https://www.nclinmed.com/ Novelty in Clinical Medicine en daily 1 Mon, 01 Jan 2024 00:00:00 +0330 Mon, 01 Jan 2024 00:00:00 +0330 https://www.nclinmed.com/article_181461.html Background: Vaccination rates among women of reproductive age are low, and many women are hesitant to get vaccinated.Objectives: The aim of the study was to determine the opinions of senior midwifery and nursing students regarding the recommendation of the COVID-19 vaccine to women of reproductive age and to identify the factors that affect their counseling proficiency.Methods: This cross-sectional study collected data from 504 senior midwifery and nursing students using the "Individual Identification Form," "Vaccine Opinion Form," and "Scale of Attitudes Toward the COVID-19 Vaccine" in an online environment with the snowball sampling method. Various statistical methods, such as the t-test, chi-square analysis, correlation analysis, ANOVA, logistic regression, and decision tree analysis, were used to analyses the collected data.Results: Out of all the students, 84.3% were women, 50.2% belonged to the nursing department, and 97.6% had received at least two doses of the COVID-19 vaccine. While 44.4% of the students said they would not recommend vaccination to pregnant, breastfeeding, or planning to get pregnant women, 22.6% reported that they could suggest the COVID-19 vaccine to all three groups. The students who believed they had the competency to counsel others about vaccines and had previously received a flu shot were more likely to recommend a COVID-19 vaccine. On the other hand, the students who did not consider vaccines to be safe, believed they could be harmful, and had not received adequate training on vaccines were less likely to recommend them.Conclusions: Students who lacked knowledge about COVID-19 vaccines and counseling competency were less likely to recommend vaccination. https://www.nclinmed.com/article_181807.html Background: Job satisfaction of health care employees is of great importance because of its implications on the quality of provided services. Moreover, the need for sufficient job satisfaction has negative implications on healthcare provision, resulting in high turnover rates and low performance. Objectives: To fill the knowledge gap of measuring the current level of job satisfaction of health care providers in both governmental and private hospitals in West Bank-Palestine.Methods: This study is a cross-sectional one that adopted a quantitative approach. Data were collected from 370 employees in the healthcare sector. The sample included both private and public hospitals. The tool A self-administered Mueller/McCloskey satisfaction scale based on previous studies (Clinton, 2015) was used for all employees in different departments and specialties.Results: Healthcare providers have more than 30% satisfaction levels in multiple fields such as their monthly salary, yearly vacations and holidays, number of work hours, weekend arrangements, dealing with direct supervisors, dealing with co-workers, social communication inside work times, interaction with workers from other healthcare specialties, work environment, and work conditions.It showed that more than half of the healthcare providers are generally satisfied (54.9%) with a score of 60% to less than 80%, while around one-third of them are generally unsatisfied (33.6%) with a score of less than 60%.Conclusion: We found that 55% of HCPs work in the private sector and 44% work in the governmental sector, in HCPs aged between 36 and 45 it was high satisfaction from young employees, in our opinion when ever-increasing age increases coping mechanisms and satisfaction and could be controlled the stressors, in measurement situations we didn’t find any significant difference between Male and female in satisfaction expect the maternity level, married employees have higher levels of satisfaction than single, and more than half of sample have generally satisfaction it was 54.9%. https://www.nclinmed.com/article_181884.html Background: Cubitus valgus deformity is a condition that is often treated with supracondylar corrective osteotomy. Meanwhile, tardy ulnar nerve palsy requires an anterior transposition of the ulnar nerve. This is the most common and preferred procedure. However, there is a lack of research on using a combined approach to deal with both cubitus valgus deformity and tardy ulnar nerve palsy. Objectives: The purpose of this study was to establish if anterior transposition of the ulnar nerve is necessary in patients with medial closed-wedge osteotomy for cubitus valgus deformity with tardy ulnar nerve palsy. Methods: This cross-sectional study involved two groups of patients. In the first group, a closed wedge osteotomy was performed without nerve transposition. In the second group, a closed wedged osteotomy was performed with anterior transposition of the ulnar nerve. Results: The two-point discrimination test was conducted on two groups of patients, group 1 and group 2, both before and after surgery. The mean pre-operative two-point discrimination for group 1 was 5.6, which improved to 3.8 post-operatively. Similarly, the mean pre-operative two-point discrimination for group 2 was 7.5, which improved to 4.0 post-operatively. The mean Disabilities of the Arm, Shoulder and Hand (DASH) score for both groups improved significantly after surgery. For group 1, it improved from 28.8 (pre-operative) to 15.6 (post-operative). For group 2, it improved from 32.5 (pre-operative) to 16.2 (post-operative). The mean Humerus Elbow Wrist (HEW) angle, which is a measure of joint deformity correction, was also improved in both groups after surgery. For group 1, it improved from 35.8 (pre-operative) to 11.4 (post-operative), and for group 2, it improved from 37.2 (pre-operative) to 12.0 (post-operative). The range of motion (ROM) angle was also measured before and after surgery. The mean pre-operative ROM angle was 115 for group 1 and 112.5 for group 2. The mean post-operative ROM angle was 119 for group 1 and 117.5 for group 2. Overall, the functional outcome and deformity correction were excellent in all patients in both groups. Conclusion: It has been found that treating cubitus valgus deformity with a medial closed wedge osteotomy relieves tension on the tethered ulnar nerve. There seems to be no need for anterior transposition of the ulnar nerve to recover from tardy ulnar nerve palsy. Additionally, there is very little chance of an accidental nerve injury during the procedure. https://www.nclinmed.com/article_183341.html Background: Deep vein thrombosis (DVT) is a very common and fatal but preventable complication that can occur in patients after surgery. Since the identification of risk factors may help to prevent DVT or early intervention, risk factors should be identified at the patient's admission to the operating room and preventive measures should be taken based on that. However, no scale has been developed to measure the risk of DVT in candidate patients for surgery. Objectives: Therefore, this study was conducted with the aim of developing and validating a scale to measure the risk of DVT in patients who are candidates for surgery. Methods: This methodological study was conducted in 2022 in the hospitals of Zahedan city, south east of Iran. 120 candidate patients for surgery were included using available sampling method and were evaluated using the DVT risk assessment scale. This scale has 3 dimensions, 12 items and 45 sub-items. Validation of the scale was investigated by content validity index (CVI), content validity ratio (CVR), face validity and reliability (internal consistency and measurement stability over time).Results: The content validity and face validity of the scale were confirmed by 10 experts. Internal consistency was also confirmed by Cronbach's alpha of 0.91.Conclusion: The current findings showed that the scale for measuring the risk of DVT in candidate patients for surgery has good validity and reliability and can be used to measure the risk of DVT in surgical candidates referring to the operating room. https://www.nclinmed.com/article_181693.html Background: Renal colic is one of the most common emergency department (ED) presentations, with patients often presenting with severe and sudden onset flank pain. Ventricular arrhythmia parameters (Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio) on ECG in patients presenting with renal colic. Objectives: The aim of this study was to evaluate the risk of cardiac arrhythmia in patients with renal colic using Tp-e interval, tp-e/QT ratio and Tp-e/QTc ratio as potential cardiac arrhythmia stimulators.Methods: Patients presenting to the tertiary emergency department with renal colic within a 6-month period between 10 June 2022 and 31 December 2022 were included in the study. Patients underwent an ECG at the time of admission, QT interval and Tpe interval measurements were performed in leads D2 and V5.Results: In patients with renal colic attacks, D2 Tpe levels were significantly higher compared to both the pain-free period and the control group (p=0.036). D2 Tpe /QTc levels were found to be significantly higher in the renal colic attack period, in the pain-free period and compared to the control group (p=0.041).Conclusion: The Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio may be associated with fatal ventricular arrhythmias in patients presenting to emergency departments with renal colic pain. https://www.nclinmed.com/article_181462.html Lyme Disease (LD) has had a massive increase in prevalence as it has spread globally in the past 2 decades, both over a greater geographical range and at greater pace.  This concerning trend is the result of humans living closer to LD carriers, increased clinical awareness of LD, and climate change induced habitat expansion. Urban development places communities closer to LD-carrying ticks, yet researchers' understanding of LD lags behind, with poor genomic understanding of many LD strains. While efforts to bridge this gap have been attempted through citizen science and improved testing accessibility, data scarcity in resource-poor regions remains a monumental challenge to overcome. This gap is especially true in regions without clinical awareness of LD and a lack of resources for research dissemination to a global audience. Comprehensive data collection is crucial for identifying LD efficiently so healthcare workers can timely identify infected patients. Urgent action is imperative to prevent future health crises and soaring costs, as the rate of LD spread is increasing year-on-year. With this escalation being fueled in part by climate change, researchers must remain flexible in their data collection methods and find ways to curb spread. Improved community-level LD monitoring, clinical recognition, and broader research dissemination can enhance patient care, inform public health strategies, and secure funding for critical further research. https://www.nclinmed.com/article_179091.html Background: Cortical Blindness is most commonly caused by stroke or traumatic brain injury. The case study has the unique function of outlining the story of a young patient who incurred multiple gunshot wounds in an incident that ultimately transpired into a complete and permanent cortical blindness. Case presentation:  The present subject exhibits cortical blindness in the absence of either etiology. The proposed etiology is that of perioperative hypoxic seizures. Neuroanatomical and pathophysiological framework is established to elucidate the conditions surrounding the outcome. Discussion: It is known that acute neuronal ischemia presents as drastically urgent to the tune of a five-minute intervention window, and it is learned that the prognosis of recovery from cortical blindness is statistically confined to an interval of around six months. Statistical context paves the way for a practical perspective on rehabilitation for patients with vision loss. https://www.nclinmed.com/article_181694.html Background and Objectives: Juvenile autoimmune hepatitis is an inflammatory immune-mediated liver disease that affects infants to adolescents. Clinical presentation of AIH may resemble other hepatic diseases such as viral or toxic hepatitis and Wilson disease, presenting with fatigue, nausea, vomiting, jaundice, fever, and pruritus.Case Presentation: A 16-year-old male with a history of congenital ichthyosis, xerosis cutis, mild intermittent asthma and environmental allergic rhinitis presented to the clinic with upper respiratory symptoms. The patient appeared jaundiced, which prompted referral for acute evaluation leading to a diagnosis of autoimmune hepatitis and inflammatory bowel disease. Discussion: Juvenile autoimmune hepatitis is a rare and quite serious inflammatory liver disorder affecting infants to adolescents. Due to its resemble with many other liver disease, differential diagnosis is bit challenging. Overall, our patient's prognosis appears to be positive. https://www.nclinmed.com/article_165637.html Here, we will explore the key factors for effective and comprehensive management process against COVID-19 based on their empirical evidence. These factors are categorized into three axes: logistic, individual, and external. One of the important factors for ensuring the safety of treatment staff, patients, and community members is the provision of necessary equipment and facilities.1 In hospitals that have been designated as referrals for COVID-19, several logistical solutions have proven to be significant. An effective measure to prevent the spread of COVID-19 is to separate infected individuals from those who are not infected. This can be achieved by conducting a triage of all patients at the entrance of hospitals. Triage helps to identify individuals with similar symptoms of COVID-19 so that they are not mistakenly placed in high-risk areas.2After the initial visit, if a person is suspected of having COVID-19, they will be directed to a designated location for diagnostic tests and a CT scan of their lungs.1 The route to this location will be pre-specified and will not come into contact with other patients. Once the diagnostic procedures are completed, the next steps will be determined.It is also recommended that clients enter and exit the facility through a single route. This will help with disease prevention and allow for better monitoring and control of patients. Some people may try to leave through different exit points due to fear, which can increase the risk of spreading the disease in society.To prevent any hand contact with the entrance doors of the wards, electronic doors should be used. HEPA filters should be installed, and proper ventilation should be established. A separate dressing room for the medical staff at the entrance of the inpatient wards should be created. After finishing their work shift, the medical staff should have access to a separate area for bathing. Drinks such as mineral water, fruit juice, or milk should be provided to the personnel during each shift. Vitamin supplements should be used to strengthen the immune system. Personal protective equipment such as hats, glasses, gloves, and masks should be provided to avoid getting infected with the virus. Disposable food containers should be used. All surfaces should be disinfected with approved solutions before and after the shift. Personnel vehicles should also be disinfected according to the written program.It is important to note that ongoing training is crucial for medical staff to improve their attitude, awareness, and performance. In terms of infection control, adherence to relevant protocols is crucial. This includes proper hand washing and disinfection, correct usage of personal protective equipment (such as maintaining distance between the face and N95 mask and proper gown coverage), avoiding touching the head and face, refraining from using mobile phones in the ward, reporting any symptoms of disease and quarantining immediately, practicing proper collection and transfer of patient waste and dirty clothes, and continuously studying ministerial instructions and health center recommendations for COVID-19 control and prevention. These should be considered routine responsibilities of medical staff and must be strictly implemented.It is important to consider the medical records staff at hospitals who handle patients' files after they have been discharged. They should always wear gloves and handle paper files only for the recommended time period before placing them in plastic bags and taking the necessary measures. It is also important to not overlook external factors like the risk of contamination from a person who has been in contact with a patient. In such cases, if there is any doubt about the contamination of the patient, it is recommended to test the accompanying person and quarantine them until the test results are available.It is important to inform the relevant health center about all family members of a patient. Food given by patients' families or charitable organizations might cause problems. Before distributing such food items, it is necessary to directly consult with the hospital nutritionist and get confirmation. Patients with COVID-19 who are transferred to the hospital by Emergency Medical Services (EMS) may contaminate the ambulance, potentially infecting other patients during subsequent dispatches. To solve this problem, a special ambulance car wash should be set up in the hospital environment where the vehicles can be disinfected and washed immediately.Based on the materials mentioned, it can be concluded that in order to boost immunity against COVID-19, it is crucial to establish coordination between the human and material resources within the organization. This includes creating an effective network, facilitating favorable communication, and implementing comprehensive and efficient management practices. The role of managers in controlling this crisis is particularly important, as they must plan effectively, make proper use of facilities and equipment, distribute and adjust human resources appropriately, and monitor and control external threats, turning them into opportunities whenever possible. https://www.nclinmed.com/article_180286.html Introduction and Aims: According to trials, side effects after the injection of the vaccine include pain at the injection site, fatigue and headache, as well as pain at the injection site, fatigue and headache, lethargy. It is important for people to know the side effects of vaccines. Case presentation: The patient was a 32-year-old woman who was taken to the hospital emergency room after receiving the second dose of corona vaccine. In the initial assessments, all of her hemodynamic symptoms were normal, his breathing pattern and rhythm were normal, and her spo2 was above 94%. Glasgow coma criterion was used to assess the level of consciousness. Her level of consciousness was 3 out of 15 based on the Glasgow Coma Scale. For him cardiac and respiratory monitoring, O2 therapy with face mask, blood tests, ECG, echo, Chest CT scan and brain MRI and MRV were performed. All cases were normal. The patient regained full consciousness two days after admission to the ICU and was discharged in good general condition after four days in the hospital. Discussion: One of the vaccines that has been injected and entered in Iran was Sinopharm. In different studies, the most common side effect was pain and burning at the injection site, general malaise, body aches, fever, and headache, fever, pain at joint, chest and muscle, shortness of breath, swelling of glands. In these studies, side effects were mild to severe. CNS or PNS disorders caused by vaccine are mild. Severe disorders are rare. Conclusion: People who are vaccinated against COVID-19 experience reactions following the injection. All of these reactions are to be expected and indicate that your immune system is doing its job and learning how to fight the coronavirus. The side effects of Sinopharm were different and mild to severe. Given that the person in question has no history of disease and all tests performed on him are normal, his loss of consciousness can be due to the rare side effects of the sinopharm vaccine. https://www.nclinmed.com/article_181463.html Background and Objectives: Our case presents an aggressive and resistant biological course, leading to a poor prognosis in a patient with mycosis fungoides, who underwent multiple therapies with no resolution, requiring aggressive chemotherapy due to systemic involvement. Case Presentation: A 64-year-old Hispanic male presented to the dermatology clinic for evaluation of hardened, erythematous lesions distributed on his trunk and upper extremities with associated generalized pruritus. He stated the lesions have been present for about 2 years and have since grown in size. Pathology from punch biopsies take from the lesions confirmed. A diagnosis of mycosis fungoides. Topical glucocorticoids and systemic retinoid treatment were initiated, but after six months the disease progressed to involve lymph nodes. He underwent multiple rounds of radiation on advanced lesions. Patient was referred to an oncologist to continue treatment given the poor prognosis. Discussion: Mycosis fungoides is a form T cell lymphoma that that is usually limited to the cutaneous tissue. A high expression of CD30+ lymphocytes in the epidermis is indicative of transformation into advanced large cell lymphoma, suggesting an aggressive clinical course and overall poor prognosis. Although mycosis fungoides is typically a low-grade, indolent malignancy our case has shown an aggressive and resistant biological course, leading to a poor prognosis. https://www.nclinmed.com/article_180287.html Background and aims: One of the most important topics in the discussion of trauma are bullet and shrapnel injuries, which have increased in incidence in recent years Injuries caused by firearms are numerous injuries that sometimes cause the death of people. The following article is a report of a case of bullet impact. Case presentation: The patient, a 20-year-old man, was directly hit by a bullet in the shoulder due to the impact of a war colt bullet during a fight. The trauma caused by the bullet had resulted in damage to the brachial plexus and its location in the vicinity of the carotid artery and in front of the trachea and in front of the seventh cavity of the neck. It was evident, during the surgery, a bullet was observed near the left side of the carotid, the bullet was slowly removed without damaging the trachea, esophagus, thyroid, and carotid, and then the wound was closed and bandaged with sutures, and after a few days, he was discharged from the hospital.Conclusion: The scientific evaluation of all trauma patients caused by gunshot wounds should always follow a logical order and attention to all possible causes can be lifesaving for these patients. Injuries caused by a bullet can cause severe problems and injuries in a person that are irreparable and even cause the death of the patient. The best treatment method for these victims is surgery and removal of the bullet. In this patient, considering that only one bullet hit the patient's shoulder and caused damage to the brachial plexus, and the lack of surgery and removal of the bullet could lead to weakness and inability to move or loss of sensation in the shoulder area. The arm or hand gets sick. The vicinity of the bullet next to the carotid can cause complications for the patient such as: the carotid being under pressure by a foreign object (bullet) and reducing the blood supply to the brain vessels, the wall being scratched by the foreign object and eventually the carotid rupture, according to the location of the bullet, any action. The treatment and movement of the bullet would have caused more and irreparable damage and the patient might have lost his life in this surgery.