UCC Student Medical Journal Vol. 1 (2019)

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https://hdl.handle.net/10468/16574

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    UCC Student Medical Journal 1st Edition
    (UCC Medical Research and Technology Society, 2019) O'Donoghue, Ciara; O'Shea, Robert; Abrar, Samin
    UCC Student Medical Journal 1st Edition
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    The state of malaria in a rural-mission hospital in Nkhoma, Malawi
    (UCC Medical Research and Technology Society, 2019) Crowley, Bailey; O'Brien, Éabha; Kabota, Sam
    Introduction: In recent times, malaria has fallen out of the limelight due to an economical migration of populations into medium and higher income settings. Despite this, it remains endemic in 31 countries with 228 million cases per annum. In Malawi, the WHO have reported that all of its citizens are at risk of contracting the disease. In this study we hope to expand on the clinical data available at a rural mission hospital in Malawi, as well as highlight some of the external global health factors in such environments. Methods: An observational retrospective cohort study looking at severe malaria admission in a paediatric population was conducted. The Nkhoma hospital Paediatric department was the centre of the data collection which focused on the diagnosis of severe malaria, as well as the signs and symptoms and treatment regimens of same. Results: Severe malaria accounted for over 40% of all paediatric admissions in the month of May 2019. Patients suffered from anaemia (80%) and cerebral malaria (41%), as well as a host of generalised symptoms such as fever (95%), vomiting (36%), malaise (30%), and diarrhoea (21%). Promisingly, a strict and comprehensive treatment regime for severe malaria was in practice with artesunate, Lumefantrine used in ~100% of cases. Conclusion: Sadly, malaria continues to create horrendous amounts of morbidity and mortality, but our united commitment to eradicating malaria is stronger than ever. 
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    The effects of postoperative delirium on outcomes in hip fracture patients
    (UCC Medical Research and Technology Society, 2019) FitzGerald, Kieran; O'Donnell, Brian
    Background: Hip fractures have reached epidemic levels in an ever-ageing population. Based on this increase, the rate of postoperative delirium (POD) is simultaneously expected to rise as it seems to be a disproportionate hazard post-hip surgery. POD is purported to have detrimental effects, but prevention and screening efforts remain inadequate. Therefore, examination of recent evidence for negative outcomes, including decreased survival and increased complications, is critical if we seek best practice. Objectives: This review examines the most recent evidence for the effect of POD on mortality of hip fracture patients and other outcomes such as length of stay, discharge destination and functional outcomes. Methods: Two electronic database searches resulted in selection and critical appraisal of ten studies. Results: Across the ten articles selected for review, the prevalence of POD ranged from 18-53.3%. Nine studies focused on mortality. In unadjusted analysis, mortality was found to have a significantly increased association with POD. However, several papers showed with effective adjustment for confounding or contributory variables, no independent association was observed. Medical complications was a focus in four of the articles, and the association with POD was observed following adjustment. Similar results were reported for increased non-home discharge and length of hospital stay. Conclusion: POD has some effect on outcomes in hip surgeries but future research needs coherence of methods across the field and comprehensive accounting for the increased age and comorbidities of POD patients. Determining whether factors like increased length of stay are themselves the cause, rather than the result, is imperative. The lack of consistent high-quality research frustrates the validity of many of the papers conclusions on increased mortality. While we await such research an effort still needs to be made to prevent POD, especially given the more valid evidence of other less fatal effects.
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    Trends in novel psychoactive substance use and the impact of Irish legislative efforts
    (UCC Medical Research and Technology Society, 2019) Mazurek, Andrew; Bolster, Margot
    Introduction: Novel Psychoactive Substances (NPS) are emerging at increasingly rapid rates, creating unpredictability in drug markets and ineffective drug policies. Ireland has a drug-induced mortality rate greater than three times the European average and the highest rate of NPS use. Given the scarcity of published literature, the National Advisory Committee on Drugs has recommended trends in NPS use be studied in order to facilitate appropriate public health measures. Objectives: To critically evaluate the published literature on NPS and establish the health risks associated with their use, trends in drug-induced fatalities, and the efficacy of legislative policies in reducing NPS consumption. Methods: A systematic search of Medline and PubMed was completed based on pre-defined inclusion criteria, and relevant studies were selected for comprehensive analysis. Results: Clinical experiences of NPS abusers predominantly involved neurological or psychological symptoms, coupled with cardiovascular effects. While the overall prevalence of NPS presentations in Europe remains low, fatal overdoses were primarily attributed to acute overdose and commonly involved ingestion of synthetic cathinones. Legislation in 2010 resulted in decreased rates of recent and problematic NPS use, along with higher rates of negative user experiences. No significant displacement towards established illicit drugs was reported. Conclusion: This systematic review has demonstrated the current state of knowledge regarding NPS within an Irish context. The trends in NPS prevalence and toxicity are important considerations for the development of effective drug monitoring or enforcement strategies. This knowledge is further relevant for emergency physicians and forensic pathologists in order to make accurate medical assessments.
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    Risk assessment of non-communicable diseases (NCDs) in rural Maharashtra, India
    (UCC Medical Research and Technology Society, 2019) Marwaha, Shivika
    The research question I addressed was - To what extent do socioeconomic factors influence the risk of developing lifestyle diseases such as Obesity, Hypertension and Type II Diabetes Mellitus in Rural and Urban Indian women aged 35-55 years? Having lived in the urban parts of India for the majority of my life, this opportunity exposed me to healthcare in rural India and language barriers due to the diversity of subIndian cultures.