European Journal of Medicine

Number 8 (2), 2020

43-46
Prejudice, Stigma and the Refusal to Offer Health Services of an Obese Pregnant Woman – An Ethical Viewpoint

Authors: Astrit M. Gashi, Gent Sopa, Arianit Sherifi, Çlirim Vehapi, Dardan Ismajli, Albulena Gashi

Abstract

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Obesity in pregnancy is a medical condition that has short- and long-term negative consequences for the mother as well as for the child. Therefore, it is a necessity that these women are informed and educated about their condition as well as should be actively encouraged to reduce weight. Because of the negative social stereotype that follows obese persons, they face daily prejudice and stigma in their work, everyday life, and when receiving health services. This paper aimed to present a case, the refusal of the obstetricians to perform a cesarean section on an obese pregnant woman. The refusal was based on the fear of complications during or after the operative intervention, and subsequent consequences that they may imply. Refusing to treat this patient, regardless of the high risk of complications, was unjustified, unfair, and ethically unacceptable. There are no circumstances where the individual status of the patient should be a reason not to offer them the medical services that they need. The medical staff in these cases should have in mind any special medical precautions needed and apply their knowledge aiming an adequate and accurate medical service for every patient. Therefore human values are essential to good medical practice. Health personnel should not claim special moral status that would allow them to deny the patient's right to medical treatment and always show respect for patient autonomy.

47-55
Assessment of Left Ventricular Systolic Function after Acute Myocardial Infarction by Tissue Doppler Imaging

Authors: Mousa Qasim Hussein, Omar S. Hamad, Noor Hamza Abdulkhdhur Al-khuzaie

Abstract

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Number of views: 197

The coronary artery disease is the leading cause of mortality and morbidity globally and acute myocardial infarction is the commonest mode of presentation. The tissue Doppler imaging shows myocardial motion (measured as tissue velocity) at specific locations in the heart. Tissue velocity indicates the rate at which a particular point in the myocardium moves toward or away from the transducer. Integration of velocity over time yields displacement or the absolute distance moved by that point. The most common method for determining ventricular volumes is the Simpson rule, or the "rule of disks.” This technique requires recording an apical, four- and/or two-chamber view from which the endocardial border is outlined in end-diastole and end-systole. A cross-sectional study carried out in The AL-Kindey Teaching Hospital (November 2017 – July 2018), 60 patients, 39 (65 %) males and 21(35 %) females with acute myocardial infarction of first time admitted to CCU. All patient were admitted to Coronary Care Unit and Left Ventricular systolic function had been evaluated by measuring Systolic myocardial velocity (sm) by Pulse Wave tissue Doppler imaging and Ejection Fraction by Simpson’s method. Results revealed that 25 patients (41.7 %) of them presented with anterior Myocardial infarction, inferior Myocardial infarction in 17 patients (28.3 %), lateral Myocardial infarction in 11 patients (18.3 %), and septal Myocardial infarction in 7 patients (11.7 %). (60.6 %) of anterior Myocardial infarction, (24.2 %) of inferior Myocardial infarction, (9.1 %) of lateral Myocardial infarction, and (6.1) of septal Myocardial infarction were associated with Ejection Fraction <55. There were significant differences between means of 4 mitral annular sites Sm by ejection fraction for patients with anterior, lateral Myocardial infarction, and septal Myocardial infarction.

56-61
Recent Advances in Colon/Colorectal Cancer Biomarker Developments

Authors: Sanjay Kumar Pandey, Sweta Pandey, Sudhakar Dwivedi, Naresh Bajaj

Abstract

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Number of views: 209

Cancers of the colon and rectum known as colorectal cancer. Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Colorectal cancer usually begins as a slow-growing, non-cancerous polyp, which can progress over time to aggressive cancer. If a cancerous polyp is not removed, it can enter the lining of the large intestine, causing the cancer to spread to other organs through the blood or lymphatic vessels. With screening, it is possible to detect and remove polyps before they become cancerous. The increase in colorectal cancer awareness and screening has contributed to an overall decrease in the incidence of colorectal cancer over the past 30 years. Scientist have learned a lot about colorectal cancer, but it needs more research to find ways to prevent and detect the disease earlier. It is difficult to detect in the early stages. However, secretory proteins have been used as an ideal biomarker to detect the progression of colon cancer in cancer patients. Colorectal cancer detection techniques at the molecular level have facilitated the development of new signature drugs designed to inhibit unique pathways of colorectal cancer development and immunity.Serum/tissue protein expression may help general practitioners to identify colon cancer in earlier stages. Recently, the discovery of biomarkers is important in cancer biology and disease management. DNA, RNA, metabolites, enzymes, mRNAs, aptamers, and proteins biomolecules may help an early prediction of disease. This review explains recent advances on new developments in molecular markers associated with colorectal cancer.

62-66
Co-morbidities of Microcytic Anemia in Severe Acute Malnutrition Infants: A Tertiary Care Hospital Experience in Central India

Authors: Priyanka Shukla, Jyoti Singh, Sudhakar Dwivedi, Sanjay Kumar Pandey

Abstract

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Number of views: 211

When microcytosis occur with severe acute malnutrition it is characterized by body’s tissues thus organs do not get enough oxygen as the red blood cells becomes smaller in size and carries less oxygen which causes sudden major weight loss requiring a quick nutritional and medical intervention. SAM was diagnosed by WHO – MUAC method. Complete blood count and red cell indices were measured by automated 5-part hematoanalyzer and microcytosis was determined by peripheral smear method.Among all SAM infants with microcytic anemia; WBC was elevated and comparative mean value of RBC, MCV and MCH were statistically significant. Xeropthalmic stage and eyes puffiness was associated clinical symptoms of SAM infants with microcytosis. The result of the study emphasizes the importance of identifying the co-morbidities of microcytic anemia in SAM infants.

67-71
The Concept of Preparing Female Students for Pregnancy Management

Authors: Dina Venskovich

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Number of views: 217

In this article topical issues addresses, related to the preparation of pregnant students for pregnancy and the birth of healthy children. The special section «Physical Education for Pregnant Women» is developed and presented in the academic discipline «Physical Education» as «Additional Type of Education» intended for students studying in non-sports specialties in higher educational establishments. In most cases, in the process of life, all students are faced with the issues of motherhood and fatherhood, bearing healthy children and maintaining the correct lifestyle (lifestyle) during pregnancy. Surprising is the fact that these issues are not discussed in high school at school, they are not considered at the university, and only when a woman is already pregnant, she can attend theoretical classes in medical institutions, practical classes in various health and fitness centers (on a paid basis) or be self-taught and study the necessary material on your own. In our opinion, it is necessary to approach this period in life more consciously, to prepare your body in advance for bearing and giving birth to a healthy child. Be prepared for physiological changes and hormonal changes that will ensure the correct development of the fetus, as well as prepare for the upcoming delivery. If a woman in advance will think more seriously about her health and prepare her body for conception, then in the future we will be able to prevent the appearance of many problems and thus get away from the phrase – «A sick child is born from unhealthy parents».