Irish journal of medical science
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Diabetes Mellitus is a health challenging of the century, more than 300 million people lives with diabetes, and it is one of the biggest global health concerns, awing to its complications. Good glycemic control is the cornerstone to decrease risk of type 2 diabetes complications. Even though, many people still have poor glycemic control which can be partly attributed to late insulin initiation, that can be challenging and forced by numbers of barriers. Identification and analysis of these barriers is crucial to find out effective way to overcome them. ⋯ Many barriers have been identified to influence the initiation of insulin therapy, fear from hypoglycemia was found to be the most influencing barrier. Increasing patient's awareness of symptoms of hypoglycemia, and always take their meal after insulin injection can help to overcome hypoglycemia.
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The efficacy of copeptin in patients with severe head injuries remains unclear. ⋯ Serum copeptin levels rise after graded TBI and can distinguish between patients with and without intracranial or extracranial lesions evident on CCT. Copeptin levels also aid in identifying moderate or severe TBI and in predicting 28-day mortality.
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Necrotising fasciitis is a devastating infection characterised by rapidly progressing necrotising infection of the superficial fascia with secondary necrosis of the overlying skin. ⋯ Differentiating cellulitis and necrotising fasciitis can be difficult when presenting signs and symptoms are non-specific. If not treated quickly with antibiotics and debridement of the infected tissue, the patient may develop septic shock within hours.
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The cause of voice problems in teachers are excessive voice strain, improper voice emission, and wrong emotional responses to occupational stress. The aim of the study was to analyze the relationship between subjective voice assessment of professionally active teachers treated for voice disorders and their stress-coping styles. ⋯ In addition to proper voice emission, the prevention and rehabilitation of occupational voice disorders in teachers should also include stress management techniques, as this can help reduce the incidence of functional voice disorders in this occupational group.
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Major trauma data in the developed world trends towards increased rates of lower energy mechanism in an older cohort. This study examines how the mechanism of trauma, injury pattern and outcomes differ between a younger and older cohorts in an Irish trauma unit. ⋯ This study highlights the increased mortality and morbidity experienced by older trauma patients compared with a younger cohort. The findings support the development of "silver trauma" care pathways and directing resources to meet the needs of older trauma patients and optimize clinical outcomes.