Clinico-haematological profile of adult pancytopenia patients at a tertiary care institute in South India

Background: Pancytopenia is not a disease by itself; rather it describes simultaneous presence of anemia, leukopenia and thrombocytopenia resulting from a number of disease processes. Varieties of hematological and non-hematological disorders may affect bone marrow either primarily or secondarily, resulting in the manifestation of pancytopenia. The incidence of various hematological disorders causing pancytopenia varies due to geographical distribution and genetic predisposition. This study highlights the spectrum of causes, clinical presentation and bone marrow morphology of pancytopenia.Methods: This prospective observational study was conducted for a period of two years at Al-Ameen Medical College, Bijapur, Bangalore. During this period, fifty patients with a hematological diagnosis of pancytopenia were studied during period in the department of pathology.Results: Among the 50 cases studied, 35 were males and 15 were females. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was predominant blood picture. Bone marrow study showed 72% hypercellular marrow, 12% normocellular and 16% hypocellular marrow. The commonest cause for pancytopenia was megaloblastic anemia followed by iron deficiency anaemia and malaria.Conclusions: The present study concludes that detailed hematological investigations along with bone marrow examination in pancytopenic patients is helpful to diagnose or rule out the causes of pancytopenia.

Changing the HRM Vision into Reality the Role of Manager’s Skills for Implementing Change Within the Organization: A Chinese Study

The global corporate competitive survival behavior has changed dramatically over the past few years, the change process which has forced organization’s to engage in frequent changes large and small. The palpable truth, that changes are the additional burden on the manager’s shoulders. The assumption is that not all managers have the capability to carry the burden successfully to attain the targets. The Coffee Chain is one of the identifiable hospitality industry has high sensitivity to the external environmental changes. To survive in the competitive environment, coffee chains must have a vision to react quickly to the changing business models. To be successful in the industry, there are winning techniques proposed in the competency of people management. This study investigated the skill set of the managers to the competency in people management while implementing change in the organization. The questionnaire was constructed, tested and managed to a total of 447 individuals in the coffee chain organizations in China. Total 447 usable surveys were analyzed using Microsoft excel and Chi-Square analysis to test the study hypotheses. The result showed that managers motivating, communication, trust, empowerment and delegating skills for implementing change have a positive and significant impact on the employee's in the coffee organizations in China. This study suggests the value of interpersonal skills in successfully implementing change, specifically the abilities to motivate, communicate, and create supportive environments for teams. Managers who possess and demonstrate these skills are perceived as more effective in driving change.

FINANCIAL REWARDS CLIMATE AND ITS IMPACT ON EMPLOYEE ATTITUDES TOWARDS JOB SATISFACTION IN THE RETAIL ORGANIZATIONS

Job satisfaction is an attitudinal variable that reflects how people feel about their jobs overall. All aspects of the particular job, good or bad, Positive or negative, are likely to contribute to the development of feelings of satisfaction or dissatisfaction. The endeavor of this research was to find out whether financial rewards have an influence on the attitudes and feeling of employees. A questionnaire was constructed, analyzed and managed a total of 172 employees in the retail organization. Thus 172 usable surveys were analyzed the attitudes of employees on different aspects of their job. Findings showed that financial rewards caused positive job satisfaction of employees and boosted their commitment and increase the output of the organization. However, a high level of employee dissatisfaction was recorded in employee compensation and the amount of work they perform and the amount of responsibilities they accept. The result of this study highlights the role of job satisfaction of employees' and responsibilities of organizations in the promotion of good quality practices of HRM in retail business, and offers a substitute alleyway for employees' satisfaction and performance

Measuring the health-related Sustainable Development Goals in 188 countries : a baseline analysis from the Global Burden of Disease Study 2015

Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59.3 (95% uncertainty interval 56.8-61.8) and varied widely by country, ranging from 85.5 (84.2-86.5) in Iceland to 20.4 (15.4-24.9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r(2) = 0.88) and the MDG index (r(2) = 0.2), whereas the non-MDG index had a weaker relation with SDI (r(2) = 0.79). Between 2000 and 2015, the health-related SDG index improved by a median of 7.9 (IQR 5.0-10.4), and gains on the MDG index (a median change of 10.0 [6.7-13.1]) exceeded that of the non-MDG index (a median change of 5.5 [2.1-8.9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs.Peer reviewe

Burden of hospitalized childhood community-acquired pneumonia: A retrospective cross-sectional study in Vietnam, Malaysia, Indonesia and the Republic of Korea

Background: Few studies describe the community-acquired pneumonia (CAP) burden in children in Asia. We estimated the proportion of all CAP hospitalizations in children from nine hospitals across the Republic of Korea (high-income), Indonesia, Malaysia (middle-income), and Vietnam (low/middle-income). Methods: Over a one or two-year period, children <5 years hospitalized with CAP were identified using ICD-10 discharge codes. Cases were matched to standardized definitions of suspected (S-CAP), confirmed (C-CAP), or bacterial CAP (B-CAP) used in a pneumococcal conjugate vaccine efficacy study (COMPAS). Median total direct medical costs of CAP-related hospitalizations were calculated. Results: Vietnam (three centers): 7591 CAP episodes were identified with 4.3% (95% confidence interval 4.2;4.4) S-CAP, 3.3% (3.2;3.4) C-CAP and 1.4% (1.3;1.4) B-CAP episodes of all-cause hospitalization in children aged <5 years. The B-CAP case fatality rate (CFR) was 1.3%. Malaysia (two centers): 1027 CAP episodes were identified with 2.7% (2.6;2.9); 2.6% (2.4;2.8); 0.04% (0.04;0.1) due to S-CAP, C-CAP, and B-CAP, respectively. One child with B-CAP died. Indonesia (one center): 960 CAP episodes identified with 18.0% (17.0;19.1); 16.8% (15.8;17.9); 0.3% (0.2;0.4) due to S-CAP, C-CAP, and B-CAP, respectively. The B-CAP CFR was 20%. Korea (three centers): 3151 CAP episodes were identified with 21.1% (20.4;21.7); 11.8% (11.2;12.3); 2.4% (2.1;2.7) due to S-CAP, C-CAP, and B-CAP, respectively. There were no deaths. Costs: CAP-related hospitalization costs were highest for B-CAP episodes: 145.00 (Vietnam) to 1013.3 USD (Korea) per episode. Conclusion: CAP hospitalization causes an important health and cost burden in all four countries studied (NMRR-12-50-10793)

Effects of Ivacaft or in Patients with Cystic Fibrosis Who Carry the G551D mutation and have severe lung disease

BACKGROUND: The development of ivacaftor represents a significant advance in therapeutics for patients with cystic fibrosis (CF) who carry the G551D mutation. Patients with an FEV1 &lt; 40% predicted represent a considerable proportion of eligible patients but were excluded from phase 3 clinical trials, and the effectiveness of the drug in this population is, therefore, unknown.METHODS: Data were collected from adult CF centers in the United Kingdom and Ireland with patients enrolled in an ivacaftor compassionate use program (FEV1 &lt; 40% or on lung transplant waiting list). Clinically recorded data were collated from patient records for 1 year prior and for a period of 90 to 270 days following ivacaftor commencement. Each patient was matched to two control subjects who would have met the requirements for the compassionate use program with the exception of genotype.RESULTS: Twenty-one patients received ivacaftor for a median of 237 days. Mean FEV1 improved from 26.5% to 30.7% predicted (P = .01), representing a 16.7% relative improvement. Median weight improved from 49.8 to 51.6 kg (P = .006). Median inpatient IV antibiotic days declined from 23 to 0 d/y (P = .001) and median total IV treatment days decreased from 74 to 38 d/y (P = .002) following ivacaftor. Changes in pulmonary function and IV antibiotic requirements were significant compared with control subjects.CONCLUSIONS: Ivacaftor was clinically effective in patients with CF who carry the G551D mutation and have severe pulmonary disease. The reductions in treatment requirements were clinically and statistically significant and have not been described in less severe populations.</p