Risk factors for myocardial infarction among low socioeconomic status South Indian population

<p>Abstract</p> <p>Background</p> <p>As longevity increases, cases of myocardial infarction (MI) are likely to be more. Cardiovascular disease (CVD) is a major global health problem reaching epidemic proportions in the Indian subcontinent, also among low socio-economic status (SES) and thin individuals.</p> <p>Objectives</p> <p>The present study was undertaken to elicit risk factors for MI among low SES Southern Indians and to find out its association with body mass index (BMI).</p> <p>Materials and methods</p> <p>A case-control study of patients with MI matched against healthy control subjects was carried out in a tertiary care teaching hospital. Standard methods were followed to elicit risk factors and BMI. Chi-square and Fishers exact test for categorical versus categorical, to show relationship with risk factors were analyzed.</p> <p>Results</p> <p>A total of 949 patients (male (M) = 692 and post menopausal female (F) = 257) and 611 age and sex matched healthy controls were included. In our study, BMI was below 23 in 48.2% of patients and below 21 in 22.5%. The risk of developing MI was significantly more in males (odds ratio (OR) = 3.3, 95% confidence interval (C.I.) = 2.69-4.13), among females with post-menopausal duration (PMD) of more than or equal to 3 years (OR = 9.27, 95% C.I. = 6.36-13.50) and in those with BMI less than 23 with one or other risk factors (P = 0.002, OR = 1.38, 95% C.I. = 1.13-1.70).</p> <p>Conclusion</p> <p>BMI cannot be considered as a lone independent risk factor, as the study population had low BMI but had one or more modifiable risk factors. It would be advisable to keep BMI at least 21 kg/m²for screening program. Health education on life style modification and programs to diagnose and control diabetes and hypertension have to be initiated at community level in order to reduce the occurrence.</p

The development of an instrument for measuring teachers’ and students’ beliefs about differentiated instruction and teaching in heterogeneous chemistry classrooms

Diversity and differences between students are the reality that teachers deal with daily. To address this reality, developments in education aim to provide teachers with the knowledge and requisite skills needed for differentiated instruction (DI). DI is a pedagogical-didactic approach that enables teachers to systematically address students’ diverse learning needs. However, no validated instruments currently exist to measure or evaluate teachers’ and students’ beliefs toward DI in chemistry. Hence, there is a need to develop such questionnaires to examine students’ and teachers’ sense of self-efficacy (SE) and attitudes (AT). We describe the development and validation processes of such questionnaire that have been developed based on relevant literature on DI and on teachers’ experience with DI in a heterogeneous classroom. The items were validated by experts’ panel, a readability test, and a field test. A confirmatory factor analysis was undertaken to investigate the factor structure of the teachers and students’ questionnaires based on pilot test reliability, Cronbach’s alpha revisions, and rerun alpha. As a result, the SE and AT of students towards DI instrument entailed 38 items with a five-factor structure indicating a high reliability. Three factors of attitudes, (α) = 0.98, and two factors of self-efficacy, (α) = 0.91. The SE and AT of teachers entailed 55 items with a five-factor structure indicating a high reliability of self-efficacy, (α) = 0.95 and of attitudes towards DI in heterogeneous chemistry classrooms, (α) = 0.93

EFFICACY OF MULLIGAN MOBILIZATION VERSUS MUSCLE ENERGY TECHNIQUE IN CHRONIC SACROILIAC JOINT DYSFUNCTION

Background: Sacroiliac joint dysfunction represents 15% of low back pain conditions. Normal sacroiliac joint works as a safeguard and transmits upper body weight into the pelvis and lower extremities. If the SIJ is hypomobile, it cannot effectively absorb forces and other body parts may be overstressed causing musculoskeletal dysfunction. The study conducted by comparing the effectiveness of Mulligan mobilization versus muscle energy technique in chronic SIJ dysfunction. Methods: 45 patients with chronic sacroiliac joint dysfunction from both genders joined the study. They were divided into three groups 15 in each group. Group A: received Mulligan mobilization with movement using posterior and anterior innominate methods plus conventional treatment program. Group B: received muscle energy technique using a post-isometric relaxation technique to erector spinae, hamstrings, iliopsoas and quadratus lumborum plus conventional treatment program. Group C: control group obtained conventional treatment program only. Doppler imaging of vibration, palpation meter, and the visual analogue scale was utilized for evaluating patients (pre and post-treatment). Results: The study findings revealed a statistical remarkable improvement in post-intervention values for sacroiliac mobility in Mulligan mobilization group (p > 0.0001) and a statistically significant decrease of anterior pelvic tilting angle in Mulligan mobilization and muscle energy technique groups (p > 0.0001), also a significant decrease of pain in the 3 groups compared with pre-intervention values (p > 0.0001), additionally, Mulligan mobilization group showed a statistical high detectable difference in right and left sacroiliac mobility more than muscle energy technique and control groups (p > 0.0001). Conclusion: Mulligan mobilization is more effective than muscle energy technique in the treatment of chronic sacroiliac joint dysfunction