Acute hemodynamic effects of methylxanthine therapy in preterm neonates: Effect of variations in subgroups.

BACKGROUND: Methylxanthines have cardiac stimulant effects. The current study aimed to compare acute hemodynamic changes between caffeine and aminophylline in ≤34 weeks' preterm neonates. METHODS: The study was performed using information on echocardiography measurements from preterm neonates recruited for apnea of prematurity (75 of 240) and preventing extubation failure (113 of 156) studies. The neonates were randomized either to the caffeine or aminophylline groups. Neonates with no maintenance followed by loading doses with both the methylxanthines (caffeine and aminophylline) and incomplete echocardiography examination were excluded. RESULTS: Cardiac parameters were found to be similar between groups. The heart rate was higher among the aminophylline-treated neonates (p < 0.001) than among the caffeine-treated ones. End-systolic volume was higher among both caffeine- (p < 0.001) and aminophylline-treated neonates (p = 0.001) when compared with pretreatment values. End-diastolic volume was statistically higher in both groups' neonates (p = 0.01). The odds of increase in cardiac output was higher; however, increase in ejection fraction was less in caffeine-treated small-for-gestation-age neonates. CONCLUSION: Caffeine has similar effects on cardiac parameters as aminophylline; however, caffeine-treated small-for-gestation stratification gave rise to significant cardiac variations.

Thyroid status among critically ill patients admitted in the intensive care unit of the government tertiary care hospital in Mandya: a retrospective study

Background: The nonthyroidal illness syndrome, also known as the low T3 syndrome or euthyroid sick syndrome. Any acute severe illness can cause abnormalities of circulating Thyroid Stimulating Hormone (TSH) or Thyroid Hormone (TH) levels in the absence of underlying thyroid disease. The laboratory parameters of this syndrome include low serum levels of T3 and high levels of reverse T3, with normal or low levels of thyroxine (T4) and normal or low levels of TSH. This condition may affect 60-70% of critically ill patients. The severity of illness correlates well with the reduction in total serum T3 level. Objectives of the study was to assess the thyroid status of critically ill patients admitted in intensive care unit of a tertiary care hospital.Methods: This is a retrospective observational study done at Department of General Medicine, MIMS, Mandya among patients admitted with critical illness to ICU. 100 patients admitted with critical illness to ICU are included in this study. Thyroid function reports obtained from case sheets, data entered into MS Excel sheet and analysed.Results: Out of 100 patients studied 34 patients had sepsis, 26 patients had respiratory failure, 20 patients had Congestive cardiac failure, 12 patients had acute renal failure and 8 patients had Diabetic ketoacidosis. Among 100 patients 63% had abnormal thyroid function test, 56% had low T3, 12% had low T4, 2% had high T4 and 3% had low TSH.Conclusions: Thyroid function abnormality suggesting Non thyroid illness or euthyroid sick syndrome is common among critically ill patients.

A study on outcome of rodenticide poisoning patients admitted to a tertiary care teaching hospital in relation to the chemical content of that poison

Background: Poisoning is the major health problem in India. Rodenticides are the commonest poisoning in Asian countries like India. Rodenticides are the substance used to kill rats. Prognosis mainly depends on chemical content of poison.Methods: This retrospective record-based study was conducted between January 2017 to December 2017 at government hospital department of general medicine, MIMS, Mandya, Bangalore, Karnataka, India. Data regarding age, sex, marital status, occupation, type of poison, route of exposure, and outcome of poisoning and associated co-morbid conditions were collected from the hospital records and documented in the pre-structured proforma. Descriptive analysis was carried out by the mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results: Out of 56 patients 33 (59%) were female 23 (41%) were male. Most common age group was 20 to 30 years, followed by 31 to 40 years group. Most common poison was yellow phosphorous (41%), followed by aluminium phosphide (29%). Most common complication was hepatitis (20%),followed by cardiogenic shock (9%).Total mortality was 3 (5%).Conclusions: Among rodenticides yellow phosphorous was most common consumed poison in present study. Aluminium phosphorus was most lethal poison. Even though there is no specific antidote, early symptomatic treatment is the key in reducing the mortality.

Awareness on oral health among ayurvedha siddha practitioners in Chennai, Tamil Nadu - a questionnaire study

The aim of this study is to find out the awareness on oral health among Ayurvedha and Siddha practitioners in Chennai, Tamil Nadu. A cross-sectional survey was performed among a sample of 102 Ayurvedha and Siddha practitioners in Chennai, and data regarding their awareness of oral health were obtained using a closed-ended questionnaire. The SPSS software version 17 was employed to find the frequency distribution among the variables. Among the 102 Ayurvedha and Siddha practitioners approached, 94.1% of the respondents knew the reason for the occurrence of dental caries. Around 76.5% responded that fluoride in toothpaste can prevent dental caries, but only 58.8% of them had advised their patients to use fluoride-containing toothpastes. A total of 89.2% knew that oral health was related to systemic diseases. About 92.2% responded that they informed the patients about the importance of oral hygiene and also about smoking and tobacco-related oral diseases. Majority of them [99%] thought that Ayurvedha/Siddha medicine could cure oral diseases, with halitosis [40.2%] as the most common dental finding. Many of them [94.1%] responded that they had oral health as a part of their syllabus. Around 89.2% referred their patients to the dentists and also most of them [98%] thought that they need further information about prevention of oral diseases. Ayurvedha and Siddha practitioners already have substantial amount of oral health knowledge, and they are keen to expand their knowledge. Patients regularly ask for their advice on both general and oral health care issues, and there is a definitive need for interdisciplinary symposia/lectures/conferences and providing them with access to information on available dental services