Experience of a recreational diabetic day by a non-governmental organisation, T1 Diams, in Mauritius

Background: T1 Diams, a non-profit organisation on the island of Mauritius, has been working on the implementation of therapeutic and educational activities for its members. It regularly organises a recreational diabetic day (‘Enjoy life’ or ‘T1 Diams en Balade’).Aim: To give an overview of a typical diabetic recreational day.Methods: The author participated in several of these activities organised by the organisation in 2014 and 2015.Results: A total of 22 patients came to the event; 11 (≥ 12 years old) attended for the day. The morning session was dedicated to diabetic therapeutic education and was carried out by two diabetes nurses. During the afternoon session there were physical activities for those > 12 years old and low-intensity activities for the other group. The menu for lunch was devised by a nutritionist. Blood glucose levels were regularly monitored. The patients did their own insulin injections.Conclusion: This recreational diabetic day gives an opportunity for parents to be reassured that their diabetic children can be autonomous. The day was carried out in a professional way so as to empower the patients. These activities should be organised regularly during the year.Keywords: diabetic recreation day, diabetic therapeutic education, T1 Diams, Type 1 diabete

Medical Students React to Cadaveric Dissections

The medical student is under considerable stress as he is facing a professional course that needs total dedication and concentration. As enters the course, he goes through the anatomy curriculum, which involves interaction with cadavers and cadaveric material. This study analyses the reactions of students on their first exposure to the human cadaver. 300 students were included in the study. A proforma was designed with the objective of identifying specific patterns of attitudes and problems faced by the students on their first exposure to the human cadaver. Viewpoints regarding the need for pre-education sessions were also elicited. The positive feelings included a curiosity and interest  to learn about the structure of human body. Few were scared, some put off by the formalin fumes and few were hesitant to dissect the cadaver. Students also felt a sense of gratefulness to the people who donated their bodies for dissection. It was reported by some that negative feelings influenced their routine activities. Students felt the need to seek help from faculty in overcoming their anxiety. They felt that a pre-education session should be conducted before the formal dissection teaching begins which could instill a sense of respect into the minds of the students and eliminate the feeling of anxiety. A better teacher – student interaction will go a long way in improving the attitude of students towards cadaveric dissection. This will offer a stable mental status for the fresh medicos to handle higher levels of stress in their clinical careers, thereby reducing the drop- out rates. ÂÂ

The Anatomy of Right Conus Artery and its Clinical Significance

Background of the study: An intimate knowledge of the anatomy of coronary arteries, the ‘Crown’ of the heart, does a self-evident pre-requisite for a complete understand of the coronary artery disease or for more intelligent planning of surgery. The right conus artery (R.Con.A) is the first ventricular branch of the right coronary artery (RCA). The aim of this study is to analyse the number and level of ostia in the anterior aortic sinus with regard to the sinu-tubular junction, pattern of origin of right conus artery, angulations of right conus artery, and the branching pattern of right conus artery. The above findings would be of great significance in the interpretation of coronary arteriography, angiography, surgical revascularization of myocardium and embryological interpretations.  Methods: A total number of thirty cadaveric hearts and twenty angiograms were utilized for this study.  This is carried out by dissection method and by coronary angiographic images study. The study is carried out to analyse the number and level of ostia in the anterior aortic sinus with regard to the sinu-tubular junction, pattern of origin of right conus artery, angulations of right conus artery, and the branching pattern of right conus artery. Results:  The results shows that the percentage calculation   of multiple ostium is less than double and single ostia. Individual having triple or multiple opening   go in for cardiac problems. The percentage level of ostia, above the sinu-tubular junction was less than that of the below and at the level of sintubular junction. For the pattern of origin more population had the right conus artery arising from the right coronary artery. In this study the angulation between direct origin of right conus artery from aorta and the angulation between right coronary artery (RCA) and right conus artery was significant .The angulation study suggests that the right conus artery with aortic origin was obtuse and with right coronary artery it was acute. Regarding branches more population had long branches which were boon for them. The results of angiographic images   regarding pattern of origin was almost nearer with the previous study and dissection method. The positive results found in the present study provide an extensive knowledge of the right conus artery pattern which is essential for the diagnostic and therapeutic interventional procedures. Conclusion: The existence of right conus artery bridges for collateral circulation between the right and left coronary system which is really significant in ischaemic changes of heart

A study of the cardio-depressant actions of harman alkaloids isolated from the seeds of Peganum harmala

Introduction: The plant Peganum harmala is a shrub native to the arid parts of the world including India. It’s therapeutic value is attributed to the presence of alkaloids harmala and harmine in the dried ripe seeds. In traditional medicine these seeds are considered to have anti-spasmodic, hypnotic, anodyne, emetic, emmenogogue, stimulant, aphrodisiac, lactogogue and antihelminthic actions. Objectives: The present study was undertaken to find out the effects of the active principle extracted from the seeds of Peganum harmala on isolated cardiac muscle and skeletal muscle preparations and the probable mechanism of action Materials & Methods: The harman alkaloid isolated from Peganum harmala seeds was used for experiments on isolated preparations of frog heart and frog rectus abdominis muscles and the responses were recorded on a rotating smoked drum on a kymograph. Results: The Harman alkaloids were shown to inhibit the normal contractions and also the inotropic actions of Adrenaline, 5HT and calcium on isolated frog heart. These have not shown any effect on the frog rectus abdominus muscle either on their own or on the contractions induced by Acetylcholine. Conclusion: Harman alkaloids have cardio-depressant activity, it is unlikely that these alkaloids have a specific receptor antagonistic activity. Also these have found to inhibit the cardiac muscle contractions but not the skeletal muscle contractions. The cardio-depressant action may be due to calcium channel blockad

A study of the smooth muscle relaxant actions of harman alkaloids isolated from the seeds of peganum harmala

Introduction: The plant Peganum harmala is a shrub native to the arid parts of the world including India. It’s therapeutic value is attributed to the presence of alkaloids harmala and harmine in the dried ripe seeds. In traditional medicine these seeds are considered to have anti-spasmodic, hypnotic, anodyne, emetic, emmenogogue, stimulant, aphrodisiac, lactogogue and antihelminthic actions. Objectives: The present study was undertaken to find out the effects of the active principle extracted from the seeds of Peganum harmala on isolated smooth muscle and skeletal muscle preparations and the probable mechanism of action Materials & Methods: The harman alkaloid isolated from Peganum harmala seeds was used for experiments on isolated preparations of rat uterus, guinea pig ileum, rabbit jejunum and frog rectus abdominis muscles and the responses were recorded on a rotating smoked drum on a kymograph. Results: The active principle in Peganum harmala seeds was shown to inhibit spontaneous movements of isolated rat uterus, guinea pig ileum and rabbit jejunum. Also shown to inhibit contractions of oestranised rat uterus induced by oxytocin, contractions of guinea pig ileum induced by histamine and acetyl choline. Have not shown any effect on contractions of frog rectus abdominus muscle. Conclusion: Harman alkaloids have anti-spasmodic, tocolytic, anti-cholinergic and anti-histaminic activities, it is unlikely that these alkaloids have a specific receptor antagonistic activity. Also these have found to inhibit the smooth muscle contractions but not the skeletal muscle contractions. The smooth muscle relaxant action may be due to calcium channel blockad

ANALISI DELL’INDICE DI INTERAZIONE BAMBINO-PETS IN FATTORIA ZOOANTROPOLOGICA: STUDIO PILOTA

INTRODUZIONE - La didattica applicata alla zooantropologia prevede un’attuazione in campo educativo e pedagogico dei principi zooantropologici; essa si prefigge un duplice obiettivo: di ridurre il gap relazionale tra animali e giovani generazioni e di recuperare i contenuti e le valenze della relazione, al fine dell’utilizzo pedagogico ed educativo. Nasce un nuovo modello educativo che pone al centro delle strutture pedagogiche l’animale, non più come oggetto da sfruttare, ma come soggetto che aiuti il bambino nella sua crescita educativa (1,2). In quest’ottica generale, la Fattoria Zooantropologica sembra essere un buon sistema in grado di permettere la “fruizione” da parte di bambini e\o soggetti con disabilità di questo modello relazionale e di consentire, altresì, attività e terapie assistite con gli animali (3,4). La Fattoria Zooantropologica offre l’opportunità di attivare la relazione reciproca in un ambiente nuovo, attraente e confortevole tra il fruitore e l’animale che giova di un habitat naturale e familiare. L’esperienza diretta permette ai bambini di usare tutti i loro sensi per imparare: più i bambini vedono, toccano, odorano, sentono, gustano, più imparano (5,6). Partendo da questi presupposti, lo studio si è posto l’obiettivo di effettuare una valutazione del gradimento delle differenti specie animali, attraverso l’analisi degli indici di interazione dei bambini rispetto agli animali presenti in fattoria, al fine di fornire delle linee guida nella scelta del pet in relazione ad una amplificazione delle risposte cognitive ed emozionali del bambino

A Study on surgical management of distal humerus fractures in adults by open reduction and internal fixation

Distal humerus fractures represent one of the most complicated and challenging fractures in the upper extremity. Distal humerus fractures in adults are difficult fractures to treat because of significant comminution and they are rare fractures which prevents the individual surgeon from accumulating sufficient personal experience to critically evaluate the results of the treatment. Aims & Objectives: 1. To evaluate the role of operative management in distal humerus fractures. 2. To follow up & evaluate results on patients operated upon and note the functional outcome and complications. Patients and Methods: The present study is a prospective study of 30 cases of Distal humerus fractures (AO Type 13.A, 13.B and 13.C, 12 male and 18 females, age ranging from 20 to 70) treated by open reduction and internal fixation over two years, from September 2016 to August 2018 was conducted in department of orthopaedics, Prathima institute of medical sciences, Karimnagar. All patients were selected among admissions, operated and results were assessed clinically and radiographically. The functional evaluation of the results Cassebaum’s scale has been chosen. The follow up period ranges with average of 7 months and patients were assessed for functional capacity and radiological fracture healing capacity periodically every 4 – 6 weeks and complications noted. Results: Outcome of surgical management of distal humerus fractures in adults by open reduction and interal fixation was evaluated using Cassebaum scale it was observed that 47% cases presented with excellent outcome, 30% cases presented with good outcome, 20% cases presented with fair outcome, 1% cases presented with poor outcome. In the present study 7% patients had superficial wound infections with hardware pain and 7% patients had presented with hardware pain and 3% delayed union 3% ulnar neuropathy, respectively. Conclusion: The concept of open reduction and internal fixation of fractures of the distal humerus with dual plates is very valuable, in restoring articular surface and early rehabilitation which decreases morbidity, resulting good functional outcome

Compliance with mismatch repair testing in pT1 colorectal cancer diagnosed before the age of 70 years

Mismatch repair (MMR) testing is recommended in the Netherlands for all patients under 70 years of age with newly diagnosed colorectal cancer (CRC) in order to identify Lynch syndrome. T1 CRC can be removed by local excision or oncological surgical resection. We evaluated the frequency of MMR testing in pT1 lesions within the Dutch CRC screening cohort. pT1 CRC diagnosed within the Dutch population-based screening program from 2016-2018 were identified by the Dutch pathology registry (PALGA). Pathology reports were evaluated, including registration of MMR testing (by immunohistochemistry and/or microsatellite instability PCR). Frequency of MMR testing was compared between pT1 tumors that were treated by local (endoscopic or transanal) excision and oncological surgical resections. A total of 3.692 pT1 CRCs were diagnosed (median age 63 years, 61.4% males). MMR testing was performed in 83% and uptake increased over time (71% in 2016 to 92% in 2018, p<0.01). MMR testing was significantly more often performed in younger patients and in academic hospitals. When pT1 CRC was treated by oncological surgical resection (n=1.132), MMR testing was performed in 89% of cases and was known prior to oncological resection in 51% of cases. MMR testing occurred significantly less often in case of local excision (80% of n=2.560) compared to oncological surgical resection (p<0.01). MMR testing was performed in 83% of T1 CRCs and uptake increased over time. MMR testing was more frequently performed in pT1 CRC resected by oncological surgical resection compared with local excision.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Symptoms of anxiety and depression are related to cardiovascular responses to active, but not passive, coping tasks

Objective: Anxiety and depression have been linked to blunted blood pressure (BP) and heart rate (HR) reactions to mental stress tests; however, most studies have not included indices of underlying hemodynamics nor multiple stress tasks. This study sought to examine the relationships of anxiety and depression with hemodynamic responses to acute active and passive coping tasks. Methods: A total of 104 participants completed the Hospital Anxiety and Depression Scales and mental arithmetic, speech, and cold pressor tasks while BP, HR, total peripheral resistance, and cardiac output (CO) were assessed. Results: After adjustment for traditional risk factors and baseline cardiovascular activity, depression scores were negatively associated with systolic BP, HR, and CO responses to the mental arithmetic task, while anxiety scores were inversely related to the systolic BP response to mental arithmetic. Conclusion: High anxiety or depression scores appear to be associated with blunted cardiac reactions to mental arithmetic (an active coping task), but not to the cold pressor test or speech tasks. Future research should further examine potential mechanisms and longitudinal pathways relating depression and anxiety to cardiovascular reactivity