Effectiveness Of Self-Instructional Module (Sim) On Paternal Attitude Of Expectant Fathers And Maternal Satisfaction On Perinatal Outcome

Introduction: Paternal involvement (PI) has been recognized to have an impact on pregnancy and in-fant outcomes. The mother抯 satisfaction during the birthing process is the most frequently reported in-dicator in the evaluation of the quality of maternity services. The aim of the study is to assess the effec-tiveness of self-instructional module on paternal attitude towards perinatal outcome and maternal satis-faction on paternal attitude. Methodology: A cross-sectional study was conducted on 320 expectant fathers attending antenatal clin-ic. A five-point rating scale was used to assess the attitude of paternal on pregnancy and labour outcome and check list to assess the postnatal mother satisfaction. Results: The scores improved significantly after intervention, in experiment group, the pre-test, mean score was 78.61 and the post-test mean score was 120.56, whereas in the control group, the pre-test mean score of 79.43 and the post-test mean score was 80.25. In the experimental group, 81.88% of mothers were satisfied whereas 18.12% were not satisfied. In control group, 48.75% were satisfied, while 51.25% were not satisfied. Conclusion: Most fathers were very positive about their partner抯 pregnancy. They, however, need to be motivated to use that knowledge into practice.

Uso inapropriado de inibidores de bomba de prótons intravenosos e fatores associados em um hospital de alta complexidade no Brasil / Inappropriate usage of intravenous proton pump inhibitors and associated factors in a high complexity hospital in brazil

ABSTRACT BACKGROUND: Intravenous (IV) use of proton pump inhibitors (PPIs) is advised only in cases of suspected upper gastrointestinal bleeding (UGIB) or impossibility of receiving oral medication, although there has been a persistent practice of their inappropriate use in health institutions. OBJECTIVE: The purpose of our study was to measure the inappropriate use of IV PPIs in a high complexity hospital in Brazil and to estimate its costs. METHODS: Retrospective study of 333 patients who received IV omeprazole between July and December of 2018 in a high complexity hospital in Brazil. RESULTS: IV omeprazole was found to be appropriately prescribed in only 23.4% patient reports. This medication was administered mainly in cases of suspected UGIB (19.1%) and stress ulcer prophylaxis in patients with high risk of UGIB unable to receive medication orally (18.7%). It was observed a statistically significant association between adequate prescription and stress ulcer prophylaxis in patients with high risk of UGIB unable to receive medication orally; patient nil per os with valid indication for PPIs usage; prescription by intensive care unit doctors; prescription by emergency room doctors; intensive care unit admission; evolution to death; sepsis; and traumatic brain injury (P<0.05). On the other hand, inadequate prescription had a statistically significant association with surgical ward prescription and non-evolution to death (P<0.05). The estimated cost of the vials prescribed inadequately was US$1696. CONCLUSION: There was a high number of inappropriate IV omeprazole prescriptions in the studied hospital, entailing greater costs to the institution and unnecessary risks.

RESUMO CONTEXTO: Atualmente, o uso intravenoso (IV) dos inibidores de bomba de prótons (IBPs) é indicado em poucas situações, como em casos de hemorragia digestiva alta ou impossibilidade de recebê-los via oral. Há diversos estudos mostrando o uso excessivo desse fármaco, na forma intravenosa, desnecessariamente e acarretando altos custos aos hospitais. OBJETIVO: Avaliar as indicações, posologias, duração do tratamento e custos das prescrições de omeprazol intravenoso. MÉTODOS: Estudo retrospectivo de 333 pacientes que receberam omeprazol intravenoso entre julho a dezembro de 2018 em um hospital de alta complexidade no Brasil. RESULTADOS: A prescrição de omeprazol intravenoso foi considerada totalmente adequada em apenas 23,4% das prescrições analisadas. O medicamento foi administrado principalmente em casos de suspeita de hemorragia digestiva alta (HDA) (19,1%) e profilaxia de úlcera de estresse em paciente com alto risco de HDA impossibilitado de receber via oral (18,7%). Foi observada associação estatisticamente significativa entre prescrição adequada e profilaxia de úlcera de estresse em paciente com alto risco de HDA impossibilitado de receber medicamento via oral; paciente em nil per os com indicação válida de IBPs; prescrição por médico da UTI; prescrição por médico do pronto atendimento; admissão na UTI; evolução a óbito; sepse; e traumatismo cranioencefálico (P<0,05). Já a prescrição inadequada teve associação estatisticamente significativa com prescrição por setor cirúrgico e a não evolução a óbito (P<0,05). O custo estimado do total de ampolas prescritas inadequadamente foi de US$1696,00. CONCLUSÃO: Houve um elevado número de prescrições de omeprazol intravenoso inadequadas no hospital estudado, acarretando um custo elevado para a instituição.

How genetics works: An illustrative case report.

In this communication, we report the case of a four year old boy who presented with reduced vision in the right eye. He had visual acuity of light perception right eye and 6/12 in the left eye and anterior segment examination was normal. Fundus examination of the right eye showed a falciform retinal fold extending from the optic nerve temporally involving the entire retina with exudates within the falciform fold and dense pigmentation peripherally. The left eye showed mild macular temporal dragging of the vessels and 360° of peripheral laser scars. In addition he also had some characteristic systemic features such as developmental delay, obesity, dysmorphic facies and tapered fingers. Using this case as an example, we present a systematic, logical approach to a patient with a possible genetic disorder. The growing field of ocular genetics now allows for improved diagnosis using stepwise cost efficient testing as demonstrated herein.

Auxotrophy-Based Detection of Hyperornithinemia in Mouse Blood and Urine

Abstract Gyrate atrophy of the choroid and retina (GACR) is a hereditary form of progressive blindness caused by homozygosity for loss-of-function mutations in the ornithine aminotransferase gene (Oat). The high levels of circulating ornithine that lead to ophthalmic symptoms in young adults are also displayed by 2 ornithine aminotransferase (OAT)-deficient mouse models of GACR. Here, we have developed an inexpensive and quantitative bacteria-based test for detecting hyperornithinemia in blood or urine samples from these mutant mice, a test that we suggest could be used to facilitate the identification and treatment of OAT-deficient humans before the onset of visual impairment.

AIDS Awareness among Clinical Dental Students of Karnataka, India.

Objective: HIV-infected patients, with or without knowledge of their own serologic status are seeking dental care in increasing numbers. Dental students are at the risk of exposure to the HIV infections during their clinical training if adequate and stringent infection control measures. The objective of the present study was to assess the level of understanding and awareness of this disease among the third year clinical dental students at a private dental institution in Mangalore, Karnataka, India. Materials and methods: A cross sectional survey of 100 third year clinical dental students of Karnataka was carried out using a self-administered questionnaire. The questionnaire comprised of sociodemographic details, apart from 8 questions on knowledge and 2 questions on attitude towards HIV/AIDS patient. Descriptive analysis was carried out. Results: The response rate was 100%. Majority of students’ knew that AIDS is a disease of immunity. About 78% of the students knew that HIV/ AIDS is transmitted by contaminated blood products. Eighty six percent of the subjects knew which test was done to detect AIDS while others were not quite sure of it. Only 15% answered correctly regarding the percentage risk of transmission of HIV to a health care worker following contaminated needle stick injury. Most of the students were either not aware or not sure about the universal precaution measures to be taken while treating an AIDS patient. Conclusion: The results showed that the third year dental students of Karnataka, India had fair knowledge and good attitude regarding HIV/AIDS. However it did reveal some of the inadequacies and misconceptions regarding the disease among the dental students.

Spontaneously resolving macular cyst in an infant

The purpose of this study is to describe transient macular cysts in an infant and correlate their occurrence with normal development events. A newborn Caucasian girl presented with a protruding corneal mass in her left eye at birth. She underwent a complete ophthalmic examination. A keratinized staphylomatous malformation involving the entire cornea and precluding further visualization of the anterior and posterior segment was observed in the left eye. Spectral domain optical coherence tomography [SD-OCT] of the right eye performed when the child was approximately 6-week-old had revealed an unexpected finding of macular cysts involving the inner nuclear and outer retinal layers. Corneal transplant in the left eye was performed a month later. Ocular examination under anesthesia just prior to surgery revealed normal intraocular pressure, anterior segment and retina in the right eye. SD-OCT was normal in both eyes and showed complete resolution of the cysts in the right eye. The patient had not been on any medications at that time. Although clinical retinal examination might be unremarkable, SD-OCT may reveal cystic spaces in the macula. In the absence of conditions known to be associated with macular edema, transient macular cysts may arise due to a developmental incompetence of the blood-retinal barrier or may represent transient spaces created during normal migration of retinal cells. Further study is warranted to delineate the entity of transient macular cysts in infancy

Genetics for the ophthalmologist

The eye has played a major role in human genomics including gene therapy. It is the fourth most common organ system after integument [skin, hair and nails], nervous system, and musculoskeletal system to be involved in genetic disorders. The eye is involved in single gene disorders and those caused by multifactorial etiology. Retinoblastoma was the first human cancer gene to be cloned. Leber hereditary optic neuropathy was the first mitochondrial disorder described. X-Linked red-green color deficiency was the first X-linked disorder described. The eye, unlike any other body organ, allows directly visualization of genetic phenomena such as skewed X-inactivation in the fundus of a female carrier of ocular albinism. Basic concepts of genetics and their application to clinical ophthalmological practice are important not only in making a precise diagnosis and appropriate referral, but also in management and genetic counseling

Transplante de fígado. Relato do primeiro caso realizado no Hospital das Clínicas da Faculdade de Medicina de Ribeiräo Preto da Universidade de Säo Paulo / Liver transplantation. Case report of the first patient submitted to this procedure at the Hospital das Clínicas da Faculdade de Medicina de Ribeiräo Preto-USP

O transplante de fígado constitui o principal tratamento para os pacientes portadores de doença hepática crônica ou aguda, em situações em que outras opções terapêuticas clínicas e/ou cirúrgicas näo tenham sido eficazes no controle da doença. Dentre as doenças do fígado, o carcinoma hepatocelular, quando de pequeno tamanho, constitui uma das indicações para a realizaçäo do transplante. Relatamos o caso do primeiro paciente submetido ao transplante de fígado no Hospital das Clínicas da Faculdade de Medicina de Ribeiräo - USP. Ele era portador de cirrose hepática pelo vírus da hepatite C, associada à presença de carcinoma hepatocelular; enquanto em lista de espera pelo transplante, foi submetido à embolizaçäo arterial e alcoolizaçäo tumoral com o intuito de ser impedida a progressäo da neoplasia. O transplante de fígado foi realizado sem intercorrências cirúrgicas, utilizando-se a técnica de piggyback com anastomose biliar colédoco-colédoco com permanência de dreno de Kher. O esquema imunossupressor utilizado foi o duplo, associando-se ciclosporina A e prednisona. No nono dia de pós-operatório, ocorreu episódio de rejeiçäo celular, tratado com sucesso com metilprednisolona (1.0 g/.dia, IV durante três dias). O paciente recebeu alta hospitalar no 13° dia de pós-operatório. O caso evidencia a importância do diagnóstico precoce e a indicaçäo do transplante de fígado em portadores de carcinoma hepatocelular, bem como, uma das possíveis complicações no pós-operatório. A concretizaçäo de mais um grupo especializado no tratamento das doenças crônicas do fígado e o desenvolvimento científico, tecnológico e de ensino da Regiäo de Ribeiräo Preto, no interior do Estado de Säo Paulo, possibilitaram a realizaçäo, com sucesso, do caso aqui relatado

Seasonal variations in water quality of an oxbow lake in response to multiple short-time pulses of flooding (Jataí Ecological Station - Mogi-Guaçú River, Luiz Antonio, SP-Brazil)

Mogi-Guaçu River is a six-order floodplain river in the upper Paraná River Basin, Southern Brazil. Its yearly discharge varies from a minimum of 100 m(3).s(-1) to a maximum of 600 m(3).s(-1). Diogo Lake is a shalow lake located at its floodplain within the Jataí Ecological Station (Luiz Antonio, São Paulo State) and is connected throughout the year to the river through a narrow and shallow channel. The main finding of this study is that the river hidrology controls the annual variations in lake hydrochemistry through a series of hydraulic effects related to oscillations in river discharge. Lake water quality is a resultant of differential contribution from local and regional watersheds. During the low water period, lake water quality is determined by inputs from Cafundó Creek, which drains the local watershed into the lake. Raising the river level during the rain season results in the damming of lake and culminates with the entrance of river waters into the plain. The geochemistry of waters in this system is determined by weathering of sandstones with basalt intrusions. Waters are acidic (river pH = 6.00 to 7.02 and stream-lake pH = 5.15 to 6.7) and dominant cations are Na+ and K+. Major anions are almost exclusively represented by bicarbonate and an unknown concentration of organic acid anions. The overall ionic load of these soft waters in the system is therefore very low.