A study to assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Post Dialysis Home Care among Caregivers of Chronic Renal Failure patients undergoing Hemodialysis at K.G Hospital, Coimbatore

The educational programme regarding post dialysis home care is a vital role in improving caregivers knowledge of post dialysis home care. The educational programme will help to maintain the nutritional status, day to day care of vascular access and to prevent the infection and complications of Chronic Renal Failure patient undergoing hemodialysis. The aim of the study was to assess the effectiveness of Structured Teaching Programme on knowledge of post dialysis home care among caregivers of Chronic Renal Failure patients undergoing hemodialysis attending nephrology department at K.G Hospital. Modified IMOGENE KING’S goal attainment model was adopted in this study. Extensive reviews of literature, professional experts and expert guidance led the research to design the methodology. Under the classification of Quasi experimental research design the researcher has chosen one group pre-test post-test design of this study. By using purposive sampling technique, 30 subjects were selected. The data was collected by using a structured interview questionnaire in various aspects on knowledge regarding post dialysis home care. The content validity was obtained from 7 experts and reliability of the tool was found to be 0.76 in knowledge regarding post dialysis home care. The pilot study was conducted at Nephrology Department in K.G Hospital for a period of 1 week with 5 samples. After pilot study the researcher had proceeded to conduct main study. Main study was done a period of 4 weeks after getting a written permission from the Director of nursing at K.G Hospital. Thirty samples were selected by using purposive sampling technique (n = 30) pre-test knowledge score was assessed by using structured questionnaire. After pre-test the group received Structured Teaching Programme for 30 minutes. After 7 days the post-test had been conducted by using the same tool. The demographic variables were tabulated by using frequency distribution and the level of knowledge were tabulated by using descriptive and inferential statistics. The effectiveness of Structured Teaching Programme and comparison between the pre-test and post-test knowledge score were analysed by using paired ‘t’ test. It was found that the value were statistically significant at 5% level. An association between knowledge and selected demographic variables such as age, gender, education, occupation, income of the family per month, place of residence, types of family, relationship with patient, marital status and source of information was calculated by using ‘Chi square test’. The results showed that there is a significant association between knowledge and education among caregivers of Chronic Renal Failure patients undergoing hemodialysis. The results of the study revealed that Structured Teaching Programme was effective in improving the level of knowledge on post dialysis home care among caregivers of Chronic Renal Failure patient undergoing hemodialysis at K.G Hospital. CONCLUSION: The present study is supported by a other studies, which ensures that the Structured Teaching Programme was an effective teaching tool used to increase the level of knowledge regarding post dialysis home care among caregivers of Chronic Renal Failure patients undergoing hemodialysis at nephrology department at K.G Hospital

Analysis of basic Architectures used for Lifecycle Management and Orchestration of Network Service in Network Function Virtualization Environment

The Network Function Virtualization (NFV), Software Defined Networking are technologies, so which are in combination inorder to provide a high flexibility for network and dynamical continuum of resources for the deployment of services in the environment of high network programmability. A Network Function Virtualization Orchestration (NFVO) is an important topic played a major role in above scenario and in high availability of Virtual Network Functions (VNF), lifecycle and configuration management of network elements. However, the hardware usage is one of the obstacle towards network programmability and is generally considered as a contrast with respect to NFV concepts. In this paper shows many architectures, workflow in virtualization environment, compatibility, flexibility is discussed. These architectures involve in great enhancement of network infrastructure in virtualized environment. Each architecture is needed to gain better results in network function virtualization environment

The Value of Green: Evidence from the First Mandatory Residential Green Building Program

There has been recent interest in green building and development practices and research. Resulting from growing environmental awareness and concerns, mandatory residential green building programs have been implemented nationally at the municipal level and Texas has passed legislation to create a statewide program. However, the impact of greenness on residential property values has not been rigorously evaluated. This study examines residential transaction prices in two cities and finds a statistically significant premium associated with green properties. Additionally, there is evidence of a larger premium associated with green properties located in Frisco, Texas which has the nations first mandatory green building program

Efficacy and safety of ivabradine as an add-on to atenolol in patients with chronic stable ischemic heart disease

Background: Heart rate is the important key factor for determining the cardiac output, myocardial oxygen demand and coronary blood flow. Reduction in heart rate is the main stay of treatment for preventing and treating IHD. Due to the interactions with other drugs and adverse effects of the conventional drugs, the management of IHD focused on novel targets. Ivabradine is a novel specific and selective if current inhibitor of SA node. The objective of the study was to efficacy and safety of ivabradine as an add-on to atenolol in patients with chronic stable ischemic heart disease.Methods: Interventional, open label, prospective clinical study was done over a period of 1 year. Single centered study conducted in 50 patients in the Outpatient Department of cardiology, Tirunelveli Medical College Hospital, Tirunelveli. Endpoints noted were reduction in resting heart rate using 12 lead ECG and improvement in Canadian cardiovascular society (CCS) class of angina grading.Results: Ivabradine in reducing the heart rate at the end of 1 month (86.60±9.16) and at the end of 3 months (81.82±8.37) compared with baseline (93.08±11.67). CCS class of grade of angina also improved at the end of one month and 3 months compared with baseline. Grade IV (3 - 0 - 0), grade III (7 - 3 - 1) and grade II (40 - 8 - 9).Conclusions: Ivabradine is safe and effective in preventing and treating further anginal attacks in patients with chronic stable ischemic heart disease already on atenolol therapy

Knowledge, attitude, and practice of pharmacovigilance among health care professionals in a tertiary care hospital: a cross sectional study

Background: Spontaneous reporting of Adverse drug reactions (ADRs) has played an important role in the detection of serious, unsuspected, and unusual ADRs previously not detected during the clinical trials. However, underreporting remains a major obstacle in the implementation of pharmacovigilance program. The present cross-sectional study was conducted to assess the knowledge, attitude, and practice (KAP) related to pharmacovigilance among the health-care professionals (HCPs) in Tirunelveli Medical College Hospital, Tamilnadu.Methods: To assess KAPs of Health care professionals toward pharmacovigilance and ADR reporting; a predesigned, structured, 12 item questionnaire was used.Results: A total of 200 questionnaires were distributed among the HCPs including Postgraduate, Interns and Staff nurses. 72.7% postgraduates, 54.29% interns and 52.63% of staff nurses were aware regarding the existence of a National Pharmacovigilance Program of India. 72.7% postgraduates, 65.71% interns and 52.63% staff nurses felt that ADR reporting is a professional obligation for them .Only 37.14% interns, 15.79% staff nurses and 11.4% postgraduates have been trained for reporting adverse reactions. Although all staff nurses (100%) followed by 79.50% postgraduates and 48.57% interns experienced ADR in their practice, only 31.58% staff nurses, 20.50% postgraduates and 11.43% interns have ever reported ADR to pharmacovigilance centre.Conclusions: The deficiencies in knowledge and attitude require urgent attention not only to improve the rate of spontaneous reporting, but also for enhanced safety of the patients. Pharmacovigilance should be included in the nursing curriculum and workshops should be conducted for the undergraduate and postgraduate medical students regularly

Comparison of 0.25% Bupivacaine with 0.375% Ropivacaine for Field Block in Inguinal Hernia Repair

BACKGROUND : This study was conducted to compare the efficacy and advantages of 0.25% Bupivacaine and 0.375% Ropivacaine for field block in inguinal hernia repair. AIM : A prospective randomized double blinded study. METHODS : Study was conducted on 60 patients posted for elective inguinal hernia repair. They were divided into 2 groups – Bupivacaine and Ropivacaine. Field block was instituted with mean volume of 35ml to block ilioinguinal, iliohypogastric, genital branch of genitofemoral nerve. Patients were observed for onset, adequacy, duration of post-operative analgesia and side effects. Onset of block is assessed by pin prick test. Pain was assessed by the visual analog scale (VAS). Adequacy of block was judged by the need for supplementary analgesia. At the end of surgery, Post operative pain score was assessed by Verbal Rating Score (VRS). Rescue analgesia were given when needed. RESULTS : The onset of blockade is quicker in Bupivacaine (5.6min) whereas Ropivacaine takes longer (11.3min). With local infiltration at the neck of the sac , 13.3% patients were graded in mild pain in both groups. With inadequate analgesia, some needed narcotic supplementation and fall into moderate pain, 13.3% in B group and 16.7 % in R group. Block failure patients were converted to GA - 10% in B group and 11% in R group. They were excluded from the study. Adequate block with no supplementation was 63.3% in B group and 56.7% in R group which shows no significance. The average duration of post operative pain relief was 4.8hours in B group and 4.15hours R group. Both groups were haemodynamic stable throughout the study. CONCLUSION : Inguinal field block is found to be safe and fulfills the requirements of quality analgesia with minimal or no side effects. Ropivacaine is less cardiotoxic than Bupivacaine. Ropivacaine compared to Bupivacaine provides efficient analgesia with good postoperative pain relief

A Study of Prevalence of Diastolic Dysfunction in Rheumatoid Arthritis Patients

AIMS: The aim of this study was to evaluate the prevalence of diastolic dysfunction in rheumatoid arthritis patients and to compare them with age and sex matched controls. The correlation between diastolic dysfunction and disease activity was looked for. METHODS: The study was a cross sectional study involving 40 patients (8 maleand 32 female) with RA without clinically evident heart disease and 20 healthy subjects (16 female and 4 male) who served as a control group. Both groups were matched for age and sex. Echocardiographic and Doppler studies were conducted in all patients with RA and control subjects. RESULTS: Our study shows that patients with RA have a higher prevalence of diastolic dysfunction (40%) than non-RA subjects (10%). The ejection fraction was preserved in all patients. The result in this study showed E/A ratio in RA patients was 1.135 (0.822–1.448) and in the control group was 1.305 (1.122–1.487). Dt in RA patients was longer compared to the control population (180 ms ± 27..77vs. 160.5 ms ± 11.95) with a significant p value.). The E/E′ index of RA patients was 8.447 ± 2.32 which was higher compared to the study population 7.946+/- 0.43. The LA volume indexed to body surface area was significantly higher in patients of RA compared to study group. It was 23.03+/- 7.53 in study group as compared to 18.18+/- 2.44 with a significant p value of 0.007. This study showed significant correlations between duration of disease, disease severity and echocardiographic measurements. There were no statistically significant differences between diastolic dysfunction and normal diastolic function groups in term of age of the patient, duration of disease, DAS 28, rheumatoid factor. CONCLUSION: Prevalence of diastolic dysfunction in the rheumatoid arthritis group (40%) was higher compared to controls (10%). LV diastolic function had significant correlation with RA disease severity and duration of disease