Objective: Irreversible hearing loss is a frequent side effect of the chemotherapeutic agent cisplatin and shows considerable interpatient variability. The variant rs1872328 in the ACYP2 gene was recently identified as a risk factor for the development of cisplatin-induced ototoxicity in children with brain tumors. We aimed to replicate this finding in patients with osteosarcoma. Methods: An independent cohort of 156 patients was genotyped for the rs1872328 variant and evaluated for the presence of cisplatin-induced ototoxicity. Results: A significant association was observed between carriership of the A allele and cisplatin-induced ototoxicity after the end of treatment (P=0.027). Conclusion: This is the first study replicating the association of ACYP2 variant rs1872328 with cisplatin-induced ototoxicity in patients with osteosarcoma who did not receive potentially ototoxic cranial irradiation. Hence, the ACYP2 variant should be considered a predictive pharmacogenetic marker for hearing loss, which may be used to guide therapies for patients treated with cisplatin. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
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Δευτέρα 29 Φεβρουαρίου 2016
Identification of a serum transglutaminase threshold value for the noninvasive diagnosis of symptomatic adult celiac disease patients: a retrospective study
Abstract
Background
A celiac disease (CD) diagnosis is based on duodenal histology, with the exception of children showing anti-tissue transglutaminase (anti-tTG) serum levels exceeding ten times the cut-off. Our aim was to reproduce this simplified approach in adults, identifying an anti-tTG threshold value useful to diagnose CD without endoscopic procedures.
Methods
A total of 671 adult CD patients were subjected to blood sampling to determine anti-tTG serum levels, as well as to endoscopy with biopsy to perform duodenal histology. The anti-tTG serum levels/cut-off ratio was compared with the degree of duodenal lesions.
Results
Anti-tTG serum levels/cut-off ratio determined in patients with type IIIc was significantly higher than that measured in patients with type IIIb (p < 0.001), IIIa (p < 0.001), II (p < 0.05) and 0 (p < 0.001) of Marsh–Oberhuber histological classification. A significant correlation (r = 0.297, p < 0.0001) was found between the anti-tTG serum levels/cut-off ratio and the degree of duodenal lesions. The anti-tTG serum levels/cut-off ratio was classified as an accurate parameter (AUC = 0.715, p < 0.0001), with the best diagnostic performance obtained considering the threshold value >3.6 (sensitivity = 76.8 %, PPV = 97.2 %).
Conclusions
The anti-tTG serum levels/cut-off ratio correlates with the degree of duodenal lesions and, if used with the threshold value >3.6, could avoid endoscopy with biopsy in about 75 % of seropositive adults waiting for CD diagnosis. However, since this procedure could also imply CD diagnosis in almost 3 % of seropositive patients with normal villous architecture, a consensus opinion is needed to suggest its use in the diagnosis of adult CD.
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Ultrasound Elastography is Useful for Evaluation of Liver Fibrosis in Children - A Systematic Review.
Objectives: Adult studies have proven ultrasound elastography as a validated measure of liver fibrosis. This study aimed to review the available literature on ultrasound elastography in children in order to evaluate the ability of the method to distinguish healthy from fibrotic liver tissue and investigate whether cut-off values for liver fibrosis in children have been established. Methods: A literature search was performed in MEDLINE, EMBASE, the Cochrane Library and Web of Science to identify studies on ultrasound elastography of the liver in children. Only original research articles in English concerning ultrasound elastography in children with and without liver disease, younger than 18 years, were included. All reference lists of the included articles were hand-searched for further references. Results: Twenty-seven articles were included. Elastography in children without liver disease was investigated in 14 studies and were comparable to those existing for adults. Twelve studies compared elastography to liver biopsy in children with liver disease and found that cirrhosis was correctly diagnosed, whereas it was more difficult to assess severe fibrosis correctly. For the distinction between no, mild and moderate fibrosis in children with liver disease the method was less accurate. Ultrasound elastography was able to differentiate between children with and without liver fibrosis. In children without liver disease ultrasound elastography showed consistent liver stiffness values comparable to those found in adults. No fibrosis-specific cut-offs were proposed. Conclusion: Ultrasound elastography was able to diagnose cirrhosis, distinguish healthy from fibrotic liver tissue and showed consistent liver stiffness values in children without liver disease. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,
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Growth Pattern in Paediatric Crohn's Disease is Related to Inflammatory Status.
Objectives: The respective role of disease activity and steroid therapy in growth impairment in paediatric-onset Crohn's disease (CD) is still debated. Our aim was to investigate whether the growth pattern of CD children was correlated with the inflammatory status during the disease course, regardless the cumulative duration of steroid therapy. Methods: 107 patients with a diagnosis of CD =2 years and for whom >=2 height measures were available during follow-up, were identified between 1998 and 2010. Height, C-reactive protein (CRP), orosomucoid and steroid therapy duration were collected at each visit. The relationship between the evolution of growth velocity and inflammatory status during follow-up was investigated using a linear mixed model with random coefficients. Results: Median age at diagnosis was 11.7 years (Q1-Q3: 9.8-13.5). Mean height for age (H/A) z-score was 0.14 +/- 1.29 at diagnosis and 0.05 +/- 1.23 among the 75 patients who had reached their final height at maximal follow-up (median: 4.9 years; Q1-Q3: 3.8-6.4). Growth failure (H/A z-score
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Food Intake Adequacy in Children and Adolescents with Inflammatory Bowel Disease.
Objectives: Diet assessment is essential in the care of patients with inflammatory bowel disease (IBD). We aimed to study food intake in children with IBD and evaluated the relationship of dietary intake with disease activity and nutritional status in these children. Methods: This cross-sectional study investigated 68 children and adolescents with IBD (57 Crohn's disease, 11 ulcerative colitis). Evaluation included clinical, laboratory and nutritional assessment including 3 days diet record. Results: Compared to RDA, the intake of patients with IBD was significantly poor for carbohydrates (75%, p = 0.016), calcium (49%, p
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Acculturation Strategies Among South Asian Immigrants: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study
Abstract
In the past, epidemiologic research on acculturation and health has been criticized for its conceptual ambiguity and simplistic measurement approaches. This study applied a widely-used theoretical framework from cross-cultural psychology to identify acculturation strategies among South Asian immigrants in the US and to examine sociodemographic correlates of acculturation strategies. Data were from the Mediators of Atherosclerosis in South Asians Living in America study. We used latent class analysis to identify groups of individuals that were similar based on cultural attitudes and behaviors. We used latent class regression analysis to examine sociodemographic correlates of acculturation strategies. We found that South Asian immigrants employed three acculturation strategies, including separation (characterized by a relatively high degree of preference for South Asian culture over US culture), assimilation (characterized by a relatively high degree of preference for US culture over South Asian culture), and integration (characterized by a similar level of preference for South Asian and US cultures). Respondents with no religious affiliation, those with higher levels of income, those who lived a greater percentage of their lives in the US, and those who spoke English well or very well were less likely to use the separation strategy than the assimilation or integration strategies. Using epidemiologic cohort data, this study illustrated a conceptual and methodological approach that addresses limitations of previous research on acculturation and health. More work is needed to understand how the acculturation strategies identified in this study affect the health of South Asian immigrants in the US.
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How to read a medical research article
An emergency medicine physician and educator shares his process for reading and analyzing a medical journal article
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Maurice Davis Band - The Wrong Goodbye
The Wrong Goodbye is the brain child of singer/songwriter Maurice Davis. The mission is to raise awareness, remove the stigmatism that keeps people silent and help bring suicide to an end.
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How to read a medical research article
An emergency medicine physician and educator shares his process for reading and analyzing a medical journal article
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Maurice Davis Band - The Wrong Goodbye
The Wrong Goodbye is the brain child of singer/songwriter Maurice Davis. The mission is to raise awareness, remove the stigmatism that keeps people silent and help bring suicide to an end.
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How to read a medical research article
An emergency medicine physician and educator shares his process for reading and analyzing a medical journal article
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Maurice Davis Band - The Wrong Goodbye
The Wrong Goodbye is the brain child of singer/songwriter Maurice Davis. The mission is to raise awareness, remove the stigmatism that keeps people silent and help bring suicide to an end.
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EMT-B & Dispatchers Needed, Philadelphia, PA - L&P Care Ambulance Inc.
Job Summary: Performs professional and technical duties to render basic life support care in the emergency and non-emergency transportation setting. Education: High school diploma or equivalent required. Certifications: Pennsylvania state certified EMT-B. BCLS certification (CPR). Driver's License - current and valid driver's license. Employees must adhere to all procedural guidelines in HR Policy 1-13 ...
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How to read a medical research article
An emergency medicine physician and educator shares his process for reading and analyzing a medical journal article
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Maurice Davis Band - The Wrong Goodbye
The Wrong Goodbye is the brain child of singer/songwriter Maurice Davis. The mission is to raise awareness, remove the stigmatism that keeps people silent and help bring suicide to an end.
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Full-time Paramedic $3500 Sign-on - EMSA/AMR
Paramedic – EMSA/Oklahoma City (Relocation Bonus Available) Want to make a real difference in the world and improve your own paramedic skills in the process" EMSA is seeking ambitious, resourceful caregivers to work full-time in our fast-paced, ALS, 911 system. We challenge paramedics by setting high performance standards and implementing innovative treatment protocols; we reward our team by offering ...
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Full-time Paramedic $3500 Sign-on - EMSA/AMR
Paramedic – EMSA, Tulsa, OK (Relocation Bonus Available) Want to make a real difference in the world and improve your own paramedic skills in the process" EMSA is seeking ambitious, resourceful caregivers to work full-time in our fast-paced, ALS, 911 system. We challenge paramedics by setting high performance standards and implementing innovative treatment protocols; we reward our team by offering ...
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EMS Billing, eCPR Software & Services
AIM strives to be the trusted national leader in the delivery of mission critical EMS software and services.
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Our Company, Our People, Our Customers
AIM strives to be the trusted national leader in the delivery of mission critical EMS software and services.
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ImageTrend to Demonstrate Elite Community Health™ at EMS Today
AKEVILLE, MINN. and BALTIMORE, MD. - ImageTrend, Inc. announced the public introduction of the enrollment feature in Elite Community Health, which helps agencies enroll community paramedicine patients into the optimal program, at EMS Today in Baltimore. Elite Community Health is the company's patient-centric community paramedicine solution, which is based on ImageTrend Elite's multi-platform ...
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Firefighter in Chagrin Falls Ohio Discovers a New Way to Lift Patient with Weak Shoulders
Binder Lift prevents possible trip to the ED >The Situation While conducting a 30-day field trial on the Binder Lift, Chagrin Falls firefighters responded to a woman who was found sitting on the floor and in need of lift assistance. Even though there was no injury to be found, the woman was anxious and tearful. After further assessment paramedic Ben Speidel learned that she had bilateral rotator ...
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Multiple neural signatures of social proof and deviance during the observation of other people's preferences
Abstract
Detecting one's agreement with or deviation from other people, a key principle of social cognition, relies on neurocognitive mechanisms involved in reward processing, mismatch detection, and attentional orienting. Previous studies have focused on explicit depictions of the (in)congruency of individual and group judgments. Here, we report data from a novel experimental paradigm in which participants first rated a set of images and were later simply confronted with other individuals' ostensible preferences. Participants strongly aligned their judgments in the direction of other people's deviation from their own initial rating, which was neither an effect of regression toward the mean nor of evaluative conditioning (Experiment 1). Most importantly, we provide neurophysiological evidence of the involvement of fundamental cognitive functions related to social comparison (Experiment 2), even though our paradigm did not overly boost this process. Mismatches, as compared to matches, of preferences were associated with an amplitude increase of a broadly distributed N400-like deflection, suggesting that social deviance is represented in the human brain in a similar way as conflicts or breaches of expectation. Also, both early (P2) and late (LPC) signatures of attentional selection were significantly modulated by the social (mis)match of preferences. Our data thus strengthen and valuably extend previous findings on the neurocognitive principles of social proof.
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Psychophysiological responses to auditory change
Abstract
A comprehensive characterization of autonomic and somatic responding within the auditory domain is currently lacking. We studied whether simple types of auditory change that occur frequently during music listening could elicit measurable changes in heart rate, skin conductance, respiration rate, and facial motor activity. Participants heard a rhythmically isochronous sequence consisting of a repeated standard tone, followed by a repeated target tone that changed in pitch, timbre, duration, intensity, or tempo, or that deviated momentarily from rhythmic isochrony. Changes in all parameters produced increases in heart rate. Skin conductance response magnitude was affected by changes in timbre, intensity, and tempo. Respiratory rate was sensitive to deviations from isochrony. Our findings suggest that music researchers interpreting physiological responses as emotional indices should consider acoustic factors that may influence physiology in the absence of induced emotions.
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Psychophysiological arousal and inter- and intraindividual differences in risk-sensitive decision making
Abstract
The current study assessed peripheral responses during decision making under explicit risk, and tested whether intraindividual variability in choice behavior can be explained by fluctuations in peripheral arousal. Electrodermal activity (EDA) and heart rate (HR) were monitored in healthy volunteers (N = 68) during the Roulette Betting Task. In this task, participants were presented with risky gambles to bet on, with the chances of winning varying across trials. Hierarchical Bayesian analyses demonstrated that EDA and HR acceleration responses during the decision phase were sensitive to the chances of winning. Interindividual differences in this peripheral reactivity during risky decision making were related to trait sensitivity to punishment and trait sensitivity to reward. Moreover, trial-by-trial variation in EDA and HR acceleration responses predicted a small portion of intraindividual variability in betting choices. Our results show that psychophysiological responses are sensitive to explicit risk and can help explain intraindividual heterogeneity in choice behavior.
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Management of Foreign Body Safety Pin (Closed and Open) in Bronchus and Oesophagus – A Technical Note
2016-02-29T05-09-57Z
Source: The Southeast Asian Journal of Case Report and Review
Sathish A Ponni, Sithananda Kumar Venkatesan, Sivaraman Ganesan, Kalaiarasi Raja, Arun Alexander, Sunil Kumar Saxena.
Safety pin as a foreign body in upper aero digestive tract is not a common occurrence and accounts for less than 3% of all trachea bronchial foreign bodies, yet it is of great concern to all ENT surgeons. This is because of its sharp end, which can result in impaction in aerodigestive tract resulting in lethal intra operative and post operative complications. This study highlights the potential risk of accidental ingestion and aspiration of safety pin which is a common household object and various techniques we follow to remove a safety pin via bronchoscopy and esophagoscopy.
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The pharmacokinetics of vancomycin in patients with severe acute pancreatitis
European Journal of Clinical Pharmacology
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Vitamin D supplementation and quality of life following diagnosis in stage II colorectal cancer patients: a 24-month prospective study
Supportive Care in Cancer
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Potential dual role of activating transcription factor 3 in colorectal cancer
Anticancer Research
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Factors associated with the success of in vitro fertilization in women with inflammatory bowel disease
Digestive Diseases and Sciences
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Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures
Gastrointestinal Endoscopy
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A comparison of survival in patients with hepatocellular carcinoma and portal vein invasion treated by radioembolization or Sorafenib
Liver International
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Management of eosinophilic esophagitis during pregnancy
Digestive Diseases and Sciences
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Incorporating HIV/hepatitis B virus/hepatitis C virus combined testing into routine blood tests in nine UK Emergency Departments: The Going Viral campaign
HIV Medicine
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Inhibition of colon cancer growth by docosahexaenoic acid involves autocrine production of TNFα
Oncogene
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Racial disparities in treatment and survival of patients with hepatocellular carcinoma in the United States
Hepatobiliary Surgery and Nutrition
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Preoperative low-dose weekly cisplatin and continuous infusion fluorouracil plus hyperfractionated radiotherapy in stage II–III esophageal carcinoma
Clinical and Translational Oncology
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Simeprevir and sofosbuvir with or without ribavirin to treat recurrent genotype 1 hepatitis C virus infection after orthotopic liver transplantation
Liver Transplantation
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Inflammatory bowel disease affects the outcome of fecal microbiota transplantation for recurrent clostridium difficile infection
Clinical Gastroenterology and Hepatology
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The risk of associated diarrhea in nasogastric tube insertion: A systematic review and meta-analysis
Digestive and Liver Diseases
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Effect of index hospitalization costs on readmission among patients undergoing major abdominal surgery
JAMA Surgery
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Phase I study of pre-operative continuous 5-FU and sorafenib with external radiation therapy in locally advanced rectal adenocarcinoma
Radiotherapy & Oncology
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Is timing of medical therapy related to outcome in painful chronic pancreatitis
Pancreas
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Neoadjuvant Chemotherapy with Divided-dose Docetaxel, Cisplatin and Fluorouracil for Patients with Squamous Cell Carcinoma of the Esophagus
Anticancer Research
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Propensity score-matched study of laparoscopic and open surgery for colorectal cancer in rural hospitals
Journal of Gastroenterology and Hepatology
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Babies born with gastroschisis and followed up to the age of six years faced long-term morbidity and impairments
Acta Pediatrica
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4’-THIODNA: UNEXPECTED BEHAVIOUR
2016-02-29T03-14-14Z
Source: International Journal of Current Research and Review
Mohamed I. Elzagheid.
This viewpoint briefly discusses the impact of 4-thiosubstitution on oligonucleotides behaviour. The study in the reviewed articles has shown unexpected A-form formation, and unexpected RNA-like behaviour of the 4-thioDNA. This has been confirmed by the unexpected interaction of 4-thioDNA with Lividomycin A, a RNA major groove binder, and by resistance to cleavage by DNase I, which is a DNA-specific endonuclease. 4-ThioDNAwas also recognized by RNase V1 which is a RNA-specific endonuclease. These all findings will trigger the main focus of this viewpoint.
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ANIMATION TECHNIQUE: AN EFFECTIVE TOOL TO UNDERSTAND CERTAIN BIOCHEMICAL PROCESSES LIKE BIOLOGICAL OXIDATION
2016-02-29T03-14-14Z
Source: International Journal of Current Research and Review
Joshi P. N..
Background: Learning or computer assisted teaching-learning is becoming popular at every stage of life. Animation is one of the computer applications and can have its impact on teaching-learning process. Aims: The present study was designed to know whether the use of animation technique, in teaching can improve the process of understanding Methods: For this a group of 50 students was selected. The objectives of the study were explained to them. Pre-test was conducted by giving questionnaire. The topic was taught to them using overhead projector slides. Post test 1 was conducted giving same questionnaire. Then same topic was taught to them using animation tool. Post test 2 was conducted. The data obtained in the form of correct answers for all the three tests was analyzed statistically. At the same time feedback forms were given to all the students for purpose of analyzing the results qualitatively. Results: The results of pretest (P= NS) and posttest1 (p
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SCIENTOMETRICS: A NEED FOR PHYSICAL THERAPY
2016-02-29T03-14-14Z
Source: International Journal of Current Research and Review
Mahamed Ateef.
Due to the emergence of electronic media into science and technology, the awareness and acquaintance to scientific data has been increased during the past three decades. Internet facilities have made possible the reach of data to all the academicians/researchers. Mushrooming of publications and duplication of articles has been tremendously increased in the recent years. Due to the emergence of new science called scientometrics, the quality and quantity of scientific material is expected to be measured and analyzed on the basis of scientific measures. This modern technology measures not only the published material also the evaluation of scientists (H-index) and their role in particular field along with the ranking of field experts and expertise. These measures and analysis not only determines the impact of scientific work but also the upcoming researchers to choose particular field experts for their ongoing work to yield authenticated outcomes and validation of research performance. Scientometrics basically focuses on assessment and evaluation of scientific rigor 1.And emphasize the relative growth and scientific priority in many fields. The modern Scientometrics also means to explain the quality of work based on bibliometric analysis of scientific publications and citations. In brief Scientometrics is the study of measuring and analysis of science and its innovations
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SERUM LACTATE DEHYDROGENASE LEVELS IN GASTROINTESTINAL TRACT CARCINOMA PATIENTS BEFORE AND AFTER SURGERY
2016-02-29T03-14-14Z
Source: International Journal of Current Research and Review
V. Bhagyalakshmi, N. Sundara Veena, C. H. Ratna Kumar, G. V. Benerji, M. Jaiprakash Babu.
Background and Objectives: To study the role of Serum Lactate Dehydrogenase (LDH) as a diagnostic parameter in gastrointestinal tract (GIT) carcinoma patients. To compare the level of serum Lactate Dehydrogenase in metastatic and non metastatic Gastrointestinal tract carcinoma patients. To evaluate preoperative and post operative serum Lactate Dehydrogenase level in Gastrointestinal tract carcinoma patients. Materials and Methods: Studied 20 patients of Gastrointestinal tract carcinoma admitted in surgical ward were selected for study group. Out of 20 patients, 15 patients were Gastrointestinal tract carcinoma without metastasis. 5 patients were Gastrointestinal tract carcinoma with metastasis. 20 healthy individuals were included in the control group. The correlation of serum Lactate Dehydrogenase levels in pre operative and post operative Gastrointestinal tract carcinoma patients were studied. Results: Serum Lactate Dehydrogenase levels were elevated in pre operative GIT carcinoma patients with and without metastasis. Serum Lactate Dehydrogenase levels were decreased in post operative patients of Gastrointestinal tract carcinoma without metastasis but elevated in postoperative patients with metastasis. Conclusion: The study showed serum Lactate Dehydrogenase as an independent diagnostic and prognostic bio marker.
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ASSESSMENT OF KNOWLEDGE ON REPRODUCTIVE HEALTH AMONG THE WOMEN
2016-02-29T03-14-14Z
Source: International Journal of Current Research and Review
Kumari M. J..
Introduction: The aim of study was to assess the level of knowledge on reproductive health among the women at Puducherry and find out relationship between the knowledge on reproductive health and the selected clinical variables of women. Material and Methods: A descriptive cross-sectional research design was adapted to assess the level of knowledge on reproductive health among the women in multi-specialty Hospital, Puducherry. Consecutive sampling technique was used to select 500 women who were fulfilling the inclusion criteria. The data collection was done in regional language (Tamil) by face to face interview method through using structured interview schedule. Results: The study findings revealed that the level of knowledge on reproductive health among the 500 women, 220(44%) had inadequate knowledge, 253 (50.6%) women had moderately adequate knowledge and only 27 (5.4%) women had adequate knowledge. The mean value of knowledge regarding reproductive health among the women was 6.8 with the standard deviation of 2.4. There was statistically significant relationship found between the knowledge and history of reproductive health problems, family history of reproductive illness and use of family planning methods among the women. Conclusion: The study concluded that out of 500 women, only 27 had adequate knowledge on reproductive health. It shows that they want to improve their knowledge on reproductive health to prevent reproductive disease and promote their health. The health care providers have to take right steps promptly to reduce mortality and morbidity of the women..
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A COMPARATIVE STUDY OF CLONIDINE VERSUS TRAMADOL AS ADDITIVE TO BUPIVACAINE IN EPIDURAL ANAESTHESIA
2016-02-29T03-14-14Z
Source: International Journal of Current Research and Review
Mahesh Sutariya, Anand J. Amin, Miss Archana B. Behl.
Introduction: Pain is unpleasant sensory-emotional experience and one of the most feared symptoms experienced. Epidural anesthesia is safe, well practiced and inexpensive neuraxial block technique. Bupivacaine is commonly used for epidural anaesthesia. Researches have been conducted to identify different techniques and drugs that improve the quality of surgical anaesthesia, prolong the effect of bupivacaine and duration of postoperative analgesia. Objectives: To evaluate efficacy of epidural tramadol and clonidine used as adjuvant to bupivacaine. To compare onset and duration of sensory and motor blockade, quality of anaesthesia and duration of postoperative analgesia. Methods: A prospective, randomized placebo control study was undertaken, involving 90 patients from SMIMER hospital, Surat. Three groups were allotted 30 patients each and were given, bupivacaine+saline (Group A)/ Bupivacaine+tramadol (Group B)/ bupivacaine+clonidine (Group C). Results were recorded and analyzed. Results: The onset of sensory block was fastest in Group C. Total duration of sensory blockade was longest in Group B. Total duration of analgesia was longest in Group B, followed by Group C based upon Visual Analogue Scale. Both tramadol (Group B) and clonidine (Group C) prolong duration of analgesia and decrease requirement of post-operative analgesic doses and amongst them tramadol (Group B) is superior. Conclusion: Tramadol and clonidine both are used as adjuvant to bupivacaine for epidural anaesthesia and post-operative analgesia. Tramadol provides longer duration of post-operative analgesia without sedation and requirement of analgesic is less within 24 hours. Tramadol is useful because of its cost effectiveness and easy availability.
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Κυριακή 28 Φεβρουαρίου 2016
EMERGENCY PERIPARTUM HYSTERECTOMY: INCIDENCE, INDICATIONS AND FETOMATERNAL OUTCOME IN A TERTIARY CARE HOSPITAL
2016-02-28T23-03-01Z
Source: International Journal of Current Research and Review
Saima Wani, Perveena Fareed, Yasmeena Gull, Neha Mahajan.
Objectives: The objectives of this study were to determine the incidence, maternal characteristics, indications and the maternal and perinatal outcome of emergency peripartum hysterectomies done in the Department of Obstetrics and Gynecology Government Medical College Srinagar. Study Design: This was a retrospective descriptive study done from January 2011-December 2013 over a three year period. Results: The incidence of peripartum hysterectomy during the study period was 1.46/1000 deliveries. The frequent age group was 31-35 years. The main indication of peripartum hysterectomy was life threatening hemorrhage due to uterine rupture (23), uterine atony (22), placenta accrete (18), placental abruption (16), placenta previa (13), broad ligament hematoma (7), retained placenta, Secondary postpartum hemorrhage and uterine fibroid (1 each) 81.37% hysterectomies were total and 16.63% were subtotal. The average pre- and intraoperative blood loss was 2.5 Lt +0.6. All patients needed blood transfusion. All patients received Perioperative antibiotics. Intraoperative complications developed in 15 patients which were bladder injury (5), Adnexial bleeding (5) and broad ligament hematoma (4). 69.6% patients needed intensive care. The common post operative complications were febrile morbidity (15.68%), wound sepsis (10.78%), pneumonia (8.82%), coagulopathy (5.88%), Cuff cellulitis and vesicovaginal fistula (1.96% each). The stillbirth rate was 303/1000. Most stillbirths occurred in uterine rupture (61.29%) followed by placental abruption (25.80%). Maternal mortality rate was 117/1000 live births. The average hospital stay was 13+4days. Conclusion: Emergency peripartum hysterectomy has significant effect on fetomaternal morbidity and mortality. Hence antenatal identification of high risk patients and proper management of second and third stage of labor and emergency preparedness are important in decreasing the rate of peripartum hysterectomy and improving the outcome.
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EVALUATION OF COLOR AND LIGHTING PREFERENCES IN ARCHITECTS’ OFFICES FOR ENHANCING PRODUCTIVITY
2016-02-28T23-03-01Z
Source: International Journal of Current Research and Review
Zahra Poursafar, Nandineni Rama Devi, Lewlyn L. R. Rodrigues.
Background: Knowledge of design basics is key to the successful planning and implementation of any interior design project. The elements and principles of design represent general, universal ideas that refer to every aspect of design. Aim: This paper is focusing on occupants Preferences regarding to Color and Lighting in the Architects offices in Iran and India to increase the level of personalization in work environment and improving the Productivity. The outcome of this research would establish the link between architectural elements and Productivity. Moreover, the study would give clear indicators for the future architects to have a base for understanding the requirements and produce architectural components to suit to their specific requirements. Methodology: The data was primarily sourced through a self-administered survey questionnaire using random sampling method on representative sampling basis. Result: The finding of the study indicated that for employees in offices there are wide variety of Preferences in case of Color and Lighting. Also the outcome reveals employees Productivity in architects offices is affected by architectural elements. Conclusion: There are different Preferences regarding Colour and Lighting for employees in architects offices under the study. This difference would depend on distinction among behavioural, attitudinal and emotional pattern of the individuals. The result is based on the users subjective impression and personal Preferences in case of Colour and Lighting.
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Contributors
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
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Forthcoming Issues
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
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Preoperative Evaluation—Can We Really Make a Difference in Outcomes?
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Lee A. Fleisher
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Preoperative Evaluation
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Debra Domino Pulley, Deborah C. Richman
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Preoperative Evaluation
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Debra Domino Pulley, Deborah C. Richman
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Preoperative Clinics
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Angela F. Edwards, Barbara Slawski
Teaser
Preoperative evaluation clinics have been shown to enhance operating room efficiency, decrease day-of-surgery cancellations, reduce hospital costs, and improve the quality of patient care. Although programs differ in staffing, structure, financial support, and daily operations, they share the common goal of preoperative risk reduction in order for patients to proceed safely through the perioperative period. Effective preoperative evaluation occurs if processes are standardized to ensure clinical, regulatory, and accreditation guidelines are met while keeping medical optimization and patient satisfaction at the forefront. Although no universally accepted standard model exists, there are key components to a successful preoperative process.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/24wfUU9
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Preoperative Consultations
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Stephan R. Thilen, Duminda N. Wijeysundera, Miriam M. Treggiari
Teaser
Preoperative consultation is an important intervention that likely has most benefits for intermediate-risk to high-risk patients undergoing major surgery. Consultation rates are likely increasing and there is significant practice variation in the use of consultation. Consultations should be available within a well-organized and coordinated process of preoperative assessment. Preoperative consults should be accessible to anesthesia and surgical teams involved in the procedure and to the providers involved in postoperative care. The role of preoperative consultation should evolve as a rational approach and emerge as a value-based service. New payment methodologies are likely to facilitate appropriate use of this important resource.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1oIljqb
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Perioperative Ethical Issues
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Arvind Chandrakantan, Tracie Saunders
Teaser
Shared decision-making is a paradigm of patient engagement that is assuming greater importance in the era of value-based health care. The basic tenets include patient engagement on clinical decisions, taking into account multiple factors that influence physician and patient decision-making. Understanding and reconciling diametrically opposed views of care are important tenets of shared decision-making. Because many decisions are made preoperatively, the applicability of these principles may be useful especially in the situation of a higher risk surgical candidate. Many patients with Do-Not-Resuscitate (DNR) orders are undergoing procedures to improve quality of life. This article explores shared decision-making and DNR.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1pjxFFY
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Preoperative Laboratory Testing
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Matthias Bock, Gerhard Fritsch, David L. Hepner
Teaser
Routine preoperative testing is not cost-effective, because it is unlikely to identify significant abnormalities. Abnormal findings from routine testing are more likely to be false positive, are costly to pursue, introduce a new risk, increase the patient's anxiety, and are inconvenient to the patient. Abnormal findings rarely alter the surgical or anesthetic plan, and there is usually no association between perioperative complications and abnormal laboratory results. Incidental findings and false positive results may lead to increased hospital visits and admissions. Preoperative testing needs to be done based on a targeted history and physical examination and the type of surgery.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1oIlhi9
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Preoperative Assessment of the Patient with Cardiac Disease Undergoing Noncardiac Surgery
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Lee A. Fleisher
Teaser
The American College of Cardiology/American Heart Association has published Guidelines on Perioperative Evaluation. Preoperative evaluation should focus on identifying patients with symptomatic and asymptomatic coronary artery disease. The guidelines advocate using the American College of Surgeons National Surgical Quality Improvement Project Risk Index to determine perioperative risk. Diagnostic testing should be reserved for those at increased risk with poor exercise capacity. Indications for coronary interventions are the same in the perioperative period as in the nonoperative setting. In patients with a prior coronary stent, optimal antiplatelet therapy and timing of elective noncardiac surgery is evolving.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1pjxD0M
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Preoperative Evaluation
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Anand Lakshminarasimhachar, Gerald W. Smetana
Teaser
Postoperative pulmonary complications (PPCs) are common after major non-thoracic surgery and associated with significant morbidity and high cost of care. A number of risk factors are strong predictors of PPCs. The overall goal of the preoperative pulmonary evaluation is to identify these potential, patient and procedure-related risks and optimize the health of the patients before surgery. A thorough clinical examination supported by appropriate laboratory tests will help guide the clinician to provide optimal perioperative care.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1oIlge9
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Stratification and Risk Reduction of Perioperative Acute Kidney Injury
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Selma Ishag, Charuhas V. Thakar
Teaser
Perioperative acute kidney injury (AKI) is associated with an increased morbidity and mortality. The incidence of AKI varies depending on preoperative risk factors and the surgical setting. Preoperative risk stratification is critical for informed consent and perioperative planning. Perioperative renal protection strategies are potentially invaluable in the prevention of AKI. Current advances in the development of biomarkers may offer the opportunity for early diagnosis and the implementation of therapeutic strategies. Increased awareness and concerted efforts by all perioperative physicians are needed to provide an improved outcome for surgical patients.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1pjxEls
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Perioperative Approach to Anticoagulants and Hematologic Disorders
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Jisu Kim, Richard Huh, Amir K. Jaffer
Teaser
Hematologic disorders and patients on anticoagulants or at risk for venous thromboembolism encompass a broad array of diagnoses, which can potentially complicate perioperative planning and management. This article addresses both bleeding and clotting concerns as well as special hematologic issues.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1oIlgL4
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Preoperative Anemia
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Ankit J. Kansagra, Mihaela S. Stefan
Teaser
Previously undiagnosed anemia is often identified during routine assessment of surgical patients. Although studies suggest that perioperative anemia is associated with worse outcomes and a strong predictor for postoperative red cell transfusions, anemia is frequently ignored. Preoperative optimization of patients undergoing elective surgical procedures associated with significant blood loss, along with strategies to minimize intraoperative blood loss, shows promise for reducing postoperative transfusions and improving outcomes. In most situations, anemia can be corrected prior to elective surgeries and interventions. Future research should assess the timing and methods of optimization of preoperative anemia in surgery and which patients are best candidates for therapy.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1pjxE4E
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Preoperative Nutrition and Prehabilitation
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Ruchir Gupta, Tong J. Gan
Teaser
Enhanced recovery after surgery is the natural evolution of what were previously referred to as fast track programs and seeks to implement a series of interventions to improve and enhance recovery after major surgical procedures. Two important preoperative aspects are nutrition and prehabilitation. Identifying nutritionally deficient patients allows preoperative intervention to optimize their nutritional status. The contribution of cardiopulmonary exercise testing to the evaluation of perioperative risk, subsequent development of a training program, and the use of indices to risk stratify and measure improvement after a training program allow a personalized preoperative program to be developed for each patient.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1oIlfXE
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Preoperative Evaluation of Patients with Diabetes Mellitus
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Joshua D. Miller, Deborah C. Richman
Teaser
There are more than 29 million people in the United States with diabetes; it is estimated that by 2050, one in 3 individuals will have the disease. At least 50% of patients with diabetes are expected to undergo surgery in their lifetime. Complications from uncontrolled diabetes can impact multiple organ systems and affect perioperative risk. In this review, the authors discuss principles in diabetes management that will assist the perioperative clinician in caring for patients with diabetes.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1pjxB9d
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Preoperative Assessment of Geriatric Patients
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Justin G. Knittel, Troy S. Wildes
Teaser
Geriatric patients are over-represented in hospitalizations, surgeries, and perioperative complications. Special consideration is required for this patient group in the perioperative period because of the prevalence of comorbid diseases, functional impairments, and other deficits. A comprehensive preoperative evaluation strategy is recommended to identify and address these issues. Systematic, multidomain assessments should be performed and paired with risk reduction efforts. A shared understanding of patient function and long-term health goals is also important for providing patient-centered care of the geriatric surgical patient.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1oIlfH2
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Implantable Devices
Publication date: March 2016
Source:Anesthesiology Clinics, Volume 34, Issue 1
Author(s): Ana Costa, Deborah C. Richman
Teaser
Technology is the prominent feature of the twenty-first century, including in medicine. There are very few organs that cannot be stimulated, shocked, or infused. With more and more implantable devices being approved for clinical use, anesthesiologists have to regularly take care of patients who have these devices. An understanding of the devices, the associated comorbidities, and the perioperative risks is crucial for safe management of these patients. Cardiac devices are discussed in some detail; neurostimulators and other implantable devices are briefly described. The principles of assessment and management are similar for all patients with implanted devices.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1pjxASv
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The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma: an experimental study in swines
OBJECTIVE: Optimal hemodynamic resuscitation strategy of the trauma patient with uncontrolled hemorrhage and severe head injury in the pre-hospital setting remains a special challenge. Permissive hypotension prior to definite surgical haemostasis promotes coagulation, decreases blood loss and favors survival. However, hypotension is associated with poor outcome in severe head injury. The purpose of this experimental animal study was to assess the impact of permissive hypotension on survival, hemodynamic profile and brain oxygenation parameters before and/or after definite surgical haemostasis.
PATIENTS AND METHODS: Six-week-old pigs (n=12) underwent general anesthesia and brain injury was produced by the fluid percussion model. Animals were instrumented to measure hemodynamic parameters and cerebral blood flow. All animals (n=12) were subjected to laparotomy and a surgical knot was placed through the abdominal aorta wall. Uncontrolled hemorrhage was simulated by pulling out the intentionally left protruding free ends of the suture (goal MAP=30 mmHg). Animals were randomly divided into two groups; group A (n=6) was subjected to aggressive fluid resuscitation (goal SAP >80 mmHg) and group B (n=6) was left hypotensive (permissive hypotension). Animals who survived one hour of hypotensive shock underwent definite surgical haemostasis and were resuscitated for one hour. We measured survival, hemodynamic and brain oxygenation parameters at different time points before and after surgical haemostasis.
RESULTS: All animals from Group A and 50% from Group B died before surgical haemostasis. In surviving animals (Group B, 50%, p=0.033), MAP, CO, rCBF, SjO2 and AVDO2 were restored to pre-procedural levels.
CONCLUSIONS: Permissive hypotension by delaying fluid resuscitation up to definite surgical haemostasis improves survival, hemodynamics and allows restoration of cerebral oxygenation in severe head injury.
L'articolo The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma: an experimental study in swines sembra essere il primo su European Review.
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Management of Avian pox in Turkeys
2016-02-27T23-59-58Z
Source: International Journal of Livestock Research
Chaitanya yalavarthi, deepthi balam, Ramesh putchakayala.
Turkey poults were presented to clinic with cutaneous pustules all over body. Based on findings of clinical examination and lesions it was diagnosed as Avian pox. Successful management of Avian pox with procain pencillin and clinical outcome were discussed.
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Reproductive and Early Growth Traits of Intensively Reared West African Dwarf (WAD) Kids in a Humid Tropical Environment
2016-02-27T23-59-58Z
Source: International Journal of Livestock Research
Paul Chidiebere Okafor, Cosmas Chikezie Ogbu, Hariet Ndofor-Foleng.
The objectives of the study were to evaluate the reproductive, early growth and linear body traits of WAD goats reared intensively. Twenty-five WAD goats (20 does and 5 bucks) aged 7-8 months (9.0 to 12.0kg bwt) were mated naturally (1 buck: 4 does) to generate the kids studied. Animals were managed intensively. Kids suckled their dams until weaning before being separated. Litter size at birth, sex of kid, body weight (BW) and linear body traits from birth to 6 months of age (moa), weaning weight (Wwt), and mortality from birth to 6moa were evaluated. Data collected were presented using descriptive statistics. Pearson correlation analysis was used to study the relationship between traits. Birth weight was 1.75 ± 0.06kg; litter size was 2.08 ± 0.11 while Wwt was 7.11 ± 0.11kg. Body weight at 2, 4, and 6moa ranged between 4.00 and 5.20kg, 6.10 and 8.20kg, and 9.00 and 12.00kg, respectively. Body weight gain (BWG) at 2, 4, and 6 moa was 48.26 ± 1.16g/day, 52.21 ± 1.24g/day, and 49.39 ± 1.27g/day, respectively. Growth rate from birth to weaning, weaning to 6moa, and birth to 6moa was 45.04 ± 0.80g/d, 51.82 ± 1.30g/d, and 47.15 ± 0.55g/d, respectively. Number of males/litter, number of kids weaned/litter and mortality/litter from birth to 6moa was 0.54 ± 0.08, 1.86 ± 0.13, and 0.39 ± 0.17, respectively. Body weight values at different ages were positively interrelated (P
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Σάββατο 27 Φεβρουαρίου 2016
Normal and impaired control of functional movements in stroke: Role of neural interlimb coupling
While close cooperation of muscle activation between the two legs during gait has been known for several years, only during recent years has it become evident that the mechanism of "neural interlimb coupling" plays a major role in the control of a number of functional movements. Neural interlimb coupling is defined as a flexible, task-specific, physiologically meaningful linkage of limbs during complex movements. Experimentally, this mechanism can be demonstrated through the analysis of reflex responses.
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Vestibular Evoked Myogenic Potentials (VEMPs) for Examining Vestibular Function and Dysfunction
Vestibular evoked myogenic potentials (VEMPs) allow one to evaluate function (and dysfunction) of the vestibular nervous system, using stimuli that are now more reliable than earlier similar versions of this exam. Stimuli that have been developed include air-conducted sound and bone-conducted vibration and are reproducible, with a short rise-time and short duration. Responses are recorded against a background of tonic muscle activity, and the muscles that are used nowadays are the sternocleidomastoid muscle (cervical VEMPs or cVEMPs) and the inferior oblique muscle (ocular VEMPs or oVEMPs) (Colebatch et al., 1994; Rosengren et al., 2005; Iwasaki et al., 2007; Todd et al., 2007; Rosengren et al., 2009; Zhang et al., 2011).
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Normal pressure hydrocephalus: Increase of utricular input in responders to spinal tap test
Idiopathic normal pressure hydrocephalus (NPH) is characterized by the clinical triad of cognitive impairment, urinary incontinence and gait disturbance (Hebb et al., 2001, Relkin et al., 2005). Although this disease was first described nearly 50 years ago, (Adams et al., 1965) the pathophysiology is still under discussion. There is some evidence that increased cerebrospinal fluid (CSF) pulse pressure (Lenfeldt et al., 2004) could lead to increased liquor diapedesis in the periventricular white matter following ventricular dilatation (Kristensen et al., 1996).
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The diagnostic accuracy of in Transthyretin Familial Amyloid Polyneuropathy
Transthyretin familial amyloid polyneuropathy (TTR-FAP) is a rare, adult-onset, hereditary disorder characterized by the primary extracellular deposition of amyloid fibrils in unmyelinated and small myelinated fibers, with later involvement of the large fibers (Said et al., 1984).
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New immunoassays for total, IgA and IgM antibodies against hepatitis E virus: Prevalence in Italian blood donors and patients with chronic liver or kidney diseases
Hepatitis E virus (HEV) is a zoonotic agent that causes acute hepatitis in humans with sporadic infections and outbreaks in developing countries worldwide. The global spread of HEV remains underestimated because of subclinical infections and lack of sensitive diagnostic assays.
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Full title with Editorial board members
Source:International Journal of Psychophysiology, Volume 101
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Instructions to Authors
Source:International Journal of Psychophysiology, Volume 101
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IOP-details
Source:International Journal of Psychophysiology, Volume 101
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Adverse drug events due to Antiretroviral Therapy in a Northern Indian Tertiary Care Institution
2016-02-27T07-25-17Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Shamiya Sadiq, Sapna Gupta, Vijay Khajuria, Vishal R Tandon, Annil Mahajan, Mrityunjay Gupta.
Background: The introduction of highly active antiretroviral therapy (HAART) has led to significant reduction in acquired immune deficiency syndrome (AIDS) related to morbidity and mortality. However, adverse drug reactions (ADRs) to antiretroviral treatment (ART) are major obstacles. Aims and Objective: To examine the adverse effects of antiretroviral therapy in a tertiary care hospital. Materials and Methods: Ninety patients receiving antiretroviral therapy were studied prospectively over a period of 6 months and were evaluated for ADRs. Result: Of the 90 patients, 80 (89%) developed ADRs. A total of 111 ADR events were seen in 80 patients. The number of adverse drug events was seen higher in females (64%) than males (36%). The maximum frequency of ADRs was seen with Zidovudine + Lamivudine + Nevirapine (70.27%) combination followed by Stavudine + Lamivudine + Nevirapine (21.62%) and Stavudine + Lamivudine + Efavirenz (8.10%). Anemia and gastritis (12% each) were most common ADRs followed by vomiting (11.7%) and rash (10.8%). Most of the adverse drug events (ADE) were of type A (83.78%). The severity of most of the ADR events was mild (70.27%), followed by moderate (27.02%) and severe (1.78%). Conclusion: ADRs are common with HAART. Maximum number of ADRs occurred in females and Zidovudine + Lamivudine + Nevirapine (70.27%) combination was the main culprit. To minimize the potential risks of ADR due to ART, the clinicians need to detect them earlier and prevent them whenever possible and choose drugs with safer adverse drug profile.
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Effect of topical sodium fusidate, calcium mupirocin and papain—urea on wound healing in diabetic wistar rats
2016-02-27T07-25-17Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Smita Shenoy, Raghu Murthy, Lalit Mohan, Amoolya Gowda, Venu Madhav Nelluri.
Background: Poor wound healing is a complication of diabetes mellitus. Various agents have been used to promote wound healing in diabetic patients. Papain urea is used as a sloughing agent, whereas sodium fusidate and calcium mupirocin are used as topical antimicrobials for wounds in diabetics. Aims and Objective: To evaluate effect of topical sodium fusidate, calcium mupirocin, and papainurea on wound healing in diabetic wistar rats. Materials and Methods: Incision and excision wound models were used. Each model had five groups of six rats each and one group was nondiabetic control. Diabetes was induced in the remaining four groups, one diabetic control, and three test groups in each model, using streptozotocin (30 mg/kg intraperitoneally). Wounds were made in diabetic rats with blood glucose levels of more than 250 mg/dL. Paraffin ointment base was applied to wounds of nondiabetic and diabetic control, whereas sodium fusidate, mupirocin, and papainurea were applied topically to three test groups, respectively, in each model. Result: In sodium fusidate-treated group, there was a significant increase in breaking strength of incision wound, contraction rate, and hydroxyproline content of excision wound as compared to diabetic control group. There was significant decrease in period of epithelization in sodium fusidate-treated group compared to diabetic control group. There was no significant alteration in wound healing by mupirocin and papainurea. Conclusion: Topical application of sodium fusidate promoted wound healing in diabetic rats.
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Dengue: multicentre clinical profile of patients admitted in intensive care unit
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Akash Rajender, Deepa C., Krishna K., R. S. Chaudhri, Gaurav R., Priyanka C..
Background: Dengue with 2.5 billion people at risk and 50 million new cases every year is one of the most rapidly spreading vectors borne disease in world. We aimed to analyse the clinical profile of dengue patients requiring ICU admission. Methods: In a cross-sectional, observational, multicenter case study 105randomly selected laboratory positive dengue subjects were randomly selected from four tertiary care centers ICUs. Socio-demographical, clinical, therapeutic & laboratory parameters were evaluated. Statistical analysis was done using SPSS version 14.0. Results: The main cause of ICU admission was shock or hypotension due to sepsis (20%). Most patients presenting complaint was fever (93.33%), bodyache (84.76%) and retro-orbital pain (34.3%). Most prevalent warning sign indicating severe dengue was abdominal pain (37.4%). Mucosal bleed (20.9%) was the most common haemorrhagic manifestation. 37.14% with warning signs and 62.86% patients with severe dengue required ICU care. Conclusions: A rapid assessment of clinical profile, presenting symptoms and warning signs can aid in early decision for requirement of ICU admission & may go a long way in decreasing mortality.
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Bipedicled transverse abdominal flap for coverage of exposed iliac crest due to post traumatic tissue loss in left inguinal region
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Narendra G. Naik, Sangram Karandikar.
It is a surgical challenge for any plastic surgeon to choose the type of flap in the case of large inguinal canal tissue loss with exposed crest of ilium. Most repair methods provide inadequate closure of the defect for the large tissue loss over the inguinal region with exposure of the iliac crest. There are very few cases reported in the literature about transverse bipedicled abdominal flap for tissue defect over the inguinal region with exposure of the iliac crest bone and upper part of the thigh. In this case, by taking advantage of the large, loose, and lax nature of the abdominal skin, systematic primary closure of the donor as well as recipient site has been successfully achieved.
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Diagnostic surprises in early pregnancy: two case reports
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Madhuri N..
Early pregnancy poses diagnostic challenges to the clinician in developing countries because of lack of early antenatal check-up and lack of ultrasound use in first trimester. Extrauterine pregnancies are rare and mostly tubal. Non tubal ectopic pregnancies are still rarer and most often surprise the surgeons intraoperatively. Here two such cases are reported, of women presenting with acute abdomen, no significant period of amenorrhea and no specific risk factors for ectopic pregnancy. First is an ovarian pregnancy managed conservatively by wedge resection. Second is a case of cornual pregnancy managed by cornual resection and uterine repair.
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Digital gangrene a rare early manifestation of Wegener’s granulomatosis: a case report
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Akash Mathur, Dinesh Gurjar, Arvind Lakesar, Ramkrishna Sai, Aradhana Singh, Hemant Malhotra.
Wegener's granulomatosis (WG) or Granulomatosis with polyangiitis (GPA) rarely presents with digital gangrene being an early manifestation. We report a case of 60-year-old woman who presented with fever and cough with occasional hemoptysis along with painful bilateral feet digital gangrene. X ray chest and HRCT thorax of the patient was suggestive of multiple nodulo-cavitatory lesions. HPE of the lung lesion showed granulomatous pathology. CT Angiography was suggestive of multiple calcified and non-calcified lesions in infra renal aorta with stenosis of right dorsalis pedis artery. Biopsy of the skin lesion revealed a leucocytoclastic vasculitis. We eventually diagnosed GPA in light of clinical symptomatology with HPE of lung mass showing granulomatous lesion along with a positive cANCA. A few months after starting combined cyclophosphamide and steroids patient had significant symptomatic improvement. Hence Wegeners granulomatosis should always be considered as a possibility while evaluating a patient of digital gangrene specially with pulmonary and renal involvement.
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A rare case of bacteremia due to Acinetobacter junii in an immunocompetent adult
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Asifa Nazir, Rumana Farooq, Nahid Nahvi.
The genus Acinetobacter comprises a complex and heterogeneous group of bacteria, many of which are capable of causing a range of opportunistic, often nosocomial, infections in humans. Acinetobacter junii is a rare human pathogen associated with bacteraemia in neonates and paediatric oncology patients. We report a unique case of bacteremia caused by Acinetobacter junii, in a patient with no risk factors identified.
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Single coronary artery with origin of right coronary artery from left circumflex in a patient with ventricular tachycardia: a case report
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Sanjeev Sanghvi, Satish Lingaraju.
Only a few cases of a single coronary artery (CA) have been described. Almost all cases reported so far also had associated atherosclerotic coronary artery or valvular heart disease. We present a 48 years old male with atypical chest pain with an episode of Ventricular Tachycardia (VT) on treadmill test (TMT). Coronary angiography (CAG) showed a single Left coronary artery (LCA) with Right coronary artery (RCA) arising from left circumflex artery (LCX) without any atherosclerotic disease.
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Metanephric adenoma of kidney: a rare and distinct entity
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Purwa Patil, Varsha Bhatia, Vidya Arole, Nisha Thakare.
Metanephric adenoma (MA) is an unusual renal neoplasm with benign behaviour most of the times. Clinically MA mimics malignant renal neoplasms due to nonspecific signs and symptoms such as polycythaemia, haematuria and abdominal pain. MA usually presents as a mass lesion on radiographic studies and can be found incidentally. The treatment of choice is surgical excision. Though MA is usually a benign tumour, increase in the knowledge of MA pathology may lead to less invasive treatments in the future. Less than 200 cases of metanephric adenoma are reported till date in the literature.
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Basal cell carcinoma involving tip and alar area of nose in a patient of hills of Uttarakhand: report of a rare case and review of literature
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Hitendra Prakash Singh, Malti Kumari Maurya, Ashok Kumar.
Basal cell carcinoma (BCC) account for the vast majority of non-melanoma skin cancers (75%) and well over 25 percent of all cancers diagnosed each year. BCC has a predilection for fair-skinned individuals but can occur in Latin American and African American patients. Treatment of this tumour revolves around surgical excision or radiation therapy. Surgical excision can be accomplished using a variety of techniques including curettage and electrodessication, Mohs surgery and wide surgical excision. A case of BCC occurring in a lady of hilly areas of Uttarakhand, India and was treated with wide surgical excision and repaired with nasolabial flap has been described here.
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Dengue and HEV co-infection in a case of hepatitis
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Mohd Amir Khan, Cyrus Cavina, Varun Shetty, Santwana Dinesh Chandrakar, S. T. Nabar.
A 35 years old male presented in the casualty of D.Y. Patil hospital with chief complaints of fever with chills since 10 days. Due to high endemicity of malaria in the Navi Mumbai region an initial diagnosis of malaria was made. Patient was admitted and started on anti-malarials. Initial reports were positive for dengue NS1 antigen. As the patient had severe jaundice a possibility of another co-infection was considered. On further investigation hepatitis E (HEV) Ig M was positive. This case illustrates the importance of considering co-infections in endemic areas that can pose diagnostic dilemmas.
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Live music therapy in waiting area of intensive care units: a novel concept for betterment of close relatives of ICU patients
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Sundar Sumathy, Ramesh Bhuvaneswari, Varathan Kala.
Family members of ICU patients experience high levels of stress and anxiety. We explored a novel concept of live music therapy for relatives of ICU patients. Weekly 1-hour sessions of live music therapy consisting of devotional songs and prayers were performed in waiting area of ICU in a tertiary care hospital. Responses of 100 first degree relatives of ICU patients were documented using an 8-item questionnaire. 69% of the subjects rated live music therapy sessions as excellent; 50% of the subjects reported that they felt excellent after a single session. Such sessions were reported as a felt need by 77% of the subjects; 92% of the subjects reported that there were high chances that they would recommend such sessions in the hospital in future. In our study, we found our concept to be feasible, acceptable and highly appreciated as well as encouraged by first degree relatives of ICU patients.
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Self-medication among medical student in King Abdul-Aziz University
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Mooataz Mohammed Aashi, Hisham Abdulhamid Alghanmi, Rabaa Hashim Alhibshi, Bashair Abdulrahim Alsaati, Naif Jeza Aljohani.
Background: A huge number of medications are used without prescriptions which make us face a real problem which is the overuse of medications. Medication overuse dose come with physical, mental and emotional abnormalities. The objective of the study was to investigate the irrational uses of these medications which are NSAIDS, paracetamol, antibiotic antihistamines, opioids, and anti-anxiety drugs among medical students in KAU. Methods: We conducted a descriptive cross sectional survey of 507 students enrolled at medical college of King Abdul-Aziz university in Jeddah 2015. The two steps stratified random sampling was used to collect the data. The questionnaire includes a socio-demographic information and data about using any of the following medication as anti-anxiety, antibiotics, paracetamol, opioids, (NSAIDs), and anti-histamine. The data entry and analysis was done by SPSS software package version 20. Results: Paracetamol were the most frequently 117 (23.1%) drug uses by medical students, followed by antihistaminic 48 (9.5%), antibiotic 33 (6.5%), NSAIDS 22 (4.3%), anti- anxiety 7 (1.4%) and opioid 4 (0.8%). Most of them were self-medication (74%). Relief fever was the most common cause for seeking self-medication reported by medical student 103 (20.4%), most frequent side effects was nausea and vomiting 47 (9.3%) Conclusions: There is an increase of self-medication in medical students of KAU especially paracetamol and NSAIDs use. We suggest increasing studies on the local irrational use of medications and increasing awareness on the importance of prescribed medications.
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Assessment on growth pattern of Khasi children in the state of Meghalaya, India
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Barikor C. Warjri.
Background: This paper makes an attempt to describe the growth pattern and their sexual differences among the Khasi tribe in the state of Meghalaya in India. In the study we include 495 girls and 557 boys aged 3 to 18 years. Methods: In this Study the weight and height of these children were taken. Preece-Baines model 1 (PB1) has been used. This model was adopted for fitting the means of weight and some important linear measurements (Preece and Baines 1978), 1 using Levenberg-Marquardt method through SPSS (version 17.0) and origin software (version 8.0) for windows. All data were managed and analyzed using SPSS/PC software, version 15, in which the level of significance was set at 15%. The analysis will be carried out to present the basic descriptive statistics of anthropometric variables viz., height, weight, etc. according to sex and age groups. Results: The growth pattern of the Khasi children in the present study are described in terms of anthropometric measurement is observed that girls are heavier than boys at 3 and 4 years of age and boys are significantly heavier than girls from 5 to 6 years old. However girls are heavier than boys at the age of 12 years of age. It is further observed that boys are significantly heavier than girls and are statistically significant, except at the age of 15. It is found that both boys and girls are more or less similar in weight from 7 to 12 years of age. Conclusions: In terms of height boys are generally taller than girls across ages except at adolescence from 11 to 12 years where girls are taller than boys. The differences between the sexes are statistically significant after 14 years of age; the estimate values for adult height are 157.5 in males and 152 in females.
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Association of major depression with blood pressure and vascular complications of type 2 diabetes mellitus
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Akash Rajender, Deepa C., Krishna Kanwal, R. S. Chaudhri, Gaurav Rajender, Priyanka Choudhary.
Background: The WHO estimates the diabetic population to increase to 366 million by 2030 worldwide, with maximum 79.4 million Indians. Depression is an undiagnosed co-morbidity leading to significant disability, non-compliance and postulated to cause poorer glycemic control leading to early disease complications. We aimed to detect depression and study its correlation with vascular complications among type 2 diabetes mellitus (T2DM) patients. Methods: In an observational study, 312 randomly selected T2DM patients were evaluated at tertiary care center in Northern India. Socio-demographic, clinical and laboratory data was collected. Montgomery Asberg depression rating scale (MADRS) was used to detect depression. Groups with and without major depression were compared for various diabetes variables. Statistical analysis was carried out using the SPSS version 14.0. Results: One third T2DM patients (32.05%) suffered from major depression. Depression was significantly associated with diabetic patients having cardiac (p 0.01), ophthalmic (p 0.04), nephropathy (p 0.01), cerebrovascular (p 0.001) complications and diabetic foot (p 0.04). However, depression showed no significant association with systolic blood pressure, neuropathic and infectious complications. Conclusions: Identification of depression and its appropriate management may go a long way in delaying diabetic vascular complications by improving treatment adherence and subsequently glycemic control.
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Clinical spectrum of hypothyroidism: a cross sectional study in Puducherry, South India
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Darshan Savery M., Vijay Prasad C., Vishnu Prasad R..
Background: Hypothyroidism is characterised by underactive thyroid gland where there is reduced synthesis and secretion of thyroid hormones by the gland. With nearly one fifth of the population affected by hypothyroidism it is important to understand the clinical presentation of the disease. The present study aims to explore various clinical signs and symptoms of patients with hypothyroidism in Puducherry, South India. Methods: The study was carried out as a cross sectional study in a tertiary care medical college hospital, Puducherry among 213 patients who are admitted for various reasons and found to have hypothyroidism on laboratory investigations. With help of specialists in various fields all the patients were evaluated thoroughly and findings of the history and examination were noted down. Data entry was done in Epi Data version 3. Means and proportions were calculated using the software SPSS version 21. Results: Most of the hypothyroid patients (168/213) were females, giving a female: male ratio of approximately 3.4: 1. Primary hypothyroidism was found in most of the study participants (91%) and sub clinical hypothyroidism was seen in 6.2% of the patients. Commonest clinical presentation of the hypothyroid patients were fatigue (83.6%), weight gain (66.7%), were dry/coarse skin (52.1%) and voice change (50.7%). Conclusions: The commonest symptom being fatigue and weight gain while the commonest clinical sign was dry skin and voice change.
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Prevalence, phenomenology and etiology of delirium in medically ill patients
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Susan Solomon, Pradeep Thilakan, Jesudas Jayakar.
Background: Delirium is one of the most common causes of referral of medically ill patients for psychiatric management and is associated with significant morbidity and mortality. The aim of the study was to determine the prevalence and etiology of delirium among medically ill patients and to describe its phenomenology. Methods: A cross-sectional descriptive study was conducted in the general medical ward of a tertiary care hospital. Four hundred patients were screened for delirium using the confusion assessment method. The delirium rating scale revised-98 was used to further characterize the severity and phenomenology of delirium. Descriptive statistics such as frequencies, means and standard deviation were used. Chi square test was applied to compare categorical variables and Fishers exact test was used to test associations. Student t test was used to compare the means of independent groups. Results: The prevalence of delirium was 9.75%. Male gender (69.23%) and age above 60 years (66.67%) were significantly associated with delirium (p values of 0.04 and
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Functional outcome of surgical management of tibial plateau fractures in adults
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Arunim Swarup, Avinash Rastogi, Siddharth Singh, Kamal Swarn.
Background: Tibial plateau fractures are one of the commonest intra articular fractures. These injuries encompass many varied fracture configuration that involve medial, lateral or both tibial plateau with varied degree of compression and articular displacements. Being one of the major weight bearing joints of the body, these fractures are of paramount importance. Since there are various modalities for fixation of these fractures with satisfactory results, but there is no general consensus as to which modality is the best in terms of functional outcome and proving the superiority of one over the other. Keeping this aim in mind, we have conducted the present study to determine the efficacy of different practised methods of fixation, and if one are superior to the other. Methods: Sixty cases of tibial plateau fractures were treated with various surgical modalities and were followed up for a period of 2 years (2013 to 2015) at N.S.C.B Subharti hospital and their functional outcome was evaluated using Rasmussens functional score. Results: On selection these patients were classified according to Schatzker classification and were fixed accordingly using percutaneous cannulated cancellous screw, plating using LCP/ buttressing by open or MIPPO technique and screws depending upon the fracture configuration. Early range of motion was started as soon as pain subsided and weight bearing was deferred until radiological signs of union were evident. The knee range of motion was excellent to very good and weight bearing after complete union was satisfactory. Infection and stiffness in 2 cases was seen and there was one case of non-union in this series. Conclusions: Surgical management of tibial condylar fracture will give excellent anatomical reduction and rigid fixation to restore anatomical congruity, facilitate early motion, hence to achieve optimal knee function and reducing post traumatic osteo-arthritis.
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Radial nerve palsy following plate osteosynthesis of shaft humerus in relation to posterior verses anterolateral approach
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Bishnu Prasad Patra, Saroj Kumar Patra.
Background: Fracture shaft of humerus is a relatively common upper limb injury. Although it can be managed conservatively still surgical management is the recent trend worldwide. Open reduction and plate osteosynthesis is the gold standard and commonly practiced method of management. Iatrogenic radial nerve palsy following fracture fixation is a usual complication. Though most cases recover with time, but the incidence is variable in different approach. We compared two common approaches for fixation of middle 1/3rd of shaft of humerus fracture based on frequency of secondary radial nerve palsy and fracture healing. Methods: A prospective comparative study of management of all middle 1/3rd shaft humerus fracture was undertaken in our institute from Jan 2012 to Nov 2014. Total 42 patients were operated in this period of which six patients lost to follow up, so all total 36 cases were included in the study. Among these 36 patients 16 patients were operated by posterior approach and rest 20 were operated by Anterolateral approach. All patients were followed up at 2nd post-operative day, 2 weeks, 6 weeks, 3 months, 6 month and 1year. Frequency of radial nerve palsy with its outcome and fracture union was accessed in postoperative follow-ups. Results: There were total 3 cases of iatrogenic radial nerve palsy found in patients operated by posterior approach but all these patients recovered by average 5 month (3 to 6 months). There was not a single case of radial nerve palsy seen following humerus fixation by anterolateral approach. All 36 patients had good radiological union by 1 year, of which 2 patients of anterolateral approach and 1 patient from posterior approach required bone grafting to achieve union. Conclusions: Both the approaches had similar outcome in terms of fracture healing but there was significant difference in frequency of secondary radial nerve palsy, commonly seen in posterior approach.
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A prospective observational study of dengue fever with thrombocytopenia with reference to treatment
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Shashidhara Kuppegala Chikkaveeraiah, Rajashekar Reddy, Arun Kumar.
Background: Dengue fever is treated according to the WHO guidelines worldwide but due to the unavailability of blood products and economic constraints treating physicians often modify according to the patients requirements and try to give best available treatment for the patients. So we did an observational study of dengue fever and evaluated the clinical profiles and prognosis of dengue fever with reference to the treatment in JSS Medical College, Mysore in south India, a tertiary medical centre. Methods: This two year prospective, observational study was conducted in JSS Medical College. A total of 128 patients were evaluated and were divided into three groups like group 1-mild risk, group 2-moderate risk and group 3-high risk depending on the platelet count levels and bleeding diathesis. Group 1 received supportive treatment, group 2 received supportive treatment and steroids (Inj dexamethasone 4mg IV q8h) and group 3 received supportive treatment with steroids and platelet transfusion. Clinical evaluation and relevant investigations like blood culture; malarial parasites and febrile serology (acute and convalescent) were performed. Results: This observational study revealed that dengue fever can be managed symptomatically according WHO guidelines and platelet transfusion is done only when platelet count is less than 10000/cumm or in bleeding diathesis irrespective of platelet count. Conclusions: Steroid usage alone or along with platelet transfusion had no effect on the platelet count or on the overall outcome of the patient.
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Effect of Anulom Vilom Pranayam on auditory reaction time in Indian population aged 18-22 years
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Manish Dhadse, Ameet Fadia.
Background: Reaction time is one of the important methods to study a persons central information processing speed and is an index of sensory, motor and cognitive processes. Auditory reaction time, an important psychophysical method useful for relating mental events to physical measures is significantly correlated to changes in breathing period. Objective of the study was to evaluate effect of Anulom Vilom pranayam on auditory reaction time. Methods: 60 volunteers from a tertiary care hospital of Mumbai were divided into two groups (study group and control group) of 30 each. Study group practised Anulom Vilom pranayam for 8 weeks. Control group were busy in their routine activities during that period. Pre-study and post-study measurements of auditory reaction times for high tone and low tone were done in both groups. Results: Statistical analysis was carried out and paired t-test was applied. Post-study auditory reaction time of study group for high tone and low tone showed significant decline than control group. Conclusions: Anulom Vilom pranayam which observed to reduce auditory reaction time have health promoting, boosting, toning effects on central neural structures; quantity, pattern of release of neurotransmitters and mental interaction involved in information processing. In light of the influence of psychosocial stressors, inappropriate nutrition and lack of physical activity in modern life on the development of stress related disorders, Anulom Vilom pranayam may have considerable potential in its prevention and is complementary to overall stress management.
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Observation on analgesic efficacy and adverse effects of intrathecal administration of bupivacaine versus bupivacaine-midazolam combination in lower limb surgeries in a tertiary care hospital
2016-02-27T04-42-06Z
Source: International Journal of Research in Medical Sciences
Md. Mohsin, Rekha Kumari.
Background: Postoperative pain relief can improve functionality, reduce physiological and emotional morbidity and improve quality of life. Neuraxial blocks not only reduce the incidence of venous thrombosis, pulmonary embolism, cardiac complications, bleeding transfusion requirements and respiratory depressions but also provide effective postoperative analgesia. One of the methods of providing postoperative is to prolong the duration of intrathecally administered bupivacaine by using additives such as opioids such as midazolam, clonidine and ketamine. Intrathecal administration of midazolam induces antinociceptive effects in humans. The present study was undertaken to evaluate the additive analgesic effects of intrathecal midazolam in combination with bupivacaine in lower limb surgeries in a tertiary care hospital and to compare the results with the use of bupivacaine alone. The aim of this study was to observe and compare the quality of spinal anaesthesia and occurrence of side effects in thirty cases administered with bupivacaine and thirty cases administered with bupivacaine-midazolam combination. Methods: Sixty cases admitted for lower limb surgery were divided into equal groups I and II. Cases in group I received intrathecal bupivacaine while those in group II received intrathecal combination of bupivacaine and midazolam. Data regarding quality of anesthesia and side effects were recorded and compared. Results: There was a significantly higher duration of a pain-free period in cases administered with intrathecal combination of bupivacaine and midazolam. Conclusions: Addition of preservative free midazolam to 0.5% hyperbaric bupivacaine for subarachnoid block prolongs the duration of effective analgesia as compared to bupivacaine alone. The utilization of intrathecal midazolam also decreases the incidence of postoperative nausea-vomiting.
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The ageing neuromuscular system and sarcopenia – A mitochondrial perspective
Abstract
Skeletal muscles undergo structural and functional decline with ageing, culminating in sarcopenia. The underlying neuromuscular mechanisms have been the subject of intense investigation, revealing mitochondrial abnormalities as potential culprit within both nerve and muscle cells. Implicated mechanisms involve impaired mitochondrial dynamics, reduced organelle biogenesis and quality control via mitophagy, accumulation of mitochondrial DNA (mtDNA) damage and respiratory chain defect, metabolic disturbance, pro-apoptotic signalling, and oxidative stress. This article provides an overview of the cellular mechanisms whereby mitochondria may promote maladaptive changes within motor neurons, the neuromuscular junction (NMJ), and muscle fibres. Lifelong physical activity, which promotes mitochondrial health across tissues, is emerging as an effective countermeasure for sarcopenia.
This article is protected by copyright. All rights reserved
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A clinical study of minor physical anomalies in patients with schizophrenia
2016-02-27T02-38-39Z
Source: International Journal of Research in Medical Sciences
Kamal Nath, Mithun Dutta, Aparajeeta Baruah, Subrata Naskar.
Background: Minor physical anomalies (MPA) are unusual morphological deviations that have no serious medical or cosmetic significance to an individual. But however minor they may be, various studies across the world have revealed their significance as a possible endophenotype of schizophrenia. This study is an attempt towards understanding the various sociodemographic and illness correlates as well as the prevalence of MPA in people with schizophrenia. Methods: 100 admitted patients who fulfilled the criteria for schizophrenia as laid down by international classification of diseases version 10 (ICD-10) and other inclusion and exclusion criteria over one year period with age between 16-60 years were included in the study. A standardized semi structured proforma for various sociodemographic and illness variables and Waldrop minor congenital anomaly scale (weighted version) were applied on the study subjects. Data obtained was analyzed using SPSS and chi-square was applied to find out statistical association. Results: Minor physical anomalies were found to be present in only 15% of subjects and they have a statistically significant association with age (p=0.041) and occupation (p=0.002). Conclusions: The study of MPA in schizophrenia is a novel attempt to unearth any subtle associations between the genetic abnormality and its interactions with the various psychophysiological as well as other environmental factors which ultimately leads to the endophenotype and in some cases to the ultimate illness state. In our study the presence of MPA in 15% of the subjects with various degree of severity probably indicates heterogeneity of the schizophrenia illness and a complex interaction with various factors from genotype to phenotype.
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Self-perceived risk and barriers to cervical cancer screening among patients seeking care at a tertiary care teaching hospital in Tamil Nadu
2016-02-27T02-38-39Z
Source: International Journal of Research in Medical Sciences
Lokeshwari Jayaraman, Maheshwari K., Sanjeev Kumar Khichi, Abhishek Singh, Shewtank Goel, Avijit Roy, Jayaprakash K., Pooja Goyal.
Background: Identification of characteristics of women, their perceptions of own risk and barriers to accessing existing screening services can provide important information for shaping screening services. The objective of the study was, the present study was undertaken to ascertain the perceptions of risk and barriers to cervical cancer screening by women seeking care at a tertiary care teaching hospital in Tamil Nadu. Methods: The current survey was planned and executed by the Department of Obstetrics and Gynecology of a tertiary care teaching institution of Tamil Nadu during February to July 2015 using a pre-designed questionnaire among 177 study participants. Inclusion criteria were 18 years and above, non-pregnant and consenting for the survey. Women seeking the antenatal care were excluded from this study. The study population consisted of women seeking family planning services at Obstetrics and Gynecology Department. Results: The traditional risk factors for development of cervical cancer were observed in a considerable proportion of the study participants. Sexual debut earlier than 20 years was very common mentioned by nearly 67% of participants. Majority of study participants i.e. more than 50% had multiple sexual partners. About 32% of the study subjects felt that they were at no risk of developing cervical cancer and 34.5% felt no need for screening for the condition. Of women perceiving themselves to be at risk of cancer of the cervix, 80% expressed the need for cervical cancer screening compared to 58.75% of those who had no opinion on own risk. Conclusions: self-perception of not being at risk is documented to be associated with low uptake of screening. Concerned health education programs need to bring clearly to the end user the difference between precancerous lesions and invasive cervical cancer and the treatment options available.
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Factors affecting the assessment of mitotic count in histopathological sections of tumors: a study of interobserver and intraobserver variability
2016-02-27T02-38-39Z
Source: International Journal of Research in Medical Sciences
Navya Narayanan Orchid, Sathi Puthanpurayil.
Background: Mitotic count is the most commonly used method of assessing the proliferative activity of a tumor. It is usually done in routine Hematoxylin & Eosin stained sections and is used for classification, grading, prognostication of tumors and sometimes as a decision factor for treatment. There are numerous variables that can influence the mitotic count like delay in fixation, thickness of the section, size of the high power field of the microscopes and so on. This study is designed to assess the relative importance of Intra-observer variability and Inter-observer variability on mitotic counting by keeping all different procedural factors constant. Methods: Sections from forty cases of breast cancer and twenty cases of high grade lymphoma formed the study material. Mitotic counts done by the principal investigator under standard conditions were compared with counts done by another experienced observer under standard conditions to evaluate the inter-observer variability. The principal investigator will make all counts twice at intervals of one month to assess intra-observer variability. Paired t test and linear regression were the statistical tests used in analysis. Ki-67 immunohistochemistry was also done in sections fixed at different intervals. Results: Our study showed that inter-observer (p=0.261) and intra-observer variation (p=0.261) is not statistically significant. In case of inter-observer variability the correlation is weak and not significant. Conclusions: Reproducibility in mitotic counting can be achieved by following a strict morphological criteria as well as a strict counting protocol.
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