Redefining indications and evaluation of dissection versus diathermy method of tonsillectomy

The current availability of randomized clinical trials have assessed the efficacy of the most common presumed indications for tonsillectomy, but the controversery still exists So, the present study was conducted to assess (1) Whether tonsillectomy leads to any significant benefits as compared to watchful waiting (2) evaluating the two most commonly used techniques for tonsillectomy i.e; cold dissection & diathermy. 170 patients were included,104 were assigned to the surgical group (Group A) & 66 patients acted as control (Group B).The surgical group underwent tonsillectomy.The efficacy of tonsillectomy viz-a-viz chronic tonsillitis related morbidity, school absenteeism, & work absenteeism, Group A beta hemolytic streptococcal pharyngitis, otitis media, Rhinosinusitis, obstructive sleep apnea & psoriasis was studied.The results of our study were as; Majority among children (7-15 years)& the mean age of adult population was 23.02 years.Tonsillectomy definitely provided benefit in case of chronic tonsillitis, mild to moderate obstructive sleep apnea on polysomnographic findings where as the Patients who had been included in this study to redefine otitis media & rhinosinusitis as an indication for tonsillectomy did not benefit much when compared to the watchful waiting groupThe three most commonly used techniques of tonsillectomy i.e; cold steel using ties & packs, cold steel using monopolar diathermy for hemostasis & using monopolar diathermy exclusively were evaluated.The operating time was least for the diathermy alone method. The intraoperative blood loss was minimal for the monopolar diathermy method. The primary hemorrhage rate was maximum in technique of cold steel with ties & packs as hemostasis.The secondary hemorrhage rate was maximum in monopolar diathermy method. The postoperative pain measured by using the verbal rating scale was considerable after using monopolar diathermy alone with 33% complaining of severe pain & 67% complaining of moderate pain

EFFECT OF CROSS FIT EXERCISES ON WEIGHT LOSS OF MALES IN LAHORE

The purpose of this research was to explore the effect of Cross Fit, a latest fitness techniques being used all over the world to get a good physique and health, in reducing weight of male persons ranging from 18 to 25 years. A sample of 8 male students ranging age from 18 to 25 years to measure the change in variables like Body weight, %age Fat ratio, %age of Total Body Water contents, %age of Lean Muscle Mass after applying Cross Fit training program in pre and post analysis. After designing and applying a 28 days Cross Fit plan and diet plans for each individual according to their Basal Metabolic Rate (BMR) and Total Daily Energy Expenditure (TDEE), it was found that there is a positive significant change in these variables mentioned above which showed that Cross Fit training program d

RELATIONSHIP BETWEEN SOCIAL CONTROL AND SPORTS

The main objective of the study is to evaluate the effects and relationship between social control and sports. Social control is extremely basic for each general public. Without social control, society and in addition individual can't exist. Hence, the need of social control is exceptionally basic. Social control is important for the presence and association of a general public. Players learn violent strategies from sports, this give them a better cure for deviant behaviors. players learns how to obey the laws in sports this enables to develop discipline in society and help to promote cultural values and also it help to develop better instruction among people. Sports are a useful to create accountability environment in society. Results of this research work showed that the sports have positive effect on social control

EFFECT OF CROSS FIT EXERCISES ON WEIGHT LOSS OF MALES IN LAHORE

The purpose of this research was to explore the effect of Cross Fit, a latest fitness techniques being used all over the world to get a good physique and health, in reducing weight of male persons ranging from 18 to 25 years. A sample of 8 male students ranging age from 18 to 25 years to measure the change in variables like Body weight, %age Fat ratio, %age of Total Body Water contents, %age of Lean Muscle Mass after applying Cross Fit training program in pre and post analysis. After designing and applying a 28 days Cross Fit plan and diet plans for each individual according to their Basal Metabolic Rate (BMR) and Total Daily Energy Expenditure (TDEE), it was found that there is a positive significant change in these variables mentioned above which showed that Cross Fit training program d

Adherence to guidelines for hospitalized community-acquired pneumonia over time and its impact on health outcomes and mortality.

Compliance with validated guidelines is crucial to guide management of patients hospitalized with community-acquired pneumonia (CAP). Data describing real-life management and treatment of CAP are limited. We aimed to evaluate the compliance with guidelines over time, and to assess its impact on all-cause mortality and clinical outcomes. We retrospectively compared two cohorts of patients admitted to the hospital, throughout 2005, just after the implementation of a local clinical pathway based on CAP international guidelines, and 7 years later over 2012. We included all patients with a diagnosis of pneumonia and/or related complications. 564 patients were included. The Pneumonia Severity Index calculation was better documented in 2012 (25.23 %) compared to 2005 (17.70 %; p = 0.032), but compliance with guideline empirical antibiotic therapy was lower in 2012 (56.70 %) than in 2005 (68.75 %; p = 0.004). Performance of guideline recommended urinary antigen tests was higher in 2012, and associated with 57.3 % lower odds of in-hospital mortality (95 % CI 15.0-78.5 %) and with 65.9 % lower odds of 30-day mortality (95 % CI 31.5-83.0 %). Compliance with empirical antibiotic therapy was associated with 2.9 days lower mean length of hospital stay (95 % CI -4.2 to -1.6 days) and with 2.0 days lower mean duration of antibiotic therapy (95 % CI -3.3 to -0.7 days). Compliance with guidelines changed over time, with some effects on mortality and with an apparent reduction in the length of hospital stay and the duration of antibiotic therapy. Specific clinical training and hospital control policies could achieve greater compliance with guidelines, and thus reduce a burden on hospital services

Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis

Background: The burden of non-communicable disease (NCDs) has grown rapidly in low- and middle-income countries (LMICs), where populations are ageing, with rising prevalence of multimorbidity (more than two co-existing chronic conditions) that will significantly increase pressure on already stretched health systems. We assess the impact of NCD multimorbidity on healthcare utilisation and out-of-pocket expenditures in six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Methods: Secondary analyses of cross-sectional data from adult participants (>18 years) in the WHO Study on Global Ageing and Adult Health (SAGE) 2007–2010. We used multiple logistic regression to determine socio-demographic correlates of multimorbidity. Association between the number of NCDs and healthcare utilisation as well as out-of-pocket spending was assessed using logistic, negative binominal and log-linear models. Results: The prevalence of multimorbidity in the adult population varied from 3∙9% in Ghana to 33∙6% in Russia. Number of visits to doctors in primary and secondary care rose substantially for persons with increasing numbers of co-existing NCDs. Multimorbidity was associated with more outpatient visits in China (coefficient for number of NCD = 0∙56, 95% CI = 0∙46, 0∙66), a higher likelihood of being hospitalised in India (AOR = 1∙59, 95% CI = 1∙45, 1∙75), higher out-of-pocket expenditures for outpatient visits in India and China, and higher expenditures for hospital visits in Russia. Medicines constituted the largest proportion of out-of-pocket expenditures in persons with multimorbidity (88∙3% for outpatient, 55∙9% for inpatient visit in China) in most countries. Conclusion: Multimorbidity is associated with higher levels of healthcare utilisation and greater financial burden for individuals in middle-income countries. Our study supports the WHO call for universal health insurance and health service coverage in LMICs, particularly for vulnerable groups such as the elderly with multimorbidity

Adherence to guidelines for hospitalized community-acquired pneumonia over time and its impact on health outcomes and mortality

Compliance with validated guidelines is crucial to guide management of patients hospitalized with community-acquired pneumonia (CAP). Data describing real-life management and treatment of CAP are limited. We aimed to evaluate the compliance with guidelines over time, and to assess its impact on all-cause mortality and clinical outcomes. We retrospectively compared two cohorts of patients admitted to the hospital, throughout 2005, just after the implementation of a local clinical pathway based on CAP international guidelines, and 7\ua0years later over 2012. We included all patients with a diagnosis of pneumonia and/or related complications. 564 patients were included. The Pneumonia Severity Index calculation was better documented in 2012 (25.23\ua0%) compared to 2005 (17.70\ua0%; p\ua0=\ua00.032), but compliance with guideline empirical antibiotic therapy was lower in 2012 (56.70\ua0%) than in 2005 (68.75\ua0%; p\ua0=\ua00.004). Performance of guideline recommended urinary antigen tests was higher in 2012, and associated with 57.3\ua0% lower odds of in-hospital mortality (95\ua0% CI 15.0-78.5\ua0%) and with 65.9\ua0% lower odds of 30-day mortality (95\ua0% CI 31.5-83.0\ua0%). Compliance with empirical antibiotic therapy was associated with 2.9\ua0days lower mean length of hospital stay (95\ua0% CI -4.2 to -1.6\ua0days) and with 2.0\ua0days lower mean duration of antibiotic therapy (95\ua0% CI -3.3 to -0.7\ua0days). Compliance with guidelines changed over time, with some effects on mortality and with an apparent reduction in the length of hospital stay and the duration of antibiotic therapy. Specific clinical training and hospital control policies could achieve greater compliance with guidelines, and thus reduce a burden on hospital services

Socio-demographic correlates of multimorbidity in SAGE countries.

<p>Notes</p><p>1. Multimorbidity defined as two or more chronic conditions in the same individual</p><p>2. Additional covariates included in the model in China: provinces; Ghana: ethnic groups (Akan, Ga-Adangbe, and others); India: states; South Africa: provinces, ethnic groups (back, white, coloured, and others).</p><p>3. Country dummy variables were included in the model to adjust for heterogeneity among countries in the pooled analysis.</p><p>Socio-demographic correlates of multimorbidity in SAGE countries.</p