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The International League Against Epilepsy (ILAE) task force on neonatal seizures has recently published draft guidelines and consensusbased recommendations on the treatment of neonatal seizures. This update provides a summary of the recommendations and the changes in management compared to the previous WHO ILAE guidelines, published in 2011, with emphasis on practical decision making requirements for a pediatrician.
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Background: Nearly one third of people who suffer major psychiatric disorders end up with a long- term disability and dependency. They are most likely to be non-adherent to medication due to various reasons including lack of knowledge or insight about their illness and treatment which in turn leads to exacerbation of their illness, reduce treatment effectiveness, or make them less responsive to subsequent treatment, multiple hospitalizations and poor quality of life. Materials and methods: A cross sectional study was carried out in outpatients attending the Psychiatry OPD using the consecutive sampling technique. Subjects meeting the ICD-10 Diagnostic criteria for psychiatric disorders, age 18 year and above, subjects willing to participate in the study were included. A structured proforma, the Drug attitude inventory and the WHO-QOL-BREF questionnaires were used for assessment. Results: Mean age of subjects = 38.07 + 11.07 years. Mean medication cost = Rs. 917.82 + 397.89. 87 subjects participated in the study and of them 48% were adherent to medication and 52% were non-adherent. 56% of males and 43% females were adherent to medication. There was significant association between the occupation and the type of family of the subjects and medication adherence (p<0.05). Majority of patients with medication non-adherence were seen in schizophrenia, delusional disorder, bipolar disorder, generalized anxiety disorder, obsessive-compulsive disorder and substance related disorder. Majority (44.5%) of them reported fear of side effects, followed by stopping the medication when feeling better (35.5%) as the reasons for non-adherence followed by cost, embarrassment, etc. There was significant association between the psychological and social quality of life and medication adherence (p<0.05). Conclusions: This study implicates the importance of psycho education about the diagnosis, prognosis, need for medication and the expected adverse effects which should be clearly explained to the patient. The therapeutic alliance is the most effective component in helping the patient maintain medication adherence and subsequently better quality of life.
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Non-healing ulcers or Dushtavrana possess a great challenge to the doctors, as it is a very common problem presented by the patients. It is not only that the patient feels the pain and discomfort but the others who look at the patient, they also feel a lot of discomfort. It creates a very embarrassing situation for the patient in his day to day life. After trying for all the therapies eventually patient looks forward to Ayurvedic system of medicine with a very little ray of hope that here his ulcer may be healed. Fortunately only with the help of Ayurvedic medicines and without any sort of surgical intervention the patient get healed. This article presents the conservative management of non-healing ulcers or Dushtavrana which proved to be a miracle for the patients.
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Introduction: Among the various strategies for in routine total knee replacement (TKR), tranexamic acid (TA) has always been a safer and affordable method. Surgeons have used it in intravenous, intraarticular or in a combined manner to reduce blood loss because it is easily available and has an easy dosing regimen. We aim to find out its efficacy and associated complication when used intravenously. MaterialsandMethods: This study was done in our institute among 27 cases who was operated for primary TKR. They were distributed into two groups based on the use of TA. Hemodynamic parameters such as blood loss, reduction in hemoglobin (Hb), and blood transfusion were assessed. Student’s t‑test and ANOVA were utilized for tests of significance. Results: Out of 27 patients, 17 (62.9%) were female and in the age group of 51–60 years. Most 22 (81.5%) had osteoarthritis. The difference in blood loss across various pathologies and comorbidities was statistically insignificant. Average blood loss was 266.2 ml ± 64 ml (Range = 150–406 ml) per TKR in the 1st group. In 2nd, it was 667.5 ± 111.5 ml (Range = 414–860 ml) (P < 0.001). Mean Hb loss was 0.78 ± 0.275 g/dl (Range = 0.1–1.2 g/dl) in Group A. It was statistically significant comparing to Group B where it was 1.86 ± 0.55 g/dl (Range = 1.5–3.7 g/dl). Tourniquet used though decreased blood loss, it was not statistically significant. Conclusion: TA used in intravenously is very effective in decreasing the loss of blood and transfusion requirements in patients of primary TKR.
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Low water potential related stresses are regulated by modifying water uptake and loss to avoid low water potential, accumulating solutes which in turn enhance active principles and its gene expressions. Present study examined effect of in vitro induced absorption of mannitol and PEG (poly ethelene glycol) 6000 in Indian pennywort, Centella asiatica (L.) Urb., neutraceutical plant, evidenced by phenotypic, molecular and phytochemical analyses. Both mannitol and PEG 6000 induce water deficit conditions in plants and retarded normal plant biomass in terms of fresh and dry weights. These effects were significantly less severe in plants subjected to mannitol, compared to PEG. PEG and mannitol imposed water deficit, resulted in decline in major active compound, asiaticoside evidenced by HPTLC of asiaticoside content. Differential expression of some selected key genes in the asiaticoside pathway including squalene synthase and ? amyrin synthase by qPCR, confirmed decrease in transcript level expression of asiaticoside, whereas upregulated transcript level expression was observed in cycloartenol synthase for synthesis of phytosterols. Estimation of total flavonoids and phenolics under different water deficit conditions were found declined. In conclusion, water deficit by mannitol and PEG 6000 can significantly affects processes associated with biomass growth and ability to synthesize secondary metabolites in C. Asiatica.
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Phaeohypomycosis is a rare cutaneous and subcutaneous fungal infection caused by dematiaceous fungi. They have a widespread global distribution occasionally affecting humans. A 26-year-old woman presented with multiple skin lesions over her face and extremities for last 7 years, unresponsive to systemic amphotericin B and itraconazole. Further investigations revealed CARD9 mutation and phaeohyphomycosis caused by the pigmented fungus Exserohilum rosatratum. Lesions subsequently improved with oral flucytosine and itraconazole
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Introducción: El uso diario de ayudas para la higiene oral y la profilaxis oral anual o semestral por parte de los profesionales de la odontología (dentistas, higienistas dentales, asistentes dentales) son dos maneras efectivas de mantener una buena higiene oral. El presente estudio se llevó a cabo para evaluar el conocimiento, la actitud y la práctica sobre higiene bucal entre higienistas dentales que trabajan en el oeste de Maharashtra, India. Materiales y métodos: se realizó un estudio de cuestionario entre 52 higienistas dentales en activo de diferentes áreas del oeste de Maharashtra. Se diseñó un cuestionario estructurado, cerrado autoadministrado para recopilar los datos que constaba de dos partes y comprendía 31 preguntas. Se hizo un análisis estadístico utilizando estadísticas descriptivas. Resultados: En este estudio, más del 50% de los participantes conocían la importancia del mantenimiento de la higiene bucal y los diferentes tipos de ayudas para la higiene bucal y correctos métodos de uso de esas ayudas para la higiene oral. Alrededor del 96% de los participantes pensaba que la técnica de cepillado adecuada es necesaria para mantener una buena higiene bucal. Conclusión: El conocimiento general, la actitud y la práctica de los participantes del estudio con respecto a las ayudas para la higiene bucal se observaron en un nivel promedio.
Introduction: Everyday use of oral hygiene aids and annual or biannual oral prophylaxis by dental professionals (Dentists, Dental hygienists, Dental assistants) are two effective ways of maintaining good oral hygiene. The present study was conducted to assess the knowledge, attitude, and practice about oral hygiene among working dental hygienists in Western Maharashtra, India. Materials and methods: A questionnaire study was conducted among 52 working dental hygienists from different areas of Western Maharashtra. The structured, self-administered, close-ended questionnaire was designed to collect the data which consist of two parts and comprised 31 questions. Statistical analysis was done using descriptive statistics. Results: In this study, more than 50% of participants were known the importance of oral hygiene maintenance and different types of oral hygiene aids and correct methods of using those oral hygiene aids. About 96% participants thought that proper brushing technique is necessary to maintain good oral hygiene. Conclusion: The study participant's overall knowledge, attitude and practise regarding oral hygiene aids were seen at average level.
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Humans , Oral Hygiene/education , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires/statistics & numerical data , Dental Hygienists/education , Dental ProphylaxisABSTRACT
Objectives@#The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency posing unprecedented challenges for health authorities. Social media may serve as an effective platform to disseminate health-related information. This study aimed to assess the extent of social media use, its impact on preventive behavior, and negative health effects such as cyberchondria and information overload. @*Methods@#A cross-sectional observational study was conducted between June 10, 2020 and August 9, 2020 among people visiting the outpatient department of the authors’ institution, and participants were also recruited during field visits for an awareness drive. Questions were developed on preventive behavior, and the Short Cyberchondria Scale and instruments dealing with information overload and perceived vulnerability were used. @*Results@#The study recruited 767 participants with a mean age of about 45 years. Most of the participants (>90%) engaged in preventive behaviors, which were influenced by the extent of information received through social media platforms (β=3.297; p<0.001) and awareness of infection when a family member tested positive (β=29.082; p<0.001) or a neighbor tested positive (β=27.964; p<0.001). The majority (63.0%) of individuals often searched for COVID-19 related news on social media platforms. The mean±standard deviation scores for cyberchondria and information overload were 9.09±4.05 and 8.69±2.56, respectively. Significant and moderately strong correlations were found between cyberchondria, information overload, and perceived vulnerability to COVID-19. @*Conclusions@#This study provides evidence that the use of social media as an information- seeking platform altered preventive behavior. However, excessive and misleading information resulted in cyberchondria and information overload.
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Background: Diabetic nephropathy is the leading causeof End-Stage Renal Disease (ESRD) emerging indeveloped as well as developing countries, with thecomplicated pathogenesis. The study of expression ofthe genes related to kidney cells e.g. podocytes has beenshown to be associated with the condition, helping in theelucidation of pathogenesis of the disease. Previouslythe gene expression associated was studied in urinesamples. Material and Methods: In the present study, itwas attempted to analyze the mRNA expression ofpodocyte related genes viz. podocalyxin, podocin andsynaptopodin in Peripheral Blood Mononuclear Cells(PBMCs) in patients with diabetes with and withoutnephropathy in comparison with healthy controls byreverse transcriptase Polymerase Chain Reaction(PCR), followed by semi-quantitative PCR. Results:The expression of Synaptopodin (SYNPO) wasincreased in diabetics than the controls, while nosignificant difference was found for Podocalixyn(PODXL) and Podocin (NPHS2). The expression ofPODXL and NPHS2 was significantly up-regulated;SYNPO was unaltered in microalbuminuric patientsthan healthy controls. PODXL and SYNPO wereincreased significantly in nephropathy subjects thancontrols, with no significant change in NPHS2. Theexpression of only PODXL was found to be upregulated in microalbuminuric patients as compared toT2DM patients without nephropathy. PODXL, SYNPOwere significantly up-regulated and NPHS2 wassignificantly down-regulated in nephropathy subjects ascompared to T2DM patients without nephropathy. Asignificant down-regulation was found for NPHS2expression in nephropathy patients than microalbuminuric patients of T2DM with nephropathy.Conclusion: The detection of gene expression of theseproteins can be used as an early marker for the detectionof development of nephropathy in T2DM patients andpreventive measures can be taken to prolong the onsetof nephropathy in these patients, increasing the lifeexpectancy.
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Background@#Residential and commercial cleaning is a part of our daily routine to maintain sanitation around the environment. Health care of professionals involved in such cleaning activities has become a major concern all over the world. The present study investigates the risk of musculoskeletal disorders in professional cleaners involved in floor mopping tasks. @*Methods@#A cross-sectional study was performed on 132 mopping professionals using a modified Nordic questionnaire. The Pearson correlation test was implemented to study the association of perceived pain with work experience. The muscle strain and postural risk were evaluated by means of three-channel electromyography and real-time motion capture respectively of 15 professionals during floor mopping. @*Results@#Regarding musculoskeletal injuries, risk was reported majorly in the right hand, lower back, left wrist, right shoulder, left biceps, and right wrist of the workers. Work experience had a low negative association with MSDs in the left wrist, right wrist, right elbow, lower back, and right lower arm (p < 0.01). Surface EMG showed occurrence of higher muscle activity in upper trapezius and biceps brachii (BB) muscles of the dominant hand and flexor carpi radialis and BB muscles of the nondominant hand positioned at the upper and lower portion of the mop rod, respectively. @*Conclusion@#Ergonomic mediations should be executed to lessen the observed risk of musculoskeletal injuries in this professional group of workers.
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The Severe Acute Respiratory Syndrome-related Coronavirus 2 or novel coronavirus (COVID-19) infection pandemic continues to spread. Since the outbreak of the COVID-19 in Wuhan (China), healthcare workers have been infected and are considered at high risk of contamination. Moreover, in addition to the physical effects of COVID-19, the pandemic results in important mental health issues among healthcare workers such as anxiety, stress, depression, and further nervous or mental disorders. Despite the increasing number of clinical trials aiming to develop vaccines or test antiviral molecules, till now no efficient anti- SARS-CoV-2 drugs have been validated. The COVID-19 pandemic led us to call for an urgent nutritional intervention model that should be established to prevent and/or reduce the negative impact of COVID-19 on healthcare workers. In the present paper, we suggest a safe nutritional supplementation of MgZn- B vitamins (B1, B6, B9, and B12) in healthcare workers as pre-exposure and post-exposure new prophylactic treatments. Furthermore, the paper reports the scientific arguments and the possible mechanisms by which the Mg-Zn- B vitamins supplementation may exert its beneficial effects in the healthcare workers facing the COVID-19 pandemic. Overall, the Mg-Zn- B vitamins supplementation would enhance the immune response against SARS-CoV2, prevent inflammatory processes and oxidative stress, fight or alleviate the COVID-19-related mental health issues, or even reduce the replication. Each element of the supplementation possesses important and promising effects contributing to the possible efficiency of the suggested Mg-ZnB vitamins supplementation in healthcare workers
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COVID-19 , Algeria , Magnesium , Post-Exposure Prophylaxis , Pre-Exposure Prophylaxis , Severe acute respiratory syndrome-related coronavirus , ZincABSTRACT
Background: Diabetes Mellitus (DM) is one of theleading non-communicable disorders, leading tovarious complications viz. cardiovascular diseases,retinopathy, nephropathy, neuropathy and peripheralvascular disorders. Diabetic Nephropathy (DN)patients further develop into End Stage Renal Disease(ESRD) and they have to undergo the repeated bloodtransfusions, increasing the social and economicburden. The number of risk factors are known forcausation of diabetic nephropathy including theenvironmental, biochemical as well as genetic factors.The association of nephropathy with various genes hasbeen proved. Aim and Objectives: In the present studywe attempted to check the association ofInsertion/Deletion (I/D) polymorphism of AngiotensinConverting Enzyme (ACE) in diabetic patients withand without nephropathy and also with thebiochemical markers. Material and Methods: Eachgroup consisted of 110 individuals viz. diabetics withand without nephropathy and age and gender matchedhealthy controls. Results: The determination of I/Dpolymorphism by polymerase chain reaction revealedthe significant increased 'D' allele frequencies inpatients of diabetes with and without nephropathy thanthe controls, while no significant difference was notedin genotype frequencies. The odds ratios for thispolymorphism were calculated to be 1.84 and 2.41 forDM and DN respectively in comparison with thehealthy controls. The regression analysis indicated I/Dpolymorphism is associated positively with all thelipid parameters, except High Density LipoproteinCholesterol (HDL-C) which was negatively associatedwith the polymorphism. The levels of lipid parameterswere also significantly increased in patients of diabeteswith and without nephropathy carriers for 'D' allelethan the patients having 'I' allele, while the level ofHDL-C was significantly decreased. Conclusion: Theconclusion can be made from these results that, thepresence of I/D polymorphism of ACE may increasethe risk of development of nephropathy in generalpopulation, with the role of 'D' allele in its causation,along with its effect on the biochemical markers.
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Biologically synthesized silver nanoparticles have emerged as one of the prime areas of investigation in recent years due to their wider application in biomedical and pharmaceutical sciences. In the present paper, we report the biosynthesis of silver nanoparticles using aqueous leaf extract of T. zebrina and its antibacterial activity against common human pathogenic bacteria such as Staphylococcus epidermidis, Staphylococcus aureus, Salmonella enterica, Escherichia coli and Bacillus cereus. The antibacterial activity of the biosynthesized silver nanoparticles were compared with amikacin which was used as the positive control. The results of the study revealed good zones of inhibitions of the nanoparticles against test organisms that were comparable to amikacin and hence has a great potential in the preparation of drugs used against bacterial diseases.
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Background: Recurrent facial palsy in a patient merits investigation for underlying etiology.Case characteristics: 8-year-old boy with erythematous itchy skin lesion and recurrentfacial palsy. Observation: He had a past history of aseptic meningitis andnephrocalcinosis. Raised angiotensin converting enzyme levels, interstitial lung disease onCT chest, and non caseating granulomas on skin biopsy clinched the diagnosis ofsarcoidosis. Message: Multisystem involvement and recurrent lower motor facial nervepalsy is a clinical clue for sarcoidosis.
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Background and Objectives: Salivary gland neoplasms are relatively uncommon. They have a wide variety of histopathological types with diverse biological behavior. It involves all the major and minor salivary glands in the head and neck. This article focuses on the various types of major salivary gland tumors treated at a tertiary cancer center along with their surgical morbidities and outcomes. Materials and Methods: Data of all the salivary gland neoplasms operated in the head and neck services between January 2012 and December 2013 were retrieved from a prospectively collected database. The clinical, demographic data and types of surgeries along with the morbidities were collated from the database and the details regarding the follow-up were collected from the electronic medical record. Results: Out of 235. cases registered, 107. patients were treated at our institute. The parotid gland was most commonly involved; majority were malignant lesions. Sixty-two patients were treatment naive at presentation. Majority presented with advanced disease. Superficial parotidectomy was the most common surgery performed and neck dissection was done in 27. patients. Facial nerve palsy was the most common complication following surgery. (16%). Sixty patients received adjuvant treatment. All patients on follow-up were alive at their last visit, with 10. patients having recurrence. Factors influencing the disease-free survival were extracapsular spread, tumor grade, and perineural invasion. Conclusion: The postoperative morbidities and outcomes for major salivary gland neoplasms in our series were acceptable and comparable to the results available in the literature. Appropriate treatment of the salivary gland neoplasm will yield good outcomes with acceptable morbidity.
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Background and Objectives: Salivary gland neoplasms are relatively uncommon. They have a wide variety of histopathological types with diverse biological behavior. It involves all the major and minor salivary glands in the head and neck. This article focuses on the various types of major salivary gland tumors treated at a tertiary cancer center along with their surgical morbidities and outcomes. Materials and Methods: Data of all the salivary gland neoplasms operated in the head and neck services between January 2012 and December 2013 were retrieved from a prospectively collected database. The clinical, demographic data and types of surgeries along with the morbidities were collated from the database and the details regarding the follow-up were collected from the electronic medical record. Results: Out of 235. cases registered, 107. patients were treated at our institute. The parotid gland was most commonly involved; majority were malignant lesions. Sixty-two patients were treatment naive at presentation. Majority presented with advanced disease. Superficial parotidectomy was the most common surgery performed and neck dissection was done in 27. patients. Facial nerve palsy was the most common complication following surgery. (16%). Sixty patients received adjuvant treatment. All patients on follow-up were alive at their last visit, with 10. patients having recurrence. Factors influencing the disease-free survival were extracapsular spread, tumor grade, and perineural invasion. Conclusion: The postoperative morbidities and outcomes for major salivary gland neoplasms in our series were acceptable and comparable to the results available in the literature. Appropriate treatment of the salivary gland neoplasm will yield good outcomes with acceptable morbidity.
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Heterotopic glial tissue is very rare in the orbit. Our case was an adult, which is unique since most cases reported in literature involve children. We describe a case of a 60‑year‑old man who presented with an orbital mass, which histopathologically revealed heterotopic glial tissue.