Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study

Introduction: The objective of the study was to present our last 5-years experience of peritonitis and validate POSSUM score in predicting mortality and morbidity in patients of enteric perforation (EP) peritonitis. Methods: Data was collected prospectively for all peritonitis cases admitted in single surgical unit from January 2005 to December 2009. Parameters for calculating POSSUM were also retrieved; in these patients, O:E (Observed vs. Expected) ratio of mortality and morbidity were estimated after calculating predicted mortality and morbidity by exponential regression equations. Results: 887 patients with peritonitis were admitted and treated in this unit during the 5 years of study period. Duodenal (n=431; 48%) followed by ileal (n=380; 42.8%) perforations were the commonest. Mean age of the patients was 34 years and 86% were males. Mean delay in presentation was 78.5 hrs. Mean duration of hospital and ICU stay was 13 and 7.2 days. Postoperative complications were seen in 481 (54%) patients, and 90 (10%) patients died. POSSUM scores and predicted mortality/morbidity were calculated in 380 patients of ileal perforation peritonitis; O:E ratio of mortality and morbidity were 0.47 and 0.85 in these patients. Conclusion: POSSUM and P-POSSUM are accurate tools for predicting morbidity and mortality respectively in EP patients. Though they may sometime over or under predict morbidity as well as mortality.Key words: Enteric perforation, Peritonitis, POSSUM , P-POSSU

Hemorrhagic stroke—Pathomechanisms of injury and therapeutic options

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151916/1/cns13225_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151916/2/cns13225.pd

ASSESSMENT OF MAGNESIUM (MG) AND ZINC (ZN) IN CARCINOMA BREAST PATIENTS

Objectives: The objectives of the study were to determine and compare serum magnesium (Mg) and zinc (Zn) concentrations between breast carcinoma patients and healthy controls. Methods: Determination and comparison of serum Mg and Zn was done between 50 breast carcinoma patients and 50 healthy controls. Determination and comparison of LFT in between 50 breast cancer patient during different course of chemotherapy. Trace element analysis was done using atomic absorption spectrophotometry. Statistical comparison was done, results were expressed as Mean±SD, p<0.05 was considered to be statistically significant. Results: All groups were statistically matched in age, sex, and p>0.05. Serum Mg concentrations in cases and controls (0.9920±0.38 mg/dL) and (1.49±0.58 mg/dL) respectively, p≤0.0001* serum Zn concentrations in cases and controls were (66.74±12.58 μg/dL) and (90.88±14.51 μg/dL), respectively, p≤0.0001*. Conclusion: Both serum (Zn) and (Mg) showed significant decreases in breast carcinoma patients as compare to healthy controls

Efficacy of vijaysar, aloevera alone and their combination in the treatment of newly diagnosed cases of type 2 diabetes mellitus: a randomized single blind prospective study

Background: Diabetes mellitus is a disease was known since ancient time and all system of medicine over world were tried to cure this disease. Unfortunately the numbers of diabetes patients are increasing day by day due to many risk factors such as sedentary life, obesity etc.Methods: A total of 120 patients with newly diagnosed type 2 diabetes mellitus attending OPD of UPUMS, Saifai, Etawah, Uttar Pradesh, India, were included in the study. Patients were divided into 4 groups. Group-1, 2, 3 and 4 received Aloevera, Vijaysar, Aloevera + Vijaysar and Glimepiride respectively for thirteen weeks. Sample for fasting blood sugar and postprandial blood sugar were measured at baseline, 1st, 2nd, 3rd, 5th, 8th and at 13th week. HbA1c and Lipid profile were measured at baseline and at thirteen week.Results: Significant decrease in FPG, 2hPG, and HbA1c level were achieved in all groups but effects was maximum in Glimepiride group. Vijaysar had shown better glucose control than Aloevera as well as Aloevera + Vijaysar group. Synergism was shown by both herbal drugs for FPG control but not for 2hPG. The Effect of Vijaysar alone on 2hPG was similar to Glimepiride.Conclusions: Vijaysar could be a promising herbal drug for the treatment of mild uncomplicated cases of type-2 diabetes mellitus; however both drugs have shown synergism for FPG control. Both herbal drugs were safe during our study, only one patient of Vijaysar group had complaint of diarrhoea, which was subsided one week later

Copper thiocyanate (CuSCN): an efficient solution-processable hole transporting layer in organic solar cells

Here, we report copper(I) thiocyanate (CuSCN) as an efficient and solution-processable hole transport layer (HTL) in bulk heterojunction solar cells. Three different combinations of the most studied active layers of P3HT:PC61BM, PCDTBT:PC71BM and PTB7:PC71BM were used for photovoltaic device fabrication with the simplest device structure of ITO/CuSCN/active layer/Al. The use of CuSCN as an HTL has improved light absorption within the active layer and thereby leads to up to 5.94% and 4.60% power conversion efficiencies (PCEs) for the active layers of PCDTBT:PC71BM and PTB7:PC71BM, respectively. These results are slightly better when compared to the devices fabricated using thermal deposition of MoO3 and solution processed deposition of PEDOT: PSS as an HTL under similar conditions. We have observed that the annealing temperature for HTLs in organic solar cells has a significant effect on the PCE, specifically the fill factor (FF) and short-circuit current (J(sc)). In the present work, the resulting HTLs were characterized using UV-vis-NIR spectroscopy, scanning electron microscopy (SEM), atomic force microscopy (AFM) and transmission electron microscopy (TEM) for better understanding. Finally, we have provided a further example of solution-processable CuSCN as an efficient HTL in organic solar cells, in general

Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage

Aneurysmal subarachnoid hemorrhage (aSAH) continues to be associated with significant morbidity and mortality despite advances in care and aneurysm treatment strategies. Cerebral vasospasm continues to be a major source of clinical worsening in patients. We intended to review the clinical and experimental aspects of aSAH and identify strategies that are being evaluated for the treatment of vasospasm. A literature review on aSAH and cerebral vasospasm was performed. Available treatments for aSAH continue to expand as research continues to identify new therapeutic targets. Oral nimodipine is the primary medication used in practice given its neuroprotective properties. Transluminal balloon angioplasty is widely utilized in patients with symptomatic vasospasm and ischemia. Prophylactic “triple‐H” therapy, clazosentan, and intraarterial papaverine have fallen out of practice. Trials have not shown strong evidence supporting magnesium or statins. Other calcium channel blockers, milrinone, tirilazad, fasudil, cilostazol, albumin, eicosapentaenoic acid, erythropoietin, corticosteroids, minocycline, deferoxamine, intrathecal thrombolytics, need to be further investigated. Many of the current experimental drugs may have significant roles in the treatment algorithm, and further clinical trials are needed. There is growing evidence supporting that early brain injury in aSAH may lead to significant morbidity and mortality, and this needs to be explored further.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151874/1/cns13222_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151874/2/cns13222.pd

An observational study to compare adenosine deaminase level among diabetes patients

Background: Obesity is a complex disorder that involves some degree of over-consumption1 coupled with a metabolic derangement. As ADA has been putatively associated with inflammation, and adipose tissue inflammation is the hallmark of insulin resistance in obese T2DM patients. This study attempted to compare serum ADA in T2DM subjects.Methods: This observational cross-sectional study was conducted in the Department of Biochemistry at MGM Medical College and MY Hospital. All the patients and controls were clinically examined, and routine biochemical tests were analyzed for all subjects. ANOVA has been applied to assess the variance between groups.Results: Mean age of controls was 56.91 years where as mean age in the group of a subject with Obesity with diabetes was 40.91 years and with Obesity without diabetes was 48.10 years. ADA level was more among diabetes patients having obesity than diabetes patients having no obesity and controls.Conclusions: This is very much evident through this study that ADA may be treated as prognostic predictor of diabetes either linked to obesity or not, though more studies are warranted in same direction to make this finding conclusive and acceptable biochemical evidence

Assessment of burn-out among staff nurses working in a tertiary care health centre in North India

Background: This descriptive, cross sectional study identified the occurrence of burnout and some associated factors among nurses working in various departments at Indira Gandhi Medical College, Shimla, Himachal Pradesh, India which is a tertiary care health centre in the state.Methods: A total of 257 nurses screened in the hospital out of which 81 completed the study. Eighty-one nurses answered a self-administered questionnaire (sociodemographic aspects, working conditions, and Maslach Burnout Inventory). Mean scores were compared using ANOVA test. Student T-test was applied to compare mean scores between the groups.Results: All the participants were females (100%), with up to five years’ experience. High levels of emotional stress (45.7%) and depersonalization (24.7%) were identified, as well as low professional fulfilment (6.2%), and 8.6% presented burnout. The following factors were associated: high levels of emotional stress and always perform tasks very quickly (p=0.04) and receiving a salary incompatible to the effort employed (p=0.03); high levels of depersonalization and with up to five years’ experience (p=0.02) and often perform tasks very quickly (p=0.008). For 19.0%, at least two of the three dimensions pointed to high propensity to the syndrome.Conclusions: Searching for personal solutions for work problems must draw our attention, since it discourages health and work performance. Professionals may feel more fulfilled and satisfied by adjusting their work expectations. However, on a long-term basis, persisting in stressful work conditions enhances emotional exhaustion, depersonalization and feelings of low fulfilment at work

Dosimetric measurements of Onyx embolization material for stereotactic radiosurgery

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135017/1/mp7918.pd