eng
International Travel Medicine Center of Iran
International Journal of Travel Medicine and Global Health
2322-1100
2476-5759
2016-06-01
4
2
41
46
10.20286/ijtmgh-04022
33009
Amodiaquine-Associated Asthenia: A Case Based Review and Gaps in Literature
Obaro Michael
micobaro@gmail.com
1
Joseph Badejo
2
Adewale Bakre
3
Adebola Orimadegun
4
Olusegun Ademowo
5
Catherine Falade
6
Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
Department of Pediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Nigeria
Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
Introduction: Amodiaquine is a partner drug in the artemisinin-based combination therapy artesunate-amodiaquine. Reports of the adverse drug reaction known as amodiaquine-associated asthenia are scarce, and this adverse reaction needs to be investigated in detail. This article presents and reviews a case of amodiaquine-associated asthenia. A literature search for the characteristics of this adverse reaction highlighted gaps in the literature.
Methods: A case of probable amodiaquine asthenia was described and discussed under the sub-headings of epidemiology, clinical features, laboratory features, aetiopathogenesis, and management. A literature search limited to Medline Health Databases (Medline and PubMed Central, PMC) using the search terms and was conducted on 10 March 2015. Retrieved literature on the subject was closely scrutinized for relevant details of adverse drug reactions to amodiaquine when used in the management or prophylaxis of malaria. Cited literature within retrieved manuscripts was examined manually for other relevant literature. Papers retrieved from the search were used to describe the existing knowledge and gaps in it of the adverse drug reaction under sub-categories of incidence, clinical features, laboratory features, aetiopathogenesis, and management.
Results: Thirty-nine manuscripts were retrieved; 20 had content relevant to the objectives of this review. The frequency of amodiaquine-associated asthenia in different populations ranged from 12–36%. There is a paucity of reports, and no detailed study of this adverse reaction has been published in popular English medical literature.
Conclusion: With the use of amodiaquine as a partner drug in antimalarial combination therapies being scaled up, well-structured studies are needed on adverse reactions to amodiaquine and to investigate amodiaquine-associated asthenia. In addition, approaches to elucidating this adverse reaction more effectively in children need to be developed.
https://www.ijtmgh.com/article_33009_a9af7a6676f4348a749fe6d739fe8195.pdf
Amodiaquine
Asthenia
weakness
Malaria
Nigeria
eng
International Travel Medicine Center of Iran
International Journal of Travel Medicine and Global Health
2322-1100
2476-5759
2016-06-01
4
2
47
52
10.20286/ijtmgh-04023
33010
مقاله پژوهشی
The Formation of a Self-Funded Global Health Fellowship within a Department of Family Medicine
Christopher Sanford
casanfo@uw.edu
1
Claire Fung
2
James Sherwood
3
Anna McDonald
4
Eric Tobiason
5
Thomas Norris
6
Department of Family Medicine, University of Washington, Seattle, WA, USA
Department of Family Medicine, University of Washington, Seattle, WA, USA
Department of Family Medicine, University of Washington, Seattle, WA, USA
Department of Family Medicine, University of Washington, Seattle, WA, USA
Department of Family Medicine, University of Washington, Seattle, WA, USA
Department of Family Medicine, University of Washington, Seattle, WA, USA
Introduction: The need for global health training for early-career family medicine physicians is greater than the supply. This paper details the formation of a one-year, self-funded global health fellowship for early-career family medicine physicians. Methods: In August of 2012, the University of Washington Department of Family Medicine established a self-funded, non-ACGME (Accreditation Council for Graduate Medical Education)-accredited fellowship in global health. The fellowship is targeted at early-career family medicine physicians. During the one-year fellowship, the global health fellow rotates through a variety of clinics in the greater Seattle area, including HIV, TB, STD, and other infectious disease clinics. Other activities include selected global health courses at the University of Washington, practice in a continuity clinic seeing both family medicine and pre- and post-travel patients, and a variety of teaching, speaking, and publishing opportunities. The fellow may spent up to two months overseas engaged in clinical practice and/or research; one option for fellows is to work and teach at the district hospital in Naivasha, Kenya, at which the University of Washington has established an ongoing teaching and practice program. The majority of the fellow’s salary and benefits is funded by the fellow’s clinical activities. This funding mechanism allowed the fellowship to be launched with minimal of institutional financial support. Results: Of the first three graduating fellows, two now practice primarily in the US and one works in Malawi with Seed Global Health. The fifth fellow will begin in August 2016. The robust and increasing number of applications suggest that this fellowship is meeting an ongoing need. Conclusion: This fellowship demonstrates that the need for global health training of early-career, family medicine physicians can at least be met in part by self-funded fellowships of this nature.
https://www.ijtmgh.com/article_33010_9dea80bd03e314d9c08a3c38e1b518e2.pdf
Global Health
Fellowship
family medicine
Travel Medicine
Tropical Medicine
Post-Graduate Education
eng
International Travel Medicine Center of Iran
International Journal of Travel Medicine and Global Health
2322-1100
2476-5759
2016-06-01
4
2
53
56
10.20286/ijtmgh-04024
33011
مقاله پژوهشی
Development, Validity and Reliability of Dysphagia Assessment Test in Iranian Adults after Stroke
Shiva Ebrahimian Dehaghani
1
Zahra Khosropoor
2
Hatef Yousefzadeh
3
Arya Hamedanchi
doctorarya@yahoo.com
4
Speech and Language Pathology Department, Shiraz University of Medical Sciences, Shiraz, IR Iran
Speech and Language Pathology Department, Shiraz University of Medical Sciences, Shiraz, IR Iran
Speech and Language Pathology Department, Shiraz University of Medical Sciences, Shiraz, IR Iran
Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
Introduction: Many patients who have had strokes suffer from dysphagia which can lead to aspiration pneumonia in 20% to 25% of cases. Early assessment of dysphagia has can reduce the risk of death and the cost of medical care. The present study developed a questionnaire to assess dysphagia in adult patients who have suffered strokes and determined the validity and reliability of the content. Methods: The phases of the study consisted of item generation, analysis of content validity and determination of reliability. To assess the content validity, the primary questionnaire was rated by five experts on swallowing disorders. Items with low scores were removed from the questionnaire. Next, 30 stroke patients were assessed using the final questionnaire and the reliability was assessed by Cronbach's alpha. Results: The average scores of the items ranged from 0.4 to 1. Only two items were omitted because of insufficient content validity. The Cronbach's alpha was 0.71 and the standard error of deviation was 4.96, signifying that the reliability was acceptable. Conclusion: This questionnaire has good content validity and reliability. Although it can be used for clinical assessment of stroke patients who suffer from dysphagia, the concurrent validity should be determined by comparison with to a gold standard such as videofluoroscopy.
https://www.ijtmgh.com/article_33011_c34499cbcd33069eb3eab0746c243def.pdf
Dysphagia
Stroke
Assessment
Validity
Reliability
Iran
eng
International Travel Medicine Center of Iran
International Journal of Travel Medicine and Global Health
2322-1100
2476-5759
2016-06-01
4
2
57
64
10.20286/ijtmgh-04025
33012
مقاله پژوهشی
Iran’s Medical Tourism Development Model in Cardiac Surgery
Fatemeh Noori
1
Mehrdad Kargari
m_kargari@modares.ac.ir
2
Faculty of Systems and Industrial Engineering, Tarbiat Modares University, Tehran, IR Iran
Faculty of Systems and Industrial Engineering, Tarbiat Modares University, Tehran, IR Iran
Introduction: Since medical tourism is considered as an incremental activity in this sector and proper infrastructures in country to make medical tourism are lacking, announcement by authorities to provide perquisites of medical tourism to make the first clinic hotel and health town are necessary for the purpose of developing medical tourism in Iran, all of these side issues should be investigated. Methods: Cardiovascular diseases are very common because of pollution and industrial development. In this research, by extracting related studies on medical tourism and its localization, using hospitals data bank and questionnaire of 640 medical tourists, only 528 of them were approved and finally by using IBM SPSS modular 14.1 software decision tree in data algorithm, efficiency and purity level were obtained. The method for data preprocess step is utilized to extract the best model. Two preprocess steps are deleting useless and correlated features, because data should be prepared until model has the least error. Results: Among the examined algorithm including C&RT, CHAID and Multiple Linear Regression, it was shown that C&RT has the optimal results. The results obtained from this research indicate that C&RT binary decision tree has the smallest error value (0.078) and the greatest accuracy value (0.922). Conclusion: In this research, first effective factors on heart medical tourism were investigated with the help of experts in this field, then C&RT and CHASID models using Clementine software and multiple linear regression variables were compared and ranked. With respect to this algorithm, personnel behavior, social security and communication variables are respectively the most important factors for medical tourist attraction.
https://www.ijtmgh.com/article_33012_287da6bc7d8acdcbb9bcc69a135b74c9.pdf
Cardiac Surgery
Medical Information System
Medical tourism
eng
International Travel Medicine Center of Iran
International Journal of Travel Medicine and Global Health
2322-1100
2476-5759
2016-06-01
4
2
65
68
10.20286/ijtmgh-04026
33013
مقاله پژوهشی
Satisfaction of Supplementary Insurance and Medical Services during Trips in War Survivors and their Families
Mohammadreza Soroush
1
Batool Mousavi
2
Farzaneh Maftoon
fmaftoon5@gmail.com
3
Kazem Mohammad
4
Zohreh Ganjparvar
5
Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
Prevention Department, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
Health Services Management Group of Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
Epidemiology and Statistical Department, Health Faculty, Tehran University of Medical Sciences, Tehran, Iran
Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
Introduction: During trips the imposed costs are aggravated due to time and financial limits, not being familiar with treatment centers that are covered by the insurances and charges for accommodation. Insurance, especially supplementary treatment services insurance can be an appropriate solution to decrease these costs. These kinds of insurances cover a range of services including outpatient services to hospitalization and even sometimes unlimited services. The purpose of this study was to evaluate the satisfaction of war survivors and their families under the cover of supplementary insurance from medical care during trips. Methods: This study was cross -sectional descriptive. The size of studied population was 77 people from war survivors and their families who were assessed by a provided questionnaire in 2015. The including criteria was war survivors and their families under the cover of Veterans and Martyrs Affair Foundation (VMAF) and supplementary insurance war survivors. The prepared questionnaire included two sections; the first section was included the personal indications and the second section included satisfaction evaluations. Results: The prevalence of using medical care during trips in war survivors and their families was 2.72% and using medical care with supplemental insurance in trips was 1.5%. The obtained results from the questionnaires revealed that the highest satisfaction on medical care services and its distance belongs to the veterans' families with the mean of 4.57and 4.27, respectively. In the subject of taking back the costs, martyrs’ families were the least satisfied with the mean of 2.17. A significant relationship was found between sex and distance of the medical care services in trips (p=0.046). Men had more satisfaction compared to women. Finally it can be mentioned that there was not a significant relationship between client group and distance of medical care services during trips (p=0.067). Conclusion: According to the results, affording the costs and paying them back by the insurance company needs modifications.
https://www.ijtmgh.com/article_33013_0a51f340c9fd5c339e333bb57e5d3eda.pdf
Travel
Insurance
Satisfaction
Medical Services