Efficacy of intracuff dexamethasone in reducing the incidence of post-operative sore throat: an original article

Background: Postoperative sore throat is the most common and most distressing complaint of patients after general anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff dexamethasone in reducing the incidence of this distressing postoperative symptom.Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal saline respectively. The cuff was prefilled with dexamethasone or normal saline  one hour prior to intubation to allow time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs after surgery.Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients (8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of hoarseness of voice between the two groups.Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence of hoarseness of voice

Tectaria polymorpha (Wall. ex Hook.) Copel. (Tectariaceae), a new distributional record for Kerala

Tectaria polymorpha (Wall. ex Hook.) Copel., is a rare species belongs to the family Tectariaceae. In southern India, so far it has been reported from Karnataka and Tamil Nadu States only. We report the occurrence of this species in Kerala State from Shendurney Wildlife Sanctuary, a part of Agasthyamala Biosphere Reserve. Taxonomic treatment with detailed description, specimens examined, ecology, distribution, note, key to the species of Kerala and photographs are provided here for its easy identification

Difference in the effect of Swadhyay due to differing cultural environments: a study of college age youth in Gujurat, India and Texas, United States

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references (leaves 91-94).This thesis is primarily concerned with the effect of a grassroots spiritual movement on the lives of youth in India and the United States. Swadhyay is a movement that began in India in the 1940s under the leadership of Shri Pandurang Shastri Athavale. The Swadhyay philosophy includes beliefs based in the Vedic tradition. Swadhyay also makes use of unconventional methods of devotion in the form of prayogs or experiments. In addition to explaining the main beliefs of Swadhyay, this thesis also discusses the youth group portion of Swadhyay, Divine Brain Trust (DBT). My research consists of two sections: field work and scholarly research. I traveled to India for three months in the summer of 2003 to interview and observe with college-age youth. Once I returned to the United States, I complemented my Indian research with the same types of activities and interviews with Swadhyayee college youth in the United States over the fall and winter of 2003. The compiled data was then analyzed for differences in the youth's perceptions of Swadhyay as well as the nature of the background environments for the two samples. In addition to the fieldwork, I have also consulted literature research on both Swadhyay and the experiences of second generation South Asian youth in America at large. The latter research was done to place my specific findings into larger context. My analysis showed that there is a difference in the way Swadhyay is perceived by the young Swadhyayees in the two countries. Their background environments (including personal and family information) were also found to be different based on the data I collected. This confirms an association between the two factors, but does not imply a causal relationship. The comparison of the experiences of the American respondents and second generation South Asians at large shows many common features, including religion as a factor in identity and assimilation

INCIDENCE OF MINOR AILMENTS OF PUERPERIUM AND RELATED KNOWLEDGE AMONG POSTNATAL MOTHERS.

Objective: The objective of the study was to identify the incidence and knowledge of minor ailments of puerperium among postnatal mothers and to develop an information leaflet on the management of minor ailments of puerperium.Methods: A quantitative approach with descriptive design and convenience sampling technique was used in this study. With these methods, the researcher selected 100 postnatal mothers attending Obstetrics and Gynecology ward, AIMS, Kochi. A semi-structured questionnaire along with a checklist was used to assess the knowledge and the incidence of minor ailments among postnatal mothers.Result: The result showed that the common incidence of minor ailments was afterpain (67%), perineal discomfort (50%), constipation (43%), and fatigue (67%). Majority of the postnatal mothers had average knowledge (65%) level, and some of them had good knowledge (21%), and some of them had poor knowledge (14%).Conclusion: The study revealed that the main four problems of minor ailments of puerperium were afterpain, perineal discomfort, constipation, and fatigue. Number of studies from different part of the world, including India, shows that a large proportion of postnatal mother experiences minor ailments of puerperium. This provides evidence for giving importance to minor ailments of puerperium. Researchers also provided a baseline information leaflet on the management of minor ailments of puerperium

Knowledge and practices regarding pharmacoeconomics among resident doctors in a tertiary care teaching hospital

Background: With skyrocketing health care costs, even the essential care provided by the health care service providers need to be evaluated under the lens. The development of nationwide awareness of cost-benefit, cost-utility and cost-effectiveness of services is the need of the hour. The objectives of the present study were to assess the knowledge about pharmacoeconomics among resident doctors and to assess the clinical application of pharmacoeconomics among them.Methods: A cross sectional questionnaire-based survey was conducted among resident doctors involving both interns and post-graduates of a teaching medical college. There were 20 questions; initial ten were for knowledge assessment and next ten questions assessed practical applications. Questions assessed the knowledge regarding components of pharmacoeconomics, direct and indirect medical costs, and application of pharmacoeconomics, local cost-effectiveness decisions and advantages of pharmacoeconomics.Results: Of the 118 participants who took part in the study, 42 were clinicians working in medical college hospital, 12 were clinicians working in dental college hospital, 24 medial postgraduates, 30 dental postgraduates and 10 interns. Nearly 90% of the respondents opine that concepts of pharmacoeconomics are not followed in every teaching hospital in India. Many participants (90%) opined that health economics and pharmacoeconomic are different. Nearly 94% of participants have not under gone any training regarding pharmacoeconomics. More than 95% respondents have opined that principles of pharmacoeconomics has to be introduced into current medial undergraduate curriculum.Conclusions: This study shows light on the knowledge and practices of resident doctors regarding principles of pharmacoeconomics. This study has revealed the level of awareness of younger generation regarding pharmacoeconomics

Relationship of rheumatoid factor positivity to prevalence of joint manifestations in type 2 diabetes which are unrelated to rheumatoid arthritis

Background: The present study was designed to investigate the relationship of rheumatoid factor positivity to the prevalence of joint manifestations in type 2 diabetes which are not attributable to rheumatoid arthritis.Methods: We evaluated 192 type 2 diabetes patients with rheumatological complications and age and sex matched non-diabetic controls for rheumatoid factor (RF) positivity. Diabetic patients with frozen shoulder, LJM syndrome, carpal tunnel syndrome, trigger finger, DISH and Dupuytren’s contracture were evaluated for RF positivity.  Results: RF was positive in 47 patients (24.4%) when compared to controls (4.2%). RF positivity was associated with an increased prevalence of joint manifestations in diabetic group when compared to controls. RF positivity was not related to the duration of diabetes nor was it related to long term glycemic control.Conclusion: RF positivity resulted in an increased prevalence of joint manifestations in diabetes, which were unrelated to rheumatoid arthritis

Association of obesity with physical activity, television viewing, video /computer gaming among school children in Mangalore

Introduction:&nbsp;There is an increasing prevalence of obesity worldwide in children which can be attributed to changes in lifestyle such as sedentary habits, television (TV) viewing, playing computer games, and consumption of snacks while watching television. The present study was done to find the association between obesity and TV viewing, computer game playing, sedentary lifestyle in children and also with a secondary objective to assess the association between blood pressure and TV/computer game viewing, sedentary lifestyle in children. Materials and methods:&nbsp;A cross sectional study was conducted at 4 high schools and Pre University Colleges (PUC’S) in and around Mangalore during the study period of 4 days from 6 -12 august 2014. 509 students were enrolled. Information was gathered by asking the subjects to fill up a structured questionnaire. Nutritional status was assessed based on Body mass index (BMI) and waist-hip ratio, waist-height ratio for all subjects. Blood pressure was measured for all the subjects. Results:&nbsp;It was found that among males 2.7% of students were obese and in females it was 2.3%. There was a significant association between blood pressure and consumption of snacks while watching TV and also between blood pressure and their habit of consumption / buying of snacks/ fast-food advertised in TV. A significant association was found between central obesity (Waist-hip ratio and Waist-height ratio) and the number of hours of physical activity per week in schools. Conclusion:&nbsp;There is a need to develop preventive intervention like reducing snack consumption while watching TV and increasing the time dedicated to physical activity

Genetic identification and phylogenetic relationships of Indian clariids based on mitochondrial COI sequences

Mitochondrial cytochrome C Oxidase I (COI) sequence variation among the clariid fishes of India (Clarias magur, C. dussumieri and C. gariepinus) and their relationship with other representative clariids was studied in this work. Three species were sampled and together with 23 COI sequences from GenBank were used to reconstruct phylogenetic relationships in the family Clariidae. The study revealed two clades: one consisting of the African species with C. dussumieri, and the other of Asian species suggesting the prevalence of intra-continental diversification of catfishes. This study further revealed that the genus Clarias is monophyletic. For the COI gene, the interspecies genetic divergence ranged from 0.056 to 0.182. The mean genetic difference between C. dussumieri and other selected African species in this study is 12.1%. It was also observed that the morphological similarity of C. dussumieri and C. magur was not replicated in the genetic level. Clarias dussumieri was more close to African catfish C. gariepinus thus indicating the utility of COI phylogeny to identify the well-known African-Asian relationships within catfishes. The results also showed that C. magur and C. batrachus are genetically distinct from each other

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes