Profile Study of Negative Autopsy among the Post Mortem Cases Referred from Medical Officers to Forensic Medicine Department, Ahmedabad, India

Background: The principal aim of an autopsy is to determine the cause of death, and the state of health of the person before he or she died. But in several instances even after detailed autopsy and various laboratory investigations, autopsy surgeon/ Forensic medicine expert cannot determine the cause of death and they end up with negative autopsy. The present study was carried out to find out the types of cases where we were unable to determine cause of death after autopsy at forensic medicine department, B J medical college, civil hospital, Ahmedabad, India.Methods: A total of 251 dead bodies were referred by Medical officers to forensic medicine department, B J medical college, Ahmedabad for expert post mortem examination from 1st January 2011 to 31st December 2015.Results: After thorough and complete post mortem examination, it was found that in 43(17.13%) cases no opinion as to the cause or nature of death could be given. Most common types of cases include decomposition (53.50%), and skeletal remains (23.25%).Conclusion: According to above mentioned facts it is clear that chances of getting cause of death is very poor if time lapse more and more after death like in decomposition and skeletal remains

Community-engaged strategies to promote hepatitis B testing and linkage to care in immigrants of Florida

AbstractTo improve early identification and linkage to treatment and preventive services for hepatitis B virus (HBV) in persons born in countries with intermediate or high (>2%) HBV prevalence, the University of Florida Center for HIV/AIDS Research, Education, and Services (UF CARES) employed community-engaged strategies to implement the Hepatitis B Awareness and Service Linkage (HBASL) program. In this brief report, we present a summary of program components, challenges, and successes. Faith and community-based networks were established to improve HBV testing and screening and to increase foreign born nationals (FBNs) access to HBV care. A total of 1516 FBNs were tested and screened for hepatitis B. The majority were females (50.4%), Asians (62.8%), non-Hispanic (87.2%), and they also received post-test counseling (54.8%). Noted program advantages included the development of community networks and outreach to a large population of FBNs. The major challenges were institutional delays, pressures related to meeting program deliverables, and diversity within FBNs populations. Community health workers in the United States can replicate this program in their respective communities and ensure success by maintaining a strong community presence, establishing partnerships and linkage processes, developing a sustainability plan, and ensuring the presence of dedicated program staff

Is there a post-PPH syndrome?

BACKGROUND: Despite early studies reporting significant decreases in postoperative pain and morbidity with the procedure for prolapse and hemorrhoids (PPH) compared to traditional hemorrhoidectomy, certain complications and long-term efficacy remain uncertain. This study was performed to assess the prevalence of usage of PPH and the observed postoperative complaints and complications. METHODS: A questionnaire was mailed to national and international members of the American Society of Colon and Rectal Surgeons (ASCRS) and the accumulated data were reviewed. RESULTS: The rate of response to the 2,642 questionnaires was 28.5% (n=754). Of the 754 respondents, 531 (70.4%) had performed PPH and 451 (84.9%) continued to perform PPH. The most commonly reported postoperative complaint was delayed postoperative pain. Pain lasting for months was reported by 15.1% of respondents. Persistent bleeding was reported by 34.5%, and 40.9% felt there is a post-PPH syndrome. CONCLUSIONS: Some long-term studies critically examining PPH have come to fruition. A majority of respondents continued to perform PPH. Nearly half of these agreed that there is a post-PPH syndrome relating to postoperative morbidities. The most disturbing morbidity was lasting perineal pain of unexplained etiology demanding challenging management. Persistent bleeding from hemorrhoidal disease distal to the staple line requires further management and raises the question as to the use of PPH as a permanent remedial procedure

Development of an Attribution of Racial/Ethnic Health Disparities Scale

The purpose of this study was to develop an Attribution of Racial/Ethnic Health Disparities (AREHD) scale. A convenience sample of undergraduate college students (n = 423) at four Midwestern universities was recruited to respond to the survey. A pilot test with undergraduate students (n = 23) found the survey had good acceptability and readability level (SMOG = 11th grade). Using exploratory factor analysis we found the two a priori subscales were confirmed: individual responsibility and social determinants. Internal reliabilities of the subscales were: individual responsibility (alpha = 0.87) and social determinants (alpha = 0.90). Test–retest stability reliabilities were: individual responsibility (r = 0.72) and social determinants (r = 0.69). The AREHD subscales are satisfactory for assessing college student’s AREHD

Migraine and vascular disease biomarkers: A population-based case-control study.

Background The underpinnings of the migraine-stroke association remain uncertain, but endothelial activation is a potential mechanism. We evaluated the association of migraine and vascular disease biomarkers in a community-based population. Methods Participants (300 women, 117 men) were recruited as a part of the Dutch CAMERA 1 (Cerebral Abnormalities in Migraine, an Epidemiologic Risk Analysis) study. Participants were aged 30-60 (mean 48) years, 155 migraine had with aura (MA), 128 migraine without aura (MO), and 134 were controls with no severe headaches. Plasma concentrations of fibrinogen, Factor II, D-dimer, high sensitivity C-reactive protein (hs-CRP), and von Willebrand factor antigen were compared between groups, also stratifying by sex. Results Fibrinogen and hs-CRP were elevated in migraineurs compared to controls. In logistic regression analyses, MO and MA had increased likelihood of elevated fibrinogen, and MA had increased likelihood of elevated Factor II and hs-CRP. Fibrinogen and Factor II were associated with MA in women but not men. In the migraine subgroup, the total number of years of aura, but not headache, predicted elevated hs-CRP, and the average number of aura, but not headache, attacks predicted all biomarkers but Factor II. Conclusions Elevated vascular biomarkers were associated with migraine, particularly MA, as well as with years of aura and number of aura attacks

Ileorectal anastomosis for ulcerative and Crohn\u27s colitis.

Except in the presence of severe perineal suppuration or sphincter damage by previous surgery for fistulas, the rectum was preserved in all patients considered candidates for surgery for inflammatory disease of the bowel. A primary anastomosis with a single-layer 5-0 monofilament stainless steel wire was carried out when a relatively healthy rectum with erythema and granularity presented. For patients with more severe disease of the rectum, a two-stage operation with intensive interval treatment of the rectum stump with topical corticosteroids was carried out. Of a total of eighty-six patients with involvement of the colon and rectum with either Crohn\u27s disease or chronic ulcerative colitis, fifty-six patients were treated by local abdominal colectomy and ileorectal anastomosis. Twenty-four had primary anastomosis and thiry-two had a two-stage operation. One anastomotic dehiscence developed. A mean follow-up of 8.4 years (6 months to 20 years) has been satisfactory. Only three anastomoses have been taken down for unsatisfactory results. With the proper selection of patients and with appropriate treatment of the diseased rectal segment, a large majority of patients with inflammatory disease of the bowel can have long-term salutory results after colectomy and ileorectal anastomosis