ABSTRACT
Abstract Neglected elbow dislocation is an uncommon condition and its treatment remains challenging. We present a case of a middle-aged woman presenting with neglected elbow dislocation and multi-direction instability in whom open reduction of the elbow joint and circumferential ligamentous reconstruction with a gracilis tendon graft was done. The functional outcome assessed with the Mayo elbow performance index was excellent. This circumferential technique is undoubtedly a viable technique and the indications can be extended to even manage a neglected dislocation. This procedure reduces the need or diminishes the duration of external fixation requirement and thereby encourages early mobilization.
Resumo A luxação negligenciada do cotovelo é uma condição incomum e seu tratamento permanece desafiador. Apresentamos o caso de uma mulher de meia-idade que apresentou luxação negligenciada do cotovelo e instabilidade multidirecional, na qual foi realizada redução aberta da articulação do cotovelo e reconstrução ligamentar circunferencial com enxerto de tendão gracilis. O resultado funcional avaliado com o índice de desempenho do cotovelo de Mayo foi excelente. Essa técnica circunferencial é, sem dúvida, uma técnica viável e as indicações podem ser estendidas para gerenciar até mesmo um deslocamento negligenciado. Este procedimento reduz a necessidade ou diminui a duração da exigência de fixação externa e, assim, incentiva a mobilização precoce.
Subject(s)
Humans , Female , Adult , Joint Dislocations , Elbow Joint , Joint Instability , Ligaments, ArticularABSTRACT
The present study aims to identify the ?nancial strengths and weaknesses of the salem steel plant by properly establishing relationships between the items of the balance sheet and pro?t and loss account. The study covers Salem Steel Plant, a special steels unit of Steel Authority of India Ltd, pioneered the supply of wider width stainless steel sheets / coils in India. The study has been undertaken for the period of twelve years from 2011-12 to 2020-21and the necessary data have been obtained from SAIL database. The liquidity position was strong in case of both the selected companies thereby re?ecting the ability of the companies to pay short-term obligations on due dates and they relied more on external funds in terms of long-term borrowings thereby providing a lower degree of protection to the creditors. The study will help investors to identify the nature of SAIL industry and will also help to take decision regarding investment.
ABSTRACT
Background and Objectives@#This study was aimed at assessing recovery from otitis media (OM) and variables associated with it among 1- to 6-year-old children. @*Subjects and Methods@#We assessed 87 children with OM otologically and audiologically. Medicines were prescribed, and medication compliance was ensured. The children were followed up after 3 months to judge the status of OM as resolved or recurrent. Data were statistically analyzed to derive the risk of recurrence of OM with effusion (OME) and acute OM by degree of hearing loss, type of tympanogram, age group, and sex. @*Results@#The overall recurrence rate was 26%. The risk of recurrence was higher for OME (odds ratio [OR]=4.33; 95% confidence interval [CI]: 1.90 to 9.83); at AC auditory brainstem peak V responses up to 40 dBnHL (OR=5.20; 95% CI: 2.05 to 13), 50 dBnHL (OR=3.47; 95% CI: 0.5 to 23), and 60 dBnHL (OR=16.09; 95% CI: 4.36 to 1.2); in B (OR= 3.16; 95% CI: 1.36 to 7.33) and C tympanograms (OR=2.83; 95% CI: 0.70 to 11.41); and in the age group of 5-6 years (OR=8, 95% CI: 2.23 to 28). The risk of recurrence of OM did not differ between male and female patients. @*Conclusions@#The rate of recurrence was comparable to or lower than that reported in the pediatric population of other countries. The findings suggest that children with OME, severe pathology, or age of 5-6 years require more attention and frequent monitoring to minimize the risk of recurrence.
ABSTRACT
Purpose: To analyze the hesitancy and motivational factors related to coronavirus disease 2019 (COVID?19) vaccination among patients visiting for eye care. Methods: A telephonic survey was conducted using validated questionnaires consisting of 36 questions in five sections from July 1 to July 31, 2021. Patients visiting six tertiary centers and one secondary center of our eye hospitals were interviewed over their phones, and their responses were entered onto the Google forms. The responses were recorded as demographics, health status, awareness about vaccination, factors contributing to hesitancy or acceptance to vaccinate, and general perception about the vaccine. Results: A total of 5033 patients were surveyed. The mean age was 49.0 ± 14.2 years. A total of 563 (11.2%) patients gave a history of symptoms or were tested positive for COVID?19; 2225 (44.2%) patients were already COVID?19 vaccinated. Around 2883 (56%) patients were aware of getting infection despite vaccination, and 4092 (81.3%) perceived vaccination should be compulsory. The main reason for vaccination hesitancy was the fear of side effects (n = 487, 17.3%). The fear of getting infected was the most common reason for vaccination (n = 911, 40.9%). Factors associated with a lower proportion of vaccinated individuals included younger age (P < 0.001), female gender (P < 0.001), lower education (P < 0.001), lower income (P < 0.001), and rural residence (P = 0.33). Conclusion: Creating awareness about the minor side effects and reassurance can allay an individual’s fears. The fear associated with the rapid spread of infection and associated mortality needs to be utilized to increase vaccination acceptance. A targeted approach toward groups with poor uptake of vaccination is necessary.
ABSTRACT
Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID?19 pandemic. Methods: This was a prospective, cross?sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID?19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed. Results: One thousand four hundred seventy two patients were recruited with advanced cataracts. Absence of ophthalmic care nearby (44.2%), lack of awareness regarding elective surgeries (42.6%), lack of public transportation (37%), fear of contracting COVID?19 (23.4%), and waiting for outreach camps (20.4%) were found to be the reasons behind the delay in cataract surgery. 53.7% of the patients had worsening of defective vision and 55.3% of them had difficulty in carrying out activities of family living. 30.8% of the patients faced difficulty in commuting and 8.4% of the patients suffered a fall during this pandemic due to worsening of the visual acuity. Conclusion: The lockdown imposed during the pandemic has created a significant backlog of patients who are progressing to advanced cataracts due to lack of ophthalmic care nearby, lack of awareness regarding elective surgeries, lack of public transportation, and no outreach camps. Proactive measures to deal with this backlog are of utmost need to prevent blindness due to cataract
ABSTRACT
Financial statements are the pulse of an organization to understand the healthy financial position of an organisation. This Study was taken up in Tamilnadu Industrial Development Cooperative Bank (TAICO), Chennai with the objective to determine the variation in the items of income statement and balance sheet by common size statement, to evaluate the performance of the bank by comparative study and to ascertain the solvency, liquidity and profitability ratios of the bank. For the purpose of the study, last three years financial statements were obtained from the bank.With the help of Common size balance sheet, Comparative Balance sheet and Ratios of Profitability, Solvency and Liquidity the financial status was obtained. The bank has seen a down side during the pandemic period as visible from the analysis. It is also very positive to note that deposits has risen and the bank is close to pre-pandemic status as per 2021 reports. The bank has to concentrate on investing in Fixed assets and also ensure that profits are used in this regard. Other variables indicate a healthy financial statement of the bank
ABSTRACT
A Pythagorean fuzzy set is the successful ?eld which includes membership and non membership functions. It has been extended from intuitionistic fuzzy set. It reaches many application with the support of score, Accuracy, Distance and Similarity measures. In this paper, cosine similarity measure is used with Pythagorean fuzzy set. An algorithm is developed for proposed method. An illustrative example is included. Comparison is also made with Score, Accuracy and Similarity measure function.
ABSTRACT
Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
ABSTRACT
OBJECTIVES@#Elder abuse has significant adverse consequences for the overall health and well-being of the elderly, including premature mortality. Using cross-sectional data, we assessed the prevalence of elder abuse in India, its variation across states, and associated factors. @*METHODS@#Nationally representative data from the first wave of the Longitudinal Aging Study in India were analyzed. Bivariate and multivariate analyses were used to study the prevalence, state variations, and associated factors of elder abuse. @*RESULTS@#Overall, 5.2% of elderly adults (≥60 years) had experienced abuse in the year prior to the survey and 3% had experienced abuse within their own household. Verbal abuse or disrespect was the most common form of abuse. Considerable variation was observed in the prevalence of elder abuse across states and union territories, with the highest prevalence observed in Bihar (11.6%) and Karnataka (10.1%). In regression analysis, education level emerged as a protective factor against elder abuse, particularly among women. Older adults who lived alone, had functional limitations, had multiple morbidities, and had been hospitalized in the past year were more likely to experience abuse. Older adults who experienced abuse were 2 times more likely to experience depressive symptoms. @*CONCLUSIONS@#Cross-state variation in the prevalence of elder abuse and subgroup differences suggest that state-specific interventions and essential monitoring of older adults with functional limitations, chronic diseases, and recent hospitalization can further reduce the prevalence and consequences of elder abuse in India.
ABSTRACT
As the world grapples with the problem of the coronavirus disease 2019 (COVID-19) pandemic and its devastating effects, scientific groups are working towards solutions to mitigate the effects of the virus. This paper aimed to collate information on COVID-19 prediction models. A systematic literature review is reported, based on a manual search of 1,196 papers published from January to December 2020. Various databases such as Google Scholar, Web of Science, and Scopus were searched. The search strategy was formulated and refined in terms of subject keywords, geographical purview, and time period according to a predefined protocol. Visualizations were created to present the data trends according to different parameters. The results of this systematic literature review show that the study findings are critically relevant for both healthcare managers and prediction model developers. Healthcare managers can choose the best prediction model output for their organization or process management. Meanwhile, prediction model developers and managers can identify the lacunae in their models and improve their data-driven approaches.
ABSTRACT
ABSTRACT@#Orofacial odontogenic infection, although arises from dental origin, can extend into the facial spaces and lead to debilitating complications. This study analysed the clinical pattern and management of orofacial odontogenic infection in a tertiary hospital namely Hospital Raja Permaisuri Bainun in Perak, Malaysia. We investigated any associations between socio-demographic factors, diabetic, comorbidities, smoking, pregnancy, antibiotic resistance, number and type of space infected towards prolonged hospital stay. All adult patients with orofacial odontogenic infections treated by Department of Oral and Maxillofacial Surgery from 2014 to 2018 were included. Clinical patterns were evaluated. Statistical analysis was performed to measure various variables towards prolonged hospital stay. A total of 154 patients (78 male, 76 female) were included in this study with mean age of 37.95 ± 14.9 years. Key factors of orofacial odontogenic infection requiring admissions were swelling, pain, trismus, odynophagia, reduced oral intake, raised floor of mouth and dyspnea. Among inpatients, three factors were significantly associated with prolonged hospital stay, namely antibiotic resistance, multiple space and secondary space infection. Local prevalence data was reported. Pus culture and sensitivity tests were recommended for all inpatients with multiple space and secondary space involvement, in order to rule out antibiotic resistance and to improve recovery rate.
Subject(s)
Tooth DiseasesABSTRACT
As the world grapples with the problem of the coronavirus disease 2019 (COVID-19) pandemic and its devastating effects, scientific groups are working towards solutions to mitigate the effects of the virus. This paper aimed to collate information on COVID-19 prediction models. A systematic literature review is reported, based on a manual search of 1,196 papers published from January to December 2020. Various databases such as Google Scholar, Web of Science, and Scopus were searched. The search strategy was formulated and refined in terms of subject keywords, geographical purview, and time period according to a predefined protocol. Visualizations were created to present the data trends according to different parameters. The results of this systematic literature review show that the study findings are critically relevant for both healthcare managers and prediction model developers. Healthcare managers can choose the best prediction model output for their organization or process management. Meanwhile, prediction model developers and managers can identify the lacunae in their models and improve their data-driven approaches.
ABSTRACT
Background: Football is the sport that requires a lot of high-intensity dynamic movements like jump, i.e. while heading and kicking a ball. Unstable surfaces like Bosu ball in the fields of rehabilitation and general fitness are effective in joint stabilization by improving the sensory efficiency of soft tissue during dynamic activities. Thus the purpose of the study was to see the effects of Bosu ball exercise on jump performance in football players. Methods: A total of 90 football players participated in the study. The players were categorized into two groups experimental group (n=45) who underwent Proprioceptive training on Bosu ball with their regular football training program and control group (n=45) underwent regular football training program. The players were trained for six weeks. Jump assessment at pre and post-intervention was done for all subjects using the single-leg hop test and Vertical Jump test. Results: The results revealed a significant difference in pre and post assessment experimental > control group single-leg hop test and vertical jump test with p-value 0.000 (< 0.05). Conclusion: Bosu ball training was effective in improving the single-leg hop distance and vertical jump height in male football players.
ABSTRACT
Not many studies have compared more than two drugs in attenuating pressor responses to laryngoscopy and intubation. This study compares four groups of considerable size. The present study compared intravenous esmolol, diltiazem, and lignocaine, for their efficacy to abate pressure response to laryngoscopy and intubation. METHODSThis is a prospective, randomized, double-blinded, controlled clinical study conducted among 220 patients of ASA grade I/II (age 18–60 years), undergoing elective surgical procedure requiring general anaesthesia with endotracheal intubation over a period of 15 months at a tertiary hospital setup. Study subjects were categorised as Groups D, E, L, and N that received diltiazem (0.2 mg/Kg IV), esmolol (2 mg/Kg IV), lignocaine (1.5 mg/Kg IV), and normal saline, respectively; each group had 55 patients. Haemodynamic parameters were recorded at baseline, after drug administration, immediately after intubation, and at 1-, 3-, and 5-minutes after intubation. Data entry and analysis were performed using MS Excel and SPSS-PC-17 version, respectively. One-way ANOVA and the chi-square test were used to evaluate the difference. P < 0.05 was considered significant. RESULTSA maximum increase in haemodynamic parameters occurred immediately after intubation. The increase in heart rate and rate pressure product were significantly lower in Group E (+2.93% & +15.31%), whereas the increase in blood pressure was lower in Group D (8.51%). CONCLUSIONSHaemodynamic stability during laryngoscopy and endotracheal intubation is an integral and essential goal of any anaesthetic management plan and was more effectively maintained with esmolol and diltiazem than with lignocaine.
ABSTRACT
Presence of different bacterial pathogens in the urinary tract results in the occurrence of infectious diseases among the human beings. The emerging multi drug resistance capacities of pathogens are the major constrain in the treatment of bacterial diseases. Researchers are trying to develop new antimicrobial agents from natural resources including marine organisms to combat the issue. This research work has carried out to investigate the anti-bacterial activity of sea star Pentaceraster mammillatus against ten common UTI pathogens. Four different polar solvents viz; methanol, acetonitrile, dichloromethane and ethanol were used for the experiment. At the lowest concentration (250µg/ml), none of the above said extracts has showed any inhibitory effects in the pathogens; however the concentrations such as 500 and 1000µg/ml of extracts inhibited the bacterial growth. Acetonitrile and dichloromethane showed higher inhibitory effects on gram positive bacterial strains Mycoplasma genetalium (4.3 ± 0.23 mm) and Staphylococcus aureus (4.1 ± 0.21 mm) respectively. Ethanolic extract showed some good inhibitory effects on M. genetalium (3.5 ± 0.14 mm) and the methanolic extract demonstrated relatively lower inhibition.
ABSTRACT
Background: India contributes to 25% of neonatal mortality around the world. In developing countries neonatal mortality is quite high despite of advances in perinatal and neonatal care. The establishment of Special Newborn Care Units (SNCU) has been quite essential in reducing the neonatal morbidity and mortality. This study was conducted to assess the outcome of SNCU at a newly commissioned tertiary care teaching hospital at Nellore District, Andhra Pradesh. Aim of this study the morbidity and mortality patterns in an SNCU at tertiary care teaching hospital.Methods: It was a Retrospective, Hospital based, Descriptive study which was done among neonates admitted to SNCU, Nellore District, Andhra Pradesh for a period of 1 year (January 2015-December 2015). All the neonates admitted to SNCU, Nellore District, Andhra Pradesh during the study period were included in the study. Data was recorded in a predesigned semi-structured proforma. the data was entered into excel-sheet and analyzed using SPSS software version 21.Results: A total of 1015 babies were included in the study. Almost half 592(58.32%) were born in this hospital(inborn) and 423(41.67%) babies were referred from peripheral hospitals and nursing homes (out born). about 3/4th 767(75.5%) of babies were admitted in the first 24 hours of life. Almost half (53.4%) of the study group were male and 46.6% were female. The chief causes of admission in SNCU were Respiratory Distress Syndrome (40.2%) followed by birth asphyxia (19.1%), sepsis (13.3%), Neonatal Jaundice (9.9%) and prematurity (6.6%). In our study 63.0% patients were discharged, 19.3% had left hospital against medical advice, 10.1% died and 7.6% were referred to other institutions for specialized treatment.Conclusion: Respiratory Distress Syndrome, neonatal sepsis, neonatal hyperbilirubinemia, and HIE as the major causes of morbidity. Low Birth Weight and prematurity were the commonest contributors of death, therefore, attempts to prolong the pregnancy each week might improve the neonatal outcome considerably.
ABSTRACT
Background: Adequate and safe food is a basic requirement for every individual. Inadequate food leads to food insecurity. Household-level food insecurity may directly influence the health of an individual. We aimed to assess the prevalence of household-level food insecurity in the rural areas of Kaniyambadi block and to assess the household level determinants of food insecurity.Methods: A cross-sectional study was conducted in villages of Kaniyambadi block, a rural development block of Vellore district in Tamil Nadu. Households were the unit of study. The interview was conducted with a pre-tested, semi-structured questionnaire in Tamil. ‘U.S. Food Security Survey module’, September 2012, for a reference period of 30 days was used to determine food security status.Results: One hundred and fifty households were selected; 15 from each 10 randomly selected villages. Prevalence of food insecurity we got as 52.7% [95% CI: 44.6%, 60.8%]. Determinants like ‘low (<1225 INR/ month) per capita income’ [Adjusted odds ratio (AOR)- 6.7; 95% CI: 3.3,13.6]; ‘presence of debt at the time of interview’ [AOR- 3.5; 95% CI:1.7, 7.3] and ‘presence of at least one smoker in the family’ [AOR- 3.2; 95% CI:1.5, 6.8], were found to be associated significantly with food insecurity, after adjusting for the clusters by multi-level modelling.Conclusions: Food insecurity is a hidden phenomenon in India. Poverty is the key determinant behind this. To alleviate food insecurity, it will be logical to adopt multi-dimensional approaches with thrust on implementing the existing poverty alleviating programs
ABSTRACT
Background: Bubble continuous positive airway pressure (bCPAP), a non-invasive respiratory device provides continuous pressure that helps recruitment of more alveoli, increases the lungs, functional residual capacity and decreases the work of breathing in newborns admitted with respiratory distress. Bubble continuous positive airway pressure (bCPAP) is the most important respiratory support in different types of respiratory conditions in level III. In this observational study, author reported this research using bCPAP therapy as the primary respiratory support in level III unit in tertiary care centre in Chengalpattu, Tamil Nadu, India. Despite reporting their indications, duration of use and adverse effects we tried to search for further improvement in other areas of CPAP therapy in level III newborn unit.Methods: This prospective observational study included 250 babies delivered in obstetric unit and admitted with respiratory distress within 6 hours of birth at level III care. They were treated according to level III newborn unit protocol. Those data were collected and entered in the proforma. Newborns were followed up till discharge.Results: A total of 250 babies satisfying the inclusion criteria delivered in Chengalpattu Medical College Hospital, Tamil Nadu, India (mean gestational age 36'2 weeks, mean birth weight 2.5'1.2 kg were included. All newborns were given bCPAP as the primary support. The most common underlying cause of respiratory distress was transient tachypnea of newborn (44%), followed by respiratory distress syndrome (24%) and prolonged respiratory transition (18%). The therapy success rate was 86%. Only 35 newborns failed to respond to CPAP. The most common adverse effect was eye puffiness (19%).Conclusions: Bubble continuous positive airway pressure (b CPAP) therapy use is being well established in level III unit for various respiratory conditions with minimal failure and adverse effects. Its use in extreme preterms and initiation after 6 hours is controversial.
ABSTRACT
Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients. Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.