Drug utilization pattern and analysis of quality of life in Indian patients of Parkinson’s disease

Background: Parkinson's disease (PD) is a highly debilitating disease characterized by tremors, bradykinesia and rigidity. It leads to lowered self-esteem and psychological consequences which affect quality of life. The aim of this study is to study the drug utilization pattern and assess the quality of life in patients of Parkinson’s Disease.Methods: 40 patients of PD at least 1 month duration and 20 age-based controls were analyzed for quality of life using Parkinson’s Disease Questionnaire-39 (PDQ-39). Drug prescriptions were analyzed.Results: Mean number of anti-Parkinson drugs prescribed is 2.65±1.21. Of 106 anti-Parkinson drugs prescribed, 45% were levodopa and carbidopa combinations, followed by dopamine agonists (18%), anticholinergic drugs (15%), amantadine (12%), MAO inhibitors (5%) and COMT inhibitors (5%). There were significant problems in speech, performance of daily chores and daytime somnolence (p<0.0001). Depression, isolation, cognitive decline and memory loss were noteworthy in the patients as compared to controls (p<0.05). 25% patients felt embarrassed due to their disease; 59% felt affected by others’ opinion, 60% felt difficulty in communicating with others (p<0.05). Almost 2/3rd patients needed help in personal care as compared to the control group (p<0.0001).Conclusions: Quality of life of parkinsonian patients is severely affected in spite of them receiving a large number of drugs. This may be both due to disease progression as well as medication. Levodopa-carbidopa combination is the most prescribed medication. Use of levodopa and carbidopa combination must be evaluated properly. Newer guidelines and interventions are the need of the hour which may provide a better outcome on the quality of life of parkinsonian patients

Child Drawing: A Projective Tool for Dental Anxiety Assessment

INTRODUCTION: Assessment of child’s anxiety is important in order to determine the success of dental treatment. Drawing, a nonverbal, self-report, projective and non-invasive technique may prove be helpful and needs to be explored in order to access anxiety in children requiring dental treatment.AIM: To investigate the applicability of children’s drawings as an indicator to measure their level of anxiety.MATERIALS &amp; METHOD: A cross-sectional study was conducted in a total of hundred children between age group of 4-6 years. Children were asked to draw dental operatory on A4 sheet and colour it with basic set of 12 colours. The drawing was scored using Child Drawing: Hospital (projective scale) scale and the results were compared with pulse oximeter readings (physiological parameter) and Venham Picture Test scorings.RESULTS: Child Drawing: Hospital scale scoring had a positive correlation with pulse oximeter reading (involuntary) (p-value = 0.125) and a negative correlation with Venham picture test (p-value = 0.140).CONCLUSION: Drawing may be statistically significant projective tool significant to assess child anxiety in dental setting

Topographic Distribution of Carious Lesion on Young Permanent Mandibular Molars and Its Relation to Periapical Index Score of Apical Periodontitis: A Radiographic Analysis

INTRODUCTION: Caries in young permanent teeth progress rapidly resulting in early pulp involvement which further progresses into loss of mineralized tissue and severe periapical pathologies. The Periapical Index scoring system (PAI) proposed by Ørstavik et al. in 1986 is an invaluable diagnostic tool used to evaluate periapical lesion extent and severity by 2D digital intraoral periapical radiographic analysis with minimal radiation exposure and hence treatment planning.AIM: To evaluate the relationship of the surface distribution of caries in young permanent molars, pulpal involvement and periapical index (PAI) score with respect to individual root forming young permanent mandibular molars. MATERIALS AND METHOD: In this retrospective single-centre study, 100 pulpally involved carious young permanent mandibular molars were included, selected from the departmental records between August 2018-2019. Topographic distribution of caries and radiographic analysis (using PAI) was evaluated to see the effect of anatomical site of caries, individual anatomical form of root, and extent &amp; severity of apical periodontitis developed.RESULT: No significant correlation between the site of caries involvement and PAI score was observed. PAI score for distal roots was higher(PAI&gt; 2) as compared to mesial root for pulpally involved carious young permanent first molars (p-value mesial root-0.576 , distal root-0.591)CONCLUSION: PAI score is independent of the topographic distribution of caries and no correlation was observed. Periapical radiolucency does not depend on caries distribution, either it is mesial, distal or occlusal

To assess the role fiberoptic bronchoscopy in the evaluation of hemoptysis

Background: To prospectively evaluate the efficiency of the fiberoptic bronchoscopy (FOB) examination in the evaluation of patients with hemoptysis.Methods: We prospectively reviewed 50 patients who underwent FOB for hemoptysis. There were 39 male and 11 female. The mean age was 46 years with a range from 21 to 83 years. The patients were divided between two groups on the basis of their chest roentograms (46% with normal and 54% with abnormal findings).Results: Hemoptysis  in normal  and abnormal chest roentograms was  respectively attributed  to bronchiectasis in         5 (21.7%) and 3 (11.1%) cases, bronchogenic carcinoma in 2 (8.6%)  and 9 (33.3%) cases, bronchitis in 2 (8.6%) and 3 (11.1%) cases, tuberculosis in 2 (8.6%)  and 5 (18.5%) cases, cryptogenic causes in 8 (34.7%)  and 4 (14.8%) cases and pseudohemoptysis  in 2 (8.6%) cases (bleeding from upper respiratory tract).  Conclusions: Fob plays a pivotal role in the evaluation of hemoptysis. It was found that left upper lobe followed by right upper lobe was the site most consistent with the findings, with bronchogenic carcinoma being the most common non- infectious cause. Infectious etiology was the most common pathology behind hemoptysis and bronchiectasis was the most important risk factor

Caries Pattern In Primary Molars With Early Pulpal Involvement In Mixed Dentition

INTRODUCTION: Caries in primary dentition may lead to high risk in permanent dentition; it is therefore important to identify those children who are caries affected. Specific and distinct patterns of caries attack might indicate a distinct etiology or are most likely associated with the subsequent development of carious lesions on other surfaces of teeth.AIM: To assess caries susceptibility and prevalence in primary teeth and evaluate the prevalence of caries according to individual molar surfaces in 4-8 year old children.MATERIAL AND METHODS: A cross sectional retrospective study was conducted in the pediatric department of SGT Dental College using convenient sampling with caries in teeth as chief complaint. 70 radiographs were examined in the age group of 4-8 years. Lesions present on mesial, distal and occlusal surfaces were recorded on the chart after radiographic examination.RESULTS: As per results, distal surface of D(45.40%) and mesial surface of E (37.80%) showed maximum caries on adjacent proximal surfaces and significant dependence (p value&lt;0.05) was found between the presence of lesions on adjacent proximal surfaces. The D(76.1% )and E(79.1% )showed significantly higher caries experience on the proximal surfaces in conjunction with occlusal caries but were statistically not significant.CONCLUSION: In the presence of non-proximal caries (occlusal caries), the chances of proximal caries are increased as seen radiographically. Thus need for treatment, are likely being underestimated during visual examinations alone

Electronic structure of Pr2MnNiO6 from x-ray photoemission, absorption and density functional theory

The electronic structure of double perovskite Pr2MnNiO6 is studied using core x-ray photoelectron spectroscopy and x-ray absorption spectroscopy. The 2p x-ray absorption spectra show that Mn and Ni are in 2+ and 4+ states respectively. Using charge transfer multiplet analysis of Ni and Mn 2p XPS spectra, we find charge transfer energies {\Delta} of 3.5 and 2.5 eV for Ni and Mn respectively. The ground state of Ni2+ and Mn4+ reveal a higher d electron count of 8.21 and 3.38 respectively as compared to the atomic values of 8.00 and 3.00 respectively thereby indicating the covalent nature of the system. The O 1s edge absorption spectra reveal a band gap of 0.9 eV which is comparable to the value obtained from first principle calculations for U-J >= 2 eV. The density of states clearly reveal a strong p-d type charge transfer character of the system, with band gap proportional to average charge transfer energy of Ni2+ and Mn4+ ions.Comment: 18 pages, 9 figure

COVID-19 vaccination up-take in three districts of Nepal

Vaccine hesitancy during the COVID-19 pandemic continues to be an issue in terms of global efforts to decrease transmission rates. Despite high demand for the vaccines in Nepal, the country still contends with challenges related to vaccine accessibility, equitable vaccine distribution, and vaccine hesitancy. Study objectives were to identify: 1) up-take and intention for use of COVID-19 vaccines, 2) factors associated with vaccine up-take, and 3) trusted communication strategies about COVID-19 and the vaccines. A quantitative survey was implemented in August and September 2021 through an initiative at the Nepali Ministry of Health and Population Department of Health Services, Family Welfare Division. Data were collected from 865 respondents in three provinces (Bagmati, Lumbini, and Province 1). Ordinal multivariate logistic regression was utilized to determine relationships between vaccination status and associated factors. Overall, 62% (537) respondents were fully vaccinated and 18% (159) were partially vaccinated. Those respondents with higher education (p \u3c .001) and higher household income (p \u3c .001) were more likely vaccinated. There were also significant differences in vaccine up-take across the three provinces (p \u3c .001). Respondents who were vaccinated were significantly more likely to perceive vaccines as efficacious in terms of preventing COVID-19 (p = .004) and preventing serious outcomes (p = .010). Among both vaccinated and unvaccinated individuals, there was a high level of trust in information about COVID-19 vaccines provided through local health-care workers [e.g. nurses and physicians]. These results are consistent with other findings within the South Asia region. Targeted advocacy and outreach efforts are needed to support ongoing COVID-19 vaccination campaigns throughout Nepal