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1.
Indian J Ophthalmol ; 2023 Jul; 71(7): 2827-2834
Artículo | IMSEAR | ID: sea-225138

RESUMEN

Purpose: Data on social?emotional aspects among children with strabismus in India are scanty. We compared the emotional symptoms (ES), loneliness and social dissatisfaction (LSD), and self?esteem (SE) and their associated risk factors among children with and without strabismus in India. Methods: A cross?sectional case–control study design was used to recruit 101 children with strabismus aged 8 to 18 years and a control group of 101 children that were age? and gender?matched. Interviews were performed using standardized scales to assess ES, LSD, and SE. Variations in the intensity of ES, LSD, and SE were assessed using multiple classification analysis (MCA). Results: A total of 202 children participated in the study. The mean ES, LSD, and SE scores were 3.4 (standard deviation [SD] 1.9), 48.4 (SD 3.2), and 22.1 (SD 3.8) for the strabismus group and 1.8 (SD 1.5), 33.3 (SD 3), and 31.3 (SD 2) for the non?strabismus group, respectively. Among the strabismus group, the highest levels of mean ES, LSD, and SE scores were observed among children facing problems in performing daily tasks. Amongst the non?strabismus group, children studying at the primary level and those facing neglect had the highest mean scores. In MCA, being affected with strabismus had the highest effect on the intensity of ES, LSD, and SE with a beta (?) value of 0.223 (P = 0.016), 0.922 (P < 0.001), and 0.853 (P < 0.001). Conclusion: A significantly high proportion of children with strabismus deal with elevated levels of ES, LSD problems, and low SE as compared with non?strabismus children, highlighting the need to address the poor social?emotional health of children

2.
Indian Pediatr ; 2023 Apr; 60(4): 294-297
Artículo | IMSEAR | ID: sea-225408

RESUMEN

Objectives: To assess intelligence Quotient (IQ) in transfusion dependent ?-thalassemia major patients using Malin Intelligence Scale for Indian Children (MISIC) and to correlate verbal IQ (VIQ), performance IQ (PIQ) and full scale IQ (FSIQ) with serum ferritin levels and annual blood transfusion requirements. Methods: Cross-sectional study design, enrolling 100 patients of transfusion-dependent ?-thalassemia aged 6 years to 15 years 11 months. IQ was assessed using MISIC. Results: Mean (SD) full scale IQ was 95.96 (7.23). IQ was ‘average’ in most of the patients. There was a significant negative correlation of serum ferritin levels with object assembly (r=-0.215, P=0.034) component of PIQ; annual blood requirement with general comprehension component of VIQ (r=-0.275, P=0.006) and age at diagnosis with PIQ (r=-0.273, P=0.006). There was a significant linear correlation of PIQ (r=0.280, P=0.005) and FSIQ (r=0.274, P=0.006) with pre-transfusion hemoglobin. Conclusion: IQ correlates with age at diagnosis and average annual pre-transfusion hemoglobin. This highlights the importance of early diagnosis and maintenance of satisfactory hemoglobin levels

3.
Indian J Ophthalmol ; 2023 Apr; 71(4): 1426-1431
Artículo | IMSEAR | ID: sea-224940

RESUMEN

Purpose: An algorithm for automated segmentation of meibomian glands from infrared images obtained using a novel prototype infrared hand?held imager has been proposed in this study. Meibomian gland dysfunction (MGD) is quantified in terms of five clinically relevant metrics. A comparison of these metrics in patients with MGD has been presented against a sample of the normative healthy population. Methods: This is a prospective cross?sectional observational study. Patients presenting to the clinics were enrolled after written informed consent. The everted eyelids of 200 eyes of patients (of which 100 were healthy and 100 were diagnosed with MGD) were imaged using a prototype hand?held camera. The proposed algorithm was used to process the images using enhancement techniques and the glands were automatically segmented. A comparison of glands of normal eyes versus MGD?affected eyes is performed using five metrics presented in this study: (i) drop?out, (ii) length, (iii) width, (iv) the number of glands, and (v) the number of tortuous glands. Results: The 95% confidence interval for the metrics did not show any overlap between the two groups. In MGD patients, the drop?out ratio was higher than normal. The length and number of glands were significantly lesser than normal. A number of tortuous glands were more in the MGD group. The metrics for MGD versus healthy and cut?off ranges were computed in the results. Conclusion: The prototype infrared hand?held meibographer and the proposed automatic algorithm for gland segmentation and quantification are effective aids in MGD diagnosis. We present a set of five metrics, which are clinically relevant for guiding clinicians in the diagnosis of MGD

4.
Artículo | IMSEAR | ID: sea-221393

RESUMEN

Introduction: Osteoarthritis of the knee is a common musculoskeletal diseases affecting a major population in India. It can impact the individual's functions and activities of daily living. Total knee arthroplasty may raise controversy when treating the younger, athletic patient with arthritis. Arthroscopic debridement, high tibial osteotomy, unicondylar knee arthroplasty, and total knee arthroplasty allow younger patients to maintain an active, healthy lifestyle but can take a longer time to rehabilitate. PFO could be used as an alternative procedure. The Proximal Fibular Osteotomy, which provides immediate short term relief in cases with medial compartment osteoarthritis. Resecting a segment of fibula, loosens the lateral side allowing the upper tibia to settle into a more favorable lateral alignment, shifting the mechanical axis towards neutral or valgus. Aims & objectives: Ÿ To assess the functional, clinical and radiological outcome of proximal fibular osteotomy in grade 2 and 3 OA of knee and followed up for 1 year. Ÿ The clinical and functional outcome is accessed by Knee Society Score and VAS observed pre-op , post-op ,3 months ,6 months and 12 months. Ÿ The improvement in radiology is accessed using change in the medial joint space improvements in CP angle, change in the ratio of medial joint space to lateral joint space observed pre-op and post-op Methodology: The patients selected had grade 2 and 3 Osteoarthritis of knee according to Kellgren Lawrence classification between the age groups 20yrs-80yrs and are admitted to RajaRajeswari Medical College and Hospital, Bangalore. The Sample Size is 30 and is calculated based on previous studies as well as approximate availability of number of cases in the above mentioned duration satisfying inclusion and exclusion criteria. Clinical, functional and radiological outcome were used, Results were calculated using Knee Society Scoring Scale score. This study Conclusion: suggested that Proximal Fibular Osteotomy is an alternative procedure that can be used to treat medial compartment knee Osteoarthritis, if the patients are selected carefully. Patients followed up for one year showed a significant improvement in radiological, clinical and functional outcomes and thereby is an effective method of treatment in younger patients with Grade 2 and Grade 3 Osteoarthritis with an average BMI of 26.2.

5.
Artículo | IMSEAR | ID: sea-216465

RESUMEN

Objectives: The objectives were to determine the proportion of elderly among the new psychiatry outpatient attendees, identify their sociodemographic profile and clinical presentations, and determine risk factors associated with suspected organic conditions in patients presenting with acute onset and chronic presentations. Methodology: This retrospective cross-sectional study focused on the elderly presenting with psychiatric symptoms to a psychiatric setting. The onset of symptoms at presentation was divided into acute and chronic conditions. Clinical symptom clusters and the risk factors associated with organic conditions were identified. The Chi‑square and Fisher’s exact test were used to find an association between factors and outcome (organic/functional). Results: Elderly seeking consultation constituted < 10% of total new case registration. Acute onset was seen in one-third and chronic presentation constituted nearly two-thirds of the group. The common clinical presentations with acute onset were acute psychosis, altered sensorium, and psychosis due to an organic etiology. The most common clinical presentation with chronic course was chronic psychosis. Nearly 40% had suspected organicity. Increasing age, structural abnormality in brain imaging, and the presence of stressors were risk factors for the onset of psychiatric presentation in the elderly (P = 0.001). Conclusion: Early detection of the clinical syndrome, identification of organic conditions, and appropriate and prompt referral to the general physician should be the rule for the care of the elderly presenting to a psychiatric facility.

6.
Natl Med J India ; 2022 Dec; 35(6): 348-356
Artículo | IMSEAR | ID: sea-218239

RESUMEN

BACKGROUND Systematic data on mental health issues among adults awaiting cataract treatment are not readily available in India. We explored the prevalence and predictors of depressive and generalized anxiety (GA) symptoms in a cohort of adults awaiting cataract surgery. METHODS Our study is based on data from baseline assessments which were conducted as part of a multicentre prospective, longitudinal cohort study. Subjects were recruited from four eye hospitals to assess depression and GA and associated risk factors using standardized scales, i.e. Center for Epidemiologic Studies–Depression Scale (CES-D) and Generalised Anxiety Disorder (GAD-7). Variation in the intensity of depression and GA was assessed using multiple classification analysis (MCA). RESULTS A total of 813 adults awaiting cataract surgery participated, of whom 456 (56.1%) were men. The mean (SD) CES-D and GAD-7 scores were 24.6 (7.8) and 6.3 (SD 4.2) for men and 25.8 (8.9) and 6.9 (4.4) for women, respectively. The overall prevalence of depression score of >16 was 87.4% (95% confidence interval [CI] 84.7%– 89.6%), and GA score of >10 was 57.1% (95% CI 53.5%–60.7%). The prevalence of comorbid depressive and anxiety symptoms was 56.6% (95% CI 52.9%– 60.2%). MCA showed that being neglected and mistreated by family/friends because of vision condition and facing difficulty and requiring help with daily tasks had the highest effect on the intensity of both depression (beta=0.254 and 0.238, respectively) and GA (beta=0.219 and 0.211, respectively). CONCLUSION The majority of adults with untreated cataract had both depressive and GA symptoms. These findings could be used for planning mental health interventions for adults awaiting cataract surgery.

7.
Artículo | IMSEAR | ID: sea-225934

RESUMEN

Acute colonic intramural hematoma is a rare clinical entity. In most cases reported in literature a surgical management is used. Here we present a case of an 8-year-old boy who was found to have a colonic intramural hematoma following a fall from bicycle. Considering the age of the child and hemodynamic stability a conservative management wasadopted and the child was successfully managed

8.
Artículo | IMSEAR | ID: sea-223628

RESUMEN

Background & objectives: The association between hyperglycaemia at admission, diabetes mellitus (DM) status and mortality in hospitalized SARS-CoV-2 infected patients is not clear. The purpose of this study was to determine the relationship between DM, at-admission hyperglycaemia and 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection requiring intensive care. Methods: All consecutive moderate-to-severe patients with SARS-CoV-2 infection admitted to the intensive care units (ICUs) over six months were enrolled in this single-centre, retrospective study. The predicators for 28 day mortality were analysed from the independent variables including DM status and hyperglycaemia at-admission. Results: Four hundred and fifty two patients with SARS-CoV-2 were admitted to the ICU, with a mean age of 58.5±13.4 yr, 78.5 per cent being male, HbA1c of 7.2 per cent (6.3-8.8) and 63.7 per cent having DM. Overall, 28 day mortality was 48.9 per cent. In univariate analysis, mortality in diabetes patients was comparable with non-diabetes (47.9 vs. 50.6%, P=0.58), while it was significantly higher in hyperglycaemic group (60.4 vs. 35.8%, P<0.001). In multivariate Cox regression analysis, after adjusting for age, sex and comorbidities, hyperglycaemia at-admission was an independent risk factor of mortality [hazard ratio (HR) 1.45, 95% confidence interval (CI) (1.06-1.99), P<0.05]. Interpretation & conclusions: This study showed that the presence of hyperglycaemia at-admission in critically ill SARS-CoV-2 patients was an independent predictor of 28 day mortality. However, the findings may be susceptible to unmeasured confounding, and more research from prospective studies is required.

9.
Artículo | IMSEAR | ID: sea-225758

RESUMEN

Neuroleptic malignant syndrome (NMS)is a life-threatening complication seen in psychiatric patients exposed to antipsychotic medications. NMSis associated with medication with dopamine antagonist action. The typical tetrad of symptoms of NMS includes fever, muscle rigidity, altered mental status and autonomic dysfunction. Acute pulmonary embolism is one of the major complications seen in patients diagnosed with neuroleptic malignant symptoms. Here we present a case report of a 64 years old female with a history of psychiatric illness, presented with fever, rigidity andaltered mental status and diagnosed to haveNMS. Later her condition was complicated by pulmonary embolism. She was treated with bromocriptine and heparin infusion and improved symptomatically.

10.
Journal of Dental Anesthesia and Pain Medicine ; : 75-86, 2022.
Artículo en Inglés | WPRIM | ID: wpr-925239

RESUMEN

This review aims to identify the influence of the vehicle and its concentration used to carry calcium hydroxide (Ca(OH)2 ) medicament on postoperative pain.The protocol for this review was registered in the open science framework (Registration DOI-10.17605/OSF.IO/ 4Y8A9) and followed the guidelines provided by the Joanna Briggs Institute. Reporting was based on the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR). Literature screening and searches were performed on PubMed/Medline, Scopus, and EBSCO hosts. Furthermore, additional records were manually analyzed using various sources. The selected studies were published in English and included the use of any vehicle adjunct to Ca(OH)2 to evaluate postoperative pain using qualitative and quantitative pain assessment tools. Descriptive analysis was conducted to review the study design, vehicle elements, and their effects.A preliminary search yielded 7584 studies, of which 10 were included. According to the data collected, the most commonly used Ca(OH)2 vehicles were chlorhexidine (CHX), normal saline, and camphorated paramonochlorophenol/glycerine (CPMC/glycerine), which had a significant effect on postoperative pain. Among the included studies, six evaluated the effect of CHX as a vehicle. It was observed that a higher concentration of the vehicle (2%) showed a favorable response in reducing postoperative pain.A majority of studies have validated a positive consequence of using a vehicle on postoperative pain. Although higher vehicle concentrations were found to alter postoperative pain levels, the data were insufficient to draw a firm conclusion. Our scoping review indicates that further clinical studies should focus on using different vehicles at various concentrations and application times to check for feasible and safe exposure in addition to providing pain relief.

11.
Rev. Soc. Bras. Med. Trop ; 54: e02532020, 2021. tab
Artículo en Inglés | LILACS | ID: biblio-1155541

RESUMEN

Abstract INTRODUCTION: We compared the hepatitis C virus (HCV) core antigen test with the HCV RNA assay to confirm anti-HCV results to determine whether the HCV core antigen test could be used as an alternative confirmatory test to the HCV RNA test. METHODS: Sera from 156 patients were analyzed for anti-HCV and HCV core antigen using a chemiluminescent microparticle immunoassay (Architect i2000SR) and for HCV RNA using the artus HCV RG RT-PCR Kit (QIAGEN) in a Rotor-Gene Q instrument. RESULTS: The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 77.35%, 100%, 100%, and 89.38%, respectively. HCV core antigen levels showed a good correlation with those from HCV RNA quantification (r =0.872). However, 13 samples with a viral load of less than 4000 IU/mL were negative in the HCV core antigen assay. All gray-zone reactive samples were also RNA positive and were positive on repeat testing. CONCLUSIONS: The Architect HCV core antigen assay is highly specific and has an excellent positive predictive value. At the present level of sensitivity (77%), the study is still relevant in a low-income setting in which most of the HCV-positive patients would go undiagnosed, since HCV RNA testing is not available and/or not affordable. HCV core antigen testing can also help determine the true burden of infection in a population, considering the fact that almost 50% of the anti-HCV positive cases are negative for HCV RNA.


Asunto(s)
Humanos , Hepatitis C/diagnóstico , Hepacivirus/genética , ARN Viral , Sensibilidad y Especificidad , Antígenos de la Hepatitis C , Anticuerpos contra la Hepatitis C
12.
Pediatric Gastroenterology, Hepatology & Nutrition ; : 145-153, 2021.
Artículo en Inglés | WPRIM | ID: wpr-895401

RESUMEN

Purpose@#Children treated for Hirschsprung disease (HD) are adversely affected by fecal incontinence and soiling. This can be detrimental to their physical, psychosocial quality of life (QoL) and impacts the normal functioning of their family. QoL studies in HD are predominantly from developed countries. We measured general quality of life, impact on family and functional bowel status using validated questionnaires in HD children in a developing country. @*Methods@#Patients with HD, treated in a tertiary paediatric institution in India between 2010 and 2017, were identified. Patients and/or their proxy completed the Pediatric Quality of Life and Family Impact Module questionnaires. Functional outcomes were assessed using Rintala's score. @*Results@#A 86 children and their parents participated in the study. Majority had rectosigmoid disease (67.4%) and underwent Soave's endoanal pull through (74.4%). A 21% of patients had low Rintala score indicating poor functional bowel outcomes. Only 11% of children had poor QoL scores. Family functioning outcomes were also severely affected in the same subgroup of patients. There was statistically significant correlation between Rintala score and QoL scores (p-value<0.001). Disease severity, type of surgery, and duration of follow-up did not have a statistically significant impact on the QoL. @*Conclusion@#QoL in children with HD was comparable to the general population. Bowel dysfunction affects a notable number of children and was the most significant determinant of poor QoL.

13.
Pediatric Gastroenterology, Hepatology & Nutrition ; : 145-153, 2021.
Artículo en Inglés | WPRIM | ID: wpr-903105

RESUMEN

Purpose@#Children treated for Hirschsprung disease (HD) are adversely affected by fecal incontinence and soiling. This can be detrimental to their physical, psychosocial quality of life (QoL) and impacts the normal functioning of their family. QoL studies in HD are predominantly from developed countries. We measured general quality of life, impact on family and functional bowel status using validated questionnaires in HD children in a developing country. @*Methods@#Patients with HD, treated in a tertiary paediatric institution in India between 2010 and 2017, were identified. Patients and/or their proxy completed the Pediatric Quality of Life and Family Impact Module questionnaires. Functional outcomes were assessed using Rintala's score. @*Results@#A 86 children and their parents participated in the study. Majority had rectosigmoid disease (67.4%) and underwent Soave's endoanal pull through (74.4%). A 21% of patients had low Rintala score indicating poor functional bowel outcomes. Only 11% of children had poor QoL scores. Family functioning outcomes were also severely affected in the same subgroup of patients. There was statistically significant correlation between Rintala score and QoL scores (p-value<0.001). Disease severity, type of surgery, and duration of follow-up did not have a statistically significant impact on the QoL. @*Conclusion@#QoL in children with HD was comparable to the general population. Bowel dysfunction affects a notable number of children and was the most significant determinant of poor QoL.

14.
Artículo | IMSEAR | ID: sea-215266

RESUMEN

A 5-month-old child presented to the Paediatric Outpatient Department with complaints of fever, loose stools, blood in stool, and multiple subcutaneous swellings over the chest wall. The patient was given antibiotics and treated for acute gastroenteritis with a possibility of component of cow’s milk allergy also being considered. The routine blood counts revealed platelet count of 4.94 K / mL, along with Hb 10.2 g / dL, MCV - 80 fL, WBC - 13.6 x 109 / L. An LDH of 512 U / L (normal up to 451 U / L) and ESR of 2 mm / 1st hr. Liver function tests were within normal range. Her preliminary coagulation screening test showed both PT as well as aPTT to be prolonged beyond 120 sec each. She was further sent for complete laboratory evaluation for bleeding disorder. In view of the history of foul smelling stools, suggesting malabsorption, stool sample was analysed which showed presence of fat globules. USG was reported as normal study. Blood group was O positive.Abetalipoproteinemia is a very rare metabolic, autosomal recessive disease resulting from mutations encoding microsomal triglyceride transfer protein (MTP) leading to deficiencies in the apolipoproteins B-48 and B-100 with reported prevalence of less than one case per 100,000. Typical manifestations are failure to thrive, hypocholesterolaemia and fat malabsorption. Other features like fatty liver, acanthocytosis, and anaemia are usually present in infancy and neuro-ocular complications during adolescence. Early diagnosis and management can prevent disease progression

15.
Artículo | IMSEAR | ID: sea-214738

RESUMEN

Leptospirosis is a zoonotic disease seen all over the world caused by pathogenic members of the genus Leptospira. Humans are infected by direct or indirect contact with an environment contaminated by urine of infected animals such as rodents, cattle and dogs. As the clinical manifestations of leptospirosis are nonspecific, laboratory diagnostic methods are needed for definitive diagnosis.METHODSThis is a retrospective study conducted in the Department of Microbiology, Government Medical College, Kottayam, Kerala, in patients with clinical features of acute febrile illness from January 2015 to December 2018. A total of 2941 blood samples were received for leptospira serology. They were subjected to specific anti leptospira IgM ELISA by Panbio Diagnostics, Brisbane, Australia. In the year 2018, 43 samples received during flood period were subjected to PCR, in addition to antileptospira IgM ELISA. For PCR, blood in EDTA, CSF and urine were sent to Manipal Centre for Virus Research, Karnataka. Twenty-five blood samples were sent for Microscopic Agglutination Test to Department of Veterinary Microbiology, College of Veterinary and Animal sciences, Mannuthy, India. Modified Faine’s criteria were assessed based on clinical, epidemiological and laboratory findings.RESULTSAmong 2941 cases of acute febrile illness, 777 (26.4 %) cases were serologically positive (IgM ELISA) for leptospirosis. Among 777 cases, maximum cases 481 (61.9 %) were seen during the year 2018, followed by 106 (13.64 %) cases during the year 2016, 104 cases (13.38 %) during the year 2015 and 86 (11.06 %) cases during the year 2017. Maximum cases were seen during the month of August, September, and October. Among 43 cases during flood 2018, 35 were (81.4 %) males and 8 (18.6%) were females. Maximum cases were seen in the age group of 41-50 years. Among the 43 cases, fever was present in all the 43 (100%) cases followed by myalgia in 36 (83.7 %) cases. Headache was seen in 22 (51.16%) cases, jaundice in 16 (37.2%) cases, cough and breathlessness in 15 (34.9%) cases, conjunctival suffusion in 13 (30.2% ), oliguria in 13 (30.2%) cases, vomiting in 11 (25.6 %) cases, abdominal pain in 7 (16.3%) cases, diarrhoea in 4 (9.3% ) cases, altered sensorium in 3 (6.9%) cases. Among complications, acute kidney injury was seen in 13 (30.2%) cases, followed by respiratory injury (ARDS) requiring mechanical ventilation in 10 (23.3%) cases and myocarditis in 4 (9.3%) cases.CONCLUSIONSLeptospirosis is a zoonotic disease of protean clinical manifestations with difficulty in diagnosis. Confirmation by diagnostic test is essential so that early diagnosis helps in early treatment and prevention of complications in turn reducing mortality.

16.
Asian Pacific Journal of Tropical Biomedicine ; (12): 333-340, 2020.
Artículo en Chino | WPRIM | ID: wpr-950292

RESUMEN

Objective: To compare the anti-proliferative effect of sodium thiosulfate on human colorectal cancer cells (HT-29) and normal small intestine cells (IEC6). Methods: Cells (HT-29 and IEC6) were treated with different concentrations of sodium thiosulfate ranging from 0.5 mM to 80 mM for 24 h. Cell viability was measured via crystal violet and MTT assays. HT-29 cells were further treated in the presence and absence of mitochondrial electron transport chain (ETC) inhibitors, K

17.
Asian Pacific Journal of Tropical Biomedicine ; (12): 333-340, 2020.
Artículo en Chino | WPRIM | ID: wpr-823948

RESUMEN

Objective: To compare the anti-proliferative effect of sodium thiosulfate on human colorectal cancer cells (HT-29) and normal small intestine cells (IEC6). Methods: Cells (HT-29 and IEC6) were treated with different concentrations of sodium thiosulfate ranging from 0.5 mM to 80 mM for 24 h. Cell viability was measured via crystal violet and MTT assays. HT-29 cells were further treated in the presence and absence of mitochondrial electron transport chain (ETC) inhibitors, KATP channel opener and closer and H2S inhibitors for 24 h followed by sodium thiosulfate in order to study their respective roles in the anti-proliferative activity of sodium thiosulfate. Results: The IC50 values of sodium thiosulfate on HT-29 cells were 40.93 mM and 42.45 mM by crystal violet and MTT assay whereas, in the case of IEC6 cells, the values were 45.17 mM and 47.22 mM. The inhibition of endogenous H2S enzymes and KATP channel induced no change in the anti-proliferative capacity of sodium thiosulfate. However, the anti-proliferative activity of sodium thiosulfate was enhanced in the presence of mitochondrial ETC inhibitors. Conclusions: HT-29 cell growth is effectively attenuated by sodium thiosulfate and the anti-proliferative activity of sodium thiosulfate is enhanced in the presence of mitochondrial ETC inhibitors.

18.
J Genet ; 2019 Nov; 98: 1-10
Artículo | IMSEAR | ID: sea-215391

RESUMEN

Rattans, the spiny climbing palms of Arecaceae (Palmae) family exhibit high endemism to the biodiversity hot spots in India. Of the five rattan genera, Calamus is the only genus found in peninsular India with 15 of 21 species, endemic to the Western Ghats. The extensive utilization of rattans owing to their strength, durability and huge demand has resulted in depletion of their natural resources. Ofthe 15 endemic species, C. nagbettai is the most affected species on account of endemism, low population size and restricted distribution with fragmented populations. The present study revealed high amount of genetic diversity in the surviving scattered populations of the species using microsatellite markers. High gene flow (Nm = 1.498) observed across the populations resulted in low genetic differentiation (14%). A clear genetic admixture could be seen in Kerala as well as one of the Karnataka’s populations while the remaining two populations were genetically distinct. UPGMA, PCoA and STRUCTURE analyses showed significantly different genetic composition in Kerala population compared to other populations. Kerala and Karnataka populations of C. nagbettai were also unique in their genetic structure and allelic composition. Therefore, effective management and conservation strategies have to be implemented to preserve the rarealleles with adaptive potential to protect this economically valuable Calamus species from endangerment. Overexploitation, low seed set and poor regeneration, as well as habitat fragmentation can further threaten the survival of this endemic, narrowly distributed dioecious rattan species in the Western Ghats region.

19.
Artículo | IMSEAR | ID: sea-210406

RESUMEN

The aim of this study is to initiate the pharmacist–psychiatrist collaborative patient education in ambulatory caresettings. A prospective cohort study was conducted in psychiatry out-patient department of a tertiary care teachinghospital over a period of 6 months. All the eligible patients were enrolled, and the necessary information was collected.The collected data were analyzed for medication adherence by using medication adherence rating scale and healthrelated quality of life by using the World Health Organization Quality of Life questionnaire. Student t-test was usedto analyze the results at p-value <0.05. A total of 210 patients were analyzed and followed for a period of 6 months.When compared to the baseline values, a significant improvement in medication adherence and quality of life witheach follow-up at p-value <0.05 was observed. The study results have evidently proven that pharmacist–psychiatristcollaborative approach could significantly improve patient education and related clinical outcomes.

20.
Artículo | IMSEAR | ID: sea-211331

RESUMEN

Background: Absence of menstrual period in a woman of reproductive age group could be physiological or pathological. Ascertaining the cause for this is a common clinical scenario faced by physicians. It is also a common clinical problem in women who are on treatment with antipsychotic medication. This cross-sectional study aimed to assess the occurrence of antipsychotic induced amenorrhoea among women aged 18-45 years, attending outpatient services of a tertiary care setting, the factors associated and to assess the effective strategies of treatment.Methods: Retrospective chart review of clinical details of women in the reproductive age group who fulfilled the inclusion criteria was carried out. They were divided into two groups: Group A included 84 women with antipsychotic induced amenorrhea and Group B included 94 women on antipsychotics and had normal menstrual cycles. Various factors and strategies which worsened or alleviated the symptoms were noted.Results: Women who were less than 35 years of age, on antipsychotic treatment for more than two years duration (52;83.9%) and those who were on treatment with Risperidone (69;73.4%) were identified as having the risk of developing antipsychotic induced amenorrhoea. The strategy of switch of medication to prolactin sparing antipsychotic was more effective in regularising the menstrual cycles (43;87.8%).Conclusions: In women presenting with amenorrhoea, a possible medication induced aetiology need to be considered, especially use of antipsychotics. Further understanding of the complexities of this relationship may help to guide the assessment and proper treatment of women with antipsychotic related amenorrhoea.

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