Assessment of Ear Nose and Throat morbidities prevalent in the school going children aged 5-14 years in rural area of Jamnagar

Background: India is home to more than 400 million children forming about 35% of its total population. Upper respiratory tract infections predispose a child to complications such as otitis media, tonsillitis, and sinusitis that further contribute to morbidity leading to hearing impairment and learning disability & even RHD. Unfortunately these morbidities are either not detected or remain untreated making situation worse. Aims and objectives:1. To assess the prevalence of common Ear Nose and Throat symptoms among children aged 5-14 years and to study its relationship with socio-demographic factors 2. To know regarding health seeking behavior in relations to Ear Nose and Throat morbidities. Materials and method: A cross-sectional study was done over a period of 2 months among 300 school children aged 5-14 years of six government schools of Jamnagar district. Assessment was done through clinical examination and oral questioners. Results: Prevalence of Ear Nose and Throat morbidity was 46.66%; Ear (14.33%), Nose(28.66%) and Throat(10%).Common Ear Nose and Throat problems were– common cold(23%), cough(9.67%), sore throat(8.34%) and ear ache(8.67%). Associations of Ear Nose and Throat morbidity with age and religion were statistically significant. Only 31.40% of children had taken treatment for the problems. Mother’s education had statistically significant association on health seeking behavior of school children. Conclusion: Prevalence of Ear Nose and Throat morbidity was very high among school children, only 1/3 children had taken treatment, indicating negligence towards problems on the part of parents as well as teachers suggesting strong need for sensitization of parents and teachers

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Working with black minority ethnic children and adults

Research has indicated that working with black minority ethnic clients, is an area that creates some uncertainty for health and social care staff. Although, policies and practices are changing and developing there continues to be some ambiguity and ambivalence around working with individuals from different ethnic groups. This thesis considers two situations on a clinical level in which working with minority ethnic clients might raise additional dilemmas and challenges. These include working therapeutically with an ethnically dissimilar adult in therapy and working with black minority ethnic children in domestic violence situations. The first paper is a review of literature on addressing race in cross-racial therapy. In particular this paper focuses on how clinicians might bring up the issue of race in therapy, the factors which influence a therapist in discussing race and outcome studies in which race has been addressed in cross-racial therapy. The second paper is an empirical study exploring health and social care professionals’ perceptions and experiences of working with black minority ethnic children who are in domestic violence situations. This paper examines professionals’ perceptions of these children's family and of the wider professional system and considers how these two factors result in ongoing challenges for professionals working in this field. The paper also examines how these perceptions and dilemmas influence practice. The final paper is a reflective account of the hidden stories that were uncovered within me as researcher, participants and children throughout my research journey. In summary, the three papers demonstrate the important of remaining open in working with black minority ethnic clients, taking the time to understand the multiple influences within their lives and considering them as individuals rather than labelling. The papers also indicated the importance of having the confidence to ask questions about racial difference and in domestic violence situations where stories may remain hidden.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Working with black minority ethnic children and adults

Research has indicated that working with black minority ethnic clients, is an area that creates some uncertainty for health and social care staff. Although, policies and practices are changing and developing there continues to be some ambiguity and ambivalence around working with individuals from different ethnic groups. This thesis considers two situations on a clinical level in which working with minority ethnic clients might raise additional dilemmas and challenges. These include working therapeutically with an ethnically dissimilar adult in therapy and working with black minority ethnic children in domestic violence situations. The first paper is a review of literature on addressing race in cross-racial therapy. In particular this paper focuses on how clinicians might bring up the issue of race in therapy, the factors which influence a therapist in discussing race and outcome studies in which race has been addressed in cross-racial therapy. The second paper is an empirical study exploring health and social care professionals’ perceptions and experiences of working with black minority ethnic children who are in domestic violence situations. This paper examines professionals’ perceptions of these children's family and of the wider professional system and considers how these two factors result in ongoing challenges for professionals working in this field. The paper also examines how these perceptions and dilemmas influence practice. The final paper is a reflective account of the hidden stories that were uncovered within me as researcher, participants and children throughout my research journey. In summary, the three papers demonstrate the important of remaining open in working with black minority ethnic clients, taking the time to understand the multiple influences within their lives and considering them as individuals rather than labelling. The papers also indicated the importance of having the confidence to ask questions about racial difference and in domestic violence situations where stories may remain hidden

Solvent-free facile synthesis of di-octyl phthalate over heterogeneous sulfated zirconia acid catalyst

The present study reports the synthesis of di-octyl phthalate (DOP), widely used as a plasticizer, via solvent-free esterification of phthalic acid and n-octanol over sulfated zirconia (SZr) heterogeneous acid catalyst. A comparison with other heterogeneous acid catalysts such as K-10 acid activated clay, zeolites (β and Y), Amberlyst-15 resin shows the superior activity of SZr, exhibiting maximum conversion of n-octanol (88%) with 93% DOP selectivity at 160 °C in 6 h. The rate of the reaction for SZr catalyst is computed as 17.3 mmol h−1 g−1. The catalyst activity is stable upon recycling for up to five cycles. The weak acid sites of the catalyst are postulated as the responsible active centres involved in the reaction. The reaction has been successfully scaled up over twenty five times; and the product DOP (67 g, 99% by GC) isolated and characterized by FT-IR and 1H NMR spectroscopy. It is noteworthy that the activity of SZr catalyst is comparable with that of H2SO4 and p-toluene sulphonic acid (p-TSA), which clearly suggets its potential as an efficient alternative to conventional commercial homogeneous acid catalysts for the synthesis of DOP

Solvent-free facile synthesis of di-octyl phthalate over heterogeneous sulfated zirconia acid catalyst

747-755The present study reports the synthesis of di-octylphthalate (DOP),widely used as a plasticizer, via solvent-free esterification of phthalic acid and n-octanol over sulfated zirconia (SZr) heterogeneous acid catalyst. A comparison with other heterogeneous acid catalysts such as K-10 acid activated clay, zeolites (β and Y), Amberlyst-15 resin shows the superior activity of SZr, exhibiting maximum conversion of n-octanol (88%) with 93% DOP selectivity at 160 °C in 6 h. The rate of the reaction for SZr catalyst is computed as 17.3 mmol h−1 g−1. The catalyst activity is stable upon recycling for up to five cycles. The weak acid sites of the catalyst are postulated as the responsible active centres involved in the reaction. The reaction has been successfully scaled up over twenty five times; and the product DOP (67 g, 99% by GC) isolated and characterized by FT-IR and 1H NMR spectroscopy.It is noteworthy that the activity of SZr catalyst is comparable with that of H2SO4 and p-toluene sulphonic acid (p-TSA), which clearly suggetsits potential as an efficient alternative to conventional commercial homogeneous acid catalysts for the synthesis of DOP