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@#Introduction: Computer usage has become an indispensable tool in the official set up of all the workplaces in the current era. Predominance of musculoskeletal disorders (MSDs) in relation to habitual posture during work is the utmost problem of modern society. Teaching staff stand out amongst a group of workers exposed to occupational MSDs. The objective of this study was to identify the prevalence and risk factors of musculoskeletal disorders in relation to posture and computer ergonomics at workplace among the college and university staff in Petaling Jaya, Malaysia. Methods: This cross-sectional quantitative study was conducted from August 2019-October 2019, among 419 volunteers by using a self-administered survey questionnaire. Descriptive and bivariate statistics were used for the analyses of multiple variables. The association between demographic characteristics, computer ergonomics and prevalence of musculoskeletal pains were analyzed through Chi-square test. Results: 55.8 % respondents (n=234) reported neck pain (NP), (n=196) 46.8% shoulder pain (SP) and (n=308) 73.5% low back pain (LBP) respectively. A significant relationship between desktop computer usage and musculoskeletal pains in LBP (P=0.036) and SP (P=0.023) was observed. Significant association of head posture was found with NP (P=0.002), SP (P=0.042) and LBP (P=0.001), correspondingly. Discussion: Habitual postures were significantly associated with musculoskeletal pains while using computer. Conclusion: This study proved with precession that higher prevalence rate of musculoskeletal disorders was undoubtedly influenced by prolonged sitting, awkward postures at workstation, and repetitive movements of shoulders and hands. Further synchronous studies are vital to limit the modern era of musculoskeletal disorders
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Background: Following the invention of monaural stethoscope by Laennec and X ray by Roentgen in 18th century there was spectacular advancements in cardiology. The myocardium can be affected by various disease process unrelated to abnormal pressure or volume loads. These processes may be inflammatory, metabolic, infiltrative, ischemic or primary with significant overlap. These diseases usually present as cardiomegaly. In pediatric age group cardiac diseases will present early, sometimes without any signs and symptoms like sudden death due to less cardiac reserve. Few cases of sudden death also showed huge cardiomegaly in postmortem X rays. authors want to carry out this study to find out most common cause of cardiomegaly with silent chest as authors usually miss the diagnosis and these cases may present as sudden death without giving much time to intervene. The aim of the study is to know the most common cause of cardiomegaly without significant murmur in pediatric age group above one year.Methods: Prospective observational study done at a tertiary care hospital Hyderabad over a period of one year from January 2018 to January2019.Results: Most common cause of cardiomegaly without significant murmur was cardiac beriberi. It is mostly prevalent in rural areas of Telangana, mostly occurring in breastfed babies and below six years. All cases were recovered after proper treatment. Fortunately, it is associated with nil mortality, if timely treatment was initiated.Conclusions: Cardiac beriberi which is easily preventable and if treated in proper time it will associated with nil mortality. As it was occurring commonly breastfed babies supplementation of Thiamine to mothers was very useful as a preventive strategy.
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Systemic lupus erythematosus (SLE) is a complex autoimmune syndrome characterized by various co-existing autoantibodies (autoAbs) in patients' blood. However, the full spectrum of autoAbs in SLE has not been comprehensively elucidated. In this study, a commercial platform bearing 9400 antigens (ProtoArray) was used to identify autoAbs that were significantly elevated in the sera of SLE patients. By comparing the autoAb profiles of SLE patients with those of healthy controls, we identified 437 IgG and 1213 IgM autoAbs that the expression levels were significantly increased in SLE (P < 0.05). Use of the ProtoArray platform uncovered over 300 novel autoAbs targeting a broad range of nuclear, cytoplasmic, and membrane antigens. Molecular interaction network analysis revealed that the antigens targeted by the autoAbs were most significantly enriched in cell death, cell cycle, and DNA repair pathways. A group of autoAbs associated with cell apoptosis and DNA repair function, including those targeting APEX1, AURKA, POLB, AGO1, HMGB1, IFIT5, MAPKAPK3, PADI4, RGS3, SRP19, UBE2S, and VRK1, were further validated by ELISA and Western blot in a larger cohort. In addition, the levels of autoAbs against APEX1, HMGB1, VRK1, AURKA, PADI4, and SRP19 were positively correlated with the level of anti-dsDNA in SLE patients. Comprehensive autoAb screening has identified novel autoAbs, which may shed light on potential pathogenic pathways leading to lupus.
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Background: Dyslipidaemia is a significant risk factor for coronary heart disease which may lead to an increased risk of atherosclerosis in Type I diabetes mellitus at a younger age. Methods: This prospective study was conducted in the department of Biochemistry and Paediatrics at Gold Field Institute of Medical Sciences & Research, Faridabad. Twenty children with type 1 diabetes mellitus were enrolled on the basis of inclusion and exclusion criteria and were assessed for the levels of glucose, total cholesterol, triglycerides, High Density Lipoprotein, Very Low Density Lipoprotein, Low Density Lipoprotein and cholesterol to HDL ratio and were compared with same number of matched healthy controls of similar age. Results: The result of the present study showed that all the above mentioned parameters were significantly (P<0.001) higher in type 1 diabetes mellitus as compared to the control group with glucose levels of 207.6 mg/dl, triglycerides levels of 210 mg/dl, cholesterol levels of 250 mg/dl, VLDL levels of 45 mg/dl, LDL levels of 172 mg/dl and cholesterol to HDL ratio of 7.8 whereas HDL levels were significantly lower i.e. 31.2 mg/dl in Type 1 Diabetes Mellitus. Conclusions: The patients are at a higher risk of developing atherosclerosis and dyslipidaemia at an early age.
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<p><b>INTRODUCTION</b>Perioperative glycaemic control is an important aspect of clinical management in diabetic patients undergoing cataract surgery under local anaesthesia. While poor long-term glycaemic control has significant implications for surgery, perioperative hypoglycaemia or hyperglycaemia may also compromise patient safety and surgical outcomes. We aimed to survey ophthalmologists and anaesthesiologists on their approach and to identify the prevalent practice patterns in Singapore.</p><p><b>METHODS</b>This was a cross-sectional questionnaire-based survey conducted in four public hospitals in Singapore with established ophthalmology and anaesthesia units. Respondents were approached individually, and the self-administered questionnaires comprised questions related to practice patterns, clinical scenarios and awareness of pre-existing guidelines.</p><p><b>RESULTS</b>A total of 129 doctors responded to the questionnaire survey. 76 (58.9%) were from ophthalmology departments and 53 (41.1%) were from anaesthesia departments. The majority chose to withhold oral hypoglycaemic agents (82.9%) and/or insulin (69.8%), and keep the patient fasted preoperatively. A blood glucose level ≥ 17 mmol/L prompted 86.0%-93.8% of respondents to adopt a treat-and-defer strategy, while a level ≥ 23 mmol/L prompted 86.0%-96.9% of respondents to cancel the cataract surgery. The respondents were consistently more concerned about perioperative hyperglycaemia (n = 99, 76.7%) than intraoperative hypoglycaemia (n = 83, 64.3%).</p><p><b>CONCLUSION</b>The current study presented the prevalent practice patterns of ophthalmologists and anaesthesiologists in the perioperative management of diabetic patients undergoing cataract surgery in four public hospitals in Singapore. Further research in this field is required, and may be useful for the future formulation of formal guidelines and protocols.</p>
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Adult , Female , Humans , Male , Middle Aged , Anesthesia, Local , Methods , Anesthesiologists , Blood Glucose , Cataract Extraction , Cross-Sectional Studies , Diabetes Mellitus , Blood , Epidemiology , Incidence , Ophthalmologists , Perioperative Care , Methods , Singapore , Epidemiology , Surveys and QuestionnairesABSTRACT
We present a case of a 53-year-old woman who developed multifocal insufficiency fractures associated with adefovir dipivoxil (ADV) induced osteomalacia, including recurring metatarsal insufficiency fractures and a subtrochanteric femoral insufficiency fracture requiring surgical fixation. She had received low-dose ADV treatment for 59 months for chronic hepatitis B viral infection at the time of presentation with subtrochanteric fracture. Imaging evidence of multifocal insufficiency fractures and metabolic disease on background of hypophosphatemia is attributed to hypophosphatemic osteomalacia from adefovir-induced renal proximal tubular dysfunction. Radiologists and clinicians should be aware of the possibility of insufficiency fractures in patients receiving ADV therapy to avoid delayed diagnosis and progression of high-risk proximal femoral fractures.
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OsteomalaciaABSTRACT
The purpose of this study is to regulate the ROS [Reactive oxygen species] defense system in cardiac damage induced by CCI[4] [Carbon tetra chloride] in rats using Hybanthus enneaspermus. Administration of CC14 induces damage in the heart of rats as proved by estimation of antioxidant enzymes such as, SOD [Superoxide dismutase], CAT [catalase], GPx [Glutathione Peroxdiase], GR [Glutathione Reductase], GST [Glutathione-S-Transferaes]. However, treatment with HEE in CCI[4] intoxicated rats was found to be protected the heart, as indicated by the enzyme level in serum. A significant increment of serum enzymes level such as SOD, CAT, GPx, GR and GST were observed following HEE treatment during CCI4 intoxication whereas MDA [Malondialdehyde] level in HEE treated rats were decreased. The results of our experiment suggest that the treatment of HEE may be the critical remedy for the adverse effect of CCI[4] in heart function
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Any hypothalamic disturbance manifesting clinically is considered a major red flag for multiple sclerosis, whereas MRI lesions involving deep grey matter structures are considered an intermediate red flag. However, hypothalamic lesions manifesting clinically with hypersomnia have been described in some patients of multiple sclerosis. We report a case where the first and presenting feature of multiple sclerosis was acute onset hypersomnia with bilateral hypothalamic lesions. On review of recent literature, we also question whether clinical or radiological hypothalamic involvement is really so unusual that it should be considered a red flag for multiple sclerosis
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PURPOSE: To find the association of trial without catheter (TWOC) outcome for first spontaneous acute urinary retention (AUR) in benign prostatic obstruction with age, prior lower urinary tract symptoms (LUTS), retention volume at catheterization (RV), and size of prostate. METHODS: Our prospective observational analytical (interventional) study enrolled 77 cases of spontaneous AUR over 24 months. After clinical evaluation, digital rectal examination, and transabdominal ultrasonography, all patients were catheterized per urethra and their RV was recorded. TWOC was administered after 2 or 3 doses of 0.4 mg tamsulosin-oral absorption control system and after 48-72 hours had passed. A successful endpoint was defined as a maximum flow-rate, >5 mL/sec; voided volume, >100 mL; postvoid residue, <200 mL; and voiding within 6 hours of catheter removal. Data obtained from 58 patients were analyzed after excluding the cases lost to follow-up and secondary exclusion. Age, RV, duration of LUTS, and prostate volume on examination and ultrasonography (PUSG) were recorded and statistically analyzed. Prostate-specific antigen levels were obtained on follow-up and cases of cancer, as seen on transrectal ultrasound-guided biopsy, were secondarily excluded. RESULTS: The patients had a mean age of 65.89+/-8.67 years. Prior LUTS was seen in 35 patients (2.07+/-2.91 months). The mean PUSG and RV were 46.81+/-20.58 mL and 854.8+/-36.26 mL, respectively. Thirty patients underwent a successful TWOC; a mean age of 63.13+/-8.58 years (mean+/-standard deviation; unpaired t-test; P=0.0053) and a PUSG of < or =45 mL (Pearson chi-square test; P=0.0427) were significantly associated with a successful outcome. CONCLUSIONS: There is a significant association between TWOC outcome, age (P=0.0053), and PUSG (P=0.0427).
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Humans , Absorption , Biopsy , Catheterization , Catheters , Digital Rectal Examination , Follow-Up Studies , Lost to Follow-Up , Lower Urinary Tract Symptoms , Prospective Studies , Prostate , Prostate-Specific Antigen , Retention, Psychology , Sulfonamides , Urethra , Urinary Retention , Urination DisordersABSTRACT
Protein Energy Malnutrition [PEM] is a global problem among children. Worldwide 27% under five children are malnourished. PEM is more prevalent in India where almost half [47%] the children are underweight. Assessment of PEM has traditionally been clinical which is time consuming and skill dependent, with considerable inter-observer variability. Hence, biochemical markers like serum protein and albumin measurements may be used for the assessment of nutritional status. At the same time, there is a controversy, whether edema can be considered as a reliable clinical marker of hypoalbuminemia. Readily available and reliable tests and can often detect nutritional deficiencies before they have an adverse effect on biological functions and certainly before deficiencies can be detected by physical examination. The study was designed to assess PEM in children using biochemical markers like serum protein, albumin and protein electrophoresis and establishing a correlation between edema and hypoalbuminemia. This analytical case control study was done in the Narayana Medical College and Hospital from September 2007 to September 2009. The material for the study consisted of 50 cases of PEM and 20 normal healthy children. In PEM cases, total protein and serum albumin were found to be significantly lower in comparison to normal healthy controls. Thus total protein and serum albumin may become useful indicators of the nutritional status of the malnourished children and good markers of PEM. Albumin and beta fractions of Serum Protein Electrophoresis were significantly lower while alpha 1, alpha 2 and gamma globulin fractions were significantly higher in malnourished children in comparison to controls
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Humans , Male , Female , Biomarkers , Blood Proteins , Serum Albumin , Electrophoresis , Hypoalbuminemia , Nutritional Status , gamma-GlobulinsABSTRACT
Posterior urethral valves (PUV) are now commonly suspected on antenatal ultrasound, but can present with a broad spectrum of severity postnatally. Rarely, the diagnosis is missed until adolescence or adulthood when the patient usually presents with lower urinary tract symptoms. We describe an even rarer case of PUV in a late adolescent who first presented with preserved renal function and urinary incontinence. We review the literature on presentation, natural history and outcomes of both early and late presenting PUV cases.
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Adolescent , Humans , Lower Urinary Tract Symptoms , Natural History , Urethra , Urinary IncontinenceABSTRACT
PURPOSE: To determine whether diabetic macular ischaemia is associated with ischaemic heart disease (IHD), hyperlipidaemia, hypertension (HTN) and nephropathy. METHODS: Prospective case-control study from January to December 2001, involving 102 type 2 diabetic patients (aged 40-80 years), 59 with unilateral / bilateral macular ischaemia and 43 concurrent controls. Diabetic retinopathy was graded and macular ischaemia assessed by fundus examination, central fundus photography and fluorescein angiography. Systemic examination and laboratory investigations were done to evaluate systemic diseases. The associations were analysed by Chi-square test and Student's t-test. The significance of the variables as independent risk factors was tested by logistic regression analysis. RESULTS: Macular ischaemia was not associated with IHD (P=1.00); HTN (P=1.00) and hyperlipidaemia (P=0.30). Nephropathy was significantly associated with macular ischaemia (P=0.025; odds ratio [OR]: 2.62; 95% confidence interval [CI]: 1.16-5.9). The association remained significant after controlling for age, gender, duration of diabetes, severity of retinopathy, HTN, IHD and hyperlipidaemia. Further, the association with nephropathy was not affected by the presence of macular isachaemia in one or both the eyes (P=0.39). CONCLUSION: Macular ischaemia may serve as a marker for nephropathy in type 2 diabetes mellitus irrespective of the severity of retinopathy.
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Adult , Aged , Aged, 80 and over , Case-Control Studies , Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/complications , Diabetic Retinopathy/complications , Female , Humans , Ischemia/etiology , Macula Lutea/blood supply , Male , Middle Aged , Prospective StudiesABSTRACT
Posterior mediastinum is a rare site for teratoma. We report a primary benign mature teratoma in posterior mediastinum in a 20-month-old male child. A preoperative radiological diagnosis made on x-ray and computed tomography of chest was confirmed on histopathological examination