ASSOCIATION OF MPV AND RDW WITH DISEASE ACTIVITY IN PATIENT WITH RHEUMATOID ARTHRITIS.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by inflammation of the synovial joints. Disease activity assessment plays a crucial role in guiding treatment decisions and monitoring disease progression in RA patients. Thus, the current study examines the association between Mean Platelet Volume (MPV), Red Cell Distribution Width (RDW), and disease activity in RA patients. A total of 100 patients were included following the inclusion and exclusion criteria. All participants underwent physical examination and laboratory tests. Disease activity was assessed using the Disease Activity Score 28 (DAS28). The cut-off levels for RDW and MPV were 14.8 and 11.25, respectively. However, a significant association was observed between RDW levels and DAS28, indicating that the group with RDW ≤14.8% displayed higher DAS compared to the RDW >14.8% group. Also, MPV levels did not exhibited statistically significant variations. RDW levels did not show significant disparities among patients with different comorbidities. There is a significant correlation exists between RDW and disease activity in RA exists. Moreover, RDW can be utilized in clinical settings to monitor disease activity effectively. Since RDW is routinely included in standard blood tests, it is cost-effective and more convenient for treating RA cases.

TRIGLYCERIDE - GLUCOSE INDEX, REMNANT CHOLESTEROL AND COMMON CAROTID ARTERY INTIMA-MEDIA THICKNESS AS AN ATHEROSCLEROTIC MARKER IN ISCHEMIC STROKE PATIENTS.

Ischemic stroke (IS) is a major global health concern, often resulting from atherosclerosis and insulin resistance (IR). The triglyceride-glucose index (TyG index), remnant cholesterol (RC), and common artery intima-media thickness (CIMT) are potential markers for assessing atherosclerosis and cardiovascular risk in IS patients. A cross-sectional study was conducted to investigate the association between TyG index, RC, CIMT, and IS in adult patients recruited from a hospital. Demographic, clinical, and laboratory data were collected, and statistical analysis was performed. The study included 50 participants with a balanced gender distribution and a mean age of 57.64 years. Laboratory characteristics showed notable values, and CIMT > 0.6 mm was associated with higher NIH Stroke Scale scores. RC exhibited significant correlations with age, CIMT, lipid profile, and TyG index. The study highlights the potential of TyG index, RC, and CIMT as atherosclerotic markers in IS patients. Favorable prognostic outcomes were observed, emphasizing the importance of early diagnosis and management to improve patient outcomes.

Effectiveness of a Community Health Worker-Driven Intervention in Improving the Quality of Life of Caregivers of Children With Disability in Rural Karnataka, India.

Purpose To assess the effectiveness of a community-health-worker (CHW)-driven intervention in improving the quality of life (QOL) of caregivers of children with disability in rural Karnataka, India. Methodology A community-based quasi-experimental study with cluster randomization on the village level was done. CHWs provided structured health education and training for the intervention arm. Pre- and post-intervention, the QOL and Zarit burden scores were compared between and within the two arms. Results From baseline, the physical domain score improved from 49.66 to 53.88 (p < 0.001). The Zarit burden scores decreased from 33.27 to 28.89 (p < 0.001). On comparing the post-test QOL scores between the two arms, the physical domain scores increased from 51.68 to 56.08 (p = 0.025). The Zarit burden scores also significantly decreased from 31.50 to 26.28. Conclusion The intervention by the CHWs on the caregivers has significant improvements in the physical domain of QOL and a reduction in caregiver burden.

Microwave-assisted synthesis of GdOF: Eu3+/Tb3+ ultrafine phosphor powders suitable for advanced forensic and security ink applications.

The rare-earth-doped inorganic ultrafine oxyfluoride host matrices in forensic science, especially in latent fingerprint detection and anti-counterfeiting applications, were still unexplored and may replace the existing technology owing to its high sensitivity. Herein, GdOF: Eu3+/Tb3+ ultrafine red and green phosphors were synthesized via a rapid, green microwave-assisted hydrothermal method at 150 °C. The phosphors synthesized by this novel method possess good luminescent intensity for the hypersensitive 5D0→7F2 transition of Eu3+ and 5D4→7F5 transition of Tb3+ ions as compared to the phosphors prepared via other conventional methods such as co-precipitation synthesis, sol-gel synthesis, and microwave-assisted co-precipitation synthesis. Further, an enhancement in the luminescent intensity of the ultrafine phosphor was noticed when the microwave parameters and pH values were tuned. The optimized red and green phosphors having high luminescence intensity, good color purity, and high quantum yields of 89.3%, and 71.2%, respectively, were used for the visualization of latent fingerprints on various substrates. These promising phosphors exhibited excellent visualization regardless of the background interference and limit the risk of duplication and are highly reliable. The security inks developed using these phosphors are highly efficient for anti-counterfeiting applications. These multifunctional properties of investigated phosphors can be explored for security applications.

Impact of Self-Help Groups among Persons With Disabilities in Rural Karnataka - A Comparative, Cross-Sectional Study.

Background: The prime concern for an individual with disability is independence. Self-help groups (SHGs) provide opportunities for those with such needs. Objectives: The objectives of the study were (i) to assess the impact of SHGs on the livelihood, social inclusion, and community participation of those with disability and (ii) to evaluate the self-esteem and assess the role of such SHGs among those with disability. Materials and Methods: This was a community-based, cross-sectional study. An interview schedule captured responses to standardized questionnaires (community-based rehabilitation assessment tool, Rosenberg's self-esteem score, and Social Inclusion Scale). Responses were scored and compared among the two groups of those with disability (member or nonmember of SHGs). Results: The median scores for all our outcome variables were found to be more among those with disabilities enrolled in SHGs than those who were not with a significant association in the component of empowerment, sociocommunity participation, social inclusion, and self-esteem. Conclusion: SHGs improve social and community participation of individuals with disability. It empowers them to lead independent lives and also contributes to social inclusion.

Variable antifungal activity of curcumin against planktonic and biofilm phase of different candida species.

OBJECTIVE: To evaluate the in vitro antifungal activity of curcumin against 2 strains of Candida albicans (ATCC 90028 and a clinical isolate - JY strain) and 1 isolate each of 3 nonalbicans - Candida species [Candida parapsilosis (ATCC 22019), C. glabrata (ATCC 90030), and C. dublieniensis (MYA 646)]. MATERIALS AND METHODS: Planktonic MIC of the 4 Candida species was determined using micro broth dilution assay according to CLSI M27-A3 criteria. The biofilm development and sensitivity assay were performed with the 2 C. albicans strains. RESULTS: Curcumin at high concentrations (0.1-2 mg/mL) was effective in inhibiting planktonic organisms of all the 5 tested Candida strains. The planktonic phase and the biofilm phase of C. albicans ATCC 90028 exhibited similar MIC values for curcumin (0.5 mg/mL). Both curcumin and fluconazole were ineffective against the mature biofilms of JY strain. CONCLUSION: Our results reported here for the first time, in particular for the biofilm state of C. albicans, imply that curcumin a natural product could be used as a therapeutic alternative to conventional antifungals although further investigations are required to evaluate its potential.

A study of emotional intelligence and perceived parenting styles among adolescents in a rural area in Karnataka.

CONTEXT: Adolescence is the time which is crucial for the overall development of a person both mentally and physically. In this period, along with academic intelligence, emotional intelligence (EI) also plays an equal or strong role in student life. AIMS: This study was to assess EI, parental bonding, and their association among adolescents in high schools under Sarjapur PHC area. SUBJECTS AND METHODS: This was a cross-sectional study conducted among high school students under Sarjapur PHC area. The EI was assessed using EI scale which measured self-awareness, self-regulation, motivation, empathy, and social skills. The parental bonding instrument was utilized to determine the parental styles of both the parents and was interpreted in terms of care and protection as neglectful parenting, affectionless control, optimal parenting, and affectionate control. RESULTS: A total of 300 adolescents were interviewed. It was seen that most of them had low EI in self-awareness, i.e., 92 (30.7%), motivation 99 (33%), and social skills 101 (33.7%). It was also observed that most of them had high EI in self-regulation, i.e., 98 (32.7%) and moderately high EI in empathy 117 (39%). The study group perceived that 147 (49%) of the fathers and 109 (36.3%) of the mothers had affectionless control. CONCLUSION: Along with poor parenting, most of the respondents also have low EI in self-awareness, motivation, and social skills which has to be addressed for the future of the country.

Pyoderma gangrenosum: A clinico-epidemiological study.

BACKGROUND: Pyoderma gangrenosum is a neutrophilic dermatosis of unknown etiology, with inconstant systemic associations and a variable prognosis. AIMS: To study the clinical features and systemic associations of pyoderma gangrenosum and its response to treatment. METHODS: All patients diagnosed to have pyoderma gangrenosum at the dermatology department of the Government Medical College, Kozhikode, from January 01, 2005 to December 31, 2014 were included in this prospective study. RESULTS: During the 10-year study period, 61 patients were diagnosed to have pyoderma gangrenosum. A male predilection was noted. The most common clinical type was ulcerative pyoderma gangrenosum (90.2%). More than 60% of patients had lesions confined to the legs; 78.7% had a single lesion and 27.9% had systemic associations. Most patients required systemic steroids. Patients with disease resistant to steroid therapy were treated with intravenous immunoglobulin G and split-thickness skin grafts under immunosuppression induced by dexamethasone pulse therapy. All except one patient attained complete disease resolution. LIMITATIONS: The main limitation of our study was the small sample size. CONCLUSIONS: The male predilection documented by us was contrary to most previous studies. We found split-thickness skin graft to be a useful option in resistant cases. More prospective studies may enable the formulation of better diagnostic criteria for pyoderma gangrenosum and improve its management.

Severe cutaneous adverse drug reactions: a clinicoepidemiological study.

BACKGROUND: Drug eruptions range from transient erythema to the life threatening severe cutaneous adverse reactions (SCAR) that encompass Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms complex (DRESS). AIMS AND OBJECTIVES: To study the clinical and epidemiological aspects of cutaneous adverse drug reactions (CADR). MATERIALS AND METHODS: Ethical clearance was obtained from the institutional ethics committee. All patients admitted in the Dermatology ward of our tertiary care hospital with CADR (those who fit in the category of probable or possible drug reaction as per WHO casuality assessment) from first September 2011 to 31(st) August 2012 were included in this cross sectional study after obtaining written informed consent. The drug reaction patterns observed in the study population were determined and the common offending drugs were identified. RESULTS: In the study, population of males outnumbered females and the majority were between 46 and 60 years of age. The commonest reaction pattern observed was SJS- TEN spectrum of illness and aromatic anticonvulsants were the common offending drugs. Prompt withdrawal of the culprit drug and administration of systemic steroids with or without I/V Ig reverted the adverse reaction in all except one. CONCLUSION: Severe drug reactions predominated as the study population was comprised of inpatients of a tertiary referral centre. Though; previous authors had reported a mortality rate of up to 20% in DRESS, all our patients with this reaction pattern, responded well to treatment. The mortality rate among TEN cases was much lower than the previous reports. Early diagnosis, prompt withdrawal of the suspected drug, careful monitoring for development of complications and immediate intervention can improve the prognosis of CADR.

Suprahyoid pharyngotomy for excision of laryngeal venous malformation.

We report an uncommon case of symptomatic venous malformation of the larynx in a 22-year-old man, and the successful surgical management thereof. A detailed radiologic investigation of the lesion was done, followed by surgical excision via a suprahyoid pharyngotomy using cold instruments. Long-term follow-up was maintained, and the patient had subjective and objective resolution of his symptoms and signs at 3 years postoperatively. We conclude that radiology can reveal hitherto unsuspected extensions of vascular malformations in the neck and that surgical excision is a viable mode of treatment in upper aerodigestive venous malformations.

Cost-effectiveness of open versus arthroscopic rotator cuff repair.

BACKGROUND: Economic evaluation of surgical procedures is necessary in view of more expensive newer techniques emerging in an increasingly cost-conscious health care environment. This study compares the cost-effectiveness of open rotator cuff repair with arthroscopic repair for moderately size tears. MATERIALS AND METHODS: This was a prospective study of 30 consecutive patients, of whom 15 had an arthroscopic repair and 15 had an open procedure. Clinical effectiveness was assessed using Oxford and Constant shoulder scores. Costs were estimated from departmental and hospital financial data. RESULTS: At last follow-up, no difference Oxford and Constant shoulder scores was noted between the 2 methods of repair. There was no significant difference between the groups in the cost of time in the operating theater, inpatient time, amount of postoperative analgesia, number of postoperative outpatient visits, physiotherapy costs, and time off work. The incremental cost of each arthroscopic rotator cuff repair was pound675 ($1248.75) more than the open procedure. This was mainly in the area of direct health care costs, instrumentation in particular. DISCUSSION: Health care policy makers are increasingly demanding evidence of cost-effectiveness of a procedure. This study showed both methods of repair provide equivalent clinical results. CONCLUSION: Open cuff repair is more cost-effective than arthroscopic repair and is likely to have lower cost-utility ratio. In addition, the tariff for the arthroscopic procedure in some health care systems is same as open repair.

[Severe thrombocytopenia in a child with type 1 diabetes].

We describe here a young girl who developed severe thrombocytopenia following Varicella infection. She was previously diagnosed with diabetes. In addition she demonstrated anti-nuclear factor positivity. Immune thrombocytopenic purpura induced by varicella is rare in children with diabetes.