Awareness about disaster management among accredited social health activists in field practice area of a medical college in Mysuru

Background: The changing global climate due to human influences is leading to a greater incidence of extreme weather events and natural disasters. The natural and man-made disasters have a great impact on physical and mental health and health system. Disaster preparedness is therefore important at all levels of the health system. Being the first contact of the health system to the communities, accredited social health workers have a great role in managing the disasters at the village level. This study attempts to assess the awareness regarding disaster management among accredited social health activists (ASHAs) in the field practice area of J.S.S. Medical College in Mysuru, Karnataka.Methods: A community-based cross-sectional study was conducted for one month in July 2019. A total of 40 ASHAs were assessed by direct interview method using a pre-structured, validated questionnaire. The data were entered into the Microsoft Excel spreadsheet and analyzed using SPPS version 22.Results: The median years of experience of ASHAs were 10 years (interquartile range: 5.75-10) with a minimum and maximum experience of 2 and 10 years respectively. None of the study participants had received any trainings or mock drills for disaster management/ preparedness. The awareness about disaster management was low among the ASHAs assessed. Most of the ASHAs (92.5%) had average knowledge about disaster management while 7.5% had only poor knowledge.Conclusions: The awareness about disaster management among ASHAs is very poor. We recommend training programs and mock drills for the frontline health workers to improve awareness and disaster preparedness.

Dosimetric analysis and clinical outcomes of brachial plexus as an organ-at-risk in head-and-neck cancer patients treated with intensity-modulated radiotherapy

Objectives: To document the dose received by brachial plexus (BP) in patients treated with intensity-modulated radiotherapy (IMRT) for head-and-neck squamous cell carcinoma (HNSCC) and report the incidence of brachial plexopathy. Methods: Newly diagnosed patients of HNSCC treated with radical or adjuvant IMRT were included in this retrospective study. No dosimetric constraints were applied for BP maximum dose equivalent dose (EQD2 α/β = 3). Patients with minimum 6-month follow-up were included and patients with suspicion of plexopathy were evaluated further. Results: Sixty-seven patients were eligible and 127 BP were analyzed. The mean BP maximum dose (BPmax) was 62.4 Gy (+6.9), while mean BP volume was 28.1 cc (+4.1). Proportion of patients receiving BPmax >66 and >70 Gy were 34.7% and 14.2%. The mean BPmax for T4 tumors was significantly higher than T1 tumors (65 vs. 57.5 Gy, P = 0.005) but when adjusted for N-category, T-category was not independently significant in accounting for BPmax >66 or >70 Gy. Mean BPmax for N0 versus N2+ was 59.8 versus 65.6 Gy (P = 0.0001) and N1 versus N2+ was 61.6 versus 65.6 Gy (P = 0.018). After adjusting for T-category, patients with N2+ had a mean 4.2 Gy higher BPmax than N0-N1 (P = 0.0001). Stage III–IV patients had a mean six Gy higher BPmax doses than Stage I–II disease (P = 0.0001). With a median follow-up of 28 months (interquartile range 16–42), no patient had brachial plexopathy. Conclusion: Clinically significant plexopathy was not seen in spite of majority having over 2-years follow-up and a third of patients having dose above the recommended tolerance. Only nodal category independently influenced dose to the brachial plexii

Rare Origin of Accessory Left Gastric Artery from Splenic Artery and Its Clinical Significance: A Case Report

During routine dissection of abdomen an accessory leftgastric artery was found arising from the splenic arteryin one out of 30 adult formalin fixed cadavers in theDepartment of Anatomy, Kasturba Medical CollegeManipal. The origin of left gastric artery was normal.The accessory artery was running upwards behind usualleft gastric artery and run along lesser curvature of thestomach and also gave oesophageal branch supplyingthe lower part of esophagus. Before attempting anysurgical procedure on stomach or lower end ofoesophagus, preoperative evaluation of the arterialpattern and variations is desirable for correct surgicalapproach and to reduce postoperative complications.However, accessory left gastric origin from splenicartery becomes important to be noted when the patientundergoes angiography for diagnostic bleeding orduring trans catheter therapy. Knowledge about thesevariations is also important to be noted prior to surgeryin order to prevent postoperative complications whichwould be fatal.

A study of clinical/biological markers of exacerbation/progression in a cohort of patients admitted with acute excerbation of COPD

Background:Exacerbations of chronic obstructive pulmonary disease increases the morbidity, hospital admissions, mortality, and strongly influence health-related quality of life. The aims of this study to know the Clinical profile of COPD and acute exacerbation, Role of clinical markers in diagnosis and follow up of exacerbation.Methods: A prospective study of a cohort of 60 patients hospitalized for AECOPD was undertaken to identify markers for frequent exacerbation and progression of disease. Advised to fill the SGRQ questionnaire, At the time of discharge 6MWT done and analyzed. C Reactive protein levels at the time of admission done and analyzed. Sputum grams stain culture, total counts and differential counts done and analyzed. At the time of discharge spirometry done both pre and post bronchodilators by using asthalin inhaler with or without spacer, results were analyzed.Results:There was statistically significant drop in the SPO2 levels in frequent exacerbators over 6 months follow up time. There was statistically significant elevation of sputum Neutrophil counts in frequent exacerbators and Eosinophil counts in infrequent exacerbators, there was a drop in the CRP levels of from the time of initial exacerbation to 6 months follow up time. There was statistically significant drop in FEV1 in frequent exacerbators over 6 months follow up study. The drop of 6MWT was more in patients, who had frequent exacerbations.Conclusions:Patients with more frequent exacerbation have more symptoms, drop in the saturation level and have more sputum neutrophil counts. Patients with more frequent exacerbations will have more deterioration of lung functions (FEV1.6MWT).

[LAMP assay for rapid diagnosis of cow DNA in goat milk and meat samples]

Animal species detection is one of the crucial steps for consumer's food analysis. In the present study we developed an in-house built loop-mediated isothermal amplification [LAMP] assay for rapid detection of adulterated cow DNA in goat milk/meat samples. The cow milk/tissue DNA in goat milk/meat samples were identified in the developed LAMP assay by either naked eye visualizing with SYBR Green I dyes or by detecting the typical ladder pattern on gel electrophoresis. This test can detect up to minimum 5% level of cow components admixed in goat milk/meat samples and can be completed within 1 h 40 min starting from DNA extraction from milk/meat samples and can be performed in a water bath. Developed LAMP methodology is simple; rapid and sensitive techniques that can detect adulterant like cow components in goat milk/meat are more accurate than other existing DNA based technologies

Variant inferior root of ansa cervicalis / Variación de la raíz inferior del asa cervical

Ansa cervicalis is a loop of nerves found in the anterior wall of the carotid sheath in the carotid triangle of neck innervating infrahyoid muscles. Its superior root has fibres from the first cervical nerve that leaves the hypoglossal nerve and joins the inferior root formed by the branches from the second and third cervical nerves. The two roots join to form ansa cervicalis. The ansa cervicalis nerve formation is relatively complex, as its course and location along the great vessels of the neck vary. In the present case on the left side of an adult male cadaver the inferior root was absent and the contributions from C2 and C3 were joining independently with the superior root of ansa to form ansa cervicalis. However no such variation was found in the ansa cervicalis formation on the right side.

El asa cervical es un loop de nervios que se encuentra en la pared anterior de la vaina carotídea, en el triángulo carotídeo del cuello, que inerva los músculos infrahioideos. Su raíz superior tiene fibras del primer nervio cervical que sale del nervio hipogloso y se une a la raíz inferior formada por las ramas de los nervios cervicales segundo y tercero. Las dos raíces se unen para formar el asa cervical. La formación del asa cervical del nervio es relativamente compleja, ya que su curso y ubicación varía a lo largo de los grandes vasos del cuello. En el lado izquierdo del cuello de un cadáver adulto de sexo masculino, la raíz inferior del asa cervical estaba ausente y las contribuciones de los ramos de C2 y C3 se unieron, de forma independiente, con la raíz superior del asa y así formar el loop.

Correspondence between vocal intensity and listeners' estimation of perceived nasality in cleft palate speech

A relationship often superseded in the management of individuals with cleft lip and/or palate is the association between phonatory features and deviant resonance. This study was aimed [1] to explore a relationship between loudness of voice [phonatory feature] and nasality [defiant resonance] and [2] to quantify the correlation between intensity and perceived nasality in the utterances of individuals with repaired cleft lip and palate. The experiment was conducted in two stages. The first stage involved eight subjects with repaired cleft lip and palate producing sustained vowels /a/, /i/ and /u/ in isolation and two sentences comprising three meaningful bisyllabic words in Tamil. Sentence 1 was loaded with non-nasal sounds and sentence 2 with nasal consonants. The subjects produced these at four different loudness levels viz, loud, normal, soft, and whisper. Stage 2 involved fifteen listeners [undergraduate students in Speech and Hearing], who were required to rate the degree of perceived nasality of the speech samples obtained at the different loudness level in Stage 1. They were provided with a 5-point equal appearing interval-rating scale ranging from hyponasality to severe hypernasality. Results indicated maximum nasality was perceived while the subjects produced voices of loud intensity. This is discussed with reference to findings from the literature and its practical implications

Acute appendicitis in Kuwait

Three hundred cases of appendicitis were analysed for age, sex nationality, clinicopathological presentation, postoperative complications and sepsis. The peak age of the subjects was in the third decade, and the male: female ratio was 3:1. Only 24% of patients were Kuwaiti [Kuwait is a very cosmopolitan community]. Diagnosis was based upon pain and tenderness in all the patients. Rectal examination was done in 21.7%. The normal appendicectomy rate was 12.7%, and the perforation rate 14%. Peroperative surgeon's sensitivity, specificity and accuracy of diagnosis was studied; surgeon's specificity was found to be only 47.4%. Overall, postoperative complications were seen in 36.3% of the patients. The relationship between sepsis and pathological findings and peritoneal reaction is discussed