Biblical community : moving from multicultural congregation to an intimate spiritual family

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How effective is intra-cuff lignocaine in reducing post-operative sore throat and emergence cough: a comparative study

Background: Sore throat and cough during emergence are common side effects of general anaesthesia and its incidence is reported by 30-70% of patients after tracheal intubation. Also, not to forget the hemodynamic fluctuations associated with it, adds on to the magnitude of the problem. Thinking of a simple and cost-effective way to tackle this problem, this study was undertaken to determine the benefits of using intra-cuff lignocaine to prevent post intubation sore throat and emergence cough. The objective of this study to assess the efficacy of intra-cuff 2% lignocaine solution, in reducing emergence cough and post-operative sore throat after extubation in general surgery patients intubated for 2-4 hours.Methods: A prospective observational study where 100 ASA I and II status patients divided into 2 groups of 50 each was compared. In one group ETT cuff was filled with air, while in the other group, 2% plain lignocaine solution was used. Side effects like sore throat, coughing and blood pressure changes were assessed. Chi square and t-tests were used to compare the findings.Results: Among those patients where intra-cuff lignocaine was used, only 27.5% complained of sore throat and 12.5% had emergence cough, whereas among those patients where intra-cuff air was used, 72.5% had post-operative sore throat and 87.5% of patients had cough on emergence.Conclusions: This study proves that 2% intra-cuff lignocaine is an effective method in reducing post-operative sore throat and emergence cough and thereby beneficial in controlling the hemodynamic changes associated with emergence

Comparison of empirical antibiotics used with microbiological sensitivity pattern among patients admitted with urinary tract infection

Background: Symptomatic Urinary tract infection (UTI) is among the most common infection described in hospital settings. Inappropriate use of antibiotics initiated before the laboratory results of urine culture contribute to increasing resistance to antibiotics in uropathogens. Awareness of the disease, knowledge of the spectrum of antibiotics and common complication of UTI will help to reduce morbidity and mortality. This study compares common empirical antibiotics used with their  clinical outcomes and microbiological sensitivity pattern among patients admitted with UTI in a tertiary care hospital.Methods: It is a cross sectional study conducted in inpatients of Pushpagiri medical college, Thiruvalla from January 2017 – June 2018. Assuming that 50% of organisms will show sensitivity to empirical antibiotic therapy with a relative precision of 20% and alpha error of 5 %. Sample size is calculated as 100. Those patient  satisfying the inclusion criteria was recruited into the study after obtaining informed consent till the sample size attained. Symptoms on the day of admission was assessed using the questionnaire for Clinical profile. Primary outcome was matching of empirical antibiotics with culture and sensitivity pattern.  Secondary outcomes were Symptom resolution on third day with empirical antibiotics and profile organisms causing UTI.Results: Majority of the population belonged to 61-80 year of age (57%). The study population had 44 percent male and 56 females.72 percent of total population was diabetic.  The most common antibiotic used to treat empirically was piperacillin –tazobactum accounting for 47.2 percent followed by ceftriaxone  45 percent. Others contributed less than 8 percent.75 percent of empirical antibiotics matched with culture and sensitivity report in the study population.The most common organisms found was Escherichia coli (61%) followed by Klebsiella pneumonia(15 %) The most common resistant organism was E Coli followed by Klebsiella pneumonia. Esbl resistance was encountered in 28 cases and carbepenamase resistance in 2 percent cases. 27 percent of diabetic patient had resistant organism infection in urine. Symptoms  of  urinary tract infections were better resolved when empirical antibiotics used had  matched microbiological sensitivity pattern.Conclusions: After the age of 60 year UTI occurred almost equal in male and females There was only 75 percent agreement with empirical antibiotics and culture sensitivity report. Resistant organism were common in the diabetic population. Most common organism encountered in symptomatic UTI is E coli. Symptomatic resolution occurred in majority of cases where the empirical antibiotic was sensitive than compared to resistant case. Some of the resistant cases had symptomatic resolution  possibly explained by the in vivo sensitivity. As the agreement with empirical antibiotics became low, hospital antibiotic policies must reviewed and changed according to resistance pattern and type of organism that is locally prevalen

Tourist Profiles and Characteristics vis-à-vis Market Segmentation of Ecotourism Destinations in Kerala

Kerala, a classic ecotourism destination in India, provides significant opportunities for livelihood options to thepeople who depend on the resources from the forest and those who live in difficult terrains. This article analysesthe socio-demographic, psychographic and travel behavior patterns and its sub-characteristics in the backgroundof foreign and domestic tourists. The data source for the article has been obtained from a primary survey of 350randomly chosen tourists, 175 each from domestic and foreign tourists, visiting Kerala’s ecotourists destinationsduring August-December 2010-11. Several socio-demographic, psychographic and life style factors have beenidentified based on the inference from field survey. There is considerable divergence in most of the factorsidentified in the case of domestic and international tourists. Post-trip attributes like satisfaction and intentions toreturn show that the ecotourism destinations in Kerala have significant potential that can help communities in theregion.Keywords: Tourists, Ecotourism, Socio-demographic, Psychographic, Lifestyle, Motivation, Satisfaction,Revisi

Evaluation of the association between dyslipidemia and hypertensive disorder of pregnancy: a nested case control study

Background: Hypertensive disorders of pregnancy are an elusive group of diseases with multifactorial etiopathologies and varied manifestation. Abnormal pre pregnancy lipid profile is shown to have a positive correlation with endothelial dysfunction which in turn leads to development of hypertensive disorder of pregnancy.Methods: A total of 222 pregnant women who were aged between 18-35 years, with no obstetric and medical risk factors and less than 16 weeks of gestation who gave informed written consent were recruited for the study. Their baseline demographics and fasting blood samples were collected, blood samples were centrifuged, and serum was stored at -80-degree celsius. Patients were followed up till delivery and those with hypertensive disorders in pregnancy (n=22) was identified, defined as case. Control was selected after matching for body mass index and frozen serum samples were analyzed.Results: Overall incidence of hypertensive disorders in pregnancy in the study group was 12.4%. The mean early trimester fasting lipid values were higher in patients who developed hypertensive disorders, difference in mean between cases and controls was TC  - 16.25 mg/dl (p-0.061), TGL- 21.45 mg/dl (p-0.143),  LDL- 2.4 mg/dl (p-0.82) and for HDL 4.55 mg/dl (p-0.25). However, on stratification of early trimester fasting lipid level based on National Cholesterol Education Program (NCEP) criteria, Total cholesterol level greater than 160 mg/dl showed an odds ratio of 12.66 (p-0). Patients with early trimester fasting total cholesterol levels greater than 160mg/dl has a higher risk of developing hypertensive disorder in pregnancy.

Socio-Economic Aspects of Sustainable Ecotourism Development: The Case of Kerala

The paper is an attempt to shed light on the socio-economic aspects of the local communities on the development of ecotourism in Kerala. Most of the local communities in the ecotourism destinations are tribes who have been excluded from the mainstream society and are not a part of Kerala’s overall development setting. The paper also tries to situate the community perception on the sustainable livelihood of ecotourism sites of Kerala. Data for the study is obtained from a primary survey by dividing the ecotourism destinations in Kerala into three zones, 230 from south zone, 220 from central zone  and 200 from north zone  with a total sample size of 650 based on the notion of community based ecotourism initiatives of the state. The result of the study confirms that ecotourism has helped to enhance the livelihood of the marginalized community. With well-knit policies it is possible to tag ecotourism of Kerala as an important tourism destination in the global tourism map. Key Words: Perception, Livelihood, Marginalized community, Community based Ecotourism, Sustainabilit

Study on Value Engineering in Construction Projects

Value engineering is a technique by which we get to know how the cost of the project can be optimized without affecting the quality, requirements, function of the particular project. This paper tells us about the various factors which affect value engineering technique, the problem areas in the construction of buildings and also about the importance of application of value engineering to construction projects. Value engineering is a proven technique and the need of the current era