Chronic obstructive pulmonary disease patients and steroids: benefit or harm

Background: Corticosteroids are being widely used in conditions related to allergy and inflammation. There are great species differences in the responses to glucocorticoids that mean a “steroid resistant” species. Steroids have profound effect on inflammatory response by way of vasoconstriction, decreased chemotaxis and interference with macrophages. There still are enormous gaps in our knowledge of the action of glucocorticosteroids in patients of chronic obstructive lung disease (COPD).Methods: This study was done in the department of general medicine at SKIMS, Srinagar from December 2017 to December 2018 on patients of chronic obstructive pulmonary disease. A total number of 100 patients were enrolled for the study but 20 patients, 10 from each group lost their follow up. To see the effect of steroids on pulmonary function tests, patients were divided into case and control group. Patients in case group were given prednisolone 30 mg orally for two week (tapering dose). Patients in control group were given placebo for the same duration of two weeks. Steroid response was defined as 15% improvement in baseline forced expiratory volume (FEV).Results: Steroid response was defined as 15% increase in forced expiratory volume in one second/forced vital capacity (FEV1/FVC) after receiving tapering dose of prednisone 30 mg for 2 weeks, no patients in case group showed increase in FEV1/FVC of 15%. The change in pulmonary function tests was comparable in each group (p>0.5).Conclusions: The change in pulmonary function tests were comparable in each group (p>0.5). So, steroids in stable patients of COPD are best to be avoided

Effect of initial system-environment correlations with spin environments

Understanding the dynamics of open quantum systems is a highly important task for the implementation of emerging quantum technologies. To make the problem tractable theoretically, it is common to neglect initial system-environment correlations. However, this assumption is questionable in situations where the system is interacting strongly with the environment. In particular, the system state preparation can then influence the dynamics of the system via the system-environment correlations. To gain insight into the effect of these correlations, we solve an exactly solvable model of a quantum spin interacting with a spin environment both with and without initial correlations for arbitrary system-environment coupling strengths. We show that the effect of the system state preparation may or may not be significant in the strong system-environment coupling regime at low temperatures. We also study the dynamics of the entanglement between two spins interacting with a common spin environment with and without initial system-environment correlations to demonstrate that the correlations can play a significant role in the dynamics of two-qubit systems as well.Comment: 11 pages, comments most welcom

Assessment of causality and severity of various reported adverse drug reactions by different classes of anti-cancer drugs

Background: Chemotherapy involves highly complex regimens and hence accounts to high susceptibility towards Adverse Drug Reactions. All antineoplastic drugs have potential to cause one or more Adverse Drug Reactions which may vary from mild to severe form. So the aim of this study was to determine the prevalence of Adverse Drug Reactions in patients treated with chemotherapy.Methods: After getting approval from the Institutional Ethical Committee, the prospective observational study was conducted in the Department of Pharmacology in association with Department of Radiation Oncology and Department of Medicine, Government Medical College, Srinagar between April 2015 to October 2016. All patients of either sex and any age receiving anti-cancer drugs in the inpatient department of radiation oncology were included. The mean age of the study population was 51 years and 53.9% of them were males and 46.1% of them were females. The WHO-UMC system was used for assessment of case programme and case reports. The severity of adverse drug reactions was determined by using modified Hart wig and Siegel scale.Results: Most of the reported ADR’s were moderate to mild in severity according to modified Hart wig and Siegel scale. Most of the frequent ADR’s were certain followed by probable and possible according to WHO-UMC causality assessment.Conclusions: Antineoplastic drugs have a narrow therapeutic index and the dosage needed to achieve a therapeutic response usually proves toxic to the body’s rapidly proliferating cells. Measures need to be put into place to reduce the physical, emotional and economic burden on the patient due to adverse drug reactions. Therefore, there is a need for vigilant ADR monitoring to decrease morbidity and mortality due to ADR’s which require further studies on large populations

Incremental cost-effectiveness and tolerability of Diclofenac + Proton pump inhibitor compared to tramadol in the treatment of knee osteoarthritis

Background: In a climate of economic uncertainty, cost effectiveness analysis is a potentially important tool for making choices about health care interventions. Patients with knee osteoarthritis are treated mostly with Diclofenac (NSAID) + Proton Pump Inhibitors (PPI) and Tramadol (Opioids) in everyday practice.Aim: Present study was aimed to assess clinical effectiveness, adverse events and cost-effectiveness between Diclofenac + PPI and Tramadol.Methods: Authors conducted prospective randomised control open label study on 40 patients at Orthopedic OPD of tertiary care hospital. Patients were given either Tramadol controlled releases tablets (200mg CR OD) or Diclofenac sustained release tablets (100mg SR OD) + PPI (Omeprazole 20mg OD) for two weeks. Clinical effectiveness was assessed by KOOS osteoarthritis index score consisting of five parameters and visual analogue scale. Suspected ADRs were recorded and incremental cost effective ratio for both drugs was calculated.Results: After application of KOOS questionnaire Authors found net quality gain in symptoms was 24.45 in diclofenac +PPI group which was much higher against 14.15 found in tramadol group. Again ADR profile of tramadol was 29 with nausea and somnolence topping the list which was far more than only 10 in DIC +PPI group. Lastly cost-effective analysis was done where again DIC+PPI showed average cost effective ratio 5.73 verses tramadol 11.8 with an incremental cost-effectiveness ratio (ICER) of -2.72.Conclusions: Diclofenac +PPI is as effective as tramadol in the treatment of pain due to knee osteoarthritis with the potential for feAuthorsr side effects. Diclofenac + PPI was also found to be cost-effective when compared with tramado

Crisis management process for project-based organizations

Purpose: The purpose of this paper is to study the crisis management process for project-based organizations (PBOs) by developing a comprehensive model and propositions. Design/methodology/approach: This paper is based on a conceptual study. A literature review is considered a primary source for studying contemporary research, including 171 publications in total, which embody qualitative, quantitative, conceptual and theoretical studies. For data analysis, content analysis is used, which is comprised of descriptive and thematic analysis. Findings: This study identifies five imperative elements of crisis management for PBOs which include (1) sense-making (information gathering and crisis interpretation), (2) decision-making (accurate and timely decision), (3) response (reactive response), (4) outcome (success/failure) and (5) learning. Based on these findings, this study proposes an integrative model of the interplay between sense-making, decision-making, response, outcome and learning. Furthermore, the findings lead to propositions for each of the elements. The paper contributes to the literature on dynamic capability theory. Originality/value: This paper explores the crisis management process for PBOs. The proposed model deepens the understanding of the practices and processes of project-based crisis management.Peer reviewe

The Combined Effect of Safety Specific Transformational Leadership and Safety Consciousness on Psychological Well-Being of Healthcare Workers

Occupational health researchers have begun to realize that the psychological well-being of healthcare workers who are providing treatment against COVID-19 is deteriorating. However, there is minimal research conducted on it, particularly in the context of leadership. The current study aims to fill this important gap by identifying critical factors that can enhance the psychological well-being of healthcare workers. We proposed that safety specific transformational leadership enhances psychological well-being among healthcare workers, and COVID-19 perceived risk mediates this relationship. Furthermore, the safety conscientiousness of healthcare workers was proposed to be a boundary condition that enhances the negative relationship between safety-specific transformational leadership and COVID-19 perceived risk. Data were collected from healthcare workers (N = 232) treating COVID-19 patients in the hospitals of Pakistan through well-established adopted questionnaires. The discriminant and convergent validity of the data was tested through confirmatory factor analysis by using AMOS statistical package. The mediation and moderation hypotheses were tested by using PROCESS Macro by Hayes. The results showed that safety specific transformational leadership enhances psychological well-being among healthcare workers, and COVID-19 perceived risk mediates this relationship. Moderation results also confirmed that safety conscientiousness moderates the relationship between safety specific transformational leadership and COVID-19 perceived risk. This study offers implications for both researchers and practitioners

Jeopardies of Aversive Leadership: A Conservation of Resources Theory Approach

The research on the dark side of leadership is still in its infancy. We have contributed to this line of research by proposing that work alienation acts as an underlying mechanism through which aversive leadership results in reduced job performance. We further propose that psychological capital (PsyCap) acts as an important personal resource that reduces the negative effects of aversive leadership in the form of work alienation. The proposed model gets its support from the conversation of resources theory given by Hobfoll (1989) which suggests that stressful situation like an aversive leadership results in the loss of employee resources as a result of that he/she indulges in work alienation and shows poor job performance to retain back the lost resources. People with better personal resources in the form of PsyCap are better able to cope-up with the aversive leader behavior and make them able to avoid work alienation. It is a time-lagged study. The data for the current study was collected from 321 employees working in the service sector organizations, particularly universities, banks and telecom organizations, through personally administered questionnaires. The results supported the mediation and moderation hypothesis. Limitations and future research along with theoretical and practical implications are given at the end

Response surface optimization of gamma radiation-induced variation in functional quality of Nelumbo nucifera rhizome flour at various particle sizes

The cumulative effect of particle size (PS), gamma radiation dose (GRD), and suspension period (SP) on the functional quality of N. nucifera rhizome flour was optimized. A tri-factorial central composite design was constructed at five levels of each of PS, GRD, and SP. The N. nucifera rhizome flour at the selected particle sizes (50, 100, 150, 200, and 250 μm) was subjected to gamma irradiation at the selected levels of GRD (5, 10, 15, 20, and 25 kGy) followed by the analysis of its functional properties at different levels of SP (6, 12, 18, 24, and 30 h). The response-surface analysis showed a statistically significant linear positive effect of PS on the water absorption capacity (WAC) and swelling capacity (SC) and a linear negative effect on protein solubility index (PSI) ( p=0.000-0.028). The GRD showed a significant linear positive effect on oil absorption capacity (OAC) and PSI while a linear negative effect on WAC and SC (p=0.000-0.008). The PS and GRD showed significant quadratic negative effects on WAC, OAC, and SC. However, the SP showed no significant linear effect on the studied functional properties of the flou