ABSTRACT
Background: Worldwide stroke is accounted as the second leading cause of death and third cause of disability. Changes in physiological variables such as temperature, blood pressure, blood glucose levels, and their deleterious effect in terms of mortality and morbidity are of major concerns for the treating physicians. Aim and Objectives: The aim of the study was to study changes in temperature and its relation to 7th day outcome in acute stroke patient. Materials and Methods: A prospective hospital-based study was conducted, after approval of Institutional Ethical committee, recruiting 150 acute stroke patients presenting within 6 h of developing symptoms. Temperature was recorded every 8 h for 48 h and stroke severity was assessed using modified Rankin scale on admission and on the 7th day after admission. Results: Categorical variables were analyzed using Chi-square analysis and means of continuous variables were compared using analysis of variance. For any significant difference in mean temperature at two consecutive readings, paired sample t-test was used. Multinomial logistic regression analysis was done to predict outcome in acute stroke patients. The difference in the mean temperature at 8 h, 16 h and 40 h after admission was significant between male and female patients. Temperature at 16th h of admission was found to be significant for improved, status quo, and worsened comparison. Temperature at 24th h of admission was also found to have significant value but only for status quo and worsened outcome. Conclusion: The authors conclude that the mean temperature of the patients remained within the normal range in the first 48 h. The temperature at various intervals may not consistently predict the 7th day outcome in acute stroke patients.
ABSTRACT
Background: The female reproductive cycle encompasses various physiological phenomenon and menstruation being one such is associated with various problems affecting the quality of life. Premenstrual syndrome (PMS) is one of them. Body mass index (BMI) is considered a modifiable risk factor for PMS and is also related to the age at menarche. Aim and Objectives: To determine the correlation of BMI with PMS and the age of onset of menarche among medical students. Materials and Methods: The cross-sectional study was conducted at a Medical College at Gangtok, among 100 consenting participants after obtaining due permission from the Institutional Ethics Committee. Apart from demographic details, height and weight were recorded along with age of onset of menarche. The presence or absence of PMS was evaluated using Calendar of Premenstrual experiences, a self-reported dairy measure of PMS developed by Mortola et al. Results: Mean age of participants was 20.7 years and at mean age of 12.5 years they attained menarche. Girls who had either low or high BMI attained menarche at a higher age, but the difference was not significant (P = 0.142). Association between PMS and BMI was poor (0.027, P = 0.869). The correlation analysis found a poor negative correlation (?0.052, P = 0.606) between BMI and age at menarche. The correlation between age at menarche and the presence of PMS was positive (0.182, P = 0.07). Conclusion: PMS was seen in 53% of the study population, but only 24% had a high BMI. Deviated BMI from normal had menarche at a higher age and there was a poor correlation between the BMI and PMS.
ABSTRACT
Children with asthma often lack the strength to activate their pressurised metered dose inhaler (pMDI). A recently developed sleeve device that attaches to a pMDI reduces the activation force of pMDIs from 36 - 39 Newtons (N) to 12.6 N and monitors the remaining doses with a built-in counter. Objectives. To examine the usability and patient experience of the Easy Squeezy (ES) sleeve attachment device in the paediatric patient population. Methods. This cross-over study included 40 participants aged 5 - 10 years, half of whom had previous experience in using a pMDI. The experienced participants had used a pMDI for at least 1 year, and the inexperienced participants had no experience of using a pMDI. Participants and their parents recorded their responses on the ease of use, perceptions and satisfaction with using the pMDI alone and the pMDI with the ES. Results. The participants felt that it was easier for them to activate the pMDI using the ES. They liked the ES device more than the pMDI and felt happier using the ES device. The parents reported that their children would be happier using the ES and would find it easier to activate the pMDI using the ES, that the built-in counter in the ES would make it easier to keep track of the doses, and that their children would be more likely to take the ES to school and use it there compared with the pMDI. They would recommend the ES to other parents and were willing to buy the device with their own money. Conclusion. The paediatric participants and their parents reported that the ES made it easier for children to activate the pMDI, that the counter made it easier to keep count of the doses, and that the aesthetics of the ES could potentially remove the stigma attached to use of a pMDI
Subject(s)
Humans , Nebulizers and Vaporizers , User-Centered Design , Metered Dose Inhalers , Performance-Enhancing SubstancesABSTRACT
Success for maximum isolation of anaerobes depends on maintaining critically low oxygen levels throughout and growth in a reduced medium with exclusion of inhibitory substances. Hence a dual system was used equipped with candle combustion for instant exhaustion of major part of oxygen from a sealed jar, along with acidified steel wool for residual oxygen purging. For inhibitory substances removal, test anaerobes were grown on anaerobic medium layered on buffer charcoal agar bed. After 48 hours incubation average colony sizes were compared with that of growths in conventional Gas-Pak system. Better growths were noted in the innovative system.
ABSTRACT
Background: Traditionally, enteric feeds are withheld for a period of 48-72 hrs, sometimes even more following enteric anastomosis depending upon return of full peristaltic sounds. This results in a period of nonstimulation of gut –‘Gut Rest’, which was supposed to result in better anastomotic healing. But this same also deprives the intestinal mucosa of surface nutrients as well as prolongs parenteral fluid therapy, thereby depriving the patients of adequate nutrition. Along with it, prolonged parenteral therapy also keeps the patients bound to bed with its resultant complications like, prolonged hospital stay and increased cost of therapy. Objectives: To compare the benefits of early enteral feeding over conventional enteric feeding following enteric anastomosis with special regards to patients recovery and complications. Methods and materials: The selection of patients into group A (60) and group B (60) was done after having fulfilled inclusion and exclusion criteria. Informed consent was obtained. The patients of group A were fed via enteral route within 24 hrs of enteric anastomosis. The patients of group B were fed via enteral route after 48-72 hrs or appearance of full peristaltic sounds following enteric anastomosis. These patients were followed in post operative period for their drain output, any nausea, vomiting or significant abdominal distension, prolonged ileus, post operative duration of shospital stay, post operative infective complications (e.g. wound infection, UTI, RTI), and different haematological and biochemical examinations. Results: This study shows that post operative nausea-vomiting, anastomotic leakage rate, re-exploration , wound infection and RTI rates are higher in group A than those of group B. In this study, the incidence of UTI in post operative period is higher in group B. But the differences in above mentioned variables are not statistically significant. Whereas appearance of intestinal peristaltic sound is earlier in group A (42.8 ± 10.68 hours) compare to that of group B (52.6 ± 13.46 hours). Here, the difference is statistically significant (p value = 0.000022) The duration of post operative hospital stay is shorter in group A (8.45 ± 5.143 days) than that of group B (10.533 ± 4.952 days). The difference of duration post operative hospital stay is statistically significant (p value = 0.0257). Removal of nasogastric tube, resumption of oral feeding, and passage of first flatus and/or defecation were earlier in the group A than that of the group B; the differences were statistically significant. The post operative day-5 albumin level is better in group A (3.147 ± 0.4409 gm/dl) than that of group B (2.935 ± 0.3124 gm/dl). This difference is also statistically significant (p value = 0.0029). There are three mortalities in group Awhereas one mortality in group B. This difference in mortality in two groups is not statistically significant.
ABSTRACT
Effects of daily (one hour prior to onset of darkness) injection of melatonin (25 micrograms/100 g body wt. for 30 days) on concentrations of blood glucose and adrenal catecholamines were studied in adult male roseringed parakeets, P. krameri under both natural (NP; about 12L:12D) and artificial long (LP; 16L:8D; lights were available in between 0600 and 2200 hrs) or short (SP; 8L:16D; lights were available between 0600 and 1400 hrs) photoperiodic conditions. The results indicate that neither LP, nor SP as such exerts any significant effect on blood glucose titre of control (vehicle of hormone administered) birds. Treatment with melatonin, however, induced hyperglycemia in both NP and LP bird groups, but hypoglycemia in SP birds. Unlike glycemic levels, amount of epinephrine (E) and norepinephrine (NE) in adrenals of control birds exhibited significant changes under altered photoperiods. A decrease in E and an increase in NE were noted in adrenals of both LP and SP birds. Exogenous melatonin in NP birds also caused a decrease in E and concomittant rise in NE levels. On the other hand, treatment of melatonin in both LP and SP bird groups resulted in an increase in the quantity of both E and NE compared to respective values in adrenals of melatonin injected NP birds. However, relative to the amount of E and NE in adrenals of placebo treated LP and SP birds, significant effect of melatonin treatment was observed only in SP birds. The results suggest that influences of exogenous melatonin on the levels of both blood glucose and adrenal catecholamines are largely modulated by short rather than long photoperiods.