EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063) http://ephjournal.com/index.php/mhs <p><strong><span id="cell-4-name" class="gridCellContainer"><span class="label">EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063) </span></span></strong> publishes a wide range of high quality research articles in the field (but not limited to) given below: Psychiatric and mental health nursing, Learning disability nursing, Pediatric nursing, Geriatric nursing, Nursing of people in acute care and long term care institutional settings, Home health nursing, Community and Home care, Critical and emergency care etc. <br><span style="font-size: 1.5em;"><strong> <span style="text-shadow: #ff6600 0px 0px 3px;">Current Impact Factor: 2.475</span></strong></span></p> en-US <ul> <li>All contributor(s) agree to transfer the copyright of this article to <strong>EPH Journal.</strong></li> <li><strong>EPH Journal</strong> will have all the rights to distribute, share, sell, modify this research article with proper reference of the contributors.&nbsp;</li> <li><strong>EPH Journal</strong> will have the right to edit or completely remove the published article on any misconduct happening.</li> </ul> editor@ephjournal.com (Naeem Akhtar) info@ephjournal.com (Naveen Malik) Wed, 28 Feb 2018 13:34:11 +0000 OJS http://blogs.law.harvard.edu/tech/rss 60 The Association between Central Obesity and Peak Expiratory Flow Rate (PEFR) in Elderly at Pedawa Village, Buleleng, Bali, Indonesia http://ephjournal.com/index.php/mhs/article/view/487 <p><strong>Objective. </strong>To determine the association between central obesity and peak expiratory flow rate (PEFR).</p> <p><strong>Methods.</strong> A cross-sectional analytical study was carried out in Pedawa village, Buleleng District, Bali Province, Indonesia, on August 13, 2016. A total of 117 elderly subjects above 60 years old were included in the study to assess the association between central obesity and PEFR, but only 90 subjects met the inclusion criteria of this study.</p> <p><strong>Results.</strong> Regardless of sex, using backward multiple regression analysis, fat has a negative correlation (β = -0.376) against PEFR while the visceral fat (β = 0.440) and height (β = 0.274) were positively correlated. Specifically in elderly with underweight and normal BMI, variables that were positively correlated with PEFR on multivariate analysis including visceral fat (β = 0.450) and height (β = 0.315), while fat had a negative correlation (β = -0.309). In elderly with overweight and obesity BMI, fat was the only variable that significantly correlated with PEFR on bivariate analysis (r = - 0.723, p =&nbsp; 0.004), and no other variables were eligible for inclusion in the multivariate analysis.</p> <p><strong>Conclusions.</strong> This study found that, the percentage of visceral fat had a positive correlation with PEFR in the elderly with underweight and normal BMI, while the percentage of fat had a negative correlation with PEFR in the elderly with overweight and obesity BMI. This study didn’t find any association between waist circumference and PEFR.</p> IGPS Aryana MD, KAW Nugraha MD, AAGORK Putra MD, IAJD Kusumawardani MD, RAT Kuswardhani MD, N Astika MD, IB Putrawan MD, R Purnami MD, IGNB Artana MD, IBN Rai MD ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 http://ephjournal.com/index.php/mhs/article/view/487 Wed, 28 Feb 2018 09:38:12 +0000 Impact of Bladder Distension on Organs at Risk in 3D Intracavitary Brachytherapy for Cervical Cancer http://ephjournal.com/index.php/mhs/article/view/490 <p>Objectives:</p> <p>To determine the effects of bladder distension on organs at risk (OAR) during ICBT for cervical cancer with 3D Imaging based Planning.</p> <p>&nbsp;MATERIALS AND METHODS:</p> <p>Twenty-eight patients with cervical cancer who received high-dose radiation (HDR) brachytherapy using 7Gy x 4 fractions, were included in the study. For three-dimensional (3D) analysis, pelvic CT scans were obtained with indwelling catheters in place (defined as empty bladder) and repeated scans with 200-cc of sterile water in their bladders (defined as full bladder). To compare the International Commission on Radiation Units and Measurements (ICRU) point doses with 3D-volume doses, the volume dose was defined by using two different criteria, D2cc (the minimum dose value in a 2.0-cm<sup>3</sup> volume receiving the highest dose) and D50% (the dose received by 50% of the volume of the OAR) for OARs.</p> <p>&nbsp;RESULTS:</p> <p>For patients with a full bladder, the mean bladder D2cc increased from 395 to 558.4 cGy (41%, p &lt; 0.001). However, the bowel D2cc and sigmoid colon D2cc decreased from 477.4 to 216.1 cGy (55.0%, p &lt; 0.001) and 450.8 to 350.8 cGy (22%, p= 0.001), respectively. The mean D50% values of both the bladder and the bowel decreased from 301.6 to 227.3 cGy (25%, p &lt; 0.001) and from 116.5 to 74.3 cGy (36%, p &lt; 0.001) with a full bladder, respectively.</p> <p>The mean D50% for sigmoid colon also decreased from 148 cGy to 119.3 cGy (19%, p&lt; 0.001) with bladder distension. However, there was no significant difference in rectal D2cc and D50% values.</p> <p>&nbsp;CONCLUSION:</p> <p>Full bladder technique reduces sigmoid colon and bowel wall radiation exposure. The bladder gets a higher point dose and rectum remains unaffected.</p> MUHAMMAD ALI, Hooryia Bajwa Bajwa, Bilal Muhammad Muhammad, K Rehman Rehman, I Niazi Niazi, I Haider Haider, A Masood Masood ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 http://ephjournal.com/index.php/mhs/article/view/490 Wed, 28 Feb 2018 09:39:19 +0000 Hematological and cytogenetic factors modulating the severity of the Sickle-cell disease at the University Hospital Sourô Sanou http://ephjournal.com/index.php/mhs/article/view/520 <p><strong>Introduction</strong><br>Sickle cell disease is a monogenic disease with variables clinicals manifestations and various complications. This variability is related to the phenotype, the intracellular hemoglobin concentration, the importance of fetal hemoglobin, the quality of the Therapeutic outlet, and association with others pathologies: membrane abnormalities, G6PD’s deficiency, Gilbert ‘s disease etc. ...it is a prospective study of twelve major sickle cell disease affected children on hematological and genetic factors modulating the severity of their illness.<br>Materials and Methods&nbsp;</p> <p>Twelve major sickle cell disease affected children were included in this study. The following tests were made for each of them: -A full blood count with manual blood smears reading.<br>-Identification of their beta's Haplotypes by RFLP followed by PCR.<br>-A search of the mutation of the sixth codon of the beta gene and a search of rearrangements of alpha locus were executed.<br>The most common factors influencing the synthesis of fetal hemoglobin in the African context were sought by molecular biology. They were: BCL11A (rs10189857, rs1427407) HMIP (rs9399137) Xmn1 (rs7482144). Some specific mutations responsible for the disease of Gilbert and G6PD deficiency negatively modulate the evolution of sickle cell disease were studied by molecular biology aussi.<br> <strong>Results</strong><br>The full blood counts with blood smear revealed regenerative microcytic hypochromic: anemia;&nbsp;aplastic microcytic hypochromic anemia and&nbsp;regenerative normochromic normocytic anemia&nbsp;</p> <p>&nbsp;The Giants' polynuclears; larges platelets and even macropolycytes probably related to a deficiency in folic acid.<br>The attendance of hypercytoses (Polynucléosis, thrombocytosis, hyperréticulocytose) and erythroblastosis are amenable to treatment with hydroxyuré.<br>The presence of Howell Jolly's body witness functional asplenia, mononucleosis and trophozoïte of Plasmodium means that the anti-infection prevention must be rigorous.<br>The beta loci Genotyping showed: six compounds heterozygous S / C with five Haplotypes Benin / Cameroon and one haplotype Senegal / Cameroon; six homozygous s / s including four &nbsp;Haplotypes Benin / Benin, two Haplotypes Benin / Senegal.<br>No patient has alone three mutations (BCL11A, HMIP, and Xmn1) support for synthesis of fetal hemoglobin.<br>&nbsp;Four patients have&nbsp;α<sup>-3, 7</sup>&nbsp;type of thalassemia .For G6PD’s deficiency, a hemizygous A- and a conductor A- were diagnosed. The research for favorable mutations of UGTA1 to Gilbert's disease found three cases.<br> <strong>Conclusion</strong><br>Sickle cell disease is modulated by several genetic factors that it is useful to know for adequate therapeutic management.</p> Sawadogo S., Kissou S.A., Kouldiati J., Traoré -Sawadogo H., Kafando E., Nacro B. ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 http://ephjournal.com/index.php/mhs/article/view/520 Wed, 28 Feb 2018 09:43:30 +0000 Self- Doctor http://ephjournal.com/index.php/mhs/article/view/523 <p><em>The aim of this project is to develop a program entitled as ‘Self Doctor’ SD, &nbsp;that motivates children to discover health and its importance in life. In fact, there are hundreds of games which are related to health, and each one focuses on a different target. However, few ones are found which concentrate on teaching the children the ability to diagnose, identify symptoms, and treatment for simple health issues.</em></p> Fatima Saleh Al Dhaen, Naseema Najaf ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 http://ephjournal.com/index.php/mhs/article/view/523 Wed, 28 Feb 2018 09:50:07 +0000 Perineal Dermatitis: A neglected Problem in Patients at Critical Care Unit http://ephjournal.com/index.php/mhs/article/view/504 <p>Abstract: The literature reveals there has been limited critical discussion of the inter-relationship between urinary incontinence, the vulnerability of the skin and the clinical implications. This article critically re-examines the literature to identify and apply relevant scientific principles and evidence to inform effective intervention. It includes background on the structure, function and disruption to the skin's barrier. The implications for fundamental and largely taken-for-granted nursing practices, such as washing the skin, are examined. The current state of knowledge is analyzed, specifying the types of evidence available and its weaknesses, highlighting implications for a research agenda.</p> Hanan Mohammed Mohammed, Mona Nadr ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 http://ephjournal.com/index.php/mhs/article/view/504 Wed, 28 Feb 2018 00:00:00 +0000