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Background: There is paucity of literature regarding health related quality of life in Spasmodic Dysphonia (SD) especially from India. This study assessed HRQoL in it’s global and disease specific aspect by previously validated instruments in patients with SD.Methods: The study was performed in AIIMS, New Delhi. Subjects with SD as well as age and gender matched healthy controls were enrolled from Movement Disorder and botulinum toxin clinic, Department of Neurology, AIIMS, New Delhi. Uneducated patient, those could not read questionnaires & cases who had received botulinum toxin within 6 months were excluded from the study. Each patient filled SF-36, BDI, VoiSS-30 and VPQ questionnaire.Results: 14 pts of Spasmodic Dysphonia (SD) were enrolled. Compared with controls SD patients suffered from statistically significant impaired global health related quality of life (SF36) in areas of role physical (p = 0.007), general health (p = 0.004), social functioning (p = 0.024), role emotion (p = 0.008) and mental health (p=0.039). Patients with SD scored much worse in BDI scale than their control group (12.57±8.0 vs. 4.71±5.0, p=0.005). 65% pt of SD had depression out of whom 14% had moderate depression. SD patient group showed statistically significant impaired scores in disease-specific QOL (VoISS) in 2 out of 3 subscales, impairment (p= <0.001) and emotional (p=<.001) but not in physical (p=0.44). Voice quality of patients with SD was severely affected compared to controls (mean 37± 8.0 vs. 12.9± 1.5).Conclusions: This study clearly demonstrated that patients with SD suffered from significant impairment in HRQoL as compared to controls. Higher proportion of patients with SD suffered from mild to moderate depression compared to their control.
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Cellulose is a linear homopolymer polysaccharide having water insoluble property. Various cellulose derivative prepared by etherification gains water solubility and shows thermoresponsive gelation. Thermoresponsive polymers are sensitive to thermal environment surrounding them and in response to it they show change in their property. Thermogelation behaviour of cellulose derivatives varies with degree and type of substitution. The main aim behind presenting this article is to summarize the thermosensitive property and application of various cellulose derivatives. This review stresses mainly on cellulose derivatives, methyl cellulose, hydroxypropyl methylcellulose and ethyl (hydroxyethyl) cellulose.
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Between 1990 and 2000, 5499 balloon mitral valvotomies were performed at GB Pant Hospital. Amongst these, 45 patients required surgical intervention, which form the basis of this report. There were 18 males and 27 females with the mean age of 26.5+/-8.3 years and weight of 42.9+/-7.39 kg. Thirty-five patients underwent open-heart surgery and 10 closed-heart surgery. Twenty-five patients developed acute severe mitral regurgitation during balloon mitral valvotomy and required emergency open-heart surgery. Morphine based anaesthetic technique with careful attention to haemodynamic monitoring was used in these patients. All patients required a high inotropic support to terminate the cardiopulmonary bypass. The closed-heart surgical procedures included emergency exploration for cardiac tamponade (4), exploration + closed mitral valvotomy (4), and elective closed mitral valvotomy (2). The overall mortality was 9%, which is much higher than the reported mortality for elective mitral valve replacement. Morphine based anaesthetic technique is useful in these patients. Adequate oxygenation, vasodilators, inotropes and diuretics are required for preoperative stabilisation of patients who develop acute mitral regurgitation, while those who develop cardiac tamponade need volume replacement along with inotropes and immediate surgical decompression of the tamponade.