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Journal of General Practice

ISSN: 2329-9126

Open Access

Articles in press and Articles in process

      Perspective Pages: 1 - 2

      How Chronic Illness Affects Mental Health

      Chenge Criel*

      Chronic illness is a term used to describe any long-term health condition that persists over time and often requires ongoing treatment. Examples of chronic illnesses include diabetes, arthritis, cardiovascular disease, chronic pain conditions, and autoimmune diseases, among others. While the physical toll of these conditions is widely recognized, the mental health implications are often underestimated. The reality, however, is that chronic illness can significantly affect mental health in ways that may not always be immediately apparent to the individual or their caregivers. The relationship between chronic illness and mental health is complex and bidirectional, meaning that chronic illness can lead to mental health challenges, and mental health challenges can, in turn, exacerbate the physical symptoms of illness.

      Perspective Pages: 1 - 2

      The Role of First Responders in Emergency Care

      Eva Pawlas*

      First responders are the first individuals to arrive at the scene of an emergency, and their role is crucial in providing initial care and stabilizing patients before they are transported to more advanced medical facilities. These professionals include Emergency Medical Technicians (EMTs), paramedics, fire-fighters, and police officers. Each plays an essential role in emergency care, working together as a team to mitigate the effects of medical crises, accidents, natural disasters, and other unexpected events. The importance of their training, decision-making abilities, and ability to work under pressure cannot be overstated, as their actions in the initial moments of an emergency can significantly impact the outcome of a patient's recovery.

      Opinion Pages: 1 - 2

      Navigating Daily Life with Chronic Pain

      Friedman Carlos*

      Living with chronic pain is a daily challenge that millions of people face across the world. Unlike the temporary discomfort that most people experience from time to time, chronic pain is persistent, lasting for months or even years. It can be the result of a variety of conditions, ranging from arthritis and fibromyalgia to back problems or nerve damage. But regardless of the cause, the impact on one's daily life is profound. Navigating daily life with chronic pain involves not just managing the physical discomfort, but also contending with the emotional and psychological toll it takes. Over time, chronic pain can change the way people live, how they see themselves, and how they relate to others. The journey is complex, with challenges that ebb and flow, and strategies that must be adjusted as time goes on.

      Opinion Pages: 1 - 2

      How to Know When to See a General Practitioner

      Balzer Barbel*

      Knowing when to see a General Practitioner (GP) can be a confusing decision for many people. It's easy to feel unsure about whether your symptoms are serious enough to warrant a doctor's visit or if it's something that will resolve on its own. A significant number of individuals delay seeing a GP, thinking they can manage their symptoms themselves, but in some cases, delaying medical care can lead to complications or worsen the problem. On the other hand, visiting a doctor unnecessarily can lead to wasted time and resources. Striking the right balance is key. Understanding when to seek medical attention can prevent small issues from becoming serious and provide you with the guidance necessary for maintaining your health.

      Commentary Pages: 1 - 2

      The Evolving Role of Physicians in Modern Healthcare

      Jawad Meier*

      The role of physicians in healthcare has long been rooted in the foundational principles of medical practice diagnosis, treatment, and care. However, over the years, the role of physicians has undergone a significant transformation. This evolution is due to multiple factors such as advances in medical technology, changes in healthcare delivery systems, the expansion of patient expectations, and the globalized nature of healthcare information. While physicians have always been at the forefront of patient care, the modern healthcare landscape has placed new demands on their expertise, responsibilities, and approaches to patient care. In the past, physicians were seen as the undisputed authorities when it came to patient care. Their judgment was central to all medical decisions, and patients often adhered to their advice without question.

      Commentary Pages: 1 - 2

      The Physiology of Sleep: Why Rest Is Essential for Your Body

      Meena Alin*

      Sleep is one of the most important yet often overlooked processes that our body undergoes on a daily basis. While it might seem like a passive activity, sleep is crucial to maintaining our physical and mental health. It is during sleep that our body undergoes a series of restorative processes that are essential for survival and well-being. Despite its importance, the true understanding of sleep's physiology and its profound effects on the body remains a subject of scientific exploration. Yet, the basic principle is simple: sleep is not merely a break from the demands of life but a vital period during which the body recharges, repairs, and performs essential functions to maintain health. The human body requires sleep for many reasons, ranging from cognitive functioning to physical restoration.

      Brief Report Pages: 1 - 2

      The Role of Physiology in Health and Disease

      Star Saukanj*

      Physiology is the branch of biology that studies the functions and mechanisms occurring within living organisms. It focuses on how biological systems work at molecular, cellular, tissue and organ levels to maintain life. By examining the normal functioning of the body, physiology also provides invaluable insights into how these functions can be disrupted, leading to disease. In both health and disease, understanding physiology is crucial as it informs medical practice, disease prevention, and therapeutic strategies. The body’s physiological processes are essential for maintaining homeostasis, which is the stable internal environment necessary for proper functioning. Homeostasis regulates factors such as body temperature, pH, blood pressure, and glucose levels. When these processes become unbalanced or disrupted, the body is prone to disease.

      Brief Report Pages: 1 - 2

      Primary Health Organizations: Bridging Gaps in Healthcare Delivery

      Karim Rahman*

      Primary Health Organizations (PHOs) play a crucial role in the healthcare system, serving as the cornerstone of accessible and comprehensive health services. These organizations, operating at the community level, aim to provide primary care that is continuous, comprehensive, and coordinated. They bridge gaps in healthcare delivery by focusing on prevention, early diagnosis, treatment, and long-term management of chronic conditions, often in collaboration with specialists, hospitals, and public health agencies. The primary objective of PHOs is to improve the overall health of populations, reduce the burden on secondary and tertiary healthcare systems, and enhance the patient experience by offering services that are closer to where people live and work.

        Research Article Pages: 1 - 17

        Feasibility of a Decision Support Tool for the Pharmacological Management of Depression

        Stephen Kellett1,2*, Melanie Simmonds-Buckley1,2, Mike Seneviratne1, Katherine Morgan2, Mark Boon3 and Ian Seymour4

        Objective: The accurate prescription of antidepressants is technically complex and difficult to achieve. This project therefore sought to evaluate the feasibility of integrating an evidence-based decision support tool (Predictix) into General Practice. Methods: This was a real-world mixed methods evaluation in N=2 General Practices of the experiences of patients (n=24), General Practitioners (GPs; n=4) and Predictix administrators (n=2). Suitable patients were assessed using Predictix and this produced a recommendation for the likely most efficacious anti-depressant. Two patient study groups were created (a) antidepressant recommended by Predictix and (b) a GP clinical opinion override group. Both groups of patients were followed up at 12-weeks. The PHQ-9 was embedded in the Predictix assessment, and the measure was recompleted at 12-weeks follow-up. Qualitative interviews were conducted with GPs, patients and administrators and a reflexive thematic analysis (RTA) conducted. Results: It took 20-minutes to administer Predictix and then 3-days for the prescription to be issued. N=19 (88%) received a Predictix selected antidepressant (2 participants dropped out during the Predictix assessment), of whom 8/19 recovered. The N=3 (14%) in the GP override group all recovered. The common qualitative themes across GPs, patients and administrators were managing expectations, individualized care and burden. Conclusion: Whilst decision support tools have the potential for increasing prescribing accuracy for antidepressants, practical and psychological barriers to implementation need to be identified and resolved.

          Mini Review Pages: 1 - 3

          Factors Associated towards Mothers Practicing Acceptable Diet of 6-23 Months Old Children in Gimbichu Woreda, Oromia Regional State, Ethiopia

          Techane Sisay Tuji and Addisu Dabi Wake

          The infant young child feeding model of World Health Organization (WHO) suggests introducing complementary food for new born babies starting at the sixth month. Breast milk has to be round out by any other foods to fill the nutrient demand of the child. These complementary foods are required to fill the calorie, protein, and micronutrient gap between the total nutritional need of the child and the amount contributed by the breast milk. Sufficient complementary food has to be diversified and prepared from different food groups in a solid or semisolid form and needs to be commenced timely from the sixth month of the child’s age by implementing the quality of foods consumed as the child get older.

          Research Article Pages: 1 - 9

          Factors Associated Towards Mothers Practicing Acceptable Diet of 6?23 Months Old Children in Gimbichu Woreda, Oromia Regional State, Ethiopia: A Community Based Cross-Sectional Study

          Tuji Techane Sisay* and Addisu Dabi Wake

          Background: Accurate complementary feeding plays a great role in preventing childhood under nutrition, infectious disease, and mortalities. The available data suggests that the rates for Minimum Acceptable Diet (MAD) are low across all regions worldwide. For instance, rates are four in every ten (41.1%), in East Asia and Pacific and lowest in West and Central Africa at 8.6%, East and South Africa at 9.8%, and South Asia at 13.0%. However, Factors Associated towards Mothers Practicing Acceptable Diet of 6–23 Months Old Children living in study area is unknown. Therefore, this study was aimed to assess factors associated towards mothers practicing acceptable diet of 6-23 months old children in Gimbichu Woreda, Oromia Regional State, Ethiopia.

          Materials and methods: A community-based cross-sectional study was conducted among 782 mothers/caregivers paired with infants and children aged 6 to 23 months with a response rate of 97.1%, from March 12 to April 08, 2019. One-stage cluster sampling technique was employed. A structured pretested tool was used to collect the data. The binary logistic regression analysis was applied for MAD. All variables were transformed to multivariable logistic regression model irrespective of any transforming criteria to control the effects of confounder/s and to identify statistically significant variables. Finally, the variables which had independent correlations with MAD were identified on the basis of Adjusted Odds Ratio (AOR) and a p-value less than 0.05with 95%CI were claimed as statistically significant.

          Results: The proportion of acceptable diet was 30.1% (26.7, 33.1%). Mothers’ secondary and above educational level (AOR= 2.78, 95%CI (1.12, 6.89), mothers attending PNC (AOR=6.45, 95%CI (1.71, 13.33), mothers’ who had good knowledge in infant feeding AOR=8.46, 95%CI; (3.81,11.80), mothers’ involvement on feeding AOR=5.10, 95%CI; (2.47,10.52), mothers whose attending ANC (AOR=3.86, 95% CI (1.99,14.94), wealth index ranked at richest category (AOR=3.24 ,95%CI (1.24,8.45) and husbands’ involvement (AOR=5.75, 95% CI (1.18,12.79) were positively associated with MAD.

          Conclusion: The proportion of MAD practice by infants and children of the study area was low. Mothers’ secondary and above educational level, mothers’ attending PNC, mothers’ who had good knowledge on infant feeding, mothers’ involvement on feeding, mothers whose attending ANC, wealth index and husband’s involvement were factors positively associated with MAD. Assuring mother’s involvement on decision making and promoting husband involvement on infant and child feeding are strongly recommended to mitigate the problem.

            Review Article Pages: 1 - 8

            Stillbirth and its Association with Early Rupture of Membranes in Sub-Saharan Africa: Systematic Review and Meta-Analysis

            Telksew Yelma Yezengaw*, Tariku Dingeta Amante, Tesfaye Assebe Yadeta and Biruk Shalmeno Tusa

            Background: Stillbirth rate is an important indicator of access to quality antenatal and delivery care services. Many previous pocket studies were conducted to assess the magnitude of stillbirth and its association with premature rupture of membrane. However, the level of stillbirth, as well as its relationship with Premature Rupture of Membrane (PROM) varies from study to study. Objectives: This systematic review and meta-analysis was conducted to estimate the pooled prevalence of stillbirth and its association with the early rupture of membranes in sub-Saharan Africa. Search strategy: Electronic databases such as PubMed Central PMC, Cochrane library, Medline via Virtual Health Library (VHL), HINARI (Health Inter Network Access to Research Initiative) portal, and Google scholar were used for searching for original articles. Selection criteria: All Published and unpublished observational studies (prospective and retrospective cohort studies, case-control studies, and cross-sectional studies) that deal with stillbirth and their association with early rupture of membranes in sub-Saharan African women were included. Data collection and analysis: The extracted data analyses were done using STATA (version.16.0) software. Texts, figures, and tables were used to describe the included original articles. The heterogeneity of the studies was checked by I-squared statistics. A Random-effects method was applied to estimate the pooled prevalence of stillbirth and the effect size of the early rupture of membranes in sub-Saharan Africa. Subgroup analysis was performed based on region (East, West, Central, and Southern Africa) and year of study (before 2015 and after 2015). A funnel plot and Egger’s regression test was used to see publication bias. Main result: Pooled prevalence of stillbirth in sub-Saharan Africa was 6.4% (95% CI: 5.5-7.3). In sub-group analysis, Southern African regions had a higher stillbirth prevalence and the western African regions had a lower than East and Southern Africa. The prevalence of stillbirth in the region is increased from 4.1% (95% CI: 2.2–6.0) before 2015 to 7.1%(95% CI: 5.8-8.3) after 2015. The pooled odds ratio results from seven studies showed the non-significant effect of early rupture of membrane on stillbirth (pooled OR=1.54, 95% CI: 0.26-2.82). According to the regression test (Egger test), there was no small study effects or publication bias (P=0.108). Conclusions: The pooled prevalence of stillbirth in sub-Saharan Africa was relativity high. The analysis establishes the minimal effects of early rupture of membrane on stillbirth. Therefore, we recommend that strengthening the testing intervention is crucial to reduce the still relatively high stillbirths. Funding: No fund was received for this work.

              Editorial Pages: 1 - 1

              Diagnostic Strategies are the Specific Tools

              H. Innesu

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              Prognosis is the identity of the character and reason of a sure
              phenomenon. Analysis is used in lots of exclusive disciplines, with
              versions in the use of good judgment, analytics, and revel in, to
              determine "motive and impact". In systems engineering and computer
              science, it's far usually used to determine the reasons of symptoms,
              mitigations, and answers. Analysis is frequently tough, because many
              signs and symptoms and symptoms are nonspecific, and can best be
              undertaken with the aid of registered and licensed health experts. As
              an instance, redness of the skin (erythema), through itself, is an
              indication of many disorders and for this reason does not tell the
              healthcare expert what is incorrect. Accordingly differential analysis,
              wherein several feasible reasons are compared and contrasted, need
              to be achieved. This entails the correlation of numerous pieces of
              records observed by using the popularity and differentiation of
              patterns. Occasionally the procedure is made clean by a sign or
              symptom (or a set of several) this is pathognomonic. The method of
              differential analysis is based totally on locating as many candidate
              illnesses or situations as viable which can in all likelihood purpose
              the symptoms or symptoms, observed via a process of removal or as
              a minimum of rendering the entries greater or much less likely by
              means of similarly medical assessments and other processing,
              aiming to attain the point wherein handiest one candidate disorder or
              condition stays as likely. The final end result may additionally remain
              a list of feasible conditions, ranked so as of possibility or severity.
              One of these lists is frequently generated by means of computeraided
              analysis systems. In a pattern reputation approach the
              company makes use of experience to apprehend a sample of
              scientific characteristics. Its miles specifically primarily based on sure
              symptoms or signs being related to certain diseases or situations,
              now not necessarily related to the extra cognitive processing
              concerned in a differential analysis. This will be the number one
              method utilized in cases where illnesses are "apparent", or the
              issuer's revel in may additionally allow her or him to understand the
              circumstance quick. Theoretically, a certain pattern of symptoms or
              signs and symptoms can be at once associated with a sure therapy,
              even without an exact decision concerning what's the actual disease,
              but this type of compromise contains a full-size hazard of missing a
              analysis which simply has a distinctive therapy so it can be
              restrained to instances wherein no diagnosis may be made. Over
              diagnosis is the diagnosis of "ailment" so one can by no means
              purpose signs and symptoms or loss of life at some stage in a
              affected person's lifetime. It’s far a problem as it turns people into
              patients unnecessarily and due to the fact it could cause monetary
              waste (overutilization) and remedies which could reason harm. Over
              diagnosis takes place whilst a disorder is diagnosed effectively, but
              the analysis is inappropriate. A correct prognosis can be beside the
              point because treatment for the sickness is not to be had, now not
              needed, or now not desired. Clinical diagnosis or the actual
              procedure of creating a analysis is a cognitive manner. A clinician
              uses several assets of information and puts the portions of the puzzle
              together to make a diagnostic impression. The preliminary diagnostic
              affect can be a broad time period describing a category of sicknesses
              in place of a selected ailment or circumstance. After the initial
              diagnostic influence, the clinician obtains comply with up
              assessments and processes to get extra facts to assist or reject the
              authentic prognosis and could try to narrow it all the way down to an
              extra unique stage. Diagnostic strategies are the specific tools that
              the clinicians use to slender the diagnostic opportunities.

              Editorial Pages: 1 - 1

              Anesthesiologists are Predicted to Have Knowledge of Human Physiology

              Bingxi Zhao

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              Anesthesiology is the medical uniqueness involved with the overall
              perioperative care of patients earlier than, throughout and after
              surgery. It encompasses anesthesia, intensive care medicine,
              important emergency medicinal drug, and pain medicinal drug. A
              medical doctor specialized in anesthesiology is known as an
              anesthesiologist. There are special approaches of referring to the
              sector of anesthesiology and physicians who specialize in it relying
              on the area of the world. As a strong point, the core element of
              anesthesiology is the exercise of anesthesia. This comprises using
              diverse injected and inhaled medications to provide a loss of
              sensation in patients, making it feasible to carry out approaches that
              might in any other case motive intolerable ache or be technically
              unfeasible. Safe anesthesia calls for in-depth understanding of
              diverse invasive and non-invasive organ aid techniques which might
              be used to control sufferers' critical capabilities while under the
              results of anesthetic pills; those include superior airway management,
              invasive and non-invasive hemodynamic video display units, and
              diagnostic strategies like ultrasonography and echocardiography.
              Anesthesiologists are predicted to have professional knowledge of
              human physiology, medical physics, and pharmacology, as well as a
              large general understanding of all regions of medication and surgical
              procedure in every age of patients, with a particular cognizance on
              the ones components which might also effect on a surgery. In latest
              decades, the function of anesthesiologists has broadened to attention
              now not just on administering anesthetics all through the surgical
              operation itself, however additionally ahead so as to pick out highrisk
              patients and optimize their fitness, in the course of the process to
              keep situational awareness of the surgical procedure itself to be able
              to improve protection, in addition to afterwards so as to sell and
              enhance healing. This has been termed "perioperative medicine". In
              the 19th century, the beginnings of preferred anesthesia began with
              the advent of ether in Boston and chloroform inside the UK to bring
              about a state of unawareness and unresponsiveness to the ache of
              surgical insult. With the isolation of cocaine in the mid-nineteenth
              century there started out to be tablets available for neighborhood
              anesthesia. Through the stop of the nineteenth century, the quantity
              of pharmacological alternatives multiplied and that they commenced
              to be implemented both peripherally and neuraxially. Then within the
              20th century neuromuscular blockade allowed the anesthesiologist to
              completely paralyze the affected person pharmacologically and
              breathe for him or her through mechanical air flow. With those new
              tools, the anesthetist may want to intensively manage the affected
              person's body structure bringing about vital care remedy, which, in
              many nations, is in detail related to anesthesiology. Anesthesiologists
              have key roles in primary trauma, resuscitation, airway management,
              and worrying for other patients outside the operating theatre who
              have critical emergencies that pose an instantaneous danger to
              existence, again reflecting transferable competencies from the
              operating room, and allowing continuity of care whilst patients are
              brought for surgical operation or in depth care. This branch of
              anesthesiology is together termed critical emergency remedy, and
              includes provision of pre-medical institution emergency medication
              as a part of air ambulance or emergency scientific offerings, as well
              as safe switch of significantly ill sufferers from one part of a clinic to
              another, or among healthcare facilities. Anesthesiologists typically
              shape part of cardiac arrest groups and speedy reaction teams
              composed of senior clinicians that are without delay summoned while
              a affected person's coronary heart stops beating, or after they
              deteriorate acutely whilst in sanatorium. Exclusive models for
              emergency medicine exist internationally: inside the Anglo-American
              version, the patient is hastily transported by means of non-health
              practitioner vendors to definitive care along with an emergency
              department in a health center. Conversely, the Franco-German
              technique has a health practitioner, often an anesthesiologist, come
              to the patient and offer stabilizing care inside the area. The patient is
              then triaged at once to the appropriate branch of a health facility.

              Commentary Pages: 1 - 1

              Neuroscience is the Medical Study of Apprehensive Machine

              Lei Wang

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              Neuroscience is the medical study of the apprehensive machine.
              It’s far a multidisciplinary technological know-how that combines
              physiology, anatomy, molecular biology, developmental biology,
              cytology, pc technology and mathematical modeling to apprehend the
              fundamental and emergent residences of neurons, glia and neural
              circuits. The expertise of the biological basis of gaining knowledge of,
              reminiscence, conduct, belief, and attention has been defined by
              using Eric Kandel because the "remaining assignment" of the
              biological sciences. The view that the heart became the supply of
              awareness becomes no longer challenged till the time of the Greek
              physician Hippocrates. He believed that the mind turned into now not
              simplest concerned with sensation—due to the fact that most
              specialized organs (e.g., eyes, ears, tongue) are located in the head
              close to the mind—however becomes also the seat of intelligence.
              Plato additionally speculated that the mind become the seat of the
              rational a part of the soul. Aristotle, but, believed the coronary heart
              become the middle of intelligence and that the mind regulated the
              quantity of warmth from the coronary heart. This view became
              normally normal until the Roman health practitioner Galen, a follower
              of Hippocrates and doctor to Roman gladiators, determined that his
              sufferers misplaced their mental faculties after they had sustained
              harm to their brains. In parallel with these studies, paintings with
              brain-damaged sufferers by Paul Broca cautioned that positive
              regions of the mind had been answerable for certain functions. On
              the time, Broca's findings had been visible as a affirmation of Franz
              Joseph Gall's idea that language turned into localized and that sure
              mental functions have been localized in unique areas of the cerebral
              cortex. The localization of function hypothesis became supported via
              observations of epileptic patients performed by way of John Hugh
              lings Jackson, who effectively inferred the organization of the motor
              cortex by looking the progression of seizures via the frame. Carl
              Wernicke further advanced the concept of the specialization of
              particular brain systems in language comprehension and production.
              present day studies through neuroimaging techniques, still makes
              use of the Bradman cerebral cytoarchitectonic map (relating to study
              of cell structure) anatomical definitions from this period in continuing
              to show that distinct areas of the cortex are activated inside the
              execution of unique obligations. The medical take a look at of the
              anxious machine extended considerably for the duration of the
              second one half of the 20 th century, basically due to advances in
              molecular biology, electrophysiology, and computational
              neuroscience. This has allowed neuroscientists to have a look at the
              anxious gadget in all its factors: how it's far structured, the way it
              works, how it develops, the way it malfunctions, and how it could be
              modified. Neuroscience is also allied with the social and behavioral
              sciences, as well as with nascent interdisciplinary fields. Examples of
              such alliances encompass neuroeconomics, choice theory, social
              neuroscience, and neuromarketing to address complex questions
              about interactions of the brain with its environment. A observe into
              purchaser responses for instance uses EEG to research neural
              correlates related to narrative transportation into testimonies
              approximately strength performance. As an example, it has emerged
              as viable to apprehend, in a good deal detail, the complicated
              strategies occurring within a single neuron. Neurons are cells
              specialized for conversation. They’re capable of talk with neurons and
              other mobile kinds through specialized junctions called synapses, at
              which electrical or electrochemical indicators can be transmitted from
              one mobile to some other. Many neurons extrude an extended skinny
              filament of axoplasm known as an axon, which may expand to distant
              parts of the body and are able to swiftly wearing electric alerts,
              influencing the activity of other neurons, muscle tissues, or glands at
              their termination points. An anxious device emerges from the
              assemblage of neurons which might be connected to each other.

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