IMJ Health : August 2016

Medical Journal: Volume-2, Issue-8, August 2016

Critical Review of Different Sociological Perspectives toward Conceptualization of Management of Health Services

Abstract—Theories of sociology of health and illness defy the biomedical model of disease as many of them are ‘concerned with the social origins and influence on disease’ rather than pathological reasons only. There are five sociological perspectives of health and illness: Social Constructionism, Marxism, Feminism, Foucaulian analysis, and Functionalism. These different sociological perspectives were critically analyzed through this article as for better understanding of conceptualize management of health services Social Constructionism is a sociological perspective focus on the sociology of knowledge and reality. Marxism focuses on equity between social classes and emphasizes inequality in capitalist society. According to Marxism inequality of distribution healthcare services in capitalist society arise from the marginalization of some categories of the population who do not contribute to economic system. Feminist theory is to understand and explore the multiple and various reasons for inequalities between the genders. In the healthcare sector, feminists believe that healthcare organizations are hierarchical systems, where doctors (usually men) are at the top level while nurses (usually women) have a lower level of importance. Main areas that Foucault theory emphasizes are power, knowledge and discourse. Foucault believes that there is a relationship between power and knowledge. This relationship appears clearly in the health field, as medical professionals comprise a group of people who have special knowledge (medical knowledge) and they gain the power from this knowledge. Finally, functionalism is a sociological perspective that describes society as a system made up of ‘interconnected and interrelated parts’ and it highlights the relationships between different parts of society In conclusion, the five sociological perspectives provide holistic picture about conceptualization of healthcare systems.

KeywordsSocial Constructionism, Marxism, Feminism, Foucaulian analysis, Functionalism

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Perforated Jejunal Gastrointestinal Stromal Tumor(GIST) Presenting as Acute Abdomen: A Rare Presentation

Abstract— Gastrointestinal stromal tumors (GIST) are rare neoplasms of the gastrointestinal system. A case of 40 year old man having tense tender abdomen with obliterated liver dullness and shifting dullness was presented in emergency, it was further investigated on X rays, where pneumoperitoneum was found. This case was then decided to go for Laparatomy after routine investigations to further explore. On exploratory laparatomy, diffuse peritonitis with brown coloured fluid was observed. A 10 x 5 x 7 cm mass was found having an opening communicating with the gut lumen was present around 10 cm from the ligament of treitz. However, no adjacent structures, liver or parietal peritoneum seemed to be involved. Gross examination of the specimen revealed an outward bulging mass, which was centrally necrotic and contained hemorrhagic-necrotic material. On histo-pathological examination, features suggestive of gastrointestinal stromal tumor (GIST) with mixed spindle and epitheoid pattern was seen. Mitoses were slightly increased (<5/10′ HPFs) leading to the conclusion of LOW GRADE GIST with tumor free margins of gut (R0 resection). So it was a case of Gastrointestinal stromal tumors (GIST), which is a rare medical presentation. So it was decided to report this case as a rare case presentation.

Keywords: Gastrointestinal Stromal Tumors (GIST), Neoplasms, Gastrointestinal system

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Microbiological Study of Pharyngitis at a Teaching Hospital, Chinakakani, (Andhra Pradesh) India

Abstract—The aim of the study was to observe the prevalence of various microorganisms from throat swab specimens in patients attending a tertiary care hospital at Chinakakani, Guntur. Throat swab specimens were collected aseptically from 100 patients and cultured on appropriate bacteriological media. Isolates were identified by biochemical tests & antimicrobial susceptibility performed by standard methods. Out of 100 Samples, culture was positive in 25 samples. So Bacterial infection was found in 25% of Pharyngitis. Streptococcus pyogenes was the commonest isolate, followed by Staphylococcus aureus and Candida albicans. Majority of bacteria were Streptococcus pyogenes, Staphylococcus aureus and Candida albicans. In 60% it was mixed infection. The susceptibility patterns varied depending on the drugs, but most of the organisms were susceptible to penicillin, erythromycin and vancomycin. Improved personal hygiene and health education of the masses on how to care for ear, nose and throat will greatly reduce these microbial infections. This study will be useful for control strategies and for predicting pathogen prevalence in throat swabs.

Keywords Pharyngitis, Streptococcus Pyogenes, Throat Swab

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Factors associated with Dementia with special reference to Serum Homocysteine Level: A Case-Control Study

Abstract—Prevalence of degenerative dementias and dementias associated with cerebrovascular disease is increasing with the time. Dementia is one of the most significant public health problems. Demographic data, medical history, general biochemical data and serum total homocysteine (tHcy) levels was used in this study to examine the differences between dementia and normal control groups. A cross-sectional study was conducted on 236 individuals who were above the age of 65 years. These participants went through the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), demographic characteristics, biochemical data and tHcy level. Each of the above mentioned factors was assessed. There were significant differences in the history of hypertension, diabetes mellitus, marital status, alcohol consumption (AC), BMI value, and triglyceride (TG) and serum tHcy levels. The logistic regression analysis showed significant differences in marital status, AC and tHcy. So it can be concluded that elevated serum tHcy, no AC and no partner are associated with the risk of dementia in elders of Southern Taiwan. It needs further researches to identify and reduce the risk of dementia.

Keywords: Dementia; Homocysteine; partner; alcohol consumption.

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Morphometric study of Sacral Hiatus for Caudal Epidural Block

Abstract— Study of variation of sacral hiatus in dry bone is important as it determines access of sacral hiatus for caudal epidural anaesthesia and analgesia. So this descriptive observational study was conducted on 80 adult sacrum bones were studied at department of Anatomy, SMS Medical College, Jaipur with the aim to examine Morphometry of Sacral hiatus including shape, length, A-P diameter at apex and transverse width at base. Most commonly found shape of sacral hiatus in this study was inverted U/V shape. Length of sacral hiatus ranged 6 to 43 mm with more than half cases having length between 10-20 mm. Most sacrum (81.25%) had anterio-posterior diameter of 4 to 8 mm. Half of the sacrum had transverse width at sacral cornua between 9-13 mm. It can be concluded that anatomical variations in sacral hiatus are cause of caudal epidural anaesthesia failure and procedure related complications. Understanding these variations may improve success of caudal epidural anaesthesia and decrease incidence of complications. So this study will be useful to increase success rate of epidural anaesthesia.

Keywords Sacrum, Sacral hiatus.

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