Volume-2 ~ Issue-4
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| Paper Type | : | Research Paper |
| Title | : | A Study of Knowledge & Awareness of Medical Doctors Towards Radiation Exposure Risk At Tikur Anbessa Specialized Referral And Teaching Hospital, Addis Ababa, Ethiopia |
| Country | : | Ethiopia |
| Authors | : | Daniel Zewdneh, Seife Teferi Dellie, Tewodros Ayele |
 |
: | 10.9790/3008-0240105  |
Abstract: Increasing concern has recently been expressed in the literature that the referring doctor's knowledge of radiation doses incurred during radiological procedures is inadequate. Such information may be particularly relevant when the expansion of imaging technology is considered. Hence the objective of this work is to assess the awareness of physicians about radiation dose and hazards of radiation. The study was performed among medical doctors at Tikur Anbessa Specialized Referral Teaching Hospital, the largest medical school in the country. A 135 self administered questionnaire was circulated randomly from a range of specialties; out of which 114 questionnaires were completed and used in the study giving a response rate of 85%. Participants were asked about the radiation dose from a chest radiograph, the annual dose from background radiation, and cancer risk from several common radiological procedures. A mean score of 7.1 out of 19 was achieved. 12 doctors had received formal training about ionizing radiation, and these participants scored higher than those with no previous training in this area. Our survey suggested that clinicians' awareness of radiation doses imparted during common radiological procedures, and the consequent risk to the individual patient is poor. A major curriculum revision of both undergraduate and graduate medical education regarding awareness on radiation is mandatory to improve this deficiency.
Keywords: Radiation exposure, radiation dose, lifetime cancer risk, radiation protection
Keywords: Radiation exposure, radiation dose, lifetime cancer risk, radiation protection
[1]Radman.co.uk.RadmanAssociates;2007.Availablefrom:http://www.radman.co.uk/training/RPSCourses.pdf [Accessed10 June 2008].
[2] Bury B. X-ray dose training: are we exposed to enough. Clin Radiol 2004;59:926.
[3] Jacob K, Vivian G, Steel JR. X-ray dose training: are we exposed to enough? Clin Radiol 2004;59:928–34.
[4] Gower-Thomas K, Lewis MH, Shiralkar S, Snow M, Galland RB, Rennie A. Doctor‟s knowledge of radiation exposures is deficient. Br Med J 2002;324:919.
[5] Adams D. Blast from the past: a cautionary tale. Br Med J 2002;324:121.
[6] Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, et al. Radiation exposure in multi-slice versus single slice spiral CT: results of a nationwide survey. Eur Radiolgy 2003;13:1979–91.
[7] Yates SJ, Pike LC, Goldstone KE. Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. Br J Radiol 2004;77:472–8.
[8] Wiest PW, Locken JA, Heintz PH, Mettler FA Jr. CT scanning: a major source of radiation exposure. Semin Ultrasound CT MR 2002;23:402–10.
[9] Shrimpton PC, Hillier MC, Lewis MA, Dunn M. National survey of doses from CT in the UK: 2003. Br J Radiol 2006;79:968–80.
[10] Hart D, Wall BF. UK population dose from medical X-ray examinations. Eur J Radiol 2004;50:285–91.
[2] Bury B. X-ray dose training: are we exposed to enough. Clin Radiol 2004;59:926.
[3] Jacob K, Vivian G, Steel JR. X-ray dose training: are we exposed to enough? Clin Radiol 2004;59:928–34.
[4] Gower-Thomas K, Lewis MH, Shiralkar S, Snow M, Galland RB, Rennie A. Doctor‟s knowledge of radiation exposures is deficient. Br Med J 2002;324:919.
[5] Adams D. Blast from the past: a cautionary tale. Br Med J 2002;324:121.
[6] Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, et al. Radiation exposure in multi-slice versus single slice spiral CT: results of a nationwide survey. Eur Radiolgy 2003;13:1979–91.
[7] Yates SJ, Pike LC, Goldstone KE. Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. Br J Radiol 2004;77:472–8.
[8] Wiest PW, Locken JA, Heintz PH, Mettler FA Jr. CT scanning: a major source of radiation exposure. Semin Ultrasound CT MR 2002;23:402–10.
[9] Shrimpton PC, Hillier MC, Lewis MA, Dunn M. National survey of doses from CT in the UK: 2003. Br J Radiol 2006;79:968–80.
[10] Hart D, Wall BF. UK population dose from medical X-ray examinations. Eur J Radiol 2004;50:285–91.
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| Paper Type | : | Research Paper |
| Title | : | Prevalence of Hemoglobinopathies among the Konda Kammaras of Visakhapatnam District, Andhra Pradesh |
| Country | : | India |
| Authors | : | Haritha. P1, Lakshmi. V, Veerraju.1, Sarkar. B.N, Rao.V R |
|
: | 10.9790/3008-0240608 |
Abstract: Hemoglobinopathies including the Sickle cell disease and the thalassemias, which are inherited recessively cause a serious problem across the world in general. In India the prevalence of sickle cell trait varies from 5-40% among many tribal populations from different states however the overall prevalence of beta thalassemia varies from 3-4% but varies from 1-17% in different ethinic groups. As these disorders are inherited prevention of this disease is therefore theoretically possible through population screening and counseling. The present study among the Konda Kammaras is done based on this concept. The present study aims to assess the prevalence of hemoglobinopathies among the Konda Kammaras of Visakhapatnam district. 103 unrelated individuals (50 male and 53 female) aged between 22-58 years were considered in this study. All the individual samples were screened by using NESTROFT, Complete blood count and Cellulose-acetate membrane electrophoresis. The suspected cases have been confirmed of the presence or absence of mutation status by sequence analysis. The overall prevalence of hemoglobinopathies among this population is 14.56% with 13.59% of Sickle cell trait and 0.97% Beta thalassemia trait.
Keywords: Beta thalassemia, Konda Kammara, Prevalence, Sickle cell, Visakhapatnam.
Keywords: Beta thalassemia, Konda Kammara, Prevalence, Sickle cell, Visakhapatnam.
[1] Rund D, Oron-Kami V, Filon D, Goldfarb A, Rachmilewitz E, Oppenheim A 1997. Genetic analysis of bete thalassemia intermedia in Isreal: Diversity of mechanisms and unpredictability of phenotype. Am J Haematol, 54: 16-22.
[2] Angastiniotis, M., Pavlides, N., Aristidou, K., Kanakas, A., Yerakaris, M., Eracleous, E. & Posporis,T. (1998) Bone pain in thalassaemia: assessment of DEXA and MRI findings. Journal of Pediatric Endocrinology and Metabolism, 11(Suppl. 3), 779–784
[3] Weatherall, D.J (2001) Phenotype – genotype relationship in monogenic disease: lessons from the thalassemias. Nat. Rev. Genet, 2, 245-255.
[4] Balgir RS, 2000. The burden of haemoglobinopathies in India and the challenges ahead. Curr. Sci., 79:1536-1547.
[5] Vaz FE, Thakur CB, Banerjee MK, Gangal SG. 2000. Distribution of beta-thalassemia mutations in the Indian population referred to a diagnostic center. Hemoglobin. 24:181-194.
[6] Kattamis C, Efremoy G and Poorakul S.1981 Effectiveness of one tube osmotic fragility screening in detecting beta thalassemia trait . J Med. Genet, 18(4); 266-270.
[7] Dacie JV, Lewis SM. 1991. Practical Haematology. Seventh Edition . (Churchill Livingstone, London).
[8] Betke K, Marti HR and Schlicht I. 1959. Estimation of small percentage of foetal haemoglobin. Nature 184: 1877-1878.
[9] Morengo-Row AJ 1965; Rapid electrophoresis and quantitation of hemoglobins on cellulose acetate. J Clin Pathol 18:790-2
[10] Naidu, J. M., H. W.Mohrenwiser and J.V.Neel 1985. A Serobiochemical genetic study of Jalari and Brahmin Caste populations of Andhra Pradesh, India . Human Hered., 35:148- 156.
[2] Angastiniotis, M., Pavlides, N., Aristidou, K., Kanakas, A., Yerakaris, M., Eracleous, E. & Posporis,T. (1998) Bone pain in thalassaemia: assessment of DEXA and MRI findings. Journal of Pediatric Endocrinology and Metabolism, 11(Suppl. 3), 779–784
[3] Weatherall, D.J (2001) Phenotype – genotype relationship in monogenic disease: lessons from the thalassemias. Nat. Rev. Genet, 2, 245-255.
[4] Balgir RS, 2000. The burden of haemoglobinopathies in India and the challenges ahead. Curr. Sci., 79:1536-1547.
[5] Vaz FE, Thakur CB, Banerjee MK, Gangal SG. 2000. Distribution of beta-thalassemia mutations in the Indian population referred to a diagnostic center. Hemoglobin. 24:181-194.
[6] Kattamis C, Efremoy G and Poorakul S.1981 Effectiveness of one tube osmotic fragility screening in detecting beta thalassemia trait . J Med. Genet, 18(4); 266-270.
[7] Dacie JV, Lewis SM. 1991. Practical Haematology. Seventh Edition . (Churchill Livingstone, London).
[8] Betke K, Marti HR and Schlicht I. 1959. Estimation of small percentage of foetal haemoglobin. Nature 184: 1877-1878.
[9] Morengo-Row AJ 1965; Rapid electrophoresis and quantitation of hemoglobins on cellulose acetate. J Clin Pathol 18:790-2
[10] Naidu, J. M., H. W.Mohrenwiser and J.V.Neel 1985. A Serobiochemical genetic study of Jalari and Brahmin Caste populations of Andhra Pradesh, India . Human Hered., 35:148- 156.
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| Paper Type | : | Research Paper |
| Title | : | The Rapidly Disappearing Science and Art of Pathology in Developing Countries |
| Country | : | India |
| Authors | : | Dr. Raghvendra Gumashta, Dr. Shamim Akhtar |
|
: | 10.9790/3008-0240914 |
Abstract: The carefully learnt and traditionally transferred art and science of observation, precision and distinguished unparalleled competence is diminishing its glory into the dark horizons through its disintegration in multiple new disciplines, high technological advancements and non-sustenance with the pace of rapid scientific growth. Such a scenario is resulting into general disinterest of medical graduates into the discipline of Pathology, low morale of its practitioners and near absolute termination of opportunities to grow among the subject experts. A loud thinking is necessitated among the medical fraternity, in general, and pathologists, in particular, to device the ways and means of rejuvenating the ever rusting status of Pathology. This shall not only enable enthusiasm among its practitioners, but also generate new ventures for innovations, education and research. The article highlights the intrinsic and extrinsic, but closely interwoven factors, situations and circumstances, which if dealt with great care shall yield rich dividends towards reverting the current trend, develop future models of growth and sustainability in the field of Pathology.
Key Words: clinical, diagnosis, laboratory, pathological, qualitative, testing
Key Words: clinical, diagnosis, laboratory, pathological, qualitative, testing
[1] Pena G P, Andrade-Filho J S, How Does a Pathologist Make a Diagnosis?, Arch of Path & Lab Med 2009; 133(1):124-132.
[2] Gray I P, Carter J Y. An evaluation of clinical laboratory services in sub-saharan Africa: Ex africa semper aliquid novi?, Clinica Chimica Acta 1997; 267(1):103-128.
[3] Murphy J, Henry J B. Effective utilization of clinical laboratories, Hum Patho 1978; 9(6): 625-633.
[4] Burke M D. Clinical laboratory consultation: appropriateness to laboratory medicine, Clinica Chimica Acta 2003; 333(2): 125-129.
[5] Barclay J E, Special problems of cost analysis and cost-benefit analysis as applied to large multi-test analysers, J of Autom Chem 1983; 5, (2):71-74.
[6] Willcocks S. The development of clinical management at an NHS Trust hospital: A case study example, J of Mgt in Med 1994; 12(3):168-177.
[7] Ward C, Kendal, Ramirez, Bernardo, Rotarius, Timothy. The Laboratory Workforce Shortage: A Managerial Perspective, Hea Care Mgr 2011; 30(2):148-155.
[8] France N, Lawrence S, Smith J F. New Zealand pathologists: a case study in occupational control, J Mgt in Med 2001, 15(1):28-43.
[9] Ramsay A D, Locally organised medical audit in histopathology, J Clin Pathol 1991;44:353-357.
[10] Jaques, Elliott. Diagnosing sources of managerial leadership problems for research and treatment, Consult Psych J: Pract & Res 2001; 53(2): 67-75.
[2] Gray I P, Carter J Y. An evaluation of clinical laboratory services in sub-saharan Africa: Ex africa semper aliquid novi?, Clinica Chimica Acta 1997; 267(1):103-128.
[3] Murphy J, Henry J B. Effective utilization of clinical laboratories, Hum Patho 1978; 9(6): 625-633.
[4] Burke M D. Clinical laboratory consultation: appropriateness to laboratory medicine, Clinica Chimica Acta 2003; 333(2): 125-129.
[5] Barclay J E, Special problems of cost analysis and cost-benefit analysis as applied to large multi-test analysers, J of Autom Chem 1983; 5, (2):71-74.
[6] Willcocks S. The development of clinical management at an NHS Trust hospital: A case study example, J of Mgt in Med 1994; 12(3):168-177.
[7] Ward C, Kendal, Ramirez, Bernardo, Rotarius, Timothy. The Laboratory Workforce Shortage: A Managerial Perspective, Hea Care Mgr 2011; 30(2):148-155.
[8] France N, Lawrence S, Smith J F. New Zealand pathologists: a case study in occupational control, J Mgt in Med 2001, 15(1):28-43.
[9] Ramsay A D, Locally organised medical audit in histopathology, J Clin Pathol 1991;44:353-357.
[10] Jaques, Elliott. Diagnosing sources of managerial leadership problems for research and treatment, Consult Psych J: Pract & Res 2001; 53(2): 67-75.
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| Paper Type | : | Research Paper |
| Title | : | Hematological changes in malaria: A comparative study |
| Country | : | India |
| Authors | : | Dr Shamim Akhtar, Dr Raghvendra Gumashta, Dr Sadhana Mahore, Dr. Sabiha Maimoon |
|
: | 10.9790/3008-0241519 |
Abstract :
Objectives: The hematological changes usually associated with malaria are well known. This study was conducted to estimate and compare the predominance & severity of hematological changes in common types of malaria.
Methodology: This observational study included 400 suspected malarial patients attended in Out Patient Department (OPD) and In Patient Department (IPD) of NKP Salve Institute of Medical Sciences & Research Centre and Lata Mangeshkar Hospital Nagpur, during April 2009 to March 2011. The diagnosis of malaria was confirmed by thick and thin film stained with Leishman's staining for malaria parasite and Antigen test (i.e. HRP2). Complete Blood Counts (CBCs) were performed using an automated SYSMEX machine.
Results: Among the samples of consenting participants tested, 70% of the patient had thrombocytopenia, 94% anemia, 12% lymphopenia and 17% monocytosis. The incidence of thrombocytopenia was slightly more in P. Falciparum (58.69%) than P. Vivax (30.18%) cases, p value > 0.05, whereas there was no significant difference in the incidence of anemia in two groups (34.68% vs 33.82%) with p value > 0.05. However, lymphopenia was observed in 33.33% cases of P. Vivax as compared to 11.11% in P.Falciparum cases, p value < 0.04. Eosinophilia was 12.16% and basophil count was normal in both groups.
Conclusions: P.Falciparum as well as P.Vivax can cause significant hematological changes with high incidence of thromboctopenia, anemia, lymphopenia and monocytosis.
Key Words: Hematology, Malaria, Plasmodium falciparum, Plasmodium vivax
Objectives: The hematological changes usually associated with malaria are well known. This study was conducted to estimate and compare the predominance & severity of hematological changes in common types of malaria.
Methodology: This observational study included 400 suspected malarial patients attended in Out Patient Department (OPD) and In Patient Department (IPD) of NKP Salve Institute of Medical Sciences & Research Centre and Lata Mangeshkar Hospital Nagpur, during April 2009 to March 2011. The diagnosis of malaria was confirmed by thick and thin film stained with Leishman's staining for malaria parasite and Antigen test (i.e. HRP2). Complete Blood Counts (CBCs) were performed using an automated SYSMEX machine.
Results: Among the samples of consenting participants tested, 70% of the patient had thrombocytopenia, 94% anemia, 12% lymphopenia and 17% monocytosis. The incidence of thrombocytopenia was slightly more in P. Falciparum (58.69%) than P. Vivax (30.18%) cases, p value > 0.05, whereas there was no significant difference in the incidence of anemia in two groups (34.68% vs 33.82%) with p value > 0.05. However, lymphopenia was observed in 33.33% cases of P. Vivax as compared to 11.11% in P.Falciparum cases, p value < 0.04. Eosinophilia was 12.16% and basophil count was normal in both groups.
Conclusions: P.Falciparum as well as P.Vivax can cause significant hematological changes with high incidence of thromboctopenia, anemia, lymphopenia and monocytosis.
Key Words: Hematology, Malaria, Plasmodium falciparum, Plasmodium vivax
[1] World Health Organization. World malaria situation in 1994. Parts1-111.Weekly Epidemiol Rec 1997; 72:269-90.
[2] Murphy GS, Oldfeild EC. Falciparum malaria. Inf Dis Clin North Am 1996; 10:747-75.
[3] Facer CA. Hematological aspect of malaria In: Infection and Hematology. Oxford Butterworth Heinemann Ltd., 1994:259-94.
[4] Jandle JH. Hemolytic anemias caused by infection of red blood cells. In: Blood. 2nd edition. New York: Little brown and company, 1996:473-501.
[5] Price RN, Simpson JA, Nosten F. Factors contributing to anemia after uncomplicated falciparum malaria. Am J Trop Med Hyg 2001; 65:614-22.Beals PF. Anemia in malaria control: A practical approach. Ann Trop Med Parasitol 1997; 91:713-8.
[6] Perrin LH, Mackey LJ, Miescher PA. The hematology of malaria in man. Sem Hematol 1982; 19:70-81.
[7] Clark IA, Chaudhri G. Tumour necrosis factor may contribute to the anemia of malaria by causing dyserythropoiesis and erythrophagoytosis. Brit J Haematol 1988; 70:99-103.
[8] Angus BJ, Chotivanich K, Silamut K, Ruangveerayuth R, Hardeman MR. Red blood cell deformability as a predictor of anemia in severe Falciparum malaria. Am J Trop Med Hyg 1999; 60:733-7
[9] Perrin LH, Mackey LJ, Miescher PA. The hematology of malaria in man. Sem Hematol 1982; 19:70-81.
[10] Abdallah S, Weatherall DJ, Wickramasinghe SN, Hughes M. The anaemia of P.falciparum malaria. Br J Haematol 1980; 46:171.
[2] Murphy GS, Oldfeild EC. Falciparum malaria. Inf Dis Clin North Am 1996; 10:747-75.
[3] Facer CA. Hematological aspect of malaria In: Infection and Hematology. Oxford Butterworth Heinemann Ltd., 1994:259-94.
[4] Jandle JH. Hemolytic anemias caused by infection of red blood cells. In: Blood. 2nd edition. New York: Little brown and company, 1996:473-501.
[5] Price RN, Simpson JA, Nosten F. Factors contributing to anemia after uncomplicated falciparum malaria. Am J Trop Med Hyg 2001; 65:614-22.Beals PF. Anemia in malaria control: A practical approach. Ann Trop Med Parasitol 1997; 91:713-8.
[6] Perrin LH, Mackey LJ, Miescher PA. The hematology of malaria in man. Sem Hematol 1982; 19:70-81.
[7] Clark IA, Chaudhri G. Tumour necrosis factor may contribute to the anemia of malaria by causing dyserythropoiesis and erythrophagoytosis. Brit J Haematol 1988; 70:99-103.
[8] Angus BJ, Chotivanich K, Silamut K, Ruangveerayuth R, Hardeman MR. Red blood cell deformability as a predictor of anemia in severe Falciparum malaria. Am J Trop Med Hyg 1999; 60:733-7
[9] Perrin LH, Mackey LJ, Miescher PA. The hematology of malaria in man. Sem Hematol 1982; 19:70-81.
[10] Abdallah S, Weatherall DJ, Wickramasinghe SN, Hughes M. The anaemia of P.falciparum malaria. Br J Haematol 1980; 46:171.