Knowledge,attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City,India / 世界急诊医学杂志（英文）

BACKGROUND:This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. METHODS:The study subjects comprised of interns who volunteered from the four dental col eges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistical y significant differences (P<0.05) between assessed knowledge and anxiety. RESULTS:Out of 183 interns, 39.89％ had below average knowledge. A total of 123 (67.21％) reported unavailability of professional training. The majority (180, 98.36％) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1％ participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant (P=0.983). CONCLUSION:There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Heterogeneous Occlusal Traits among Monozygotic Twins from the Village of Twins – A Report of 3 Cases.

Research involving twins contributes much to the scientific world as they enable one to understand the complex morphological variations and the phenotypic expressions of various genes. Twin research study design illustrates and explains the relative contribution and interactions of genes and the environmental factors responsible for the development of a particular trait. Quantification of the genetic and environmental contributing factors enables researchers to explore the variations to various physical, behavioural disorders and dental diseases like dental caries, periodontal diseases and malocclusion. Research with monozygotic twins who share the same genetic pool and similar environmental factors estimates the expression of a particular trait by disentangling the shared genetic coding and environmental contributing features. Monozygotic twin pairs may not always be a look alike in resemblance or other features given that fact that the original zygotic genome might be altered due to epigenetic and environmental factors. This case report elaborates three monozygotic twins from a unique village of twins who differ in their occlusal characteristics.

Current costs & projected financial needs of India’s Universal Immunization Programme.

Background & objectives: India’s Universal Immunization Programme (UIP) is one of the largest programmes in the world in terms of quantities of vaccines administered, number of beneficiaries, number of immunization sessions, and geographical extent and diversity of areas covered. Strategic planning for the Programme requires credible information on the cost of achieving the objectives and the financial resources needed at national, State, and district levels. We present here expenditures on immunization services in India in 2012 (baseline) and projected costs for five years (2013-2017). Methods: Data were collected from the Immunization Division of the Ministry of Health and Family Welfare, Government of India, and immunization partners, such as the World Health Organization and UNICEF. The cost components were immunization personnel, vaccines and injection supplies, transportation, trainings, social mobilization, advocacy and communication activities, disease surveillance, Programme management, maintenance of cold chain and other equipment, and capital costs. Results: Total baseline expenditure was ` 3,446 crore [1 crore = 10 million] (US$718 million), including shared personnel costs. In 2012, the government paid for 90 per cent of the Programme. Total resource requirements for 2013-2017 are ` 34,336 crore (US$ 5, 282 million). Allocations for vaccines increase from ` 511 crore in 2013 to ` 3,587 crore in 2017 as new vaccines are assumed to be introduced in the Programme. Interpretation & conclusions: The projections show that the government immunization budget will be double in 2017 as compared to 2013. It will increase from ` 4,570 crore in 2013 to ` 9,451 crore in 2017.

The need for better evidence to evaluate the health & economic benefits of India’s Rashtriya Swasthya Bima Yojana.

In this review the existing evidence on the impact of Rashtriya Swasthya Bima Yojana (RSBY) is discussed in the context of international literature available on health insurance. We describe potential pathways through which health insurance can affect health and economic outcomes, discuss evidence from other developing countries, and identify potential biases and inconsistencies in existing studies on RSBY impact. Given the relatively recent introduction of RSBY, lack of quality, verifiable data on utilization patterns, and the absence of reliable evaluation studies, there is a need to exercise caution while assessing the merits of the programme. Considering the enormous potential and cost of the programme, we emphasize the need for a rigorous impact evaluation of RSBY. It will not only help capture the real impact of the scheme, but may also be able to estimate the extent of systemic inefficiencies at the level of the consumer.

Caries risk assessment among school children in davangere city using carigram

To assess the caries risk among 12-years old children using the Cariogram and to evaluate it by comparing with the actual change in DMFT and DMFS over a period of two year. A two year prospective study was conducted among 12 years age group school going children in Davangere city. At the baseline relevant and required information regarding the oral hygiene, diet, fluoride usage were obtained using a specially prepared pro forma and the saliva samples were collected from study subjects and the required microbiological analysis was done, as per the instructions of Cariogram version 1997. Caries experience was assessed using DMFT and DMFS index. Re-examination was done after two years and caries increment was calculated. The data so obtained was fed into the Cariogram software based on which they were divided in five groups which were; 0-20% [high risk], 21-40%, 41-60%, 61-80% and 81-100% "Chance of avoiding caries". The caries risk profile generated by the software was compared with caries increment over two years and subjected to statistical analysis. Eighty nine point twenty nine percent of the children in the very low risk group as predicted by Cariogram at baseline did not develop new caries lesions by the end of two years follow-up. Higher risk children at baseline developed higher number of new carious lesions. Cariogram can be a reliable tool in caries prediction. It can aid in identifying different risk groups in a community and developing preventive strategies for reducing caries risk in children

Neonatal Varicella.

Varicella or chickenpox is primarily an infectious disease of childhood and majority of population is infected upto 15 years of age. Rarely, varicella is seen in newborns as congenital or perinatal infection, but in such cases mortality rate is very high. Here we present two cases of neonatal varicella with secondary complications, one with varicella pneumonia and other developing severe secondary skin infection and sepsis.

Effectiveness of Conventional Drug Therapy of Plaque Psoriasis in the Context of Consensus Guidelines: A Prospective Observational Study in 150 Patients

BACKGROUND: Evidence for superior outcome by adhering to therapy guidelines is imperative to their acceptance and adaptation for the optimal management of disease variants. OBJECTIVE: Comparative study of prospective outcomes in simultaneous consideration of independent variables in groups of 150 patients of plaque psoriasis either treated adhering to or in digression of standard guidelines. METHODS: The psoriasis area severity index (PASI) and the dermatology life quality index (DLQI), prior to and after three months of uninterrupted therapy were examined in treatment groups among 150 patients. Recovery rates of 75% or more in PASI were compared. Independent variables were also examined for their bearing on the outcome. RESULTS: The vast majority was early onset disease phenotype. All three treatment regimens when administered in adherence to the guidelines yielded significantly superior rates of defined recovery both in PASI and DLQI. Compromise of the therapeutic outcome appeared in high stress profiles, obesity, female sex and alcohol, tobacco or smoking habit. CONCLUSION: Conventional drug therapy of plaque psoriasis yields superior outcome by adhering to the consensus guidelines. Psychiatric address to stress must be integral and special considerations for phenotypic/syndromic variants is emphasized for effective therapy of psoriasis.

Development and evaluation of a hot-melt coating technique for enteric coating

Conventional enteric coating requires the use of organic based polymers which are equally hazardous to the environment and operating personnel. Hot-melt coating avoids the use of solvents and is a safer and time-saving process. The present study was designed to assess the efficacy of hot-melt coating (HMC) as an enteric coating technique. Pellets prepared by extrusion spheronization were selected as the core formulation for a model of the gastric irritant drug diclofenac sodium (DFS) because of their innate advantages over single-unit formulations. Stearic acid (SA) and palmitic acid (PA) were evaluated as enteric hot-melt coating materials. HMC was carried out in a specially modified coating pan by applying SA and PA in molten state onto preheated pellets to achieve a coating level of 5-15 %w/w. Hot-melt coated pellets were evaluated for disintegration pH and in vitro dissolution in the pH range 1.2 to 6.8, along with basic micromeritics. SEM of coated pellets showed a uniform and smooth coating. These results indicated that HMC of both SA and PA exhibited very good enteric coating ability. The coated pellets showed negligible drug release in acidic pH. As the pellets were subsequently transferred to a higher pH level, a gradual increase in release of the drug from the pellets was observed with increasing pH of the dissolution media. The release was dependent upon coating extent, providing sustained enteric release as opposed to abrupt release with mixed release kinetics.

O revestimento entérico convencional requer o uso de polímeros orgânicos os quais são igualmente danosos ao meio ambiente e ao pessoal que o executa. O revestimento por fusão a quente evita o uso de solventes e é processo mais seguro e que consome menos tempo. O presente estudo foi planejado para avaliar a eficácia do revestimento por fusão a quente (RFQ) como técnica de revestimento entérico. Os péletes preparados por esferonização por extrusão foram selecionados como formulação central para modelo de fármaco irritante gástrico, o diclofenaco sódico (DFS) em razão das vantagens inerentes sobre as formulações de única dose. O ácido esteárico (AE) e o ácido palmítico (AP) foram avaliados como materiais para o revestimento de fusão a quente. O RFQ foi realizado em recipiente especialmente modificado, aplicando AS e PA no estado fundido em péletes pré-aquecidos para atingir nível de revestimento de 5 a 15% p/P. Os péletes revestidos por fusão a quente for avaliados quanto ao pH de desintegração e à dissolução in vitro na faixa de pH de 1,2 a 6,8, juntamente com base micromerítica. O SEM dos péletes revestido mostrou revestimento uniforme e plano. Esses resultados indicaram que o RFQ tanto do AE quanto do AP apresentou capacidade de revestimento muito boa. Os péletes revestidos mostraram pouca liberação do fármaco em pH baixo. Como os péletes foram, subsequentemente, transferidos para pH mais altos, observou-se aumento gradual na liberação do fármaco dos péletes com o aumento do pH do meio de dissolução. A liberação foi dependente da extensão do revestimento, sendo a liberação entérica controlada, contrariamente à liberação abrupta com cinéticas mistas.

Structural and qualitative evaluation of microscopy and directly observed treatment centers under revised national tuberculosis control programme in Nanded city of Maharashtra.

Structural and qualitative evaluation of Revised National Tuberculosis Control Programme (RNTCP) is important to determine actual status of the programme in the field settings and to uncover the concealed gaps. The present cross-sectional study assessed the infrastructural facilities and quality of services provided through microscopy and directly observed treatment (DOT) centers at Nanded city of Maharashtra. The investigator made on spot observation on the activities at microscopy and DOT centers and assessed the infrastructural facilities using an observational checklist. Expert microbiologist cross checked the microscopy report done by the laboratory technicians. It revealed that retrieval mechanism was not functioning in more than half of the DOT centers. Only 5 DOT providers were trained in RNTCP. Stock of sputum containers, methylene blue, and carbol fuchsin was found to be inadequate at some microscopy centers. Half of the laboratory technicians reported high false positive result in spite of being trained. Improvement of infrastructural and logistic support along with the refreshing training for the workers are needed for effective implementation of RNTCP.

QTL analysis for some quantitative traits in bread wheat / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Quantitative trait loci (QTL) analysis was conducted in bread wheat for 14 important traits utilizing data from four different mapping populations involving different approaches of QTL analysis. Analysis for grain protein content (GPC) suggested that the major part of genetic variation for this trait is due to environmental interactions. In contrast, pre-harvest sprouting tolerance (PHST) was controlled mainly by main effect QTL (M-QTL) with very little genetic variation due to environmental interactions; a major QTL for PHST was detected on chromosome arm 3AL. For grain weight, one QTL each was detected on chromosome arms 1AS, 2BS and 7AS. QTL for 4 growth related traits taken together detected by different methods ranged from 37 to 40; nine QTL that were detected by single-locus as well as two-locus analyses were all M-QTL. Similarly, single-locus and two-locus QTL analyses for seven yield and yield contributing traits in two populations respectively allowed detection of 25 and 50 QTL by composite interval mapping (CIM), 16 and 25 QTL by multiple-trait composite interval mapping (MCIM) and 38 and 37 QTL by two-locus analyses. These studies should prove useful in QTL cloning and wheat improvement through marker aided selection.

Andhra Pradesh cold chain system marching beyond routine to obtain WHO accreditation.

The GOAP-PATH partnership project provided an opportunity to carryout situational analysis of the cold chain system in the State of Andhra Pradesh. Apart from identifying areas of work many quality issues like freezing of vaccine were brought to light, which lead to development of a comprehensive plan of action for total overhauling of cold chain system. Introduction of new technologies, training, infrastructure and software development has reformed the cold chain system. The EVSM (Effective vaccine stores management initiative) self assessment was done recently for the Central vaccine stores at Hyderabad and the results of this self assessment has raised the confidence of health personnel to aim for WHO, EVSM accreditation for central vaccine store at Hyderabad.

Effect of laparoscopic sterilization on the incidence of ectopic pregnancy

In order to assess the impact of the tubal sterilization on the incidence of Ectopic Pregnancy, a retrospective analysis of patients with ectopic pregnancy was carried out from January 1971 to December 1990. there was no change in the age groups during the study period in sterilized and nonsterilised groups. The incidence of parity was low in the nonsterilised compared to the sterilized group [p<0.05]. the total number of sterilizations [laparoscopic sterilization and tubectomy] and ectopic pregnancies were doubled during the period 1981-90 compared to 1971-80 periods [p<0.05]. a significant increase in ectopic pregnancy was observed mainly in the non sterilised group