Screening of gestational diabetes mellitus: comparison of glucose challenge test done in non fasting state (DIPSI criteria) and fasting state (WHO criteria): a prospective study

Background: The recent data shows 16.55% prevalence of gestational diabetes mellitus in India. Hence universal screening has become important and we need a simple procedure which is economical and feasible to perform in the Indian context. The comparison of screening methods for gestational diabetes mellitus by 75 gm oral glucose challenge testing done in fasting state (WHO) and non-fasting (DIPSI) state was done.Methods: Cross sectional prospective study done on 225 antenatal women between 20-24 weeks coming to tertiary level hospital in a single working unit were included. They were subjected to two screening glucose challenge tests for detection of gestational diabetes mellitus. Results of glucose challenge tests using 75 gm of anhydrous glucose done in fasting and non fasting state were compared. Values of standard 100 gm oral glucose tolerance test done were considered gold standard.Results: The prevalence of gestational diabetes mellitus was found to be 12.4% by oral glucose tolerance testing. Glucose challenge test with 75 gm done in fasting state was abnormal in 14.7% and abnormal in 15.6% done in non fasting state. The sensitivity of 75 gm GCT done in fasting was 60.7% and the sensitivity of 75 gm GCT done in non fasting state was 67.9%. The specificity of 75 gm GCT done in fasting state was 91.9% and the specificity of 75 gm GCT done in non fasting state was 91.9%.Conclusions: Sensitivity and specificity of the screening tests done by 75 gm GCT done in non fasting state is comparable with screening done in fasting state. Screening done by 75 gm GCT done in non fasting state is convenient and more feasible in Indian setup

A comparative study of efficacy of misoprostol with methyl ergometrine and carboprost in active management of third stage of labour

Background: To assess the efficacy and safety of Misoprostol 800ug per rectally in active management of third stage of labour.Methods: In this prospective study, a total of 200 pregnant women who delivered after 34 weeks of gestation at a tertiary teaching institute were included. The women were divided in to 4 groups by using randomization depending on the drug given at birth of anterior shoulder. Group A were given 800ug of Misoprostol per rectally, Group B were given 0.2mg of methyl ergometrine, Group C were given 125ug of Carboprost and Group D was the control group. The duration of third stage of labor and the blood loss was calculated and the results of all four groups were compared.Results: Out of 200 antenatal women, the average duration of third stage of labor was shortest in the misoprostol group (8.88 minutes).The reduction in blood loss was significant with misoprostol as compared to ergometrine (p=0.016) and carboprost (0.009).The difference in pre and post-delivery hemoglobin was also significantly significant with misoprostol as compared to methyl ergometrine (0.048), carboprost (0.0001) and control (0.006).Conclusions: Misoprostol 800ug per rectally is an effective alternative in the active management of third stage of labor as compared to methyl ergometrine and carboprost

Circulating sST2 and catestatin levels in patients with acute worsening of heart failure: a report from the CATSTAT‐HF study

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FIBRE OPTICAL COUPLER SIMULATION BY COMSOL MULTIPHYSICS SOFTWARE

Funding: The research has been supported by the European Regional Development Fund project No.1.1.1.1/18/A/068. The Institute of Solid State Physics, University of Latvia as a Center of Excellence has received funding from the European Union’s Horizon 2020 Framework Programme H2020-WIDESPREAD-01-2016-2017-TeamingPhase2 under grant agreement No. 739508, project CAMART2.The paper presents a simulation model developed for a special optical coupler intended for coupling radiation from signal and pump sources used for the realization of cladding-pumped doped fibre amplifiers. The model is developed in COMSOL Multiphysics and used to assess the pumping efficiency for different side pumping angles and different numbers of electromagnetic modes. The obtained results show that the highest pumping efficiency, above 75 %, is achieved for 5–14 modes when two fibres representing the pump source and the signal source form a 10-degree angle between their central axes. The search for the optimal number of modes corresponds to the development trend in optical coupler technology where the multimode pumping by light-emitting diode (LED) replaces the classical scheme with a single-mode pumping by a laser diode (LD). © 2022 Sciendo. All rights reserved. --//-- This is an open access article Elsts E., Supe A., Spolitis S., Zakis K., Olonkins S., Udalcovs A., Murnieks R., Senkans U., Prigunovs D., Gegere L., Draguns K., Lukosevics I., Ozolins O., Grube J., Bobrovs V. FIBRE OPTICAL COUPLER SIMULATION BY COMSOL MULTIPHYSICS SOFTWARE (2022) Latvian Journal of Physics and Technical Sciences, 59 (5), pp. 3 - 14, DOI: 10.2478/lpts-2022-0036 published under the CC BY-NC-ND 4.0 licence.ERDF No.1.1.1.1/18/A/068; The Institute of Solid State Physics, University of Latvia as a Center of Excellence has received funding from the European Union’s Horizon 2020 Framework Programme H2020-WIDESPREAD-01-2016-2017-TeamingPhase2 under grant agreement No. 739508, project CAMART2

Usage of Glimepiride/Metformin Fixed-dose Combination with Insulin in Management of Type 2 Diabetes Mellitus: An Indian Experience

Background: Type 2 diabetes mellitus (T2DM) poses a major public health burden. The present case-based questionnaire survey evaluated the treatment pattern and clinical experience of healthcare professionals (HCPs) in prescribing glimepiride/metformin fixed-dose combination (FDC) with insulin, with or without other oral hypoglycemic agents (OHAs), to patients with T2DM in the Indian setting. Material and methods: A retrospective, multicenter, observational, case-based questionnaire survey was conducted at several healthcare centers in India with the help of medical records of patients having T2DM, who were prescribed different strengths of glimepiride/metformin FDC. Data was collected from the patients’ medical records and were analyzed using statistical tests. Results: A total of 1,013 patients with T2DM were included in this study. The mean (± standard deviation [SD]) age of patients was 53.5 ± 13.9 years. Mean duration of diabetes was 6.3 ± 4.8 years. About 70.1% of the patients received glimepiride/metformin FDC as first-line therapy and 29.9% received it as second-line therapy. Around 66.3% of the patients in first-line glimepiride/metformin FDC group received insulin once a day, and the proportion increased to 86.8% of the patients in second-line therapy group. Other OHAs were used in 754 (74.4%) patients. About 18.2% (n = 185) patients reported change in weight, with a slightly larger number of patients having reduction in weight. There was considerable reduction in HbA1c, FPG and PPG in patients receiving glimepiride/metformin FDC with insulin, irrespective of OHA use. Efficacy and tolerability were reported as good to excellent for 96.2% and 94.8% patients, respectively. Conclusion: This case-based questionnaire survey shows the usage pattern of various strengths of glimepiride/metformin FDC with insulin and the HCPs’ practice approach regarding early initiation of this combination in Indian patients with T2DM

Dosimetric verification of brain and head and neck intensity-modulated radiation therapy treatment using EDR2 films and 2D ion chamber array matrix

Background: The evaluation of the agreement between measured and calculated dose plays an essential role in the quality assurance (QA) procedures of intensity-modulated radiation therapy (IMRT). Aim: The purpose of this study is to compare performances of the two dosimetric systems (EDR2 and I\u2032matriXX) in the verification of the dose distributions calculated by the TPS for brain and head and neck dynamic IMRT cases. Materials and Methods: The comparison of cumulative fluence by using Kodak extended dose rate (EDR2) and I\u2032matriXX detectors has been done for the evaluation of 10 brain, 10 head and neck IMRT cases treated with 6 MV beams. The parameter used to assess the quality of dose calculation is the gamma-index (g -index) method. The acceptance limits for g calculation we have used are 3% and 3 mm respectively for dose agreement and distance to agreement parameters. Statistical analyses were performed by using the paired, two-tailed Student t-test, and P< 0.01 is kept as a threshold for the significance level. Results: The qualitative dose distribution comparison was performed using composite dose distribution in the measurement plane and profiles along various axes for TPS vs. EDR2 film and TPS Vs I\u2032matriXX. The quantitative analysis between the calculated and measured dose distribution was evaluated using DTA and g-index. The percentage of pixels matching with the set DTA and g values are comparable for both with EDR2 film and I\u2032matriXX array detectors. Statistically there was no significant variation observed between EDR2 film and I\u2032matriXX in terms of the mean percentage of pixel passing g for brain cases (98.77 \ub1 1.03 vs 97.62 \ub1 1.66, P = 0.0218) and for head and neck cases (97.39 \ub1 2.13 vs 97.17 \ub1 1.52%, P = 0.7404). Conclusion: Due to simplicity and fast evaluation process of array detectors, it can be routinely used in busy departments without compromising the measurement accuracy

Social emotional competence, learning outcomes, emotional and behavioral difficulties of preschool children : parent and teacher evaluations

This paper addresses the role of social emotional competence in the emotional and behavioral problems and learning outcomes of preschool children based on their parents’ and teachers’ evaluations. In this study, we compared the perceptions of teachers and parents when evaluating the same child using the multi-informant assessment. First, the associations and differences between both the informant evaluations were investigated. Second, the correlation of the social emotional competence and emotional, and behavioral difficulties among preschool children was analyzed, separately addressing their parents’ and teachers’ evaluations. Third, the role of the preschool children’s social emotional competence in their emotional and behavioral problems, and learning outcomes was investigated building the regression and mediation models. The sample consisted of 507 preschool children (3–6 years, mean age 4.85 years, SD 0.82) and their parents and teachers. Both informants completed the Strengths and Difficulties Questionnaire and Social Skills Improvement System Social-Emotional Learning Brief Scales, and teachers reported on each child’s learning outcomes (by completing a three-item Learning outcomes measure). When comparing both informants’ evaluations, positive associations were found between teacher and parental evaluations of prosocial behavior and emotional, and behavioral difficulties of preschool children, as well as self-management. Parents evaluated their children higher than teachers in conduct problems, hyperactivity, prosocial behavior, and total difficulty, while teachers evaluated children higher than parents in social emotional competence. According to teachers, the social emotional competence of preschool children was negatively correlated to all difficulty scales, and positively related to the prosocial behavior scale. The demographic variables, as well as parental socioeconomic status and children’s belonging to a vulnerable group were not found to be significantly associated with the preschool children’s learning outcomes. However, social emotional competence remains a significant variable in teacher-rated learning outcomes of preschool children even if sociodemographic variables are controlled. Our findings indicate that a higher level of social emotional competence and lower levels of social, emotional, and behavioral difficulties are related to a higher preschoolers’ academic learning in their teachers’ evaluation. This suggests the importance of early facilitation of social emotional competence as a key factor for academic success and more positive behavioral outcomes.peer-reviewe

Prevalence of Mistreatment or Belittlement among Medical Students – A Cross Sectional Survey at a Private Medical School in Karachi, Pakistan

Background: Mistreatment or belittlement of medical students either by faculty or fellow students has often been reported. Perception of mistreatment has also been associated with increased degree of psychological morbidity. There is a lack of such studies being conducted amongst the medical students of Pakistan. The aim of this study was to determine the prevalence and forms of perceived mistreatment and presence of mental health morbidity in a private medical school in Pakistan. Also, any association between mental health morbidity and mistreatment was to be identified. Methods: A cross sectional study was carried out on medical students from Aga Khan University Hospital, Karachi, Pakistan during the period of June-September 2007. A self administered questionnaire, adapted from Frank et al and Baldwin et al was distributed to a total of 350 students. The questionnaire consisted of three parts: the first dealing with the demographics of the population, the second concerning the various forms of mistreatment, while the third assessed the mental health of students using the General Health Questionnaire 12(GHQ12). Descriptive statistics were performed. The Chi-square test and Fisher\u27s exact tests were applied. Results: A total of 350 students were approached out of which 232 completed the questionnaire giving a response rate of 66.2%. Mistreatment was reported by 62.5% (145/232) of the respondents. Of these, 69.7% (83/145) were males and 54.9% (62/145) were females. There was a significant relationship between gender, year division, stress at medical school and possible use of drugs/alcohol and reported mistreatment but no statistical relationship was seen with psychiatric morbidity. The overall prevalence of psychological morbidity was 34.8% (77/221). Conclusion: This study suggests high prevalence of perceived mistreatment and psychological morbidity among Pakistani medical students. However, no association was found between these two aspects of medical student education. There is a need to bring about changes to make the medical education environment conducive to learning. Increased student feedback, support systems and guidance about progress throughout the year and the provision of adequate learning resources may provide help with resolving both of these issues