Sandifer syndrome: the mis-interpretable disorder

Sandifer syndrome (SS), a movement disorder which is characterised by spasmodic torsional dystonia with back arching and rigid opisthotonic posturing, negatively impacting predominantly the neck, back, and upper extremities. Symptomatic gastro-esophageal reflux disease, esophagitis, or the presence of a hiatal hernia are all associated with Sandifer syndrome. The cause of Sandifer syndrome being uncertain, lifestyle adjustments and modifications highlights as the appropriate mode of treatment. To treat the condition and help relax the baby after feeding, dietary changes or medications can be administered. The case report of a patient with Sandifer Syndrome is considered for observation. Upon arrival, the child was stable, and an Electro-encephalogram (EEG) test revealed nothing abnormal. The child was taking several Anti-epileptic drugs (AED’s), which were stopped in favour of Sodium valproate and Pyridoxine.  An opinion from a Gastro-enterologist was sought in light of the epilepsy and possible Gastro-esophageal reflux disease (GERD), and they suggested a milk scan. Rantac was then started, and breastfeeds were thickened. Milk can indicate mild GERD and a reduction in episode frequency. So, sodium valproate was discontinued. Haemodynamically stable child was discharged from the hospital with Pyridoxine and Carnisure. Studies shows most cases of SS improve over time, within the first 24 months in general.

Premature Hair Greying - Magnitude and Associated Factors: A cross-sectional study in a university in Mysuru

Background: Premature hair greying (PHG) refers to the diffuse loss of hair color at an age earlier than that is generally accepted as physiological. Studies have found that it affects self-esteem and social life. Our efforts were to estimate the prevalence among students <25years and understand the associated factors. Design and Methods: A cross-sectional study using a simple random sampling technique was used to survey 358 students at a university in Mysuru. The data were analyzed using SPSS v22. The association and relationship of PHG with attributed risk factors and various socio-clinical factors have been analyzed using Chi-Square Test, Independent sample t-test, and Mann Whitney U-test. A p-value of less than 0.05 has been considered statistically significant. Results: In this study, the prevalence of PHG was 28.2%. We observed that PHG was associated with male gender, obesity, and positive paternal, maternal, and family history of PHG. The relation of PHG with lower dietary iron intake, tobacco smoking amount, and frequency was also found in this study. However, no association between PHG and psychological stress, alcohol consumption, dietary Vitamin B12, and D intake, shampoo, and oil usage frequency was found. Conclusion: We recommend that further studies should be done to check if weight reduction, smoking cessation, and maintenance of dietary iron adequacy can help in preventing PHG

Aspect of sleep quality amid undergraduate medical students in correlation with BMI.

Purpose: This study aimed to assess the quality of sleep among medical undergraduates from different phases of the medical program using the Pittsburgh Sleep Quality Index (PSQI) and to study the association of body mass index (BMI) with the quality of sleep among them. Material and Methods: Sleep quality was assessed among 482 medical undergraduates using the PSQI. Students undergoing treatment for psychiatric illness, diabetes or hypertension, history of alcohol consumption, and smoking were excluded from the study. Obesity was ascertained by calculating the BMI and categorized into 2 groups of23.0 according to the World Health Organization (WHO) guidelines for the Asian population. The chi-square test was utilized to compare seven components of PSQI and sleep quality for different phases and BMI groups and SPSS 24 was used to compare the components and the global score. Results: Only 0.8% of the total sample classified their sleep as very bad whereas 69.5% classified themselves as fairly good sleepers. The study participants had an average sleep time of 7.06±1.26 hours. The sleep duration (p23 had daytime dysfunction every day. Conclusions: It is necessary to create awareness among medical undergraduates about the importance of good sleep hygiene which will help them to improve their academic performance

Quantification of the overall environmental impact of idle driving in Sweden and proposals for behavior-affecting measures

Den accelererande klimatförändringen idag kommer huvudsakligen från mänskliga aktiviteter. Utsläppen från människor rubbar naturens balans idag och ännu mer i framtiden. Den största boven är koldioxid, som bland annat släpps ut från bilar med förbränningsmotor. Statistik påvisar att koldioxidutsläppen minskar för nyare bilar, dessvärre ökar antalet bilar med tiden. En del av problemet ligger i tomgångskörning. Tomgång kallas det låga varvtalet en förbränningsmotor ligger vid då den är igång men inte används. I Sverige är det endast tillåtet att ha bilen på i tomgång max en minut i de flesta kommunerna, med undantag för fordon som får ha motorn igång längre för att driva en anläggning. Mängden av tomgångskörning i Sverige fastställdes med hjälp av beräkningar baserad på litteraturstudie och statistik. Orsaker till att tomgångskörning förekommer och förares attityd till tomgångskörning hos olika befolkningsgrupper undersöktes med hjälp av en enkätundersökning. Slutsatsen som kunde dras är att tomgångskörning utgör ca 25 % av all koldioxidutsläpp från personbilar. De vanligaste situationerna då bilister hade bilen i tomgång var vid stilla trafik, kö på drivethrough, värma bilen och när de väntade på någon. Majoriteten hade bilen på tomgång i längre än två minuter vilket överskrider de lokala hälsoskyddsföreskrifterna. Enkätundersökningen visade att brist på kunskap angående tomgångskörningens hälso- och miljöpåverkan är en avgörande orsak till att tomgångskörning sker.The accelerating climate change today comes mainly from human activities. Emissions from humans are disturbing the balance of nature today and even more in the future. The biggest problem is carbon dioxide which, among else, is emitted from cars with internal combustion engines. Statistics show that carbon dioxide emissions are decreasing for newer cars, but unfortunately, the number of cars increases over time. Part of the problem lies in idling. Idling refers to running a vehicle's engine when the vehicle is not in motion. In Sweden, it is only allowed to have the car idle for a maximum of one minute in most municipalities, except for vehicles that may have the engine running longer to operate a plant. The amount of idle driving in Sweden was determined using calculations based on literature study and statistics. Reasons for idle driving and driver attitudes to idle driving in different population groups were examined using a questionnaire survey. The conclusion that could be drawn is that idle driving constitutes about 25% of all carbon dioxide emissions from passenger cars. The most common situations when motorists had the car idle were at heavy traffic, queuing at drive through, heating the car and when they were waiting for someone. The majority had the car idle for longer than two minutes, which exceeds the local health protection regulations. The survey showed that lack of knowledge regarding the health and environmental impact is a crucial reason for idling

Quantification of the overall environmental impact of idle driving in Sweden and proposals for behavior-affecting measures

Den accelererande klimatförändringen idag kommer huvudsakligen från mänskliga aktiviteter. Utsläppen från människor rubbar naturens balans idag och ännu mer i framtiden. Den största boven är koldioxid, som bland annat släpps ut från bilar med förbränningsmotor. Statistik påvisar att koldioxidutsläppen minskar för nyare bilar, dessvärre ökar antalet bilar med tiden. En del av problemet ligger i tomgångskörning. Tomgång kallas det låga varvtalet en förbränningsmotor ligger vid då den är igång men inte används. I Sverige är det endast tillåtet att ha bilen på i tomgång max en minut i de flesta kommunerna, med undantag för fordon som får ha motorn igång längre för att driva en anläggning. Mängden av tomgångskörning i Sverige fastställdes med hjälp av beräkningar baserad på litteraturstudie och statistik. Orsaker till att tomgångskörning förekommer och förares attityd till tomgångskörning hos olika befolkningsgrupper undersöktes med hjälp av en enkätundersökning. Slutsatsen som kunde dras är att tomgångskörning utgör ca 25 % av all koldioxidutsläpp från personbilar. De vanligaste situationerna då bilister hade bilen i tomgång var vid stilla trafik, kö på drivethrough, värma bilen och när de väntade på någon. Majoriteten hade bilen på tomgång i längre än två minuter vilket överskrider de lokala hälsoskyddsföreskrifterna. Enkätundersökningen visade att brist på kunskap angående tomgångskörningens hälso- och miljöpåverkan är en avgörande orsak till att tomgångskörning sker.The accelerating climate change today comes mainly from human activities. Emissions from humans are disturbing the balance of nature today and even more in the future. The biggest problem is carbon dioxide which, among else, is emitted from cars with internal combustion engines. Statistics show that carbon dioxide emissions are decreasing for newer cars, but unfortunately, the number of cars increases over time. Part of the problem lies in idling. Idling refers to running a vehicle's engine when the vehicle is not in motion. In Sweden, it is only allowed to have the car idle for a maximum of one minute in most municipalities, except for vehicles that may have the engine running longer to operate a plant. The amount of idle driving in Sweden was determined using calculations based on literature study and statistics. Reasons for idle driving and driver attitudes to idle driving in different population groups were examined using a questionnaire survey. The conclusion that could be drawn is that idle driving constitutes about 25% of all carbon dioxide emissions from passenger cars. The most common situations when motorists had the car idle were at heavy traffic, queuing at drive through, heating the car and when they were waiting for someone. The majority had the car idle for longer than two minutes, which exceeds the local health protection regulations. The survey showed that lack of knowledge regarding the health and environmental impact is a crucial reason for idling

Comparing WHO C-Model generated C-Section probabilities to actual delivery outcomes in a tertiary care centre

Background: A model which takes into account several relevant factors and gives the probability of C-Section in a woman would have the advantage of preparing for such an event. The identification of women at high risk of C-Section (>50% risk) would provide the opportunity for understanding risks involved in pursuing a vaginal delivery whereas if the risk of C-Section was less (<50%) it would prove useful in counselling for a vaginal delivery. We used the WHO C-Model with the aim to find the predictability of this model in our facility and the overuse of C-section in the 10 Robson’s Groups.Methods: A retrospective observational study in which all women who gave birth at our hospital from June 2016 to May 2017 were included and C-Section probability was calculated using the C-Model. Comparison with the actual mode of delivery was done to find the sensitivity, specificity, positive and negative predictive value of the model and the overuse of C-Section in the Robson’s Groups.Results: Out of the 314 C-Sections done only 45 women had a >50% probability, giving the model a sensitivity of 14.33%, specificity of 98.8%, positive predictive value of 90% and negative predictive value of 60.56%. Robson’s Groups 5 and 3 demonstrated the greatest overuse of C-Sections.Conclusions: The WHO Model when applied to this centre showed a high positive predictive value for C-Sections but the negative predictive value or the ability to correctly predict a vaginal delivery was much less