Risk factors for anti tuberculous drugs induced hepatitis: a prospective survey from a chest clinic in a general hospital

A prospective survey on 14 consecutive cases with tuberculous drug induced hepatitis was done at our chest clinic in a state general hospital over a period of 15 months. There were 30 controls chosen randomly from the chest clinic register. The cases had lower mean body mass index (P<0.008), serum albumin (P<0.005) and higher serum globulin (P<0.04). Serum liver transaminases and total bilirubin rose significantly during the acute episode of drug induced hepatitis. Among the risk factors studied, only chronic hepatitis B carrier status was found to be more prevalent among the cases. There was one death (7.1%) over the whole study period

Metabolic changes during ramadan fasting in normal people and diabetic patients

Fasting is obligatory on all Muslims every year during the 9th Islamic lunar month of Ramadan with exemption to sick, travelers and pregnant women. In spite of the fact that Islam provides exemption from fasting to people suffering from illnesses like diabetes, many patients still want to fast for personal convictions. Physicians often face a dilemma as to how to advise them. Several studies have been published on the effects of fasting; some of the results are controversial. The present study was undertaken to establish the effects of Ramadan fasting on various physiological parameters in normal people and in diabetic patients. This could be used as basis for advice to such patients. The study group consisted of 53 diabetic patients (31 male and 22 female) and 56 (21 male 35 female) healthy volunteers as controls. Inclusion criteria of diabetic patients were: to be non-insulin dependent, and be stable and under reasonable control on oral hypoglycemic drugs and or diet control alone. The subjects were evaluated 1-2 weeks before commencement of fasting (visit 1), at the 4th week of Ramadan fasting (visit2) and one month after the end of the Ramadan fast (visit3). Blood samples were collected on each occasion at least 8 hours after the last meal. Our results showed statistically significant weight reduction (P<.001) at the end of Ramadan fast in both groups, however it was not maintained in both groups when values were compared before Ramadan and one month after Ramadan. Fasting blood sugar and HBA1C showed significant reduction (P<.001) among diabetics but not in control group. The other parameters e.g. cholesterol, blood urea and creatinine did not show any significant changes before and during Ramadan. There was statistically significant increase in serum cholesterol and triglyceride and uric acid (P<.001) among healthy volunteers (control group) one month after Ramadan compared to before Ramadan; however no such changes were seen among diabetic group. There was no reported case of serious complication due to fasting in both groups. Conclusion: Ramadan fasting lead to significant body weight reduction and improvement of glycaemic control in diabetic patients with out other significant metabolic changes

A Beneficial Resemblance of the Origin of Hindu Law : Religious Observation

This paper aims to improve our understanding about the prevalence and determinants of Hindu law in both historical and comparative perspectives with an introductory reflections on the nature and role of law in society the inter relationship between religion and their sources in general further issues covered include the triple origins of Hindu law in priestly codes Dharmaas religious law and the controversy over religion and secularism in the courts today Attention is given to definition of the category Hindu attempts to legislate the universal structure of Hindu Scriptures as It is especially pertinent for students interested in comparative legal theory of Hindu law the inter sections of law religion and religious practices and the role of law in determining or reforming the social orde

Emotional and spiritual quotient for sustainable education’s service quality

A sustainable ecosystem of universities needs to show outstanding performance in the areas of employability, institutional social responsibility, and creative and performing arts. Thus, this study determined the influential role of emotional quotient (EQ) and spiritual quotient (SQ) on the lecturers’ excellence service quality (ESQ), which eventually led to effective classroom teaching. The data of 127 respondents were analyzed using the structural equation model with partial least square. The results confirmed that both types of quotients positively influence the lecturers’ teaching progression at the university. EQ and SQ have the encouraging power to motivate the academicians for the best service to the university through a quality learning experience. It can be concise that institutions that practice EQ and SQ values can perform better and blend a harmonious working spirit and tandem with the university’s growth. Support for sustainable development goal (SDG-4) via EQ and SQ is now required in humanizing education to ensure academicians’ competency and well-being, particularly in the aftermath of the Corona Virus Disease-19 disruption. Policymakers in the university should now capitalize the intelligence through professional initiatives. This study could have been better with a bigger sample size, but the investigation had limited access due to the university's policy on privacy

Review of Kawasaki Disease

Abstract Background: Kawasaki disease is one of the leading causes of acquired heart disease in children. It is an acute self-limited vasculitis that predominantly affects infants and children younger than 5 years of age. These patients present with nonspecific symptoms, such as fever and lymphadenopathy, making the diagnosis challenging. This disease can have serious and potentially fatal outcomes, and prompt recognition of this disease is vital to the patient’s outcome. We present a complete review of the disease, including the epidemiology, pathophysiology, diagnosis and management of acute Kawasaki disease, the natural history of this disease, and follow up of these patients as they transition into the adult cardiology practice. Methods: Our systematic review information were collected from articles retrieved from PubMed library. Keywords that were used included; Kawasaki disease, coronary artery disease, coronary artery aneurysm, pediatric coronary artery disease, epidemiology of Kawasaki disease and treatment of Kawasaki disease. We included only relevant to the topic articles. No exclusion criteria were applied. Conclusions: Kawasaki disease incidence tends to be increasing over the last decade in the united states. Seasonality of the disease has been described in Japan. It is a mysterious disease with unknown etiology, however, multiple hypotheses have been proposed and tested to explain the pathophysiology. As this disease has an associated high morbidity and mortality, prompt recognition and management of this disease is important to the patient’s overall prognosis and survival

Compliance to national guidelines on the management of chronic obstructive pulmonary disease in Malaysia: a single experience

Introduction: Malaysia has a high rate of smoking prevalence and the figure is increasing. Although there has been many local and regional studies on the prevalence and symptomatology of chronic obstructive pulmonary disease patients, data is lacking on the degree of compliance to national management guidelines in the treatment of chronic obstructive pulmonary disease. Methods: 86 patients who attended the respiratory outpatient clinic of the Hospital Universiti Kebangsaan Malaysia were enrolled into a prospective, observational study. Results: 88 percent of the patients were male and the majority was ethnically Chinese (65 percent). The majority of patients were in the moderate to very severe categories, with a mean FEV1 of 0.97 +/− 0.56 L/sec and predicted mean FEV1 percentage of 43.1 +/− 21.3 percent. 58 percent of the patients were on long-acting beta-agonist, 65 percent were on inhaled steroids, and only 16 percent were on scheduled pulmonary rehabilitation. Conclusion: The low uptake rate for long-acting beta-agonist and pulmonary rehabilitation could be attributed to several factors. Financial cost, the need for strict compliance to a structured rehabilitation regime, lack of significant social support and clear up-to-date guidelines are possible reasons

Hospitalised patients' awareness of their rights: a cross-sectional survey from a tertiary care hospital on the east coast of Peninsular Malaysia

INTRODUCTION: Optimal patient care varies considerably from place to place and is influenced by scientific as well as social developments. The purpose of this study was to investigate awareness and pertinent issues regarding informed consent among hospitalised patients and to determine lapses, in order to improve the standard of care. METHODS: A questionnaire-based cross-sectional survey was conducted among inpatients at a tertiary care level hospital. RESULTS: 90 percent of patients were aware of their rights, and 85 percent had enough information regarding their illness and modality of treatment. However, treatment options were discussed with 45 percent of cases only, and 65 percent of patients were informed of their duration of treatment. Most of the patients from the surgical group, haemodialysis unit and those with minor ailments were very satisfied with the doctors (92 percent, 86 percent and 96 percent, respectively), as opposed to only 36 percent of cancer patients and 70 percent of acquired immunodeficiency syndrome (AIDS) patients (p-value is less than 0.0001). Almost all patients (99 percent) said that their religious beliefs were respected by the staff and they had no problems in accessing them in times of need. Informed consent was obtained by the doctor in 98 percent of cases and by the nurse in two percent. 98 percent of the patients mentioned that their treatments/examinations were conducted in an atmosphere of privacy and that their personal information was kept confidential by their doctors. CONCLUSION: Patients were reasonably informed about their illness. Their privacy and religious beliefs were duly respected. Treatment options and the duration of treatment were not discussed with all patients. Cancer and AIDS patients were less satisfied with the attending staff. The results suggest that there is a need for periodic surveys of patient satisfaction with the quality of care

QUALITATIVE ASSESSMENT OF RENAL BLOOD PRESSURE USING NANOTECHNOLOGY INTERVENTION

The renal system is one of the major organ systems present in the human body, it is responsible for maintaining electrolyte balance, secreting important hormones, and maintaining homeostasis in the body. Every individual has 2 kidneys which are located behind the peritoneum at the level of L2-L3 from the vertebral column. Broadly kidneys function to filter blood, purify it, and eliminate toxic waste. We propose a diagnostic test that evaluates the renal blood flow rate in the kidneys and assesses their functioning based on their hemodynamics in the given time frame. Here we aim to explore the application of nanoparticles to assess localized blood pressure in the kidney based on the illumination intensity/radioactivity. Connexin40(Cx40) is a transmembrane protein present in juxtaglomerular apparatus, Cx40 gold antibodies prepared can be conjugated with nanoparticles and introduced in renal circulation. Imaging technologies such as fluorescence/computed tomography can be used to detect these nanoparticles. Once injected they can be assessed and information on renal blood flow can be obtained. The intensity generated on screening can be used for the assessment of renal blood pressure. This information will be valuable for the assessment of kidney function

Attitudes towards euthanasia and physician-assisted suicide among physicians and patients in a multi-cultural society of Malaysia

Due to globalization and changes in the health care delivery system, there has been a gradual change in the attitude of the medical community as well as the lay public towards greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come acros situations where such issues are raised with increasing frequency. As euthanasia has gained worldwide prominence, we aim to explore the beliefs and attitude of our patients and physicians towards it and related issues