16 research outputs found

    Study of the magnitude of premenstrual syndrome in a tertiary care institute in Pondicherry, India

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    Background: Premenstrual syndrome is cyclical physical and behavioural symptoms that appear in days preceding menstruation and interfere with work or life style followed by a symptom free interval. The common affective and somatic symptoms seen are mood swings, irritability, anxiety, breast tenderness, weight gain and abdominal bloating. The present study was done to detect premenstrual syndrome and encourage students to seek treatment which would improve quality of life both socially and academically.Methods: A cross-sectional study was conducted over a period of three months from November 2018 to January 2019 among medical students in a tertiary care institute in Pondicherry. A detailed questionnaire regarding premenstrual symptoms and screening for depression was obtained from all study subjects. Diagnosis of premenstrual syndrome was done if there were at least one affective symptom like mood swings, insomnia, anxiety and one somatic symptom like abdominal bloating, breast complaints and weight gain.Results: Total of 207 students were screened out of whom 155 (74.87%) students were found to have premenstrual syndrome. 41 students did not have the same, 11 students were excluded as they were having endocrine disorders like polycystic ovarian syndrome and thyroid abnormalities. 60.6% had mild 38.4% moderate 4.5% had severe premenstrual syndrome. Commonest symptoms were mood swings 81.9% followed by anxiety 80% and fatigue 71.6% breast complaints and joint pains were seen in 71% equally so also abdominal bloating and weight gain which was seen in 67%. Depression was found in 52.9% of the students.Conclusions: Premenstrual syndrome is prevalent among medical students commonly and detecting it and encouraging students to seek treatment will help them perform better socially and academically

    Cognitive Functions in Abstinent Alcohol Dependent Males – A Cross Sectional study.

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    INTRODUCTION: Humans have drunk alcohol for atleast 12000 years and it was being used in religious rituals in ancient cultures. Alcohol is an organic compound in which the functional hydroxyl group is attached to a carbon atom. Ethanol is the type of alcohol found in alcoholic beverages and its chemical formula is CH3-CH2-OH. The lifetime risk for alcohol use disorders is more than 15% for men and between 8% and 10% for women, making alcoholism among the most common psychiatric conditions observed in the western world. In India, the estimated number of alcohol users in 2005 was 62.5 million, with 17.4% of them being dependent users. (Ray R, national survey on extent, pattern and trends of drug abuse in India, 2005) The deleterious effects of alcohol on cognitive functioning were reported as early as the 1880s separately by wernicke and by korsakoff, followed by Hamilton, fisher and weschler. It was after the introduction of clinical neuropsychological model by Fitzhugh and co- workers on cognitive function in alcoholism which marked the beginning of systematic research in this area. (Fein G, Bachman L, Fisher S, et al, 1990) Wide research has been done in clinically evident cognitive impairments like those seen in korsakoff syndrome occurring due to thiamine deficiency. But there are no large scale epidemiologic studies to establish the prevalence of cognitive impairment in abstinent alcoholics which is not evident during routine interviews. The rate of abstinent alcoholics with cognitive impairments has been reported in myriad studies. Most of the samples chosen for these studies where from inpatient or out-patient treatment settings and had used convenient samples. (Fein G, Bachman L, Fisher S, et al, 1990) Although studies show that cognitive deficits are reversible after prolonged abstinence, residual deficits do exist for some patients. Although cognitive deficits are reversible during sustained abstinence, residual deficits persist in some patients for extended periods of time. Because of the patient’s cognitive deficits, they find it difficult to continue their treatment and participate in treatment and also indulge effectively in their life. Assessing these functions as clinicians becomes essential as it helaps us choose appropriate treatment and to time the treatment. With this note it is also important to understand that not all alcoholics develop cognitive impairment. As a result it eventually instilled a need for determining cognitive functions in alcohol dependent subjects during their abstinent period for better treatment outcome and to choose appropriate treatment in them. Hence this study is conducted among alcohol dependent males during their abstinence period to assess their cognitive functions and to find the correlation between duration of abstinence and cognitive functions

    A Study to determine the efficacy of 0.3m Sodium Citrate as an Antacid Prophylaxis against Aspiration Pneumonitis in Obstetric Patients undergoing Elective Ceaserean Section under General Anesthesia

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    INTRODUCTION: Pulmonary aspiration of gastric contents in patients undergoing surgical procedures under General anesthesia still remains one of the common intra operative complications. This carries even more greater significance in emergency scenarios where the preoperative fasting guidelines are not met with. The obstetric subset of patients still carries even more increased risk of pulmonary aspiration, since they have delayed gastric emptying time and reduced LES tone and hence, they are considered always as full stomach. In UK, the recent maternal mortality auditing report shows that, majority of deaths resulting from anesthetic events in the peri-operative period are found to be associated at the time of induction of general anesthesia. This is thought to result from two major causes, inhalation of gastric contents (aspiration) and failure to intubate the trachea, resulting in cardiac arrest. Aspiration occurs in 1 in every 3000 cases of anaesthesia and accounts for 10% - 30% of the deaths related with anaesthesia. Studies regarding perioperative aspiration in general surgical population in US shows incidence of 1/3216, morbidity of 1/ 16576 & mortality of 1/71829. As it has been shown that acid aspiration causes chemical pneumonitis, various methods are used to reduce the pH and volume of the stomach contents. Particulate antacids, e.g Aluminium hydroxide and Magnesium trisilicate, were used until they themselves were implicated in causing a chemical reaction in the lungs of animals [1]. Hence, particulate antacids should be avoided in the perioperative setting. This led to the use of non-particulate antacids. Of all the non particulate antacids, the most popular is 0.3 mol sodium citrate. This drug is specially useful in neutralizing of gastric acid especially during emergency surgical procedures under general anesthesia. The risk of pulmonary aspiration is severe when the gastric content has a pH 25ml. It has been proven that, when administered as a single dose before the induction of anesthesia 0.3 molar sodium citrate is effective in elevating gastric pH above 3.5 in all patients. The risk of acid pneumonitis should aspiration occur, would therefore be minimized. In Indian scenarios, not much of studies or reviews are there regarding the administration and efficacy of sodium citrate as antacid prophylaxis. Hence this study was carried out with an aim to establish the efficacy and to encourage the routine use of 0.3 molar sodium citrate, especially in the obstetric population. In this study, pH of gastric content samples before and after sodium citrate administration are measured with aid of a digital pH meter and is used to determine the efficacy of 0.3M sodium citrate. AIM OF THE STUDY: The objective of this study is to establish the efficacy of 0.3m sodium citrate, a non particulate antacid in neutralizing the secreted gastric acid- as prophylaxis against aspiration pneumonitis in obstretic patients undergoing elective lower segment cesarean section under general anesthesia. MATERIALS AND METHODS: After obtaining approval from the institutional ethical committee of Govt. Kilpauk Medical College and Hospital, Chennai-10 and written informed consent, fifty term pregnant patients of ASA physical status I & II undergoing elective lower segment cesarean section under standardized general anesthesia were enrolled in the study. This study was conducted in Govt. Kilpauk Medical College and Hospital, Chennai from May 2012-August 2012. Study Design: Our study was a double- blind prospective randomized control study. Double Blinding Technique: The solutions to be administered to the patients were prepared by anesthesiology assistant who prepared the solutions in such a way that both the solutions are stored in identical amber coloured bottles and labeled accordingly. The testing solution, 30ml of 0.3 molar sodium citrate was labeled SOLUTION A. The control solution, 30ml of distilled water was labeled SOLUTION B. Study Period: The study period was from the time of 30minutes before induction of anesthesia up to 2 hours in the postoperative period. Observation Period: Patients in both the groups were monitored and observed in the PACU for 24 hours for any side effects and complications. Study Groups: The 50 selected and assessed patients were randomly divided into two groups of 25 patients each. GROUP A -25 patients received 30ml of testing solution A. GROUP B-25 patients received 30ml of control solution B, Both the solutions were kept in identical amber coloured bottles. So, neither the patient who is receiving it nor the person giving it, did not know what is contained inside the bottle. The analyzer then allotted them into 2 groups. 25 patients who had received 30ml 0.3 molar sodium citrate were assigned to group A or study group. Remaining 25 patients who had received 30ml of distilled water were allocated to group B or control group. At the end of the surgery, after obtaining the gastric aspirate before extubation, all patients in both the groups were given Inj. Ranitidine 50mg i.v. to protect them from the aspiration risk. Patient Selection:atients Inclusion Criteria (Obstetric Patients): 1. pts undergoing elective LSCS under general anesthesia, 2. pts fasting for >= 8hrs, 3. no use of any other particulate antacids in the preoperative period. Exclusion Criteria: 1. Patients with BMI > 30, 2. patients with anticipated difficult airway, 3. patients undergoing emergency surgery, 4. h/o any drug use or disease which alters the gastric secretion, 5. h/o any drug allergy, 6. patient refusal for GA, Materials Used in Our Study: 1. Testing solution A or control solution B- 3,0ml in amber color bottles, 2. Digital pH meter, 3. Nasogastric tube, 4. 20ml syringe, 5. Xylocaine jelly and adhesive tapes, 6. Stethoscope. RESULTS: Fifty (50) female patients in ASA I & II who are at term pregnancy, undergoing elective lower segment caesarean section under general anesthesia were selected for the study. The data & measurements obtained from the study were analyzed & tabulated using SPSS. In this study, a ‘p’ value of less than 0.05 was considered statistically significant and a ‘p’ value of less than 0.001 was taken as highly statistically significant. SUMMARY: A prospective randomized double blind study was designed to establish the efficacy of 0.3molar sodium citrate in pregnant patients undergoing elective lower segment caesarean section under general anesthesia. Based on the analysis of the results and discussion in our study, the conclusions arrived at are summarized as below. In our study, 1. The demographic variables such as age, height, weight & body mass are comparable between the groups, 2. The preoperative fasting time was around 9 hours, which is also comparable in both the groups. 3. We observed that the baseline pH was > 2.5 and were comparable with no significant difference between the study and control groups. 4. The mean pH measured at 5 minutes, 30 minutes and extubation in study group was statistically significantly higher in the study group than in the control group. (p value < 0.001- highly significant). 5. The mean pH in the study group was maximally highest at 5min after intubation, signifying the protective effect of 0.3M sodium citrate during the time of induction, laryngoscopy and intubation. 6. No patient were at high risk zone (i.e pH <2.5) in the study and control groups, at any time during the anesthesia. 7. No patients were observed to have complications like aspiration, nausea or vomiting in the intra operative or postoperative period. 8. The side effects of general anesthesia like nausea, vomiting, 9. pigastric pain was found in few of our patients in both the groups with not much statistical significance in our study. CONCLUSION: We conclude that the non particulate antacid 0.3 molar sodium citrate given orally about 20min before induction of anesthesia, is an effective and safe antacid for anti-aspiration prophylaxis in all elective obstetric surgeries without producing any side effects

    Attitude towards mental illness among doctors and nurses in a tertiary care centre, Pondicherry, India

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    Background: Stigma can prevent care and treatment of mentally ill. About 54% of diagnosable mental disorders are seen in primary care settings. There is a gross underestimation of psychiatric morbidity among patients by substantial proportion of non-psychiatric clinicians. Hence there is a need to assess the attitude towards mental illness among doctors and staff nurses. The objectives of the study were to assess the attitude towards mental illness among doctors and nurses, to compare the attitude between doctors and nurses, to find if there is any correlation between duration of training or posting and attitude, to find if educational status had any influence on attitude, to find if there is any gender influence on attitude. Methods: It is a cross sectional descriptive study conducted in a private medical college, Pondicherry among doctors and nurses who had completed their under graduation with a sample size of 221 (Doctors-120, Nurses-101). The instruments used were a semi-structured demographic profile and 34 items of OMICC (Opinion About Mental Illness in Chinese Community). The data was entered in Microsoft Excel 2013 analyzed using descriptive statistics, unpaired t-test, pearson’s correlation coefficient.Results: Only 25% of doctors and 4.9% of nurses positive attitude when overall score was considered. Doctors group had higher positive attitudes compared to nurses in domains separatism, stereotyping, benevolence and stigmatisation.Conclusions: There was no correlation between duration of psychiatry posting and attitude

    An Intrusion Detection Using Machine Learning Algorithm Multi-Layer Perceptron (MlP): A Classification Enhancement in Wireless Sensor Network (WSN)

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    During several decades, there has been a meteoric rise in the development and use of cutting-edge technology. The Wireless Sensor Network (WSN) is a groundbreaking innovation that relies on a vast network of individual sensor nodes. The sensor nodes in the network are responsible for collecting data and uploading it to the cloud. When networks with little resources are deployed harshly and without regulation, security risks occur. Since the rate at which new information is being generated is increasing at an exponential rate, WSN communication has become the most challenging and complex aspect of the field. Therefore, WSNs are insecure because of this. With so much riding on WSN applications, accuracy in replies is paramount. Technology that can swiftly and continually analyse internet data streams is essential for spotting breaches and assaults. Without categorization, it is hard to simultaneously reduce processing time while maintaining a high level of detection accuracy. This paper proposed using a Multi-Layer Perceptron (MLP) to enhance the classification accuracy of a system. The proposed method utilises a feed-forward ANN model to generate a mapping for the training and testing datasets using backpropagation. Experiments are performed to determine how well the proposed MLP works. Then, the results are compared to those obtained by using the Hoeffding adaptive tree method and the Restricted Boltzmann Machine-based Clustered-Introduction Detection System. The proposed MLP achieves 98% accuracy, which is higher than the 96.33&amp;percnt; achieved by the RBMC-IDS and the 97% accuracy achieved by the Hoeffding adaptive tree
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