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ABSTRACT Purpose: To compare the outcomes of intravitreal dexamethasone implant used as either an adjuvant or a switching therapy for diabetic macular edema in patients with poor anatomic response after three consecutive monthly injections of ranibizumab. Methods: This retrospective study included patients with diabetic macular edema who received three consecutive doses of ranibizumab as initial therapy and demonstrated poor response. A single dose of intravitreal de xamethasone implant was administered to these patients. The patients were divided into two groups according to the treatment modalities: the adjuvant therapy group, consisting of patients who continued treatment with ranibizumab injection after receiving intravitreal dexamethasone implant, and the switch therapy group, consisting of patients who were switched from ranibizumab treatment to intravitreal dexamethasone implant as needed. The main outcome measurements were best corrected visual acuity and central retinal thickness at baseline and at 3, 6, 9, and 12 months of follow-up. Results: In this study that included 64 eyes of 64 patients, the best corrected visual acuity and central retinal thickness values did not significantly differ between the groups at baseline and at 6 months of follow-up (p>0.05). However, at 12 months, the best corrected visual acuity values in the adjuvant and switch therapy groups were 0.46 and 0.35 LogMAR, respectively (p=0.012), and the central retinal thickness values were 344.8 and 270.9, respectively (p=0.007). Conclusions: In a real-world setting, it seems more reasonable to use intravitreal dexamethasone implant as a switch therapy rather than an adjuvant therapy for diabetic macula edema refractory to ranibizumab despite three consecutive monthly injections of ranibizumab. Patients switched to intravitreal dexamethasone implant were found to have better anatomic and visual outcomes at 12 months than those who continued ranibizumab therapy despite their less-than-optimal responses.
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ABSTRACT A patient presented with corneoscleral thinning five months after the treatment of suspected ocular squamous surface neoplasia with mitomycin-C and interferon. For tectonic and aesthetic purposes, we decided to perform lamellar corneoscleral transplantation. The approach used established new tectonic support and corneal homeostasis. This technique might be an option in similar cases.
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Background: Generalised peritonitis secondary to Ileal Perforation is a common surgical emergency in tropical countries. It has become the fifth most common cause of abdominal emergency due to high incidence of enteric fever, tuberculosis, non-specific enteritis in these regions. To compare the management approaches by evaluatingObjective: the morbidity & mortality outcome of primary repair and ileostomy in non-traumatic ileal perforation with respect to pre- operative parameters, intra-operative findings & post-operative complications and mortality. Study is aMethods: randomized retrospective and prospective comparative observational study done from April 2022 to March 2023, 70 cases of ileal perforation fulfilling the inclusion & exclusion criteria and subdivided them into two groups. Patients who underwent primary repair & ileostomy into group 1 & 11 respectively. In our study the median age groupResults: affected were 36-50 years, males preponderance was there. Surgical site infection is the most common complications associated with both the procedures. Leak & Burst abdomen were the most devastating complication among primary repair. In our study increased rate of Post-operative complications were observed more in group 1 than group 11, Though Cosmetic acceptance & cost effectiveness was better to be in group 1 patients. In ileal perforation,Conclusion: Exteriorization procedure, temporary de-functioning ileostomy plays an important role is more appropriate compared to primary repair in terms of post-operative complications & mortality. Yet the primary determinant to choose the procedure remains to be general condition of the patient & intra-operative findings.
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Aims: Boerhaavia diffusa Linn belongs to the family Nyctaginaceae has been documented for its antioxidant, anticancer, anthelmintic & neuropharmacological effects. Literature review of the plant revealed that some research works are performed during this plant. That’s why; this study was performed to gauge the antioxidant, anticancer, anthelmintic & neuropharmacological activities of the methanolic extract from the leaves of Boerhaavia diffusa (MEBD). Method and Results: Antioxidant activity was evaluated using DPPH free radical scavenging assay using serial dilution concentration and the IC50 was 1.51. Anticancer test was done using cell viability assay. During anticancer test in the concentration of 1000µg/mL the percent of inhibition was 29.16%. Anthelmintic activity was investigated using earthworms (Pheretima posthuma) and fresh leaf juice of the plant. In anthelmintic activity, the time of paralysis for fresh leaf juice was begin from 64 min 55 sec and end to 23 min 19 sec while the time for tested drug Albendazole was started from 76 min 09 sec and end to 30 min 43 sec. Besides, the time of death start from 71 min 09 sec and end to 29 min 54 sec for leaf juice and for Albendazole the time of death start from 82 min 19 sec and end to 38 min 18 sec respectively at several doses which suggest considerable anthelmintic activity of the plant. Neuropharmacological activity was performed by hole cross and light/dark box tests at the doses of 200 mg/kg and 400 mg/kg in Swiss albino mice contrast to the test drug Diazepam (2mg/kg). The extract significantly decreases the locomotor activity as shown by the results of hole cross test which indicate significant antidepressant property. The results also matching the activity in light/dark box test. Conclusion: Thus, the obtained results in the research work provide a support for the utilization of this plant for medicinal purposes and encourage further investigations for more fruitful results.
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Background: - Sports Achievement Motivation is the effort of an athlete puts in to succeed in their chosen eld, such as overcoming obstacles or mastering a task. It is a strong psychological factor for determining the athlete's performance. - The purpose of the study was to compare the Sports achievement MotivationPurpose: between the Active and Inactive school going boys in Paschim Medinipur district. Materials & Methods: -Total Sixty (60) subjects were taken from Harimara Konarpur S.S.C High School, Goaltore, Paschim Medinipur, West Bengal for the study. They were divided into two groups such as Active and Inactive Groups. Thirty (30) Active and Thirty (30) Inactive boys (age, 16-18yrs) were randomly selected for the study. To measure the Sports achievement Motivation between Active and Inactive boys, a questionnaire developed by Kamlesh (1990) was employed. For statistical analysis and Interpretation of data't' test was conducted at 0.05 level of signicant. -The nding of the study reveals that there was a signicantResult & Discussion: difference found on Sports achievement Motivation between Active and Inactive boys. It was observed from the table that Mean and SD of the active boys were (15.56 & 3.12) and Mean and SD of Inactive boys were (12.42 & 2.08) and MD was (3.14). It was also seen that calculated t-value (5.78) was more than the table value in the signicant of 0.05 Level of Condence. So, the Active boys have better sports achievement motivation because they were involved in various types of physical activities & games and sports regularly. Similarly, Inactive boys have lower level of sports achievement motivation than Active boys because they were not involved in games and sports. -On the basis of obtained result, it has been observed thatConclusion: Active boys have higher sports achievement motivation than the Inactive boys.
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A modified online questionnaire comprising of demographics, knowledge and practice based questions was prepared and distributed online amongst 215 dentists irrespective of their specialty. A stipulated time of two weeks was given to receive response. The data collected was segregated and analyzed using MS excel for descriptive analysis. The response rate of 76% was achieved as 163 responses were received out of 215 participants. The survey respondents comprised of 32.5% percent of graduates, 35.5% endodontists and rest post-graduates of other specialties. Around 78.5% respondents experienced instrument separation during cleaning and shaping while 12.5 % during initial negotiation. Regarding the level of fracture inside the canal almost 71.5% observed separation in apical third of canal in mesial roots (65.6%) of mandibular molars. Most of the clinicians preferred bypassing technique (59.9%) as first line of treatment. 21.9% respondents preferred to leave the separated instrument in canal without further treatment & 8.8% clinicians opted for retrieval of separated instrument. 9.4% referred to endodontist for further treatment. Most of the respondents were aware about the basic technique and about the role of magnification in management of separated instrument although more information and training is needed to get aquanted with latest techniques and equipments for the treatment of separated instrument
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Trauma affects children from all communities and regions. Among nursing students, the prevalence of childhood trauma is a concern that can have long-lasting effects on their mental health and well-being. Childhood trauma refers to experiences of physical, emotional, or sexual abuse and neglect during childhood. The prevalence of childhood trauma among nursing students has significant implications for their mental health and well-being. Various factors contribute to childhood trauma among nursing students, such as personal and family issues, environmental factors etc. Understanding the prevalence of childhood trauma among nursing students is crucial for healthcare institutions and educators to develop appropriate support systems and interventions that address the unique challenges faced by this population
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Introducción: la marcación de biomoléculas con radionúclidos es una técnica fundamental en la medicina nuclear que permite la visualización y tratamiento de diversas enfermedades, especialmente el cáncer. Materiales y métodos: este trabajo aborda en detalle los métodos y aplicaciones de esta tecnología, incluyendo la selección de radionúclidos, la conjugación con biomoléculas mediante agentes quelantes como Ácido dodecano tetraacético (DOTA), Ácido Dietilen Triamino Penta Acético (DTPA) y Ácido hidracinonicotínico (HYNIC), y los procesos de purificación y caracterización. Resultados: se presentan ejemplos específicos, como la marcación de Bevacizumab y Tocilizumab con 99mTc y 177Lu, destacando sus aplicaciones en la imagenología y terapia del cáncer. Además, se exploran las aplicaciones clínicas y futuras investigaciones en el campo, enfatizando el potencial de la medicina personalizada y las terapias combinadas. Discusión: la tecnología de marcación con radionúclidos continúa avanzando, prometiendo mejoras significativas en el diagnóstico y tratamiento de enfermedades complejas, ofreciendo herramientas precisas y eficientes para la gestión de la salud. Presentamos una visión exhaustiva de las técnicas, estudios de caso y el impacto de esta metodología en la práctica clínica.
Introduction: The labeling of biomolecules with radionuclides is a fundamental technique in nuclear medicine that allows the visualization and treatment of various diseases, especially cancer. Materials and methods: This work discusses in detail the methods and applications of this technology, including radionuclide selection, conjugation to biomolecules using chelating agents such as dodecane tetraacetic acid (DOTA), Diethylene Triamino Penta Acetic Acid (DTPA), Hydrazinonicotinic acid (HYNIC), and purification and characterization processes. Results: Specific examples are presented, such as the labeling of Bevacizumab and Tocilizumab with 99mTc and 177Lu, highlighting their applications in cancer imaging and therapy. In addition, clinical applications and future research in the field are explored, emphasizing the potential for personalized medicine and combination therapies. Discussion: Radionuclide tagging technology continues to advance, promising significant improvements in the diagnosis and treatment of complex diseases, offering accurate and efficient tools for healthcare management. This chapter provides a comprehensive overview of the techniques, case studies and the impact of this methodology in clinical practice.
Introdução: A marcação de biomoléculas com radionuclídeos é uma técnica fundamental na medicina nuclear que permite a visualização e o tratamento de várias doenças, especialmente o câncer. Materiais e métodos: este artigo discute em detalhes os métodos e as aplicações dessa tecnologia, incluindo a seleção de radionuclídeos, a conjugação com biomoléculas usando agentes quelantes, como Ácido dodecano tetra-acético (DOTA), Ácido dietileno triamino pentaacético (DTPA) e Ácido hidrazinônico-tínico (HYNIC), e os processos de purificação e caracterização. Resultados: são apresentados exemplos específicos, como a marcação de Bevacizumab e Tocilizumab com 99mTc e 177Lu, destacando suas aplicações em imagens e terapia de câncer. Além disso, são exploradas as aplicações clínicas e as pesquisas futuras no campo, enfatizando o potencial da medicina personalizada e das terapias combinadas. Discussão: A tecnologia de marcação com radionuclídeos continua avançando, prometendo melhorias significativas no diagnóstico e no tratamento de doenças complexas, oferecendo ferramentas precisas e eficientes para o gerenciamento da saúde. Apresentamos uma visão geral abrangente das técnicas, estudos de caso e o impacto dessa metodologia na prática clínica.
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Humans , Organotechnetium Compounds/chemistry , Chelating Agents , Technetium/chemistry , Bevacizumab/chemistry , Antineoplastic Agents, Immunological/chemistry , Lutetium/chemistry , Molecular Imaging , Antibodies, Monoclonal, Humanized/chemistry , Isotope Labeling , Neoplasms/diagnostic imagingABSTRACT
Objetivo: Determinar la prevalencia de las anomalías dentomaxilares (ADM) y necesidad de tratamiento de ortodoncia en escolares de 6 años en cinco comunas en Chile. Material y método: Estudio de corte transversal, observacional y descriptivo. La muestra fue de 1102 escolares. Se realizaron exámenes clínicos aplicando la Guía de Referencia Clínica a Ortodoncia para Servicios Públicos de Salud, para determinar la prevalencia de las ADM y necesidad de tratamiento de ortodoncia. El análisis estadístico utilizó el programa STATA®, considerando estadísticamente significativo p 0.05. Resultados: 1102 escolares de 6 años fueron examinados, 48,8% niñas y 51,2% niños. La prevalencia de niño/as con anomalías dentomaxilares fue 59.1%. Las tres más prevalentes fueron: apiñamiento dentario o rotaciones (21,6%), resalte aumentado (17,6%) y overbite aumentado (15,9%). La necesidad de tratamiento de ortodoncia encontrada fue de 34,7% con evidente necesidad y un 25,3% con leve necesidad. Conclusión: Se evidencia la necesidad de incluir en las políticas públicas de salud oral, estrategias de diagnóstico y tratamiento temprano de ADM por su alta prevalencia.
Objective: To determine the prevalence of dento-maxillary anomalies (DMA) and the orthodontic treatment need in 6-year-old schoolchildren in five areas of Chile. Material and method: Cross-sectional, observational and descriptive study. The sample consisted of 1102 6-year-old schoolchildren. Clinical examinations were carried out applying the Clinical Reference Guide for Orthodontics in Public Health Services, to determine the prevalence of DMA and the need for orthodontic treatment. Statistical analysis used the STATA® program, considering p ≤ 0.05 statistically significant. Results: 1102 6-year-old children were examined, 48.8% were girls and 51.2% boys. The prevalence of children with DMA was 59.1%. The three most prevalent were: dental crowding or rotations (21.6%), increased overjet (17.6%), and increased overbite (15.9%). The orthodontic treatment need was 34.7% of patients with great need and 25.3% with moderate need. Conclusion: The need to include early diagnosis and treatment strategies for DMA in public oral health policies is evident due to its high prevalence.
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Humans , Male , Female , Child , Malocclusion/epidemiology , Chile/epidemiology , Prevalence , Cross-Sectional Studies , Dental Care , Early Diagnosis , Overbite/epidemiology , Health Services Needs and Demand , Malocclusion/prevention & controlABSTRACT
In 2021, US healthcare spending surpassed $4.3 trillion, about 18.3% of GDP, and is projected to grow over 5% annually until 2028 [1, 2]. The US healthcare system, which often fails to provide the best patient outcomes at the lowest cost, is fragmented and inefcient. It is organized around silos of providers, payers, and pharmacies, not centered on patients' needs, leading to duplication, waste, and poor care coordination. Built on a fee-for-service payment model, the system prioritizes service volume over value and quality [3]. Despite efforts to link care to value, this model incentivizes overuse, underuse, and misuse of resources. The fragmented care and lack of accessible patient outcome data hinder informed decision-making. The focus remains on billable services rather than disease prevention or health promotion, resulting in higher rates of chronic conditions, complications, mortality, and acute care spending. In searching for solutions to these pervasive healthcare challenges, articial intelligence (AI) offers promising possibilities. AI has tremendous potential to transform clinical care by optimizing resource utilization, enhancing care delivery, and improving patient outcomes. There are three major areas in which we envision AI to be valuable for improving care: (1) streamlining administrative tasks to increase physician productivity, (2) rapidly assisting physicians in diagnosis and treatment, and (3) vastly tracking quality metrics to improve the healthcare system.
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The study of Land Use/Land Cover (LULC) is crucial for managing natural resources in response to increasing human demands in today's ecosystem. This research primarily employs Geographic Information System (GIS) and land use data to path changes in Dharmavaram mandal, situated in the Ananthapur district of Andhra Pradesh, India. The focus of this paper is on analyzing and recognizing alterations in LULC between 2017 and 2023 using Esri Land cove Sentinel-2 10 metre Land use and Land cover data. The integration of remote sensing technology and GIS tools has facilitated the monitoring of land use and land cover changes over time. This technology has unveiled changes at both regional and global levels, providing substantial bene?ts to the scienti?c community.
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Sports Competition Anxiety test (SCAT) constructed and standardized by Martins was administrated on 30 inter university (15 male & 15 female) players of Vidyasagar University. The age of subjects ranged between 19 to 25 years. The purpose of the study was to compare the level of Anxiety between male and female inter university football players of Vidyasagar University, Midnapur, West Bengal. Statistical analysis has been done by T- test and the significance of the result was seen on 0.05 level. The T- test showed that there was no significant difference was found in mean difference among the male and the female Inter university football players in relation to Sports Competition Anxiety.
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Back ground: Long-coronavirus disease is the long-term consequences of COVID-19 infection experienced by individuals who are infected with the virus. Signs, symptoms, and problems that persist or worsen following an acute COVID-19 infection are collectively referred to as long COVID. This study tries to determine the correlation between vaccination status and the post-COVID long-term effects in vaccinated versus non-vaccinated infected individuals. Methodology: It was a cross-sectional descriptive design, encompassing 416 individuals. Study cases represented vaccinated individuals who were infected and were suffering from the long-term consequences of COVID-19, as opposed to non-vaccinated infected individuals. Individuals who were neither infected, vaccinated, or unvaccinated considered as a reference group for estimating the correlation utilizing Odds ratio (OR). Result: This study revealed that vaccinated individuals were more commonly affected by weakness (OR= 0.93; 95% CI 0.49-1.7), joint pain (OR= 0.7; 95% CI 0.41-1.4), and concentration problems (OR= 0.87; 95% CI 0.44-1.7) so that present study didn’t notify significant statistical findings for post-COVID conditions risks regarding to vaccination status. Conclusion: The correlation between vaccinated and non-vaccinated individuals who develop post-COVID-19 conditions showed that risk factors for developing these conditions were independently associated with vaccination status among infected participants.
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Background: Most head and neck cancers arise from the mucosal epithelium of the oral cavity, pharynx, and larynx, and are collectively referred to as head and neck squamous cell carcinoma (HNSCC). Early-stage HNSCC are managed by surgery alone where whereas locally advanced cancers require multimodal treatment which involves surgery followed by adjuvant radiotherapy(RT) or chemoradiotherapy(CRT). Methods: The present study was conducted at the State Cancer Institute, Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, MP, India. About 60 patients of either sex, randomized into two groups of 30 patients in each group fulfilling the inclusion and exclusion criteria were scheduled to undergo radiation with Cisplatin. Arm A patients received accelerated fraction, while Arm B received conventional fraction. Result: Most patients in both arms were males aged 50-60. In both arms, most patients had primary lesions in the oral cavity and were classified as stage III. Mucositis was more severe in Arm A than in Arm B. All of the patients in both arms were suffering from dysphagia during treatment. Complete response was achieved by 55.56% of patients in Arm A and 48.57% in Arm B. Conclusion: It was concluded that an accelerated regimen could be preferred over a conventional one per the clinical response observed and toxicity management. Disease-free survival can be predicted using a large sample size and time.
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Introduction: Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. But when these emotions are persistent, excessive and irrational and affect a person's ability to function, anxiety becomes disorder. The purpose of the study was to ?nd out the status of state and trait anxiety of B. P. Ed students andPurpose: general degree college students at Baliapal, Balasore, Odisha. Total 50 college going students (25 B. P. Ed students and 25 generalMethodology: degree college students) were selected randomly as subject for the present study. The age ranging was between 18-23 years. State and Trait anxiety of the students were measured through questionnaire prepared by Spielberger (1988). Mean and standard deviation were used as descriptive statistics and t- test was conducted to ?nd out the difference between the two means. The 0.05 level of con?dence was considered for this study. Result revealed that there was a signi?cant difference between B. P. Ed students and general degree college students in respectResults: of State anxiety and Trait anxiety because calculated value (2.76 & 2.16) are more than the table value. On the basis of the obtainedConclusion: result, it has been observed that B. P. Ed students were better in state and trait anxiety than the general degree college students.
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An animal bite is an injury caused by the mouth and teeth of an animal including humans. The present study was conducted in 2023 with the objective to assess the knowledge and practice regarding animal bite among bite victims attending OPD services of CHC, Karukachal. A descriptive research design & convenient sampling technique were used to conduct the study among 50 animal bite victims attending OPD services of CHC, Karukachal. The data were collected using self-structured knowledge and practice questionnaire. The data were analysed by using descriptive statistics. The results showed that most of the samples (84%) had average knowledge regarding animal bite. Also, 90 percent of samples cleaned the area of animal bite using soap and water; 50 percent cleaned the area thoroughly for 15 minutes, 76 percent of samples kept the suspected animal under observation. Twenty-six percent applied antiseptic solution or creams to the affected area, 76 percent consulted the doctor at the day of bite itself. All the samples were got vaccinated against rabies after animal bite. The study concluded that improved community awareness regarding animal bite and its management is required to fight against rabies.
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Milk is a source of essential nutrients, but food safety across the milk supply chain has emerged as an integral part of food trade. Of the several food safety hazards, antimicrobial-resistant Staphylococcus species have emerged as one of the major microbial hazards with significant public health concerns. The present cross-sectional study was undertaken with the objective to isolate Staphylococcus species from the milk supply chain, characterize isolates for antimicrobial resistance, and trace the origin of isolates using molecular techniques. Samples collected from the formal and informal milk supply chains showed prevalence of Staphylococcus species of 4.3% (n=720); isolates were identified as coagulase-positive (S. aureus 67.7% and S. intermedius 6.4%) and coagulase-negative (S. lentus 9.6%, S. sciuri 3.2%, S. xylosus 3.2%, S. schleiferi 3.2%, S. felis 3.2%, and S. gallinarum 3.2%) species. Staphylococcus isolates showed antimicrobial resistance to methicillin (32.2%), ?-lactam (41.9%), and macrolide-lincosamide-streptogramin B (3.2%). Staphylococcus isolates phenotypically resistant to methicillin also carried the mecA gene and displayed diverse pulsed field gel electrophoresis (PFGE) profiles, indicating their diverse origins in the milk supply chain. Based on the similarity of PFGE profile, the origin of one of the Staphylococcus isolates was traced to the soil in contact with milch cows. The findings of this study highlight the need for more comprehensive microbial risk analysis studies across the milk supply chain, capacity building, creation of awareness among stakeholders about the judicious use of antimicrobials, and protection of public health using a One-Health approach.
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Objective. This article presents a literature review to explore and analyze the current situation of pressure ulcers or lesions or decubitus ulcers, pathophysiological, epidemiological aspects, and risk factors. The progress in evidence of the effectiveness of preventive repositioning in the appearance of these lesions in vulnerable hospitalized patients is also evaluated. Methods. Databases were reviewed in non-systematic manner, including the Cochrane Wounds Specialized Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, SciELO, and Lilacs. The general search terms included [pressure ulcers or pressure lesions or decubitus ulcers] and [prevention or preventive] and [repositioning or positioning or position changes or postural change] and [patient at risk or vulnerable] and [hospitalized or ICU or intensive care]. Systematic literature reviews, randomized clinical trials, observational studies, cost-effectiveness and qualitative studies in English or Spanish were included. Results. Although globally, the incidence, prevalence, and years of disability associated to these lesions has diminished between 1990 and 2019, the high impact on health persists. Evidence found on the effectiveness of repositioning in preventing pressure ulcers and health associated costs has been evaluated with certainty between low and very low, as a result of conducting research with serious methodological limitations that report results with high inaccuracy. Conclusion.The findings reported present that these lesions persist at hospital level and continue being a global social and health problem with high impact on health budgets. Likewise, there is a need to develop greater quality research on prevention strategies, such as repositioning, which validate their effectiveness, and justify their use.
Objetivo. Este artículo presenta una revisión de la literatura con el objetivo de explorar y analizar la situación actual de las úlceras o lesiones por presión o úlceras por decúbito, aspectos fisiopatológicos, epidemiológicos, y factores de riesgo. Se evalúa además el progreso en la evidencia de la eficacia del reposicionamiento preventivo en la aparición de estas lesiones en pacientes vulnerables hospitalizados. Métodos. Se revisaron bases de datos de forma no sistemática, incluyendo The Cochrane Wounds Specialised Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, Scielo, y Lilacs. Los términos de búsqueda generales incluyeron [úlceras por presión o lesiones por presión o úlceras por decúbito] y [prevención o preventivo] y [reposicionamiento o posicionamiento o cambios de posición o cambio postural] y [paciente en riesgo o vulnerable] y [hospitalizado o UCI o cuidados intensivos]. Se incluyeron revisiones sistemáticas de la literatura, ensayos clínicos aleatorizados, estudios observacionales, estudios de costo-efectividad y cualitativos en idioma inglés o español. Resultados. Aunque globalmente la incidencia, prevalencia y años de incapacidad asociado a estas lesiones ha disminuido entre 1990 y 2019, el impacto en salud persiste de forma elevada. La evidencia encontrada sobre la eficacia del reposicionamiento en prevención de úlceras por presión y costos asociados en salud ha sido evaluada con certeza entre baja y muy baja, como resultado de la realización de investigaciones con serias limitaciones metodológicas que reportan resultados con alta imprecisión. Conclusión.Los hallazgos reportados presentan que estas lesiones persisten a nivel hospitalario y continúan siendo un problema social y de salud mundial con alto impacto en los presupuestos en salud. Así mismo se presenta la necesidad de desarrollar mayor investigación de calidad en estrategias preventivas como el reposicionamiento, que validen su eficacia, y justifiquen su utilización.
Objetivo. Este artigo apresenta uma revisão da literatura com o objetivo de explorar e analisar a situação atual das úlceras por pressão ou úlceras de decúbito, os aspectos fisiopatológicos e epidemiológicos e os fatores de risco. Também avalia o progresso na evidência da eficácia do reposicionamento preventivo no desenvolvimento dessas lesões em pacientes hospitalizados vulneráveis. Métodos.Foram revisados bancos de dados não específicos do local, incluindo The Cochrane Wounds Specialised Register; Medline, Scopus, PubMed, Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, Scielo e Lilacs. Os termos gerais de pesquisa incluíram [úlceras de pressão ou lesões por pressão ou úlceras de pressão ou úlceras de decúbito] e [prevenção ou preventivo] e [reposicionamento ou posicionamento ou mudanças de posição ou mudança postural] e [paciente em risco ou vulnerável] e [hospitalizado ou UTI ou terapia intensiva]. Foram incluídas revisões sistemáticas da literatura, ensaios clínicos randomizados, estudos observacionais, estudos de custo-efetividade e qualitativos em inglês ou espanhol. Resultados. Embora, em geral, a incidência, a prevalência e os anos de incapacidade associados a essas lesões tenham diminuído entre 1990 e 2019, o impacto na saúde continua alto. As evidências encontradas sobre a eficácia do reposicionamento na prevenção de úlceras por pressão e os custos de saúde associados foram avaliadas com certeza baixa a muito baixa, como resultado de pesquisas com sérias limitações metodológicas que relataram resultados altamente imprecisos. Conclusão. Os resultados relatados mostram que essas lesões persistem em nível hospitalar e continuam a ser um problema social e de saúde global com alto impacto nos orçamentos de saúde. Também há necessidade de mais pesquisas de qualidade sobre estratégias preventivas, como o reposicionamento, para validar sua eficácia e justificar seu uso.
Subject(s)
Humans , Nursing , Pressure Ulcer , Moving and Lifting PatientsABSTRACT
Introduction: Papillary Carcinoma originating from thyroglossal duct cyst (TGDC) is very rare, occurring in less than one percent of cases. The diagnosis is often made in these situations following the removal of benign TGDC.We provide a case report that details a case of a thirty-years man who had Sistrunk's surgery for TGDC and was subsequently diagnosed to have Papillary Cancer.It is debatable how to handle these cases; the options include either a periodic monitoring following Sistrunk's Procedure or Complete thyroid gland excision +/- radio-active iodine (RAI) ablation and suppresive hormonal therapy. A thirty-years man came toCase Presentation: our OPD with anterior midline neck swelling which moved upward with deglutition and tongue protrusion.On radiology,distinct cystic lesion was seen. Sistrunk's Procedure was performed and tissue was sent for histo-pathological reporting. A papillary carcinoma foci was identi?ed in the TGDC by histo-pathology. As a follow up and completion treatment, our patient was subjected to complete thyroidectomy. The mostDiscussion: frequent anomalies are TGDC which are encountered in thyroid development. Within TGDC remains, malignancy is present in one to two percent of cases with most being Papillary Carcinoma. TGDC are most common in females with ratio being 3:2.
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GST is a single indirect tax for the whole nation, one which will make India a unied common market. It is a single tax on the supply of goods and services, right from the manufacturer to the consumer. Under GST, the government has xed GST rates on 1,211 goods and 500 services in the range of 5 to 28 per cent. Therefore to identify the impact of GST over online purchasers, the research title was developed and the survey was done with the objectives to know the level of awareness the online purchasers have towards GST, and further study the impact of GST on Online Purchasers & there Purchase Intention. Some of the major ndings are 83% of the respondents agree that, there is a general increase in Tax rates of products after implementation of GST,72% of the respondents strongly agree that, return of products is complicated after implementation of GST, 73% of respondents strongly agree that, Cancelation of products purchased online is difcult after implementation of GST, 98% of respondents strongly agree that the product delivery is much faster. With the ndings nally it is concluded that GST has a greater impact on online purchasers despite of this there is a greater scope for E-Retailing in future.