Association of major depression with blood pressure and vascular complications of type 2 diabetes mellitus

Background: The WHO estimates the diabetic population to increase to 366 million by 2030 worldwide, with maximum 79.4 million Indians. Depression is an undiagnosed co-morbidity leading to significant disability, non-compliance and postulated to cause poorer glycemic control leading to early disease complications. We aimed to detect depression and study its correlation with vascular complications among type 2 diabetes mellitus (T2DM) patients.Methods: In an observational study, 312 randomly selected T2DM patients were evaluated at tertiary care center in Northern India. Socio-demographic, clinical and laboratory data was collected. Montgomery Asberg depression rating scale (MADRS) was used to detect depression. Groups with and without major depression were compared for various diabetes variables. Statistical analysis was carried out using the SPSS version 14.0.Results: One third T2DM patients (32.05%) suffered from major depression. Depression was significantly associated with diabetic patients having cardiac (p 0.01), ophthalmic (p 0.04), nephropathy (p 0.01), cerebrovascular (p 0.001) complications and diabetic foot (p 0.04). However, depression showed no significant association with systolic blood pressure, neuropathic and infectious complications.Conclusions: Identification of depression and its appropriate management may go a long way in delaying diabetic vascular complications by improving treatment adherence and subsequently glycemic control.

Dengue: multicentre clinical profile of patients admitted in intensive care unit

Background: Dengue with 2.5 billion people at risk and 50 million new cases every year is one of the most rapidly spreading vectors borne disease in world. We aimed to analyse the clinical profile of dengue patients requiring ICU admission.Methods: In a cross-sectional, observational, multicenter case study 105randomly selected laboratory positive dengue subjects were randomly selected from four tertiary care centers ICU’s. Socio-demographical, clinical, therapeutic & laboratory parameters were evaluated. Statistical analysis was done using SPSS version 14.0.Results: The main cause of ICU admission was shock or hypotension due to sepsis (20%). Most patients presenting complaint was fever (93.33%), bodyache (84.76%) and retro-orbital pain (34.3%). Most prevalent warning sign indicating severe dengue was abdominal pain (37.4%). Mucosal bleed (20.9%) was the most common haemorrhagic manifestation. 37.14% with warning signs and 62.86% patients with severe dengue required ICU care.Conclusions: A rapid assessment of clinical profile, presenting symptoms and warning signs can aid in early decision for requirement of ICU admission & may go a long way in decreasing mortality

IMPROVEMENT OF OPERATIONAL EFFICIENCY OF EQUIPMENT THROUGH TPM: A CASE STUDY

ABSTRACT The productivity improvement of workforce, under Indian conditions, is a far cry. Therefore, the left out area is that of equipment and that can be significantly improved through Total Productive Maintenance (TPM). The various researchers have established that TPM is an important tool to improve equipment efficiency and achieving the organizational goals. This approach is to contribute on quality as well cost fronts. TPM is essentially a tool of Lean manufacturing where in the waste need to be identified for elimination. The present study pertains to spot welding workstation which clearly reveals the inherent problems associated with the process function. The various types of wastes on this workstation are bad design of tooling, long changeover time, unplanned machine breakdowns, and machine conditions. Therefore, elimination of these wastes is necessary to improve the equipment operating efficiency (OEE). TPM methodology has been assessed on the spot welding workstation for improvement in present level of 61 % to 68% in first stage, 68% to 75% in second stage and up to or above 85% in the third stage

A Study of Perception of Breast Feeding in Pregnant Females in Bharatpur Region

Background: The breast milk feeding should be started 30 minutes after the delivery and continued exclusively for the first six months. The best food for the newborn is the breast milk. It’s the most essential diet which is much needed for the newborn’s growth and survival. Its exclusive feeding is mandatory for the first 6 months and should be continued till 2 years of life with other diet after weaning. According to studies it was seen that child was around 10 times more at risk of death in the first month of life when compared to the child which was exclusively breast fed. This study puts in an effort to find the perception of breast-feeding pregnant females in Bharatpur region. Aims and Objectives: To study the perception of breast-feeding pregnant females in Bharatpur region. Methods: This study is a cross sectional study and a standard validated questionnaire was given to the subjects. The questionnaire was given in the local language and each and every question was read out and discussed with the subject so that she understands the question and answers exactly. Results: The perception of the pregnant mothers are very poor in this region. Conclusion: The perception can increase with proper education in our country. The poor socio-economic people should be targeted and properly educated

Association of major depression with blood pressure and vascular complications of type 2 diabetes mellitus

Background: The WHO estimates the diabetic population to increase to 366 million by 2030 worldwide, with maximum 79.4 million Indians. Depression is an undiagnosed co-morbidity leading to significant disability, non-compliance and postulated to cause poorer glycemic control leading to early disease complications. We aimed to detect depression and study its correlation with vascular complications among type 2 diabetes mellitus (T2DM) patients. Methods: In an observational study, 312 randomly selected T2DM patients were evaluated at tertiary care center in Northern India. Socio-demographic, clinical and laboratory data was collected. Montgomery Asberg depression rating scale (MADRS) was used to detect depression. Groups with and without major depression were compared for various diabetes variables. Statistical analysis was carried out using the SPSS version 14.0. Results: One third T2DM patients (32.05%) suffered from major depression. Depression was significantly associated with diabetic patients having cardiac (p 0.01), ophthalmic (p 0.04), nephropathy (p 0.01), cerebrovascular (p 0.001) complications and diabetic foot (p 0.04). However, depression showed no significant association with systolic blood pressure, neuropathic and infectious complications. Conclusions: Identification of depression and its appropriate management may go a long way in delaying diabetic vascular complications by improving treatment adherence and subsequently glycemic control. [Int J Res Med Sci 2016; 4(3.000): 926-930

Neurobehavioral management of behavioral anomalies in frontal lobe syndrome

Neurobehavioral approach uses behavioral paradigm towards comprehensive rehabilitation by identifying the neurological or neuropsychological constraints that can interfere with learning and behavior of an individual. The present case study highlights the role of functional skills approach in neurobehavioral management towards cognitive rehabilitation to manage behavioral deficits in a 55-year-old man with nicotine dependence having frontal lobe lesions owing to gliosis of fronto-temporal brain regions. Based on detailed neuropsychological and behavioral assessment, a behavioral package was made involving techniques like behavioral counseling, chaining, shaping and operant methods and was carried out with the patient daily (with the help of primary caregiver) over a period of 2 months. Results showed improvement in his self-care and decrease in behavioral problems, on 12-month follow-up

Dengue: multicentre clinical profile of patients admitted in intensive care unit

Background: Dengue with 2.5 billion people at risk and 50 million new cases every year is one of the most rapidly spreading vectors borne disease in world. We aimed to analyse the clinical profile of dengue patients requiring ICU admission.Methods: In a cross-sectional, observational, multicenter case study 105randomly selected laboratory positive dengue subjects were randomly selected from four tertiary care centers ICU’s. Socio-demographical, clinical, therapeutic & laboratory parameters were evaluated. Statistical analysis was done using SPSS version 14.0.Results: The main cause of ICU admission was shock or hypotension due to sepsis (20%). Most patients presenting complaint was fever (93.33%), bodyache (84.76%) and retro-orbital pain (34.3%). Most prevalent warning sign indicating severe dengue was abdominal pain (37.4%). Mucosal bleed (20.9%) was the most common haemorrhagic manifestation. 37.14% with warning signs and 62.86% patients with severe dengue required ICU care.Conclusions: A rapid assessment of clinical profile, presenting symptoms and warning signs can aid in early decision for requirement of ICU admission & may go a long way in decreasing mortality

Staphylococcal Protein A with Engineered Cysteine: Comparison of Monomeric Content as a Critical Quality Attribute during Intracellular and Extracellular Expression

Background: The introduction of engineered cysteine in staphylococcal protein A (SPA-cys) for site-specific conjugation results in a substantial amount of dimerized SPA due to spontaneous oxidation during its production, leading to inaccessibility and thus rendering it unusable. Monomers are usually recovered from dimers by using reducing agents before conjugation in subsequent steps. However, this leads to low conjugation efficiency and increases overall cost and production time. This study aims to systematically compare and quantify the monomeric and dimeric content of SPA when produced through intracellular and extracellular routes in E. coli. Methods: Purified SPAs with and without cysteine from both intracellular and extracellular processes are compared for their monomeric content and efficiency to conjugate on solid support matrix with and without an additional pre-step of reduction. Results: The monomeric form of SPA-cys, which is a desired key quality attribute, is less than 50% when produced extracellularly. SPA-cys produced through the intracellular production process has high monomeric content (≥85%) and shows higher binding to solid support. Conclusion: The study demonstrates that the intracellular route for production of SPA-cys should be the preferred method, and the release assays for SPA-cys products should include the amount of monomeric content as one of the quality attributes. The abundance of monomeric content enhances the site-specific conjugation efficiency and density of SPA on the resin matrix