Prevalence of childhood asthma and its immediate outcome - At tertiary care rural hospital

Introduction: Asthma is a chronic inflammatory disorder of the airways resulting in episodic airway obstruction. Globally, childhood asthma is increasing in the prevalence, despite improvements in investigation and treatment. Childhood asthma seemed more prevalent in urban population and now even in rural areas of India. Objectives: To know the prevalence, assess the risk factors, severity, and immediate outcome of the treatment offered to asthmatic children in a tertiary rural hospital. Materials and Methods: All the diagnosed asthmatic children up to 18 years were enrolled in the study. All the patients of pulmonary Koch’s, congenital heart disease and chronic lung disease were excluded from the study. Clinical profile was noted in recruited patients. Results: The prevalence of childhood asthma among children visiting to our department was 3.93%. 58 (48.33%) had age of onset before the age of 6 years. Asthma was more prevalent in boys. 116 (96.66%) children presented with complain of cough, and 118 (98.33%) children had associated breathlessness. Common precipitating factors were change in season (71.66%), pollen allergy (58.33%), air pollutieon (45.00%), and passive smoking (23.33%). Exercise-induced asthma was seen in 55% cases, diurnal variation in 60% and 28.33% children had family history of atopic disease. Majority of the patient was undernourished. The average duration of stay in persistent asthma is 1.8 times more than in intermittent asthma. Conclusion: Significant number of patient becomes symptomatic before the 6 years of age. Prevention of child from exposure to passive smoking, environmental improvement, and allergen avoidance are major aspects for prevention of asthma exacerbations

Exploring two SDGs – Gender Equality and Reduced Inequalities in supportive organization

Title : Exploring two SDGs – Gender Equality and Reduced Inequalities in supportive organization. Level               : Final assignment for Master Degree in Business Administration Authors          : Raheel Mehmood Saqib, Maitrey Yogeshbhai Patel Supervisor : Agneta Sundström Examine: Jens Eklinder Frick Date                : 2020 – January Aim: The aim of our study is to explore, discuss and highlight operational ambiguities if any within the organization with respect to two goals – Gender Equality and Reduced Inequalities – of sustainable development with the support of this research work. Method: Research method has been used to conduct this study is explorative qualitative research. The data has been collected through interviews and questionnaire which was analyzed qualitatively. Result & Conclusions: All organizations under study were working towards gender equality and reduced inequalities goals. Organizational factors are more important in achieving these two goals. However, we also found some minor irregularities in policies, recruitment process and in employees’ compensation. Suggestions for future research: For future research one can take and analyze the same topic with quantitative method with more respondents and more data which requires more time.  Another research study comparing different organizations with the perspective of gender equality and reducing inequalities or with other SDGs can be possible. Contribution of the thesis: This research paper contributes to the existing literature by pointing out the flaws and weaknesses in the operations of the supportive organizations whose job is to assist other companies. This paper also gives the suggestions in order to tackle issues arising in compliance with two SDG goals i.e. Gender Equality & other Inequalities

Guillain - Barre syndrome in a patient with acute myocardial infarction with ventricular septal defect repair treated with plasma exchange

Guillain - Barre syndrome (GBS) is an acute, frequently severe progressive illness of peripheral nervous system that is autoimmune in nature. GBS after myocardial infarction (MI) with ventricular septal defect (VSD) is uncommon with high mortality rate if not treated promptly. [1] We report a successful outcome of GBS post MI with VSD in a 60-year-old male patient who was on a ventilator treated successfully with therapeutic plasma exchange

Partial phenotyping in voluntary blood donors of Gujarat State

Introduction: Partial phenotyping of voluntary blood donors has vital role in transfusion practice, population genetic study and in resolving legal issues.The Rh blood group is one of the most complex and highly immunogenic blood group known in humans. The Kell system, discovered in 1946, is the third most potent system at triggering hemolytic transfusion reactions and consists of 25 highly immunogenic antigens. Knowledge of Rh & Kell phenotypes in given population is relevant for better planning and management of blood bank; the main goal is to find compatible blood for patients needing multiple blood transfusions. The aim of this study was to evaluate the frequency of Rh & Kell phenotype of voluntary donors in Gujarat state. Materials and Methods: The present study was conducted by taking 5670 samples from random voluntary blood donors coming in blood donation camp. Written consent was taken for donor phenotyping. The antigen typing of donors was performed by Qwalys-3(manufacturer: Diagast) by using electromagnetic technology on Duolys plates. Results: Out of 5670 donors, the most common Rh antigen observed in the study population was e (99.07%) followed by D (95.40%), C (88.77%), c (55.89%) and E (17.88%). The frequency of the Kell antigen (K) was 1.78 %. Discussion: The antigen frequencies among blood donors from Gujarat were compared with those published for other Indian populations. The frequency of D antigen in our study (95.4%) and north Indian donors (93.6) was significantly higher than in the Caucasians (85%) and lower than in the Chinese (99%). The frequencies of C, c and E antigens were dissimilar to other ethnic groups while the ′e′ antigen was present in high frequency in our study as also in the other ethnic groups. Kell antigen (K) was found in only 101 (1.78 %) donors out of 5670. Frequency of Kell antigen in Caucasian and Black populations is 9% & 2% respectively. The most common Kell phenotype was K-k+, not just in Indians (96.5%) but also in Caucasians (91%), Blacks (98%) and Chinese (100%). Conclusion: Phenotype and probable genotype showed wide range of variations in different races and religion. Reliable population based frequency data of Rh & Kell antigens has vital role in population genetic study, in resolving medico legal issues and in transfusion practice

Therapeutic plasma exchange in pediatric patients of Guillain-Barre syndrome: Experience from a Tertiary Care Centre

Background and Objective: Therapeutic Plasma Exchange (TPE) is performed effectively and safely in adult patients, but the use of TPE is limited in paediatric patients due to lack of universally accepted indications and technical challenges like establishment of adequate vascular access, low blood volume, increased incidence of adverse events during procedure and poor co-operation of patients during procedure. We present our experience of TPE in paediatric patients to assess the effectiveness and safety of TPE in paediatric patients. Materials and Methods: A total 122 TPE procedures were performed in 40 paediatric patients between 3 to 15 years of age group with Guillain Barre Syndrome (GBS). TPE procedures were performed on alternate days depending on the clinical condition of the patient. Patient′s total blood volume was calculated as per Nadler′s formula and processed through central double lumen catheter. 1-1.5 plasma volume was exchanged with normal saline and fresh frozen plasma. Results: A total of 122 TPE procedures (with an average of three procedures per patient) were performed on 40 paediatric patients. More than three TPE procedures were performed in 29 patients, of which 27 patients showed improvement from grade-0 and grade-I to grade-III. One did not show any response and succumbed to the disease. Complications were observed in 14 patients which were well managed. Inadequate vascular access was most common complication observed in 11 patients. Conclusion: TPE in paediatric patients has been increasing and has been shown to be effective as first line or adjunctive therapy in selected diseases. It is safe procedure when volume shifts, calcium supplementation and venous access are taken care

Linear Endoscopic Ultrasound Examination of the Biliary System and Its Clinical Applications

Endoscopic ultrasound (EUS) examination of the biliary system plays pivotal role in pancreatobiliary studies. EUS offers a safe and noninvasive method of the biliary tract disorder evaluation. Although radial EUS provides a straightforward orientation, practicing biliary system examination with a curvilinear echoendoscope is advisable because of its added therapeutic benefits. Linear EUS may pose challenge in understanding the orientation and tracing nondilated bile duct in the beginning. However, adopting a systematic station-wise approach can help in comprehending the orientation and effectively tracing the entire bile duct. In this review, we have discussed linear EUS examination of the bile duct and gallbladder from various stations and its clinical applications