Common Complain Research Articles

Painful Hashimoto's thyroiditis: myth or reality?

Neck pain is a common complain, being in most cases due to non-thyroidal causes. However, a minority of patients suffer from painful thyroid diseases. Among them, sub-acute thyroiditis (SAT) is the most frequent one. Rare thyroid-related causes of neck pain include hemorrhage within a thyroid nodule as well as Riedel's thyroiditis and suppurative thyroiditis. In the last 30years, a few cases of a painful variant of Hashimoto's thyroiditis (HT) have been described. Biochemical, ultrasound, and histologic features were clearly suggestive for HT in all of the published cases and definitely ruled out the diagnosis of SAT. While sound descriptions of painful HT are present in the literature, it is important to emphasize that only 20 cases were reported from the year 2000 until now. The condition, however, is clinically relevant because neck pain was reported to be refractory both to steroids and to other analgesic drugs, being thyroidectomy the only effective treatment for pain relief in these patients. This short review analyzes currently available data supporting a role for HT as a rare cause of neck pain.

Оценка качества жизни у больных с идиопатической легочной гипертензией: первый опыт применения триметазидина

Objective - to estimate the quality of life with therapy of trimetazidine in patients with idiopathic pulmonary hypertension, I-III functional class. Material and methods. In this study we included 29 patients (27 women and 2 men) aged 41.9±10 years. All patients had a common complain of angina-like symptoms. The patients were divided into 2 groups. The first group consisted of 11 patients (1 men and 10 women) who were additionally prescribed trimetazidine 35 mg twice daily for 24 weeks. The second group included 18 patients (1 men and 17 women) who continued to receive standard and specific therapy. At baseline and after 24 weeks all patients were examination, which included: laboratory (general and biochemical blood tests, D-dimer), clinical and instrumental examinations (electrocardiography, echocardiography, chest radiography, scintigraphy, a 6-min walking test, spirometry). We are take into consideration: age, sex, functional class (World Health Organization), complaints, tolerance, a 6-min walking test, Holter electrocardiogram in 12 lead, SF-36 questionnaire. Results. We analyzed the questionnaire SF-36 quality of life compared to before and after treatment trimetazidine: improvement in general health (p<0.02), physical role functioning (p<0.02), improvement index bodily pain (p<0.01), Vitality (p<0.02), mental health (p<0.01). Our study showed that the SF-36 questionnaire reliably describes the patient's physical, social and mental condition. Conclusion. Trimetazidine therapy improves quality of life in patients with idiopathic pulmonary hypertension, complaining of chest pain.

Disparities in psychosocial cancer care: a report from the International Federation of Psycho-oncology Societies.

The aim of the study was to understand the characteristics of the International Federation of Psycho-oncology Societies (FPOS) and possible disparities in providing psychosocial care in countries where psycho-oncology societies exist. A survey was conducted among 29 leaders of 28 countries represented within the FPOS by using a questionnaire covering (i) characteristics of the society; (ii) characteristics of the national health care system; (iii) level of implementation of psycho-oncology; and (iv) main problems of psycho-oncology in the country. Twenty-six (90%) FPOS returned the questionnaires. One-third reported to have links with and support from their government, while almost all had links with other scientific societies. The FPOS varied in their composition of members' professions. Psychosocial care provision was covered by state-funded health services in a minority of countries. Disparities between countries arose from different causes and were problematic in some parts of the world (eg, Africa and SE Asia). Elsewhere (eg, Southern Europe and Eastern Europe), austerity policies were reportedly responsible for resource shortages with negative consequences on psychosocial cancer care. Half of FPOS rated themselves to be integrated into mainstream provision of care, although lack of funding was the most common complain. The development and implementation of psycho-oncology is fragmented and undeveloped, particularly in some parts of the world. More effort is needed at national level by strong coalitions with oncology societies, better national research initiatives, cancer plans, and patient advocacy, as well as by stronger partnership with international organizations (eg, World Health Organization and Union for International Cancer Control).

Prevalence of Dysmenorrhea and its Impact on Quality of Life among Nursing Students at Assuit University, Egypt

Primary dysmenorrhea is one of the most common complains and gynecological problem worldwide among young female girls. A cross sectional descriptive study was implemented on 188 nursing students at Assuit University, Egypt. The main aim was to determine the prevalence of dysmenorrhea and its impact on the quality of life, particularly absenteeism from college. Data were collected through self-structured interviewing questionnaire for data related to socio-demographic characteristics, menstrual characteristics, habits and medical characteristics, menstrual associated symptoms activities, treatment used, and methods of managing dysmenorrhea. Moreover; Quality of Life Scale and verbal multidimensional scoring system were used to assess the severity of dysmenorrhea.The mean age of the students was 20 (range 17-22) years. The average age of menarche was 13.2 years, (9 to 15 years).The vast majority (90.4%) were single, suffered from dysmenorrhea, had a regular menstruation, menstrual duration between 21-34 days, had a positive family history of dysmenorrhea, and prepared for menarche. The prevalence of dysmenorrhea was very high (90.4%), which significantly higher with consummation of tea, coffee, coke, chocolate, and obesity as well, females with menstrual bleeding duration 7 days and more, menstrual duration cycle between 21 and 34 days, and those who had a positive family history of dysmenorrhea. There was a significant association between Quality of Life and severity of dysmenorrhea. Based on the results of the study it can be concluded that dysmenorrhea is a common health problem, having negative effects on the quality of life among university female students. So., we suggest implementation of an educational program to increase the awareness of the adolescent girls during the activity time. College officials and college health program coordinators may benefit from considering dysmenorrhea in the context of improving their college attendance rates and academic performance of their students. Participating in regular physical activity program to help them to decrease the negative impact of dysmenorrhea on their academic, social and even personal life.

Epidemiological, Clinical and Paraclinical Study of Hydatid Cysts in Three Educational Medical Centers in 10 Years

Background: Echinococcosis or hydatidosis, caused by the larval stage of Echinococcus granulosus (E. granulosus), is an important public health problem in many areas of the world and Iran is a country of endemic situation for hydatidosis In the present study, we evaluated epidemiological, complications and clinical characteristics of hydatidosis at three University Medical Centers in Tehran over a 10-year period. M aterials and Methods: This is a descriptive cross-sectional study performed in patients with hydatid cysts. Information about age, gender, number of cysts, organ involvement, morbidity and mortality and relapse were collected from medical records of hydatid patients. Paraclinic information such as CT Scan, MRI, ultrasound, complete blood count, pathological diagnosis and complication of disease were collected. R es ults: Overall, 81 patients, 35 (43.2%) male and 46 (56.8%) female, who were diagnosed as having hydatid cyst by clinical and radiological findings, with pathologic documentation were studied in three university medical center registries over a 10-year period (2003- 2012) in Tehran. Fourteen patients (17% of cases) had complications resulting from this disease. Patients' age ranged from 5 to 86 years, and the peak prevalence of the disease was between 20 and 40 (34% of cases). C onclusion: Iran is a country of endemic situation for hydatidosis. Prevalence rate of hydatidosis in Iran was reported to be 0.61-2 in 100000 populations . The highest rate of infection and complications were in patients of 20-40 years age. Clinical examination revealed that abdominal pain was the most common complaint and was present in 51.7% of the cases. Other most common complain were cough, abdominal mass, dyspnea, icterus, chest pain, dyspepsia, back pain and seizure; and it was result of occupying effect of cysts in organs. This is similar with previous studies in Iran

Family Dysfunction and Self-Medication for Acute Febrile Illness

Background: Fever is a common complain from patients globally. Self medication for acute febrile illness is also a common practice but often with severe consequences. The family influences the health of the individuals and hence the community in several ways. Family function has major influence on decisons made at home including health seeking behaviour. Objectives: This study set out to determine the relationship between family function and self medication for acute febrile illness in a primary care setting in Jos, in order to proffer solutions to irresponsible and dangerous practices. Methods: It was a cross-sectional study at the GOPD of Bingham University Teaching Hospital (BHUTH), Jos from October 2012 to February 2013. The study population comprised all patients who presented at the study site with fever or history of fever of not more than two weeks duration and who met the inclusion criteria. Data was collected with interviewer-administered structured questionaire and analysed with the Statistical Program for Social Science (SPSS), version 21. Results: The study revealed a high level of self medication (85.0%) in the study population. Most (92.5%) of the participants were from highly functional families. There was a statistically significant relationship between family dysfunction and self medication for acute febrile illness. Conclusion: There is a high level of self medication among the study population. Although highly functional families were in the majority, family dysfunction was significantly related to self medication.

Anterior knee pain and lower extremity functions in Indian adolescent population

Background & Purpose - Anterior knee pain is one of the most common musculoskeletal complain seen in Indian adolescent population with high incidence among those who are active in sports and recreation. The purpose of this study was to investigate the age of onset of anterior knee pain, to find its effect on sports participation and also to find the activities which are maximally affected due to anterior knee pain in Indian population. Method- A questionnaire based survey was conducted among 50 subjects using three outcome measures namely self made demographic questionnaire, anterior knee pain scale and lower extremity functional scale. Result- Maximally affected activities are running, jumping & squatting and maximally affected functions are squatting, running on uneven ground, making sharp turns while running and hopping with increase incidence of anterior knee pain among those who participate daily in sports. Conclusion- The study concluded, that in adolescent age group of 11-17 years, anterior knee pain is more prevalent in adolescent girls with the age of onset being around 13 years for girls & 14.5 years in boys and it also showed moderate positive correlation between anterior knee pain and lower extremity functions

Musculoskeletal Teaching and Training in Saudi Internal Medicine Residency Programmes

Background: Musculoskeletal (MSK) conditions are among the most common complains presented at the clinical practice, accounting about 15% - 30% of all primary care encounters. However, clinical doctors continue to document a low level of confidence in their musculoskeletal clinical skills. Objectives: The aim of this study is to evaluate the internal medicine (IM) residents for confidence and perception in demonstrating musculoskeletal clinical skills. Methods: 37 items paper-based questionnaire was developed and piloted to investigate IM residents in Saudi Arabia during June-December 2011. Results: The study indicates residents’ low self-confidence in demonstrating MSK physical examinations with total mean (10/24). Respondents also show general agreement that MSK problems are very common in patient visits, and indicate the importance of MSK clinical screening in all standard clinical examination of patients, yet they point to current inappropriate practice in handling most cases. Respondents show lower perception of undergraduate and postgraduate training, regarding the inadequate training and assessment in MSK. Conclusions: The study shows inadequate MSK education, during and post, medical school training and that there are different training approaches for the different specialties, which undermines MSK training altogether.

Appropriateness of knee MRI prescriptions in a hospital of Birjand, 2014

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Knee pain is one of the most common complains which cause patients to visit a doctor and Magnetic Resonance Imaging (MRI) is one of the common diagnostic methods which are common to find the cause of Knee pain. This study aim to determine knee MRI appropriateness, in Valiasr hospital of Birjand in 2014.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this study descriptive – analytical study, 150 patients referred to MRI unit were selected using convenient sampling method. Data were gatherers using a Questionnaire and then analyzed by SPSS16 using descriptive statistics and Pearson, chi-square and Fisher's exact tests. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Of 150 cases, 70 (46.7%) were considered inappropriate, 7 (4.7%) were uncertain, and 73 (48.7%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was 46200000 Rails. A statistical significant relation was observed between appropriateness of prescription with sex, jobs, education, physician specialist and referring institution.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Considering the high rate of inappropriate prescriptions, it is necessary to find the causes. Developing, customization, and perform clinical guidelines in all of our country may help reducing this rate.

Physical Stress during Menstrual Cycle; A Study On Pain, Discomfort &amp; Exhaustion

Premenstrual syndrome (PMS) is a set of physical, emotional &amp; behavioral symptoms that start during the week preceding menstruation &amp; are alleviated when the menstrual flow begins. The purpose of this study was to evaluate symptoms of PMS in relation to intensity of pain &amp; physical stress by using Sadaf Stress Scale (SSS). PMS affects menstruating women globally &amp; causes extensive personal &amp; public health problems with high degree of absenteeism. It is the most common gynecological problem that has been reported to affect the ability of women to carry out daily activities. Data was collected from women aged 17-35 years having premenstrual pain. The prevalence was determined by questionnaire include issues about exercise, intensity of pain, severity and flow of blood during reproductive cycle. Results shows 15% mild, 14% moderate &amp; 5% sever symptoms of physical stress with only 4% females are interested in doing exercise. Premenstrual pain was one of the most common complain among these females of reproductive age with sever to moderate discomforts during menstruation along with the concerns of heavy or moderate bleeding. It is recommended that inquiries about pelvic pain &amp; menstrual discomforts should be made compulsory in health care centers, so that this major problem could be overcome causing hindrances in routine life with women.

Sleep in Schizophrenic Patients: Discrepancy Between Self-reported Versus Recorded Sleep

Introduction Sleep disturbances are common complains among schizophrenia patients. Based on these subjective complaints, treatment often involves hypnotic and/or anxiolytic medications with disturbing side effects that increase patients' drug load. Most hypnosedatives are prescribed based on subjective complaints, but little information is published on the relationship between self-report and recorded sleep in this population. Objectives The present study examined the correlation between subjective and objective evaluation of sleep measures among schizophrenia patients compared with age- and gender-matched controls. Method The sample comprised two groups: 30 schizophrenia patients (mean age=48.50, SD=12.45; 17 M, 13 F) and 30 age- and gender-matched controls (mean age= 48.56, SD=12.54; 17 M, 13 F). Subjects subjectively evaluated their sleep patterns using two qualitative reports–the Mini Sleep Questionnaire (MSQ), and Pittsburgh Sleep Quality Index (PSQI), and one quantitative report–the Technion Sleep Questionnaire (TSQ). Additionally, subjects' sleep was continuously monitored for a week with a wrist actigraph (Ambulatory Monitoring, Inc.). Results Analysis revealed no significant correlations between subjective and objective measures of sleep in all participants. Interestingly, significant interactions were found between estimation type of the discrepancy (overestimate vs. underestimate) and schizophrenia existence (schizophrenia patients vs. controls) on discrepancy of sleep efficiency [F(1,51)=6.2, p Conclusions The findings indicate that subjective reports among schizophrenia patients are unreliable, and argue for objectively evaluating sleep in this population before prescribing sleep medications.

Sacrococcygeal teratoma with recto-sigmoid fecolith in adult

Sacrococcygeal tumors are present most frequently in infancy and childhood. Incidence in the newborn is 1 in 40000 with a female to male ratio of 10:1. It is rare in adults. Less than a hundred cases of teratoma in adults have been documented in literature. Constipation is a common complain; that is refractory to treatment or results in complications such as fecal impaction warrants consideration of occult causes. In most cases, it is diagnosed in childhood, with most descriptions being found in the pediatric literature. It is extremely uncommon for the syndrome to present in adulthood. We report a case of sacrococcygeal teratoma in adult, which has treated in our hospital. The presented case has shown a large thin walled cystic pre-sacral, retro-rectal cystic mass along the intra-luminal recto-sigmoid rounded ball of fecolith. Here, we highlighted the association of sacrococcygeal cystic teratoma in adult male with fecolith, which is rarely documented. So, we should also search the cause of constipation in adulthood, not only in paediatric age-group; that is refractory to treatment or results in complications such as fecal impaction.

Post Insertion Complaints in Complete Dentures – A Never Ending Saga

Removable Complete Dentures still exist as the treatment option of choice for majority of edentulous patients. The anatomical and adaptational limitations associated with this modality often refrains a clinician from attending patients of geriatric group. Most of the complaints associated with complete dentures are actual and not psychological, contrary to the belief of most clinicians. This article attempts to cover most of the common complains of complete denture wearers along with their possible causes and remedies.

Biomarkers of fatigue related to adjuvant chemotherapy for breast cancer: Evaluation of plasma and lymphocyte expression.

e20536 Background: Fatigue is a common complain in cancer patients receiving adjuvant chemotherapy. In order to further understand its mechanism and search for potential biomarkers we conducted thi...

Physician-Patient Relationship: The Present Situation and Our Responsibilities

The "doctor-patient" relationship (DPR) or the "physician-patient" relationship (PPR) has long been recognized as a complex, multifaceted, and complicated balance of engagement between the care-seeker and the care-giver. The physician-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics. In the present moment doctor-patient relationship (DPR) or physician-patient relationship (PPR) is one of the major issues in health-care throughout the world. The most common complains about the physicians of Bangladesh is their attitude towards the patients. The patients must have confidence in the competence of doctors and should feel that they can confide in him or her. For physicians, the establishment of a good relationship with the patients is also important. In developed countries students are taught from the beginning, even before they set foot in hospitals, to maintain a professional relationship with the patients, to uphold patients' dignity, and respect their privacy. These are deficient in Bangladesh. In addition to service factors, perceived treatment cost is another factor that patients may perceive as excessive. This special article reflects the importance as well as the necessary elements to establish this sacred relationship. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18786 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 55-58

Post Insertion Complaints in Complete Dentures - A never Ending Saga

Removable Complete Dentures still exist as the treatment option of choice for majority of edentulous patients. The anatomical and adaptational limitations associated with this modality often refrains a clinician from attending patients of geriatric group. Most of the complaints associated with complete dentures are actual and not psychological, contrary to the belief of most clinicians. This article attempts to cover most of the common complains of complete denture wearers along with their possible causes and remedies.

Rectovaginal fistulas: five year's experience.

Rectovaginal fistula is an epithelial connection between the anterior wall of the rectum and posterior wall of the vagina. The etiology of the rectovaginal fistula can be trauma orginated from violent acts or foreign bodies as well as trauma during obstetric, gynecologic, or colorectal surgeries. The purpose of this study was to share our clinic experience and surgical management for rectovaginal fistulas. This study was conducted at the Department of General Surgery, University of Dicle. All patients who were treated for rectovaginal fistulas between January 2005 and December 2011 were included to this study. There were fifteen patients in a mean age of 32 ± 9.6. The most common complains of patients were arrival of gas and stool from the vagina. The etilogy of rectovaginal fistula was most commonly obstetric trauma in our patients and three of them had anal incontinance. The mean time of hospital stay was 5 days ± 1.7. Postoperative wound infection was seen in two patients and reccurence disease occurred in two patients during the postoperative period. Rectovaginal fistula treatment is a challenging condition for the surgeon since anatomical relationships and different surgical conditions changes according to the paitents. Various surgical techniques are available for the management of rectovaginal fistulas according to their etiology, size, location. For the treatment of low fistulas, best results were achieved using conservative fistulectomy, layer closure, and both-sided covering of the tissue defect with advancement vaginal and rectal flaps.

The Predictive Value of Endometrial Thickness in Endometrial Pathologies in Premenopausal Women with Abnormal Uterine Bleeding

Abstract&#x0D; Background: Abnormal uterine bleeding (AUB) is one of the most common complains in women of any age seeking gynecologic health care and needs early diagnosis and proper management due to its impacts on the quality of life. This study was conducted to investigate the cut-off value of endometrial thickness (ET) by trans-vaginal ultra-sonography (TVUS) and evaluate its accuracy in the diagnosis of the endometrial abnormalities in premenopausal women with AUB.&#x0D; Materials and Methods: In this descriptive  study, 64 married women between 35-50 years old were evaluated due to AUB during 2011-2012; TVUS and fractional curettage were done. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the ET were calculated in different cut-off values.&#x0D; Results: The pathological evaluations of the biopsies were normal in 37 (57.8%) patients and were abnormal in 27 (42.2%) patients, 19 endometrial polyps, 6 hyperplastic lesions and 2 endometrial cancers. ET=4 mm had 100% sensitivity, 100% NPV, 10% specificity and 28% PPV in the detection of endometrial abnormalities. ET&lt;10 mm had a proper sensitivity (67%-100%) and NPV (78.6%-100%) but specificity was low (%10-%44). ET=10 mm with sensitivity=63%, specificity=60%, NPV=65.8% and PPV=48.2% was introduced as the cut-off point with the best area under curve (LR+=2.22 LR- =0.77).&#x0D; Conclusion: Although an ET&lt;10 mm was less likely to be associated with an endometrial abnormality, the low PPV of ET and low area under ROC curve shows sonography has high false positivity in premenopausal women. ET≤4 mm was more reliable and could reduce unnecessary biopsies.

Prevalence of Myopia in children up to 16 years observed in tertiary care eye centre of central India

Introduction: Myopia is most common cause of childhood visual disability. In large population it remains undiagnosed. High myopia can be associated with major ophthalmic diseases such as myopic retinopathy and exudative myopic macular degeneration, myopic glaucomatous optic neuropathy and rhegmatogeneous retinal detachment. Methods: Study was conducted in Regional Institute Of Ophthalmology in central India. Children up to age of 16 years included with special emphasis on observing type and amount of myopia and it’s clinical presentation. After mydriasis eyes were examined by retinoscopy and indirect ophthalmoscopy. Results: Prevelance of childhood myopia in hospital based study was 16.5 % with male to female ratio 53:47. Most of the children were belonging to urban area(63.61%). Headache was most common complain for hospital visit. Most common age group affected was 7-12 and 13-16 years. In 18.53% of patients family history was present. Conclusion: Due to high magnitude of uncorrected Myopia it appears to be a public health problem both in urban and rural areas. An uncorrected refractive error leads to learning difficulties and reduced performances in school, ultimately affecting the psycho-social development of the child. For prevention Large-scale visual acuity screening programs must be launched to detect low vision due to myopia early and an annual check up to update the spectacle prescriptions.

AB1378 Prevalence and associated factors of chronic widespread pain among the attendees of general practice in sri lanka

BackgroundChronic widespread pain (CWP) is a common health problem within the community and among the working population [1]. This has been identified as one of the most common complains encountered...