Tuberculosis affected mankind for over 5000 yrs and continue to be a major public health problem. So to generate hypothesis about tuberculosis this study was conducted to study the profile of tuberculosis cases attending at DTC Jaipur. A record based cross-sectional study of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken. Chi-square test was used to find out association. It was found in this study that Cure Rate significantly varied with type of case, age and sex of case. It was observed highest in cat.III and below 20 yrs of age. Defaulters were max. in Relapse retreated cases and in elderly (>60 yrs.) cases whereas it was not affected significantly with age . Failure Rate was highest in category I cases and significantly varied with age and sex. About 3/4th of total deaths were observed in Failure and Relapse retreated cases. Case Fatality Rate (CFR) showed not significant variation with sex. So it can be concluded with this study that maximally affected age group with tuberculosis is either children or 40-60 years with male predominance. Category III cases are more easier to cured and Category II cases are most difficult to cured. Cure rate was lesser in 40-60 years of age group and males. Defaulters and CFR were more in category II, 40-60 year of age group and males. And Failure Rate was more in category I, 40-60 year of age group and males
Association of Treatment Outcome of Tuberculosis with type of Category of Tuberculosis-Tuberculosis is the third major cause of adult mortality i.e. 15-59 years of age group on which the nation’s economy depended on. In treatment of tuberculosis, failure of treatment and defaulters of treatment are the main hurdles. So this study was carried out with the aim to find out association of treatment outcome with category of case and diagnosed in various four quarters of year. For the study purpose 160 case sheets of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken, by identify 40 cases randomly from each of four quarter. Chi-square test was used to find out association. It was found in this study that maximum cases were of category II followed by I and II. Cure rate was found 44.38% with maximum in category III (60.42%). Defaulter rate was found 32.5% with maximum in category II (35.48%). Failure rate was found 9.38% with maximum in category I(14%). And Case Fatality Rate was found 32.5% with maximum in category II(20.97%).This variation in treatment outcome was found significantly associated for Cure rate and CFR not for Defaulter and Failure rate.
Association of Treatment Outcome of Tuberculosis with type of Category of Tuberculosis-Tuberculosis is the third major cause of adult mortality i.e. 15-59 years of age group on which the nation’s economy depended on. In treatment of tuberculosis, failure of treatment and defaulters of treatment are the main hurdles. So this study was carried out with the aim to find out association of treatment outcome with category of case and diagnosed in various four quarters of year. For the study purpose 160 case sheets of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken, by identify 40 cases randomly from each of four quarter. Chi-square test was used to find out association. It was found in this study that maximum cases were of category II followed by I and II. Cure rate was found 44.38% with maximum in category III (60.42%). Defaulter rate was found 32.5% with maximum in category II (35.48%). Failure rate was found 9.38% with maximum in category I(14%). And Case Fatality Rate was found 32.5% with maximum in category II(20.97%).This variation in treatment outcome was found significantly associated for Cure rate and CFR not for Defaulter and Failure rate.
In India, Reproductive Tract Infection (RTI) including Sexually transmitted Diseases (STDs) produce a huge disease burden. Nursing staff plays a major role in prevention of STI/RTIs. So this study was conducted aimed to know the knowledge about STIs/RTIs of nursing personnel of a tertiary care hospital of Rajasthan. 100 nursing professionals were supervised for practice and interrogated for attitude and knowledge as per a semi- structured schedule. It was found that overall mean score of nurses was 56% and only 52% had scores passing marks (>50%). Although this knowledge about STI/RTI was not found to be associated religion, caste, type of family and socio-economic status but it was found to be associated with sex, marital status and education of nurses. It was also found in this study that gap of training decreases the knowledge and number of training increases the knowledge. It was found to be associated with department where the nurses were working. So all the nurses irrespective of place of posting should be given refresher trainings at regular intervals.
— Wound infection is the second commonest complication of wound healing. This study was carried out on 250 post-operative cases operated at a district hospital of western Rajasthan, India with the aim the aim to find out prevalence of post-operative surgical site infection and its causing organism. After taking personal information and detailed clinical, operative and post-operative history of these cases, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Association was inferred with Chi-square test. Post operative surgical site infection rate was found 11.6 % which was found significantly more in intestinal surgeries than the other. Most common causative organism for infection was Staphylococci cases followed by Streptococci, E. Coli and Klebsella. Out of total 11.6% infected cases, majority (8.8%) of patients had infection with more than one organism only 2.8% were having single organism. Keywords— Post-operative surgical Site Infection (SSI), Microorganism , SSI Infection Rate.
A study on clinical presentation and various risk factors associated with pht...IjcmsdrJournal
Background: Tuberculosis is one of the most ancient infectious diseases caused by Mycobacterium tuberculosis. The population most affected is the young and economically productive one. The social factors include poor quality of life, poor housing, overcrowding, population explosion, under nutrition, lack of education, and last but not the least lack of awareness of cause of illness.
Aims and Objectives:
1. To study the clinical presentation of tuberculosis in patients.
2. To study various risk factors of tuberculosis.
Material and Methods: This study was conducted at selected designated microscopic centre (DMCs) Kanpur Nagar district has a population of 45.73lakh ( Census 2011).All the patients who were registered in the selected DMCs in the last one month of the year 2016 ( between April and May) were taken into consideration for the present study. Data was collected on predesigned and pretested questionnaire using direct personal interview method of patients at DMCs on the DOTS days of the week i.e Monday, Wednesday and Friday. Informed consent of the study subjects was taken before interview. A total of 105 registered patients were interviewed personally and also the treatment card of patients was obtained from their respective DMCs.
Results: Out of 105 cases of tuberculosis which reported at DMCs maximum no. of patients belongs to age group between 21-40 yrs of age group (58%). Majority of cases were married (65.7%) cases. (62%) cases were Hindu by religion and (58%) belongs to other backward caste. In the study we found majority of patient was illiterate (34.3%). Most common clinical presentation was cough, fever and cough with expectoration, anorexia was reported in (61.9 %) of cases (77%) were cigarette/bidi smokers, 60% were tobacco chewer. Diabetes was reported in (12.4%) cases and (3.8%) cases were HIV positive.
Background: Diabetes affects millions of people each year, it is one of the leading causes of mortality and morbidity worldwide.
Periodontal disease has recently been recognized as the “sixth complication” of diabetes mellitus, the relationship between diabetes and periodontal disease is actually bi-directional. Generally, poor oral hygiene, a long history of diabetes, greater age, and poor metabolic control are associated with more severe periodontal disease. Method: The study is an analytical cross-sectional study, 406 patients with type 2 diabetes mellitus selected through systematic random sampling from 5 UNRWA health centers. The World Health Organization’s basic methods tools were used to collect data and assess oral health.
The STUDY of the DISTRIBUTION & DETERMINANTS of HEALTH-RELATED STATES in specified POPULATIONS, and the application of this study to CONTROL of health problems.
Crimson Publishers-Longterm Mortality among Chronic Complex Patients with pol...CrimsonPublishersGGS
Longterm Mortality among Chronic Complex Patients with polypharmacy: Results of Community- Based Prospective Study by Clua Espuny in Gerontology & Geriatrics studies
Epidemiology basic is a simple way of orientation of the Doctors and health care providers on the basic aspects of epidemiology and research methodology
Abstract— Anemia in pregnancy is commonly considered as risk factor for poor pregnancy outcome and can threaten the maternal and fetal life also. So this present cases control study was carried at R. K. Joshi District Hospital Dausa (Rajasthan) India, with the aim to find out the effect of anemia in Antenatal period on pregnancy outcomes. For this study, 50 Antenatal Cases (ANCs) with anemia were selected as study group among ANCs attending for delivery in district hospital Dausa. For control group age and BMI matched 50 normal healthy ANCs without anemia were selected from the same area. ANCs with any other diseases were excluded from the study. It was found in this study that although proportion of ANCs with LSCS, PPH and Sepsis were higher in anemic ANCs but it was not found significant. Likewise IUGR, LBW babies, premature births and still births were more in anemic ANCs but it was found significant only in case of LBW babies. So it can be concluded that anemia in ANCs effect weight of newborn babies born by ANC with anemia.
Abstract—There is a scarcity of available studies in India on parental stress and depression among parents of children with intellectual disability. Present hospital based cross sectional analytical type of observational study was carried with the specific aims to assess and compare daily parenting stress and depressive symptoms among parents of children with various degree of intellectual disability. Total 90 randomly selected subjects ({both parents of mentally retarded (MR) children and normal children} were evaluated separately for daily parenting stress and depressive symptoms using the Family Interview for Stress and Coping and Hamilton Depression Rating Scale. According to Intelligence Quotient (IQ) of children, three groups were created: Group 'A' (30 parents of moderate to profound MR children), group 'B' (30 parents of mild to borderline MR children) and group 'C' (30 parents of children normal intelligence).IQ of the children was assessed by trained clinical psychologist and diagnosis was made as per ICD-10 criteria. Controls were taken from healthy volunteer and screened by two psychiatrists. A self designed, pre-tested & semi-structured detailed Performa was used for socio-demographical and clinical profile. The data were analyzed using SPSS trial version. Parents in group 'A' had significantly higher level of daily parenting stress and depressive symptoms than groups 'B' and 'C', group 'B' parents had higher level of daily parenting stress and depressive symptoms than group 'C'. Mothers experienced greater depressive symptoms and daily parenting stress compared to fathers. A positive correlation was found between daily parenting stress and depressive symptoms and negative correlation was found between IQ of the children and the daily parenting stress and depressive symptoms.
In India, Reproductive Tract Infection (RTI) including Sexually transmitted Diseases (STDs) produce a huge disease burden. Nursing staff plays a major role in prevention of STI/RTIs. So this study was conducted aimed to know the knowledge about STIs/RTIs of nursing personnel of a tertiary care hospital of Rajasthan. 100 nursing professionals were supervised for practice and interrogated for attitude and knowledge as per a semi- structured schedule. It was found that overall mean score of nurses was 56% and only 52% had scores passing marks (>50%). Although this knowledge about STI/RTI was not found to be associated religion, caste, type of family and socio-economic status but it was found to be associated with sex, marital status and education of nurses. It was also found in this study that gap of training decreases the knowledge and number of training increases the knowledge. It was found to be associated with department where the nurses were working. So all the nurses irrespective of place of posting should be given refresher trainings at regular intervals.
— Wound infection is the second commonest complication of wound healing. This study was carried out on 250 post-operative cases operated at a district hospital of western Rajasthan, India with the aim the aim to find out prevalence of post-operative surgical site infection and its causing organism. After taking personal information and detailed clinical, operative and post-operative history of these cases, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Association was inferred with Chi-square test. Post operative surgical site infection rate was found 11.6 % which was found significantly more in intestinal surgeries than the other. Most common causative organism for infection was Staphylococci cases followed by Streptococci, E. Coli and Klebsella. Out of total 11.6% infected cases, majority (8.8%) of patients had infection with more than one organism only 2.8% were having single organism. Keywords— Post-operative surgical Site Infection (SSI), Microorganism , SSI Infection Rate.
A study on clinical presentation and various risk factors associated with pht...IjcmsdrJournal
Background: Tuberculosis is one of the most ancient infectious diseases caused by Mycobacterium tuberculosis. The population most affected is the young and economically productive one. The social factors include poor quality of life, poor housing, overcrowding, population explosion, under nutrition, lack of education, and last but not the least lack of awareness of cause of illness.
Aims and Objectives:
1. To study the clinical presentation of tuberculosis in patients.
2. To study various risk factors of tuberculosis.
Material and Methods: This study was conducted at selected designated microscopic centre (DMCs) Kanpur Nagar district has a population of 45.73lakh ( Census 2011).All the patients who were registered in the selected DMCs in the last one month of the year 2016 ( between April and May) were taken into consideration for the present study. Data was collected on predesigned and pretested questionnaire using direct personal interview method of patients at DMCs on the DOTS days of the week i.e Monday, Wednesday and Friday. Informed consent of the study subjects was taken before interview. A total of 105 registered patients were interviewed personally and also the treatment card of patients was obtained from their respective DMCs.
Results: Out of 105 cases of tuberculosis which reported at DMCs maximum no. of patients belongs to age group between 21-40 yrs of age group (58%). Majority of cases were married (65.7%) cases. (62%) cases were Hindu by religion and (58%) belongs to other backward caste. In the study we found majority of patient was illiterate (34.3%). Most common clinical presentation was cough, fever and cough with expectoration, anorexia was reported in (61.9 %) of cases (77%) were cigarette/bidi smokers, 60% were tobacco chewer. Diabetes was reported in (12.4%) cases and (3.8%) cases were HIV positive.
Background: Diabetes affects millions of people each year, it is one of the leading causes of mortality and morbidity worldwide.
Periodontal disease has recently been recognized as the “sixth complication” of diabetes mellitus, the relationship between diabetes and periodontal disease is actually bi-directional. Generally, poor oral hygiene, a long history of diabetes, greater age, and poor metabolic control are associated with more severe periodontal disease. Method: The study is an analytical cross-sectional study, 406 patients with type 2 diabetes mellitus selected through systematic random sampling from 5 UNRWA health centers. The World Health Organization’s basic methods tools were used to collect data and assess oral health.
The STUDY of the DISTRIBUTION & DETERMINANTS of HEALTH-RELATED STATES in specified POPULATIONS, and the application of this study to CONTROL of health problems.
Crimson Publishers-Longterm Mortality among Chronic Complex Patients with pol...CrimsonPublishersGGS
Longterm Mortality among Chronic Complex Patients with polypharmacy: Results of Community- Based Prospective Study by Clua Espuny in Gerontology & Geriatrics studies
Epidemiology basic is a simple way of orientation of the Doctors and health care providers on the basic aspects of epidemiology and research methodology
Abstract— Anemia in pregnancy is commonly considered as risk factor for poor pregnancy outcome and can threaten the maternal and fetal life also. So this present cases control study was carried at R. K. Joshi District Hospital Dausa (Rajasthan) India, with the aim to find out the effect of anemia in Antenatal period on pregnancy outcomes. For this study, 50 Antenatal Cases (ANCs) with anemia were selected as study group among ANCs attending for delivery in district hospital Dausa. For control group age and BMI matched 50 normal healthy ANCs without anemia were selected from the same area. ANCs with any other diseases were excluded from the study. It was found in this study that although proportion of ANCs with LSCS, PPH and Sepsis were higher in anemic ANCs but it was not found significant. Likewise IUGR, LBW babies, premature births and still births were more in anemic ANCs but it was found significant only in case of LBW babies. So it can be concluded that anemia in ANCs effect weight of newborn babies born by ANC with anemia.
Abstract—There is a scarcity of available studies in India on parental stress and depression among parents of children with intellectual disability. Present hospital based cross sectional analytical type of observational study was carried with the specific aims to assess and compare daily parenting stress and depressive symptoms among parents of children with various degree of intellectual disability. Total 90 randomly selected subjects ({both parents of mentally retarded (MR) children and normal children} were evaluated separately for daily parenting stress and depressive symptoms using the Family Interview for Stress and Coping and Hamilton Depression Rating Scale. According to Intelligence Quotient (IQ) of children, three groups were created: Group 'A' (30 parents of moderate to profound MR children), group 'B' (30 parents of mild to borderline MR children) and group 'C' (30 parents of children normal intelligence).IQ of the children was assessed by trained clinical psychologist and diagnosis was made as per ICD-10 criteria. Controls were taken from healthy volunteer and screened by two psychiatrists. A self designed, pre-tested & semi-structured detailed Performa was used for socio-demographical and clinical profile. The data were analyzed using SPSS trial version. Parents in group 'A' had significantly higher level of daily parenting stress and depressive symptoms than groups 'B' and 'C', group 'B' parents had higher level of daily parenting stress and depressive symptoms than group 'C'. Mothers experienced greater depressive symptoms and daily parenting stress compared to fathers. A positive correlation was found between daily parenting stress and depressive symptoms and negative correlation was found between IQ of the children and the daily parenting stress and depressive symptoms.
Abstract—Scarring is a well recognized sequel of acne. Because of the prevalence of acne scarring and strong negative emotions it engendering affected patients, several approaches have been developed for its treatment with varying success rates. Glycolic acid 50% peels and Salicylic acid 30% Peels are classified as superficial peel and are consider safe in Indian patients. While chemical peels are widely being used in India for various indications. There is a paucity of published studies on the efficacy of chemical peel specifically for acne scars in Indian patients.
Purpose of this study was to evaluate and compare the effectively of these two agents in the treatment of acne scars. Eighty cooperative patients[≥18 years age]with predominantly moderately atrophic acne scarring were randomly divided into 2groups of 40each.Patients of group A received Glycolic acid peels and patients in group B, Salicylic acid was used at 3weeks interval for four sessions. Objective evaluations of treatment response. Subjective assessments of treatment response were also done separately by the researcher, an independent observer and the patients separately.
Both of agents led to significant reduction in the total acne scar score[p< 0.05]but no significant difference was noted between the two peels. Side effects were lesser with Salicylic acid peel.
Hence conclusion was drawn that both 50% Glycolic acid and 30% Salicylic acid peels are safe in Indian skin and equally effective in the treatment of mild to moderate acne scarring.
Abstract—Asthma is a chronic inflammatory disease of the airways that affects people of all ages. It may manifest as severe attacks, which can require urgent health care. It causes limitations in daily activities, loss of school and work days, lung function impairment, reduced quality of life, and an adverse socioeconomic burden. There is no cure of asthma, once it is diagnosed it can be managed by a good treatment plan, so that patient can live a better quality of life with the disease. This present study was planned to compare the effect of traditional treatment alone and in combination with Root Heal Therapy on asthma cases. A Quincy experiment was conducted on 60 patients of Asthma, who were taking treatment from a physician working in Jaipuriya Hospital, Jaipur. Out of these 60 asthama patients who were receiving traditional treatment, 30 patients were given this RHT along with traditional treatment. Baseline status of asthma and Asthma Quality of life Questionnaire (AQLQ) was assessed. These cases were followed for 18 months, again they were assessed as per AQLQ. Changes in status of asthma in both the group over this period were compared with Chi-square test and Unpaired 't' test. It was found that significantly more cases were benefited with this RHT in the form of number of spells of asthma, duration of illness due to asthma, mean days of activity loss and proportion of cases needed hospitalization during last one year. Pulmonary Function test were also better in experimental group than control group. Although mean number of eosinofills decrease was also found higher in experimental group but it was not found significant. It is concluded that Quality of life of these asthma cases were significantly improved on physical, emotional, social and occupational domains of life in cases with RHT than the cases only on traditional treatment.
Abstract— Gastrointestinal stromal tumors (GIST) are rare neoplasms of the gastrointestinal system. A case of 40 year old man having tense tender abdomen with obliterated liver dullness and shifting dullness was presented in emergency, it was further investigated on X rays, where pneumoperitoneum was found. This case was then decided to go for Laparatomy after routine investigations to further explore. On exploratory laparatomy, diffuse peritonitis with brown coloured fluid was observed. A 10 x 5 x 7 cm mass was found having an opening communicating with the gut lumen was present around 10 cm from the ligament of treitz. However, no adjacent structures, liver or parietal peritoneum seemed to be involved. Gross examination of the specimen revealed an outward bulging mass, which was centrally necrotic and contained hemorrhagic-necrotic material. On histo-pathological examination, features suggestive of gastrointestinal stromal tumor (GIST) with mixed spindle and epitheoid pattern was seen. Mitoses were slightly increased (<5 /> HPFs) leading to the conclusion of LOW GRADE GIST with tumor free margins of gut (R0 resection). So it was a case of Gastrointestinal stromal tumors (GIST), which is a rare medical presentation. So it was decided to report this case as a rare case presentation.
Estrogen and Progesterone Receptors Expression in Resected Gallbladder from Gall bladder Carcinoma Cases-Gallbladder carcinoma is most common malignancy of gartrointestinal tract (GIT) with poor diagnosis. Its prevalence is higher in females that too of northern India. This study aimed to identify the role of sex hormones in carcinoma gallbladder (CA GB). Resected 100 gall bladders of CA GB were examined immune-histo-chemicaly to find out ER and PR status with its association with its underlying histopathology. It was found in this study that PR status was observed in 36% of cases whereas ER status was positive in 2% of CA GB cases. It was also revealed that ER expression was specific and PR expression was more sensitive indicator in differentiating between benign and malignant carcinoma gall bladder.
Comparison of pre-mixed and sequentially intrathecal administration of Clonidine with hyperbaric Bupivacaine in caesarean sections-Adjuvant and hyperbaric Bupivacaine mixing in a single syringe before injecting the drugs intrathecally is an age old practice. It may cause intraoperative hemodynamic changes. Administering local anesthetic and the adjuvant separately may minimize these side effects. So this study was aimed to compare effect of administering hyperbaric Bupivacaine and Clonidine intrathecally as a mixture and sequentially in cases undergoing caesarean section (CS). This study conducted at a District Hospital of Rajasthan in year 2013. Cases undergoing elective caesarean sections were divided into two groups by chit box method each of two groups consists of 30 cases. One group (Group A) is given mixture of Clonidine (75 mcg) and hyperbaric Bupivacaine 0.5% (10 mg) intrathecally, whereas other Group B received Clonidine (75 mcg) followed by hyperbaric Bupivacaine 0.5% (10 mg) through separate syringes. It was found that duration of analgesia was significantly longer in Group B (466 ± 18.2 min) in which the drug was given sequentially than in Group A (334 ± 16 min). Likewise, the time to achieve highest sensory and complete motor block was significantly less in Group B than Group A. So it can be depicted that administering Clonidine and hyperbaric Bupivacaine in a sequential manner is better than mixing of the two drugs.
Pregnancy Outcome Comparison in Elderly and Non Elderly Primigravida attending at Mahila Chikitsalay, Jaipur (Rajasthan) India-Pregnancy and child birth are normal physiological processes and outcomes of most of the pregnancies are good but sometimes because of some reasons it has bad outcomes; out of that one is supposed to be elderly primi. But nowadays it becomes essential to delay the pregnancy in changing social and economic trend. Simultaneously higher advanced technique and better supported maternal and neonatal care also exist. So to have an idea of balance between these this case-control study was done on 120 elderly and 120 non-elderly primigravida to compare the pregnancy outcomes. To find out the association Chi-Square and Unpaired‘t’ test was used. It was observed in this study that although there was no significant difference in antenatal maternal pregnancy outcomes but PPH, induction of labor, cervix dystocia were significantly more in elderly. Likewise time taken to start with breast feeding was also more in elderly. In case of newborn mean APGAR score and mean birth weight was significantly lesser in elderly than non-elderly.
Abstract— Cervical ripening is an essential factor for initiation of normal labour for vaginal delivery. Prior to onset of spontaneous labour the cervix undergoes a gradual process of ripening. But in certain cases it does not occur spontaneously at term and sometimes induction of labour is required. Then cervical ripening means high bishop score in essential for successful induction of labour. This comparative study was conducted at Bikaner to compare induction of labour by vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and Intra cervical Dinoprostone gel 0.5 mg. For this purpose 100 clients were given vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and 100 clients were given Intra cervical Dinoprostone gel 0.5 mg. It was observed in this study that Dinoprostone gel is more efficacious for cervical ripening and labour induction in cases of nulliparous & primiparous at term with unfavourable cervix with intact membranes, as compared to misoprostol in terms of shorter total duration of labour, shorter mean induction delivery interval, more spontaneous vaginal deliveries, and reduced incidence of LSCS as well as instrumental deliveries.
Abstract—Dermatitis artefacta is a self-inflicted dermatologic injury with underlying primary psychiatric condition. Precipitating factors ranges from simple anxiety to interpersonal conflicts and several personality disorders including obsessive compulsive disorder, depression and psychotic disturbances. The diagnosis of this entity is often missed. Herein, we are reporting a case of dermatitis artefacta with description of its various manifestations.
Abstract— Cerebral palsy (CP) is the most common physical disability of childhood. Children with CP frequently grow slowly and are more prone to fractures. So this study was aimed to explore relationship of bone mineral density (BMD) with cerebral palsy by case-control study. This study was conducted at Department of Physical Medicine and Rehabilitation of Sawai Man Singh Medical College, Jaipur. Hip bone and spine bone was used to assess BMD. Bone mineral density was measured by DEXA in both groups i.e. study group and control group after ensuring the comparability of both groups. Difference in means of BMD in both the groups was inferred by unpaired student's’ test of significance. It was found in this study that bone mineral density of hip well as spine was significantly lowered in cerebral palsy cases.
Socio-demographic Characteristics of Clients Visiting Integrated Counseling and Testing Centre (ICTC) at SMS Medical College, Jaipur (Rajasthan) India-Human immunodeficiency virus (HIV) infection is a global pandemic and India counts for 10% of the global HIV burden and 65% of that in the South and South-East Asia. This study of clients of ICTC was carried out to know the association of HIV positivity with socio-demographic variables. Total 2412 clients have visited at ICTC of SMS Medical College, Jaipur, either voluntarily or referred by various department of this institute in ICTC in 1st quarter of 2009. They Overall HIV positivity was found 12.35% with a significant difference in voluntary and referred clients i.e. 83.59% v/s 8.36%. It was also found that HIV positivity is more in reproductive age group than extremes of ages, more in females than males, more in person who were married but presently single because of separation of spouse, divorce form spouse or death of spouse than the unmarried or married living with their spouses.
Clinical Safety and Side Effects of Intra Dermal regimen of Tissue culture Anti-rabies Vaccine-Rabies is 100% fatal but preventable disease. WHO recommends Tissue culture Anti-rabies Vaccines for post exposure treatment but this prophylaxis becomes expensive. So for reducing the 1/6th cost of this prophylaxis intradermal ARV regime was also recommended. But again there is a question mark for balance between cost effectiveness and safty so this cross sectional study was carried out in year 2013 on 654 recipients of Purified Chick Embriyo Cell Vaccine (PCECV) anti-rabis vaccine (ARV) at Anti Rabies Clinic (ARC) of a tertiary-care teaching hospital (SMS) at Jaipur, Rajasthan. Side effects were observed during the follow up visits on days 3, 7 and 28. Though all the recipients complained of local side effects at site of inoculation but these symptoms were relieved by simple administration of paracetamol and ceterizine orally. The side effects (local symptoms) noted on First dose were local itch (4%), local pain (3.8%), low grade fever (2.1%) and the local signs noted are local induration (22.3%), local erythema (1.2%). Same pattern of sign and symptoms were observed in D3 and D7 dose of injection but in decreased frequency. None of the cases had anaphylaxis or regional lymphadenopathy. Thus, this cost effective way of treating the animal bite cases using PCECV in Intra Dermal Rabies Vaccination (IDRV) is recommended to deal with the burden of animal bite cases for the prevention of Rabies in India.
Abstract— Diabetes Mellitus (DM) is a chronic and progressive condition with a hereditary predisposition which is further induced by unhealthy lifestyle. It is a silent killer with cardiovascular complications being most common cause of morbidity and mortality in patients with T2DM.
Objective: To find out association of socio demographic and clinical parameters of diabetes type 2 with hypertension and dyslipidemia among Diabetes Mellitus type 2 cases aged 18 to 70 years. Methodology: A cross sectional hospital based study was conducted on 272 type 2 DM patients attending Department of Medicine in a secondary care referral hospital after taking consent.
Results: Hypertension was present in 192 (70.59%) and dyslipidemia was present in 93 (34.19%) of type 2 diabetes patients. Age, family income, presence of family history, duration of illness, type of treatment, consumption of alcohol , BMI, Hba1c level were found to be associated significantly with both hypertension and dyslipidemia in type 2 DM patients.
Abstract—
Purpose: To evaluate the morphological changes of the Meibomian glands in patients with evaporative “dry eye” compared to normal subjects by in vivo laser scanning confocal microscopy (LSCM). To correlate these changes to the clinical observations and tear functions.
Methods: The study was based on trans-tarsal images of 30 normal and 30 diseased lids (patients with subjective complaints and objective symptoms of evaporative “dry eye”). Each participant was examined by in vivo LSCM (HRT3 Rostock corneal module). The results were compared to histological findings of normal or pathologically changed Meibomian glands.
Results: Patients with evaporative “dry eye” presented with destructive changes of the Meibomian glands as follows: occlusion of the lumen, impaired morphology of the acines, lack of normal structure and infiltration with inflammatory cells. Reported ocular surface and tear function abnormalities were correlated to the Meibomian glands dysfunction (MGD). In all cases the lid hygiene and anti-inflammatory treatment demonstrated tendency to restoration of the structure.
Cоnclusion: In vivo LSCM can effectively demonstrate the morphological changes of the Meibomian glands in patients with evaporative dry eye symptoms. This noninvasive technology is useful as a supplementary diagnostic tool for in vivo assessment of the histopathology of many ocular surface disorders and monitoring of the therapeutic effect in patients with MGD. Glandular acinar density and acinar unit diameter seemed to be promising new parameters of Meibomian glands in vivo confocal microscopy. The examination has the potential to change the evaporative dry eye treatment approach
Abstract—Spiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health and studies were conducted to find out its effect in various diseases. So this study was conducted on elderly aimed to assess the spiritual health and its association with psycho wellness. For study purpose, 30 cluster technique to identify houses with elderly (≥60 years) in Municipal Corporation area of Jaipur City. After collecting general information Spiritual Health Assessment Scale (SHAS) was used to assess spiritual health and Modified Mini Screen (MMS) was used to assess psycho-wellness in elderly. Data were anlysed and inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Majority of elderly were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness in elderly. Poorer the spiritual health of elderly leads to poorer the psycho-wellness in elderly.
A Point Cross-sectional study of Swine Flu Cases admitted at a Tertiary Level Hospital, Jaipur (Rajasthan) India-Presently in India Swine Flu cases were reported maximum from Rajasthan in this year (2015). So this study was aimed to analyzed the swine flu cases on various grounds to know the reasons for this increase. 77 swine flu cases addimited on 10.3.15 in a tertiary level hospital were interrogated. Total 2603 swine flu cases and 101 deaths were confirmed upto 10.3.15 in this current year concluding CFR 3.88%. Mean age of identified 77 swine flu cases was 41.32 ± 16.19 years with age range 1.5 to 75 years and MF ratio 0.51. Significantly more females were affected with swine flu than males but no significant age wise difference was found in males and females. Out of total 77 cases, 32.47 % were in ICU. About one third (31%) were self motivated others were from government and private health institutes. They were correctly diagnosed symptomatically in 33.77% before referred and about half of cases were advised for investigation (44.16%) for swine flu and precautions (51.95%) regarding respiratory antiquates. And 63.64% were admitted within 24 hours shows good awareness. Co morbidity was found in 57.14% of admitted cases and maximum (84%) co morbidity was found in cases admitted in ICU.
Study on Histopathological Correlation with ER, PR, and HER 2 Neu Receptor Status in Breast Carcinoma and its Prognostic Importance
Mahendra Singh, Jagdish Kumar*, Anita Omhare, Vandana Mishra, Chayanika Kala
http://dx.doi.org/10.21276/SSR-IIJLS.2019.5.1.3
Abstract—The frequent occurrence of epidemics even after the launching of the Integrated Diseases Surveillance Programme (IDSP) was an indication toward inadequacy of the control system. These epidemics/outbreaks may be identified if disease status analysis is done properly. The aim of the this study was to find out status of some of major diseases included in the IDSP in a tertiary level hospital of western Rajasthan. It was a record-based analysis carried out in hospitals attached to SMS medical College, Jaipur (Rajasthan) India. Weekly report of IDSP in 'L' Form was collected of year 2015 from SMS Medical College, Hospitals. Data related to major diseases of IDSP were gathered from these reports. These reports were analysed in percentage and proportion. It was observed among major six diseases studied in this present study, majority of cases were of Swine flue followed by Dengue, Scrub Typhus and Malaria. There was no case of Chikungunia and Enteric Fever. When deaths due to these major six diseases were observed it was found that majority of deaths occurred due to Swine flue followed by Dengue, Scrub Typhus and Malaria. Malaria death was due to Plasmodiun Falcifarrum. Maximum PCR was of Swine flue (42.32%) followed by Dengue (29.16 %), Scrub Typhus (21.87%) and Malaria (6.65%). Maximum PDR was of Swine flue (93.08%) followed by Dengue (3.08%), Scrub Typhus (3.08%) and Malaria (0.77%). Overall Case Fatality (CFR) of these diseases was found 9.2%. Regarding variation CFR of these diseases it was found that maximum CFR was of Swine flue (20.23%) followed by Scrub Typhus (1.29%), Dengue (1.06%) and Malaria (0.97%). This variation of CFR as per the type of diseases was found with significant variation (p<0.001).So more emphasis should be given to more fatal disease like swine flue.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Abstract—Epidemiological study of Rivers State University of Science and Technology Port Harcourt, Nigeria was carried out to identify the morbidity pattern in the University community in order to establish the current health status and trends. This study utilized secondary morbidity data sourced from Health Services Department. Data on staff mortality were obtained from the Personnel/Establishment Division. Methods employed for data collection were health records survey and data collection sheets. Morbidity information required were date, sex, age, department, card number and diagnosis of each case. Information required for each mortality case was date, sex, age, department, salary level and the cause of death. Of all cases of morbidity, communicable diseases comprised 17.5%; non-communicable diseases 24.1%, generalized disease symptoms 55.2% and others 3.2%. The study revealed that the leading causes of morbidity in the University were fever/headache/cold (36.9%), hypertension (13.6%), generalized body pain (7.5%), abdominal pain/vomiting (6.7%) and diabetes (4.9%). Hypertension emerged the second major cause of morbidity among the staff and males had higher rate of morbidity compared to females. It was also concluded that although mortality was increasing with time but there was no sex wise significant difference in mortality trend. It was recommended among others that Diabetes Mellitus and Hypertension being silent killers should be monitored regularly within the University community. Also the current practice of manual data entry should be replaced with computerized data system for better health records management.
Test positivity – Evaluation of a new metric to assess epidemic dispersal med...Olutosin Ademola Otekunrin
Epidemic control may be hampered when the percentage of asymptomatic cases is high. Seeking remedies for this problem, test positivity was explored between the first 60 to 90 epidemic days in six countries that reported their first COVID-19 case between February and March 2020: Argentina, Bolivia, Chile, Cuba, Mexico, and Uruguay.
Test positivity (TP) is the percentage of test-positive individuals reported on a given day out of all individuals tested the same day. To generate both country-specific and multi-country information, this study was implemented in two stages. First, the epidemiologic data of the country infected last (Uruguay) were analyzed. If at
least one TP-related analysis yielded a statistically significant relationship, later assessments would investigate the six countries. The Uruguayan data indicated (i) a positive correlation between daily TP and daily new cases (r = 0.75); (ii) a negative correlation between TP and the number of tests conducted per million inhabitants (TPMI, r = 0.66); and (iii) three temporal stages, which differed from one another in both TP and TPMI medians (p < 0.01) and, together, revealed a negative relationship between TPMI and TP. No significant relationship
was found between TP and the number of active or recovered patients. The six countries showed a positive correlation between TP and the number of deaths/million inhabitants (DMI, r = 0.65, p < 0.01). With one exception –a country where isolation was not pursued , all countries showed a negative correlation between
TP and TPMI (r = 0.74). The temporal analysis of country-specific policies revealed four patterns, characterized by: (1) low TPMI and high DMI, (2) high TPMI and low DMI; (3) an intermediate pattern, and (4) high TPMI and
high DMI. Findings support the hypothesis that test positivity may guide epidemiologic policy-making, provided that policy-related factors are considered and high-resolution geographical data are utilized.
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
Life Style for Adult Patients with Hyperthyroidism at Baghdad Teaching Hospitaliosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Whilst breast cancer is a fatal disease affecting millions worldwide, identification and management of these patients did not initially attract critical attention to minimize the impact of lockdown, post-lockdown, and other measures. Breast cancer patients' conditions may not remain stable without proper care, worsening their prognosis. Proper care includes the timely instigation of surgery, systemic therapy, and psychological support. This includes low-and middle-income countries where there are already concerns with available personnel and medicines to adequately identify and treat these patients. Consequently, there was a need to summarize the current scenario regarding managing breast cancer care during COVID-19 across all countries, including any guidelines developed. We systematically searched three scientific databases and found 76 eligible articles covering the medical strategies of high-income countries versus LMICs. Typically, diagnostic facilities in hospitals were affected at the beginning of the pandemic following the lockdown and other measures. This resulted in more advanced-stage cancers being detected at initial presentation across countries, negatively impacting patient outcomes. Other than increased telemedicine, instigating neo-adjuvant endocrine therapy more often, reducing non-essential visits, and increasing the application of neo-adjuvant chemotherapy to meet the challenges, encouragingly, there was no other significant difference among patients in high-income versus LMICs. Numerous guidelines regarding patient management evolved during the pandemic to address the challenges posed by lockdowns and other measures, which were subsequently adopted by various high-income countries and LMICs to improve patient care. The psychological impact of COVID-19 and associated lockdown measures, especially during the peak of COVID-19 waves, and the subsequent effect on the patient's mental health must also be considered in this high-priority group. We will continue to monitor the situation to provide direction in future pandemics.
—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
Patients Knowledge and Attitude towards Tuberculosis in a Rural Setting in Al...inventionjournals
Introduction: Tuberculosis is a major cause of illness worldwide. The burden is rising globally due to poverty, increasing population and HIV/AIDS. In developing countries, poor knowledge and perception of tuberculosis is prevalent, which causes delay in diagnosis and treatment of tuberculosis..India has the highest number of TB cases in the world. Material and Methods: The present study was conducted in Rural Health Training Centre, Jawan, of Jawahar Lal Nehru Medical College,AMU, Aligarh .A semi structured questionnaire was used to collect data from January- March,2015. A total of 80 subjects ,more than 15 years age group,residents of Jawan,were selected who either had completed tuberculosis treatment or are still on treatment.An informed consent was taken,before starting the questionnaire. Results: shows that out of 80 subjects under study,50% were in age –group 35 to 55 years and 75 % were males. Radio/T.V. was the maximum source of information on tuberculosis (60%), followed by health workers or community workers(50%) .Few subjects got information about T.B. from family members and friends/neighbours. 87.5% of the subjects were aware of the evening rise of temperature inT.B., followed by blood in sputum(80%) and cough more than 3 weeks(42.5%).Regarding causes of T.B.,76.25% of the subjects said that T.B. was due to smoking, followed by alcohol consumption(42.5%). 85% of the subjects knew that T.B. was a communicable disease.70% of the subjects knew that the mode of transmission of T.B. was during coughing.50% of the subjects believed that tuberculosis could be transmitted by sharing of common materials with T.B. patients.70% of the subjects reported that BCG immunization prevented tuberculosis. More than half(55%) of the participants reported that the transmission of T.B. could be prevented by avoiding personal contact with the T.B. patient. Conclusion: The study showed that the knowledge of people relating to T.B. is insufficient in most of the aspects.TB awareness programs should focus on reduction of TB associated stigmas.We need to train our health workers and also educate our masses especially those living in rural areas
Occupational exposure to blood & body fluids among the nursing staff in a ter...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
CARDIOVASCULAR DISEASE
CARDIOVASCULAR DISEASE
Cardiovascular Disease
Introduction
Cardiovascular disease posits a major cause of premature deaths and disability throughout the world and contributes to a significant increase in healthcare costs, particularly in medication, healthcare services, and production loss. Specifically, heart diseases and stroke accommodate the highest prevalence rate in the USA; accommodate an average of 610,000 and 365,000 annual deaths from CVD (CDC, 2015). Similarly, every year, CVD causes the USA approximately, $207 billion for medication, healthcare services, and productivity loss. Noteworthy, heart diseases and stroke incidences vary with factors such as ethnicity, gender, age, and individuals with certain disorders. Similarly, the project accommodates notable articulations on intervention, comparison, outcome, and time as a fundamental consideration in heart diseases and stroke in the USA. Thus, an enriched articulation on heart diseases and stroke are underscoring for the project presentation.
Definition
According to (Mayo Clinic, 2018), Heart disease describes a condition that affects the heart; including blood vessels diseases arrhythmias, and other heart defects. Significantly, the heart disease is interchangeable for the CVD, articulating on the infections involving narrowed or blocked blood vessels, causing a heart attack, chest pain, and stroke, among other clinical presentations. Similarly, (Mayo Clinic, 2018) acknowledges that many CVD is preventable and treatable with healthy lifestyle choices.
Epidemiology
Cardiovascular diseases posits an undying cause of death in the USA, projected at 840, 678 deaths in 2016, averagely one in three deaths (Salim et al. 2020). Similarly, between 2013 and 2016 121.5 million adults Americans presented notable for of the CVD. Notably, between 2013 and 2015 direct and indirect costs of managing the CVD in the USA, recorded $213.8 billion and $137.4 billion respectively. Statistically, between 2013 and 2016, 57.1% of non-HN black females and 60.1% of non-HN black males presenting CVD manifestations (Salim et al. 2020). According to the researcher causes of the CVD Include atherosclerosis resulting from an unhealthy diet, lacking exercise, overweight, and smoking. In the epistemology studies, risk factors such as age, sex, family history, smoking, chemotherapy and radiation drugs, high blood pressure, poor diet, obesity, physical inactivity, stress, and poor hygiene are underscoring risk factors in the CVD (Mayo Clinic, 2018). Thus, heart disease epistemological indicates the patterns, causes, risk factors, and specific populations in the USA.
Clinical Presentations
Cardiovascular disease acclaims clinical presentations that may differ between men and women. According to (Mayo Clinic, 2018), men present significant chest pain that women and women clinical presentations such as shortness in breathing, nausea, and fatigue are more evident than in men. Admi ...
Similar to Age and Sex Profile of Tuberculosis cases and its association with treatment outcome (20)
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Age and Sex Profile of Tuberculosis cases and its association with treatment outcome
1. International Multispecialty Journal of Health (IMJH) [Vol-1, Issue-6, Aug.- 2015]
Page | 11
Age and Sex Profile of Tuberculosis cases and its association with
treatment outcome
Dr. Dilip Raj1
, Dr. Priyanka Kapoor 2
, Ms. Dia Sharma3
, Ms. Kirti Gera4
and Dr. Mukesh
Bhatnagar 5
1
Assistant Professor, Department of Community Medicine, SMS Medical College, Jaipur (Rajsthan) India
2
MD Student, Department of Community Medicine, SMS Medical College, Jaipur (Rajsthan) India
3,4
MBBS Students, SMS Medical College, Jaipur (Rajsthan) India
5
Senior Medical Officer, Department of TB and Chest, SMS Medical College, Jaipur (Rajsthan) India
Abstract— Tuberculosis affected mankind for over 5000 yrs and continue to be a major public health
problem. So to generate hypothesis about tuberculosis this study was conducted to study the profile of
tuberculosis cases attending at DTC Jaipur. A record based cross-sectional study of tuberculosis
patients attended at District Tuberculosis Centre, Jaipur were taken. Chi-square test was used to find
out association. It was found in this study that Cure Rate significantly varied with type of case, age and
sex of case. It was observed highest in cat.III and below 20 yrs of age. Defaulters were max. in Relapse
retreated cases and in elderly (>60 yrs.) cases whereas it was not affected significantly with age .
Failure Rate was highest in category I cases and significantly varied with age and sex. About 3/4th
of
total deaths were observed in Failure and Relapse retreated cases. Case Fatality Rate (CFR) showed
not significant variation with sex. So it can be concluded with this study that maximally affected age
group with tuberculosis is either children or 40-60 years with male predominance. Category III cases
are more easier to cured and Category II cases are most difficult to cured. Cure rate was lesser in 40-
60 years of age group and males. Defaulters and CFR were more in category II, 40-60 year of age
group and males. And Failure Rate was more in category I, 40-60 year of age group and males
Key words – DTC, Category, Cured Rate, Defaulters, Relapse, failure, CFR
1. Introduction
Tuberculosis is a disease caused by Mycobacterium Tuberculosis; has affected mankind for over 5000
yrs.1
and continue to be a major public health problem. It is leading cause of adult mortality ranking 3rd
after HIV/AIDS and IHD among aged 15-59 years.2
This age group is the group n which nation’s
economy depend on, so should take care of more.
India has highest TB burden of world accounting for approximately 1/5th
(20%) of Global T.B.
burden having.3
It has 1.8 million new TB cases per year with 0.8 million are new smear positive and
0.37 million people dies due to T.B. Prevalence of tuberculosis in India is 5.05%4
As per RNTCP target – Target for Cure Rate is more than 85% and target for Failure Rate,
Defaulter Rate and Relapse Rate are less than 5% for each category. But there is very varied response
from different parts of country about the targets.4-11
So to generate hypothesis about tuberculosis, this
study was conducted on tuberculosis patients attending at DTC Jaipur, which can help to understand
possible reasons for this varied response.
2. Methodology
A record based case-series type of observational study was carried out in District Tuberculosis Centre
(DTC) of Jaipur (Raj.). Sample size was calculated 120 subjects at 95% confidence and 1.5 absolute
allowable error assuming 5% prevalence of tuberculosis(4). But to have equal representation of each
2. International Multispecialty Journal of Health (IMJH) [Vol-1, Issue-6, Aug.- 2015]
Page | 12
category of cases, 30 cash sheets of tuberculosis patients were chosen randomly from each category of
cases came in year 2008. So total 120 case sheets of tuberculosis cases were included in the study.
Records of tuberculosis patents attended at DTC of year 2008 were reviewed. All the information about
tuberculosis patients with their outcome was recorded from their respective identified records. Cases
transfer out and cases having incomplete case sheets were excluded from study after counting. Socio-
demographic profile with clinical profile of these cases were found. Treatment outcome was observed as
Cured, Defaulter, Failure, Relapse and Death, transfer out cases were recorded but excluded from the
analysis.
Treatment outcome was assessed in the form of Cure Rate, Defaulter Rate, Failure Rate and
Case Fatality Rate. Category treatment regimen was accepted as per DOTs5
. To find out significance of
difference in proportion Chi-square test was used with the help of statistical software Primer (version 6)
and 'p' value <0.05 was considered significant.
3. Results
In this present study it was observed that out of total 120 tuberculosis patients maximum 59 (49.17%)
were in age group 20-40 year followed by 33.33% in <20 years, 14.17% in 40-60 years and only 3.33%
in <60 years (Fig. 1) with M:F ratio 5:3 (fig 2). Category II cases included 20 (i.e. 50%) Relapse cases,
15 (37.5%) defaulter cases and 5 (12.5%) Failure cases. (Fig 3) Out of total 120 cases, 52 (43.3% ) were
cured and 18 (15%) were died during treatment (Fig 4). Defaulter rate of these cases was 30% and
Failure rate was 8.3% (Fig 4).
Figure 1 Figure 2
Figure 3 Figure:4
< 20 20 - 40 40 -60 >60
40
59
17
4
Age wise Distribution of Tuberculosis
Cases (N=120)
Male
62.5%
Female
37.5%
Sex wise Distribution of
Tuberculosis Cases (N=120)
Defaulter
s
37.5%
Relapse
50%
Failure
12.5%
Type of cases in category II
Cure Rate
(%)
43.3%
Defaulter
rate
30%
Failure
Rate
8.3%
C F R
15%
Treatment Outcome of Tuberculosis
Patients (N=120)
3. International Multispecialty Journal of Health (IMJH) [Vol-1, Issue-6, Aug.- 2015]
Page | 13
When treatment outcome was assessed of these cases with its associates, it was found that cure
rate was maximum in category III cases i.e. 60% followed by category I and category II cases. This
variation in all the treatment outcomes assessed i.e. Cure Rate, Failure Rate and CFR was found
significant (p>0.05) except for Defaulter Rate. (Table 1)
Table 1
Treatment Outcome of Tuberculosis cases and its Associations (N=120)
Total Cases Cure Rate (%) Defaulter rate (%) Failure Rate
(%)
CFR (%)
Type of Cases
Cat I 40 42.2 30 12.5 15
Cat II 40 27.5 42.5 7.5 22.5
Defaulter 15 26.6 30 6.6 33.3
Relapse 20 30 50 10 10
Failure 5 20 40 0 40
Cat III 40 60 35 2.5 2.5
X2
Value at2 DF 20.959 3.733 6.793 17.177
P Value LS <0.001 S 0.155 NS 0.033 S <0.001 S
Age – Groups
<20 40 62.5 15 7.5 15
20-40 59 37 40.6 8.4 13.5
40-60 17 23.4 41.2 11.7 23.4
>60 4 25 75 0 0
X2
Value at 3DF 43.586 74.092 11.674 24.226
P Value LS <0.001 S <0.001 S 0.011 S <0.001 S
Sex-wise
Male 75 34.6 34.8 11.6 17.3
Female 45 57.8 28.9 2.2 11.1
X2
Value at 1DF 9.728 0.574 6.221 1.038
P Value LS 0.002 S 0.448 NS 0.013 S 0.308 NS
4. International Multispecialty Journal of Health (IMJH) [Vol-1, Issue-6, Aug.- 2015]
Page | 14
When treatment outcome among category II was observed, it was found that Cure rate was
minimum (20%) in failure cases followed by defaulter and Relapse cases and CFR was found maximum
(40%) in failure cases followed by defaulter and relapse cases. But Defaulter Rate and failure rate were
found maximum in relapse cases than defaulter and failure cases. This variation of proportion of
defaulter, relapse and failure cases was found significant for Defaulter Rate (Chi-square = 8.333 with
2 degrees of freedom; P = 0.016), Failure Rate (Chi-square = 9.852 with 2 degrees of freedom; P =
0.007) and Case Fatality Rate (Chi-square = 24.618 with 2 degrees of freedom; P <0.001) but not
found significant for Cure Rate (Chi-square = 2.760 with 2 degrees of freedom; P = 0.252). (Table 1)
When treatment outcome was observed as per age, it was found that Cure rate was maximum
(62.5%) in <20 years of age followed by in 20-40 years, >60 years and 40-60 years of age group.
Likewise Defaulter Rate, failure rate and CFR were found maximum in 40-60 years of age group. This
variation was found significant for all the treatment outcomes studied i.e. Cure Rate (43.586 with 3
degrees of freedom; P <0.001), Defaulter Rate (Chi-square = 74.092 with 3 degrees of freedom;
P<0.001), Failure Rate (Chi-square = 11.674 with 3 degrees of freedom; P = 0.011) and Case Fatality
Rate (Chi-square = 24.226 with 3 degrees of freedom; P<0.001). (Table 1)
When sex wise variation was observed in treatment outcome of cases, it was revealed that Cure
rate was higher in females and Defaulter Rate, failure rate and CFR were found higher in males than
females. Although this variation was found significant for Cure Rate (Chi-square = 9.728 with 1
degree of freedom; P = 0.002) and Failure Rate 9 Chi-square = 6.221 with 1 degree of freedom; P =
0.013) but not for Defaulter Rate (Chi-square = 0.574 with 1 degrees of freedom; P=0.448) and Case
Fatality Rate (Chi-square = 1.038 with 1 degree of freedom; P = 0.308). (Table 1)
4. Discussion:
In this present study maximum (49.17%) were in age group 20-40 year followed by <20 years, 40-60
years and <60 years. This study found M:F ratio 5:3. It is quoted in many studies that tuberculosis affect
mainly the age group (20-60 years) on which the others are depend upon. It was also reported that
tuberculosis is found predominantly in males. So observations of these studies are well comparable to
other authors.
In this study among Category II cases half of cases were Relapse cases and other half includes
defaulter cases (37.5%) and failure cases i.e. (37.5%) and (12.5%) respectively. Whereas
Cure Rate in this study was observed 43.3% whereas in majority of studies it is shown very high
ranging from 53.8% to 91%.4,8,9,12
In the present study it was observed less may be because of equal
number of category II cases were included in this study which is higher in proportion than that in other
studies, which was further supported with the fact that cure Rate was observed minimum in category II.
Other studies also reported Cure Rate minimum in category II. 4,6,8,,10
These observations were further
supported with finding of R.K. Mehra etall who reported Cure Rate 87.9%,76.4% and 48.8% in category
I, Relapse and Failure cases respectively.7
Vijay etall also observed only 39.8% Cure Rate in category
II.10
K etall14 reported Cure rate among Category I was calculated to be 61.7% (37/60). These findings
were also well in resonance with observations of present study in this regards.
Cure Rate in this present study was (62.5%) in <20 years of age followed by in 20-40 years, >60
years and 40-60 years of age group. This may be because of the reason that < 20 years age group is
under observation of their parents who are more worried about their children. It was found minimum in
40-60 years age group, who are more relaxant about their health. This fact is well supported with the
finding that Defaulter Rate, failure rate and CFR were found maximum in 40-60 years of age group.
And further supported that higher Cure Rate in females, who are supposed to be more sincere. In the
5. International Multispecialty Journal of Health (IMJH) [Vol-1, Issue-6, Aug.- 2015]
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present study overall Defaulter Rate was observed 30% which was well comparable to observations of
Vijay etall10
however Annual status report of RNTCP (2009) reported Defaulter Rate 6% India and 5%
in Rajasthan respectively.4
This Defaulter rate was not found to be associated with category of cases but
found significantly more in 40-60 years age group and in males. It may be because this group has their
other priorities in this age group.
Failure Rate was observed 8.3% in the present study which is near to observations of Vijay etall
(5.2%)11
, but was quite higher than observed by RNTCP Annual Report 2009 (2%) and other authors
studies. 4,8,9,10
Surprisingly higher Failure Rate was found in category I in present study however other
studies4,6,9
reported higher failure Rate in category II. Likewise defaulters Failure rate was also found
significantly higher in 40-60 year age group and males.
Case Fatality Rate in present study was observed 15% which was quite higher observed by
RNTCP annual Status Report4
(4% in India and 3.6% in Rajasthan) and Vijay etall11
who observed
2.2% CFR in their study. Even Karanjekar etall13
also reported lesser CFR (5%) in their study. Although
CFR not found with significant variation as per sex but found significantly more in category II and age
group 40-60 years than other counterparts. These observations regarding CFR as per category of cases
were well in resonance with RNTCP annual Status Report4
observed maximum CFR was in Failure
cases and minimum in category III.
CONCLUSIONS
Maximally affected age group with tuberculosis is either children or 40-60 years with male
predominance. Category III cases are more easier to cured than others and Category II cases are most
difficult to cured. Cure rate is less in 40-60 years of age group and males. Defaulters and CFR were
more in category II, 40-60 year of age group and males. And Failure Rate was more in category I, 40-60
year of age group and males
REFERENCES
1. TB India 2008 RNTCP Status Report
2. WHO, World Health Status 2008 : Geneva 2008
3. WHO Global Report 2008
4. RNTCP Annual Status Report 2009
5. RNTCP at a Glance: Central TB Division, Ministry of Health and Family Wellfare, Nirman
Bhawan, New Delhi, 110011 http://tbcindia.nic.in/pdfs/RNTCP%20at%20a%20Glanc
6. R.K. Mehra, V.K. Dhingra etall. “Study of Relapse and Failure cases of category I re-treated with
Category II under RNTCP – An 11 Years follow-up” Indian Jn. Of Tuberculosis 2008, 55, 188-191
7. Momd. Akhtar, Rakesh Bhargava etall. “ To Study Effectiveness of DOTS at J. N. Medical College,
Aligarh.” Lung India – 2007, vol. 24, issue 4, 128-131
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Cohort Study.” Indian Jn. Of Tuberculosis 2000, 47, 155
9. TB India 2005 – RNTCP Status Report Central TB Division DGHS MOHFW N. Delhi.
10. Vijay, Sophia etall. “ Re-Treatment Outcome of Smear Positive Tuberculosis Cases under DOTs in
Bangalore City” Indian Jn. Of Tuberculosis 2005, 49, 195
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11. Vijay, Sophia etall. “Treatment Outcome and Two and half Year Follow-up of New Smear positive
patients treated in RNTCP.” Indian Jn. Of Tuberculosis, 55 199-208
12. Sukmai Bisnoi, Amitabh Sarkar etall. “A Study of Performance Response and Outcome of treatment
under RNTCP in Tuberculosis Unit of Howrah District, West Bengal.” Indian Jn. Of Community
Medicine (2007), vol. 32 , Issue 4, 245-248
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Outcome and Follow-up of Tuberculosis Patients Put on Directly Observed Treatment Short-course
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