Management Of Medical Problems Research Articles

Medical Diseases in Pregnancy: An Acute on Chronic Focus

In the last decade or so obstetric care has evolved and become more complex. This can be attributed to a combination of factors including rising obesity rates, maternal age and medical treatment advances. Clinicians are caring for more pregnant women with chronic medical disease in addition to any de novo presentations which may occur, emphasising the need for the general medicine body to feel confident and skilled in the management of medical problems before, during and after pregnancy. One of the difficulties faced by clinicians in the assessment and management of pregnant women is the differentiation between symptoms of a normal pregnancy vs symptoms of clinical significance which warrant further investigation, particularly in mothers with background medical disease. Careful consideration and knowledge of normal pregnancy physiology is required when assessing a pregnant women/birthing person to avoid closed thinking and adverse outcomes. Unfortunately, clinician inertia around the care of pregnant women is a common feature in maternal mortality reviews. The most recent maternal mortality report discusses common themes around cardiovascular disease in pregnancy, alongside management of acute and acute-on-chronic presentations in the context of common endocrine, gastrointestinal and neurological disease in pregnancy. This article discusses some of these themes and the management of common medical problems in pregnancy.

Postoperative delirium among elderly elective orthopedic patients in Addis Ababa Ethiopia: a multicentere longitudinal study

BackgroundDelirium is a neurocognitive disorder characterized by an acute and relatively rapid decline in cognition, disturbance of consciousness, reduced ability to focus, and shift of attention. It mainly affects elderly patients with an incidence of about 8–23% after an operation. It frequently occurs between 24-hrs and 5 days after surgery. It results in serious medical management problems. Hence, identifying the incidence and associated factors may help prevent and manage its sequel in the elderly.ObjectiveAssessment of the incidence and associated factors of postoperative delirium(POD) among elderly elective orthopedic surgical patients in Addis Ababa public hospitals, Ethiopia, 2024.MethodsA multi-centered longitudinal study was conducted on 220 elderly (age ≥ 65 years) patients in four selected public hospitals of the study area from February 2024 to May 2024, and a systematic sampling technique was used to select the study units. Data was collected through chart review and interviews of patients, and postoperative delirium was assessed using the confusion assessment method (CAM). Both bivariable and multivariable logistic regression models were used for statistical analysis. The strength of association was determined with an adjusted odds ratio (AOR) with a 95% confidence interval(CI) at a p-value of < 0.05.ResultsA total of 220 patients were studied, and the incidence of POD among elderly elective orthopedic surgical patients was 33.7%. Age 65–75(AOR = 0.47, 95%CI (0.226–0.97)), Induction using ketamine (AOR = 1.32, 95%CI(1.109–3.87), p = 0.003)), perioperative opioid use (AOR = 2.20, 95%CI(1.073 4.5313)), intraoperative anticholinergic use(AOR = 2.24,95%CI(1.831–4.235)), recent hospitalization history (AOR = 2.24,95%CI(1.202–4.206)), and transfusion (AOR = 2.83,95%CI(1.295–6.193)) were significantly associated with POD (p < 0.05).Conclusion and recommendationsThe incidence of POD in the study area was high (33.7%); advanced age, hospitalization history, Anesthesia induction by Ketamine, perioperative anticholinergic uses, opioid use, and blood transfusion use were associated factors for postoperative delirium. We recommend giving due attention to elderly patients with advanced age, history of hospitalization, perioperative Ketamie use, perioperative anticholinergic uses, opioid use, and blood transfusion use undergoing elderly elective orthopedic surgery.

Sustainable location-routing problem for medical waste management using electric vehicles

The sustainable management of medical waste is essential for environmental protection and public health safety, contributing to urban development and societal well-being. This study focuses on the medical waste Location-Routing Problem with Electric Vehicles (EVs), aiming to mitigate infection risk while providing cost-effective and energy-efficient logistics solutions. It encompasses diverse elements such as disposal location selection, vehicle scheduling, recharge strategies, time windows, working duration, and load-dependent energy consumption. To tackle this complex problem, we introduce an Evolutionary Decomposition-based Adapted Large Neighborhood Search algorithm (E-ALNS/D), which surpasses existing methods such as MOEA/D-HGS, MOEA/D-LNS, MPGA, and NSGAII-LNS across various urban settings. Empirical analysis and a case study reveal opportunities for enhancing medical waste management with EVs. Key findings show that optimizing service times, adopting fast-charging infrastructure, and strategically placing temporary disposal facilities in response to unforeseen demand spikes significantly reduce energy consumption, lower infection risk, and cut charging cost. Furthermore, selecting peripheral over central disposal locations better minimizes infection risks. This research offers valuable insights for decision-makers in EV-based medical waste management, emphasizing the need to balance public health, environmental sustainability, and economic efficiency. Our methodology paves the way for future research in sustainable medical waste management with EVs.

Research on the Management Strategy of College Medical Professional Practice Based on the Perspective of Talent Training

Medical practice is an important link of medical education in universities. Its purpose is to help students get familiar with the tasks and responsibilities of medical work, let students understand the specific application of professional theoretical knowledge and skills, and improve students' professional quality and medical service level. A good job of intern management can effectively achieve this goal. At present, there are many problems, such as medical practice in colleges and universities, such as imperfect management system, weak responsibility of some teachers, and poor adaptability of students, which need to be paid attention to by relevant educators. Based on the perspective of talent training, this paper briefly analyzes the importance of medical practice in colleges and universities, expounds the prominent problems of medical practice management in colleges and universities and the corresponding solutions, aiming to improve the quality of intern education management and promote the better development of students.

P866 Management of fistulizing Crohn's Disease in a moroccan population: about 125 cases

Abstract Background Crohn's disease is an inflammatory enterocolitis, which may be complicated by enteroenteric, enterovesical, rectovaginal, enterocutaneous and anoperineal fistulas. This is a retrospective study of fistulizing Crohn's disease cases followed in our gastroenterology department. Methods We report a retrospective and descriptive study, covering all cases of fistulizing Crohn's disease, collected in the hepato-gastroenterology department at our university hospital center during a 9-year study period, from 2015 to 2023. All patients with digestive and/or anal crohn's fistula were included. Comparison of categorical variables was performed with Fisher's exact test using SPSS 10.0 software. The significance level was p &amp;lt; 0.05. Results 125 patients had a fistulizing form of Crohn's disease. The location of fistulas was represented by anoperineal fistulas (32.6%), followed by enteroenteral (22.9%) and enterocutaneous (23%) fistulas, then enterovesical (9%) and rectovaginal (3.8%) fistulas. Surgical treatment was immediately indicated in all cases of enterocutaneous and enterovesical fistulas, and 66.7% of rectovaginal fistulas. Proctological drainage was performed in 57.1% of cases of anoperineal fistulas. 33 cases of anoperineal fistulas and one case of recto-vaginal fistulas were treated with infliximab. Clinical remission was also significantly associated with medical treatment with biologics versus immunosuppressants (P=0.0018). Surgical treatment remains indicated in the majority of cases of fistulizing Crohn's disease. Conclusion Fistulizing Crohn's disease poses a problem for medical and surgical management. Surgical treatment remains indicated in the majority of Crohn's fistula cases. This study also showed that endoscopic recurrence and clinical remission were significantly associated with the type of postoperative medical treatment.

Mini review on Artificial Blood Substitutes: Future perspective of Perfluorocarbon based oxygen carriers

The primary cause of death in the battle field and in civilian trauma is haemorrhagic shock. Around 50% combat deaths occur due to haemorrhage, depending on the severity of bleeding medical supervision can be provided like in catastrophic haemorrhage individual death occurs before providing the medical care and it is not a prehospital combat medical management problem during warfare scenario, even to transport wounded personnel to causality centre often takes 45 minutes to one hours. The hazardous nature of the forward combat areas and hostile operational environment frequently prevents medical personnel from quickly reaching the wounded even if the transport distances are small. Moreover, injuries with penetrating battlefield trauma often have only a "platinum 5 minutes." It is very important for military medical personnel to understand their options for treating haemorrhage quickly and efficiently during combat. Early intervention and definitive treatment could save up to 30% of soldier’s who die of action or of wounds. In view of this there is a requirement for the development of synthetic blood substitutes or oxygen therapeutic agents (OTA) in order to maintain the tissue oxygenation. Blood substitutes are the substances which mimic one of the physiological functions of the blood that is transportation of oxygen and carbon dioxide throughout the body. Blood substitutes or OTAs are being clinically tested as artificial oxygen carriers to improve tissue oxygenation and also to reduce allogenic blood transfusions. Two types of blood substitutes are reported so far: 1. Haemoglobin based oxygen carriers (HBOCs) and 2. Perfluorocarbon based oxygen carriers (PFOCs). PFOCs has huge advantages like universal compatibility, no requirement of cold storage, longer shelf life and no risk of infection transmission. These products have their own limitations and they have been withdrawn from international market for clinical use because of their side effects. It is a challenging task to the scientists to develop a safe, stable and biocompatible blood substitute for combat scenarios and also for civilian applications.

Medication-related problems in critical care survivors: a systematic review

ObjectivesThere are numerous, often single centre discussions of assorted medication-related problems after hospital discharge in patients who survive critical illness. However, there has been little synthesis of the incidence of...

Strategi Pengelolaan Limbah Bahan Berbahaya dan Beracun Fasilitas Pelayanan Kesehatan Rumah Sakit X Mandau

Hospitals as health service institutions that carry out individual health services in a plenary manner, apart from having a positive impact, they also have a negative impact on the environment and public health by producing medical waste. As a health service provider, hospital managers are obliged to prevent environmental pollution and maintain public health. This can be achieved by carrying out proper and correct medical waste management in accordance with applicable regulations. X Mandau Hospital has implemented medical waste management even though it is not optimal and still has many shortcomings. This study aims to analyze medical waste management at X Mandau Hospital using a regulatory approach and the factors that are considered to influence medical waste management.This type of research is observational research by describing the medical waste management system from the input and process aspects to find out the problems that exist in medical waste management at X Mandau Hospital and to develop a medical waste management strategy based on factors that affect both internal and external use. SWOT analysis. The types of data used are primary data, secondary data and literature studies. The results of research at X Mandau Hospital show that the stages in medical waste management are still not in accordance with applicable regulations. In the reduction and sorting stage, the storage stage and the processing stage, serious violations were found. With an average medical waste generation of 88.98 kg / day and with the inoperable condition of medical waste treatment equipment, Hospital X is considered to be facing serious medical waste management problems. The main problem found in the input aspect is the absence of good planning in the budgeting process for system development, operation and maintenance, this then has an impact on handling the generation of medical waste. In the process aspect, operational techniques that have not met the applicable regulations have resulted in conflicts with the community which have resulted in the rejection of incinerator operations. On the other hand, the incinerator operation itself has not yet obtained a processing permit from the authorized agency. To deal with this problem, the management strategy that can be taken is to carry out efforts to develop and improve medical waste treatment facilities utilizing government support, availability of human resources, budget, facilities and infrastructure as well as the availability of technology to then take advantage of opportunities for collaboration with other parties in medical waste treatment.

Developing a novel tool to assess the ability to self-administer medication - A systematic evaluation of patients' video recordings in the ABLYMED study.

BackgroundOlder people often experience medication management problems due to multimorbidity, polypharmacy and medication complexity. There is often a large gap between patients’ self-reported and actual abilities to handle the self-administration of their medication. Here we report on the development and evaluation of a new tool to assess the ability of non-demented hospitalized patients to self-administer medication in different dosage forms. To this end, we video-recorded the patients’ medication management performance and implemented a novel assessment scheme, which was applied by several independent raters.MethodsSixty-seven in-patients ≥70 years of age and regularly taking ≥5 different drugs autonomously of the ABLYMED study agreed to the video recording of their medication management performance with five different dosage forms. All raters underwent a training and applied a standardized assessment form and written guide with rating rules for evaluation. In a pilot phase, video recordings of three patients were rated by 19 raters (15 medical students, two expert raters to determine a reference standard, and two main raters who later rated the total sample). In the rating phase, based on the ratings obtained from the two main raters, we determined interrater (assessed every section of 20 patients as agreement between the raters at one point of time) and intrarater (assessed as consistency within each rater across three points of time) agreement by intraclass correlation analysis.ResultsIn the pilot phase we obtained an overall sufficient agreement pattern, with an adjustment of the rating rules for patches. In the rating phase we achieved satisfactory agreement between the two raters (interrater reliability) and across different points of time (intrarater reliability). For two dosage forms (eye-drops and pen), rater training needed to be repeated to reach satisfactory levels.DiscussionOur novel rating procedure was found to be objective, valid and reproducible, given appropriate training of the raters. Our findings are an important part of a larger research project to implement a novel assessment for the ability to self-administer medication in different dosage forms. Further, they can support the development of patient trainings to improve medication management and secure independent living.

Need for Improvements in Medical Device Management in Low- and Middle-Income Countries: Applying Learnings from Japan's Experience.

Medical devices provide important infrastructural support in modern healthcare systems. However, in low- and middle-income countries (LMICs), inadequate maintenance and management of devices due to a shortage of healthcare personnel (not only doctors and nurses but also other professionals including biomedical engineers [BMEs]) has resulted in inefficient and weak healthcare systems. High-income countries, including Japan, have resolved these problems by developing human resources and technologies to maintain and manage these systems. In this paper, we discuss the possibility of mitigating these problems in LMICs through human resource development and technology, based on lessons from Japan's experience. The problem of medical device management in LMICs stems from the fact that there are few professionals, such as BMEs, in charge of the management of medical devices and that clinical engineering departments in charge of device management have not been established. Since the 1980s, Japan has introduced a licensing system for BMEs, establishing operational guidelines to clarify their responsibilities within hospitals and using technology to utilize data and reduce workloads. Nevertheless, workload problems and high costs required to introduce computerized management systems persist. Moreover, it would be difficult to implement the same measures as those adopted in Japan in LMICs where there is an overwhelming shortage of medical personnel. It may be necessary to further reduce workloads for data entry and device management; use up-to-date, inexpensive, and user-friendly technology; and train non-BME personnel to operate and maintain equipment.

Big Data Analysis Report on Trial of Obstetrics and Gynecology Medical Damage Liability Dispute Cases in China from 2017 to 2021

Objective: To analyze the data of the trial cases of medical damage liability disputes in obstetrics and gynecology from 2017 to 2021, with a clear understanding of Chinese medical damage liability disputes. Methods: The data of medical damage liability dispute cases in obstetrics and gynecology during 2017-2021 were collected and analyzed. The analysis directions included (1) The trial types of civil litigation cases in each year; (2) Annual distribution of civil litigation cases in obstetrics and gynecology in an annual year basis; (3) Distribution of the amount of the subject matter and the amount of civil compensation; (4) The geographical distribution of litigation cases; (5) Characteristics of the medical institution as defendant; (6) Distribution of litigation departments in medical institutions; (7) Common causes of action in obstetrics and gynecology cases; (8) Results of common injuries in obstetrics and gynecology cases; (9) Court confirmation of disputes over medical records. Results: According to the data analysis results, the distribution of litigation trial types, annual distribution, compensation amount distribution, regional distribution and other basic data were obtained, and based on the analysis of the characteristics of medical institutions, department distribution, causes of litigation, damage structure and court recognition results were systematically discussed. Conclusion: Although the liability disputes for medical damage in obstetrics and gynecology have been declining in recent years, the problems in medical treatment and management can not be ignored. Attention should be paid to them and medical problems should be avoided.

PENGELOLAAN LIMBAH MEDIS RUMAH SAKIT DARURAT WISMA ATLET DALAM PENANGANAN COVID-19 BERDASARKAN HUKUM LINGKUNGAN INTERNASIONAL

Environmental threats due to medical waste management problems have increased due to the Corona Virus Disease 19 (Covid-19) pandemic. Indonesia has experienced an increase in medical waste due to the Covid-19 pandemic, so that medical waste management at the Wisma Atlet Emergency Hospital needs more attention. The problem in this study, namely whether the medical waste management rules at the Wisma Atlet Emergency Hospital (RSDC) in handling COVID-19 are in accordance with the rules of International Environmental Law along with Indonesian Environmental Law and whether the management of COVID-19 medical waste at the Wisma Atlet Emergency Hospital is in accordance with the rules of Indonesian Environmental Law. The type of research used is normative juridical, data processing is done qualitatively, and deductive conclusions are drawn. Based on the analysis conducted, the rules for managing COVID-19 medical waste at Wisma Atlet Emergency Hospital are in accordance with International Environmental Law made by WHO and UNEP and Indonesian Environmental Law made by the Ministry of Environment and the Ministry of Health, including the SOP of Wisma Atlet Emergency Hospital regarding medical waste management. The practice of medical waste management at Wisma Atlet RSDC is also in accordance with Indonesian Environmental Law.

Depression/anxiety symptoms and self-reported difficulty managing medication regimen among community-dwelling older adults

ObjectiveTo examine the associations between depression/anxiety severity and changes in severity and self-reported difficulty managing medications among a representative sample of community-residing US Medicare beneficiaries without a reported dementia diagnosis. MethodWe used the 2018 and 2019 National Health and Aging Trend Study (analysis sample N = 3198, 98% age 70+). Depression/anxiety was measured with the PHQ-4, and difficulty managing medication was self-reported. Following descriptive statistics, we fit a multinomial logistic regression model to examine the associations between depression/anxiety symptoms in 2018 and changes in severity between 2018 and 2019 and self-reported level of difficulty managing medication in 2019. ResultsOf past-month prescription medication users in 2019, 85.2%, 10.7%, and 4.1% reported no difficulty, a little/some difficulty, and a lot of difficulty or partial/full reliance on other's help for health/functioning reasons, respectively. Both mild and moderate/severe levels of depression/anxiety in 2018 were associated with significantly higher risks of a little/some difficulty and a lot of difficulty/other's help in 2019. Compared to no change in depression/anxiety symptoms between 2018 and 2019, decreased symptoms were associated with lower risk (RRR = 0.47, 95% CI = 0.28–0.78) and increased symptoms were associated with higher risk (RRR = 1.73, 95% CI = 1.12–2.67) of a little/some difficulty managing one's medication. ConclusionsDecrease and increase in depression/anxiety are associated with decreased and increased risk, respectively, of medication self-management difficulty among community-residing older adults. Healthcare providers should more carefully assess for medication management problems in their older adults with depression and anxiety symptoms and provide individually tailored interventions for those with great difficulty self-managing medication.

Home medication management problems and associated factors among psychiatric patients using home care pharmacy services at government hospitals in western Malaysia

BackgroundProper home medication management plays a role in improving medication adherence, preserving drug efficacy and ensuring safe medication practices, which is crucial to establish positive treatment outcomes. However, no published studies are available on home medication management among psychiatric patients. The study aimed to identify home medication management problems among psychiatric patients in Malaysia and to examine the associations of inappropriate medication storage and lack of a medication administration schedule with sociodemographic factors, disease insight, number of medications and type of home care pharmacy services (HCPS).MethodsThis multicentre cross-sectional study was conducted among psychiatric patients using HCPS in six government hospitals in western Malaysia. Data were extracted from the HCPS form used for each visit as per the protocol published by the Pharmaceutical Services Division, Ministry of Health Malaysia. A minimum sample size of 169 was needed. Proportional random sampling was applied. The associations of inappropriate medication storage and lack of medication administration schedule with study parameters were analysed using multiple logistic regressions.ResultsA total of 205 home visits were conducted with 229 home medication management problems identified; inappropriate medication storage and lack of medication administration schedule topped the list. Inappropriate medication storage was significantly associated with low income [AOR = 4.34 (95% CI 1.17:15.98), p = 0.027], alcohol consumption [AOR = 14.26 (95% CI 1.82:111.38), p = 0.011], poor insight [AOR = 2.34 (95% CI 1.08:5.06), p = 0.030] and part-time HCPS [AOR = 2.60 (95% CI 1.20:5.67), p = 0.016]. Lack of administration schedule was significantly associated with low income [AOR = 6.90 (95% CI 1.46:32.48), p = 0.014], smoking [AOR = 2.43 (95% CI 1.20:4.92), p = 0.013], poor insight [AOR = 5.32 (95% CI 2.45:11.56), p < 0.05] and part-time HCPS [AOR = 2.96 (95% CI 1.42:6.15), p = 0.004].ConclusionsInappropriate medication storage and a lack of a medication administration schedule are common among psychiatric patients. The study also highlighted the potential of HCPS to improve disease insight and home medication management among psychiatric patients if the service is utilized fully.

Prevalence and Risk Factors for Diabetic Complications: 8-Year Retrospective Report from a Single Regional Diabetes Center to the Eastern Region of Morocco

Objective: This study aims to investigate the risk factors of diabetes and its complications in the eastern region. Design: This is a retrospective study conducted on diabetic patients followed at the regional center of diabetology and chronic diseases in Oujda for the period 2012-2019. Materials and Methods:Clinical, biological, therapeutic and anthropometric data were collected from patient records. Result: A total of 3.976 patients participated in the study. The frequency of complications is around 1/3. One diabetic out of four has at least one modifiable cardiovascular risk factor: arterial hypertension at 25.35%, dyslipidemia at 12.67%, overweight and obesity at 35.48% and 27.8%. The most discriminating factors in the pathogenesis of diabetic complications in order of importance are age of diabetes, hypertension, HbA1c and dyslipidemia, statistically significant associations were found with p 0.0082, 0.0001, 0.002, 0.0001 respectively). Then a multifactorial analysis coupled with a hierarchical ascending classification in birth data to two large groups of diabetics with complications and those without complications. Discussion: The age of trend T2DM has fallen to less than 40 years, so that the first characteristics of an epidemiological and nutritional transition are being established in our region. In addition, blood pressure and glycemic imbalance in diabetics reflect a problem of medical and therapeutic management that needs to be resolved. Conclusion: The pathogenesis of diabetic complications is multifactorial. However, medical care must be taken to reduce the risk of degenerative complications.

Proposed Solutions to Address the Challenges of Medical Waste Management in Health Facilities in Kamukunji Sub-County, Nairobi City County, Kenya

Medical waste management in Kenya has been greatly affected by the country's elevated production levels. The majority of medical facilities do not have an extensive medical waste management system, or if they do, they do not handle waste thoroughly, and therefore is detrimental to humans and the environment. This research focuses on health facilities’ management of medical waste in Kamukunji sub-county, assessing the specific problems of medical waste management in that area. This was a study focusing on healthcare workers, their working conditions and habits. This study was an analytical cross-sectional study design. Multistage sampling methods for the selection of 10 health facilities and 141 study participants. The R square was 0.746, indicating that medical waste management was harmed by a lack of funding, insufficient logistics, a lack of disposal sites, and a lack of understanding. This demonstrated a 74.6 percent variance in healthcare waste management due to a lack of funding, insufficient logistical supply, a lack of disposal site, and a lack of awareness. The remaining 25.4% implies that there were additional issues affecting the healthcare waste management systems of the ten health facilities evaluated. By explicitly identifying a given color with a certain category and its accompanying hazard, segregation aids to make waste processing safer. During the research period, Pumwani Maternity Hospital generated the most medical waste (80Kg) and Bahati Health Center generated the least (15Kg). The study concludes that periodic updates in medical waste management are necessary, as is refresher training for healthcare professionals and waste handlers. Additionally, it is advised that each health care facility have a safe and hygienic system in place for the handling, segregation, c collection, storage, transportation, treatment, and disposal of medical waste. All health facilities in Kenya, the study states, should adhere to the National Policy on Injection Safety and Medical Waste Management (2007). The 2007 strategy aims to emphasize the need of advocating for both the support and execution necessary to adequately manage healthcare waste. Keywords: Medical waste generation, health risks, medical waste management solutions, challenges of medical waste management, health facilities

Medical Waste Treatment Technologies for Energy, Fuels, and Materials Production: A Review

The importance of medical waste management has grown during the COVID-19 pandemic because of the increase in medical waste quantity and the significant dangers of these highly infected wastes for human health and the environment. This innovative review focuses on the possibility of materials, gas/liquid/solid fuels, thermal energy, and electric power production from medical waste fractions. Appropriate and promising treatment/disposal technologies, such as (i) acid hydrolysis, (ii) acid/enzymatic hydrolysis, (iii) anaerobic digestion, (vi) autoclaving, (v) enzymatic oxidation, (vi) hydrothermal carbonization/treatment, (vii) incineration/steam heat recovery system, (viii) pyrolysis/Rankine cycle, (ix) rotary kiln treatment, (x) microwave/steam sterilization, (xi) plasma gasification/melting, (xii) sulfonation, (xiii) batch reactor thermal cracking, and (xiv) torrefaction, were investigated. The medical waste generation data were collected according to numerous researchers from various countries, and divided into gross medical waste and hazardous medical waste. Moreover, the medical wastes were separated into categories and types according to the international literature and the medical waste fractions’ percentages were estimated. The capability of the examined medical waste treatment technologies to produce energy, fuels, and materials, and eliminate the medical waste management problem, was very promising with regard to the near future.

Blockchain in medical informatics

Aiming at the problems of information storage security and information sharing among various medical information systems, combined with blockchain consensus mechanism, encryption mechanism, peer-to-peer network, and other technologies. A medical information system scheme based on blockchain is proposed to realize the storage and sharing of medical information. The program has the characteristics of non-tampering and decentralization. This paper has designed a Practical Byzantine fault tolerance (PBFT) medical blockchain information management system. This system is multi-node maintenance and shared management system that can prevent medical information data from being tampered with and medical information leakage. It can be used to solve Medical information data management problems. Compared with the existing medical blockchain system, this medical information management system has certain advantages and better applicability.

Medical waste management during COVID-19 pandemic, a review study

Medical waste management problems are rising due to the crisis brought upon by the coronavirus disease 2019 (COVID-19) as a worldwide pandemic. The security management of medical care worldwide increases their attention due to the high risk of COVID-19 medical waste. This paper gives a review of medical waste management during the COVID-19 pandemic around the world. Furthermore, an effort has been made to prepare a review of the characteristics, generation, collection, transportation, disposal, and treatment technologies of solid waste management worldwide. Detailed data on medical waste management practices, including collection, recovery, and disposal, have been presented. The poor medical waste management in Iraq before and during COVID-19 causes a huge environmental risk and can be a possible reappearing infection source. Hence, the study also points out some recommendations for handling COVID-19 pandemic medical waste properly to reduce possible secondary effects on health and the environment and manage any possible pandemics in the future.

Equity analysis of Chinese physician allocation based on Gini coefficient and Theil index

BackgroundUnequal allocation of medical physician resource represents one of major problems in the current medical service management in China and many other countries. This study is designed to analyze the current distribution of physicians in 31 provincial administrative regions in China, to estimate the fairness of the distribution of physicians and provide a theoretical basis for the improvement of the allocation of physicians.MethodsThis study took physicians from 31 provincial administrative regions in China as the study objects, and the data were obtained from the China Health Statistics Yearbook 2019 and the official website of the National Bureau of Statistics of China. Calculation of the Gini coefficient (G) and the Theil index (T) were carried out by drawing the Lorenz curve. The fairness of present physician location in 31 provincial administrative regions in China was analyzed from the perspective of distribution by both population and service area.ResultsThe Gini coefficients of medical physicians in China are 0.003 and 0.88 by population and by service area, respectively. This shows that the distribution of medical physicians is fair basing on population, and there is little difference in the number of physicians per 1000 population in different regions. However, the physician distribution basing on service area is highly unfair and shows a large gap in the number of physicians per square kilometer between different regions. In general, Beijing, Zhejiang, Shanghai, Jiangsu, Shandong, and Tianjin are higher than the overall level of 31 provincial administrative regions. In addition, the number of medical physicians in Zhejiang, Shandong, Beijing and Jiangsu is over-provisioned.ConclusionBridging the number of medical physicians in different regions is a key step to improve the equity of physicians’ resource allocation. Thus, findings from this study emphasize the need to take more measures to reduce physician quality differences between regions, balance and coordinate medical resources. This will increase the access of all citizens to quality medical services.