Coexisting Sickle Cell Anemia and Sarcoidosis: A Management Conundrum!

Sickle cell disease and Sarcoidosis are conditions that are more common in the African American population. In this report we share an unfortunate patient who had hepatic sarcoidosis but could not receive steroids since that precipitated acute liver failure. We have discussed potential therapy options but we need more options that improve mortality

A study of predicting factors and medical expulsion therapy for solitory lower ureteric calculi

Background: The aim of our study is to evaluate the outcome of medical expulsion therapy (MET) for lower ureteric calculi and asses the clinical, laboratory and radiological factors that predict conservative approach. We evaluated the efficacy of combined drug therapy with alpha 1 adrenergic receptor antagonist tamsulosin and corticosteroid deflazacort for MET therapy for lower ureteric calculi. Methods: A prospective randomized control study was conducted in the department of surgery urology wing on out patients (OPD) basis at IIMSR Medical College Warudi District Jalna a tertiary referral center after approval from the ethical committee. The study conducted between 01 January 2020 to 31 December 2023 over period of three years. Total 76 cases included with the age 18 years old and above. The patients were examined weekly with ultrasonography and kidney ureter bladder (KUB) for 4 weeks and the stone expulsion rate and time, pain episodes during follow-up period, total diclofenac dosage and the need for any intervention was noted close monitoring and timely follow up is mandatory counselling and selection of patient is key factor. Results: Stone expulsion with patients on MET was 84% which is higher as compare to another group 57%. Conclusions: Medical therapy with a combination of α-adrenergic blocker and corticosteroid is associated with good stone expulsion rates and should be considered in all patients with lower ureteral stones of size less than 10 mm who are not having any contraindications for medical therapy provided close monitoring and timely follow up is mandatory counselling and selection of patient is key factor

Are we eliminating cures with antibiotic abuse? A study among dentists

Context: The theme of “World Health Day 2011” is “combat drug resistance- No action today, No cure tomorrow” which is very pertinent. The present study emphatically demonstrates the current issues related to the overwhelming concerns regarding indiscriminate use of antibiotics, leading to a bleak tomorrow where cures may be few.Aim: To know the prescription pattern of antibiotics for various dental procedures by dental practitioners.Materials and Methods: A pretested questionnaire was used which contained two sections pertaining to prescription of antibiotics for healthy and medically compromised patients during various dental procedures, with therapeutic and prophylactic considerations.Results: Questionnaire response rate of 66.6% was observed. Amoxicillin emerged as the most preferred antibiotic for dental procedures both as a therapeutic and a prophylactic drug. 50% of the endodontists and 40% of the general dentists opted to prescribe antibiotics during root canal therapy where ideally operative intervention would have sufficed. Overuse of antibiotics for routine scaling and extraction was observed.Conclusion: The dental profession as a whole needs to acquire a deeper understanding of the global effects of superfluous antibiotic prescription. Antibiotics when judiciously used are precise life-saving drugs

मीठापानी जलकृषि के वैविघीकरण केलिए आंडमान से एक उम्मीदवार जाति माक्रोब्रकियम लार-ए (Macrobrachium Lar-A)

कृपया पूरा लेखा पढ

Disaster Relief Workers: Health Issues

Introduction: Disaster is defined as any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area. Internationally, major disasters occur frequently, but for one country, they are unusual events. It causes severe health damage to that country. In this scenario, our rescue teams/ relief workers risk their own lives to save the life of others. Methods: The concerned topic was searched on internet in different databases with abstract or full free text available in English in previous five years. Results: This group is more vulnerable than general population to various accidents even death in relief process and also health problems such as post traumatic stress disorder, mental health risks, heat disorder, radiation exposure, respiratory problems, skin and mucous membrane problems, digestive problems, eye irritation and fatigue etc. In developed countries, their problems are dealt with great zeal, but unfortunately, in our country, we fail to address the health issue of these workers in spite of having the most important role in disaster management by providing physical and rehabilitative services to survivors. It has been proven that work output of these workers is enhanced if their health issues are taken care of properly. Discussion: We want to acknowledge the health concerns of rescue teams with possible solutions

Prospective study of fracture calcaneus with Allan’s procedure- bone grafting without implants

Background: Calcaneum is usually fractured following high energy axial traumas such is seen in cases of fall from height or road traffic accidents. If not properly managed these fractures can be a cause of prolonged morbidity in the form of pain, stiffness and deformities. We have conducted this prospective study of fracture calcaneum with the method described by Allan et al which constitute of open reduction and bone grafting without any implants. The objective of the was to determine the clinical approach, described by Allan et al for treatment of fracture calcaneum and to discuss in short the results, pitfalls and challenges associated with this.Methods: A prospective study was done on 42 patients who were diagnosed with intra-articular calcaneal fractures depending upon a predefined inclusion and exclusion criteria. All fractures of the study subjects were treated using a lateral approach by Allan’s procedure. Final outcome was assessed on the basis modified Rowe score.Results: In this study a total of 42 patients with intra-articular calcaneal fractures and treated by open reduction and bone grafting without any implants were studied. There were 36 men and 6 women. Majority of the patients tolerated the procedure well and most of the patients (95.23%) had a complete or partial restoration of heel shape. Significant residual pain was seen in only 1 (2.38 %) patient. 36 patients (85.71 %) had excellent outcome 5 patients (11.90%) had good and 1 patient (2.38%) had satisfactory outcome. Conclusions: The management of intra-articular calcaneal fracture by open reduction and bone grafting without any implants give good results with excellent functional outcome. Since no implants are used in this technique this can be a preferable procedure in rural areas and in patients with low socioeconomic status.

An unusual initial presentation of mantle cell lymphoma arising from the lymphoid stroma of warthin tumor.

BackgroundWarthin tumors presenting concomitantly with a lymphoma is vanishingly rare with only 15 reported cases in English literature. Herein, we report an unusual initial presentation of a mantle cell lymphoma involving the lymphoid stroma of a Warthin tumor.Case presentationA seventy-seven year old otherwise healthy gentleman with a 50-pack year smoking history presents with a slowly enlarging left cheek mass. CT scan of the neck demonstrated a left parotid gland tumor measuring 3.4 cm in greatest dimension. He underwent a left superficial parotidectomy, with subsequent histopathologic examination revealing a Warthin tumor with extensive expansion of the lymphoid stroma. Flow cytometric, immunohistochemical, and cytogenetic studies of the stromal component of the tumor confirmed the presence of a mantle cell lymphoma. Clinical staging demonstrated stage IVa disease, and was considered to be at low to intermediate risk due to the slow growth of the parotid lesion. The patient is undergoing close follow up with repeat PET-CT scans at six months.ConclusionTo the best of our knowledge, this is the first well documented collision tumor between mantle cell lymphoma and a Warthin tumor. This case also brings to light the significance of thorough evaluation of the lymphoid component of Warthin tumor

CBDC: EMPIRICAL STUDY ON DETERMINANTS OF CBDC USAGE PURPOSE AMONG CONSUMERS

Abstract The initiative from the government of India in making India into a digitally vibrant nation is highly admirable. India economic growth over the decade is raising at higher rate, it due to adoption of digitalization in every part of economy from banking, business, and international payment. Banks are updating according to needs and demands of the consumers providing amenable services at finger tips of the consumers. From small vendor to high business transitions are carry forward with the help of digital transition or digital currency. The primary objective of the study is determining CBDC usage purpose among consumers. The study used convenient sampling method and covered 160 banking consumers using digital banking. The findings of the study show Determinants of CBDC Usage Purpose among Consumers have been segregated into two dominant dimensions namely Payment Terminal and Financial Statibility Factor which dealing with cost of using online banking, usage of the same at all branches both nationally and internationally and security of the banking. The second factor is Usage and Payment Efficiency Factor which deals with usage of the digital banking, efficiency of the payment over the geographical location and ability of use the same without internet connections. Consumer Perception on CBDC have been segregated into two dominant dimensions namely Expectancy and Performance Factor which deals with expectancy of the consumers over usage of CBDC, knowledge on using digital currency and trust over the banking while using digital currency. A positive and significant impact of Consumer Perception on CBDC on Determinants of CBDC Usage Purpose among Consumers has been identified

Application of Supply Chain Tools In Power Plant- A Case of Rayalaseema Thermal Power Plant

Inventories are considered to be one of the important weapons of supply chain to improve the efficiency of any manufacturing unit. Continuous availability of inventories are the prime requirement for uninterrupted working .To effectively manage inventory levels, it is essential to consider the appropriate reorder points as well as the optimized ordering quantity. The proposed system uses the Genetic algorithm to find the optimized ordering quantity at proper reorder point , by considering the power plant live data as a practical case study. The proposed approach is implemented in Matlab  platform version 7.10 Key words. Inventories, supply chain, Genetic algorithm, Reorder point, ordering quantity, manufacturing unit, power plant, raw materials