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Background: Denture adhesives are alternatives used to improve retention, stability, comfort and satisfaction in patients with complete dentures. Evidence on the effectiveness of denture adhesives on resorbed mandibular ridges is scarce. Among the many commercially available denture adhesives, the ideal material for the severely resorbed mandibular ridge remains in dispute. Objective: The aim of this study was to evaluate the effectiveness of different quantities of four commercially available denture adhesives on the retention of mandibular complete dentures in severely resorbed ridges. Materials and Methods: A resorbed edentulous mandibular ridge model was manufactured in acrylic resin. A denture base was made and three loops were attached to it. Four commercially available denture adhesives (Fixodent, Perlie White, Fiftydent and Polident) were tested in amounts of 0.2 g, 0.4 g, 0.6 g, 0.8 g and 1.0 g. The acrylic resin model was evenly moistened with 1 ml of water and a weighted amount of adhesive material was applied to the denture base. The universal testing machine engaged the loops fixed on the denture base and applied the vertical displacement force. The maximum vertical displacement force values were recorded for each denture adhesive material at different amounts. Statistical calculation was performed using Kruskal Wallis with Bonferroni post hoc correction. Results: Statistically significant differences were observed in the mean values of the vertical displacement force for adhesive amounts of 0.2 g, 0.4 g, 0.6 g and 1.0 g (p<0.05) between the four adhesive materials tested. Statistically significant differences were observed when four denture adhesives were compared to each other in different amounts (p<0.05). Statistically significant differences were observed between different amounts for each of four denture adhesives (p<0.05). Conclusions: Among the four materials tested, Polident showed greater effectiveness at 0.6 g and 0.8 g, Fittydent at 0.6 g, 0.8 g and 1 g, Fixodent at 0.4 g and 0.6 g and Perlie White at 1 g and 0.8g quantity to resist vertical displacement. forces on the severely resorbed mandibular crest. Using an appropriate amount of denture adhesive allows for proper retention of the denture; Replacement of this adhesive is necessary once a day.
Introducción: Los adhesivos para prótesis dentales son alternativas utilizadas para mejorar la retención, la estabilidad, la comodidad y la satisfacción en los pacientes con prótesis completas. La evidencia sobre la efectividad de los adhesivos para prótesis dentales en los rebordes mandibulares reabsorbidos es escasa. Entre los muchos adhesivos para prótesis dentales disponibles comercialmente, sigue estando en disputa cuál es el material ideal para el reborde mandibular severamente reabsorbido. Objetivo: El objetivo de este estudio fue evaluar la efectividad de diferentes cantidades de cuatro adhesivos para prótesis dentales disponibles comercialmente sobre la retención de prótesis dentales completas mandibulares en reborde mandibular reabsorbido severamente. Materiales y Métodos: Se fabricó un modelo de reborde mandibular edéntulo reabsorbido en resina acrílica. Se hizo una base para la prótesis y se le colocaron tres bucles. Se probaron cuatro adhesivos para dentaduras postizas disponibles comercialmente (Fixodent, Perlie White, Fiftydent y Polident) en cantidades de 0,2 g, 0,4 g, 0,6 g, 0,8 g y 1,0 g. El modelo de resina acrílica se humedeció uniformemente con 1 ml de agua y se aplicó la cantidad correspondiente de material adhesivo sobre la base de la dentadura. La máquina de prueba universal enganchó los bucles fijados en la base de la dentadura postiza y aplicó la fuerza de desplazamiento vertical. Se registraron los valores máximos de fuerza de desplazamiento vertical para cada material adhesivo para dentaduras postizas en diferentes cantidades. El cálculo estadístico se realizó utilizando Kruskal Wallis con corrección post hoc de Bonferroni. Resultado: Se observaron diferencias estadísticamente significativas en los valores medios de la fuerza de desplazamiento vertical para cantidades de 0,2 g, 0,4 g, 0,6 g y 1,0 g (p<0,05) entre los cuatro materiales adhesivos para prótesis dentales probados. Se observaron diferencias estadísticamente significativas cuando se compararon cuatro adhesivos para prótesis dentales entre sí en diferentes cantidades (p<0,05). Se observaron diferencias estadísticamente significativas entre diferentes cantidades en los cuatro adhesivos para prótesis (p<0,05). Conclusión: De los cuatro materiales probados, Polident mostró mayor efectividad a 0,6 g y 0,8 g, Fittydent a 0,6 g, 0,8 g y 1 g, Fixodent a 0,4 g y 0,6 g y Perlie White a 1 g y 0,8 g para resistir fuerzas de desplazamiento vertical en la cresta mandibular severamente reabsorbida. El uso de una cantidad adecuada de adhesivo para dentaduras postizas permite una retención adecuada de la dentadura postiza; El reemplazo de este adhesivo es necesario una vez al día.
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Humanos , Adesivos/uso terapêutico , Retenção de Dentadura/métodos , Planejamento de Dentadura , Prótese Dentária/métodos , Modelos Dentários , Prótese Total , Mandíbula/patologiaRESUMO
Background@#In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years.Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann–Whitney U test was used to analyze the pain scores. @*Results@#Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. @*Conclusion@#0.2% peppermint oil was effective in reducing pain perception.
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Background@#The objective of behavioral guidance is to establish effective communication that aligns with a child's requirements to manage disruptive behavior. This study aimed to evaluate the effectiveness of the Tell-Show-Do and Ask-Tell-Ask techniques in managing dental anxiety in children during their initial appointment. @*Methods@#The study included 50 children (28 boys and 22 girls) without any prior experience between the ages of 7 and 11 at their first dental visit. The children were randomly categorized into two groups: Group 1, Tell Shows Do, and Group 2, Ask-Tell-Ask. Subsequently, all children underwent noninvasive treatment procedures such as restorations, sealants, and oral prophylaxis. Furthermore, behavioral management techniques were employed based on the allocated group. Finally, anxiety levels for all children were assessed using the Raghavendra, Madhuri, and Sujata Pictorial Scale (RMS-PS) and heart rate at three different intervals (before, during, and after). The obtained data were entered into Microsoft Excel, and statistical analysis was performed using SPSS software. A paired t-test and Mann–Whitney U-test were used to compare the mean and median values of the two groups and determine their effectiveness. @*Results@#Children in the TSD group exhibited statistically significant heart rates and RMS-PS scores in intra-group comparisons. However, children in the ask-tell-ask group showed a significant reduction only in the RMS-PS scores (P < 0.001) but not in the measures used to assess heart rate (P < 0.001). @*Conclusion@#Tell-Show-Do was more effective than ask-tell-ask in alleviating dental anxiety in children. The simultaneous application of these two strategies can synergistically alleviate dental anxiety during a child’s initial dentist appointment.
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Background@#Distraction is a technique used to divert a patient’s attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. @*Methods@#Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong–Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal–Wallis and Wilcoxon signed-rank tests. @*Results@#In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. @*Conclusion@#Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.
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Background: Eating is very essential for life. The timing of food can set all the organs and tissues in the body which relates to food digestion, absorption, and metabolism. Much research performed on many animals proves that food intake is very important which will integrate the peripheral clocks. Consequently, traditional eating habits with a good meal, timing, and interval should be ideal, and not skipping breakfast is very much important in maintaining glucose homeostasis. To make people aware of the meal timing, healthy portion of food components that have to be consumed and the time interval between food, and the importance of morning meals, this study helps to give the same. Aims and Objectives: The study of meal timing and the interval between the meals in Type 2 diabetes mellitus patients. Materials and Methods: Five hundred known cases of Type 2 diabetes patients were enrolled in the study. Reports necessary for glycemic status are collected. Diet history obtained from the patients. Results: Individuals who had their meals at an earlier time and the less time gap between their meals had good control of Diabetes when compared to the persons who had late meals and the increased time gap between the meals. Conclusion: Early or correct meal timings and fewer time intervals between meals will help in the control of Type 2 diabetes. Unhealthy timings of taking the food can lead to a severance in normal homeostasis which can result in unhealthy events. This study helps to be aware of the morbidity associated with their lifestyle habits. Further, it also helps in changing their lifestyle to a healthy eating habit which will help in reducing glycemic index and comorbidities.
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Background: Quality of Life (QOL) is an important indicator of treatment outcome for cancer therapies. QOL researches help us to explore about the impairment caused by treatment and disease on one’s social life, day to day activities and psychological conditions. The objective is to assess the health related QOL in patients suf-fering from oral cavity and throat cancer and to find out factors associated with QOL. Methodology: Facility based cross sectional study design with consecutive sampling was used to achieve a sample size of 90 patients with oral cavity and throat cancer. Result: 71(78.88%) of study participants were independent and 19(21.11%) were partially dependent, none were completely dependent. Majority of the study population perceived a poor overall QOL as revelled by the findings that only 24.4% had best scoring in overall QOL domain. Weak Positive Correlation (R2=0.224) was seen between physical and socio- emotional component of QOL (p value <0.001). Education and cancer site were significantly associated with physical component while employment and Activity of Daily Living were associated with social component of QOL. Conclusion: There is aneed to focus on ambulatory and vocational rehabilitation along with pain manage-ment for oral & throat CA patients as the study show an association of these factors with social component of QOL.
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Background: Prolonged use of N95 masks by healthcare workers might affect physical health due to mask-related hypoxia in addition to the psychological effects of N95 masks. We tried to explore the association of N95 mask-related hypoxia and headache with stress, quality of sleep, and anxiety in the current study. Materials and methods: The sample (N = 78) consisted of 41 doctors and 37 nurses involved in COVID-19 patient care and using N95 masks with or without PPE for at least 4 hours. Perceived stress scale (PSS), Coronavirus anxiety scale (CAS), and Pittsburgh sleep quality index (PSQI) were administered, and physical parameters like heart rate and oxygen saturation (SpO2) were measured. Results: Around 42% of the study participants experienced headaches after wearing an N95 mask and had a higher increase in heart rate (mean percent:10.5% vs 6.3%) and decline in SpO2 (mean percent: 2.6% vs 1.5%) compared to those who didn’t develop a headache after N95 mask use. Independent samples t-test showed a mean difference for PSS and CAS between those who experienced headaches and those who didn’t. The mean PSQI scores among the study participants were 8.91 ± 5.78; the score among those participants with and without headache was 10.57 ± 3.11 and 7.68 ± 2.53, respectively. Conclusion: Perceived corona anxiety, poor sleep quality, and corona anxiety are associated with N95-related headaches and SpO2 drop among health professionals who wear N95 masks for at least 4 hours.
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Background: Various scoring systems are available to assess the severity of cirrhosis, that is, the Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Since the liver is the major site for converting excess carbohydrates into various lipids, the deranged lipid profile can act as a prognostic biomarker of cirrhosis. We assessed the lipid profile abnormalities among patients with cirrhosis of the liver and correlated them with the severity of cirrhosis. Materials and methods: This is an analytical cross-sectional study on lipid profile as an indicator of severity in cirrhosis of the liver among patients admitted to the medical ward of a tertiary care teaching hospital in Tamil Nadu. Following detailed investigation and confirmation of cirrhosis, a fasting serum lipid profile was measured in all eligible patients with cirrhosis. Total serum cholesterol, triglyceride (TGL), and high-density lipoprotein (HDL) were measured by direct method and serum low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) were calculated by using the Friedwald formula. Results: A total of 120 patients were studied. Of them, 76 (63%) were male. Of them, alcohol (84, 75.0%), hepatitis B (8, 7.1%), and nonalcoholic steatohepatitis (NASH) (6, 5.4%) were the most common cause of cirrhosis. A clear dose-response relationship (decreasing trend) is seen in the levels of lipids for increasing severity based on the Child-Pugh score and MELD score (except for a score of ?10). Further, the cholesterol, LDL, and HDL were significantly lower among patients with ascites or with spontaneous bacterial peritonitis compared to their respective groups. However, none of the lipid profiles significantly differed based on the presence of upper gastrointestinal (UGI) bleeding. Conclusion: This study observed that there is a significant reduction in levels of lipid profile parameters like serum total cholesterol, LDL, VLDL, TGL, and HDL in patients with cirrhosis as the severity increases. Further formulation of the scoring system in association with a preexisting scoring system may provide a better assessment of patients’ prognosis in view of morbidity and mortality. We recommend it is necessary to assess the fasting lipid profile in all patients with cirrhosis and prognosticate their disease progression.
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Purpose: The aim of this study is to determine if in vitro fertilization (IVF) is associated with an increase in the incidence of retinopathy of prematurity (ROP) among preterm infants. Methods: This retrospective, comparative study included all the preterm babies who were screened under an urban multicentric outreach project between April 2019 and August 2022. Infant details including gender, birth weight, mode of conception, single or multiple gestation, gestational age and post?menstrual age in weeks, age at presentation, and any presence of risk factors were recorded and analyzed. Results: Among 444 preterm babies included in the study, 373 (84%) were conceived normally and 71 (16%) were conceived by IVF. ROP was found in 99 (22.29%) babies in total. There was no significant difference in the incidence of any stage of ROP between the two groups; however, higher stages of ROP were found to be relatively more frequent in the spontaneous conception group in our study. We also found a statistically significant difference in the presence of ROP among singletons, twins, and triplets. Conclusion: IVF was found not to independently increase the risk of ROP in preterm infants. More prospective studies and randomized controlled trials are needed to establish the relationship between the mode of conception and development of severe ROP in preterm infants
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@#Management of implant failures is difficult, especially implant fixture fracture where it is complicated and requires multispecialty care. The aim of this report is to describe the challenges of treatment planning and management of implant fixture fracture with tooth wear on patient with financial constraints. A 67-year-old retired male patient came to the dental clinic with a complaint of a mobile implant-supported fixed prosthesis, fractured implant fixture and attrited lower dentition. Treatment plan was planned around low cost with the biggest benefit of the patient. Multispecialty care is involved such as root canal treatment, implant removal, restoration of remaining dentition and replacement of missing teeth with removable prosthesis. The patient was reviewed after a month of completing full treatment resulted in a good treatment outcome. Lack of maintenance regimen leads to failure and mobility of the implant prosthesis. Proper maintenance protocol, post-insertion instructions, and good patient compliance are the key factors in determining longevity of the restoration.
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@#Introduction: Differences in baseline characteristics and response to treatment in different age groups of patients with chronic myeloid leukaemia (CML) in resource-limited countries have not been extensively studied. We aimed to determine the differences in clinicopathological parameters at diagnosis and response to imatinib in adult CML patients with younger (under 60 years; YCML) and older (60 years and older; OCML) age treated at our institution from March 2001 to March 2021. Methods: A retrospective analysis of consecutive adult CML patients receiving imatinib was performed. Clinicopathological parameters and treatment response were reviewed and analysed using hospital medical records and electronic data reports. Results: The median age at diagnosis was 50 years. OCML patients (n=17) had significantly more comorbidities. The YCML group (n=50) generally had a palpable spleen >5cm from the costal margin, mild anaemia, hyperleukocytosis and thrombocytosis. A starting dose of 400 mg/day was observed in 84% of YCML and in 65% of OCML. Cumulative complete cytogenetic response was 50% in YCML versus 70.6% in OCML, p=0.158. OCML tended to have a higher percentage of major molecular response (MMR) (52.9% versus 32%) and a shorter time to MMR, 22 months (range 5-70) versus 35 months (range 8-53). OCML experienced more haematological and non-haematological treatment-related adverse events after imatinib therapy. Conclusion: Although OCML patients had more comorbidities and treatment intolerances, overall long-term treatment response was comparable to YCML. In OCML, a more personalised approach to initial and subsequent dosing of imatinib may be considered.
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Background@#Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers.Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. @*Methods@#A total of 42 healthy children aged 7–10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants’ demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min.The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann–Whitney U test. @*Results@#The median pain score and range for the intervention and control groups were 4 (2 – 6) and 6 (4 – 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group.Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. @*Conclusion@#Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.
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Purpose@#Gestational nutrition has an impact on the growth and development of the fetus.Choline (C) and docosahexaenoic acid (DHA) are important and essential nutrients for humans that play a role in the structural integrity of the membranes as well as signalling.C is used in the synthesis of phosphatidylcholine, and cell membranes are highly enriched with DHA. The dietary intake of C or DHA during pregnancy directly influences fetal development. Currently, there is no evidence to prove the effectiveness of the combined dietary supplementation of both C and DHA during gestation on developmental outcomes in the offspring. @*Methods@#The current study was designed to assess the physical, sensory, and motor development of rat pups born to mothers supplemented with C and/or DHA during the entire gestational period. Pregnant rat dams were divided into the following five groups:Normal control (NC), Saline control (SC), Choline (C), DHA, and Choline+DHA (C+DHA).The NC dams did not receive any supplementation during the entire gestation period. The experimental groups were supplemented with Saline, C, and/or DHA, respectively, during the entire gestation (E0 to delivery). @*Results@#Rat pups (n = 6/group) exposed to combined C and DHA showed significant improvement in birth weight, fur development, eye-opening as well as weight gain on the 7th, 14th, and 21st postnatal day and pinnae detachment (assessed from birth to postnatal day 21) when compared with age-matched NC, SC or C or DHA pups. Further, significant reflex responses were observed in visual placing and bar holding of pups exposed to both C and DHA, whereas the differences in surface righting, negative geotaxis, and grasping reflexes were not significant between the groups. @*Conclusion@#Gestational supplementation of both C and DHA rather than either of them alone is better in enhancing developmental outcomes in rat pups.
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Background : COVID-19 has made a series changes in all system of life especially in education. As a result, education has changed dramatically with the distinctive rise of e-learning. The present study was aim to examine the preference and perception of MBBS student on newly introduced online live video classes. Methods:An online questionnaire survey consisting of closed and open-ended questions on nine different categories such as accessing online video content, previous experience with online learning, interaction with video lectures addressing the content, duration, visualize, timings and screen size, perceived learning experience, the online content learning assessment methods and the experience with the online learning management system.Two hundred and thirteen undergraduate medical students were participating in this study. And it was conducted by the large medical institution in Andhra Pradesh. Results: The e-learning methods were encouraged and its gaining popularity among the medical students and faculty. Our analysis shown 97.7% students were highly satisfied and 2.3% were not satisfied with online classes on comparison to the traditional methods of learning. Conclusions:The teaching method and teachers support are the pivotal elements which enable online learning experience with a mutual relationship. Furthermore, the usefulness and acceptability of e-learning among medical students as a part of their curriculum is still not fathomed in medical education.
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Purpose: This study was conducted to assess the outcomes of bleb needling for the treatment of failure of filtration surgeries in primary glaucoma with a follow?up of six months. Methods: This prospective interventional study included patients with primary glaucoma who underwent trabeculectomy or combined glaucoma and cataract surgery with failed or failing bleb after six weeks of surgery and less than two years. A comprehensive examination including best?corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, gonioscopy, slit?lamp examination, and bleb morphology grading was done. Selected patients underwent a subconjunctival bleb needling with mitomycin C (MMC) (dose 0.2 mg/ml). Postoperatively, patients were followed up on the first, third, and sixth months and were assessed with respect to IOP, need for antiglaucoma medication (AGM), and complications. Results: Sixty eyes of 59 patients were included. Preoperatively, 33.3% of patients were on one AGM, whereas postoperatively at the third month 51.7% and at the sixth month 50% of patients were on no AGM. There was a statistically significant decrease in IOP (P < 0.001) from preoperative (mean: 23.8 ± 7.86 mmHg) to postoperative first month (mean: 19.8 ± 9.08 mmHg), third month (mean: 17.4 ± 5.4 mmHg) and sixth month (mean 16.6 ± 4.39). According to the defined criteria in the current study, we achieved 22 (37.9%) successes, 31 qualified successes (53.4%), and 5 (8.6%) failures. Univariate regression analysis showed a higher failure rate among younger age groups. Gender, laterality, and intraoperative complications were not significant statistically. Conclusion: Bleb needling is a safe and effective procedure for the treatment of failed filtration surgeries
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Purpose: This study aimed to evaluate the knowledge, awareness and attitude of eye donation among non?clinical staff of tertiary eye hospitals and to convey a positive attitude toward eye donation by enhancing their awareness and knowledge. Methods: An online cross?sectional study was conducted among the non?clinical staff from all centers of a tertiary eye care hospital across Tamil Nadu. Quiz link was emailed to non?clinical staff of all the centers. On completion of the quiz, the participants viewed their respective scores and the correct answers to all questions. This activity was presumed to subsequently improve their knowledge and clear up the myths on eye donation. Results: Two hundred twenty?eight non?clinical staff from 11 hospitals participated in the quiz. Mean age was 35.3 ± 9.8 years and 130 were female staff (57.05%). One hundred eighty?one participants (79.39%) scored over 50% of the total 17 queries. One hundred eighty?six (81.58%) and 142 (62.28%) participants scored over 50% in the awareness section and knowledge section, respectively. Eye bank volunteers (73, 32.02%) were the main source of information. Twenty?four (10.53%) had already taken pledge for eye donation and 175 (76.75%) were willing to pledge, 29 (12.72%) were not willing to pledge. Twenty?two out of these 29 (75.86%) had no specific reason for not pledging. Family, religious reasons, lack of clarity and fear were least cited reasons (13.79%). Conclusion: Non?clinical staff of an eye hospital are easily approachable and are expected to be more knowledgeable by the general public around them. They might act as primary motivators in raising awareness within their family, friends, relatives and neighbors
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Early chest compressions and rapid defibrillation are important components of cardiopulmonary resuscitation (CPR). American heart association (AHA) recommends two breaths to be delivered for every 30 compressions for an adult cardiac arrest victim. Patient with an advanced airway like endotracheal tube (ETT) should be given one breath every 6 s without interruptions in chest compression (10 breaths per minute). All of the modern mechanical ventilators have option to generate spontaneous breaths by the patient if the patient has spontaneous respiratory efforts. During CPR, the mechanical ventilator is fallaciously sensing the chest compressions as patient's spontaneous trigger and thereby it delivers higher respiratory rates. Avoiding excessive ventilation is one of the components of high quality CPR as excessive ventilation decreases venous return thereby decreasing the cardiac output and also it affects intra-thoracic pressure thereby adversely affects intra-arterial pressure. As modern ventilators have trigger for spontaneous breaths and they will be erroneously triggered by chest compressions, it would be prudent to use volume marked resuscitation bags or manual breathing devices (manual self-inflating resuscitation bag, Bain's circuit) for delivering breaths which can be synchronised with compression phase of CPR at RR of 10 breaths per min with advanced airway in place. If any patient who is on mechanical ventilation develops cardiac arrest, patient should be disconnected from the mechanical ventilator and should be ventilated manually. Manual ventilation with aforementioned breathing devices should be used in a patient without and with advanced airway devices during CPR.
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We report the case of a 52-year-old patient with type 2 diabetes mellitus diagnosed with adenocarcinoma rectum, presenting with the complaint of breathlessness to the emergency department. Chest radiograph done showed a left-sided hydropneumothorax with mediastinal shift to the right side. Tube thoracostomy was done. Pleural fluid was exudative; there was no evidence of malignancy. The patient developed a right-sided pleural effusion; anaerobic bacteria were grown on pleural fluid culture. Computed tomography (CT) of the chest was done in view of the new onset empyema on the right side. The CT showed pneumomediastinum and periesophageal air pockets. Orally administered methylene blue had appeared in the pleural drain confirming the diagnosis. The patient was taken up for feeding jejunostomy and repair of tear was planned for a later date. He succumbed to sepsis due to empyema.
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Headache during pregnancy is a common complaint in the emergency room. In pregnancy, pituitary disorders include both hormone active and hormone inactive tumors. Apoplexy may be the first clinical presentation of an underlying pituitary tumor. Red flag signs of presenting symptoms, to be assessed for identifying life-threatening etiology. Various pathophysiological mechanisms have been passed for pituitary apoplexy in pregnancy. Magnetic resonance imaging of the brain is the gold standard investigation. The mainstay of management is the initiation of steroids. Transnasal transsphenoidal removal of the tumor is the definitive treatment that requires a multidisciplinary approach. The indications of surgery are the presence of symptoms due to compression and endocrine abnormalities; however, gestational period should be taken into consideration. We report a case of headache in antenatal women who presented to our emergency room diagnosed with pituitary apoplexy managed with steroids and early surgery, and discharged with good clinical outcome. We recommend a methodical approach to common symptoms that assist in diagnosing forgotten etiology.
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Context: Adaptation needs of senior citizens are not well explored in research, especially among people living in old age homes situated in developing countries like India. Aim: The aim of the study was to understand the needs and concerns of senior citizens living in old age homes and its effect on their adaptation. Subjects and Methods: Using the purposive sampling method, fifteen residents of an old age home and their three caregivers were interviewed to describe their views and experiences. The tools used were the Montreal Cognitive Assessment and an in-depth interview schedule. Statistical Analysis: Qualitative data were analyzed using Atlas ti. 7 for identifying major themes and subthemes. Results: The results showed that the major needs and concerns of senior citizens were unmet medical needs, difficulty to handle negative attitudes of staff, difficulty to adapt with new environment and culture, and emotional issues. Conclusion: Findings indicate the importance of addressing the adaptation needs of the elderly living in old age homes.