الأوراق العلمية


عرضالصفحاتعنوان الورقة +الملخصر.م
من 1 ـــ الي 7
الملخص

Error in medicine is becoming a well recognized phenomenon. The U.S. Institute of Medicine's publication in 1999 included estimations that medical error is the eighth leading cause of death in the United States and results in up to 100,000 deaths annually. "These horrific cases are just the tip of the iceberg"; and an assertion of lack of previous attention, "Yet silence surrounds this issue”. Indeed, through frequent references to the well-worn phrase from the Hippocratic oath, "First, do no harm," the proponents of the medical error movement imply that eliminating errors should come "first," before anything else on our agenda. Improving patient safety begins with prompt reporting of errors followed by analysis of the root causes and contributing factors and developing a plan of action to prevent similar errors in the future. Only in this way can a health care organization assess the safety of care delivered and whether safety is improving. The mistaken attitude in healthcare that errors are solely the fault of individual practitioners has proved a major barrier to reporting. Instead of analyzing the multiple factors that contribute to errors, efforts have focused almost entirely on making providers more careful, reinforced by fear of punishment when they fail. Until the mid-1990s, this punitive attitude severely limited the reporting of errors. In fact, research shows that when the fear of punishment is removed, reporting of errors increases by as much as 10 to 20 fold. There follows a plea to the medical profession to remember its promise to "do no harm" and that "at a very minimum, the health system needs to offer that assurance and security to the public."

1
من 8 ـــ الي 10
الملخص

Breaking bad news is one of a physician's most difficult duties, yet medical education typically offers little formal preparation for this daunting task. Without proper training, the discomfort and uncertainty associated with breaking bad news may lead physicians to emotionally disengage from patients. Numerous study results show that patients generally desire frank and empathetic disclosure of a terminal diagnosis or other bad news. Focused training in communication skills to facilitate breaking bad news has been demonstrated to improve patient satisfaction and physician comfort. Physicians can build on the SPIKE protocol organised recommendations into the mnemonic SPIKES: Setting up, Perception, Invitation, Knowledge, Emotions, Strategy and summary rather simple and a useful approach. This approach is intended to help clinicians break bad news to patients in a straightforward and empathic manner.

2
من 11 ـــ الي 18
3
من 19 ـــ الي 23
الملخص

Traditionally, Subtotal Thyroidectomy (ST) has been considered the standard surgical treatment for benign thyroid disorder because of its safety compared with Total Thyroidectomy (TT). However, with the recent introduction of safe surgical technique, TT for benign thyroid disease is being performed more frequently. Pitfalls of ST include high recurrence rate and malignancy in the remnant thyroid tissue. In this study, we compare the complication rates after ST and TT. During 3 years period 214 thyroidectomies for benign thyroid disease were performed in our hospital: 51(ST), 98(TT) and 65 lobectomy. Permanent hypocalcaemia was observed in 2 cases of ST group and 3 cases of TT group (difference is not statistically significant). Permanent RLN palsy complicated in 1 case in the ST group and 2 cases in the TT group difference is not statistically significant. In the ST group 8 cases developed recurrence of primary disease for which they need to be reoperated. Histopathological examination of the resected specimens revealed incidental micro carcinoma in 10 cases. We conclude that TT for benign thyroid disease is of comparable safety to ST with the advantage that it eliminates the possibility of malignancy in the thyroid remnants or recurrence of the primary disease.

4
من 24 ـــ الي 27
الملخص

A total of 1768 stools samples were collected from random population (Mansoura, Talkha, Belqas and Aga) of Dakhalia Province of Egypt. All the stool specimens were examined by direct wet, formalin concentration and diphagic culture method for the detection of Blastocystis hominis infection. Prevalence rates of 6.95%, 9.56% and 11.71% were found by direct wet, formalin concentration and culture method respectively. A questionnaire of information about health status and other relevant informations were filled out for each one. Abdominal pain was the common complaint (35.74%) among symptomatic bastocystosis individuals. There was significant difference in the proportion of submitted specimens positive for Blastocystis between asymptomatic and symptomatic individuals (64.73% vs 35.2%, P = 0.03). The highest prevalence of this organism was in the group aged 6 to 20 years.

5
من 28 ـــ الي 36
6
من 37 ـــ الي 42
7
من 43 ـــ الي 49
الملخص

A novel approach to reversing neuromuscular blockade is sugammadex (Org 25969). It acts by rapidly encapsulating steroidal NMBDs to form a stable complex at a 1:1 ratio and thus decreasing the free concentration of the drug from the plasma. The encapsulated complex of sugammadex and NMBDs are freely filtered by the glomerulus into the urine. The dose dependency can be readily explained by the need to bind more rocuronium in plasma as blockade becomes deeper. Sugammadex could solve the problems of residual paralysis and failed intubation . in view of the potential of sugammadex to reverse even a profound NMB, and its favourable safety profile, this agent may fulfil the criteria of an ideal reversal agent for rocuronium.1

8
من 50 ـــ الي 54
9
من 55 ـــ الي 63
الملخص

A prospective study over a period from 2009 to 2013, the 97 patients involved in this study of age group from 16 to 33 years (the median patients’ age was 28.5years) , they were re underwent unilateral or bilateral varicocelectomy. The approach of surgery depends on deep inguinal ring closing test. Regarding to the results of the test the surgical approach was determined. Indication of surgery (presentation), preoperative clinical examining, semen analysis, early postoperative examination of all cases to exclude technical failure.

10
من 64 ـــ الي 71
الملخص

Cerebrovascular disease is a major contributor to later-life dementia, accounting for up to 20% of cases of dementia. Atherosclerotic and arteriolosclerotic mechanisms account for most of the burden of disease. Cerebrovascular disease may take several forms. Macrovascular disease in the form of large vessel and larger arteriole infarcts produce a wide spectrum of clinical syndromes. Single strategic infarctions, multiple bilateral infarctions and multiple lacunar infarctions can lead to cognitive dysfunction that spans a large range of both severity and type of cognitive deficits. Microvascular disease almost certainly plays a role in the pathogenesis of dementia. Small vessel disease, which is not evident radiographically, often coexists with macrovascular disease and also with Alzheimer’s disease. Amyloid angiopathy is relevant in cognitive disorders in the elderly and causes microhaemorrhages and large haemorrhages. Other much less common aetiologies include vasculitides and CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy). Neuroimaging plays a critical role in the diagnosis of vascular dementia. There is no framework for rating the extent of cerebrovascular pathology that is validated against increasing cognitive impairment. Although advances in imaging have increased our recognition of cerebrovascular disease in the elderly, vascular dementia is still inadequately recognized in clinical practice.

11
من 72 ـــ الي 78
الملخص

Few studies have been looked at the status of leptin in renal diseases especially about nephrotic syndrome.

12
من 79 ـــ الي 81
الملخص

not found

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