Diagnoses and Management of Adult Cough: an Indian Environmental Medical Association (EMA) Position Paper (Preprint)

2020 ◽  
Author(s):  
Salil Bendre Dr ◽  
Shankar PS Dr ◽  
Krishnaprasad Korukonda Dr ◽  
Keyword(s):  
Health Care ◽  
Chronic Cough ◽  
Scientific Evidence ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Supportive Therapy ◽  
Hypersensitivity Syndrome ◽  
Position Paper ◽  
Symptomatic Therapy ◽  
Clinical Conditions ◽  
Antitussive Agents

BACKGROUND Cough is a common yet distressing symptom that results in significant health care costs from outpatient visits and related consultations. OBJECTIVE Understanding the pathobiology of cough in recent times has undergone an evolution with Cough hypersensitivity syndrome (CHS) being suggested in most cases of dry cough. In case of productive cough however ancillary mechanisms including impaired Mucociliary clearance in addition to hypermucosecretory bronchospastic conditions of Smoker’s cough, asthma-COPD overlap syndrome, AECB, allergic bronchopulmonary aspergillosis need to be critically addressed while optimizing patient care with symptomatic therapy in such cases while avoiding its misuse in most of the situations METHODS In this review, evidence-based graded recommendations on use of Pro- & Antitussives as a Position Paper were developed based on the Level and Quality of Scientific evidence as per Agency of Health Care and Quality Systems (AHRQ) and Clinical insights, offered by a multidisciplinary EMA panel in India. RESULTS Management of acute or chronic cough involves addressing common issues of environmental exposures and patient concerns before instituting supportive therapy with antitussives or bronchodilatory cough formulations containing mucoactives, anti-inflammatory or Beta-2 agonist agents CONCLUSIONS The analyses provides a real world approach on the management of acute or chronic cough in various clinical conditions including with Pro- or antitussive agents

Alternative medicine as a treatment options for COVID-19

2021 ◽  
Vol 07 ◽  
Author(s):  
Mahfuza Marzan ◽  
Md. Shahedur Rahman ◽  
Md. Abu Hena Mostofa Jamal ◽  
Mohammad Hossain Shariare ◽  
Md. Anowar Khasru Parvez
Keyword(s):  
Health Care ◽  
Vitamin D ◽  
Distress Syndrome ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Viral Disease ◽  
Global Pandemic ◽  
Medicinal Properties ◽  
Mode Of Transmission ◽  
High Infectivity

: COVID-19, a viral disease caused by SARS-CoV-2 is the reason of a global pandemic since the starting of the year 2020. The characteristic of the disease varies from mild common cold like symptoms to acute respiratory distress syndrome and multi-organ failure leading to death. World has already observed 213,453 deaths from this disease while 3,095,839 have been infected in 210 countries in total till 28 April, 2020. This disease has a devastating impact over the health care system because of its high infectivity, easy mode of transmission, lack of proper medicine and vaccine and deficiency of enough supportive healthcare arrangement. On verge of this situation scientists are searching the treatment options. However, nature has provided us with enormous herbs which have disease preventive as well as have medicinal properties. In this article we have reviewed several of these plants (ginger, clove, tea, black seed, tulsi, neem) and some vitamins (vitamin C and vitamin D) and zinc which have antiviral, anti-inflammatory, antioxidant, anti-asthmatic properties with scientific evidence. The intake of these products regularly to keep the immune system active, to experience its positive aspects might be supportive to prevent infection with the new coronavirus or to treat COVID-19.

scholarly journals Covid-19 FAQ’s in Paediatric and Congenital Cardiology – AEPC position paper.

2021 ◽  
pp. 1-21
Author(s):  
Skaiste Sendzikaite ◽  
Ruth Heying ◽  
Ornella Milanesi ◽  
Katarina Hanseus ◽  
Ina Michel-Behnke
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Data ◽  
Position Paper ◽  
Paediatric Cardiology ◽  
European Paediatric ◽  
Care Systems ◽  
The Times ◽  
Almost All

Abstract The Covid-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with Covid-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology (AEPC) receive many questions regarding Covid-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding Covid-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.

scholarly journals Elderly Patients with Pertrochanteric Hip Fracture: In Hospital Care

2019 ◽  
Vol 3 (4) ◽  
pp. 1-8
Author(s):  
Faour Martín O
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Cost Reduction ◽  
Hospital Care ◽  
Scientific Evidence ◽  
Clinical Results ◽  
Fracture Management ◽  
Care Of Elderly

Objective: To evaluate the improvement in the care of elderly patients hospitalized due to pertrochanteric hip fractures. Methods: A comparative study of two cohorts of patients admitted due to pertrochanteric hip fractu re before (2010) and after the application of in hospital management protocols (2018). The intervention consisted in the implementation of multidisciplinary measures during hospitalization based on current scientific evidence. An evaluation of the clinical results was performed, as well as the health care impact. Results: The characteristics of patients admitted for hip fracture in 2010 (216 patients) and 2018 (205 patients) were similar in age, sex, Barthel index and the Charlson abbreviated index. In 2018 patients had more comorbidity. A significant reduction of preoperative stay and overall stay in the cohort of 2018 was achieved. Detection of delirium, malnutrition and anaemia was higher in 2018, and a reduced incidence of infection and a better function al efficiency was achieved in this period. Conclusion: The introduction of measures for the improvement of the pertrochanteric hip fracture management reduces hospitalization with consequent cost reduction. Unification of criteria among professionals may b e an opportunity for better clinical results and reduction of complications.

scholarly journals Allergic rhinitis in pediatric practice: how to identify and manage

2018 ◽  
pp. 142-146
Author(s):  
N. V. Minaeva ◽  
I. P. Koryukina
Keyword(s):  
Health Care ◽  
Allergic Rhinitis ◽  
Child Health ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Quality Criteria ◽  
Care Quality ◽  
Symptomatic Therapy ◽  
Child Health Care ◽  
Pediatric Practice

The issues of diagnosis and management of allergic rhinitis (AR) in pediatric patients are considered on the basis of the current Russian clinical guidelines. The article presents the paediatrician tasks on the collection of anamnesis, the assessment of clinical symptoms, the setting of a preliminary diagnosis, the development of a diagnosis and therapy plan taking into account the modern medical care quality criteria. It also discloses the general principles of AR treatment, approaches to emergency symptomatic therapy using a combined intranasal drug Vibrocil (dimethindene + phenylephrine). The paper provides recommendations for the management of patients with allergic rhinitis in the district covered by child health care.

Thriving in the 21st Century: Outcome Assessment, Practice Parameters, and Accountability

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 831-835 ◽  
Author(s):  
David A. Bergman
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Outcomes ◽  
Practice Guidelines ◽  
Scientific Evidence ◽  
Care Practice ◽  
Health Care Outcomes ◽  
Effective Manner ◽  
Care Outcomes

The past two decades have brought about major health care changes that have been driven by an ever-increasing cost of health care, practice variability, and medical malpractice litigation. These changes pose a challenge to pediatricians to contain costs, to reduce inappropriate use of health care services, and to demonstrate improved health care outcomes. To meet this challenge, a new "clinical tool kit" is required, one that will allow the pediatrician to analyze current practices and to document effective interventions. Two of the major tools in this kit are practice guidelines and outcomes assessment instruments. Practice guidelines are optimal care specifications that provide an analytic framework for defining high-quality care and measuring health care outcomes. Ideally, these guidelines should be developed from scientific evidence. In practice, however, scientific evidence to support the majority of recommendations made in guidelines is insufficient. Consequently, these recommendations are instead developed by expert consensus. Measurement of health outcomes includes clinical outcomes, patient satisfaction, cost and use, and quality of life. Health care organizations have become very sophisticated in measuring cost and use, but considerably less work has been done in the patient-centered areas of satisfaction and quality of life. This is particularly true for children, because measures are dependent on the viewpoint chosen (parent, child, or teacher), the age of the child, and the adjustment for severity of illness. Analyzing practice patterns and improving health outcomes will not be easy tasks to accomplish. For the pediatrician to use these tools in an efficient and effective manner, a new research agenda and new skills will be required.

Unhealthy Politics

2020 ◽  
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Base ◽  
Medical Industry ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

scholarly journals Journey of the Patient With Melanoma: Understanding Resource Use and Bridging the Gap Between Dermatologist, Surgeon, and Oncologist in Different Health Care Systems

2019 ◽  
pp. 1-8
Author(s):  
Cássia Rita Pereira da Veiga ◽  
Claudimar Pereira da Veiga ◽  
Ana Paula Drummond-Lage ◽  
Alberto Julius Alves Wainstein ◽  
Andreia Cristina de Melo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Health Resources ◽  
Medical Professionals ◽  
Public And Private ◽  
Patients With Cancer ◽  
Clinical Procedures ◽  
Care Systems

PURPOSE New scientific evidence has led to modifications in the clinical practice of handling melanoma. In health care systems, there is currently a wide variety of clinical procedures to treat cancer, and the various routes have different effects on the survival of patients with cancer. Thus, this article aimed to evaluate the journey of patients with melanoma in the public and private health care systems in Brazil from the viewpoint of different medical professionals involved in the diagnosis and treatment of the disease. The study also considers the resources used for the complete delivery cycle of health care at different stages of the evolution of melanoma. METHODS We conducted a behavioral study by applying a questionnaire to a group of medical professionals. A nonprobabilistic sampling method for convenience was used, justified by the heterogeneous national incidence and the limited availability of medical professionals who diagnose and treat melanoma. RESULTS The questionnaire was answered by 138 doctors, including doctors from the Brazilian states with the highest concentration of medical specialists and regions with a higher melanoma incidence. The results of this study have the potential to enrich our understanding of the reality of Brazilian health care systems and, at the same time, allow us to discuss the multiple ways in which professionals from diverse specialist fields understand and explain decision making in health care. CONCLUSION Health care decision making is complex and, among other factors, depends on the diversity of available health resources and the knowledge of which treatments provide the greatest benefit to patients and greatest value to the system as a whole. This work can inform debates and reflection that are applicable not only in Brazil, but also in various other countries with similar realities.

scholarly journals Remineralization Strategies in Oral Hygiene: A Position Paper of Italian Society of Oral Hygiene Sciences-S.I.S.I.O. Working Group

2017 ◽  
Vol 11 (1) ◽  
pp. 527-538 ◽  
Author(s):  
Consuelo Sanavia ◽  
Marco Tatullo ◽  
Jessica Bassignani ◽  
Silvia Cotellessa ◽  
Giulia Fantozzi ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Working Group ◽  
Tooth Enamel ◽  
Scientific Evidence ◽  
Critical Discussion ◽  
Position Paper ◽  
Point Of View ◽  
Italian Society ◽  
Patient Choice ◽  
Enamel Structure

Background/Objective:The clinical conditions that lead to an alteration of the enamel structure are numerous. The diet high in sugars and acidifying substances, psychological stress that triggers parafunctional behaviors, the reduced intake of fiber-rich foods or alkalizing substances, together with other factors, contribute to demineralization of the tooth enamel. Dental mineralizing products on the current market are distinguished according to the dosage form, the active ingredient, the release technology, clinical indications and patient choice. Currently, it is necessary to propose to oral health professionals a guide to orient themselves in this chaotic choice, in order to prefer the most effective product for their own clinical target.Methods:Italian Society of Oral Hygiene Sciences-S.I.S.I.O. is one of the leading scientific Italian societies representing those dental hygienists working with high-quality standards and in agreement with scientific evidence: in the last year, the SISIO working group has carried out a study focused on remineralizing agents in dentistry, in order to give an authoritative point of view to indicate a guideline in the decision process of the choice of a remineralizing agent. We will report the results pointed out from the last consensus meeting in 2017.Results:We have reported the good the bad and the ugly have been discussed in a critical discussion of such topic.Conclusion:The SISIO experience has been reported in this position paper with the aim to serve as a useful aid in the daily choice of the clinical steps to perform, when dental professionals need to treat demineralized teeth.

scholarly journals Indigenous healers in the North West province: A survey of their clinical activities in health care in the rural areas

Curationis ◽  
1996 ◽  
Vol 19 (4) ◽  
Author(s):  
S. N. Shai-Mahoko
Keyword(s):  
Health Care ◽  
Random Sample ◽  
Southern Africa ◽  
Rural Areas ◽  
Demographic Variables ◽  
Simple Random Sample ◽  
North West ◽  
The North ◽  
Clinical Conditions

The purpose of this study was to explore the clinical conditions brought to indigenous healers by people in the rural areas in search of health care. The demographic variables and preventive, promotive, curative and follow-up activities of indigenous healers were investigated. Data were collected from a simple random sample of 35 indigenous healers. A questionnaire designed by Mogoba (1984) for investigation of training and functioning of traditional doctors in Southern Africa was modified and used to collect data.

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