RESUMEN
Objectives: Chronic illness and functional decline threaten elderly well-being. “Perceived Wellness Survey (PWS),” which measures psychosocial, physical, and intellectual well-being, may be appropriate for assessing the wellness of the geriatric population. This work has been planned to find out the validity and test-retest reliability of a PWS as a wellness-measuring tool for community-based elderly people. Materials and methods: This observational study was undertaken in the community was undertaken to assess PWS in 60 elderly individuals (?65 years). The validity of PWS was tested using Pearson product-moment correlation test. For test-retest reliability, the internal consistency of PWS was tested by Cronbach’s alpha test. Result: Around 60 individuals ?65 years (mean 69.45 ± 4.27 years), 48 males were selected by convenient sampling. Pearson’s correlation showed psychological, emotional, and physical subscale scores had a very strong positive relationship (0.734, 0.703, and 0.722, respectively) with a composite score of PWS score. Spiritual, intellectual, and social subscales showed a strong positive relationship with the composite PWS score. Test-retest variability between observations for subscales was ?0.8, which showed good reliability, except for the physical subscale, which showed unacceptable reliability. Conclusion: Perceived Wellness Survey (PWS) is an effective, feasible, highly reliable, and valid measure as a clinical assessment tool for assessing wellness in the elderly population.
RESUMEN
Tramadol is a weak mu (µ) opioid receptor agonist that acts by inhibiting serotonin and norepinephrine uptake. Tramadol undergoes extensive hepatic metabolism by a number of pathways, including CYP2D6 and CYP3A4, and by conjugation with subsequent renal excretion. The maximum recommended dose is 400 mg/day. One of the most important adverse effects of tramadol is a seizure, which usually occurs at high doses and is often generalized tonic–clonic type and self-limiting. Here, we present a case of a patient with inflammatory low backache who developed seizures while on low-dose oral tramadol. After 1 h of taking the first tablet of tramadol, he developed morbilliform rashes all over the body. One day later, he developed generalized tonic–clonic seizures followed by a loss of consciousness for 5 min. The patient was admitted to the hospital and managed conservatively with injection lorazepam and tramadol was stopped. In general, if applied in overdose, tramadol can only incite seizures in patients already suffering from some sort of disorder related to seizures or if it is administered along with antidepressants, alcohol, etc. But here, only with the use of 37.5 mg oral application, the incidence of seizure happened.
RESUMEN
Background and Objectives: Hepatitis C virus (HCV) is an important cause of chronic liver disease (CLD). Although Northeast India is believed to be a HCV hotspot, the proportion of HCV infection and the distribution of HCV genotypes in CLD cases from the region are not known. The objectives of the study were to determine the proportion of HCV infection in newly diagnosed CLD patients from Meghalaya, Northeast India, and further investigate the HCV genotype distribution in those patients. Materials and Methods: The aetiology of CLD was evaluated in 196 newly diagnosed patients, recruited consecutively over a period of 1 year in a medical college hospital from Meghalaya. Those positive for HCV infection were genotyped, and the mode of transmission of the virus was investigated. Results: A considerable proportion (43 patients, 21.9%) of CLD patients were positive for HCV (95% confidence interval [CI]: 16.7%–28.2%). Other leading causes of CLD were alcohol (36.32%) and hepatitis B virus infection (39.3%). Genotype 3 was the most prevalent (48.7%, 95% CI: 33.9%–63.8%), followed by genotype 6 (30.8%, 95% CI: 18.6%–46.6%) and genotype 1 (20.5%, 95% CI: 10.8%–35.5%). The frequency of genotype 6 was remarkably higher than in the other regions of India. Injecting drug use appeared to be the most common mode (28 patients) of acquiring HCV. This was true irrespective of the genotype. Conclusions: The presence of HCV in newly diagnosed CLD cases from Meghalaya was considerable. The genotype distribution of HCV was distinct from the other regions of India.
RESUMEN
Sudden onset symmetric peripheral gangrene (SPG) is a relatively uncommon clinical entity manifested by distal ischemic damage at two or more sites in the absence of large vessel obstruction. Here we report a case of complicated falciparum malaria with rapid onset SPG involving all the toes.