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Teikyo Medical Journal


Journal ID : TMJ-29-09-2021-10670
Total View : 533

Title : Prescribing Pattern of Drugs with QT Prolongation Potential in Thai Geriatric Population

Abstract :

Medication is one of the causes of QT prolongation, which is generally asymptomatic but can lead to fatal ventricular tachycardia/ fibrillation (VT/ VF), especially in the elderly. This study aimed to evaluate the prescribing patterns in the elderly with the risk of QT prolongation. A retrospective database study was conducted to reveal the prescribing patterns in ambulatory patients older than 65 years from 34 tertiary care hospitals in 2019. We found 3,569,139 prescriptions during the study period. 33.6% of them contained at least one drug with QT prolongation potential. The maximum number of drugs with QT prolongation potential found per prescription was 7. Omeprazole (15.63 %), furosemide (5.36%), and tramadol (3.57%) were the most frequently prescribed drugs with QT prolongation potential. The most frequently found drug interaction with the potential for QT prolongation was trazodone – fluoxetine. In addition, cardiovascular and antidiabetic drugs were the common concurrent medications found in this study, indicating that cardiovascular diseases and diabetes were the common risk factors for QT prolongation in the Thai elderly. Pharmacovigilance for the use of proton-pump inhibitors, diuretics, or the combination of antipsychotics and antidepressants on the risk of QT prolongation-related adverse events should be performed.

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Journal ID : TMJ-28-09-2021-10669
Total View : 323

Title : Assessment of the perioperative Global Quality of Life of the surgical management pattern of small bowel vascular gangrene; A prospective research study

Abstract :

In patients with Critical conditions of intestinal gangrene, an exploratory laparotomy should be performed immediately. After removing the affected segment, the remaining portion would either be anastomosed or diverted as a stoma. few studies have investigated the psychosocial effects and the Global Quality of Life after the surgical treatment for intestinal vascular gangrene (anastomosis versus stoma) and the subsequent events. In this study, perioperative outcomes of psychosocial issues were evaluated in relation to the surgical treatment of mesenteric vascular gangrene patients. Two hundred patients subjected to emergency surgical laparotomy due to mesenteric vascular gangrene were randomly divided into two groups with one hundred patients of anastomosis group and the other group of one hundred patients who had a diverting stoma. A comparative evaluation was established between the two groups using the global quality of life as a primary endpoint of the study. There was a significant difference in the quality of life between the anastomotic group and the stoma group. The global quality of life of stoma patients significantly improved after closure, (p < 0.001). The ileostomy appeared to be a safer procedure to perform in mesenteric vascular occlusion as regard morbidity and mortality rates but need strict nutritional, psychological and special home care to enhance the quality of life. On other hand, there is a higher mortality risk for the anastomosis group, particularly after a leak, but experienced a better global quality of life with uncomplicated anastomosis. The critical decision for the surgeon after resection of infarcted bowel either to do stoma or anastomosis should consider the long- term impact on patient life quality and psychological status.

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Journal ID : TMJ-27-09-2021-10668
Total View : 434

Title : Shear Bond Strength of Three Different Types of Zirconia to Resin Composite Using Experimental Surface Treatment Methods: An in Vitro Study

Abstract :

To investigate the effect of silica abrasion, hot silica abrasion, e-max particles abrasion, and alumina abrasion on shear bond strength of resin cement to three different types of zirconia (Opaque, High translucency, and Ultra translucency). The study was divided into 3 groups according to zirconia type (n=60) Opaque zirconia (O), High translucent zirconia (H), and Ultra translucent zirconia (U). Each group was further divided into 6 subgroups according to surface treatment used (n=10): Silica Particle Abrasion (S), e.max Particle Abrasion (E), Pre-sintering e.max Particle Abrasion (PE), Pre-sintering Silica Particle Abrasion (PS), Hot silica particle Abrasion (H), and Alumina Particle Abrasion (A). Composite cylinder shaped 1cm length, 5 mm in diameter were fabricated to house resin composite discoid, the composite cylinder was cemented centrally to the zirconia cubes with light cure under 5kg weight for 6 mins. The shear bond strength of the specimens was measured utilizing a universal testing machine at a crosshead speed of 0.5 mm/min. Failure loads were recorded in Newton. SBS was calculated according to the following equation: SBS (MPa) = load (N)/area (mm2) through one-way ANOVA. Highest SBS values were that of Alumina Particle abrasion (A) subgroups of (15 ∓2.1, 14.2 ∓2.5 and 13∓2.3) min Ultra-translucency, Opaque and High-translucency respectively. While the lowest was the Silica Particle abrasion (S) subgroup of (2.5∓0.6, 2.5∓0.6, and 2.7∓0.9) min Opaque, High- translucency, and Ultra-translucency respectively. Alumina Particle abrasion (A) with prime showed higher SBS values than other abrasion surface treatments.

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Journal ID : TMJ-26-09-2021-10667
Total View : 424

Title : An optimized management outcome of a challenging late intervention of pancreatic neck transection; a case report and mini-review

Abstract :

The high-grade pancreatic injury including pancreatic transection is a challenging issue in management carrying high morbidity and mortality because of the associated injuries and pancreas-specific morbidity. The late surgical intervention till a week after the accident would be highly challenging carrying a higher probability of morbidity and mortality. There is no consensus on which management strategies result in the most favorable outcomes. Herein, we will present this case report of pancreatic transection with late intervention who had an optimized approach of management to reach the best outcome. Pancreatic fracture in a 23-year-old car crash victim who had a late surgical intervention after one week of the accident. The patient had been optimized in a well-balanced approach of diagnosis and treatment till he passed with no residual complication till 2-year follow- up. The updated guidelines in conjunction with the teamwork helped us in the clinical management of this case report, and although they weren't used to replace clinical judgment, they were extremely useful for decision-making. There are higher attributable morbidity and mortality rates for injuries involving the pancreatic duct, as well as the potential for deterioration if treatment is delayed, and literature supports resection in these cases. Repetition of CT or its combination with Cholangiopancreatography (endoscopic or magnetic resonance) may be needed to make a diagnosis of ductal injury. The use of ERCP is also recommended for the purpose of diagnostic confirmation, biliary and pancreatic drainage and stenting, and intraoperative guide for pancreatic duct identification and control. The enteral access is very beneficial for the patient support in such cases.

Full article
Journal ID : TMJ-26-09-2021-10666
Total View : 434

Title : Community Health Center Worker Perspectives on Stunting Risk Factors and Challenge of Stunting Prevention Program: A Qualitative Study

Abstract :

The prevalence of stunting in lower and middle-income countries is relatively high especially in Indonesia which accounted for 27.5% of total children in 2019. In response to this, the government instituted stunting prevention program nationally, which includes supplementation of iron for high school female students and pregnant women, complementary feeding for young children, Integrated Health Service for children (Posyandu), and workshop and counseling of feeding practice for parents and health cadres. However, among many programs, evaluation on which programs succeed and what challenges are behind them rarely exists. The purpose of this study is to determine the factors associated with stunting and the effectiveness of the government-run stunting prevention program. The study used a qualitative approach with an in- depth interview method to explore the experience of health professionals in 10 Community Health Centers regarding the challenge of the stunting prevention program and the phenomenon of factors linked to stunting. Factors associated with stunting were low economic level, low education level, poor feeding practice, low birth weight, genetic disorder, infection, and poor sanitation. Challenges to the program included minimal effectiveness of supplementation of iron, invalid measurement, lack of monitoring and evaluation, and lack of sectoral collaboration. To prevent stunting, collaboration between various sectors and awareness and knowledge of stunting among parents and health cadres are needed.

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