Impact of Digital Health Education among Patients with Type 2 Diabetes Mellitus

Background: Effective delivery of health education is critical to achieving the goal of controlled diabetes. The objective was to assess the impact of health education among patients with Type 2 Diabetes mellitus. Materials and Methods: This study was quasi-experimental done with type 2 diabetes mellitus of tertiary care hospital.100 diabetes patients were included and randomized into two groups to receive health education material and standard care. The intervention consisted of health education intervention via text messages and images. The glycemic parameters were assessed before and at the end of 3 months of intervention. Paired t-tests were applied. Results: Mean (SD) of HbA1c before the start of the intervention among the patients with intervention and control arm were 10.1(�9) and10.6 (�3) respectively. There was a significant difference in FBS, PPBS and HbA1c- (198(�) vs 112(�, 277(�) vs 151(�) and 10.1(�9) vs 7.2(�9) in the intervention group before and after the intervention (p-value <0.05).No significant difference was found in the control arm. Conclusion: There was a significant difference in the group that received health education intervention compared to the standard therapy group. Thus, well-designed health education delivery could maintain better glycemic control in patients with uncomplicated type 2 diabetes mellitus. ============================================ This retrospective, observational study was conducted by collecting data from medical records during COVID 19 pandemic from March 2020 till August 2020. This was compared with the data of 2019 during similar months. The impact of COVID 19 on use of preventive and curative paediatric health care service units like outpatient department, casualty, intensive care and immunization clinic were assessed. Data from 2019 to 2020 were compared using standard parametric and nonparametric tests. There was a significant decline in routine OPD (68%) attendance during the COVID 19 period as compared to pre-COVID period. Paediatric ward admissions and PICU admissions were decreased by 55% and 42% respectively. We also observed a significant 43% decline in the number of children attending immunization clinic in the year 2020. The fear of COVID 19 pandemic and the measures taken to control the pandemic has affected the health seeking behaviour of patients. This evaluation of trends in healthcare use may help in planning the delivery of healthcare service delivery in future.

Investigation of polycyclic aromatic hydrocarbons (PAHs) in soil at Agra, India--a case study.

Polycyclic Aromatic Hydrocarbons (PAHs) are released into the environment from anthropogenic sources, such as combustion of fossil fuels, refused burning, industrial processes and motor vehicle exhausts. The concentration of PAHs in roadside soil was measured at St. John's crossing, which lies in the centre of Agra city and exposed to heavy traffic. The samples were extracted with hexane by ultrasonic agitation. The extracts were then fractioned on a silica-gel column and the aromatic fraction was subjected to HPLC for analysis of 16 priority PAH pollutants specified by environment protection agency (EPA). Total mean concentration of PAHs was found to be 15.29 microg g(-1) and it ranged from 6.72-25.91 microg g(-1). Fluoranthene, chrysene, benzo(b)fluoranthene and benzo(ghi)perylene were found to be the most abundant PAHs at this location.

Unicondylar Knee Arthroplasty Using Minimally Invasive Surgical Technique

PURPOSE: To evaluate the results of unicondylar knee arthroplasties using minimally invasive surgical(MIS) technique. MATERIALS AND METHODS: During the years 2000 and 2001, 195 unicondylar knee arthroplasties were completed by senior author with the Miller-Galante prosthesis(Zimmer, Warsaw, IN, USA). We analyzed clinical results, flexion/extension gap laxity and the radiological findings. RESULTS: The average preoperative range of motion(ROM) was 122 degrees. At the first follow-up appointment after the surgery, the average ROM was 111 degrees and it was improved to 130.1 degrees at 1-year follow up. The preoperative hospital for special surgery score was 53.8 and it was improved 92.4 postoperatively. The average extension gap for all of the surgeries was 1.47 mm and the flexion gap was 1.82 mm. The average correction of overall alignment on the follow-up x-rays was 3.9 degrees for the varus knees. The x-rays showed an increase of distal femoral valgus angle(1.79 degrees ) with 6 mm cut than with the 8mm cut(0.37 degrees ). The average proximal tibial varus angle was decreased from 5.45 degrees to 2.11 degrees and the average posterior slope of proximal tibia was decreased from 7.2 degrees to 4.5 degrees . CONCLUSION: Unicondylar knee arthroplasty by MIS technique guarantees early recovery and satisfactory radiological results. Therefore, long term follow-up evaluation is necessary.

Auto-Transfusion in Total Knee Arthroplasty

PURPOSE: The purposes of this study are to see how much the auto-transfusion reduce the need for allo- genic blood transfusion and to ascertain whether transfusion affects the incidence of deep vein thrombo- sis(DVT) in primary total knee arthroplasty(TKA). MATERIALS AND METHODS: A retrospective analysis of 263 consecutive patients who had had a primary TKA was performed. The operations included 165 unilateral and 98 one-stage bilateral cases. The predeposit autologous blood donated 1pint for the unilateral cases and 2pints for bilateral cases preoperatively. Intraoperative salvage of blood was performed using the cell saver system. The collected data from the patients charts(the estimated blood loss and the amount of transfusion) were statistically analysed to examine relationships between development of DVT and the loss of blood or transfusion. RESULTS: We excluded the data of the patients who needed to be transfused over 6pints. For the unilateral cases, the average estimated loss of blood was 307+/-150cc(50~1000), the average amount of transfusion was 1.5+/-0.8 pint(0~5), and the average amount of blood that was salvaged through cell saver system was 210+/-141 cc(0~660). Adding the autologous donation(400cc), auto-transfusion was up to 100% of the average amount of transfusion. For the one-stage bilateral cases, the average estimated loss of blood was 678+/-267cc(100~1400), the average amount of transfusion was 3.0+/-0.9 pint(1~5), and the average amount of blood that was salvaged through cell saver system was 524+/-279cc(125~1125), Adding the autologous donation(800cc), auto-transfusion was up to 100% of the average amount of transfusion. There were no statistical associations between DYT and the loss of blood or transfusion(p>0.05). CONCLUSION: Combining preoperative autologous blood donation with intraoperative salvage effectively reduces the need for allogenic blood transfusion in primary TKA.