Πέμπτη, 28 Ιουλίου 2016

High oxygen extraction and slow recovery of muscle deoxygenation kinetics after neuromuscular electrical stimulation in COPD patients

Abstract

Purpose

It was hypothesized that patients with chronic obstructive pulmonary disease (COPD) would exhibit a slow muscle deoxygenation (HHb) recovery time when compared with sedentary controls.

Methods

Neuromuscular electrical stimulation (NMES 40 and 50 mA, 50 Hz, 400 µs) was employed to induce isometric contraction of the quadriceps. Microvascular oxygen extraction (µO2EF) and HHb were estimated by near-infrared spectroscopy (NIRS). Recovery kinetic was characterized by measuring the time constant Tau (HHb-τ). Torque and work were measured by isokinetic dynamometry in 13 non-hypoxaemic patients with moderate-to-severe COPD [SpO2 = 94.1 ± 1.6 %; FEV1 (% predict) 48.0 ± 9.6; GOLD II–III] and 13 age- and sex-matched sedentary controls.

Results

There was no desaturation in either group during NMES. Torque and work were reduced in COPD versus control for 40 and 50 mA [torque (Nm) 50 mA = 28.9 ± 6.9 vs 46.1 ± 14.2; work (J) 50 mA = 437.2 ± 130.0 vs. 608.3 ± 136.8; P < 0.05 for all]. High µO2EF values were observed in the COPD group at both NMES intensities (corrected by muscle mass 50 mA = 6.18 ± 1.1 vs. 4.68 ± 1.0 %/kg; corrected by work 50 mA = 0.12 ± 0.05 vs. 0.07 ± 0.02 %/J; P < 0.05 for all). Absolute values of HHb-τ (50 mA = 31.11 ± 9.27 vs. 18.08 ± 10.70 s), corrected for muscle mass (50 mA 3.80 ± 1.28 vs. 2.05 ± 1.45 s/kg) and corrected for work (50 mA = 0.08 ± 0.04 vs. 0.03 ± 0.02 s/J) were reduced in COPD (P < 0.05 for all). The variables behaviour for 40 mA was similar to those of 50 mA.

Conclusions

COPD patients exhibited a slower muscle deoxygenation recovery time after NMES. The absence of desaturation, low torque and work, high µO2EF and high values for recovery time corrected by muscle mass and work suggest that intrinsic muscle dysfunction has an impact on muscle recovery capacity.



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Emergency surgical airway management in Denmark: a cohort study of 452 461 patients registered in the Danish Anaesthesia Database

Background

The emergency surgical airway (ESA) is the final option in difficult airway management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed airway management.

Methods

We extracted a cohort of 452 461 adult patients undergoing general anaesthesia and tracheal intubation from the DAD from June 1, 2008 to March 15, 2014. Difficult airway management involving an ESA was retrieved for analysis and compared with hospitals files. Two independent reviewers evaluated airway management according to the ASAs'2003 practice guideline for difficult airway management.

Results

In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events per thousand (95% CI; 1.0–2.4). A Supraglottic Airway Device and/or the administration of a neuromuscular blocking agent before ESA were used as a rescue in 6/27 and 13/27 of the patients, respectively. In 19/27 patients ENT surgeons performed the ESA's and anaesthetists attempted 6/27 of the ESAs of which three failed. Reviewers evaluated airway management as satisfactory in 10/27 patients.

Conclusions

The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway management was evaluated as satisfactory for 10/27 of the patients. ESA performed by anaesthetists failed in half of the patients.



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Mass. EMTs, firefighters help citizens fight summer heat wave

By Jill Harmacinski
The Eagle Tribune

ANDOVER, Mass. — As temperatures soared into the 90s again Wednesday, locals stuck by fans and air conditioning and dipped in pools and ponds trying to ride out the latest wave of sweltering heat.

Some professions are shown no mercy, however.

Late Wednesday morning as the mercury just touched 90 degrees, a fire on a South Lawrence porch was reported when residents smelled smoke and dialed 911.

Crews raced to 90-92 Jamaica St., where the single-alarm blaze in a two-story, two-family house was quickly knocked down. Fire investigators quickly determined the fire was caused by careless disposal of cigarettes. While there were no injuries, porches on the first and second floors were scorched.

"This is what we call a good stop," said Fire Chief Brian Moriarty. "These guys don't goof off. They come to work to fight fires."

They also wear 75 pounds of protective gear, so numerous Lawrence General Hospital paramedics were on standby as the firefighters worked on Jamaica Street in the sun at the top of a hill.

North of Boston paramedic Bill Kinch explained it's imperative to monitor the vital signs and temperatures of rescuers who work day after day in such oppressive heat.

If a firefighter's temperature rises above 100 degrees, heart rate goes over 120, or blood pressure exceeds 140 over 90, Kinch said he or she is immediately pulled away from the fire.

"We will literally keep them out of the fire until their vital signs drop," said Kinch, a paramedic for the past 25 years.

While body heat escapes from the head quickly, a person also can rapidly cool down if a cold towel is draped over the head. Kinch regularly does this while rehabbing firefighters in hot weather.

The healing power of water
Bottled water is also an ally to rescuers, as well as regular folks just trying to go about their business on a hot and humid day, Kinch noted.

The thing is, he explained, by the time you feel thirsty you are already dehydrated.

Those who are most at risk of dehydration are the very young and very old because their bodies aren't good at regulating heat.

"As you get older, your body becomes much worse at regulating temperature and hydration," he said.

With a prediction of a high of 94 degrees Thursday, Kinch urged people to keep an eye on their families and neighbors to make sure everyone is staying cool and hydrated.

Helping others is something the Salvation Army in Haverhill is dedicated to.

Members drove around Wednesday in their personal cars handing out ice-cold bottled water.

"We go down by the river behind the thrift store on Merrimack Street, by the Post Office in Washington Square, the public library on Main Street and other areas where homeless congregate and where we might encounter senior citizens," said Salvation Army Capt. Mari Hardy.

"We probably average six to eight cases of water per day and Wednesday is the third day in a row we've been doing this," Hardy said.

The goal is to help people keep hydrated, particularly the homeless and elderly who might not feel they need to have a drink but may be at risk of heat exhaustion.

Christina Sierra, a working mother from Methuen, joked this week that she was going to serve her family popsicles for dinner.

On Wednesday, Sierra took the day off and brought her two children to a friend's pool to cool off. Again, her daily menu plan had an icy feel.

"There is truth to ice cream for breakfast, lunch and dinner," she said.

'People are heeding the warnings'
The temperatures have been consistently high in New Hampshire, too, but officials said they've been experiencing few heat-related problems.

"I'm going to curse myself by saying we haven't had anything recently," said Lt. Anthony Rossignol of the Derry Fire Department. "We did respond to (a brush fire) a few shifts ago that was in Candia. ... When I came on, the guys were kind of expecting to go back to it because of the potential hot spots. ... But we haven't really seen anything — knock on wood — elaborate here in town."

Derry residents have been taking to public spots like Gallien's Beach and the splash pad at the Don Ball Park to cool off.

"Definitely, we've seen an increase in attendance," said Eric Bodenrader, director of Derry Parks and Recreation, who attributed the above-average patronage to the heat.

"Fortunately, we have not had any issues. ... We're staffed at both locations with supervisors, concessions attendants and lifeguards, and they're trained to look out for situations where someone may be experiencing a medical (issue)."

Plaistow Fire Chief John McArdle said he's noticed many people outside to jog or bike have been doing so earlier in the morning or later in the evening.

"I think people are heeding the warnings that we're seeing in the media to be careful and not overexert themselves," McArdle said.

Battalion Chief Randall Young of the Salem Fire Department also described the town as being fortunate, given the weather.

"We've actually been lucky. Typically when we have this type of ... long, dry, hot weather, we usually do have a lot of issues, but we've been fortunate," he said. "We haven't had a lot of problems — nothing big and not a large quantity."

Young did say, however, that the department has been fielding more medical calls than usual due to the heat and people becoming dehydrated.

"We have had a small uptick in that," Young said.

Londonderry also has experienced just a few problems related to the heat, but Battalion Chief Kevin Zins said the department, like many in the area, is "trying to be proactive, keeping guys hydrated and cool and ready so they can perform a little better when they get out in the heat."

A cooling center and mosquitoes
Vincent Ouellette, director of human services for Haverhill, said the city has been offering residents an opportunity to keep cool at the Citizens Center.

"If we get calls we would remain open at night, but we have not received any calls," he said. "I've not heard of any issues with people not having a place to be cool. But we are open on an as-needed basis."

Visits to the Plug Pond recreation area in Haverhill are also up, with crowds reaching the 200 person capacity. Ouellette said people will go the pond for an hour or so and then leave so there is a constant turn over.

"We've also seen consistent crowds at the spray park at Swasey Field," he said.

Starting Thursday morning in Lawrence, cooling centers will open at the city's senior center at 155 Haverhill St. and at Oasis Senior Day Care, a private facility located at 120 Broadway.

The senior center will be open from 8 a.m. to 7 p.m. and folks can cool day at Oasis from 9 a.m. to 4 p.m., officials said.

In Methuen, the heat coincided with spraying overnight to drastically reduce the mosquito population.

The spraying was done using truck-mounted, ultra-low volume equipment that dispenses a very fine mist of pesticides, officials said.

North Andover officials also this week issued a voluntary water ban and a simultaneous drought watch.

The town's Board of Selectmen asked residents to conserve water, including doing lawn watering between 8 p.m. to 6 a.m. They asked residents only to water their lawns every third day and to limit outside water use for washing cars and paved surfaces.

The main Lawrence Public Library got so hot that it was closed at 3:45 p.m., an hour and 15 minutes earlier than the regular 5 p.m.

The temperature was 89 degrees on the second floor and 92 degrees on the third, said Acting Director Kemal Bozkurt, who conferred with library trustees on the decision.

The excessive heat was a danger to patrons and staff, he said. The union contract provides for the closing of the library if the temperature rises above 86 degrees.

Copyright 2016 The Eagle-Tribune



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The regulatory niche of intestinal stem cells

Abstract

The niche constitutes a unique category of cells that support the microenvironment for the maintenance and self-renewal of stem cells. Intestinal stem cells reside at the base of the crypt, which contains adjacent epithelial cells, stromal cells and smooth muscle cells, and soluble and cell-associated growth and differentiation factors. We summarize here recent advances in our understanding of the crucial role of the niche in regulating stem cells. The stem cell niche maintains a balance among quiescence, proliferation and regeneration of intestinal stem cells after injury. Mesenchymal cells, Paneth cells, immune cells, endothelial cells and neural cells are important regulatory components that secrete niche ligands, growth factors and cytokines. Intestinal homeostasis is regulated by niche signalling pathways, specifically Wnt, bone morphogenetic protein, Notch and epidermal growth factor. These insights into the regulatory stem cell niche during homeostasis and post-injury regeneration offer the potential to accelerate development of therapies for intestine-related disorders.

Thumbnail image of graphical abstract

Constituents of the niche. The niche constitutes a unique category of cellular components (mesenchymal cells, Paneth cells, immune cells, endothelial cells, macrophages and neural cells), secreted or growth factors (R-spondin and EGF) and BMP inhibitors (Noggin and chordin), which along with the circadian rhythms and metabolic control provide a microenvironment for the maintenance and self-renewal of intestinal stem cells.



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Firefighter - Rowlett Fire Rescue

ROWLETT FIRE RESCUE 4701 ROWLETT ROAD ROWLETT, TEXAS 75089 http://ift.tt/12FsXGE Updated: July 27, 2016 Job Classification: Firefighter Rowlett Fire Rescue is currently seeking qualified applicants for Firefighter. Rowlett Fire Rescue would like to invite you to apply for the position of Firefighter. Applicants that are both certified firefighters AND paramedics are preferred. Certified or licensed ...

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First responders trained on how to interact with people with autism

A training video for first responders showing created to de-escalate potentially violent situations.

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Inside EMS Podcast: A double amputee paramedic's journey

Download this podcast on iTunes, SoundCloud or via RSS feed

In this week's episode, our co-host Chris Cebollero and Kelly Grayson sit down with double amputee paramedic Noah Filer. Noah was involved in a motorcycle crash that not only left him in a 6-week coma, but required him to have his left arm and leg amputated. Upon waking, Filer spent months in rehab and was able to obtain his paramedic certification. Join us as he shares his inspirational story.



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Inside EMS Podcast: A double amputee paramedic's journey

Download this podcast on iTunesSoundCloud or via RSS feed

In this week's episode, our co-host Chris Cebollero and Kelly Grayson sit down with double amputee paramedic Noah Filer. Noah was involved in a motorcycle crash that not only left him in a 6-week coma, but required him to have his left arm and leg amputated. Upon waking, Filer spent months in rehab and was able to obtain his paramedic certification. Join us as he shares his inspirational story.



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First responders trained on how to interact with people with autism

A training video for first responders showing created to de-escalate potentially violent situations.

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First responders trained on how to interact with people with autism

A training video for first responders showing created to de-escalate potentially violent situations.

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First responders trained on how to interact with people with autism

A training video for first responders showing created to de-escalate potentially violent situations.

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Advanced EMT / Paramedic - San Juan County EMS

General Purpose: San Juan County EMS Employees are considered full-time employees who work a rotating shift. Serves as driver, attendant or stand-by employee. Checks, cleans and maintains ambulance and equipment while on duty. Responds to emergency and non-emergency ambulance calls. Cares for, treats and transports the sick and injured. Any additional tasks given by San Juan County EMS Director. Follow ...

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Cytomolecular discrimination of the A m chromosomes of Triticum monococcum and the A chromosomes of Triticum aestivum using microsatellite DNA repeats

Abstract

The cytomolecular discrimination of the Am- and A-genome chromosomes facilitates the selection of wheat-Triticum monococcum introgression lines. Fluorescence in situ hybridisation (FISH) with the commonly used DNA probes Afa family, 18S rDNA and pSc119.2 showed that the more complex hybridisation pattern obtained in T. monococcum relative to bread wheat made it possible to differentiate the Am and A chromosomes within homoeologous groups 1, 4 and 5. In order to provide additional chromosomal landmarks to discriminate the Am and A chromosomes, the microsatellite repeats (GAA)n, (CAG)n, (CAC)n, (AAC)n, (AGG)n and (ACT)n were tested as FISH probes. These showed that T. monococcum chromosomes have fewer, generally weaker, simple sequence repeat (SSR) signals than the A-genome chromosomes of hexaploid wheat. A differential hybridisation pattern was observed on 6Am and 6A chromosomes with all the SSR probes tested except for the (ACT)n probe. The 2Am and 2A chromosomes were differentiated by the signals given by the (GAA)n, (CAG)n and (AAC)n repeats, while only (GAA)n discriminated the chromosomes 3Am and 3A. Chromosomes 7Am and 7A could be differentiated by the lack of (GAA)n and (AGG)n signals on 7A. As potential landmarks for identifying the Am chromosomes, SSR repeats will facilitate the introgression of T. monococcum chromatin into wheat.



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Aladtec announces milestones: over 100,000 public safety employees now sse the workforce management system and a half-billion employee shift hours have been scheduled with it

Minneapolis/St. Paul - Aladtec, Inc., the popular provider of an online employee scheduling and workforce management system for the Public Safety Sector, has recently achieved two significant milestones. With nearly 1,700 Public Safety Sector customers, Aladtec now serves more than 100,000 individual users through their Cloud based Software as a Service (SaaS) system. In addition, their customers have ...

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Mayor declares July 30th 'First Responder Family Appreciation Day'

ALBUQUERQUE, N.M. — Mayor Richard Berry has officially declared Saturday, July 30th to be the inaugural First Responder Family Appreciation Day.

An event held that evening will recognize the emotional labor of first responders, whose personal and family lives can be affected by the things they see on duty.

The appreciation event will be hosted by a group called Behind the Badge NM, a coalition which offers peer support and counseling sessions for first responders affected by stress and PTSD.

"The stuff that we see in our job doesn't go away unless you are able to get help to do that," said Laurianna Sargent, a firefighter and peer supporter for the group.

Originally, Behind the Badge NM served first responders by connecting them with others who could understand the unique challenges of the job. According to KRQE News, their services have expanded to include training others to provide healing and coping services.

Sargent notes that many first responders tend to avoid seeking help while processing traumatic events.

"This is a good opportunity to make people aware that it's okay to get help," she says.



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Ohio first responders engage in blood donation battle

By Lance Mihm
The Lima News

OTTAWA, Ohio — After a blood drive at the Ottawa Volunteer Fire Department turned out low numbers several years ago, the Putnam County Red Cross decided to up the ante a little.

Now, emergency personnel will engage in combat for a traveling plaque. The Ottawa Fire Department, Ottawa Police Department and Ottawa EMS competed in the first Battle of the Badges at the Fire Department on Wednesday.

Donors giving blood throughout the day Wednesday were rewarded with a new T-shirt and snacks after donating a pint of blood. They also voted on their favorite agency of the three, and the winning agency will get to keep the plaque until the next year's event.

"We had one a long time ago and it didn't do so well," said Micha Alt, treasurer with the Hancock and Putnam County Red Cross. "We are trying to start a tradition and we added a little friendly competition."

The new approach seemed to be paying off. By 5 p.m., 38 people had already donated blood, just two short of the goal of 40. The blood drive lasted until 8 p.m. Alt said it is important to give blood because it will help people in the region.

"About 80 percent of it will stay in northwestern Ohio region," Alt said. "It is used to fill local needs, and it goes to other places based on need."

Alt said that every pint of blood will save three people's lives, meaning the blood drive would impact 120 people once they met the goal. Everyone is also notified of how their blood helped someone through email.

""Everybody that gives blood will receive an email that says where the blood goes," Alt said. "They will know how their donation helped someone."

Copyright 2016 The Lima News (Lima, Ohio)



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Impact of inflammatory bowel disease on Japanese patients’ quality of life: results of a patient questionnaire survey

Abstract

Background

Inflammatory bowel disease (IBD) has a significant negative impact on quality of life (QOL); however, the direct impact of IBD on several aspects of patients' lives is unknown. The IMPACT survey was conducted in Europe in 2010–2011 to determine this impact. We conducted the IMPACT survey in Japan and compared the results between subgroups of patients with ulcerative colitis (UC) and Crohn's disease (CD).

Methods

The 52-item IMPACT survey questionnaire assessing treatment and the impact of IBD on patients' lives was translated into Japanese and administered to IBD patients recruited through patient advocacy groups.

Results

Between June 2013 and January 2014, 172 Japanese IBD patients completed the questionnaire (including 84 UC and 83 CD patients). Half of all patients (84/172, 48.8 %) were satisfied with their treatment plan, and half of those who had undergone surgery were satisfied with the outcome (46/87, 52.9 %). Although 34.9 % (60/172) of patients had not been hospitalized in 5 years, 50.0 % (86/172) had been hospitalized for more than 10 days. During the most recent flare, 49.4 % (85/172) of patients had to reschedule appointments because of IBD. Moreover, 32.0 % (55/172) of patients had to make adjustments such as working part-time or at home to avoid taking sick days; 35.5 % (61/172) of patients felt that they had lost a job because of IBD.

Conclusions

Our survey results indicate that IBD patients' lives and social activities are affected by the deterioration of QOL due to IBD and its symptoms.



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Study of nonenzymatic antioxidants in schizophrenic patients

2016-07-28T07-54-52Z
Source: International Journal of Research in Medical Sciences
Hemant S. Dahake, Suresh Ghangle, Jayesh Warade, Yogesh Pawade, Gaurav S. Kansara.
Background: Schizophrenia is one of the most debilitating psychiatric disorders. There is now substantial evidence of increased free radicalmediated damage in schizophrenia. These mechanisms are critical role in etiopathogenesis of schizophrenia. The potential toxicity of reactive oxygen species (ROS) is counteracted by a large number of cytoprotective enzymes and nonenzymatic anti-oxidants. Endogenous substances like albumin, bilirubin and uric acid play very important defensive role against reactive oxygen species (ROS) produced in our body. The present study was undertaken to study nonenzymatic antioxidants i.e. serum albumin, bilirubin and uric acid in first episode and chronic schizophrenic patients. Methods: 50 patients of first episode schizophrenia and 50 patients of chronic schizophrenia were included in the study. 50 numbers of age and sex matched healthy and apparently normal controls were also selected for study. Blood samples were drawn and analysed for albumin, bilirubin and uric acid from all participants. Results: The study shows significant decrease in serum albumin, bilirubin and uric acid levels in both first episode schizophrenics and chronic schizophrenic patients as compared to controls. When we compared levels of these parameters in first episode schizophrenics and chronic schizophrenics, we did not find significant difference. Conclusions: Findings in our study is suggesting that decrease in the levels of nonenzymatic antioxidants occurs in attempting neutralization of ROS in schizophrenics. This study supports the defensive role of nonenzymatic antioxidants against ROS in our body.


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Evaluation of red cell distribution width in the diagnosis of iron deficiency anemia

2016-07-28T07-54-52Z
Source: International Journal of Research in Medical Sciences
Anuja Sharma, Mahima Sharma, Vandana Sharma.
Background: Iron deficiency anemia is the most common nutritional deficiency world over and in India. It is the most important cause of microcytic hypochromic anemia. Red cell distribution width (RDW) provides quantitative assessment of anisocytosis and could be helpful in differentiating iron deficiency anemia from other microcytic anemias. The objective behind this study was to assess the role of RDW as an early indicator in diagnosing iron deficiency anemia. Methods: A total of 100 cases of microcytic anemia (MCV


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Forced vital capacity, forced expiratory volume in 1st second and forced expiratory ratio in automobile spray paint workers

2016-07-28T07-54-52Z
Source: International Journal of Research in Medical Sciences
Geetika Gupta, Sabita Yograj, Anil K. Gupta, Bhavna Langer, Mumtaz Goni.
Background: Automobile industry is a place where workers are exposed to harmful chemicals and toxic substances. Workers engaged in automobile spray painting are at a risk of developing respiratory problems. This is due to exposure to low molecular weight compounds (isocyanates) in spray paints. Methods: The present study was conducted on 100 male subjects comprising of the study group (n=50) and the control group (n=50), 18-35 years of age, non-smoker and with no pre occupational respiratory illness. The study group included workers working for 6-8 hours a day and exposed to spray paints for ≤5 years and the controls were age and BSA matched healthy office workers of the same locality. A preformed questionnaire was given to subjects and pulmonary functions parameters (forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), forced expiratory ratio (FEV1/FVC)) were recorded by computerised spirometer (Medspiror). Results: The two groups did not differ significantly on physical parameters. The pulmonary function parameters of the study group (FVC p=0.036, FEV1/FVC p=0.000) were found to be significantly different when compared to that of controls. As the age, weight, height and BSA increases there was a significant decrease in FEV1 in study group. Duration of exposure (


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Effect of training on formulation of multiple choice questions: a cross-sectional study amongst faculty in the department of biochemistry of a medical institution in India

2016-07-28T07-54-52Z
Source: International Journal of Research in Medical Sciences
Patke Vinay, Kuyare Sunil, Iyer Praveen, Bhosale Yuvaraj.
Background: Multiple choice questions (MCQs) are an important tool for assessing whether learning objectives are being achieved. A formal training is necessary to have high standards in preparing MCQs. the effect of a training program on the quality of MCQs, amongst the faculty of Department of Biochemistry was assessed. Methods: A training program was designed with the main focus on how to construct appropriate MCQs by participants based on sound scientific standards and guidelines. Topics from biochemistry syllabus for first year MBBS course were selected for the study. All the study participants were newly appointed lecturers and had not undergone any formal training program in medical education technology. Training was carried out by three experts who were formally trained in medical education and were fellows of foundation for advancement of International Medical Education and Research (FAIMER). Knowledge gained by the study participants was tested by pre-test post-test comprising objective questions. The quality of MCQs before and after intervention was assessed with a validated (checklist) containing 60 items. Results: Eight faculty members participated in the study. A statistically significant improvement was observed in the knowledge of appropriate formulation of MCQs (P


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Norsk Luftambulanse CampEurope

International training on the permanent trainingbase owned by Norwegian Air Ambulance ( Dedikated trainig helo ) -So the pilot, HEMS Tec and Anesthesiologist can train w.o. reducing the responsetime around contry, and train advanced prosedures undisturbed. CampEurope = Inviting other services to base, for learning from other services / Rising level of HEMS around Europe. In the Norwegian Air Ambulance the doc. must be able to do water-rescue, and work from Long-rope. Normally he/she operate as "Rope-man", innstructing pilote during rope-jobs. This year it was pilots, HEMS-tec`s and physicians from Austria, Switzerland, Finland and Denmark who trained with Norwegian crews. ( Norwegian Air Ambulance fund Europes largest research environment on EMS, More then 20 projects now. ) ( NLA operates the 3 bases in Denmark ) Singel engine,VFR not legal. http://ift.tt/1rSwYVH ExEMTNor

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Dangerously Hot: As mercury rises, so do fire hazards, health risks

By Jill Harmacinski
The Eagle Tribune

ANDOVER, Mass. — As temperatures soared into the 90s again Wednesday, locals stuck by fans and air conditioning and dipped in pools and ponds trying to ride out the latest wave of sweltering heat.

Some professions are shown no mercy, however.

Late Wednesday morning as the mercury just touched 90 degrees, a fire on a South Lawrence porch was reported when residents smelled smoke and dialed 911.

Crews raced to 90-92 Jamaica St., where the single-alarm blaze in a two-story, two-family house was quickly knocked down. Fire investigators quickly determined the fire was caused by careless disposal of cigarettes. While there were no injuries, porches on the first and second floors were scorched.

"This is what we call a good stop," said Fire Chief Brian Moriarty. "These guys don't goof off. They come to work to fight fires."

They also wear 75 pounds of protective gear, so numerous Lawrence General Hospital paramedics were on standby as the firefighters worked on Jamaica Street in the sun at the top of a hill.

North of Boston paramedic Bill Kinch explained it's imperative to monitor the vital signs and temperatures of rescuers who work day after day in such oppressive heat.

If a firefighter's temperature rises above 100 degrees, heart rate goes over 120, or blood pressure exceeds 140 over 90, Kinch said he or she is immediately pulled away from the fire.

"We will literally keep them out of the fire until their vital signs drop," said Kinch, a paramedic for the past 25 years.

While body heat escapes from the head quickly, a person also can rapidly cool down if a cold towel is draped over the head. Kinch regularly does this while rehabbing firefighters in hot weather.

The healing power of water
Bottled water is also an ally to rescuers, as well as regular folks just trying to go about their business on a hot and humid day, Kinch noted.

The thing is, he explained, by the time you feel thirsty you are already dehydrated.

Those who are most at risk of dehydration are the very young and very old because their bodies aren't good at regulating heat.

"As you get older, your body becomes much worse at regulating temperature and hydration," he said.

With a prediction of a high of 94 degrees Thursday, Kinch urged people to keep an eye on their families and neighbors to make sure everyone is staying cool and hydrated.

Helping others is something the Salvation Army in Haverhill is dedicated to.

Members drove around Wednesday in their personal cars handing out ice-cold bottled water.

"We go down by the river behind the thrift store on Merrimack Street, by the Post Office in Washington Square, the public library on Main Street and other areas where homeless congregate and where we might encounter senior citizens," said Salvation Army Capt. Mari Hardy.

"We probably average six to eight cases of water per day and Wednesday is the third day in a row we've been doing this," Hardy said.

The goal is to help people keep hydrated, particularly the homeless and elderly who might not feel they need to have a drink but may be at risk of heat exhaustion.

Christina Sierra, a working mother from Methuen, joked this week that she was going to serve her family popsicles for dinner.

On Wednesday, Sierra took the day off and brought her two children to a friend's pool to cool off. Again, her daily menu plan had an icy feel.

"There is truth to ice cream for breakfast, lunch and dinner," she said.

'People are heeding the warnings'
The temperatures have been consistently high in New Hampshire, too, but officials said they've been experiencing few heat-related problems.

"I'm going to curse myself by saying we haven't had anything recently," said Lt. Anthony Rossignol of the Derry Fire Department. "We did respond to (a brush fire) a few shifts ago that was in Candia. ... When I came on, the guys were kind of expecting to go back to it because of the potential hot spots. ... But we haven't really seen anything — knock on wood — elaborate here in town."

Derry residents have been taking to public spots like Gallien's Beach and the splash pad at the Don Ball Park to cool off.

"Definitely, we've seen an increase in attendance," said Eric Bodenrader, director of Derry Parks and Recreation, who attributed the above-average patronage to the heat.

"Fortunately, we have not had any issues. ... We're staffed at both locations with supervisors, concessions attendants and lifeguards, and they're trained to look out for situations where someone may be experiencing a medical (issue)."

Plaistow Fire Chief John McArdle said he's noticed many people outside to jog or bike have been doing so earlier in the morning or later in the evening.

"I think people are heeding the warnings that we're seeing in the media to be careful and not overexert themselves," McArdle said.

Battalion Chief Randall Young of the Salem Fire Department also described the town as being fortunate, given the weather.

"We've actually been lucky. Typically when we have this type of ... long, dry, hot weather, we usually do have a lot of issues, but we've been fortunate," he said. "We haven't had a lot of problems — nothing big and not a large quantity."

Young did say, however, that the department has been fielding more medical calls than usual due to the heat and people becoming dehydrated.

"We have had a small uptick in that," Young said.

Londonderry also has experienced just a few problems related to the heat, but Battalion Chief Kevin Zins said the department, like many in the area, is "trying to be proactive, keeping guys hydrated and cool and ready so they can perform a little better when they get out in the heat."

A cooling center and mosquitoes
Vincent Ouellette, director of human services for Haverhill, said the city has been offering residents an opportunity to keep cool at the Citizens Center.

"If we get calls we would remain open at night, but we have not received any calls," he said. "I've not heard of any issues with people not having a place to be cool. But we are open on an as-needed basis."

Visits to the Plug Pond recreation area in Haverhill are also up, with crowds reaching the 200 person capacity. Ouellette said people will go the pond for an hour or so and then leave so there is a constant turn over.

"We've also seen consistent crowds at the spray park at Swasey Field," he said.

Starting Thursday morning in Lawrence, cooling centers will open at the city's senior center at 155 Haverhill St. and at Oasis Senior Day Care, a private facility located at 120 Broadway.

The senior center will be open from 8 a.m. to 7 p.m. and folks can cool day at Oasis from 9 a.m. to 4 p.m., officials said.

In Methuen, the heat coincided with spraying overnight to drastically reduce the mosquito population.

The spraying was done using truck-mounted, ultra-low volume equipment that dispenses a very fine mist of pesticides, officials said.

North Andover officials also this week issued a voluntary water ban and a simultaneous drought watch.

The town's Board of Selectmen asked residents to conserve water, including doing lawn watering between 8 p.m. to 6 a.m. They asked residents only to water their lawns every third day and to limit outside water use for washing cars and paved surfaces.

The main Lawrence Public Library got so hot that it was closed at 3:45 p.m., an hour and 15 minutes earlier than the regular 5 p.m.

The temperature was 89 degrees on the second floor and 92 degrees on the third, said Acting Director Kemal Bozkurt, who conferred with library trustees on the decision.

The excessive heat was a danger to patrons and staff, he said. The union contract provides for the closing of the library if the temperature rises above 86 degrees.

Copyright 2016 The Eagle-Tribune



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Norsk Luftambulanse CampEurope

International training on the permanent trainingbase owned by Norwegian Air Ambulance ( Dedikated trainig helo ) -So the pilot, HEMS Tec and Anesthesiologist can train w.o. reducing the responsetime around contry, and train advanced prosedures undisturbed. CampEurope = Inviting other services to base, for learning from other services / Rising level of HEMS around Europe. In the Norwegian Air Ambulance the doc. must be able to do water-rescue, and work from Long-rope. Normally he/she operate as "Rope-man", innstructing pilote during rope-jobs. This year it was pilots, HEMS-tec`s and physicians from Austria, Switzerland, Finland and Denmark who trained with Norwegian crews. ( Norwegian Air Ambulance fund Europes largest research environment on EMS, More then 20 projects now. ) ( NLA operates the 3 bases in Denmark ) http://ift.tt/1rSwYVH ExEMTNor

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Norsk Luftambulanse CampEurope

International training on the permanent trainingbase owned by Norwegian Air Ambulance ( Dedikated trainig helo ) -So the pilot, HEMS Tec and Anesthesiologist can train w.o. reducing the responsetime around contry, and train advanced prosedures undisturbed. CampEurope = Inviting other services to base, for learning from other services / Rising level of HEMS around Europe. In the Norwegian Air Ambulance the doc. must be able to do water-rescue, and work from Long-rope. Normally he/she operate as "Rope-man", innstructing pilote during rope-jobs. This year it was pilots, HEMS-tec`s and physicians from Austria, Switzerland, Finland and Denmark who trained with Norwegian crews. ( Norwegian Air Ambulance fund Europes largest research environment on EMS, More then 20 projects now. ) ( NLA operates the 3 bases in Denmark ) http://ift.tt/1rSwYVH ExEMTNor

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Norsk Luftambulanse CampEurope

International training on the permanent trainingbase owned by Norwegian Air Ambulance ( Dedikated trainig helo ) -So the pilot, HEMS Tec and Anesthesiologist can train w.o. reducing the responsetime around contry, and train advanced prosedures undisturbed. CampEurope = Inviting other services to base, for learning from other services / Rising level of HEMS around Europe. In the Norwegian Air Ambulance the doc. must be able to do water-rescue, and work from Long-rope. Normally he/she operate as "Rope-man", innstructing pilote during rope-jobs. This year it was pilots, HEMS-tec`s and physicians from Austria, Switzerland, Finland and Denmark who trained with Norwegian crews. ( Norwegian Air Ambulance fund Europes largest research environment on EMS, More then 20 projects now. ) ( NLA operates the 3 bases in Denmark ) http://ift.tt/1rSwYVH ExEMTNor

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Prevalence in the utilization of text message services under the mother and child tracking system of India: a cross sectional study from Pune district, Maharashtra, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Ankita Sharma, Aakash Shinde, Anita Kar.
Background: The mother and child tracking system (MCTS) is a surveillance system to track pregnant women and children. As it includes a provision of short message service (SMS), that alerts registered beneficiaries about outstanding services. This study determined the prevalence of use of SMS by beneficiaries of MCTS from Pune district, Maharashtra. Methods: A cross-sectional study was carried out among respondents availing antenatal care or immunization services at ten randomly selected primary health centres (PHCs) in Pune district. Data was collected after consent using a semi-structured questionnaire. Data was analyzed using Statistical Package for Social Sciences (19.0 version). Results: The study included 205 pregnant women and 236 parents of children. Almost 66% of respondents owned a mobile phone and majority (91%) were residents in areas with network coverage. Among respondents of nine PHCs, 17% of respondents had heard of, and 14% reported having received a text message of outstanding services on the mobile phone. At one PHC where the auxiliary nurse midwife was sending text message reminders in local language from her mobile phone, 43% respondents were aware of text messaging services and almost 24% respondents reported receipt of text messages. Education level (p


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Alcohol and other substance abuse among youth: an obvious but neglected scenario in Shimla city of Himachal Pradesh, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Devender Kumar, Anupam Parashar, Anita Thakur.
Shimla, the former summer capital of the British in India, and the present capital of Himachal Pradesh, is the principal commercial, political and educational centre of the hilly regions of the state. For all these values, more than 1,60,000 people from different region of state are residing in urban area of Shimla. Moreover, thanks to its picturesque natural locales and pleasant climate it also attracts thousands of tourists every day. With due regards to all its importance, we want to highlight one rapidly growing social and public health problem in the city i.e. substance abuse. Substance abuse particularly among youth has become quite evident in the city in the form of alcohol, cigarette and other tobacco products, cannabinoid and opium extracts. Many contributing factors responsible for current scenario, which are being overlooked again and again, are described here as following.


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Estimation of relationship between eating habits and body mass index of students in Mount Kenya University, Rwanda

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Wilson R. Waweru, Onesmus T. Marete.
Background: Eating habits are a major concern among university students especially due to the transition from home environment where parents determine what to be eaten, to new environments where they or their peers choose the diet. Eating habits are considered determinants of health conditions and has been linked to death from Non-communicable diseases. Methods: This cross-sectional study was conducted in school of Health Sciences at Mount Kenya University. A total of 630 students from entire school of health science constituted the target population for the study. Sample size of 245 students was established. Stratified sampling technique was used to select students from department of Medical laboratory science, Nursing, Pharmacy and Public health who formed sample size for the study. Close-ended questionnaire was used as a tool for data collection. Results: The study found that majority of students had normal weight (65%) but there is a fairly high occurrence of overweight (20%) among the students. Further, female students skipped the three main meals i.e. breakfast, lunch and supper more frequently than male students. In addition, this study found that, the P-values of the chi-square test were greater than 0.05 hence there was not conclusive evidence of a statistical significant relationship between frequency of taking breakfast (P = 0.070), lunch (P = 0.167), or supper (P = 0.217) and body mass index of the students. Further the study found that food availability (61%), friends (6%), cost (1%) and accessibility of food (32%) were the factors that influenced students eating behaviors. The finding showed no statistical relationship between eating home cooked food (P = 0.114), eating self-cooked food (P = 0.056), frequency of taking sweet beverages per week (P = 0.567). However there was statistically significant relationship between frequency of taking fast food per week (P = 0.000), frequency of consuming snacks per week (P = 0.001), frequency of consuming vegetables per week (P = 0.000), frequency of consuming fruits per week (P = 0.033), frequency of consuming deep fried food per week (P = 0.026), frequency of consuming chicken per week (P = 0.008) and body mass index of the students. Additionally the study found out that students considered either the cost of food 29%, availability of food for purchase, 22%, favorite meals 15% or balanced diet when making food choices. A significant relationship between meals planning and BMI (P = 0.000) was realized as well as between living arrangement of the students and body mass index (P =0.000). Conclusions: The study concluded that the frequency of taking breakfast, lunch and supper has no relationship with body mass index of the students. However, frequency of taking fast food, frequency of consuming snacks, frequency of consuming vegetables, frequency of consuming fruits, frequency of consuming deep fried food and frequency of consuming chicken per week is statistically related to body mass index of students. The study also concluded that meal planning and living arrangement relates with students body mass index significantly.


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Clinico-epidemiological profile of confirmed swine flu (H1N1) cases admitted at an infectious disease hospital in Kolkata, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Jadab Chandra Sardar, Arkaprabha Sau, Pankaj Kumar Mandal.
Background: Swine flu is an acute infection of respiratory tract, caused by swine origin influenza A (H1N1) virus. Antigenic drift and shift of this virus is responsible for epidemic or pandemic in different parts of the world from time to time. Last pandemic started in 2009 at Mexico and USA, and spread globally with in a very short period of time. Post pandemic resurgence was noticed in various parts of India from 2010 to 2015. Methods: A record based descriptive study was carried out among the 89 confirmed swine flu (H1N1) cases admitted at Beliaghata ID and BG Hospital, Kolkata during last post pandemic resurgence in India between February 2015 to March 2015. Results: Among 89 confirmed swine flu cases 52.81% were male and 47.19% were female. Mean (±Standard Deviation) age was 38 (±18) yrs. Mean (±Standard Deviation) duration of hospital stay was 6.5 (±1.7) days. Among the admitted patients, 84 patients were discharged from the hospital but 5 patients succumbed to their illness. 95.51% patient presented with the chief complaint of fever. Among the admitted cases, 21.34% had either history of travel to swine flu (H1N1) infected area or contact with swine flu infected patients. There was a statistically significant association between outcome (death / discharge) and co-morbid conditions, (P value-0.047, α-5%, df-1). Conclusions: This study will help clinicians and public health specialist to understand the clinico-epidemiological profile of swine flu (H1N1) cases to diagnose, treat and to develop preventive strategies in future.


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Assessment of oral health hygiene among high school girls of Bengaluru city, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Nimra Shireen, Ranganath T. S..
Background: Oral health is an essential component of general health and quality of life. Dental caries is a major oral public health problem particularly among the children and adolescents. The schools remain an important setting, offering an efficient and effective way to reach children worldwide. Hence, our study aims to assess the oral health hygiene and prevalence of dental caries among high school girls of Bengaluru city - south zone. Methods: A cross sectional study was conducted for a period of four months (i.e.) September 2015 to December 2015 among high school girls of Bengaluru city. They were examined for their oral care, presence of caries and data regarding oral health hygiene was collected by using a semi-structured, indigenous, interviewer based questionnaire. Results: The mean age was 14.2+0.57 years. Majority of the girls (74.4%) said that they brush once daily; 36.8% were unaware about the type of tooth brush used by them. Only few students (14.8%) were using fluoride toothpaste; 72% girls brush their teeth in horizontal direction; 23.2% clean their tongue and 20% use mouth wash; 44% rinse their mouth after eating a meal. Nearly half of the study sample (45.2%) were suffering from dental caries, with mean DMFT score 2.54. Conclusions: Oral health hygiene habits among the study population were poor and needs to be improved. Awareness among the students about maintaining good oral health can be generated by involving the school teachers as they are considered as role models by the students.


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Exploring the potential for using 210Pbex measurements within a re-sampling approach to document recent changes in soil redistribution rates within a small catchment in southern Italy

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Publication date: November 2016
Source:Journal of Environmental Radioactivity, Volume 164
Author(s): Paolo Porto, Desmond E. Walling, Vanessa Cogliandro, Giovanni Callegari
In recent years, the fallout radionuclides caesium-137 (137Cs) and unsupported lead-210 (210Pbex) have been successfully used to document rates of soil erosion in many areas of the world, as an alternative to conventional measurements. By virtue of their different half-lives, these two radionuclides are capable of providing information related to different time windows. 137Cs measurements are commonly used to generate information on mean annual erosion rates over the past ca. 50–60 years, whereas 210Pbex measurements are able to provide information relating to a longer period of up to ca. 100 years. However, the time-integrated nature of the estimates of soil redistribution provided by 137Cs and 210Pbex measurements can be seen as a limitation, particularly when viewed in the context of global change and interest in the response of soil redistribution rates to contemporary climate change and land use change. Re-sampling techniques used with these two fallout radionuclides potentially provide a basis for providing information on recent changes in soil redistribution rates. By virtue of the effectively continuous fallout input, of 210Pb, the response of the 210Pbex inventory of a soil profile to changing soil redistribution rates and thus its potential for use with the re-sampling approach differs from that of 137Cs. Its greater sensitivity to recent changes in soil redistribution rates suggests that 210Pbex may have advantages over 137Cs for use in the re-sampling approach. The potential for using 210Pbex measurements in re-sampling studies is explored further in this contribution. Attention focuses on a small (1.38 ha) forested catchment in southern Italy. The catchment was originally sampled for 210Pbex measurements in 2001 and equivalent samples were collected from points very close to the original sampling points again in 2013. This made it possible to compare the estimates of mean annual erosion related to two different time windows. This comparison suggests that mean annual rates of net soil loss had increased during the period between the two sampling campaigns and that this increase was associated with a shift to an increased sediment delivery ratio. This change was consistent with independent information on likely changes in the sediment response of the study catchment provided by the available records of annual sediment yield and changes in the annual rainfall documented for the local area.



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Socio-demographic profile and health needs of HIV patients: a study at a tertiary care teaching hospital

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Amol Saravade, Anita Shenoy, Ratnendra Shinde, Rachana Nile.
Background: AIDS the acquired immune deficiency syndrome is a fatal illness caused by a retrovirus known as the human immune deficiency virus (HIV) which breaks the body's immune system, leaving the victim vulnerable to a host of life. It is essential to understand the priority needs of PLHIV. So that medical and non-medical, social, cultural and economical interventions can be planned to bring them in the mainstream of the society. Objective was to study the socioeconomic and demographic profile of the HIV positive patients registered at an ART clinic and to enlist and prioritize their health and other needs. Methods: The study was carried out at an ART clinic in a tertiary care centre in Mumbai. Only HIV positive patients registered at ART clinic and willing to participate in study and HIV positive patient above 18 years of age were included in the study while HIV positive patient not willing to participate in study were excluded from the study. The study was carried out during the period of April 2013 to December 2013. The statistical analysis was performed using Microsoft Excel. Results: Total number of respondents was 180. The mean age of study group is 35.49 years. Majority of the respondents had acquired at least primary or secondary education in schools, 18 (10%) respondents were graduates and only 3 (1.67%) with a post graduate degree. The priority needs as perceived by the subjects were classified as immediate, intermediate and long term needs. Conclusions: The study showed that the demographic and socioeconomic profile of the respondents reflects the same trend as at national level. The published data by NACO corroborates these findings. A substantial proportion of the total HIV +ve cases reported are living below poverty line (31.6%). This could require special interventions to ensure that they were treated for opportunistic infections and for reducing the viral load.


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Prevalence of hypertension in an urban area: a community-based survey in Trichy, Tamilnadu, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Parveen Gani, Josephine Priya K, Selvam Paramasivam.
Background: India is facing an epidemic of non-communicable diseases. Hypertension is now a disease of prime concern due to the mortality and morbidity associated with it. In order to effectively deal with this problem we must first understand the characteristics of this disease. Aims: To assess the prevalence of hypertension in an urban district in Tamilnadu and to study selected risk factors associated with it. Methods: Community based survey in Trichy district of Tamilnadu. A total of 373 individuals were screened in the field practice area of KAP Viswanatham Government Medical College. A proforma was used to collect demographic characteristics and record findings. Blood pressure was measured; BMI and waist-hip ratio were calculated. Statistical Analysis Used: Data were analyzed using SPSS version 20. Descriptive statistics, Chi-square test and unpaired (two sample) t-test were used to study the variables. Results: Prevalence of hypertension was found to be 30.56% and prehypertension was found to be 23.32%. 35.9% patients were overweight/ obese. There was no significant difference between the blood pressures of males and females. Persons above 30 years of age had significantly higher systolic (p


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Awareness and treatment seeking behaviour of malaria in selected endemic and non-endemic rural areas of Kanyakumari district, Tamilnadu, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
SureshBalan Kumaraswamy Uma, Madhumitha Manohar, Gopal Muthukrishnan, Kiruba Jebamony, Shankar Radhakrishnan.
Background: Malaria is one of the worlds major public health concerns contributing to 243 million clinical cases and around million deaths annually. India reports the highest malaria burden in the South East Asia region. There is evidence that the availability of services alone may not ensure healthy practices, as they could be influenced by socio cultural barriers and inappropriate understanding of the disease etiology. Understanding of community perceptions and practices are crucial to bring down the burden of malaria. The objectives was to assess the awareness of malaria and treatment seeking behavior in an endemic and non-endemic area and to highlight the differences in the perceptions and treatment seeking behavior between the two areas. Methods: A descriptive study was undertaken in Primary Health Centres of Rajakkamangalamthurai (Endemic) and Chembagaramanputhur (Non endemic) for 2 Months. Patients with fever above the age of 15 years attending the Outpatient department of both the PHCs were chosen as study subjects. 150 patients were included in the study. Responses regarding malaria awareness and treatment seeking behavior were obtained using pre-structured, pre-tested and closed ended questionnaire. Results: Majority of the study subjects from the endemic area gave a correct response to the questions related to the disease terminology, modes of transmission and the usefulness of indoor residual sprays than the subjects from the non-endemic area and the difference was found to be statistically significant (P


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Gender discrimination among professional college students in Agartala, India: a cross-sectional study

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Rituparna Das, Shampa Das, Sankha S. Debnath.
Background: Professional college students being at the base of the hierarchy of professional occupation may be vulnerable to harassment, discrimination and abuse regarding their gender. The present study was conducted with the objective to assess the prevalence and pattern of Gender discrimination among professional college students in Agartala, and to study their emotional response towards gender discrimination. Methods: This cross-sectional study was conducted between September to November, 2015 among students of 5 randomly selected Professional colleges of Agartala. Sample size was calculated and 450 professional college students were included in the study. Results: The present study revealed that the prevalence of gender discrimination among the professional college students was 12.45% with both the males and females being victims of gender discrimination (6.80% vs 5.56%, p value 0.77). There was a significant difference in the type of discrimination experienced by the male and female students (p value-0.01) and male faculties were the main perpetrators of gender discrimination. Regarding the emotional response towards gender discrimination majority of the students complained of frustration (28.57%) followed by helplessness (26.78%) and depression (23.21%). Conclusions: Gender discrimination can be controlled in the college premises with collective efforts to minimize the belief that one sex has rights, leadership qualities, and academic status greater than that of the other sex.


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A study on awareness of HIV among first year MBBS students in a private Medical College, Kerala, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Satheesh B. C., Thilak S. A., Sarada A. K., Madusoodanan K. V., Venugopalan P. P..
Background: India has the third largest HIV epidemic in the world with 2.1 million Indians accounting for about four out of 10 people infected with the deadly virus. The lack of awareness and misconceptions about HIV/AIDS is responsible for rapid spread in our country. Many studies reported that early educational intervention has the potential to bridge the gap both in knowledge and the negative attitudes directed towards those with HIV infection. This study was conducted to assess awareness regarding HIV/AIDS in newly admitted medical students and to assess awareness regarding HIV/AIDS among first year medical students of a private medical college in Kerala, India. Methods: A cross sectional study was conducted on first year MBBS students of a private medical college, Kerala. A total of 135 students were interviewed using pre-validated, semi structured questionnaire. Descriptive statistics were used to analyze the data. Results: All the students (100%) were aware about HIV/AIDS disease, its causative agent and diagnostics test. Majority of the students were aware about the modes of transmission and preventive approaches. A few of the respondents believed wrongly that the virus can be transmitted through mosquito bite, by hugging and kissing, through urine as well as sharing of same toilet seats and clothes with an infected person. Conclusions: Our study demonstrates an overall satisfactory level of awareness on routes of transmission and prevention of HIV/AIDS. A continuous such surveys at regular intervals would further help to assess the level of awareness and attitude towards HIV/AIDS for designing future educative programmes.


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Birth preparedness and complication readiness among primigravida women attending tertiary care hospital in a rural area

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Monika S. Patil, Vinod L. Vedpathak, Nandkeshav R. Aswar, Deepali S. Deo, Prashant L. Dahire.
Background: Maternal mortality in developing countries is still alarming. Each pregnancy may face the risk of sudden, unpredictable complications. Birth preparedness and complication readiness (BPACR) is a strategy that encourages pregnant women and their families to effectively plan for deliveries and deal with emergencies. An objective of study was to assess the status of BPACR among primigravida women and factors affecting the status of BPACR. Methods: A Cross sectional study was conducted among 400 primigravida women attending ANC OPD at tertiary care hospital, from August-November 2015. Data was collected by interviewing the subjects using pre-tested, pre-designed structured questionnaire. BPACR index was calculated. Results: In this study BPACR index was 55.83%. Most of women (98.14%) identified skilled birth attendant for delivery. Though acceptable levels of registration of women in first trimester (79.75%) and identification of modes of transport in emergency (72.25%), TT2 coverage was very low (77.75%). About 63% women were aware about transportation provided by government & 70.25% women were aware about importance of 4 or more ANC visits during pregnancy. But only 68.50% women were aware about consumption of 100-FSFA tablets, whereas 31.50% of women had saved money to pay for expenses. Very few (29.75%) women identified compatible blood donors. 40.75% women knew about any one danger signs of pregnancy. Overall no women knew about all 8 danger signs of pregnancy. Conclusions: Age and education of women and of their husbands plays an important role in awareness regarding components of BPACR.


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Study of factors of utilisation of antenatal services and awareness among pregnant women in third trimester attending government maternity hospital Warangal, Telangana State, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
L. Niharika, K. Bhavani.
Background: Understanding the factors affecting the utilization of maternity care during pregnancy and delivery is required. The present study was carried out to find out the awareness and factors associated with utilization of maternal care services. Methods: A community based observational study was conducted during September to November 2015 on randomly selected antenatal mothers attending Government Maternity hospital, Kakatiya Medical College, Warangal, India. A total of 200 third trimester pregnant women were interviewed using a pre-tested questionnaire regarding utilization and awareness of antenatal services. Statistical analysis: Percentages, Proportions and chi-square test. Results: A total of 200 antenatal mothers participated in the study. Majority (37.5%) belonged to the age group of 20-24 years in which most of the antenatal mothers belong to Hindu religion (86.3%), of which 50.7% lived in a nuclear family. In this study, the percentage of antenatal mother belonging to Upper Lower class was predominant with 26.5%. Association was also found regarding utilization of antenatal services between age of the mother and literacy of the mother. 83.5% of the antenatal mothers had taken the recommended two doses of T.T with a complete booster dose, 87.1% are aware of family planning services, 97.8% of antenatal mothers are aware of immunization and approximately 95% of the antenatal mothers are aware of mother craft classes. Conclusions: The study shows early and wide spread use of antenatal care, but it also reveals that the antenatal visits occur late in the pregnancy. The literacy and age of women has significant bearing on utilization of antenatal care by the pregnant women.


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Drinking water facility in urban field practice area of a medical college: a community based cross sectional study

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Ashiq Rashid Mir, Mahesh H. S., M. S. Rajanna, Krishna Iyengar, Cheluve Gowda.
Background: Rapid modernisation and fast urbanisation has led to rapid filling of urban areas and increased rise in migrant population in urban areas. Water is indispensible for survival of human beings thus providing safe drinking water is one of the most basic component of urban planning .1.8 Million people die of diarrhoea each year out of which majority are under 5 children and 88% of these under 5 deaths are due to unsafe drinking water (1). This study intends to assess the quality of drinking water. Methods: A Cross sectional Study was conducted in Maralur and Maralur Dinne which are under the field practice area of Sri Siddhartha Medical College in Tumkur district of Karnataka. Results: Municipal water supply was used by 79% of the people in the study. No treatment method was used for purification of water by 81% of households.32% of people used earthen vessel to store water for drinking.68% of people dipped glass in vessel using hands to take water for drinking.46% of people had no knowledge about any disease caused by impure drinking water. Only 55 % of households cleaned their water storage vessels once a week. Conclusions: Source of drinking water supply from municipality and wells were unfit for consumption. Storage methods of drinking water are conducive for growth of pathogens. Knowledge about various diseases caused by impure drinking water is also poor. Hence drinking water supply is a challenge in urban settings.


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Breast cancer awareness among women in Vikhroli: a suburban area of Mumbai, Maharashtra, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Sharayu D. Shinde, Suhas B. Kadam.
Background: Breast cancer, the second most common cancer among Indian women, accounts for seven percent of global burden of the disease. Survival rate among women with breast cancer is very poor because most of them sought treatment in advanced stage of the disease. Lack of awareness about the disease and poor facilities of screening programme may be the reason in delay for treatment. To determine the awareness about breast cancer among women in Vikhroli - a suburban area of Mumbai Methods: A community based cross sectional study is carried out in Vikhroli, a suburban area of Mumbai. Quota sampling method was used to select and include 235 women in the study. Semi-structured interview schedule was used to collect the information on breast cancer. Tabular presentation, chi square and contingency coefficients were used for data analysis. Results: Though the respondents have heard about breast cancer, they do not have in-depth knowledge about risk factors, signs and symptoms and methods of early detection. Socioeconomic status differentials are found in knowledge about breast cancer and the two are weakly associated. Conclusions: The awareness about breast cancer is low amongst women in this community. There is a need for awareness generation programs to educate women about breast cancer, propagation of correct messages and promote early detection


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A study to assess the impact of education intervention on the knowledge regarding hazards of plastic food containers in school children

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Angelin Priya, Manju Toppo, Daneshwar Singh, Nisha Singh, Soumitra Sethia.
Background: One among the most hazardous manufacture is the plastic. It has become a part of every aspect of human living. When any food material or water is stored in the plastic containers the small, measurable amounts of the materials may migrate into food and can be consumed with it through the process of leaching. Leaching means that some of the chemicals of the plastic enter the food material or water. BPA is a structural component in polycarbonate beverage bottles. Objectives were to assess the knowledge regarding safe use of Plastics and to assess the impact of educational intervention given to them. Methods: Study design-Community based educational intervention study. Study Subjects - 300 school students of standard 7-9 and 11 of two private school of Bhopal. Results: Out of 300 students, 56% used plastics in the form of tiffin and water bottle, 37.33% used in the form of Water Bottles only and 6.66% did not use Plastic in the form of anything. The knowledge of the respondents increased after the educational intervention and the difference was found to be significant (P


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Physical activity and its association with body mass index among 10-15 years school children in Kalaburagi city, Karnataka, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Mubeen Hussain, Pallavi V. Tenglikar, S. R. Nigudgi.
Background: Childhood obesity is a major public health problem, causing a significant morbidity and mortality. The objective of the present study was to identify certain associated risk factors for the prevalence of overweight and obesity among 10-15 years school children. Methods: The present study was carried out in 1,642 school children aged between 10 to 15 years in Kalaburagi city of Karnataka. A predesigned and pretested questionnaire proforma was administered to each child to collect data on their physical activity level, T.V watching, duration of sleep, availability of playground etc. Parameters of height and weight were measured and recorded following completion of the questionnaire. Results: The prevalence of overweight and obesity were more in those students who did not have accessibility of playground in-front of their houses (15.25% and 8.47%) and in those students travelling by Bus (23.16% and 10.17%) and least in those students who reaches their school by walking (8.52% and 3.85%). The prevalence of both overweight and obesity were more in those students who did not participated in any of the outdoor sports (28.52% and 28.52%), who watched Television for more than 7 hours in a week (14.25% and 8.73%) and in those students who slept for less than 6 hours a day (8.75%). Conclusions: Prevalence of overweight and obesity were high among the school children and need to be addressed by primary and secondary methods of prevention.


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A study of oral health promotion activities in India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Susheel Nalli, Shamanna Ramaswamy Bindiganavale, B. Uday Kumar Chowdary.
Background: Schools provide an important background for health promotion, as they reach around 200 million school children across India, and through them the school staff, their families, and the population as a whole. Health promotional messages can be reinforced throughout the most influential stages of childrens life, enabling them to develop lifelong sustainable attitudes and skills. Objective of the study was to identify the best suitable method of oral health promotional activity, and to identify states where there is deficiency related to oral health promotion, and to create awareness to ensure long term benefits. Methods: This current academic research reviews articles related to school based oral health programs from 2000 to 2014 which are published in English. Electronic search for literature related to school based oral health promotional activities across India using medline, pubmed, WHO, MOHFW. The articles selected were divided into five categories; divisions were based on those originating from North, South, East, West and Central India. Inclusion and Exclusion criteria - articles and reviews related to oral health promotion in children aged between 6 - 17 years were included and those adults are excluded. Fourteen articles were found to be relevant to school oral health promotion and hence were included in the present review. Data from all the fourteen articles was analyzed to determine the type of oral health promotional activity and the states in which they were organized. Results: There was paucity of oral health promotion in the eastern states of India. Oral health promotion at schools in Indian context is infrequently offered by the oral health professionals, oral health education is offered to school children as a part of dental checkup and treatment camps that are organized infrequently by the educational institutions. Conclusions: The concept of utilizing teachers for frequent oral health education and screening of any gross deposits of food debris or calculus and dental caries is practicable. Also regular oral health education by teachers was more effective than irregular oral health education by the oral health professionals.


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Assessment of health related quality of life of elderly diabetic patients attending urban primary health care facility - a cross sectional study

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Avinash Kavi, Padmaja R. Walvekar, Maheshwar D. Mallapur.
Background: Ageing is associated with decline in many body functions; and lifetime exposure to health hazards has an impact on elderly who contend with the double burden of non-communicable diseases such as Diabetes Mellitus, Hypertension, etc., Indian elderly are more prone for chronic disease like Type 2 Diabetes Mellitus and hence measuring health related quality of life among them is essential to plan interventions at primary care settings. Methods: A cross sectional study was conducted among 400 elderly patients aged 60 years and above with Type 2 Diabetes Mellitus attending outpatient department of urban primary health care facility of Belagavi city. The quality of life was assessed using modified WHO-QOL BREF questionnaire under 4 domains viz. physical health, psychological, social relationship and environment. Results: Among the participants 46% were men and 54% were women. The total scores for all the domains overall ranged between 15.75 and 73.5 with a mean score of 40.26 and a standard deviation of 11.14. The mean scores in physical, psychological, social and environmental scores were 44.21±8.50, 40.27±8.83, 36.69±14.62 and 39.9±12.58 respectively. Hypertension though the most common morbidity noted, but did not have statistically significant difference in any domains (P


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Perspectives of cancer patients regarding spirituality and its role in cancer cure

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Dinesh Kumar, Naveen K. Goel, Awadhesh K. Pandey, Kislay Dimri.
Background: Spirituality is recognized as a key determinant of health. A strong correlation between health and spiritual healing is widely existent. Present study aims at investigating spiritual aspects of cancer patients and their opinions regarding spirituality and health and also to explore their views regarding spirituality as complementary and alternative (CAM) medicine for cure of cancer. Methods: Hospital based cross sectional study conducted 1117 among cancer patients attending a tertiary health facility. Chi square test and other elementary statistical methods were applied for data analysis. Results: Among 1117 cancer patients surveyed including 44.9% males and 55.1% females, 37.9% were of the opinion that spirituality and health are interrelated. Spiritual health was assigned Rank 1 by 21.3% respondents. There were 24.6% respondents having no spiritual distress. About 73% respondents agreed with existence of spirituality as a health component. The most common reported characteristic of spiritually healthy individuals was being in peace and calm (69.4%). Majority of respondents (97.2%) had reported faith in God. Increased faith in god after suffering from the disease was reported by 68.8% respondents. Spirituality had perceived role in recovering from disease and 61.6% respondents reported change in their outlook after suffering from this disease. Conclusions: Findings of the present study support the relationship between spirituality and health. Need is felt for introducing spiritual health care in medical practice with holistic approach effectively addressing spiritual issues in cancer management.


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Oral health awareness amongst the medical student of Telengana, India

2016-07-28T06-23-49Z
Source: International Journal of Community Medicine and Public Health
Snigdha Pattnaik.
Background: Attractive smile is a sign of good health. Oral health plays an important role in individuals overall health. Majority of systemic diseases have oral manifestations. Methods: The cross sectional study was carried out amongst the medical students of an Medical college by using WHO ORAL SURVEY for adults, with aims and objectives of estimating the prevalence and severity of oral health problem in the study population, understand and analysis various determinants of diseases of oral cavity and to create awareness on oral health. Results: Out of the 250 repondents, 40% of respondent said, the condition of tooth is very good, which is a sign of good oral hygiene. 13% of the participant said they have never visited a dentist. 23%of the participants said; they visited the dentist in last 6-12 months. 32% felt it is necessary to visit dentist regularly. Conclusions: Oral diseases have a significant impact on the quality of life of individuals, their participation in society and economic productivity as well as on health systems, making oral diseases a significant public health concern. Pain and discomfort from cavities, can affect the ability of an individual to chew and to obtain adequate nutrition, which, in turn, affects the immune response and the ability to fight disease.


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Prenatal diagnosis of sirenomelia in the first trimester

2016-07-28T06-05-49Z
Source: Medicine Science | International Medical Journal
Ahter Tanay Tayyar, Ahmet Tayyar, Mehmet Baki Senturk, Ayse Disli Gurler, Hulya Akgun, Mehmet Tayyar.
Sirenomelia is a rare and fatal congenital anomaly. Incidence of sirenomelia one in 60,000 to 100,000 live births. Early prenatal diagnosis by first trimester scan should be the aim to minimize the physical and psychiatric trauma related to the termination of pregnancy at advanced gestation. Nulliparous woman aged 23 years was referred for evaluation because of absence of legs at 12 weeks 6 days of gestation. The upper half of the fetus appeared normal .The lower extremities appeared to be fused together in fixed extension and mobility at the hip and knee joints was restricted. A single umbilical artery was demonstrated using color dopler, Also, omphalocole was detected and the final diagnosis was sirenomelia. Parents opted for the pregnancy termination due to the lethal prognosis for the fetus. Etiological factors of sirenomelia sequence are still unclear. Several heterogeneous risk factors have been reported, but all of them are debatable. Anomalies of kidneys, significant oligohydramnios and concomitant hypoplasia of the lungs make a very unfavorable prognosis for sirenomelia. Termination of the pregnancy is an option due to a lethal prognosis. It should be offered to the parents when diagnosis of the sirenomelia is made. First trimester diagnosis will give oppurtunity to the patient more safer and less traumatic termination procedure.


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The effect of licorice drink on cytochrome P3A6 and P-glycoprotein gene transcription in rabbits

2016-07-28T06-05-49Z
Source: Medicine Science | International Medical Journal
Rawia Al-Balawnih, Suheil Zmeili, Yacoub Irshaid, Malek Zihlef.
The effect of licorice drink, a widely used herb in the Middle East, on hepatic and intestinal cytochrome P3A6 (CYP3A6) and P-glycoprotein (P-gp) gene transcription using rabbit as an animal model was assessed. This article reports that licorice treated groups showed a significant induction of hepatic CYP3A6 expression by 17.6-folds, and an inhibition of intestinal CYP3A6 expression by 7.6-folds. Licorice administration did not affect P-gp expression neither in hepatic nor in intestinal tissues. It is concluded that licorice can affect the metabolism of drugs that are CYP3A6 substrates, but it might not affect the transport of drugs dependent on P-gp.


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Stiftelsen Norsk Luftambulanse CampEurope

International training on the permanent trainingbase owned by Norwegian Air Ambulance ( Dedikated trainig helo )-So the pilot, HEMS Tec and Anesthesiologist can train w.o. reducing the responsetime around contry, and train advanced prosedures undisturbed. CampEurope = Inviting other services to base, for learning from other services / Rising level of HEMS around Europe. In the Norwegian Air Ambulance the doc. must be able to do water-rescue, and work from Long-rope. Normally he/she operate as "Rope-man", innstructing pilote during rope-jobs. ExEMTNor

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