositions; however, a patient centered approach is essential to handle this problem.
Keywords: Fibromyalgia; Clinical features; Quality of life; Pathophysiology and management of fibromyalgia.
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Leo F. Tauro, Geover J. Lobo, Hilda Fernandes, Celine George, P. Sathyamoorthy Aithala, Divakar Shenoy, Prathvi Shetty,
17066 Views
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A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules |
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Leo F. Tauro,1 Geover J. Lobo,1 Hilda Fernandes,2 Celine George,1 P. Sathyamoorthy Aithala,1 Divakar Shenoy,1 Prathvi Shetty1 |
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DOI 10.5001/omj.2012.31 |
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1Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore-2, Karnataka. India.2Department of Pathology, Fr. Muller Medical College Hospital, Kankanady, Mangalore-2, Karnataka. India. Received: 24 Nov 2011Accepted: 18 Jan 2012 Address correspondence and reprints request to: Leo F. Tauro, Professor, Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore-2, Karnataka. India.E-mail: drlftauro@rediffmail.com |
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Abstract
Objectives: Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis.
Methods: This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases).
Results: The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia.
Conclusion: The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC.
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Adamu Ahmed, Garba Stephen, Yahaya Ukwenya,
16670 Views
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Spontaneous Rupture of Umbilical Hernia in Pregnancy: A Case Report
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Adamu Ahmed, Garba Stephen, Yahaya Ukwenya
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DOI 10.5001/omj.2011.70 |
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Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Received: 18 May 2011 Accepted: 07 Jul 2011 *Address correspondence and reprints request to: Dr. Adamu Ahmed, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Email: mrahmed1010@yahoo.com |
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Abstract
A 28 year old woman presented with a spontaneous rupture of an umbilical hernia in her seventh month of pregnancy. She had four previous unsupervised normal deliveries. There was no history of trauma or application of herbal medicine on the hernia. The hernia sac ruptured at the inferior surface where it was attached to the ulcerated and damaged overlying skin. There was a gangrenous eviscerated small bowel. The patient was resuscitated and the gangrenous small bowel was resected and end to end anastomosis done. The hernia sac was excised and the 12 cm defect repaired. Six weeks later, she had spontaneous vaginal delivery of a live baby. We advocate that large umbilical hernias should be routinely repaired when seen in women of child bearing age.
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P. Vasanthakumar, Pramod Kumar, Mohandas Rao,
16473 Views
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Anthropometric Analysis of Palpebral Fissure Dimensions and its Position in South Indian Ethnic Adults
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P. Vasanthakumar,1 Pramod Kumar,2 Mohandas Rao1
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DOI 10.5001/omj.2013.06 |
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1Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), International Centre for Health Sciences, Manipal University, Madhav Nagar, Manipal-576104, Karnataka State, India.2Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal University, Madhav Nagar, Manipal-576104,Karnataka State,India. Received: 29 Sep 2012 Accepted: 08 Dec 2012 *Address correspondence and reprints request to: P. Vasanthakumar, Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), International Centre for Health Sciences, Manipal University, Madhav Nagar, Manipal-576104, Karnataka State, India.E-mail: vasan_ana@yahoo.co.in |
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Abstract
Objectives: The morphology and anatomical relationship of periorbital features vary according to age, sex and ethnicity. Standard database regarding periorbital region is available for other ethnic groups. Since there is no data available in the literature, specifically for south Indian ethnic adults, the present study was carried out to determine the normal average values for South Indian ethnic population related to gender.
Methods: Anthropometric measurements of both eyes were done on standardized frontal view photograph of 200 South Indian ethnic adults aged 18 to 26 years. Parameters included were palpebral fissure width (PFW), palpebral fissure height (PFH), palpebral fissure inclination (PFI), outercanthal distance (OCD), interpupillary distance (IPD), intercanthal distance (ICD) and comparisons were made between the genders using the independent t test.
Results: Significant sexual dimorphism was noted in the given parameters. Palpebral fissure width (male: 31.08 mm; female: 29.90 mm), palpebral fissure inclination (male: 5.053°; female: 6.102°), outercanthal distance (male: 95.55 mm; female: 92.44 mm) and interpupillary distance (male: 66.72 mm; female: 62.59 mm). The palpebral fissure height (male: 11.30 mm; female: 11.58 mm) and intercanthal distance (male: 34.27 mm; female: 33.41 mm) showed no significant sexual differences.
Conclusion: Statistically significant differences were found between South Indian ethnic males and female in certain key parameters. The present study suggests that ethnicity and gender should be considered in orbital surgery. To individualize the treatment planning and diagnosis, it is important for the surgeons to have knowledge of these local norms.
Keywords: Aesthetics; Anthropometry; Database; Orbital; Palpebral fissure.
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Roshina A. Khan,
16181 Views
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Peri-mortem Cesarean Delivery... A Reality not Fiction
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Roshina A. Khan
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doi:10.5001/omj.2010.98
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ABSTRACT
Antepartum hemorrhage is one of the leading causes of mortality around the world. It can result in hypovolemic shock leading to circulatory arrest during pregnancy. A well planned strategy is required for its management in all hospitals. To deliver a woman in this situation is a dilemma which needs very prompt decision and a swift speedy action. Not only the woman’s life is in danger, the fetus is also at risk and urgent delivery may be life saving for both mother and the fetus. All obstetricians should be trained to deal with such situation with full understanding and awareness of the condition.
From the Department of Obstetrics and Gynecology, Ibri Regional Referral Hospital, Ibri, Sultanate of Oman.
Received: 17 Jul 2010
Accepted: 21 Aug 2010
Address correspondence and reprint request to: Dr. Roshina A. Khan, Department of Obstetrics and Gynecology, Ibri Regional Referral Hospital, Ibri, Sultanate of Oman.
Email: roshinak@hotmail.com; tipuu@omantel.net.om
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