Numerous anecdotal reports have suggested that kiwifruit (Actinidia deliciosa) has laxative effects. This could be an acceptable dietary supplement, especially for elderly people who often present with constipation. We wished to obtain objective evidence as to whether or not kiwifruit eaten regularly could promote laxation in elderly people. Thirty-eight healthy adults of age > 60 years consumed their normal diet, with or without one kiwifruit per 30 kg bodyweight for three weeks, followed by a 3-week crossover period. Daily records were taken on frequency of defecation and characteristics of the stools. Kiwifruit significantly enhanced all tested measures of laxation in these adults. The regular use of kiwifruit appeared to lead to a bulkier and softer stool, as well as more frequent stool production. Kiwifruit as a natural remedy appears palatable to most of the population and provides improved laxation for elderly individuals who are otherwise healthy. It is likely that a number of factors in the whole fruit are involved, but the nature of the stools suggest fibre is important. This study provides evidence of the potential for improvement in bowel function, health and well-being through changes in diet.
IntroductionSelf-management interventions with Written Action Plans and case management support have been shown to improve outcomes in patients with chronic obstructive pulmonary disease (COPD). Novel telehealth technologies may improve self-management interventions. The objectives of this study were to determine whether the use of an interactive phone telesystem increases Action Plan adherence, improves exacerbation recovery and reduces healthcare use in a real-life practice of a COPD clinic.MethodsInitially, 40 patients were followed by a COPD telesystem for 1 year. Detailed data from patients’ behaviours during exacerbations was recorded. The telesystem use was then extended to 256 patients from a real-life COPD clinic. Healthcare utilisation for the year before and after telesystem enrolment was then assessed through hospital administrative databases.ResultsThirty-three of the 40 patients completed the initial 1-year study. Eighty-one exacerbations were reported in the 1-year follow-up. Action Plan adherence was observed for 72% of the exacerbations and those who were adherent had a significantly faster exacerbation recovery time. The large-scale implementation of the telesystem resulted in a significant decrease in the proportion of patients with ≥1 respiratory-related emergency room (ER) visits (120 before vs 110 after enrolment, p<0.001) and with ≥1 COPD-related hospitalisations (75 before vs 65 after enrolment, p<0.001).DiscussionCOPD Written Action Plan adherence was further enhanced with the use of telehealth technologies in a specialised clinic with experience in COPD self-management. Patients followed by the telesystem recovered faster from exacerbations and had a further decrease in COPD-related ER visits and hospitalisations.Trial registration numberNCT02275078.
Klippel-Feil Syndrome (KFS) is defined as congenital fusion of two or more cervical vertebrae. The most common signs are short neck, low hairline at the back of head and restricted mobility of neck. We report a case of a neonate who presented with complaint of respiratory difficulty and later diagnosed as case of Klippel-Feil syndrome.
Background:Mass drug administration (MDA) means once-in-a-year administration of diethyl carbamazine (DEC) tablet to all people (excluding children under 2 years, pregnant women and severely ill persons) in identified endemic areas. It aims at cessation of transmission of lymphatic filariasis.Objective:To study the coverage and compliance of MDA in Tikamgarh district during the campaign in April 2010.Materials and Methods:The activities under MDA involved administration of DEC tablets to eligible population from endemic area by health staff and Integrated Child Development Scheme (ICDS) functionaries referred as drug distributors (DD) make house-to-house visits on select dates in 2010. DEC was administered to all people (excluding children under 2 years, pregnant women and severely ill persons) with the instruction to ingest the tablet preferably on the spot.Study Design:Cross-sectional population based house-to-house visit.Setting:Urban and rural areas in Tikamgarh district identified as endemic for filariasis where MDA 2010 was undertaken.Study Variables:Exploratory - Rural and urban clusters of Tikamgarh district; Outcome - coverage, compliance, actual coverage, side effects.Analysis:Percentage and proportions.Results:Four clusters, each comprising 30 households from Tikamgarh endemic district, yielded an eligible population of 641. The coverage rate was 607 (94.6% of eligible) with variation across different areas. The compliance with drug ingestion was 89.9% with a gap of 10.1% to be targeted by intensive IEC. The effective coverage (85.2%) was just above the target (85%). Side effects of DEC were minimum, transient and drug-specific. Overall coverage was marginally better in rural areas. The causes of poor coverage and compliance have been discussed and relevant suggestions have been made.
The importance of triage tools designed specifically for children in major incidents and in the emergency department (ED) is being increasingly recognised. Triage tools should be clinically safe and evidence based where possible. This review aims to summarise the triage systems available for children in the pre-hospital and ED setting, discuss the differences in triage systems around the world and look at possible triage solutions of the future.
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