• Title/Summary/Keyword: clinical supervision

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Analysis on Outpatients with Postpartum Disease at the Korean Gynecology Clinic of Traditional Korean Medicine Hospital (한방병원에 내원한 산후병 환자의 특성 및 증상에 대한 분석)

  • Hwang, Young-Sik;Park, Nam-Chun;Lee, Jin-Wook;Yang, He-Rynn;Park, Seung-Hyeok;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.61-78
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    • 2018
  • Objectives: The purpose of this study was to analyze the current characteristics of outpatients with postpartum disease and provide a treatment instruction in the clinical field. Methods: To analyze characteristics of outpatients with postpartum disease, We searched medical records from January 1, 2015 to December 31, 2017 using Z34 (Supervision of normal pregnancy), O94 (Sequelae of complication of pregnancy), U327 (産後風) and 388 postpartum patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $33.73{\pm}3.62$ years old, 356 (91.75%) patients are full term pregnancy, 201 (51.81%) patients are first delivery, 79 (20.36%) patients had past history of abortion and 63 (16.24%) patients had past history of gynecologic disease. 2. The most subjects visited in April (10.31%). The mean duration from delivery date to visiting date was $131.5{\pm}214.6$ days. The mean number of visits after the initial visit was $1.91{\pm}1.7$. 3. The characteristics related with pregnancy and delivery are as follows. The number of subjects taken assisted reproductive technology was 19 (4.9%) and suffering from gestational disease was 28 (7.22%). The mean body weight difference between full term pregnancy and visiting date was $-8.24{\pm}3.57kg$. The number of subjects discharging lochia on visiting date was 167 (43.04%) and breastfeeding was 262 (67.53%). 4. The most chief complaint was arthralgia in 217 (55.93%) followed by general weakness, cold sensation, edema, sweating disorder, dizziness, lower abdominal pain, digestion disorder, heat sensation, defecation disorder and urination disorder. 5. The most accompanied symptom was arthralgia in 322 (82.99%), followed by sleep disorder, cold sensation, general weakness, sweating disorder, defecation disorder, edema, dizziness, digestion disorder, urination disorder, lower abdominal pain and heat sensation. 6. A total of 356 subjects were taken herbal medicine. The most prescribed herbal medicine to subjects was Gungguijohyeol-eum-gamibang (29.59%). Conclusions: These results could be helpful to diagnose and treat postpartum patients in Korean gynecologic clinical fields.

A Case of Multi-organ Failure due to Acute Chromic Acid Poisoning (급성 크롬산 중독으로 인한 다발성 장기 부전 1례)

  • Jung, Hyun Min;Eun, Hee Min;Paik, Jin Hui;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.118-121
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    • 2012
  • Chromic acid is a strong metal acid and acute poisoning is very rare. However, chromic acid causes serious complications, such as skin injuries, as well as renal and hepatic failure. We report on a case of a 47-year-old male who accidentally had chromic acid spilled over his nose and face. For the first few days, he was treated with ascorbic acid and massive hydration. However, after three days, his condition began to worsen. He was treated with hemodialysis for anuria and acute renal failure, and antibiotics for pneumonia. On day 10 of hospitalization, he expired of multi-organ failure. We suggest firm control and close supervision of chromic acid in the work place, and, considering severe complications of chromic acid, we propose a nearly and aggressive treatment.

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The Rat Model in Microsurgery Education: Classical Exercises and New Horizons

  • Shurey, Sandra;Akelina, Yelena;Legagneux, Josette;Malzone, Gerardo;Jiga, Lucian;Ghanem, Ali Mahmoud
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.201-208
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    • 2014
  • Microsurgery is a precise surgical skill that requires an extensive training period and the supervision of expert instructors. The classical training schemes in microsurgery have started with multiday experimental courses on the rat model. These courses have offered a low threat supervised high fidelity laboratory setting in which students can steadily and rapidly progress. This simulated environment allows students to make and recognise mistakes in microsurgery techniques and thus shifts any related risks of the early training period from the operating room to the lab. To achieve a high level of skill acquisition before beginning clinical practice, students are trained on a comprehensive set of exercises the rat model can uniquely provide, with progressive complexity as competency improves. This paper presents the utility of the classical rat model in three of the earliest microsurgery training centres and the new prospects that this versatile and expansive training model offers.

Home Based Dysphagia Rehabilitation for Stroke Patients Using Information and Communication Technology

  • Kim, Heejeong;Kown, Yonghwa;Choi, Heesu
    • Journal of International Academy of Physical Therapy Research
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    • v.12 no.1
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    • pp.2267-2271
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    • 2021
  • Background: Recently, a new home-based dysphagia rehabilitation method using information and communications technology (ICT) has been reported, but clinical evidence is still lacking. Objectives: To investigate the effects of home-based dysphagia rehabilitation using ICT on tongue muscle strength and volume in patients with developed dysphagia after stroke. Design: Randomized controlled trial design. Methods: Twenty patients who developed dysphagia after stroke were enrolled. The experimental group received dysphagia rehabilitation in the form of ICT-based home care. In contrast, the control group received traditional rehabilitation based on swallowing under the supervision of occupational therapists. All interventions were conducted five times a week for four weeks. Results: Both groups showed statistically significant increases in tongue muscle strength and volume after the intervention (P<.05, both). However, there were no significant differences in tongue strength or volume between the two groups after the intervention (P>.05, both). Conclusion: Home-based dysphagia rehabilitation using ICT showed effects similar to those of conventional swallowing rehabilitation in patients who developed dysphagia after stroke. These findings suggest that dysphagia rehabilitation can be conducted at home without the help of a therapist.

Quality of Breast Cancer Early Detection Services Conducted by Well Woman Clinics in the District of Gampaha, Sri Lanka

  • Vithana, Palatiyana Vithanage Sajeewanie Chiranthika;Ariyaratne, M.A.Y.;Jayawardana, P.L.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.75-80
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    • 2013
  • Background: Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. Aim: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. Methods: The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003-2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. Results: CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35-90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7-20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ${\geq}70%$, the cut off set for satisfaction. Conclusions: Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

Opinions and Perceptions on Allowing Nursing Students' Practice among Inpatients at a University Hospital (종합병원 입원 환자의 간호대학생 실습허용에 대한 견해 및 인식)

  • Kim, Youngjin;Kim, Jeesun;Kim, Hyerim;Park, Subi;So, Saetbyul;Jung, Bosung;Choh, Eunae;Lee, Seonyoung;Kim, Jeongeun
    • Perspectives in Nursing Science
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    • v.14 no.1
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    • pp.10-20
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    • 2017
  • Purpose: The aim of this study was to explore the patients' perspectives on nursing students' clinical practices in the wards, and to investigate their willingness for allowing students to practice on them. Methods: This was a descriptive study. 116 inpatients were recruited from the S University Hospital. A 60-item questionnaire was applied to collect the data. The participants were 19 years and older with sound judgement, and were not in special or intensive care units. Data analysis was done in SPSS/WIN 22.0 using descriptive statistics, Fishers exact test, and the ANOVA test. the participant answered to questionnaire from April 29th 2016 to May 10th. Results: 40 participants (34.5%) stated they would allow students' practice, while 72 (61.2%) said they would allow only under staff supervision. 5 participants (4.3%) stated they would not allow whatsoever. The 3 most allowed were emotional support, oral care, and vital signs measurement while the 3 least allowed were gastric feeding, intravenous catheterization, and urinary catheterization. Conclusion: Patients were more inclined to allow students to practice on them when a member of the medical team was present. A fair number of participants said they would be more inclined to allow students' practice if they felt the student was competent; hence, reinforcing simulation sessions is vital in enhancing students' competency and ultimately practice allowance.

The Effects of the Mixture of Herbal Extract on Developing Plaque and Gingivitis (생약복합제재에 의한 구강양치가 치태 및 치은염에 미치는 영향)

  • Shin, Sug-Rang;Kim, Sung-Jo
    • Journal of Periodontal and Implant Science
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    • v.28 no.2
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    • pp.377-388
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    • 1998
  • This double-blind controlled clinical and microbiological study was carried out to determine the effects of mouthwash preparation containing the mixture of herbal extract on developing plaque and gingivitis in the experimental gingivitis model. Following a 2-week normalization period, 34 dental students were distributed randomly into 1 of 3 treatment groups. They rinsed, under supervision, two times daily for 3 weeks with either normal saline(CT), 0.1% chlorhexidine(CH), or the mixture of herbal extract (HT), but refrained from any oral hygiene measures. The Plaque Index(PlI), the Gingival Index(GI), and the amount of Gingival Crevicular Fluid(GCF) were measured at week 0,1,2, and 3 of the experimental period, while the assessment of total wet weight of plaque and the phase contrast microscopic examination of plaque were performed at the end of experimental period(3 weeks). Subjects using mouthrinse preparation containing the mixture of herbal extract demonstrated negligible, if any, changes in the accumulation and microbial composition of plaque compared to those using normal saline, while the reduction of gingival inflammation by this mixture was highly significant and comparable to that of chlorhexidine. The results of this study indicate that the preparation containing the mixture of herbal extract do not provide any antiplaque benefits but is very effective in inhibiting the development of and in reducing existing experimental gingivitis when used as mouthrinse. Further research is needed to determine whether a significant reduction of gingival inflammation without a concomitant decrease in plaque accumulation is of clinical importance.

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Effects of 1 year of training on the performance of ultrasonographic image interpretation: A preliminary evaluation using images of Sjogren syndrome patients

  • Kise, Yoshitaka;Moystad, Anne;Bjornland, Tore;Shimizu, Mayumi;Ariji, Yoshiko;Kuwada, Chiaki;Nishiyama, Masako;Funakoshi, Takuma;Yoshiura, Kazunori;Ariji, Eiichiro
    • Imaging Science in Dentistry
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    • v.51 no.2
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    • pp.129-136
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    • 2021
  • Purpose: This study investigated the effects of 1 year of training on imaging diagnosis, using static ultrasonography (US) salivary gland images of Sjögren syndrome patients. Materials and Methods: This study involved 3 inexperienced radiologists with different levels of experience, who received training 1 or 2 days a week under the supervision of experienced radiologists. The training program included collecting patient histories and performing physical and imaging examinations for various maxillofacial diseases. The 3 radiologists (observers A, B, and C) evaluated 400 static US images of salivary glands twice at a 1-year interval. To compare their performance, 2 experienced radiologists evaluated the same images. Diagnostic performance was compared between the 2 evaluations using the area under the receiver operating characteristic curve (AUC). Results: Observer A, who was participating in the training program for the second year, exhibited no significant difference in AUC between the first and second evaluations, with results consistently comparable to those of experienced radiologists. After 1 year of training, observer B showed significantly higher AUCs than before training. The diagnostic performance of observer B reached the level of experienced radiologists for parotid gland assessment, but differed for submandibular gland assessment. For observer C, who did not complete the training, there was no significant difference in the AUC between the first and second evaluations, both of which showed significant differences from those of the experienced radiologists. Conclusion: These preliminary results suggest that the training program effectively helped inexperienced radiologists reach the level of experienced radiologists for US examinations.

Phytotherapy in periodontics as an effective and sustainable supplemental treatment: a narrative review

  • Abeer Saad Gawish;Mohammed Sherif ElMofty;Safa Jambi;Doaa Felemban;Yassmeen SalahEldin Ragheb;Shadia Abdelhameed Elsayed
    • Journal of Periodontal and Implant Science
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    • v.54 no.4
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    • pp.209-223
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    • 2024
  • Purpose: Periodontal disease is a chronic condition caused by microbial infection and mediated by the host's immune response. Phytotherapy is a therapeutic approach that utilizes a renewable resource capable of supplying less expensive medicines for the world's growing population. This review aimed to present clinical evidence on the use of complementary medicinal herbs in the treatment of periodontal diseases. Methods: Different databases were searched using the terms "herbal" and "periodontitis." All included studies were examined with a focus on herbal indications, type, and prescription length. Dentists' therapeutic and prophylactic herbal prescribing habits were also assessed. Results: Various herbs such as turmeric, neem, aloe-vera, pomegranate, catechu, tulsi, cloves, lemon grass, green tea, tea tree oil, peppermint, garlic, pineapple, oak bark, babul, bakul, sage, coriander, moringa, amla, guava, and grape seed extract have been used in the treatment of periodontitis. These herbs have been reported to exhibit a range of therapeutic effects, including anti-inflammatory, antiplaque, antihalitosis, antiresorptive, antioxidant, antibacterial, antifungal, antiviral, and antimicrobial properties. These components can be utilized in various forms such as mouth rinse, gel, oil, toothpaste, aqueous extract, mouthwash, or tooth powder. Conclusions: Several readily available herbal formulations are now available on the market and have been shown to be effective as supplemental periodontal phytotherapy. However, these should be used under the supervision of a dental professional to ensure optimal benefits and effectiveness. Therefore, it is necessary to improve the understanding of suggested herbal prescription practices among dental professionals.

Considerations for Implementing Online Art-Based Peer Supervision (온라인 미술기반 동료 슈퍼비전 실행에 대한 고려사항)

  • Yoon, Ra-Mi;Kim, Soo-In;Jung, HeeJae
    • The Journal of the Korea Contents Association
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    • v.22 no.5
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    • pp.404-415
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    • 2022
  • The purpose of this study is to propose considerations to help actual application based on the characteristics of the online art-based peer supervision execution process. Colleagues in the clinical art therapy doctoral program, including the researcher, attempted to repeatedly identify problems and apply improvements in the implementation process as research participants, and qualitatively analyzed the various data collected in the process. Looking at the characteristics of the analysis results, extensibility of materials and space was confirmed in terms of 'art-based' and initiative, convenience, and speed in terms of 'online'. The considerations identified through this are as follows. First, 'pre-structuring' should be based on clear boundaries and setting, prior consultation of the group, and self-directed preparation and attitude. Second, for the 'structural aspect of art', space and media to help immersion through creation, and stable implementation structure should be established. Third, in the 'technical aspect', it is necessary to apply a method that can deliver a work of art and a method that can communicate the creator's clear intention. Lastly, for the 'ethical aspect', it is necessary to use online software in accordance with the minimum security standards and to make efforts to repeatedly maintain confidentiality. This study is meaningful in that it suggested a practical method for maintaining the professional competence of art therapists and expanding networks among art therapists in various situations including pandemics.