Mediterranean Journal of Medical Sciences

1-8

Authors: Syed Atiqur Rahman, Md Rahman, Shahidul Islam

Background: The adequacy of mini-plate fixation for the repair of angle fractures is a continuing subject of debate. Despite advances, treatment of mandibular fractures has continued to be associated with multiple complications. Objectives: The current prospective study aimed to compare the complications between two surgical intervention groups. Methods: The study group receiving one mini-plate for rigid fixation of simple angle fractures of mandible were 21 in numbers and 25 patients received two mini-plates. Results: Overall complication rate was 19.04% in case of single plate group whereas 16% cases in double mini-plate. But infection rate in single mini-plate intervention group was little less than double plate intervention group. Malocclusion was not reported in double plate intervention group where as approximately in 5 % cases of single plate intervention group reported malocclusion in this study. Statistical analysis and p-value showed no significant difference between two surgical intervention groups. Interpretation & Conclusion: For better compliance of the patients having fracture at the angle of mandible, either one or two mini-plate can be applied. Key words: mandibular fracture, miniplates, antibiotic therapy

13-18

Authors: Selam Shkurti

Background: & Objectives: Urinary tract infection is one of the most commonly occurring infections among the patients with diabetes mellitus. Methods This investigation was based to evaluate the incidence of UTI in patients with DM. Between January, 2013 to November, 1000 diabetic urine samples were collected. All urine samples were processed in the lab following standard laboratory protocol. Results: A total of 25 UTI organisms were isolated from 361 urine samples collected from the diabetic patients attending the Department of Emergency, University Hospital Center "Mother Theresa” (QSUT) from. The incidence of UTI was recorded to 36.1%. Escherichia coli (54%) was found to be the major cause of UTI. About 5 different types of organisms isolated from the UTI samples were randomly chosen to test against the UTI antibiotics. Interpretation & Conclusion: The antibiotic susceptibility pattern revealed that ciprofloxacin and nitrofurantoin were most effective to e.coli 79.6%, and 89.4%. These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies and to assist clinicians in the choice of antibiotic therapy to prevent misuse, or overuse of antibiotics. Key Words: Diabetes mellitus (DM), Urinary Tract Infection (UTI), Bacteria, antimicrobial resistance

23-36

Authors: Najam Afaq Qureshi, Ghulam Muhammad Kundi, Qamar Afaq Qureshi, Robina Akhtar, Liaquat Hussain

Background & Objectives:The use of eHealth technologies, including mobile health, is spreading rapidly in the developing countries. According to World Health Organization (WHO), the use of mobile phones and computers is growing in these countries. Methods: Majority of the programs that WHO looked at in developing countries are identified as "technology enabled," meaning they used "information and communications technology" (ICT) to improve healthcare. The leading technologies in this context are phones, computers, and texting. The later fell into third place because so many people in these countries are illiterate. Interpretation & Conclusion: E-health systems are extending geographic access, data management, facilitating communications between patients and providers, and improving treatment and diagnosis. Among the leading types of tele-health in developing countries are "video chat" programs and phone "hotlines" that provide remote access to physicians. This research paper highlights the different aspects of eHealth systems with regard to adoption and use in developing countries. Keywords: ICTs, Adoption, Use and Developing States.

1-5

Authors: Mehmet ÖZDEMIR, Gülay AKGÜL

Background & objectives: The burden of kidney disease is disproportionately high in central Anatolia, and the conditions often remain undiagnosed until late-stage disease. In order to reduce this burden, strategies must be implemented to improve the detection of kidney disease, and preventative measures must be targeted at those at greatest risk of disease. Important risk factors among include hypertension, diabetes, and obesity. As the exact prevalence of proteinuria is not known in the general population, we undertook this study to estimate the same in a rural adult population in Kirsehir district. Methods: A survey of health and health related issues was conducted on 2524 volunteers, average age 52.19 years, selected randomly from the Kirsehir District, Turkey. A dipstick urinalysis and test for Proteinuria was performed on a clean void, untimed urine sample as a part of a 4-hour interview/examination. Ultrasound of the abdomen was done in patients with renal failure and renal biopsy was performed in selected patients. Results: Of the total 2524 individuals screened, 61.3 per cent were females. Mean age of the study population was 51.19 ± 11.2 yr. First dipstick test identified 289 individuals positive for albuminuria. Repeat dipstick could be done in only 263, of whom 117 showed persistent albuminuria. Significant proteinuria was detected in 14 individuals of the 208 who had 24 h urine protein measured. Of these 14 patients, 3 were found to have chronic renal failure, 6 were presumed to have diabetic nephropathy clinically, one each had focal segmental glomerulosclerosis and biopsy proven diabetic nephropathy, and 4 patients had proteinuria of unknown aetiology. Interpretation & conclusion: The prevalence of proteinuria in this adult rural population was 0.47 per cent (0.30-0.67%) and Males were more affected than females. The detection and treatment of chronic kidney disease in 14 individuals is bound to reduce the rate of decline of renal functions. Key words: Albuminuria - dipstick - endstage renal disease - proteinuria

13-20

Authors: Najam Afaq, Qureshi Qamar, Afaq Qureshi, Muhammad Zubair Khan, Bahadar Bahadar Shah, Irfan Marwart

Background & objectives: Several studies have evaluated the impacts of ICTs on decisionmaking process in both public and private health organizations but there is a dearth of such studies that integrate ICTs and effective decision making in Pakistan. Since the Pakistani governments continue to provide huge IT investment for its designated e-government agencies, the need to comprehend the impacts of ICTs on effective decision making becomes more important. Methods: This study strives to ameliorate the comprehension of the impacts of ICTs for decision-making process at all management levels of both public and private health organizations in Pakistan. Research on the information and communication technologies for decision-making is tabling new tools and techniques in the marketplace. Results: This study attempts to unearth literature review-based definition of the local decision-situations to help private and public sector organizations in Pakistan. Interpretation & conclusion: In the emerging ICTs environment, IT elements such as e-mail and group support facilities improve the coordination among the members of an organization in decision making. The use of these ICTs improves the organizational communication, which ultimately leads to effective decision-making Key words: ICTs; adoption factors; decision-making; healthcare; developing countries.

31-52

Authors: Qamar Afaq Qureshi, Najam Afaq Qureshi, Muhammad Zubair Khan, A Nawaz, Bahadar Shah

Background & objectives: In connection with access to information in developing countries, information flows through existing networks of communication is a main theme in the current IS literature . Methods:Information-intensive infrastructure is a requirement for information dissemination due to the shortage of network infrastructure in the majority of developing states. It is verified by many researchers that information managing technologies with their main purpose of ‘handling information’ have the advantage to enhance already existing technologies by making better information-communication a priori to new ICT innovations .Presently health information system infrastructure is deficient in resources to meet the demands and needs of increasing population in developing countries. Health care systems of developing countries have major barriers like poverty and lack of technological sophistication. Results:The basic difficulties or barriers in using information technologies include poor or inadequate infrastructure, insufficient access to the hardware and inadequate or poor resources allocation. By eliminating these barriers population health status can be improved in developing countries. Interpretation & conclusion: This study aims to determine the main issues and prospects for ehealth in the current situation of developing countries like Pakistan and the way forward for policy makers to manage all issues in future for more effective and rational decision-making in healthcare organizations. Key words: e-health; challenges; prospects; developing countries; Pakistan