Graying of the Nation: A Curse or Boon?

We will all grow old one day- if we have that privilege. Let us therefore look at older persons not as people separate from us, but as our future selves and try to find out their sufferings.

To study the psychosocial problems of aged persons residing in community and to make comparison of above findings among urban and urban slum area.

A cross-sectional study carried out in the field practice area of the Department of Community Medicine in Agra (U.P.). A total of 500 elderly patients (60 years old and above) residing in urban and urban slum area were interviewed using a pre-tested schedule.

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Practice Management Role in Monitoring Family Medicine Residents Adherence to ACGME-I Standards in Qatar

One of ACGME-I requirements was the practice management curriculum, Practice management curriculum is an essential tool, which can help in several ways, Besides training schedule, physician alert system, and several other innovative aspects of monitoring resident’s performance and prearranged activities, this will also reflect with equal measure on any training institute as well.

Practice management report is a tool used to evaluate practice activity and productivity for each resident. It also monitors their practice performance progression.

individuals/practice productivity which includes total number of patient visits seen by the resident in continuity care clinics , total number of visits to hospitalized patients, patient visits distribution by gender, patient visit distribution by age , patient visits distribution by presenting illness, and chart (SOAP) documentation.

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Challenges to Palliative Care in Pediatric Patients

The incidence of cancer is rising in pediatric population since last decade. In 2016, about 10,000 children are projected to be diagnosed of cancer in United States. Though five-year survival in most of the pediatric cancer patients is more than 80% now, cancer remains the most common cause of mortality after trauma in age group 5-14 years.

The growing population of pediatric cancer survivors warrants parallel rise in the palliative care. As per the World Health Organization (WHO) palliative care is, ‘An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness.

Through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’. Notably contemp orary thoughts advocate the integration of curative and palliative approaches in pediatric patients.

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Management of Depression and Uses of Natural Medicine

Depression is a debilitating mental problem that could affect any one. Women are more prone to a depression than men. Unmarried, middle aged, being disabled or unemployed, and family history of depression are some of the few factors that can make a person more susceptible to a depression. Use of herbal medicine is so common in everyday life that we cannot deny that it is important. Store shelves are full of various products that are used in depression.

Given that not all brands are equal. There is a different in quality, purity and content of each product. Herbal medicines are considered a health food and are therefore not regulated by the Food and Drug Administration (FDA) as a drug. While supporting clinical data regarding herbal medicines in depression are ambiguous, primary care providers may often be asked about the safety, effectiveness and side effects of these products.

The purpose of this article is to review conventional treatment and provide information about the safety, product selection, drug interaction and the side effects of herbal medicines that have strong evidence in the treatment of depression. Herbal medicines with weak or lack of evidence are not discussed.

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Stercoral Colitis Associated with Colon Perforation

A 68 year-old woman presented with lower abdominal pain for three days and constipation for 10 days. The patient had a history of end-stage renal disease under regular hemodialysis, and coronary artery disease with antiplatelet drug. Physical examination was unremarkable except rebounding tenderness over lower abdomen. Blood tests showed bandemia 9% in white blood cell counts and elevated C-reactive protein (>250 mg/L, reference value, <3 mg/L).

Abdominal radiography showed sign of retroperitoneal air - the presence of air outlining the psoas muscle (Figure 1, arrow) and one gas-contenting abscess at left lower quadrant abdomen. Computed tomography (CT) of the abdomen revealed a large amount of fecaloma within sigmoid colon with wall thickening and pericolic fat stranding, and extravasation of stool material at left pelvic region (Figure 2, arrow), and pneumoretroperitoneum extending from the lower abdominal abscess.

Under the impression of stercoral colitis associated sigmoid colon perforation, emergent exploratory laparotomy was performed. One 1.6*1 cm perforation of sigmoid colon with abscess formation was found. The pathologic report of colon resection specimen shows aggregates of hemosiderin-laden macrophages in colonic mucosa with focal transmural necrosis. The post-operation course was smooth, and the patient was discharge uneventfully twelve days later.

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Interactions of EGFR and the Hippo Pathway

Diabetes mellitus (DM) is a growing worldwide epidemic health problem. More than 350 million people worldwide are affected by DM, and one in three U.S. adults could have DM in 2050, if the current trends continue. Diabetic nephropathy (DN) is one of the most important DM complications, and it continues to rank as the leading cause of end-stage renal disease (ESRD) in the U.S. Patients must undergo either dialysis or a kidney transplantation once DN progress to ESRD, which produces a huge economic burden for society.

There is a pressing need to develop novel therapeutics for preventing or delaying the progression of DN. Progressive glomerulosclerosis and renal interstitial fibrosis are two characteristic pathological changes in the kidney in DN. Glomerular sclerosis has been at the center of attention for nephrologists.

however, increasing evidence suggests the renal tubule is a primary site of injury during DN progression, and a significant positive correlation between development of interstitial fibrosis and subsequent loss of renal function is seen in DN patients. Activation of the EGFR (Epidermal Growth Factor Receptor) has been implicated in diabetic kidney injury,  studies by us and others have found that chronic EGFR activation in diabetic kidney is detrimental, and inhibition of EGFR activation by pharmacologic or genetic strategies markedly preserved renal function and slowed DN progression.

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