Variant of Lemierre's Syndrome Secondary to Trauma

Classic Lemierre's syndrome is a septic internal jugular venous (IJV) thrombophlebitis secondary to oropharyngeal anaerobic infection in adolescent and young adult. Though upper respiratory tract infection is the most common antecedent, it has also been described following skin, soft tissues, genitourinary and gastrointestinal infections. Fusobacteria necrophorum is the commonest pathogen isolated from blood and tissue cultures but other bacteria like Eikenella correndens, Bacteroides melaninogenicus and Non Group A Streptococcal species have also been reported. The overall incidence of Lemierre's and Lemierre's like syndromes has declined since the first case report in 1936. There is however, a resurgence of cases in recent years due to more judicious use of antibiotics for treatment of upper respiratory tract infection among medical practitioners. The main stay of treatment of complete Lemierre's syndrome is prolonged antibiotic coverage and surgical drainage of nonresolving abscesses. Currently, there is no consensus opinion on the use of anticoagulation in patient with complete Lemierre's syndrome complicated by septic internal jugular thrombosis and embolism. High index of suspicion is required for early diagnosis of Lemierre's and Lemierre's like syndromes. Early and effective antibiotics therapy may prevent the development full spectrum of the syndrome and its associated complication

Homocysteine a non-conventional risk factor for vasculopathic patients

Research is underway and many other factors are being identified, including homocysteine (Hcy). Since 1990, there has been an exponential increase in the number of publications on Hcy and coronary artery disease, suggesting elevated plasma Hcy as an independent risk factor. As a result, this study was conducted to determine the prevalence of a new risk factor (homocysteine) in the general population (both young and old), as well as any differences in prevalence rates (if any) between young (less than 45 years of age) and elderly (more than 45 years of age) patients with vasculopathy. This was a case control study done in the cardiology unit of Bharti Hospital, Pune. All the patients diagnosed as cases of vasculopathies, especially IHD/Stroke/DVT (n =75) were enrolled as cases for the study, and healthy volunteers of the same age and gender matched (n =75) were enrolled as controls and subjected to the following inclusion and exclusion criteria. All cases and controls were assessed for their homocysteine level on day 0 of admission by using the MEIA/FPIA Technique on IMX, Abbott, USA. The mean homocysteine level was 23.2499 (12.2739) in cases vs. 13.24 (3.0912) in controls, with a statistically significant ‘p’ value by unpaired ‘t’ and MannWhitney statistics. Elevated Hcy levels above 15 mol/l were detected in 70% of cases and 22% of controls, respectively. On comparing homocysteine to individual vasculopathy, it was found that homocysteine was a more significant risk factor in IHD > stroke >DVT

Homocysteine a non-conventional risk factor for vasculopathic patients

Research is underway and many other factors are being identified, including homocysteine (Hcy). Since 1990, there has been an exponential increase in the number of publications on Hcy and coronary artery disease, suggesting elevated plasma Hcy as an independent risk factor. As a result, this study was conducted to determine the prevalence of a new risk factor (homocysteine) in the general population (both young and old), as well as any differences in prevalence rates (if any) between young (less than 45 years of age) and elderly (more than 45 years of age) patients with vasculopathy. This was a case control study done in the cardiology unit of Bharti Hospital, Pune. All the patients diagnosed as cases of vasculopathies, especially IHD/Stroke/DVT (n =75) were enrolled as cases for the study, and healthy volunteers of the same age and gender matched (n =75) were enrolled as controls and subjected to the following inclusion and exclusion criteria. All cases and controls were assessed for their homocysteine level on day 0 of admission by using the MEIA/FPIA Technique on IMX, Abbott, USA. The mean homocysteine level was 23.2499 (12.2739) in cases vs. 13.24 (3.0912) in controls, with a statistically significant ‘p’ value by unpaired ‘t’ and MannWhitney statistics. Elevated Hcy levels above 15 mol/l were detected in 70% of cases and 22% of controls, respectively. On comparing homocysteine to individual vasculopathy, it was found that homocysteine was a more significant risk factor in IHD > stroke >DVT

Effect of Music Interventions on Sedation in Children Undergoing Magnetic Resonance Imaging: Clinical Trial

Background: Although parenteral sedation is often required in MRI studies in children, it is stressful and increases the cost of healthcare. Objectives: We evaluated the impact of music interventions in children receiving parenteral sedation for MRI studies on total number of doses of sedation medications, sedation time, levels of cortisol and cytokines, sedation success, adverse events, parental satisfaction, and cost savings. Methods: We conducted a prospective open unblinded four-arm clinical evaluation of interventions on 471 children 1-12 years of age undergoing MRI and receiving parenteral sedation. Children were assigned to active music therapy (AMT), facilitated music listening (FML), and as comparison another intervention (child life intervention or CLI), or no intervention (NI); measures included number of doses of sedation medications, time of sedation, sedation success, adverse events, parental satisfaction, and salivary levels of the stress hormone cortisol and pro-inflammatory cytokines, before and after intervention. Results: The total number of sedation doses, total sedation time, and levels of salivary cortisol and cytokines did not differ between the four groups. One FMLA choice, Wee Sing Animal Songs, resulted in significant decrease in total sedation time and reduction of associated costs. Conclusions: The use of one type of FML led to decreased total sedation time in children. This is an important finding since FML is an inexpensive non-invasive intervention which could be of significant time and cost saving benefits

An Observational Study of Umbilical Cord Clamping and Care Practices during Home Deliveries in Central Uganda

Delayed umbilical cord clamping and care practices have important implications for infant iron stores and neonatal survival. This is especially important in countries like Uganda, where there is a high prevalence of anemia in women and children coupled with a high newborn mortality rate. This study assesses cord clamping and care practices in home births in a coverage area of 12 health centers in 4 districts near Kampala, Uganda. We interviewed 147 women, most of who had at least primary school education and delivered their babies in the homes of traditional birth attendants. Only 65% of the persons conducting delivery washed hands, and most wore gloves. Most frequent cord ties were threads (86.7%), and glove rims (8.3%). Cords were cut with clean instruments in most (93.1%) deliveries. During cord clamping, newborn was positioned at a higher level than mother in 59%, delayed clamping (≥3mins) was reported in 52%. Combination of delayed clamping and positioning of newborn at mother’s level or lower was reported in only 19%. Substances used for cord care included surgical spirit (42.4%), local herbs (24.5%), powder (22.6%), ash (21.6%), saline water (10.3%), and tea (2.8%). Cord care instructions given most commonly were: cleaning with warm saline water (27%), spirit or antiseptics (25%), and herb application (7%). Awareness regarding cord infections was poor (20%). Mother’s education level, and age were not associated with cord clamping or care practices. Our study indicates scope for interventions to help improve hemoglobin levels in infancy. Education regarding cord care practices may reduce infections

Prevalence of dry eye among paramedical students of Teerthankar Mahaveer University, Moradabad, Uttar Pradesh

Background: The prevalence of dry eye is 32% in India which is higher than global prevalence. Dry eye is not a disease but a symptom complex occurring as a deficiency and abnormalities of the tear film. Dry eye infection (DED) is perhaps the most pervasive visual sickness on the planet. The point of our investigation was to acquire the pooled pervasiveness of DED in students and investigate its expected relates. Methods: It was a cross-sectional questionnaire-based qualitative and observational study was conducted among the students of the paramedical college of Teerthankar Mahaveer university. The pre-validated questionnaire was divided into three main sections involving the demographic data including the information about gender, age, students studying stream in the second section the questions about general health and question related to dryness in the eye. Results: Out of a total of 40 participants, 65% (26) were male and 35% (35) were female with the average age of the participants was 21.40 with the average age 21.40. During day how often feeling dryness for this we got the responses of 15% (06) for never, 82.50% (33) for some time and 2.50% (01). Further we have assessed the about dryness in their eyes by presenting the question During day how often feeling dryness for this we got the responses of 15% (06) for never, 82.50% (33) for some time and 2.50% (01). Concussions: The finding that dry eye symptoms are particularly common in young adults is concerning, and warrants further study.

Acute mountain sickness.

Acute mountain sickness (AMS) is a clinical syndrome occurring in otherwise healthy normal individuals who ascend rapidly to high altitude. Symptoms develop over a period ofa few hours or days. The usual symptoms include headache, anorexia, nausea, vomiting, lethargy, unsteadiness of gait, undue dyspnoea on moderate exertion and interrupted sleep. AMS is unrelated to physical fitness, sex or age except that young children over two years of age are unduly susceptible. One of the striking features ofAMS is the wide variation in individual susceptibility which is to some extent consistent. Some subjects never experience symptoms at any altitude while others have repeated attacks on ascending to quite modest altitudes. Rapid ascent to altitudes of 2500 to 3000m will produce symptoms in some subjects while after ascent over 23 days to 5000m most subjects will be affected, some to a marked degree. In general, the more rapid the ascent, the higher the altitude reached and the greater the physical exertion involved, the more severe AMS will be. Ifthe subjects stay at the altitude reached there is a tendency for acclimatization to occur and symptoms to remit over 1-7 days

Global child health: An essential component of residency training

International child health experience has become an essential component of residency training. Over the past few decades, increased globalization has led to a “shrinking” of the world. Substantial numbers of families are immigrating to North America, and numerous children from “third-world” countries are being adopted by North American families.1 Changes in the health of people in one area of the world can quickly impact the well-being of people globally. Thus, it is increasingly important for our clinicians to be well trained in recognizing and managing health conditions not seen routinely in the past