The Medicare Physician Group Practice Demonstration: Lessons Learned on Improving Quality and Efficiency in Health Care

Discusses the experiences of ten large practices earning performance payments for improving the quality and cost-efficiency of health care delivered to Medicare fee-for-service beneficiaries

Book Review: The Courage to Lead Through Values: How Management by Values Supports Transformational Leadership, Culture, and Success

The Courage to Lead through Values: How Management by Values Supports Transformational Leadership, Culture, and Success is about being fearless and implementing the values in changing or sustaining the organization and its people. Transformational leadership is shown as an influential factor in the individual’s ability to deal with different circumstances and where leaders courageously provide support to maintain the employee confidence level. This book is also about the type of leader an individual can become, who may not have answers or solutions to every problem, but genuinely keep working on and acknowledge their inner sense of courage and values by putting their principles and values into practice. By using the methodology Management by Values (MBV), the book is wired into the leadership values and its effectiveness which brings the positive results impacted by the effective leadership and ethics in the organizations

Book Review: How to Lead

Many consider leadership a path to improve their personal, social, and professional lives. People believe that leaders add unique skills to their lives and improve the world in the long run. Accordingly, authors have provided leadership books to help individuals understand leadership and leaders. The author of this book, David M. Rubenstein, is one of them. This book offers perspectives on different leadership experiences. These are categorized into visionaries, builders, transformers, commanders, decision-makers, and masters. The vision of this book is to inspire readers to develop and enhance their leadership skills. Altogether, this book proves that there is no perfect way to lead; any person from any background can become a leader who can make positive changes

Majorization for Certain Classes of Analytic Multivalent Functions

In the present paper we investigate the majorization properties for certain classes of multivalent analytic functions defined by extended multiplier transformation. Moreover, we point out some new or known consequences of our main result

Introducing the Black Male Life Success Theory

For decades, literature has described success for Black males as an unattainable phenomenon due to the nearly insurmountable hardships they face. Although this narrative has changed within the last 15 years, there are insignificant amounts of research on Black male life success. This study sought to identify and discover how 14 Black males in Central Virginia achieved life success. This study defined life success for Black males utilizing the psychological construct of well-being. This grounded theory study identified a framework for Black male life success which included a definition for life success as well as common attributes and circumstances or Black males on their journey towards life success

Maternal anaemia and its severity: an independent risk factor for preterm delivery and adverse neonatal outcome

Background: This study was done to evaluate the effect of maternal anaemia and its severity on gestational age and neonatal outcome.Methods: This was a retrospective study, conducted in Vardhman Mahavir medical college and Safdarjang hospital, New Delhi between April 2012 to March 2013. Cases were divided in three groups i.e. non anaemic, mild to moderately anaemic and severely anaemic (according to WHO classification). A total of 1050 woman (350 in each group) were recruited for study. The following outcome measures were used: preterm delivery (<37 weeks), birth weight, APGAR score, admission of baby in neonatal intensive care unit and early neonatal death. Data was analyzed by Chi-square test. A P value of or less than 0.05 was considered as significant.Results: The risk of preterm delivery, low birth weight, poor APGAR score and admission of baby in neonatal intensive care unit was more in anaemic group and it increased with severity of anaemia which was statistically significant. The increase in risk of early neonatal death was not significant in mild/moderate anaemic group (P value 0.326) while it was statistically significant in severely anaemic group (P value 0.004).Conclusions: Anaemia in pregnancy has a recognizable association with prematurity, low birth weight and poor neonatal outcome.

Study of Metabolic Syndrome in Pre and Post Menopausal Women

Objective: The goal of this study was to determine the occurrence of metabolic disorder (MS) and its various components among pre-and postmenopausal women and their associated relationship between menopausal status and MS. Materials and methods: The present study was conducted at the Biochemistry department in association with Obstetrics and Gynecology Department, Santosh Medical College and Hospital, Ghaziabad. The necessary approval was obtained from the institutional ethical committee to conduct the study and informed written consent was also obtained from the study subjects. The cross-sectional case-control study included premenopausal females aged between 20-40 years as the control group (n=41) postmenopausal females aged between 50-60 years as the case group (n=41). Results: In the study group (post-menopause women), the mean value of BMI is 26.35±2.302 (kg/m2). In comparison with the control group (pre-menopause women), the mean value of BMI is 24.05±1.851 (kg/m2). There was a statically significant increase in the levels of BMI in the study group in comparison with the control group. There was a statically significant increase in the levels of SBP and DBP in the study group compared with the control group. In the study group, the mean value of FBS is 127.12±48.186 (mg/dl). In comparison with the control group (pre-menopause women), the mean value of FBS is 96.12±25.567 (mg/dl). There was a statically significant increase in the levels of FBS in the study group compared with the control group. Conclusion: It has been concluded that MS was significantly more prevalent among postmenopausal women than premenopausal women. This indicates that they are at risk of developing hypertension, cardiovascular disease, and type 2 diabetes mellitus. Therefore, health care workers should closely monitor for the two conditions as metabolic syndrome is an underlying condition for other non-communicable diseases and also be advised to adopt healthy lifestyles to minimize the incidence of these conditions

Study of rifampicin resistance among newly diagnosed pulmonary tuberculosis patients with type 2 diabetes mellitus: a prospective observational study

Background: Rifampicin (RIF) resistance in new cases of pulmonary tuberculosis is a matter of concern. Diabetes Mellitus triples the risk of developing tuberculosis. Early detection of TB and its resistance status in diabetics can help in improving the care and treatment outcomes of both diseases.Methods: It was a prospective study conducted from February 2019 to March 2020 in PGIMS, Rohtak on 50 patients of DM with newly diagnosed Pulmonary TB. Rifampicin resistance was detected by CBNAAT on sputum, induced sputum and BAL samples. Results: Mean age of study subjects was 51.24±10.421 (in years) with M: F ratio of 3:1 and maximum patients in 50-59 age group. The average BMI in patients was 22.49±2.42 kg/m2. The most common presenting complaint was cough (92%) followed by fever (68%). Mean serum HBA1c was 9.66±2.24 and mean FBS and PPBS was 195.81±59.08 and 302.02±99.01 mg/dl respectively. Out of 36 cases who gave sputum, 29 (80.55%) were detected rifampicin sensitive and 7 (19.44%) were rifampicin resistant whereas out of 11 who were induced, 9 (81.8%) were rifampicin sensitive and 2(18.18%) were rifampicin resistant. Out of 3 cases detected by BAL CBNAAT, 2 (66.6%) were rifampicin sensitive and 1 (33.33%) was rifampicin resistant. Overall, 10(20%) patients were detected Rifampicin resistant by CBNAAT.Conclusions: We found that TB-DM patients had a higher proportion of drug resistance (20%), so DM should be considered as an independent risk factor for MDR-TB and effective measures are required for early diagnosis of MDR-TB

Toluidine blue staining as an adjunctive tool for early diagnosis of dysplastic changes in the oral mucosa

Prognosis of oropharyngeal squamous cell carcinoma depends on early diagnosis, despite advanced surgical techniques, the 5-year survival rate remains ~40-50%. Unfortunately, it is usually detected when it becomes symptomatic. This requires treatment which gives rise to a high rate of morbidity and mortality and, furthermore, early detection of oro-pharyngeal pre-malignant lesions is important to improve the survival rate and quality of life. Since dysplasia and in situ carcinoma contain much more DNA and RNA than the normal surrounding epithelium, the use of in vivo staining, by means of toluidine blue dye, is based on the fact that it is an acidophilic dye that selectively stains acidic tissue components such as DNA and RNA. Toluidine blue staining is considered to be sensitive in identifying early oro-pharyngeal premalignant and malignant lesions. In the present study, the use of toluidine blue staining was taken into consideration to identify clinically doubtful oro-pharyngeal lesions and to compare toluidine blue stain and with the histological evaluation