AN EXPLORATORY STUDY EVALUATING EXPERIENCED STIGMA AMONG DOCTORS IN A DEDICATED COVID-19 HOSPITAL OF NORTH INDIA

Objective: Doctors may experience stigma and discrimination from community, friends and even family due to their association with COVID-19 patients. The present study was planned to assess actual stigma experienced by doctors because of working in COVID-19 wards. Methods: A cross-sectional study was conducted in the Department of Psychiatry of a dedicated COVID-19 Hospital of North India. A Google Survey Form which measured Experienced Stigma was circulated through WhatsApp groups in October-November 2020 among all the doctors working in COVID-19 ward. Data collected was analyzed statistically. Results: Around 250 doctors participated in the study and 70% of them experienced stigma in one or more ways. Approximately, 60% doctors had stopped socializing because of people’s reactions, they felt that people were afraid of them and that people avoided touching them because they were treating patients with COVID-19. 110 (44%) respondents were denied social exchanges/friendships, 88 (35.2%) felt neglected by family or friends, and 71 (28.4%) lost friendships because they worked with patients with COVID-19. Stigma was experienced significantly higher in younger age (p=0.012*), resident doctors (p=0.001**) and those with longer working hours (p=0.01*). Conclusion: Doctors experience stigma from friends, family and general public due to their contact with COVID-19 patients. Experienced stigma is higher in young age and resident doctors

Development of quantitative tools for assessment of cerebellar dysfunction

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2005.Includes bibliographical references (p. 55-56).Two tools for the quantitative assessment of cerebellar dysfunction are developed and explored. One is based on a battery of laptop tests desgined for clinical use. Extensive analysis of one of the tests using a speed/accuracy trade-off shows a correlation of 0.74 with existing scoring systems. The second involves modeling the cerebellar function in arm movement as a PID controller. Initial results show trends toward asymmetry, higher values for Gk₂₁ and Gk₂₂, and lower values for Gk₁₁ and Gk₁₂ as differences between the controller gains of ataxic subjects and control subjects when analyzing the trajectories of point to point movements. Further insight into these trends may lead to a deeper understanding of the cerebellum's function and dysfunction.by Aditi Garg.M.Eng

Evaluation of the incidence, risk factors, severity, and outcome of hydrocephalic fetuses in a tertiary healthcare center located in Northern India: a prospective observational study

Background: Hydrocephalus is a heterogeneous disease marked by abnormal dilatation of the cerebral ventricles secondary to varying etiologies. This study was aimed to determine the incidence, risk factors, severity, and outcome of hydrocephalic fetuses presenting to a tertiary healthcare hospital located in northern India.Methods: In this prospective observational study, pregnant women visiting the obstetrics outpatient department of our hospital from 01 July 2017 to 31 June 2018 were screened for hydrocephalic fetuses via ultrasonography along with a detailed history, and a comprehensive battery of diagnostic investigations. They were followed up for a minimum period of two months after delivery/termination of pregnancy.Results: A total of 3627 pregnant women were screened, of which 10 had hydrocephalic fetuses in the observed time period. The incidence of hydrocephalus was determined to be 2.75 per 1000 live births. Low socio-economic status was identified as a major risk factor. 50% of the hydrocephalic fetuses were severely afflicted and were discontinued. The remaining 50% were successfully delivered and were managed via a ventriculo-peritoneal shunt or are under close observation in the postnatal period without any adverse outcome.Conclusions: The burden of hydrocephalus is considerably high in India, as compared to western countries. In rural settings, low socioeconomic status and lack of folic acid supplementation have a major influence in the etiopathogenesis of hydrocephalus. Management of hydrocephalus requires a multidisciplinary approach and is tailored according to the severity of the presentation. Severe cases of hydrocephalus and cases with associated anomalies have a poor prognosis

A Rare Case of Deep Vein Thrombosis Secondary to Protein S Deficiency and Antithrombin III Deficiency with MTHFR (C677T) Heterozygous Mutation, and Crohn’s Disease

Deep vein thrombosis is a condition wherein a thrombus develops in the deep veins of the body, most commonly in the legs, due to increasing tendency of the blood to coagulate. One such reason is the MTHFR gene mutation, wherein an increase in homocysteine levels causes irritation of the blood vessel endothelium, causing a disturbance in Virchow’s triad, hence triggering clot formation. [1] The MTHFR gene is responsible for instructing the body to produce an enzyme called methylene tetrahydrofolate reductase(MTHFR) [2]. MTHFR gene mutations can lead to a wide range of disorders, either as a result of the elevated levels of homocysteine in the blood, or due to folate deficiency. In about 25% of individuals globally, there is a mutation of MTHFR. The MTHFR 677C\u3eT mutation is predominantly seen in the Hispanic ethnicity, whereas the MTHFR 128A\u3eC is predominantly seen in the ethnicity groups belonging to south east Asia. In the Indian population, the MTHFR mutation prevails a low frequency of 2.9%. Diagnosis and treatment are required only in cases where secondary diseases occur as a result of MTHFR polymorphism, or if there is significant family history [4]. The treatment is along the same lines as that of another diagnosed individual without the mutation. In this case, the correlation between a genetic mutation of the MTHFR gene and Protein S and Antithrombin III deficiency, along with Crohn\u27s disease, which resulted in the development of DVT in a middle aged, male individual and its management is discussed

Knowledge, attitude and practice regarding generic drugs and branded drugs: a cross sectional study

Background: Medicines play a main role in the process of human development. The rational utilization of medicines can decrease morbidity and mortality as well as improve quality of life. In an era of steeply rising health care expenses, generic medicines provide a less expensive alternative to branded medicines. Use of generic drugs can contribute to substantial savings in medicines expenditure and the issue of access and affordability is thus addressed.Methods: A sample of 500 patients selected from out patient department was randomly selected. A self-instructed questionnaire was used for the study for the duration of 1 month. Data was analyzed using IBM SPSS statistics Version 20 New York, United States. Summary statistics were expressed using mean and standard deviation (SD) for numerical variables (median and interquartile ranges [IQRs] when skewed) and counts and percentages for categorical variables.Results: Participants reported with 17.23% knowledge score, 40.65% attitude score, and 7.96% attitude score.Conclusions: In the study it was found that there is significant correlation between knowledge and attitude whereas no correlation was found between knowledge and practice regarding usage of generic drugs

A questionnaire-based study on knowledge and attitude towards counterfeit medication among the doctors in tertiary care hospital

Background: Counterfeit drugs are a global problem and suffered almost all developing and developed countries worldwide. In India, it is a major problem which results life threatening issues as well as financial loss on health system. So, we conducted a cross sectional questionnaire-based study on knowledge and exposure to counterfeit drugs of doctors at SHKM Govt. Medical College, Nuh, Haryana, India.Methods: A structured questionnaire was distributed to 100 registered doctors. The questionnaire was based on knowledge, attitude and its consequence on the heath system by the practices of counterfeit medication.Results: There were Twenty questionnaires excluded from the study due to incomplete information. Only 57.77% (46/80) subjects having the knowledge of questionnaire correct meaning of counterfeit drug. However, almost 90% (72/80) subjects were aware about its dangerous effects. More than 50% of the subjects have suggested that modern technology is capable to control counterfeiting of the medicine.Conclusions: Counterfeit drugs create a people health hazard and waste to consumer income. The proper knowledge, awareness and modern technological approaches are the devices may helpful in diminution of counterfeit medication practices.

USask Sustainability Literacy Assessment

The USask Sustainability Literacy Assessment is administered every three years to first and fourth year undergraduate students as a snapshot of sustainability literacy and culture. This information is part of the USask The Sustainability Tracking, Assessment & Rating System with the Association for the Advancement of Sustainability in Higher Education. In 2022, the survey was designed to connect with USask Undergraduate Competencies for Sustainability.Non-Peer Reviewe

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Proctitis following stereotactic body radiation therapy for prostate cancer

Background Proctitis after radiation therapy for prostate cancer remains an ongoing clinical challenge and critical quality of life issue. SBRT could minimize rectal toxicity by reducing the volume of rectum receiving high radiation doses and offers the potential radiobiologic benefits of hypofractionation. This study sought to evaluate the incidence and severity of proctitis following SBRT for prostate cancer. Methods Between February 2008 and July 2011, 269 men with clinically localized prostate cancer were treated definitively with SBRT monotherapy at Georgetown University Hospital. All patients were treated to 35-36.25Gy in 5 fractions delivered with the CyberKnife Radiosurgical System (Accuray). Rectal bleeding was recorded and scored using the CTCAE v.4. Telangiectasias were graded using the Vienna Rectoscopy Score (VRS). Proctitis was assessed via the Bowel domain of the Expanded Prostate Index Composite (EPIC)-26 at baseline and at 1, 3, 6, 9, 12, 18 and 24 months post-SBRT. Results The median age was 69 years with a median prostate volume of 39 cc. The median follow-up was 3.9 years with a minimum follow-up of two years. The 2-year actuarial incidence of late rectal bleeding ≥ grade 2 was 1.5%. Endoscopy revealed VRS Grade 2 rectal telangiectasias in 11% of patients. All proctitis symptoms increased at one month post-SBRT but returned to near-baseline with longer follow-up. The most bothersome symptoms were bowel urgency and frequency. At one month post-SBRT, 11.2% and 8.5% of patients reported a moderate to big problem with bowel urgency and frequency, respectively. The EPIC bowel summary scores declined transiently at 1 month and experienced a second, more protracted decline between 6 months and 18 months before returning to near-baseline at two years post-SBRT. Prior to treatment, 4.1% of men felt their bowel function was a moderate to big problem which increased to 11.5% one month post-SBRT but returned to near-baseline at two years post-SBRT. Conclusions In this single institution cohort, the rate and severity of proctitis observed following SBRT is low. QOL decreased on follow-up; however, our results compare favorably to those reported for patients treated with alternative radiation modalities. Future prospective randomized studies are needed to confirm these observations

Prosthodontic rehabilitation of completely edentulous patient with partial glossectomy

Oral cancer accounts for about 40% of all cancers inflicting the human beings. Those involving the tongue results in mild to severe deficiencies of phonation, deglutition, mastication, and taste depending upon the degree and extent tissues involved. Often rehabilitation of such patient is a challenge for the prosthodontist and involves a careful observation and evaluation of the residual oral function and ways to restore them. This article presents a case report of prosthodontic rehabilitation completely edentulous patient, who underwent partial glossectomy following surgical resection of the squamous cell carcinoma involving left lateral borders of the tongue. An attempt was made to restore the comfort and function of the patient with the help of palatal augmentation prosthesis, with additional assistance through speech therapy and simple oral exercises