Articles: disease.
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Changes in the color, shape, or texture of the nails can be indicative of a wide range of disease states. Podiatrists routinely have the opportunity to observe and evaluate this aspect of pedal anatomy. This article provides a review of the relevant anatomy, an approach to the history and examination, and a description of the various nail changes as they relate to specific disease entities.
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A study was carried out to assess the quality of case management of malaria, malnutrition, diarrhoea and acute respiratory tract infections in children in rural primary health services in Papua New Guinea. In particular, the study focused on the knowledge and skills of different categories of rural health workers (HW) in history taking, examination, diagnosis, treatment and patient education. Quality criteria were defined and health centre (HCW) and aidpost workers' (APWs) knowledge and practices were assessed. ⋯ Treatment knowledge was often incorrect, with inappropriate or insufficient drugs prescribed, being worst at aidpost level. These findings raise serious questions about the effectiveness of providing health services through small, isolated health units. Far greater attention must now be directed to focus on the institutionalization of problem-based training, continuous supportive supervision and maintenance of clinical skills and provision of essential drugs, supplies and equipment to ensure that rural health workers (RHW) can provide sound care.
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Severe anaemia has remained a major cause of morbidity and mortality in children of Southern Ghana since the early 1960s. 71.1% of 15450 children attending the Korle Bu Teaching Hospital, Accra referred to the laboratory for haematological studies had haemoglobin (HB) levels below 11.0 Gm/dl while 27.7% of anaemic patients had Hb levels below 7.0 gm/dl. Indeed, 71.1% of children with severe anaemia had Hb levels below 5.0 gm/dl, thus requiring urgent blood transfusion. ⋯ Iron deficiency was the commonest cause of anaemia and contributed further to the anaemias of sickle cell disease and protein--energy malnutrition. In the light of the significant decline in the prevalence of childhood anaemia in the developed world following improved counseling in nutrition, fortification of foods with iron, and iron supplementation to infants and school children, and the documented attendant improvement in growth velocity and intellectual performance we support the planned national anaemia survey and recommend for early consideration iron supplementation to older infants and pre-school children at risk.
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Some Canadians who served in the military in the Persian Gulf 4 years ago complain of a range of symptoms commonly described as Gulf War syndrome. Although the syndrome is not recognized as a clinical entity, symptoms include fatigue, lack of sleep, depression, cognitive problems, rashes, bone aches, lassitude, lack of motivation, forgetfulness, mood changes irritability and diarrhea. The medical branch of the Department of National Defence has established programs to inform, guide diagnosis and reach out to symptomatic veterans of the Persian Gulf conflict. Civilian physicians who provide similar care to military personnel who participated in the conflict are invited to call the medical branch (613 996-3752) for further information.