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Introduction:Veno-arterial extracorporeal membrane oxygenation (ECMO) is well-recognized treatment modality for patients with refractory cardiogenic shock. Uncomplicated cannulation is a prerequisite and basis for achieving a successful outcome in ECMO. Vascular access is obtained either by surgical cut-down. Common vascular access complications are bleeding and limb ischemia. Objective: To evaluate cannulation technique, the incidence of vascular complications, and their impact on the outcome. Methods: A retrospective data analysis conducted on 95 patients receiving ECMO from 2013 to 2020 was done. The patients were divided into two groups: no vascular access complications (non-VAC group) and vascular access complications (VAC group). The groups were compared related to the hospital and ICU stays and blood transfusion. Results: The patients in both groups were demographically and clinically comparable. The Non-VAC group had 75 patients, whereas the VAC group had a total of 20 patients. The main complication observed in the VAC group was bleeding from the cannulation site which required more blood transfusion than the non-VAC group (6.8 ± 1.02 vs 4.2 ± 1.26). Limb ischemia was another complication seen in the VAC group (4.2%, n = 4). Two patients had delayed bleeding after decannulation. The overall average length of stay in the hospital was statistically similar in both the groups (22 days in the VAC group vs 18 days in the non-VAC group), but the average ICU stay was more in the VAC group compared to the non-VAC group (18 days vs 12.06 days). Conclusion: Bleeding and limb ischemia are the important vascular access site complications, which increase blood transfusion requirements, ICU stay, and overall hospital stay.
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Background: Positive attitude towards menopause is believed to be associated with positive menopausal experience and vice versa. In order to improve women’s menopausal experience, thereby improving quality of life, it is important to understand their attitude towards menopause. The objectives of the research were to explore the attitude towards menopause and its relationship with various socio-demographic and life style factors among postmenopausal woman in the rural setting.Methods: This community-based cross sectional study was conducted using non probability sampling and house-to-house visit in randomly selected villages falling under rural health block Kot-Bhalwal, Jammu. 245 postmenopausal women were interviewed using modified attitude towards menopause checklist. The data so collected was analyzed using Open Epi version 3.1. For finding statistical significance, unpaired t-test and analysis of variance were used wherever needed. A p value of less than 0.05 was considered statistically significant.Results: The highest percentage of agreement with the positive item was for “a woman gets more confidence in herself after menopause” (77%). The lowest percentage of agreement with the positive item was for “going through menopause really does not change a woman in any important way,” (42.5%). There was a statistically significant mean difference between mean attitude score and religion, and no. of living children (F value=3.14, p value=0.002). No significant association was found between other sociodemographic variables and attitude towards menopause scores.Conclusions: There is a large scope of counseling and health education for improving and enhancing quality of life of postmenopausal women in rural setting of our country.
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Background: Fired clay bricks, an important construction material, are manufactured in non-mechanized, labour intensive brick kilns which mostly employ unskilled men and women. The workers, as an occupational hazard, are exposed to dust and air pollution leading to respiratory diseases.Methods: This cross sectional study was conducted among brick kiln workers in RS Pura block of Jammu district. The workers were assessed regarding respiratory symptoms and illnesses using translated version of American Thoracic Society Division of Lung Disease questionnaire (ATS-DLD-78A).Results: 692 brick kiln workers were interviewed during the course of survey and 58.8%of them were males. 45% of the respondents were working since last less than three years. Among the respiratory symptoms chronic cough, was present in 23.55% and phlegm in 22.83% of the respondents. Chronic bronchitis was present in 20.52% of the respondents. Association of respiratory symptoms in relation to sex of the respondents was found to be statistically significant (p<0.05).Conclusions: Respiratory symptoms and illness were found to be quite prevalent in the brick kiln workers. More research needs to be conducted to assess other health risks besides respiratory morbidity. Health planners need to plan for their basic sanitation facilities and periodic check ups.
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Violence against women a social evil in the society despite a lot of talk of women empowerment. Assessmentof burden in terms of prevalence will go a long way in planning the services for those affected bydomestic violence. To find the prevalence of domestic violence and associated risk factors among marriedfemales in a rural area of Jammu. This community based cross-sectional study was conducted amongrural married females using a structured and pretested questionnaire. Data was analysed using simpleproportions, chi-square test and logistic regression. 171/301(56.6%) of the respondents reported someform of the domestic violence. Psychological, physical and sexual violence rates were found to be32.16%, 9.9% and 2.33% respectively. A statistically significant association was found with variables likeliteracy, type of family, family income, sex of children etc. Relatively high levels of domestic violence inthis rural setting calls for a multidisciplinary approach involving improvement of literacy levels amongfemales, creating awareness about legal aid and screening the victims at primary health centres to mitigatethis problem.
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The current retrospective cross sectional study was undertaken using suspected ADR data collection form used under Pharmacovigiliance Programme of India (PvPI). A total of 2586 ADR events were recorded in 3years out of which 392(15.15%) were because of antimicrobials. males constituted 253 patients (64.54%) and females constituted 139 patients (35.45%) with male: female ratio as 1.8:1. Adults were more commonly affected followed by geriatric and pediatric population in both the groups. I.V route followed by oral route of drug administration accounted maximum ADR in similar way in both the genders. Monotherapy was responsible for 81.81% for males and 82.01% for females. Among combinations 78.26% in males and 64% in females were irrational as per latest WHO13th essential drug list. Majority of ADR, 88.14% and 92.80% were of moderate severity among males and females respectively. Maximum ADR were latent, type-A, probable in nature as per Naranjo and WHO-UMC scale. Inj.ceftriaxone followed by tab. azithromycin, tab.ofloxacin-ornidazole were the commonest antimicrobials responsible for ADRs in both the genders. The most common system involved was dermatological followed by GI in both males and females. On statistical comparison, no significant differences were observed among both the genders in any of the parameters except causality assessment scale (P<0.5). The current study suggests the ADRs due to antimicrobials are a significant health problem. No major gender related differences were observed in ADR profile of our study cohort.
ABSTRACT
Initial stability at the placement and development of osseointegration are two major issues for implant survival. Implant stability is a mechanical phenomenon which is related to the local bone quality and quantity, type of implant, and placement technique used. The application of a simple, clinically applicable, non-invasive test to assess implant stability and osseointegration is considered highly desirable. Resonance frequency analysis (RFA) is one of such techniques which is most frequently used now days. The aim of this paper was to review and analyze critically the current available literature in the field of RFA, and to also discuss based on scientific evidence, the prognostic value of RFA to detect implants at risk of failure. A search was made using the PubMed database to find all the literature published on "Resonance frequency analysis for implant stability" till date. Articles discussed in vivo or in vitro studies comparing RFA with other methods of implant stability measurement and articles discussing its reliability were thoroughly reviewed and discussed. A limited number of clinical reports were found. Various studies have demonstrated the feasibility and predictability of the technique. However, most of these articles are based on retrospective data or uncontrolled cases. Randomized, prospective, parallel-armed longitudinal human trials are based on short-term results and long-term follow up are still scarce in this field. Nonetheless, from available literature, it may be concluded that RFA technique evaluates implant stability as a function of stiffness of the implant bone interface and is influenced by factors such as bone type, exposed implant height above the alveolar crest. Resonance frequency analysis could serve as a non-invasive diagnostic tool for detecting the implant stability of dental implants during the healing stages and in subsequent routine follow up care after treatment. Future studies, preferably randomized, prospective longitudinal studies are certainly needed to establish threshold ranges for implant stability and for implants at risk for losing stability for different implant system.