Analysing the Factors Involved In Risk Management in a Business

This article explains the risk factors involved in a business. In each type of business, there are certain risk factors for the implementation of anything in the business. The type of risks involved can depend upon many factors. It also depends on the type of business an organisation is doing. But it is very important that the risk analyst does all the analysis of the risks that might arise in future and must take necessary actions in order to avoid those risks. The risk analyst can also try to reduce the impact of the risks on the business. Therefore, it is very important that the risk analyst should have the knowledge of how to analyse risk and then can act upon them

Cutaneous manifestations in patients with chronic kidney diseases on haemodialysis

Background: Cutaneous and mucosal disorders are of the common problems in patients on long term haemodialysis. The aim of this study was to evaluate the frequency and nature of cutaneous lesions among patients with chronic kidney diseases who received maintenance haemodialysis.Methods: Eighty patients with chronic kidney diseases on haemodialysis were studied. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.Results: The patients were 30 females and 50 males with a mean age of 47.6 years. The duration of haemodialysis was 36±11 months. All patients included in this study had at least one cutaneous manifestation attributable to CRF. The most prevalent findings were xerosis (66.2%) followed by pallor (57.5%), pruritus (51.25%), infections (33.75%), AV shunt dermatitis (16.25%), pigmentary changes (13.75%), purpura, ecchymoses (8.75%) and perforating disorders (2.5%). Hair changes were diffuse alopecia (16.25%), brittles, lustreless hair (3.75%) and sparse body hairs (1.25%). Oral changes were candidiasis (10%), angular cheilitis (3.75%), gingivitis (2.75%), fissured tongue (2.75%) and lichen planus (1.25%). Nail changes were leukonychia (10%), dystrophic nails (7.5%) onychomycosis (6.25%), subungual hyperkeratosis (5%) and half and half nails (1.25%).Conclusions: At least one cutaneous manifestation is found in all CRF patients. The etiology of CRF does not affect the cutaneous, hair or nail abnormalities. Factors such as diagnostic climate and early treatment influence some disorders such as xerosis, pruritus and infections

Cutaneous manifestations in renal transplant recipients

Background: Skin lesions both benign and malignant occur frequently in renal transplant recipients receiving long term immunosuppressive drugs. Aim was to study cutaneous manifestations in renal transplant recipients (RTRs).Methods: Thirty two patients with chronic kidney diseases who underwent renal transplant were included in the study. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.Results: Out of 32 patients, 23 (71.8%) were male and 9 (28.1%) were females. Skin infections occurred in 84.3% of the patients and most of them were fungal infections (37.5%), followed by viral infection in (31.2%) patients. Oral mucosal changes, hair and nail comprising of (34.3%), (71.8%), (43.7%) patients respectively. Only malignancy seen in one patient was basal cell carcinoma. Drug induced cutaneous manifestations were acneiform eruptions (18.75%), hirsutism (15.6%), hypertrichosis (9.3%), striae (6.25%), gingival hyperplasia (3.12%) and skin atrophy (3.12%).Conclusions: Skin lesions are a significant problem in renal transplant recipients. A careful monitoring of these patients is recommended for early diagnosis and treatment

Epidemiological study of herpes zoster in a tertiary care hospital

Background: Herpes Zoster, which presents as a localized, painful cutaneous eruption is a common clinical problem, caused by reactivation of latent Varicella Zoster Virus (VZV) and is usually self- limiting in healthy adults. In this era of HIV infection, HIV seropositive patients are at increased risk of severe or disseminated cutaneous or visceral involvement. Aim was to analyse the clinical pattern and epidemiological factors of Herpes Zoster and to know the HIV prevalence among patients with Herpes Zoster.Methods: A total of 110 patients with Herpes Zoster attending dermatology department at Uttar Pradesh university of medical sciences (UPUMS), Saifai, Etawah, India from a period of July 2015 to July 2017 were included in the study.Results: Out of 110 patients, 79 were males 31 were females. Age group varied from 8-80 years. Most common dermatomes involved were thoracic followed by ophthalmic division of trigeminal nerve. 33.6% of patients showed HIV seropositivity. Most commonly observed complication was post herpetic neuralgia which was encountered in 36% of the patients and most of these patients were above the age of 60 years. Post herpetic neuralgia was more commonly seen in seropositive individuals as compared to seronegative individuals.Conclusions: Disseminated zoster and multi-dermatomal involvement were encountered in immuno-compromised individuals. Post herpetic neuralgia was seen in elderly patients, especially in case of ophthalmic zoster.

Prevalence of hyperprolactinemia in infertile cases and its correlation with TSH in a rural set up hospital

Background: Hyperprolactinemia is a common endocrine disorder of hypothalamic-pituitary ovarian axis affecting the reproductive functions. Despite the significant role of hyperprolactinemia in infertility, serum prolactin estimation is still not universally done as a part of evaluation of infertility. This study intended to find out the incidence of hyperprolactinemia in infertility, highlight the importance of assessment of serum TSH level in hyperprolactinemia.Methods: 200 cases of primary and secondary infertility were investigated for serum prolactin levels at Acharya Vinoba Bhave Rural Hospital, Wardha from 2011-2013.Results: There were 130 (65%) cases of primary infertility as against 70 (35%) cases of secondary infertility. A maximum of 106 (53%) cases were in the age group of 26 - 30 years, with the mean age as 27.50±3.76years. There were 11.5% cases of hyperprolactinemia out of 200 cases of infertility. 21.73% cases of hyperprolactinemia had hypothyroidism.Conclusion: The high prevalence of hyperprolactinemia with infertility stresses the fact that all the cases of infertility should be subjected for serum prolactin estimation. Prolactin estimation should be done at early stages of infertility check up rather than straight away going for more costly tests or invasive procedures. There is high crude prevalence of hypothyroidism in hyperprolactinemia. All the cases of hyperprolactinemia should have TSH estimation.

Mid Day Meal Scheme: Understanding Critical Issues with Reference to Ahmedabad City

Problems of illiteracy, malnutrition, anaemia, vitamin-A and iodine deficiency are very common among children in India. In 2001 Supreme Court of India ruled that state governments must provide mid-day meal (MDM) to children of government assisted primary schools. The 2007-2008 budget of the central government has allocated about Rs. 73 billion for the MDM scheme. Therefore, it becomes imperative that a comprehensive evaluation of the programme be undertaken to judge its efficacy. We studied the implementation of the scheme, made field visits to schools to document food preparation and delivery, and collected meal samples to test them in laboratory for nutritional contents and food safety. Study seems to indicate that the implementation of the scheme may be wanting on the grounds of nutrition and food safety. For example, protein and iodine content is not sufficiently provided by the meals. Raw food samples contained uric acid levels higher than stipulated by food laws. Traces of aflatoxins were also found. Food safety may be improved by employing food safety systems such as HACCP, contracting out meal preparation and distribution to reputed private parties, and offering packaged foods which also provide variety. Offering nutrition bars and fruits such as banana not only will ensure delivery of hygienic food but it will enhance the nutrition delivery of the MDM scheme.

A rare case of acute lumbar strain

Introduction: Acute lumbar pain is a suddenly caused pain in the lower back region, and there are spasms in the lower back that result in more severe pain. It occurs in all age groups. The first attack of the lower back pain is typically caused at the age of 30-50. Acute lumbar strain is caused by pushing or tugging and weight lifting heavy objects too heavy for the person's capacity. Most cases of acute lumbar strain can be treated in two to three weeks; if you can cure or take a proper precaution, then it will not cause any injury in the low back region and cannot cause any complications in the health. The lower back pain is healed by cold applications such as ice bags (to reduce the pain and swelling), and heat is applied to the back to prevent the pain. Clinical findings: Pain in the lower back region also creates spasms in the lower back region. Diagnostic evaluation: Blood test: Hb-15.6 gm%, Total RBC count-4.7millions/cu mm, Total WBC count-70000-8000/cu mm, Total Platelet count-2.8 lacs/cu mm, Albumin-4.5 gm%, Bilirubin (conjugated)-0.3 gm%, Bilirubin (unconjugated)-1.0 gm%. Therapeutic intervention: The physician suggests non-steroidal anti-inflammatory drugs and pain killers, and a physiotherapist recommends muscle relaxation exercises. Outcome: After the specialized Treatment, the patient's pain is relieved, and the patient feels very relaxed; now, the patient has a good condition till the last date of care. Conclusion: The patient was admitted with a chief complaint of pain in the lower back region, pain associated while walking, and the patient was not able to sleep properly; there was a disturbed sleeping pattern of the patient. Diagnosed with a case of acute lumbar strain after getting proper treatment and the patient condition was improved

Effect of frequent hand washing for COVID-19 prevention

Background: Coronavirus disease 2019 (COVID-19) has become a global public health concern. While dealing with COVID-19 pandemic, hand washing and the use of hand-hygiene products has been advocated, as a preventive measure. However, frequent hand washing leads to an increased risk of skin changes ranging from dryness and peeling of skin to itching, redness and blister formation. This study aims to understand the hand-hygiene practices and compare side effects between group using hand sanitizers with the group using soap with water.Methods: A 12-item self-administered close ended questionnaire assessing the hand washing habits and effect of the same on skin was used. A total of 60 cases were enrolled. The correlation between use of hand hygiene measures and the clinical changes was studied.Results: In our study, 32 out of the 60 reported a frequency of hand washing between 5-10 times a day. The awareness about using hand moisturizer was noted in 75% individuals. Side effects were more commonly observed in group B using alcohol-based sanitizers as compared to group A using soap with water. Dryness was the most common symptom, observed in 23.3% individuals using alcohol-based sanitizers and 10% individuals using soap with water.Conclusions: Hand-hygiene measures remain the cornerstone of prevention of COVID-19 transmission. However, the use of hand-hygiene products is associated with side effects especially dryness. Regular use of hand moisturizer is essential in preventing the unnecessary effects of frequent hand washing

Bilateral ectropion in a 3 months old baby with lamellar ichthyosis: a rare case report

Ichthyosiform dermatoses are a group of hereditary disorders characterized by dryness and roughness of the skin with excessive accumulation of epidermal scales. Four main types of Ichthyosis are Ichthyosis vulgaris, x-linked recessive, lamellar ichthyosis and epidermolytic hyperkeratosis. Lamellar ichthyosis is the rarest form with an incidence of 1 in 3, 00,000. It has autosomal recessive inheritance. Ocular manifestations include exposure keratitis secondary to ectropion, unilateral megalocornea, and enlarged corneal nerve, and blepharitis, absence of the meibomian gland, trichiasis, madarosis and absence of lacrimal puncta. Ectropion of both upper and lower lids have been documented. We are reporting a rare case of lamellar ichthyosis with bilateral upper eyelid ectropion in a child