STUDY ON QUALITY OF LIFE ASSESSMENT IN DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES

Objective: The aim was to study the vision-related quality of life (QOL) for diabetic retinopathy (DR) among patients with Type 2 diabetes and to assess the direct medical cost of different treatment modalities. Methods: It was based on an individual-based analysis of QOL before and after the treatment for DR. The main objective of the study was to compare QOL between patients based on the different treatment modalities using vision function questionnaire (VFQ)-25, to evaluate the direct medical cost for DR patients undergoing different treatment modalities and to compare the cost and QOL of different treatment modalities in samples with non-proliferative DR (NPDR)/proliferative diabetic retinopathy (PDR) macular edema. The population included were patients with Type 2 diabetes with NPDR, with clinically significant macular edema and PDR, patients diagnosed to have diabetes above 5-year duration, adult patients, ocular pain those who are on regular follow-up and those who are willing to be a part of study. A total of 256 patients were selected out, of which 141 patients were satisfied the study criteria and participated in the study. Data relevant to the voice-related QOL study were obtained and recorded using VFQ-25 questionnaire. Other data relevant to the study were obtained and recorded in a semistructured data collection form by interviewing the patient or their caregivers and by direct examination of patient's medical record. Expenditure was calculated in Indian Rupees. Results: After comparing the baseline QOL with QOL after treatment, it was found that the overall QOL of the study samples in accordance with the treatment undergone was found to be improved. The overall QOL had improved after the treatment for all samples and major improvement was seen on dependency, social functioning (SF), and mental health (MH). Conclusion: The overall QOL had improved after the treatment for all samples and major improvement were seen on dependency, SF, and MH. In conclusion, the study analyzed that intravitreal bevacizumab therapy is the cheapest one and with the comparatively same clinical outcome when compared with intravitreal ranibizumab therapy for macular edema cases in patients with NPDR and PDR

Burden and resilience in caregivers of patients on maintenance haemodialysis

Background: Chronic renal failure is one among the chronic illness which due to persistence of the disease has various effects on the physiological, psychological and functional ability of the patient and his family. Although haemodialysis has become a highly safe medical procedure that significantly extended life of such patients, it is nevertheless a stressful and lengthy treatment process. The task of personal life care for such patients falls primarily on the family members. The caregiver is expected to aid in patient’s daily life activities resulting in increased physical and emotional burden. With the considerable level of burden involved the concept of resilience thus become crucial as they could function as protective factors. The current study aims to assess the level of caregiver burden and resilience in caregivers of haemodialysis patients.Methods: A cross sectional observational study was done in 120 caregivers of patients diagnosed as having ESRD on maintenance hemodialysis. Zarit Burden Interview was used for assessing caregiver’s burden. Brief Resilience Scale was used to assess caregiver’s resilience.Results: 35.8% of caregivers had severe caregiver burden while looking after dialysis patients while 45% of caregivers had moderate burden. Caregivers showed low resilience about 72.5% which displays poor problem solving and emotion-focused coping strategies.Conclusions: The study shows that more than 80% of caregivers suffered from moderate to severe burden and poor resilience among them would be a contributing factor. The study also shows that female caregivers were most affected. The burden was significantly higher in caregivers as the years spent on caregiving increased and more hours spent per day looking after the patients. Health-care providers need to address these concerns based on both patient- and caregiver-focused approaches, rather than only patient focused

Palbociclib with Letrozole in Postmenopausal Women with ER+/HER2- Advanced Breast Cancer: Hematologic Safety Analysis of the Randomized PALOMA-2 Trial.

BackgroundPALOMA-2 confirmed that first-line palbociclib + letrozole improved progression-free survival (hazard ratio, 0.58; 95% confidence interval, 0.46-0.72) in postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). This analysis evaluated palbociclib-associated hematologic adverse events (AEs) and provides insight on managing these AEs.Materials and methodsPostmenopausal women with ER+/HER2- ABC were randomly assigned 2:1 to letrozole (2.5 mg daily continuously) plus oral palbociclib (125 mg daily; 3 weeks on/1 week off) or placebo. Safety assessments were performed at baseline, days 1 and 15 (first two cycles) and day 1 of subsequent cycles, and included white blood cell, platelet, and absolute neutrophil count (ANC).ResultsPALOMA-2 randomized 666 women to palbociclib + letrozole (n = 444) or placebo + letrozole (n = 222). Neutropenia was the most common AE (95.3%) with palbociclib (grade 3, 55.6%; grade 4, 11.5%) and was managed by dose modifications; progression-free survival was similar between patients who experienced grade ≥ 3 neutropenia versus those who did not. Median (range) time to onset of neutropenia with palbociclib + letrozole was 15 (12-700) days (grade ≥ 3, 28.0 [12-854] days); median duration of each neutropenia episode grade ≥ 3 was 7.0 days. Asian ethnicity and low baseline ANC were associated with increased risk of grade 3/4 neutropenia with palbociclib (p < .001).ConclusionPalbociclib + letrozole was generally well tolerated. Neutropenia, the most frequently reported AE in women with ER+/HER2- ABC, was mostly transient and manageable by dose modifications in patients who experienced grade ≥ 3 neutropenia, without appearing to compromise efficacy. (Pfizer; NCT01740427) IMPLICATIONS FOR PRACTICE: Palbociclib demonstrated an acceptable safety profile in PALOMA-2 in women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) receiving first-line palbociclib + letrozole. Although hematologic adverse events (AEs) are typically expected with anticancer therapies and are often clinically significant, palbociclib-related hematologic AEs, particularly neutropenia (most frequent AE), were transient/manageable by dose reduction, interruption, or cycle delay, which is in contrast to the more profound neutropenia associated with chemotherapy. Palbociclib dose adjustments decreased hematologic AE severity without appearing to compromise efficacy, supporting palbociclib + letrozole as a first-line treatment for ER+/HER2- ABC

Costs & outcomes of hospitalized scrub typhus infection in a tertiary hospital in south India

Background & objectives: Scrub typhus is a rickettsial infection seen along the Asian-Pacific rim and imposes a considerable burden on affected people in low- and middle-income countries. The present study was aimed to determine the direct cost of hospitalization of scrub typhus and its trend over six years. Methods: This was a retrospective, observational, hospital based study of individuals admitted to the hospital, diagnosed with scrub typhus over six years, from January 2013 to December 2018. The potential out of pocket expenditure was evaluated. Results: A total of 198 patients were included in the study. The median cost of admission (adjusted to INR 2020) for the six years (2013 to 2018) was found to be ₹ 37,026 (US $490) [interquartile range (IQR) 22,996-64,992]. The median cost for patients admitted to the intensive care unit (ICU) was ₹ 128,046 (US$ 1695) (IQR 71,575-201,171), while the cost for patients admitted to the ward-alone was ₹ 33,232 (US $ 440) (IQR 19,609-45,373). The multivariable analysis showed that ARDS and SOFA score were the independent predictors of ICU admission. Interpretation & conclusions: Hospitalisation for scrub typhus is associated with a substantial healthcare expense. The predictors of increased cost were the presence of acute respiratory distress syndrome (ARDS), shock, increasing sequential organ failure assessment (SOFA) score and duration of hospital stay

Alterations in hippocampal serotonergic and INSR function in streptozotocin induced diabetic rats exposed to stress: neuroprotective role of pyridoxine and Aegle marmelose

Diabetes and stress stimulate hippocampal 5-HT synthesis, metabolism and release. The present study was carried out to find the effects of insulin, Aegle marmelose alone and in combination with pyridoxine on the hippocampal 5-HT, 5-HT2A receptor subtype, gene expression studies on 5-HT2A, 5-HTT, INSR, immunohistochemical studies and elevated plus maze in streptozotocin induced diabetic rats. 5-HT content showed a significant decrease (p < 0.001) and a significant increase (p < 0.001) in 5-HIAA in hippocampus of diabetic rats compared to control. 5-HT receptor binding parameters Bmax and Kd showed a significant decrease (p < 0.001) whereas 5-HT2A receptor binding parameters Bmax showed a significant decrease (p < 0.001) with a significant increase (p < 0.05) in Kd in hippocampus of diabetic rats compared to control. Gene expression studies of 5-HT2A, 5-HTT and INSR in hippocampus showed a significant down regulation (p < 0.001) in diabetic rats compared to control. Pyridoxine treated in combination with insulin and A. marmelose to diabetic rats reversed the 5-HT content, Bmax , Kd of 5-HT, 5-HT2A and gene expression of 5-HT2A, 5-HTT and INSR in hippocampus to near control. The gene expression of 5-HT2A and 5-HTT were confirmed by immunohistochemical studies. Behavioural studies using elevated plus maze showed that serotonin through its transporter significantly increased (p < 0.001) anxiety-related traits in diabetic rats which were corrected by combination therapy. Our results suggest that pyridoxine treated in combination with insulin and A. marmelose has a role in the regulation of insulin synthesis and release, normalising diabetic related stress and anxiety through hippocampal serotonergic function. This has clinical significance in the management of diabetes

Extragalactic Fields Optimized for Adaptive Optics

In this paper we present the coordinates of 67 55' x 55' patches of sky which have the rare combination of both high stellar surface density (>0.5 arcmin^{-2} with 13<R<16.5 mag) and low extinction (E(B-V)<0.1). These fields are ideal for adaptive-optics based follow-up of extragalactic targets. One region of sky, situated near Baade's Window, contains most of the patches we have identified. Our optimal field, centered at RA: 7h24m3s, Dec: -1deg27'15", has an additional advantage of being accessible from both hemispheres. We propose a figure of merit for quantifying real-world adaptive optics performance, and use this to analyze the performance of multi-conjugate adaptive optics in these fields. We also compare our results to those that would be obtained in existing deep fields. In some cases adaptive optics observations undertaken in the fields given in this paper would be orders of magnitude more efficient than equivalent observations undertaken in existing deep fields.Comment: 28 pages, 15 figures, 1 table; accepted for publication in PAS

Task shifting to frontline community health workers for improved Diabetes care in low-resource settings in India : A phase II Non-randomized controlled clinical trial

Acknowledgments: We are indebted to the our research team who worked passionately to complete the study, health workers who were willing to function as patient navigators to improve diabetes management, and to all the participants who responded to our screening invitations and structured care Funding: We acknowledge the funding received from Friends of Vellore, UK and NHS Grampian Endowment fund, University of Aberdeen- Approval Number: EA0852Peer reviewedPublisher PD

The Grizzly, February 11, 2016

Campus Safety Officers to Increase Reimert Presence • Preparing for More Snow • Ursinus Hires New VP of Admissions • Improv Troupe Set to Perform • UC Hosts Title IX Meeting • International Perspective: School vs. Work • Exploring the 80\u27s • New Spin on SPINT • Opinions: End the 21-Meal Plan; Is it Appropriate to Culturally Appropriate? • More Than Just a Trainer • Women\u27s Swimming Posts Third Perfect Seasonhttps://digitalcommons.ursinus.edu/grizzlynews/1682/thumbnail.jp

COP27 climate change conference: urgent action needed for Africa and the world

The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods.1 These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5oC compared with pre-industrial levels