A survey on factors affecting knowledge and satisfaction with care among persons with diabetes mellitus in an urban health centre and its outreach clinics in South India / Journal of the ASEAN Federation of Endocrine Societies

Objective@#To determine the level of knowledge and factors affecting knowledge and satisfaction with diabetes care among persons with diabetes at urban health centre (UHC) and community health worker (CHW)-led outreach clinics (ORC) in South India.@*Methodology@#A cross-sectional study was carried out using a structured questionnaire. One hundred patients at the UHC and 200 patients at the ORC were included.@*Results@#Patients with DM of more than eight years, with co-morbidities and maintained on insulin had good knowledge at the UHC. At the ORC, participants who received education beyond the primary level and belonging to non - Hindu religion had higher knowledge. Patients at the ORC experienced better satisfaction in terms of waiting time for appointments, consultation, registration system and counselling. At the UHC, those who received primary education or those with lower educational attainment had better satisfaction. Overall, knowledge (p=0.03) and satisfaction (p=0.00001) of diabetes care was better at the ORC than at the UHC.@*Conclusions@#Our study found better knowledge and satisfaction with diabetes care at the ORC than at the UHC. Whether or not the difference can be attributed to CHW-based clinics in the community needs to be further elucidated.

DEVELOPMENT AND VALIDATION OF YOGA MODULE FOR OBSTRUCTIVE SLEEP APNEA

Background: Sleep is an essential component of human life because it provides for relaxation and recovery from the stresses of everyday living. Reduced sleep quantity or quality leads to sleep deprivation which may offer indirect dangers by affecting cognitive and physical performance and raising the chance of motor vehicle and occupational accidents. Insomnia chronic sleep debt snoring sleep apnea circadian rhythm disturbances (including shift work syndrome) RLS parasomnias and uncommon diseases such as narcolepsy are the most common sleep disorders found in sleep clinics according to experts. Obstructive Sleep apnea is a common disorder in which your breathing stops and starts periodically while you sleep. To determine the design and validation of an Integrated Yoga Module (IYM) for OSA patients. The ?rst phase - IYM for OSA - was created based on a survey of classic books and Materials and Procedures: recently available research studies. The designed IYM was validated by 20 subject matter (yoga) experts in the second phase. Lawshe's formula was used to calculate the content-validity ratio (CVR). Yoga practices were created for the OSA Results: Integrated Yoga Module. The ?nal Integrated Yoga Module featured yoga practises with CVR ?0.5 that were assessed by 20 yoga experts and agreed in faculty group discussion. The yoga practices were designed and validated for IYM for Conclusion: OSA. By applying Lawshe's content validity criteria 20 yoga professionals veri?ed the IYM design.

Effect of Mind Sound Resonance Technique (MSRT) on Fatigue level among Type 2 Diabetics

Background: Fatigue represents a common complaint of patients with diabetes as it can be reported in up to 60% of patients, prominent in patients with type 2 diabetes. It is a major health problem, affects approximately 6% of the world's adult population, and is increasing in epidemic proportions. Evidence suggests that MSRT a yoga-based relaxation techniques significantly reduces anxiety, stress, fatigue and psychological distress. The aim of the study wasObjective: to study the effect of MSRT on fatigue levels among type-2 diabetes patients. Materials and Methods: In this interventional study with a pre-post design on 100 type-2 diabetes patients, were taught MSRT. Assessment were carried out on the 1 and 30 day of the program, using FSS, VAFS. Results: Significant reduction in fatigue levels in both FSS and VAFS respectively (p<0.00). Conclusion: This study provides evidence that MSRT practice is an effective, economical and noninvasive method to combat fatigue in diabetes patients.

Antioxidant Activities, Total Phenolic Content and Colour Parameters in the Aqueous Extracts of Avocado, Banana and Papaya Leaves (Aktiviti Antioksida, Jumlah Kandungan Fenolik dan Parameter Warna dalam Ekstrak Akueus Daun Avokado, Pisang dan Betik) / Jurnal Sains Kesihatan Malaysia

@#Literature has consistently reported that horticultural wastes including leaves, skin, stones and seeds contain substantial amounts of bioactive compounds. Therefore, this study aims to evaluate antioxidant activity, Total Phenolic Content (TPC) and colour parameters in avocado, banana, and papaya leaves. Antioxidant activity of the leaves was determined using Trolox Equivalent Antioxidant Capacity (TEAC) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assays, TPC was evaluated using Folin-Ciocalteu assay whereas the colour parameters were analysed with a colour picker software. Data analysis was carried out using SPSS version 25.0 of triplicate determinations. Mean differences among the fruit leaves extracts were determined using One-way ANOVA, while the correlations between the studied components were by the Pearson’s Correlation Coefficient test. The TEAC values were in the range of 332.30 ± 18.04 µg Trolox/g D.W. (avocado leaves) to 12217.71 ± 18.04 µg Trolox/g D.W. (banana leaves) while the DPPH radical scavenging activity was from 10.07 ± 3.89% (banana leaves) to 86.70 ± 0.26 % (avocado leaves). Besides, TPC was from 871.33 ± 38.35 µg GAE/g D.W. (papaya leaves) to 1199.08 ± 6.00 µg GAE/g D.W. (avocado leaves). The hue values were from 19º in avocado leaves extract to 37º in banana leaves extract. Results from Pearson’s Correlation Coefficient test revealed that there were no significant correlations between the studied assays. Avocado leaves had the highest DPPH radical scavenging activity and TPC among the three extracts. Findings derived from the present study could be exploited in nutraceuticals formulation.

Improvement in awareness levels and periodontal health among patients undergoing fixed orthodontic appliance therapy with established gingivitis and periodontal health maintenance program: a questionnaire based study / Mejora de los niveles de conciencia y salud periodontal entre pacientes sometidos a terapia con aparatos de ortodoncia fijos con gingivitis establecida y programa de mantenimiento de la salud periodontal: un estudio basado en cuestionarios

Objetive: Home oral care practices in patients undergoing orthodontic therapy are often ineffective in maintaining optimal plaque control. The aim of the present study was to assess the effectiveness of periodontal maintenance program in subjects with established gingivitis undergoing fixed orthodontic appliance therapy for one year. Material and Methods: Forty patients undergoing fixed orthodontic appliance therapy with established chronic gingivitis were recruited for the study. As a part of a periodontal maintenance program, a pre-validated structured questionnaire evaluating oral hygiene and periodontal health was administered at the baseline as well as at the end of the study. At the baseline Gingival Bleeding Index, Gingival Index, and Bonded Bracket Plaque Index scores were recorded, Scaling and polishing procedure was performed followed by a customised Oral Hygiene Advice (OHA) session was conducted for all the study subjects. Clinical indices were assessed and OHA was conducted at the 3rd, 6th, 9th, and 12th months of orthodontic treatment visits. Results: There was significant improvement in the clinical indices and awareness regarding oral hygiene and periodontal health level in the patients at the end of the 12th month. Conclusion: The periodontal maintenance program appeared to be effective in improving the periodontal health and awareness health awareness level about oral hygiene among patients undergoing fixed orthodontic therapy at the end of 12 months in our study population.

Objetivo: Las prácticas de cuidado bucal en el hogar en pacientes sometidos a terapia de ortodoncia suelen ser ineficaces para mantener un control óptimo de la placa. El objetivo del presente estudio fue evaluar la efectividad del programa de mantenimiento periodontal en sujetos con gingivitis establecida sometidos a terapia con aparatos de ortodoncia fijos durante un año. Material y Métodos: Se reclutó para el estudio a 40 pacientes sometidos a terapia con aparatos de ortodoncia fijos y con gingivitis crónica establecida. Como parte de un programa de mantenimiento periodontal, se administró un cuestionario estructurado pre-validado que evaluaba la higiene bucal y la salud periodontal al inicio y al final del estudio. En la línea de base, se registraron las puntuaciones del índice de sangrado gingival, el índice gingival y el índice de placa de soporte adherido, se realizó el procedimiento de raspado y pulido seguido de una sesión personalizada de consejos de higiene oral (CHO) para todos los sujetos del estudio. Se evaluaron los índices clínicos y se llevó a cabo la CHO a los 3, 6, 9 y 12 meses durante las visitas de tratamiento de ortodoncia. Resultados: Hubo una mejora significativa en los índices clínicos y la conciencia sobre la higiene oral y el nivel de salud periodontal en los pacientes al final del 12º mes. Conclusión: El programa de mantenimiento periodontal pareció ser eficaz para mejorar la salud periodontal y el nivel de conciencia de la salud sobre la higiene bucal entre los pacientes sometidos a terapia de ortodoncia fija al final de los 12 meses en nuestra población de estudio.

Comparative Evaluation of Various Cooling Techniques on Intrapulpal Temperature Rise during Direct Provisionalization - An Ex-vivo Study.

Introduction: Use of autopolymerising resin for directprovisionalization is one of the commonest methodsemployed by clinicians. However, these materials exhibit anexothermic reaction and are prone to cause pulpal damage.Thus, a combination of cooling technique and matrix materialto reduce the quantum of heat transferred to a healthy vitalpulpal tissue may be employed for minimal tissue damage.An ex-vivo study was thus envisaged to compare the efficacyof various matrix materials and cooling techniques on timerelated temperature changes in the pulp chamber duringthe fabrication of provisional FPD restorations using directtechnique.Material and Methods: A total of 100 provisionalrestorations were fabricated and were grouped on the basisof three different matrices: Vacuum template, Putty index andAlginate index and further subgrouped on the basis of variouscooling techniques employed. Thermal changes in the pulpchamber was evaluated using Cr/ Al thermocouple placedin the pulp chamber of a prepared tooth and connected to adigital thermometer. Intrapulpal temperature variations wererecorded, tabulated and statistically analysed.Results: The inter-group and intra-group statisticalcomparisons of continuous variables were done using analysisof variance with Bonferroni’s correction for multiple groupcomparisons considering the independent study groups. Theunderlying normality assumption was tested before subjectingeach variable to t test and ANOVA. In the entire study, thep-values less than 0.05 were considered to be statisticallysignificant. All the hypotheses were formulated using twotailed alternatives against each null hypothesis (hypothesis ofno difference). The entire data was statistically analysed usingStatistical Package for Social Sciences (SPSS ver 21.0, IBMCorporation, USA) for MS Windows.Conclusion: The order of heat dissipation for the differentmatrices used is as follows: Irreversible hydrocolloid matrix >PVS putty matrix > vacuum form template. It was concludedthat intrapulpal temperature rise during the direct fabricationof provisional restorations can be limited by employingdifferent cooling techniques. “Cooling” of PVS putty andalginate impression index for 2 minutes in refrigerator(Ambient temperature 10-120C) was found to be most effective“cooling” method for preventing temperature rise in pulp.

Omental Infarction: A Rare Cause Of Acute Abdomen

Omental infarction is an uncommon but important cause of acute abdominal pain, which frequently mimics other surgical presentations.Low incidence and non-specific presentation contribute to Omental infarction being misconstrued for appendicitis, peptic ulcer perforation, acute pancreatitis or mesenteric ischemia. Its etiology remains uncertain, predisposing factors include obesity, strenuous activity, trauma, and sometimes idiopathic. Its diagnosis has traditionally been one of exclusion, based on intraoperative and pathologic findings. Here, we report the case of idiopathic omental infarction in a 51-year-old male. We discuss the diagnosis of primary omental infarction as well as the role of conservative and surgical management.

A study of clinical and etiological profiles of patients presenting with Pancytopenia in NRI General Hospital

Introduction: Pancytopenia is characterized by a decrease in the red blood cells, white blood cells along with the platelet count below the normal levels. It can be due to a number of pathologic mechanisms, depending on the geographic location. Early diagnosis and treatment are crucial in the management of pancytopenia. There are very few studies regarding the clinic-pathological profile of such patients. Materials and methods: A cross-sectional study was undertaken at NRI General Hospital, Chinakakani. All eligible participants more than 13 years of age were included. Data collection was done from August 2016 to August 2018. A thorough history taking along with clinical examination and laboratory investigations were performed among the study population. Data was analyzed using SPSS version 13. Results: The most common finding suggestive of etiology was megaloblastic anemia at 38.4%, which was more common among females. Aplastic anemia was the second most common finding at 24.6%. Other diagnoses included hypersplenism, myelodysplastic syndrome and acute leukemia. Fever and pallor were the most common presenting symptoms. Blood examinations demonstrated anisopoikilocytosis, hypersegmented neutrophils, erythroblasts, macrocytes and reticulocytes, which were found in differing proportions in the various etiological diagnoses. Conclusion: It is noteworthy that megaloblastic anemia, a reversible condition, is common in India compared to the higher occurrence of aplastic anemia and myelodysplastic syndrome in developed Vijaya Kumar Vasa, Sadhna Sharma, Rakesh Nukasani, Srivani Gulleli, Phani Kumar Reddy. A study of clinical and etiological profiles of patients presenting with Pancytopenia in NRI General Hospital. IAIM, 2019; 6(2): 114-120. Page 115 nations. Clinical alertness and suspicion can assure early diagnoses and treatment can prevent complications and reduce the burden. The need for more standard management protocols is immediate.

Liver dysfunction in malaria – An observational study

Introduction: Malaria is associated with significant mortality and morbidity in India. Hepatic dysfunction in malaria is often under-diagnosed. Early identification of hepatic dysfunction is crucial for preventing complications. Materials and methods: A prospective observational study was conducted in NRI Medical College and General Hospital, Chinakakani, Guntur District in Andhra Pradesh. A total of 50 patients with malaria were studied. Liver function tests were performed to assess the type of jaundice. The collected data was analysed. Results: The incidence was P. Vivax and P. falciparum malaria were 64% and 34% respectively. The incidence of jaundice was 26%. All of them had predominantly conjugated hyperbilirubinemia. Around 14% had mixed jaundice, and 22% had hepatic jaundice. Only one case expired which had the highest level of serum bilirubin. Conclusion: Hepatic involvement is more common among those with malaria. The incidence in vivax and falciparum malaria is comparable. Conjugated bilirubinemia with elevated liver enzymes is the most common manifestation. Early screening and identification of hepatic involvement in malaria are crucial. Initiation of treatment on time will aid in reducing mortality and morbidity

Solitary Osteoma of Femur – A case report.

Osteoma is benign tumor usually seen in flat bones. Osteoma usually presents as solitary tumor. It rarely presents as multiple lesion in Gardner’s Syndrome. Osteoma involving long bones is very rare and review of literature showed only a few case reports. We report a case of osteoma involving the shaft of the femur. A 57 year old lady came with swelling over the anterolateral aspect of the thigh. Clinical and radiological examination showed a mass on the anterolateral aspect of the femur. Excision of the lesion was done and the biopsy report showed Osteoma. The patient is free from disease for the past two years. We report this case as osteoma is rare in such a location. Tumor occurring in rare locations need to be thoroughly investigated.

In Vitro Antifungal Activities against Moulds Isolated from Dermatological Specimens

Background: This study aimed to determine the minimum inhibitory concentrations (MICs) of various antifungal agents against moulds isolated from dermatological specimens. Methods: We identified 29 moulds from dermatological specimens between October 2012 and March 2013 by conventional methods. We performed antifungal susceptibility testing on six antifungal agents, amphotericin B, clotrimazole, itraconazole, ketoconazole, miconazole and terbinafine, according to the Clinical and Laboratory Standards Institute guidelines contained in the M38-A2 document. Results: Most antifungal agents were active against the dermatophytes, except for terbinafine against Trichophyton rubrum (geometric mean MIC, MICGM 3.17 µg/mL). The dematiaceous moulds were relatively susceptible to amphotericin B and azoles (MICGM 0.17-0.34 µg/mL), but not to terbinafine (MICGM 3.62 µg/mL). Septate hyaline moulds showed variable results between the relatively more susceptible Aspergillus spp. (MICGM 0.25-4 µg/mL) and the more resistant Fusarium spp. (MICGM 5.66-32 µg/mL). The zygomycetes were susceptible to amphotericin B (MICGM 0.5 µg/mL) and clotrimazole (MICGM 0.08 µg/mL), but not to other azoles (MICGM 2.52-4 µg/mL). Conclusion: Amphotericin B and clotrimazole were the most effective antifungal agents against all moulds excepting Fusarium spp., while terbinafine was useful against dermatophytes (except T. rubrum) and Aspergillus spp. However, a larger study is required to draw more solid conclusions.

A clinicopathological study of interface dermatitis.

Background: Interface dermatitis (ID) refers to a pattern of skin reaction characterized by an inflammatory infiltrate that appears to obscure the dermoepidermal junction when observed at low power examination and referred to as lichenoid tissue reaction. A wide range of inflammatory skin diseases exhibits interface change with considerable overlap of histological features. The aim of the present study was to study the clinical features and microscopic features of ID. Materials and Methods: The material for the present study consisted of skin biopsy samples collected from patients attending the outpatient Department of Dermatology. The study was conducted for a period of 3 years from 2007 to 2010. During this period, a total of 125 cases was studied. Results: In the present study, a total of 125 cases of ID was studied which presented clinically as papulosquamous disorders. Majority of the cases of ID were seen in women (57.6%). Majority of ID were lichen planus (LP) and its variants (63.2%). Clinicopathological concordance was seen in 109 cases (87.2%) and discordance in 16 cases (12.8%). Conclusion: The mere presence of an interface lichenoid inflammatory reaction should not be the sole criterion for the diagnosis of LP or one of its many variants, as now seems to be the case. A clinicopathologic correlation is absolutely essential for a conclusive diagnosis of ID.

Psoriasis in pregnancy

We report a thirty-five-year-old pregnant Bahraini patient with a flare-up preexisting psoriasis during the second half of pregnancy. At 33 weeks, intra uterine growth retardation was discovered. At 38 weeks, after failed induction, a cesarean section was performed; a healthy live female baby was delivered

ParA encoded on chromosome II of Deinococcus radiodurans binds to nucleoid and inhibits cell division in Escherichia coli.

Bacterial genome segregation and cell division has been studied mostly in bacteria harbouring single circular chromosome and low-copy plasmids. Deinococcus radiodurans, a radiation-resistant bacterium, harbours multipartite genome system. Chromosome I encodes majority of the functions required for normal growth while other replicons encode mostly the proteins involved in secondary functions. Here, we report the characterization of putative P-loop ATPase (ParA2) encoded on chromosome II of D. radiodurans. Recombinant ParA2 was found to be a DNA-binding ATPase. E. coli cells expressing ParA2 showed cell division inhibition and mislocalization of FtsZ-YFP and those expressing ParA2-CFP showed multiple CFP foci formation on the nucleoid. Although, in trans expression of ParA2 failed to complement SlmA loss per se, it could induce unequal cell division in slmAminCDE double mutant. These results suggested that ParA2 is a nucleoid-binding protein, which could inhibits cell division in E. coli by affecting the correct localization of FtsZ and thereby cytokinesis. Helping slmAminCDE mutant to produce minicells, a phenotype associated with mutations in the ‘Min’ proteins, further indicated the possibility of ParA2 regulating cell division by bringing nucleoid compaction at the vicinity of septum growth.

Factors Affecting Trial Without Catheter for First Spontaneous Acute Urinary Retention / 대한배뇨장애요실금학회지

PURPOSE: To find the association of trial without catheter (TWOC) outcome for first spontaneous acute urinary retention (AUR) in benign prostatic obstruction with age, prior lower urinary tract symptoms (LUTS), retention volume at catheterization (RV), and size of prostate. METHODS: Our prospective observational analytical (interventional) study enrolled 77 cases of spontaneous AUR over 24 months. After clinical evaluation, digital rectal examination, and transabdominal ultrasonography, all patients were catheterized per urethra and their RV was recorded. TWOC was administered after 2 or 3 doses of 0.4 mg tamsulosin-oral absorption control system and after 48-72 hours had passed. A successful endpoint was defined as a maximum flow-rate, >5 mL/sec; voided volume, >100 mL; postvoid residue, <200 mL; and voiding within 6 hours of catheter removal. Data obtained from 58 patients were analyzed after excluding the cases lost to follow-up and secondary exclusion. Age, RV, duration of LUTS, and prostate volume on examination and ultrasonography (PUSG) were recorded and statistically analyzed. Prostate-specific antigen levels were obtained on follow-up and cases of cancer, as seen on transrectal ultrasound-guided biopsy, were secondarily excluded. RESULTS: The patients had a mean age of 65.89+/-8.67 years. Prior LUTS was seen in 35 patients (2.07+/-2.91 months). The mean PUSG and RV were 46.81+/-20.58 mL and 854.8+/-36.26 mL, respectively. Thirty patients underwent a successful TWOC; a mean age of 63.13+/-8.58 years (mean+/-standard deviation; unpaired t-test; P=0.0053) and a PUSG of < or =45 mL (Pearson chi-square test; P=0.0427) were significantly associated with a successful outcome. CONCLUSIONS: There is a significant association between TWOC outcome, age (P=0.0053), and PUSG (P=0.0427).

Liquisolid compacts: an approach to enhance the dissolution rate of nimesulide.

The present study enlightens to enhance the dissolution rate, absorption efficiency and bioavailability of Nimesulide, a poorly soluble-highly permeable drug by preparing liquisolid compacts. Nimesulide liquisolid tablets were prepared by using polyethylene glycol-400 as a non-volatile liquid vehicle, microcrystalline cellulose, hydroxypropyl methylcellulose-E15, starch were used as carrier materials and silica gel as coating material in different ratios. They were characterized for different physical parameters to comply with pharmacopoeial limits. In vitro dissolution profiles of the liquisolid formulations were studied and compared with conventional formulation in pH 7.4 phosphate buffer and it was found that liquisolid tablets formulated with microcrystalline cellulose showed significant higher drug release rates than conventional tablets due to increase in wetting properties. DSC study showed that there is no interaction between the drug and excipients. In conclusion, development of nimesulide liquisolid tablets is a good approach to enhance the dissolution rate.

Rare Presentation of a Rare Disease (Erdheim-Chester disease): A Case Report

Erdheim-Chester disease (ECD) was first reported by J. Erdheim and W. Chester, in 1930. There are less than 250 reported cases till date. We report a case of ECD in a 16- year-old Malay male, who initially presented with elusive anemic symptoms with more specific symptoms of bony pain, cardiorespiratory and hepatic involvement evolving as the disease progressed.