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Engaged employees are the true assets and retaining them depends on their adaptation of existing and challenging culture of the organization. The employees have different attitudes and approach in their workplace environment and they continuously strive in the positive manner to achieve those pre-defined goals once they enter the organization of their choice. The role played by engagement on employees is such that the behaviour, values and the expectations of employees is directed towards the fulfilment of overall organizational goals and individual goals. The literature survey of employee engagement showed a strong relationship with the employee's performance and to enhance this association the workplace environment of an organization shall always work towards learning new things and developing the ideas that help the employees to keep themselves engaged in a long term. The findings and measures of past studies has been thoroughly studied and analysed for their relevancy in enhancing the employee's engagement level that can be applied in any organization striving for excellence.
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Background and Aims:Pain and PONV (postopera?ve nausea and vomi?ng) are common complaints in the period following surgery. A mul?modal approach targe?ng the reduc?on of postopera?ve pain with an opioid-sparing analgesic along with an an?eme?c medica?on would minimize opioid consump?on and its associated side effects. We evaluated the efficacy of methylprednisolone 125 mg IV taken along with oral 120 mg etoricoxib on postopera?ve pain and PONV in pa?ents undergoing laparoscopic surgeries Material and methods:A prospec?ve, randomized, double-blind study was conducted on 70 pa?ents aged between 18 and 60 years with ASA grade 1 and 2 posted for elec?ve laparoscopic surgeries. The test group was given a combina?on of methylprednisolone 125mgIV (given just before induc?on)& etoricoxib120mg oral (given 1 hr before surgery). (Group A, n=35) while control group received normal saline IV and a placebo per oral(Group B, n=35). Dura?on and quality of analgesia was assessed by visual analogue scale (VAS) score at 2,4,6,8,10,12,16,20 and 24hr as primary objec?ve. Total dose of rescue analgesic(injec?on Fentanyl 50 mcg) in first 24 hours, peri-opera?ve hemodynamic change and post op nausea vomi?ng (PONV) were observed as secondary objec?ve. Result:Demographic profiles were comparable. Dura?on of postopera?ve analgesia was significantly prolonged(p<0.05) in Group A(7.57±1.04hrs) as compared to Group B(3.05±0.5hrs). Group A showed a significant reduc?on in postopera?ve fentanyl consump?on in the form of rescue analgesic(p<0.05). Group A also showed significant reduc?on in the incidence of PONV(p<0.05). Conclusion:We conclude that single-dose administra?on of methylprednisolone IV along with oral etoricoxib has be?er analgesic efficacy in comparison to placebo for pa?ents undergoing laparoscopic surgeries.
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The conversion of natural systems to cultivated systems contributes to changes in the activities of microbial communities and biochemical processes in the soil. A total of 80 surface soil samples (0-15 cm) from 6 rainfed land use systems viz. agriculture, horticulture, agri-horticulture, forest, agroforestry and eroded lands were analyzed for biochemical properties and to derive soil quality index. The soils are slightly acid to neutral in reaction (pH-6.4-6.9) with 0.09-0.23 dS m?1 electrical conductivity (EC), loamy sand to sandy loam in texture, 1.4-6.1 g kg?1 soil organic carbon (SOC), 86-406 kg ha?1 available nitrogen, 29.3-32.6 kg ha?1 available phosphorus,65-226 kg ha?1 available potassium,10.3-21.3 mg kg?1 DTPA-Mn, 12.1-34.2 mg kg?1 DTPA-Fe, 0.34-1.01 mg kg?1 DTPA-Cu and 0.76-1.15 mg kg?1 DTPA-Zn, respectively under different land use systems. Among soil biochemical properties, the enzymic activity among land use systemsis varied from 7.4 to 12.8 µg TPF g?1 h?1 for dehydrogenase activity, 22.3 to 34.5 µg pNP g?1 h?1 for acid phosphatase, 43.4 to 60.1 µg pNP g?1 h?1 for alkaline phosphatase, 3.31 to 4.77 µg NH4-N g?1 soil min?1 for urease activity-, basal soil respiration ?0.13 to 0.30 µg CO2 g?1 soil h?1 for basal respiration , 46.5 to 242.6 µg g?1 soil for soil microbial biomass carbon (MBC) and 8.68 to 30.6 g kg?1 for total easily extractable glomalin (TEGP), respectively. The principle component analysis showed that SOC, EC, TEGP, MBC and DTPA-Zn are robust soil quality indicators under different land use systems in submontane Punjab. The forestry system has higher values for physicochemical, biochemical properties and soil quality index as against agri-horticulture, horticulture, agroforestry, agriculture and eroded system. In subsystems, eucalyptus-based forestry and mango based agri-horticulture systems are served as a better system for soil quality assessment in submontane Punjab, India.
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Introduction: Pterygium progression and recurrence is acommon complication. In various studies conducted on role ofsubconjunctival depot injection of bevacizumab, nothing hasbeen standardized with regards to dosage and its frequency.The study was done with aim to assess role and clinicalefficacy of subconjunctival injection of bevacizumab as a nonsurgical treatment modality for pterygium.Material and Methods: 80 cases of pterygium were includedin this study. Study was done over a period of 12 months fromDecember 2018 to November 2019 at a tertiary care ophthalmiccentre of Northern India. In this study, three doses of 2.5 mgof bevacizumab were administered sub-conjunctivally atmonthly interval under topical anaesthesia on Outdoor PatientDepartment basis. Standard aseptic measures were observed.Results: Cases were followed up next day after each injectionand thereafter on monthly basis for three months and finallyafter 06 months of first injection. Progression of pterygiumwas noted in 8 cases. Subconjunctival haemorrhage was notedin 41 cases. Conjunctival cyst was seen in three cases whichwere punctured in OPD, however recurrence was noted afterone month in one case. No rise in Intra Ocular Pressure (IOP)was noted.Conclusions: Subconjunctival injection of bevacizumab isuseful in treatment of patients with pterygium without local orsystemic adverse effects.
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Comparative evaluation of bepotastine besilate versus olopatadine and ketorolac combination onupper tarsal conjunctival brush cytology in patients of vernal keratoconjunctivitis. This studywas a prospective, open label, randomized, comparative clinical study. 100 patients of vernalkeratoconjunctivitis between 6 to 20 years of age of either sex willing to give informed consentwere enrolled in the study. In Group 1, 50 patients received Bepotastine besilate (0.15%) eyedrops twice daily for 8 weeks whereas in Group 2, 50 patients received Olopatadine (0.2%) andKetorolac (0.4%) combination eye drops twice daily for 8 weeks. Upper tarsal conjunctival brushcytology for eosinophil count was done in both the drug groups during the baseline and at 8th weekduring the treatment. It was found that after the 2 months of drug therapy, patients in both thegroups showed reduction in the eosinophil count. However, there was no statistically significantdifference between the two treatment groups at the baseline and at 8th week. There was 32%reduction in group A versus 28% reduction in group B in eosinophil count at the end of 8th weekcompared to baseline. Both bepotastine besilate versus olopatadine and Ketorolac combinationwere found to be effective in reducing the eosinophil count in patients of VKC.
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Background: Tumors of the nervous system are the second most common childhood cancer after leukemia. The diagnosis of CNS tumors is challenging due to non-specific symptoms in children which mimic other less serious illness.Methods: This was a retrospective analysis of case records of patients from 0-18 years of age, who were diagnosed with CNS tumors for a period of 7 years.Results: Out of total 64 patients included in this study, 32 were females and 24 were males. The mean age was 13.2 years. The most common clinical presentation in patients with brain tumors was headache (92.3%) followed by visual symptoms in the form of blurring or loss of vision (42.3%) and swaying while walking (32.6%). The overall mean symptom interval for all patients was 274.8 days (approx. 9 months) ranging from 7-1820 days. In the present study out of total 64 patients, 54 were brain tumors (35 supratentorial and 19 infratentorial) and 10 were spinal tumors. The most common tumor location was cerebellum (21.8%) followed by cerebral cortex, spine and sellar area. Based on histopathology the most common tumor type in our study was astrocytoma. There was no significant correlation of symptom interval with age and gender but was significantly associated with location and tumor grade.Conclusions: Early referral to centers with appropriate facilities will help, as many pediatric CNS tumors are low grade with better survival.
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In this study, relative toxicity of Spilanthes acmella and Calotropis procera wasevaluated against adults and larvae of Rhipicephalus (Boophilus) microplus. The aerial part ofboth plants materials were collected from Eastern Himalayan Region (West Bengal) of India.Plant materials were washed, shade dried, coarsely ground, methanol extracted and dried byrotary evaporator and collected proper yield of extracts. The crude methanolic extracts werefurther fractionated using solvents (hexane, ethyl acetate, chloroform) of different polarity andfinally aqueous fraction was collected and dried. Methanolic crude extracts and their fractions(hexane, ethyl acetate, chloroform and aqueous) concentrations of both the plants weretested against the engorged adult females and cultured larvae of Rhipicephalus (Boophilus)microplus. The bioefficacy observations are shown in table 3 and mentioned LC50, LC90 andtheir related statistics. Adult and larval stages were significantly affected by the chloroformextract of both the plants selected and observed the most potent with LC50 50.22 and 13.86mg/ml of Calotropis procera and LC50 60.94 and 25.82 mg/ml of Spilanthes acmella.
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Background: In the aetiopathogenesis of multifactorial glaucoma autoregulation of ocular blood flow plays an important role as failure of autoregulation may lead to progression of disease. Aim of this study to understand this better this study was designed to investigate the quantum of these abnormalities and their likely role in pathogenesis and prognosis of primary open angle glaucoma(POAG).Methods: This is a case control study design which involved 67 POAG patients and 67 matched controls. The parameters assessed includes peak systolic velocity(PSV), end diastolic velocity(EDV) and resistive index(RI) of ophthalmic artery(OA) and central retinal artery(CRA) of patients having POAG with age and sex matched healthy subjects. The data obtained was statistically analysed using IBM SPSS 21.Results: The study showed decreased PSV of 31.7 cm/s vs 42.7 cm/s(p=0.0001) and EDV11.7 cm/s vs 19.8 cm/s(p=0.002) with increased RI 0.63 vs 0.53(p=0.000) in OA and PSV of 15.2 cm/s vs 21.4 cm/s(p=0.001) and EDV4.7 cm/s vs 11.7 cm/s(p=0.003) with increased RI 0.69 vs 0.45(p=0.000) in CRA in both eyes in POAG patients as compared to healthy controls.Conclusion: The study has shown the promising application of ocular Doppler in evaluating POAG patients. However, more such studies are needed with larger study sample and on follow up basis for better understanding glaucoma hemodynamics and applicability of ocular Doppler in management of glaucoma.
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Introduction: Corneal disease ranks 5th among the causes ofblindness and it forms 7.1% of total blindness and is a seriouspublic health problem resulting in medical and economicburden to the nation. A study was carried out to evaluateregrafts with emphasis on factors which caused failure oforiginal graft and factors influencing graft success after repeatPK.Material and methods: The prospective study consisted ofcases of graft failure attending Eye Bank Clinic at CommandHospital, Kolkata, from Jan 2017 to Dec 2018. Intervalbetween primary graft and repeat PK was minimum of 06months. All the surgeries were performed by a single surgeon.Results: Out of 164 PK, 28 regraft (17.07%) were performed.The regrafting were carried out on cases of graft failure dueto endothelial failure (39.3%), allograft rejection (17.8%),recurrence of disease (14.2%), secondary glaucoma (10.7%),ocular surface disorder and dry eye (10.7%), Pseudomonasinfection (3.6%) and unknown (3.6%). In 13 cases simplerepeat keratoplasty and in rest 15 cases combined procedureswere done. 17 cases (60.7%) had clear regrafts and in 11cases the regraft became opaque during follow up period of06 months to 2 years (average 12.6 months). Pseudophakicbullous keratopathy had greater rate of clear regrafts (71.4%).09 out of 11 cases of failure had one of the preoperative factorslike raised IOP, anterior synechiae, corneal vascularizationand younger recipient age group. Vascularization of recipientbed was associated with greater rate of graft failure (60%).Conclusions: Better visual outcome and graft survival inregraft can be achieved by understanding the underlyingpathology and formulating a preoperative plan.
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Introduction: Eye diseases incidence and prevalence varieswith the social and environmental factors. Present researchaimed to study the prevalence of various common eye diseasesat a Tertiary Care United Nations hospital.Material and methods: It is a retrospective study of all newpatients attending the eye OPD of a tertiary care UN hospitalduring three years period Sept 2007 to Aug 2012. All patientsunderwent a thorough routine eye examination involvingvision testing by Snellen’s chart, Refraction, Tonometry, Slitlamp examination of Anterior Segment, Fundus examinationand Color Vision. Cases were also subjected to automatedperimetry, laboratory and radiological investigations ifconsidered essential.Results: A total of 217 (401) new patients attended theeye clinic. Patients attending the eye clinic were of variednationality which included patients from India, Pakistan, SouthAfrica, Uruguay, Congo, England, Iraq, Italy, Bangladesh,Netherlands, Nepal, USA etc. The three most commoncauses of eye disorders were refractive error followed byallergic conjunctivitis and Presbyopia. However, cases ofOnchocerciasis were also seen especially in those belongingto Congo. Mostly the patients were in the age group of 30-40yrs (35.4%) and 40-50 yrs (41.01%) being active militarysoldiers. Presbyopia was more common in age group 40-50yrsof age (73.3%). Majority of patients were mainly extra ocularcases (95.4%).Conclusion: The pattern of prevalence of various oculardiseases is similar to other parts of world in this age groupand with a similar occupational profile. This study will go along way in ensuring optimum provisioning of eye health carepersonnel’s and equipment for efficient eye care services.
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Objective: Comparative evaluation of efficacy and safety ofBepotastine besilate versus Olopatadine and Ketorolaccombination in patients with vernal keratoconjunctivitis.Materials and Methods: This was a prospective, open label,randomized, comparative clinical study. Hundred patients ofvernal keratoconjunctivitis between 6 to 20 years of age ofeither sex willing to give informed consent were enrolled in thestudy. In Group 1, 50 patients received Bepotastine besilate(0.15%) eye drops twice daily for 8 weeks whereas in Group 2,50 patients received Olopatadine (0.2%) and Ketorolac (0.4%)combination eye drops twice daily for 8 weeks. Symptoms andsigns scoring of VKC were recorded on baseline and at thetime of follow up at 4 and 8 weeks. Safety assessments werealso done in both the drug groups during the study period forany serious adverse effects.Results: After the 2 months of drug therapy, patients in boththe groups showed improvement in the symptoms and signsscoring of VKC. However, there was no statistically significantdifference between the two treatment groups at 4th and 8thweek. Both the drugs were well tolerated without any seriousadverse effect.Conclusion: Both bepotastine besilate versus olopatadine andKetorolac combination ophthalmic solutions were found to beeffective in alleviating the clinical symptoms and signs of VKC.
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Ocular itching and redness adversely affect the quality-of-life of vernal keratoconjunctivitis (VKC) patients. The objective of thisstudy was to evaluate changes in VKC patient's quality-of-life (QOL). The present study was prospective, open label,randomized, comparative clinical study. Hundred patients of vernal keratoconjunctivitis between 6 to 20 years of age of eithersex willing to give informed consent were enrolled in the study. In Group A, 50 patients received Bepotastine besilate (0.15%)eye drops twice daily for 8 weeks whereas in Group B, 50 patients received Olopatadine (0.2%) and Ketorolac (0.4%)combination eye drops twice daily for 8 weeks. The Quality of Life Questionnaire (QUICK) is a reliable and validated which wasassessed at baseline and at the time of follow up at 8 weeks. QUICK Questionnaire scores range from 30 to 90 with higher valuesrepresenting greater impairment. A decrease in QUICK Questionnaire score is clinically meaningful to the patients.The results showed that after the 2 months of drug therapy, patients in both the groups showed decrease in the quality of lifescoring of VKC. However, there was no statistically significant difference between the two treatment groups at 8th week. It maybe concluded that both bepotastine besilate versus olopatadine and Ketorolac combination ophthalmic solutions were found to beeffective in alleviating the clinical symptoms and signs of VKC. Hence, improving the quality of life of VKC patients.Keywords: Mast cell stabilizer, Topical NSAIDs, Newer H1-antihistaminics, Vernal keratoconjunctivitis, Quality of life
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Background: Obesity is a complex disorder that involves some degree of over-consumption1 coupled with a metabolic derangement. As ADA has been putatively associated with inflammation, and adipose tissue inflammation is the hallmark of insulin resistance in obese T2DM patients. This study attempted to compare serum ADA in T2DM subjects.Methods: This observational cross-sectional study was conducted in the Department of Biochemistry at MGM Medical College and MY Hospital. All the patients and controls were clinically examined, and routine biochemical tests were analyzed for all subjects. ANOVA has been applied to assess the variance between groups.Results: Mean age of controls was 56.91 years where as mean age in the group of a subject with Obesity with diabetes was 40.91 years and with Obesity without diabetes was 48.10 years. ADA level was more among diabetes patients having obesity than diabetes patients having no obesity and controls.Conclusions: This is very much evident through this study that ADA may be treated as prognostic predictor of diabetes either linked to obesity or not, though more studies are warranted in same direction to make this finding conclusive and acceptable biochemical evidence.
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Introduction: Radiation mitigators are the compounds whichcan minimize or ameliorate post irradiation-toxicity providedthey are administered before the onset of toxic symptoms.Hence, there is an urgent need to prevent harmful effectssecondary to ionizing radiations.Material and Methods: Sixty patients of Head and neckcarcinoma more than 18 years of age of either sex and willingto give informed consent were included in the study. In Group1, 30 patients received the Beclomethasone cream that wastopically applied from the day-1 of radiotherapy till 4-weeksafter completion of radiotherapy, whereas In Group-2, 30patients received the local application of the herbal paste fromthe day-1 of radiotherapy till 4-weeks after completion ofradiotherapy.Results: For measuring radiation-induced reactions, nonparametric test like chi-square test was applied and number ofpatients in different grades was calculated as per RTOGcriteria. Similarly for measuring radiation-induced mucosalreactions, chi-square test was applied and number of patientsin different grades was calculated as per RTOG-criteria.Conclusion: Present study revealed a marked beneficialeffects of herbal paste containing Azadirachta indica, aloevera, Ocimum sanctum and Curcuma longa on radiationinduced skin injury in patients with Head and neck carcinomaas compared to topical Beclomethasone cream.
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Radiation mitigators are the compounds which can minimize post irradiation-toxicity provided theyare administered before the onset of toxic symptoms. In present study we compared pre and posttreatment quality of life in head and neck cancer patients receiving radiotherapy.Sixty patients ofHead and neck carcinoma more than 18 years of age of either sex and willing to give informedconsent were included in the study. In Group-1, 30 patients received the Beclomethasone cream thatwas topically applied from the day-1 of radiotherapy till 4-weeks after completion of radiotherapy,whereas In Group-2, 30 patients received the local application of the herbal paste from the day-1 ofradiotherapy till 4-weeks after completion of radiotherapy. These 60 patients were evaluated at 6month post-therapy using the European organisation for research and treatment of cancer quality oflife questionnaire C30 .For measuring radiation-induced reactions, chi-square test was applied andnumber of patients in different grades was calculated as per Radiotherapy oncology group criteria.Similarly for measuring radiation-induced mucosal reactions, non-parametric test i.e chi-square testwas applied and number of patients in different grades was calculated as per radiotherapy oncologygroup criteria. As per quality of life questionnaire, evaluation on symptom scale revealed that fatigue,pain, dyspnoea, appetite loss and insomnia got worsened in Gp-1 patients, except for diarrhoea,constipation and nausea or vomiting while in Gp-2 patients, all symptoms showed improvement after6 month of completion of treatment. Comparing pre and post-treatment , the global health statusshowed statistically significant improvement in group-2 patients receiving polyherbal paste .The International Journal of Interdisciplinary and Multidisciplinary Studies (IJIMS), 2019, Vol 6, No.1,65-79. 66present study revealed a beneficial effects of polyherbal paste containing Azadirachta indica, aloevera, Ocimum sanctum and Curcuma longa on radiation induced skin injury in patients with Head andneck carcinoma as compared to topical Beclomethasone cream. Also there was improvement inquality of life in cancer patients receiving herbal paste measured at 6 month post-treatment.
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Background: Epilepsy is a challenging medical problem in India with an annual incidence of 27.27 per 100,000 population and prevalence of 572.8 per 100,000. People with epilepsy require prolonged treatment and monitoring. The main goal in the treatment of epilepsy should be adequate control of seizures, without causing any life-threatening reactions due to the medications. This study was done to get an insight into the prescription pattern of anti-epileptic drugs (AEDs) in different types of epilepsy.Methods: A prospective study was carried out for six months (Feb to June 2016) in admitted patients in super speciality ward (Lala Shyam Lal) in neurology department of PGIMS, Rohtak, Haryana. The prescription data of 100 patients of seizures was analysed.Results: Idiopathic generalised epilepsy was commonest type of epilepsy (42%) and sodium valproate was the commonest drug prescribed for its treatment (66.66%) followed by phenytoin (23.33%) Symptomatic epilepsy was second commonest seizure (30%) and phenytoin (60%) was the commonest drug prescribed for it followed by sodium valproate (30%). Common adverse effects associated with anti-epileptic drugs (AEDs) were nausea, drowsiness, weight gain, diplopia and ataxia.Conclusions: Idiopathic generalized epilepsy was the commonest type of epilepsy recorded and sodium valproate was the commonest prescribed drug.
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A hemangiopericytoma is a rare tumor that originates in the pericytes in the wall of capillaries. it is usually benign in nature and is located in the soft tissues. These tumors can originate anywhere in the body where there are capillaries. The most common locations reported are the brain, lower extremities, pelvic area, head, and neck and abdominal cavity. We have reported here a case of hemangiopericytoma in inguinal region in a 70 year old male patient, who presented with right inguinal mass, which was masking the occurrence of right indirect inguinal hernia and diagnose hemangiopericytoma by histopathology.
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The challenges faced by the medical education are similar across the globe. The learning process is problematic with large classes and most of the curriculum time spent on traditional subject oriented didactic lectures during fi rst and second professional, while teaching basic and paraclinical subjects. Various teaching methods were used to make the subjects more interesting, this study was done to determine the perception of case based learning (CBL) and to evaluate its effect in pharmacology among second year students undergoing graduation in Bachelor of Dental Surgery. The perception of student response was collected by questionnaire and records. Data obtained were analyzed statically using paired t test. 86% students (28% strongly agrees and 58% agrees) felt that CBL stimulated their desire to learn and 71% felt that it helps them to solve clinical situation in a better way. 92% felt they were motivated to learn pharmacology. Attendance record of the students improved and number of pharmacology book issued from the central library was increased during the CBL period. The Mean test score obtained by the students before CBL was 7.172 ± 2.268, which was increased signifi cantly to 9.195 ± 3.799. The overall goal of this study is to introduce CBL as an innovative teaching tool. This would help the students to develop clinical decision making skill and link pharmacology to clinical practice in a better way during the start of their carrier.
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Anthropometry is generally considered as the single most easily obtainable, inexpensive, and noninvasive method that reflects body composition and VO2max is an indication of the physical fitness of the subject. There is a paucity of data on t3he age related changes in the body composition parameters and VO2max, and the association between them in the Indian adolescent population. Hence, the present study was conceived to assess and find the association between these parameters in the students in the age group of 12-17 years. Body composition was assessed using anthropometric measures (Height, weight, BMI, waist circumference, hip circumference and skin fold thickness) and cardiorespiratory fitness (CRF) was assessed using estimated VO2max from Rockport Walk Fitness Test. We observed that the anthropometric measures were normal for the respective age groups and VO2max (mL/kg/min) in all the age groups in both the genders were in superior category according to Heywood classification. We observed higher body fat percentage (BF%) in girls of all the age groups compared to the boys and higher fat free mass (FFM) and VO2max in the boys of all age groups when compared to girls. VO2max showed a strong correlation with FFM (r=0.891, P<0.001) and a weak correlation with BF% (r=–0.322, P<0.0001). Optimal body composition and CRF can be attributed to the regular structured physical activity of one hour duration daily and the provision of adequate nutrition. FFM can be put forth as a stronger determinant of CRF than BF% in the adolescents.