Managing pregnancy in inflammatory rheumatological diseases

Historically, pregnancy in women with many inflammatory rheumatic diseases was not considered safe and was discouraged. Combined care allows these pregnancies to be managed optimally, with the majority of outcomes being favorable. Disease activity at the time of conception and anti-phospholipid antibodies are responsible for most complications. Disease flares, pre-eclampsia, and thrombosis are the main maternal complications, whereas fetal loss and intrauterine growth restriction are the main fetal complications. Antirheumatic drugs used during pregnancy and lactation to control disease activity are corticosteroids, hydroxychloroquine, sulphasalzine, and azathioprine. Vaginal delivery is possible in most circumstances, with cesarean section being reserved for complications

DIFFERENTIAL EFFECT OF NATIONAL VS. REGIONAL CELEBRITIES ON CONSUMER ATTITUDES

The present study explores the differential effects of having a National/Regional celebrity in an advertisement/ endorsement. More specifically the study intends to find out whether a National celebrity would have a more favorable impact on consumer attitudes than a Regional celebrity when endorsing the same product. Experimental design was used as the research methodology. A 3 (National Celebrity/Regional Celebrity/No Celebrity) X 2 (High/Low Involvement Product) design was conducted on student sample. The experiment was conducted on a total of 240 respondents with fictitious ads as stimuli. National celebrities were found to create more favorable consumer attitudes than regional celebrities. However, the National celebrity was also found to create a more favorable consumer attitude given the product was low involvement. It was interesting to find that the no celebrity treatment created more favorable consumer attitudes than regional celebrity condition. The study suggested that celebrity endorsements were useful but the nature of the product also has an influence on the success. One limitation was the restriction to print advertisements and another was restriction to celebrity of only one region. A major implication for the manager is that it is always better to use a National celebrity than a regional one. However, for high involvement products, celebrity endorsement need not be the only success factor. The contribution of the study is in an area which is well researched but addressing a research question which has not been investigated before.Celebrity endorsement, Consumer Attitudes, Experimental Design, Regional celebrity.

Menstrual Cycle Control in Female Astronauts and the Associated Risk of Venous Thromboembolism

Venous thromboembolism (VTE) is a common and serious condition affecting approximately 12 per 1000 people in the USA every year. There have been no documented case reports of VTE in female astronauts during spaceflight in the published literature. Some female astronauts use hormonal contraception to control their menstrual cycles and it is currently unknown how this affects their risk of VTE. Current terrestrial risk prediction models do not account for the spaceflight environment and the physiological changes associated with it. We therefore aim to estimate a specific risk score for female astronauts who are taking hormonal contraception for menstrual cycle control, to deduce whether they are at an elevated risk of VTE. A systematic review of the literature was conducted in order to identify and quantify known terrestrial risk factors for VTE. Studies involving analogues for the female astronaut population were also reviewed, for example, military personnel who use the oral contraceptive pill for menstrual suppression. Well known terrestrial risk factors, for example, obesity or smoking would not be applicable to our study population as these candidates would have been excluded during astronaut selection processes. Other risk factors for VTE include hormonal therapy, lower limb paralysis, physical inactivity, hyperhomocysteinemia, low methylfolate levels and minor injuries, all of which potentially apply to crew members LSAH data will be assessed to identify which of these risk factors are applicable to our astronaut population. Using known terrestrial risk data, an overall estimated risk of VTE for female astronauts using menstrual cycle control methods will therefore be calculated. We predict this will be higher than the general population but not significantly higher requiring thromboprophylaxis. This study attempts to delineate what is assumed to be true of our astronaut population, for example, they are known to be a healthy fit cohort of individuals, and combine physiological impacts of spaceflight (cephalic fluid shifts, lower limb inactivity) to understand specific risks associated with hormonal contraception

Prevalence of nutritional deficiencies other than anaemia among students of government commerce college of Gandhinagar, Gujarat: a cross sectional study

Background: Adolescence and young adulthood are periods of critical development and transition. Adolescent constitutes over 23% of the population in India. Nutrition and health needs of the adolescent are more because of more requirements for growth spurt and increase in physical activity. The aim was to study prevalence of nutritional deficiencies other than anaemia among students of Government Commerce College.Methods: The study was carried by Medicine Department, GMERS Medical College, Gandhinagar, India during period from July 2016 to August 2016 in purposively selected government college of Gandhinagar city. After taking the permission of principal of college and consent of the students, 421 students were examined for signs of various nutritional deficiencies other than anaemia. The data was collected by predesigned, pretested proforma and analyzed using SPSS 17.0 (Trial Version).Results: Out of total 421 students 205 (48.6%) were female. Mean age of the study students was 19.8±1.66 years. Maximum numbers of the students were in the age group of 18-21 years (60.5%). Mean age of female and male students was 19.7±1.79 years and 19.9±2.01 years respectively. The study revealed that vitamin A deficiency was present in 28 (7.0%) students. Vitamin B complex deficiency signs were seen in 96 (23.1%) students. Vitamin C deficiency signs were seen in 44 (10.5%) students. PEM was observed in 55 (13.2%) students. Essential fatty acid deficiency was observed in 60 (14.4%) students.Conclusions: High prevalence of nutritional deficiencies among these students needs great attention and health education

Impact of educational intervention regarding hazards of obesity and its preventive measures among students of commerce colleges of Ahmedabad city, Gujarat, India

Background: The prevalence of obesity has increased worldwide in almost every country in all the age groups. A college is a key location for educating students about health, hygiene and nutrition, and for putting in place interventions to promote the health of them. Objective of the study was to know the prevalence of obesity and overweight among students of commerce colleges of Ahmedabad city and to assess knowledge of these students regarding hazards of obesity and its preventive measures before and after educational interventional training.Methods: The present interventional study was undertaken during September 2011 to December 2011 in randomly selected 3 commerce colleges of Ahmedabad city, Gujarat. Total 627 students between the age group of 18 to 23 years were examined after taking written informed consent of their parents using pre-designed, pre-tested, semi-structured proforma. Anthropometric measurements were taken and BMI were calculated. The prevalence of overweight and obesity were determined based on the IOTF (International Obesity Task Force) criteria. Single educational training for 45 minutes was given to the students and their post-intervention knowledge for same was assessed after the training. Thus collected data was analyzed using SPSS 17 (Trial version).Results: Overall, the total number of obese adults identified in whole study population was 64 (10.2%) and numbers of overweight adults were 65 (10.3%). Baseline knowledge of the students regarding hazards of obesity like hypertension, cancer, heart attack and diabetes mellitus was 19.7%, 16.1%, 16.5% and 24.5% respectively which was significantly increased to 93.6%, 94.5%, 96.0% and 94.1% respectively after the intervention. Baseline knowledge of the students regarding preventive measure of obesity like avoiding junk food/ healthy diet, exercise and meditation was 23.6%, 24.4% and 25.9% respectively which was significantly increased to 95.3%, 96.9 and 97.4% respectively after the intervention.Conclusions: There was significant improvement in the knowledge regarding hazards of obesity and its preventive measures among college students after our single educational session

Harmonic scalpel versus titanium clips and l-hook in the ligation of cystic duct and artery and gall bladder dissection in laparoscopic cholecystectomy

Background: Laparoscopic cholecystectomy is a gold standard for gall bladder stone surgery. The Aim and objective of study was to compare the total duration of surgery, intraoperative complication like bile leak from cystic duct stump, spillage of bile from gallbladder and post op pain and abdomen distension and jaundice.Methods: Study was carried out in dept. of gen Surgery, Govt medical college Kota in yr. 2015-16 in a total of 50 patients with cholelithiasis with cholecystitis. Patient were equally divided randomly into two groups (a) Harmonic scalpel group and (b) Titanium Clip and L hook group. All patients with medical comorbidities, Concomitant CBD calculi, cirrhosis and portal HT were excluded from study. Intraoperatively adhesions, bile spillage from GB and cystic duct stump noted Postoperatively complain like pain abdomen, Jaundice, and fever were noted. Duration of hospital stay was observed. All results were statistically analyzed using Chi square and ANOVA test.Results: Both groups were comparable on the basis of age and sex distribution, as no statistically difference was noted (P value 0.867 and 0.999 respectively). Intraoperative findings were adhesions 5 in clip group and 7 in harmonic group. Spillage from gall bladder was 2 in Clip group and 3 in harmonic group. Mean duration of surgery was 65.20 min in clip group and 63.68 in harmonic group with no statistically significant difference in both the group (P Value 0.727). Average duration of hospital stay was similar in both the groups with a mean of 2.6 days. Postoperative complication was fever, abdomen pain and distension were 3,1,1 were respectively in the clip group and 3,2,2 respectively in harmonic group with the P value of 0.999 which was statistically insignificant. No CBD injury was noted in any case. Conversion to open cholecystectomy was not done in any case. On 1week and 1 month follow up 2 cases in clip group and 1 in HS group had collection in gall bladder fossa and none at I month.Conclusions: Harmonic scalpel offers an effective, alternative and safe method to cystic duct division and Gallbladder dissection from liver bed

Denial of Service Attack in VANET: A Survey

ABSTRACT--

Corporate Identity: Developing Means for Sustainable Competitive Advantage in Indian Context Towards Model Development

Corporate identity is a dynamic and premeditated asset integral to gaining competitive advantage in the market. It spans both the internal and external functions of the organisations. It is a variable that needs to be studied cohesively. However, the literature on corporate identity has studied the various elements in a non integrated manner. This needs to be replaced by a comprehensive understanding of the processes and nuances of corporate identity, which can help the organisations in developing sustainable competitive advantage. Additionally, this study focuses on digital media and tech savvy individuals from an emerging market: India. In order to achieve this objective, we interviewed 70 respondents from 20 companies and their consumers. Thus, we identified that corporate identity deals with strategic, emotional and social dimensions. This helped us develop a comprehensive model. Further, corporate identity was seen as a benchmark related to corporate challenges and expectations. Lastly, digital media need to work as a bonding platform among the stakeholders to ensure this