Inclusive Accommodations for Persons with Visual Impairments in Computer-Based Tests.

The accommodations in exams (for example, scribe, compensatory time, and magnification) are widely used for many years to accommodate persons with visual impairments (PVIs). Nowadays, most of the exams are conducted using computers and web-based technologies, referred to as Computer-based tests (CBTs). These CBTs play an important role in the professional assessment of an individual, starting from university admissions, courses evaluation, and grading, to recruitment in various sectors like banking, software, railways, etc. Barriers in accessing certain components of the CBTs limit the utilization of Computer-based technologies for PVIs. In this research, the availability and effectiveness of common accommodations in CBTs were evaluated and reviewed. To the best of our knowledge, this is one of the early attempts from India to systematically study the effectiveness of these accommodations. Driven by a universal design approach, it can play a key role towards the development of an inclusive examination system.

Technical and Interpretive Pitfalls in Adrenal Imaging.

The adrenal gland may exhibit a wide variety of pathologic conditions. A number of imaging techniques can be used to characterize these, although it is not always possible to attain a definitive diagnosis radiologically. Incorrect diagnoses may be made if radiologists are not attentive to technical parameters and interpretive factors associated with adrenal gland imaging. Hence, an appreciation of the intricacies of adrenal imaging strategies and characterization is required; this can be aided by understanding the pitfalls of adrenal imaging. Technical pitfalls at CT may relate to the imaging parameters, including region of interest characteristics, tube voltage selection, and the timing of contrast material-enhanced imaging. With MRI, imaging acquisition technique and evaluation of the reference tissues used in chemical shift MRI are important considerations that can directly influence image interpretation. Interpretive errors may occur when evaluating adrenal washout at CT without considering other radiologic features, including the size of adrenal nodules, the presence of fat or calcification, the attenuation of nodules, and atypical imaging features. The characterization of an incidental adrenal lesion as benign or malignant does not end the role of the radiologist; consideration as to whether an adrenal lesion is associated with endocrine dysfunction is required. While imaging may not be optimal for establishing endocrine activity, there are imaging features from which radiologists may infer function. In cases of known endocrine activity, imaging can guide clinical management, including further investigations such as venous sampling. ©RSNA, 2020.

Validating a method to assess disease burden from insurance claims.

OBJECTIVES: To validate a method that estimates disease burden as disability-adjusted life-years (DALYs) from insurance claims and death records for the purpose of identifying the conditions that place the greatest burden of disease on an insured population. STUDY DESIGN: Comparison of the DALYs generated from death records and insurance claims with functional status and health status reported by individuals who were insured with one of HealthPartners' commercial products and completed a health assessment in 2011, 2012, or 2013. METHODS: We calculated values of Spearman's ρ, the rank-order coefficient of correlation, for the correlation of DALYs with self-reported function and self-reported health. We did the same for the number of medical conditions per member and the cost of claims per member. RESULTS: The Spearman's ρ values for the correlation of DALYs with function were -0.241, -0.238, and -0.229 in 2011, 2012, and 2013, respectively (all P <.0001). The respective Spearman's ρ values for the correlation of DALYs with health were -0.197, -0.189, and -0.192 (all P <.0001). These Spearman's ρ values were similar in magnitude to those for the correlation of the number of medical conditions per member with function (-0.212, -0.213, and -0.205) and health (-0.199, -0.196, and -0.198) over the 3 years. The Spearman's ρ values for the correlation of DALYs with function and health were greater than or equal to those for the correlation of cost of claims per member with function (-0.144, -0.193, and -0.186) and greater than those for the cost of claims per member with health (-0.126, -0.150, and -0.151). CONCLUSIONS: Health plans can use DALYs calculated from their own health insurance claims and death records as a valid and inexpensive method to identify the conditions that place the greatest burden of poor function and ill health on their insured populations.

Epidemiological Study to Evaluate the Prevalence of Dentine Hypersensitivity among Patients.

BACKGROUND: Dentine hypersensitivity (DH) is a common finding with different prevalence rate. The aim of this study was to evaluate the prevalence of DH and associated risk factors. MATERIALS & METHODS: This cross-sectional survey was done among patients coming to dental hospital. The diagnosis of DH was made as the result of both clinical examination and patient's response. A self-administered structured questionnaire was used to know demography profile, self-reported DH, the activating factors, preventive measures and frequency. Descriptive statistics were obtained and frequency distribution was calculated using Chi square t test at p value <0.05. RESULTS: The total population compromised of 960 patients including 528 males and 432 females. The prevalence of dentine hypersensitivity in this sample was 42.5% and more common among male population (60.8%) and the peak age was between 30 to 39 years (39.2%). Lower anteriors were commonly involved (35.8%) and cold drinks (25.8%) are the main aggravating factor. 6.5% experience it all the time but still some do not take preventive measures. CONCLUSION: There is high prevalence rate of DH and mainly among males. Some of the patients had it all the time but still they do not want to control the problem. How to cite this article:Rane P, Pujari S, Patel P, Gandhewar M, Madria K, Dhume S. Epidemiological Study to Evaluate the Prevalence of Dentine Hypersensitivity among Patients. J Int Oral Health 2013; 5(5):15-9.

Endodontic management of maxillary second molar with two palatal roots: a report of two cases.

Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal roots and canals. Clinical examination and radiographs showed the presence of two palatal roots during the root canal procedure. The canals were biomechanically prepared with crown-down technique and obturated using lateral condensation technique with AH-Plus sealer.

Recent advances in oral anticoagulation for atrial fibrillation.

Atrial fibrillation is the most common sustained rhythm disturbance. Thromboembolic events related to atrial fibrillation result in significant morbidity, mortality and increases in the cost of healthcare. Anticoagulants are pivotal agents for the prevention and treatment of thromboembolic disorders. The latest American College of Cardiology/American Heart Association guidelines recommend antithrombotic therapy to prevent thromboembolism for all patients with atrial fibrillation, except those with lone atrial fibrillation or contraindications. Vitamin K antagonists were first synthesized in 1948 and for the past six decades they have been the only agents used for long-term oral anticoagulant therapy. Although these drugs are effective, they have numerous limitations, which have led to the development of newer anticoagulant therapies. The emerging oral anticoagulant agents are target selective. They have predictable pharmacokinetic and pharmacodynamic parameters and do not require routine monitoring. They are not associated with significant food and drug interactions, and can be administered in simple fixed daily or twice daily doses. This article reviews the current literature on various targets for anticoagulant therapy and newer oral anticoagulants for atrial fibrillation.

Practical implications of ACC/AHA 2007 guidelines for the management of unstable angina/non-ST elevation myocardial infarction.

Unstable angina/non-ST elevationmyocardial infarction (UA/NSTEMI) is one of the major life-threatening causes of hospitalization in the United States. The number of hospital discharges for acute coronary syndrome in 2005 was estimated at 1.4 million and approximately 0.4 million discharges per year were for STEMI while 1 million were for UA/NSTEMI. Evidenced-based medications and lifestyle modification interventions are probably used less frequently in patients with acute coronary syndrome. Quality improvement interventions to improve adherence to the guidelines may reduce the high mortality rates associated with ACS in contemporary practice. In this article we focused on practical implications of American College of Cardiology (ACC)/American Heart Association (AHA) 2007 guidelines for the management of UA/NSTEMI. It will aid to provide the supporting evidence for the acute as well as continued management of patients with these disorders.

Dronedarone for atrial fibrillation: a new therapeutic agent.

Atrial fibrillation is the most common of the serious cardiac rhythm disturbances and is responsible for substantial morbidity and mortality. Amiodarone is currently one of the most widely used and most effective antiarrhythmic agents for atrial fibrillation. But during chronic usage amiodarone can cause some serious extra cardiac adverse effects, including effects on the thyroid. Dronedarone is a newer therapeutic agent with a structural resemblance to amiodarone, with two molecular changes, and with a better side effect profile. Dronedarone is a multichannel blocker and, like amiodarone, possesses both a rhythm and a rate control property in atrial fibrillation. The US Food and Drug Administration approved dronedarone for atrial fibrillation on July 2, 2009. In this review, we discuss the role of dronedarone in atrial fibrillation.

Endothelial dysfunction in African-Americans.

The journey of atherosclerosis begins with endothelial dysfunction and culminates into its most fearful destination producing ischemia, myocardial infarction and death. The excess cardiovascular disease morbidity and mortality in African-Americans is one of the major public health problems. In this review, we discuss vascular endothelial dysfunction as a key element for excess cardiovascular disease burden in this target population. It can be logical window of future atherosclerotic outcomes, and further efforts should be made to detect it at the earliest in African American individuals even if they are appearing healthy as the therapeutic interventions if instituted early, might prevent the subsequent cardiac events.

Utility of ranolazine in chronic stable angina patients.

Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding of myocardial ischemia have prompted evaluation of a number of new antianginal strategies. In this review we discuss the utility of ranolazine, a recently approved novel antianginal agent and its efficacy in the diabetic patient population. In addition to its antianginal action in diabetic patients with chronic angina, ranolazine may have favorable effects on glycated hemoglobin levels.

Endothelial dysfunction: a potential tool in gender related cardiovascular disease.

The overwhelming importance of distinctive cardiovascular disease profile in women has stimulated enormous efforts to disclose its cause. In this review, we discuss vascular endothelium as a potential phenotypic marker for the genetic difference. As it is a potentially modifiable factor for cardiovascular disease, every effort should be made to detect it, either directly or indirectly, at the earliest in females who are at risk, so that the future cardiovascular events might be prevented.

Pathophysiology, diagnosis, and management of aortic dissection.

Aortic dissection is an uncommon but potentially fatal disease with catastrophic complications. A high level of suspicion is required for successful diagnosis as presenting symptoms are so variable that dissection may be overlooked in up to 39% of cases. It most commonly presents in the elderly population with a history of chronic hypertension. Rapid intervention is necessary as delay leads to higher mortality. Despite advances in diagnostic and therapeutic techniques, morbidity and mortality remains high. Advances in diagnostic imaging have raised the awareness of variants of aortic dissection, including intramural hemorrhage and penetrating aortic ulcer. This distinction is important as the clinical course of these variants differs from that of classical aortic dissection, and thus treatment may also differ. Understanding of these variants has also led to the recognition of markers that may help predict progression to classical aortic dissection and thus warrant closer vigilance in selected patient populations. The recognition that rapid diagnosis is required for management of aortic dissection has led to the investigation of serum tests as diagnostic aids. Serum smooth muscle myosin heavy chain, d-dimer, and serum soluble elastin fragments are promising tests that may help raise suspicion for the diagnosis of acute aortic dissection. The high mortality associated with surgical therapy has led to investigation of alternative approaches. Endovascular therapy has emerged as a viable option in patients with type B dissection who are too unstable for surgery. However, long-term follow up is required to validate this procedure.