Journal of General Practice

Background: The neurofibroma has been defined as a fibroma composed of “nervous and connective tissue” and held to have been first used in 1892. Moreover, an illustrated book without a figure defined it alike. Furthermore, a weighty tome also explained this similarly. Hence, what are the epidemiological features? The answer is based on a UK group that considered the use of a histopathology data pool in its analysis.

Materials and Methods: This paper contributes with personal experiences obtained among an Ethnic Group in Nigeria using a Reference Pathology Laboratory in which I was the pioneer pathologist from 1970 to 2010.

Results: It was remarkable that, up to 5 years, males predominated in consonance with the Igbo mothers’ preference for sons; as regards females the oldest teenage group was prominent in accord with their noted trend to seek attractiveness.

Conclusion: This paper gives the epidemiological features of neurofibroma among the Igbo ethnic group domiciled in a developing community.

Background: Our Emergency Department (ED) went through two periods with different managers. Although the number of beds, visits and admissions during these two periods didn't change significantly, a change in the ED’s policy, without a change in the hospital’s policy, converted a very crowded ED to an uncrowded one within few weeks, and changed the pattern of work in the hospital, gradually for many years.
Objectives: To share our experience and describe how a very crowded ED was transformed into an uncrowded one within few weeks and how we maintained the change thereafter. Methods: All data concerning the ED and other department activities were collected by using our hospital’s computerized business intelligence (BI) system.
Results: The average length of stay (LOS) of admitted patients in the ED was 5.05+0.98 hrs during period "A" (1993-2001). It dropped to 2.45+0.21 during period "B" (2002-2007) (P<0.001). The percent of patients boarding in the ED more than 10 hours dropped from 11.5+2.4% (period “A”) to 2.6+0.7% (period “B”) within three months. Despite a gradual increase in the number of admissions to the GM wards, there was a gradual decrease in the average LOS during period "B", compared to period "A" (6.1 vs. 5.5 days) (P=0.001). The death rate among patients in the ED and in the GM wards decreased significantly during period "B" (P<0.001).
Conclusions: We were able to achieve a difficult goal of eliminating overcrowding in the ED and consequently, other hospital’s wards only through assertiveness, persistence, adherence to protocols and the full personal backing of the hospital's manager.

In ancient period, learning method was memorizing only. So it was utmost important to have good attention and retention of knowledge. Students who used to lag behind were treated with Ayurveidic Herbs to improve comprehension. So my aim about this research was to shed light on these herbs and to test its validity with modern methods and take advantage of new technology. Also concept of medha-intelligence in Ayurveda and concept of MEDHYA rasayanaintelligence enhancing herb has been studied thoroughly in this experiment.

The purpose of this study was to contribute to the revision of the International Classification of Diseases (ICD-10) by exploring how mental health service users and their relatives conceive the influence of the contextual factors, as described in Chap. 21 of the ICD-10, on a) the onset of a mental or behavioral disorder; b) the resurgence of such a disorder; and c) the recovery process. In individual and group interviews, the 18 main categories of contextual factors proposed by the ICD-11 (beta draft) were discussed through the Contextual Factors Questionnaire (CFQ). Participants in individual interviews (N=28) completed the CFQ. Among the three dimensions, it was for the recovery process that the contextual factors were considered to be the most influential, followed by their influence on the resurgence of a mental or behavioral disorder and then by the influence on the onset of that disorder. The most influential factor for a single dimension was that of ‘interventions’ on the recovery process, whereas the ‘social or cultural factors’ are the most influential ones for all dimensions combined, closely followed, at par, by ‘risk factors’ and ‘interpersonal relations’. As recovery is also dependent upon health services and interventions globally, this paper suggests that these could be more effective if they were recovery-oriented and with recovery as a common overarching goal for mental as well as for physical healthcare provision and thus for global recovery. However, further work is needed to validate its reliability for enhanced mental and physical health parity in general practice.

Purpose of the research: This study was done to explore the ANA, RF and CRP in the patients with some of Rheumatic Symptoms

Materials and methods: The studies were done for 103 patients with Rheumatic Symptoms and were included in this study and their sera tested for the presence of Antinuclear Antibody (ANA), Rheumatoid Factor (RF), and Creactive protein (CRP).

Results: The results showed that 33% of the patients with Systemic Lupus Erythematosis (SLE) had+ve ANA, the remainder 67% of patients were with Rheumatoid Arthritis (RA), the incidence of SLE was 4: 1 female to male while of RA was 2: 1. The highest titers of ANA, RF, and CRP were in females. In the following age groups (10-14), (15-19) and (35-39) the incidence of SLE were in females only. No male or female with SLE in (40-44), (45-49) or (50-54).

Conclusion: The patients cleared that most patients were harmed either by Rheumatoid Arthritis or +ve Anti- Nuclear Antibody when they had Systemic Lupus Erythematosis.

Currently glucocorticoid steroid is the mainstay of treatment of chronic inflammatory diseases like asthma, COPD, rheumatoid arthritis. But many chronic inflammatory diseases are resistant to glucocorticoid steroid like pulmonary fibrosis, atherosclerosis related diseases, chronic laryngitis and chronic muscle injury. Glucocorticoid steroid has been thoroughly studied and its therapeutic potential has been exhausted, and therefore there is a need to develop new anti-inflammatory drugs or anti-inflammatory therapies. Moxa (Artemisia Argyi) is a plant, its burning smoke or Tar has strong anti-inflammatory property. In this article the author wants to introduce a new way (Moxa Tar) of treating glucocorticoid steroid resistant chronic inflammatory diseases based on some clinical experiments and hypothesis of the author’s personal observation. The purpose of this article is to open up a new field and raise researchers’ attention to this new field for developing new anti-inflammatory drugs or anti-inflammatory therapies. The methods used in this study are Crossover design, i.e. patients serve as their own control, comparing the clinical symptoms and signs before and after Moxa Tar treatment.

Purpose The length of the average General Practice (GP) consultation is increasing. In 1990 the average length was 8.33 minutes but by 2003 the median consultation length had increased to 13.3 minutes. The aims of this study were to explore patient’s perceptions of the length of the general practice consultation. Methods This is a questionnaire based study with a total sample size of (n=66). The study timeframe was July 2012 to Jan 2013 and the response rate was 82.5%. The study was conducted at a single six-partner GP training practice with a list size of approximately 13000 patients. Results The majority of patients thought that the consultation length was ten minutes. Approximately two thirds of patients did not wish for any changes to be made to the length of their GP consultations. Approximately one third of patients indicated that they would like the average length of the consultation to be longer Conclusions This research suggests that the majority of patients are happy with the length of their GP consultations and do not wish for any change. Perhaps it is the time taken to document the clinical encounter and ‘house-keeping’ duties which are responsible for the late-running of appointments rather than the face to face time spent with the patient? The patient’s satisfaction with the length of the consultation suggests that they are happy with the prioritization and time-management skills of their GPs.

Purpose The Quality and Outcome Framework (QOF) was introduced in 2004 as part of the General Medical Services Contract. In this age of austerity it has never been more important in general practice to ensure that QOF targets are achieved not only to improve the standard of care patients receive but also to ensure that income generation is maximized. We are a six-partner training practice with approximately 13,000 patients and 4 full time GP Registrars. It was an incidental finding that on reviewing the patients’ notes that the registrars had seen, the relevant QOF indicators had not been addressed in the majority of cases during the routine consultations. Methods In the first week of February 2013 random routine surgeries were retrospectively selected for each registrar and each patient’s notes were reviewed with regards to how many QOF indicators had been addressed or missed by the registrar during the consultation. A second round of audit was conducted during the final week of February to investigate if the recommendations for change in practice had made any difference to clinical performance. Results The majority of registrars significantly improved following the tutorials discussing the recommendations for change in practice. Conclusions A formal QOF induction tutorial has been developed containing the recommendations for change arising from this audit. As a result it he hoped that the standards of clinical care, opportunistic health promotion, chronic disease management, practice income and registrar job satisfaction will all improve.

Aim: Puberty is vital stage of human growth and life cycle; this stage faces different psychological, physiological changes, it is a stage when individuals are going towards maturation. For this stage human needs sufficient nutrition, lack of nutrition causes delayed puberty, stunted growth, in female, lack of nutrition cause their menarche, if female under nutrition remains in time of their child bearing it effects in child weight, due to under nutrition girl suffers from anemia.

Methods: Study is done on adolescent girls of rural area of Paschim Medinipur, by anthropometric tools different anthropometric measurements were taken.

Results: The overall means, standard deviations of height and weight of the adolescent girls were 150.01 cm (4.81) and 44.06 kg (5.70) respectively. Among all circumferential measurements mean Hip circumference is highest 84.85 cm (6.57) and among skin folds Triceps skinfold is 8.98 mm (2.03). According to table mean height increases (7.54) cm progressively from 10 years to 19 years, 8.76 kg weight increases from 10 to 19 years.

Conclusion: Age wise change is shown in this study which proves growth pattern of adolescent period.