Physician Communication Attitudes and Success in Patient-doctor Communication Amongst Medical School Students

The aim of this research paper is to assess the issue of difficulty in verbal communication amongst medical practitioners and their patients. In recent years, the push for efficiency and speed has caused physicians to decrease the time they spend with their patients. This push for efficiency has caused a strain in the healthy development of physician-patient relationships. Therefore, hospitals and clinics are suffering from a decrease of patient satisfaction and loss of customers and revenue. Previous studies have been done to assess the use of implementing techniques from the hospitality industry and having a more humanistic approach to health care in order to solve this problem (Kaplan, Greenfield, & Ware, 1989). Our study exams medical school students from the University of Nevada, Las Vegas School of Medicine. The students were evaluated based on scores from the Objective Structured Clinical Examination and compared with attitude surveys they had taken before the exam. We will be using a regression model and scatter plot regression graph to analyze our date. By using previous literature we predicted that medical school students who believed that patients should control the conversation during patient examination would have a higher OSCE score. We also believe that we should see a similar trend of increase of OSCE scores for students that believe psychosocial factors should be discussed more during patient examination. We concluded that our results were insignificant due to a small sample size, although our correlation results confirmed our hypothesis that a more humanistic approach results in better patient satisfaction and recovery outcomes

FABULA: Intelligence Report Generation Using Retrieval-Augmented Narrative Construction

Narrative construction is the process of representing disparate event information into a logical plot structure that models an end to end story. Intelligence analysis is an example of a domain that can benefit tremendously from narrative construction techniques, particularly in aiding analysts during the largely manual and costly process of synthesizing event information into comprehensive intelligence reports. Manual intelligence report generation is often prone to challenges such as integrating dynamic event information, writing fine-grained queries, and closing information gaps. This motivates the development of a system that retrieves and represents critical aspects of events in a form that aids in automatic generation of intelligence reports. We introduce a Retrieval Augmented Generation (RAG) approach to augment prompting of an autoregressive decoder by retrieving structured information asserted in a knowledge graph to generate targeted information based on a narrative plot model. We apply our approach to the problem of neural intelligence report generation and introduce FABULA, framework to augment intelligence analysis workflows using RAG. An analyst can use FABULA to query an Event Plot Graph (EPG) to retrieve relevant event plot points, which can be used to augment prompting of a Large Language Model (LLM) during intelligence report generation. Our evaluation studies show that the plot points included in the generated intelligence reports have high semantic relevance, high coherency, and low data redundancy

MITIGATING EFFECTS OF ZINGIBER OFFICINALE AGAINST REPRODUCTIVE TOXICITY INDUCED BY DICHLOROVOS IN MALE RATS

Objective: Aim of this study was to evaluate the effect of Z. officinalein mitigating oxidative damage and reproductive toxicity in the testis, induced by chronic dichlorovos administration in male Wistar rats.Methods: Twenty four adult male Wistar rats were divided into 4 groups of 6 rats in each group. Group I received olive oil (1 ml/ kg bwt/day) and served as control group, while Group II was administered dichlorovos (20 mg/kg bwt/day) and Group III & IV received a combination of dichlorovos (20 mg/kg bwt) andZingiber officinale (ginger) extract (100 & 200 mg/kg bwt) for 45 days. At the end of the treatment period, the rats were sacrificed.Results: The weight of the reproductive organs and serum FSH, LH and testosterone levels were assayed. Lipid peroxidation (LPO) (indexed by MDA) and antioxidants enzymes GSH, SOD, CAT were also analysed. Dichlorovos treatment decreased the weight of testis, epididymis, prostate and seminal vesicle as well as the serumlevels of FSH, LH and testosterone. There was a decrease in the activities of GSH, SOD and CAT as well as an increase in MDA concentration.Conclusion: Co-administration of aqueous extract ofZingiber officinalewith dichlorovos showed protective effect and increases the reproductive organs weight and enhancesserum hormones level along with increased antioxidants activities and reduced lipid peroxidation. This indicates that Zingiber officinale mitigates reproductive toxicity and oxidative damage induced by dichlorovos exposure due to its antioxidant activity in the testes

Performance Analysis of Different Classification Methods in Data Mining for Diabetes Dataset Using WEKA Tool

Data mining is the process of analyzing data based on different perspectives and summarizing it into useful information. Classification is one of the generally used techniques in medical data mining. The goal here is to discover new patterns to provide meaningful and useful information for the users. Recently data mining techniques are applied to healthcare datasets to explore suitable methods and techniques and to extract useful patterns. This paper includes implementation of different classification methods, measures, analysis and comparison pertaining to diabetes dataset. A detailed performance analysis and comparative study of these methods are done, which can be further used to choose the appropriate algorithm for future analysis for the given dataset. DOI: 10.17762/ijritcc2321-8169.15036

A Study of Obesity and Sleep Disordered Breathing

Introduction: Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality and various Cardiovascular risk factors. Obesity is strongly linked with respiratory symptoms and diseases like dyspnea on exertion, obstructive sleep apnea syndrome (OSAS). This study has been undertaken to analyze the severity of hypertension in obese patients, sleep-disordered breathing (SDB) in obese patients, to analyze whether SDB is a risk factor for hypertension in obese individuals and to correlate how many obese hypertensives have correctable SDB. Methods: A total of 200 obese patients were randomly selected from the outpatient department. Berlin's questionnaire and the Epworth sleepiness scale score (ESSS) were used to assess sleep-disordered breathing (SDB). Asian classification of obesity suggested by the World Health Organization was used for the assessment of BMI. All statistical analysis was carried out using the SPSS version20, and Appropriate Statistical tools were applied wherever required, like a test of proportion, Chi-square test etc. Results: Out of 200 subjects, 116 were male, and 84 were female. The majority of the study population (70.0%) had suffered from obstructive sleep apnea, while the rest (30.0%) had mixed sleep apnea. The mean spread of age for total selected subjects (N=200) was 45.64±12.75 years. The body mass index (BMI) between 40 and 50 kg/m2 in 49.0% obese patient. Systemic hypertension prevailed more in male (81.0%) obese subjects than female (77.4%) obese subjects. The most significant risk factor for predicting hypertension was moderate type sleep apnea (p<0.005) followed by the age of the (p<0.007) obese patients that were confirmed strongly significant on the statistical ground. Conclusion: Obesity has a very high and proportionate correlation between sleeping disordered breathing. Obstructive sleep apnea is the predominant sleep-disordered breathing in our study population. Sleep-disordered breathing is very much correctable in the obese hypertensive population by weight reduction and risk factor control

Effect of Pre-treatment Using Ultrasound and Hydrogen Peroxide on Digestion of Waste Activated Sludge in an Anaerobic Membrane Bioreactor

The rate of anaerobic digestion (AD) often depends on the rate-limiting hydrolysis step that makes organics available to microorganisms. To achieve efficient conversion of particulates to soluble materials and finally methane, the biomass in the digester must be provided with optimal operational conditions that will allow for biomass retention and substrate metabolism. Two approaches were employed in this study to improve the ultimate biodegradability of waste activated sludge (WAS) - Pre-treatment (PT) and operation using an Anaerobic Membrane Bioreactor (AnMBR). PT of WAS is one way of speeding up hydrolysis. It has been proposed that PT leads to the lysis of cells, which in turn causes the release and solubilisation, and thus availability of intracellular matter to microorganisms for microbial growth and metabolic activities. This study compared the effect of thermal, sonication, and sonication + hydrogen peroxide PT on chemical oxygen demand (COD) solubilisation of WAS. Based on the soluble COD (SCOD) release, it was concluded that combined chemi-sonic treatment resulted in better WAS degradation rather than individual ultrasonic pre-treatment and thermal PT. The highest solubilisation rate was observed at a chemi-sonic PT of 50gH2O2/kgTS and sonication duration of 60 minutes. At this PT, a COD solubilisation of 40% was observed which was significantly different than PT involving only sonication and no pre-treatment (0.88%) at 95% confidence. Therefore a peroxide-sonic PT was chosen to treat WAS in this study as it was expected to result in the greatest improvement in WAS biodegradability. In addition to PT, biodegradability of WAS can also be improved by coupling PT with an AnMBR. AnMBRs prevent biomass washout by decoupling the solids retention time (SRT) from the hydraulic retention time (HRT). Thus, a long SRT can be used to provide sufficient duration for biological activities without increasing the volume of the reactor. In this study, a 4.5L AnMBR with an HRT and SRT of 3 and 20 days, respectively was used to treat raw and PT WAS. In order to compare the biodegradability of PT and raw WAS, the AnMBR was operated in three phases. Phase 1 was operated with raw WAS, Phase 2 was operated with WAS pre-treated with 50 gH2O2/kgTS and 20 minutes ultrasound (US), and Phase 3 was operated with WAS pre-treated with 50 gH2O2/kgTS and 60 minutes US. The anaerobic biodegradability of WAS following a combination of ultrasonic pre-treatment and H2O2 addition was significantly improved, with Phase 3 resulting in the greatest improvement. The COD destruction for phases 1, 2, and 3 were 49%, 58%, and 63%, respectively whereas the volatile suspended solids (VSS) destruction for phases 1, 2, and 3 were 46%, 71%, and 77% respectively. Organic Nitrogen (Org-N) destruction increased from 44% to 52% for phases 1 and 2 respectively. A further increase of 18% in Org-N destruction was observed in phase 3. This improvement in biodegradability of WAS was attributed to the high solubilisations of COD, VSS, and ON and conversion of non-biodegradable materials to biodegradable fractions. In order to determine the effect of PT of WAS on membrane performance, the transmembrane pressure (TMP) and fouling rate were monitored throughout the operation of the AnMBR. Negligible variation in membrane performance was observed over all three phases. At a constant low flux of 2.75 litres/m2/hour (LMH), the TMP and the fouling rate remained low over the course of operation. In order to maintain the performance of the membrane, maintenance cleaning with 50 ml of 2g/L critic acid solution followed by 50 ml of 0.2 g/L sodium hypochlorite was performed three times a week. In addition, a gas sparing rate of 2 L/minute and a permeation cycle of 10 minutes with 8 minutes of operation followed by 2 minutes of relaxation was employed. During phase 2 of this study, a new membrane was installed due to a faulty gas sparging pump. A slight decrease of TMP was observed with the installation of the new membrane; however the decrease was minimal. In addition critical flux for phases 2 and 3 were determined to be in the range of 6 to 12 LMH. In conclusion, the incorporation of H2O2-US PT with AD could allow treatment plants to substantially reduce the mass flow of solids and organics and thus result in a decrease in requirements for downstream sludge processing. With sufficient maintenance, steady operation could be achieved for a hollow fibre AnMBR with a total solids concentration range of 20-25 g/L, an HRT of 3 days, and an SRT of 20 days. It was found that PT could be successfully integrated with AnMBR to substantially reduce the HRT required for digestion when compared to conventional designs

Factors influencing utilization of maternal and child health services among the postnatal mothers in hilly region

Background:Maternal mortality is a global issue and WHO recommends the use of maternal health services to help improve the health of women and babies during pregnancy and childbirth. Use of maternal health services is an effective means for reducing the risk of maternal morbidity and mortality, especially in places where the maternal and child health (MCH services utilization was poor. The main objective of this study was to assess the factors affecting utilization of MCH services among postnatal mothers in selected hilly areas of Uttarakhand.Methods: The study has adopted exploratory descriptive design. The data was collected from 196 postnatal mothers within 42 days of postnatal period by administrating self-structured questionnaire in selected community areas of Pauri District, Uttarakhand. Samples were selected by using convenient and consecutive sampling technique.Results: The present study revealed that the main reasons given by the individual women for not attending antenatal and postnatal care  services that they were apparently healthy in present pregnancy, distance from MCH centers, doctors are not available in MCH centers, better services in home and lack of time due to household work. Conclusions: The findings of this study will help the nurse-midwife who are working in community and hospital setup to understand the factors that hinder women from utilization of MCH services and provides evidence to address women’s problem for ensure effective utilization of available MCH services

RISK FACTORS, PREVALENCE AND DIAGNOSIS OF HUTCHISON GILFORD SYNDROME WITH SPECIAL REFERENCE TO CASE REPORTS

Progeria also known Hutchinson–Gilford progeria syndrome (HGPS), is an extremely rare genetic disorder. The prevalence of HGPS is 1 in 4-8 million newborns. Progeria causes premature, rapid aging shortly after birth present within the first year of life. Recently, de novo point mutations in the Lmna gene at position 1824 of the coding sequence have been found in persons with HGPS. Lmna encodes lamin A and C, the A-type lamins, which are an important structural component of the nuclear envelope and play a role in protein processing. The most common HGPS mutation is located at codon 608 (G608G). This mutation responsible for creating a cryptic splice site within exon 11, which deletes a proteolytic cleavage site within the expressed mutant lamin A. In Progeria, gene mutation results in the deletion of a Zmpste24/FACE1 splice site in prelamin A, preventing end terminal cleavage. The result of this point mutation can be observed by the main clinical and radiological features include alopecia, thin skin hypoplasia of nails, loss of subcutaneous fat, and osteolysis. The common symptoms of HGPS is a loss of eyebrows and eyelashes which can observed in early childhood and due to receding hairline and blading can also observed. Generally, this patient has facial character include microganthia (small jaw), craniofacial disproportion, prominent eyes, scalp veins and alopecia (loss of hair), restricted joint mobility and severe premature atherosclerosis. Laboratory findings are unremarkable, with the exception of an increased urinary excretion of hyaluronic acid. There is presently no effective therapy is available for Hutchinson-Gilford progeria syndrome (HGPS) but, it is essential to monitor carefully cardiovascular and cerebrovascular disease So, Treatment usually includes low dose aspirin which helps prevent the atherothrombotic events, stroke and heart attacks by hindering platelet aggregatio

(SI10-062) Comprehensive Study on Methodology of Orthogonal Interleavers

Interleaving permutes the data bits by employing a user defined sequence to reduce burst error which at times exceeds the minimum hamming distance. It serves as the sole medium to distinguish user data in the overlapping channel and is the heart of Interleave Division Multiple Access (IDMA) scheme. Versatility of interleavers relies on various design parameters such as orthogonality, correlation, latency and performance parameters like bit error rate (BER), memory occupancy and computation complexity. In this paper, a comprehensive study of interleaving phenomenon and discussion on numerous interleavers is presented. Also, the BER performance of interleavers using IDMA scheme is displayed