Development of Cybermoms: A Computer-mediated Peer Support Group to Address the Needs of Young Mothers

This article presents findings from a three-year demonstration project in Sudbury, Ontario that used Internet-based technologies combined with other program elements to support teen mothers through the establishment of a computer-mediated peer support group. Based on an analysis of survey data and qualitative data from online chat messages, we conclude that most participants of the Cybermoms program gained some benefit from access to computers and the Internet, particularly in terms of online peer support. While online participation cannot immediately change life circumstances related to poverty, interactions within the program, such as the real time chat sessions with social service providers and decision-makers supported the young women in transcending some of the limitations and boundaries of their lives. Sharing experiences and knowledge helped young women to deal with the challenges of parenting and to navigate through the requirements of oppressive service systems. Other benefits of ICT technologies included schooling, labour market transitioning, and life skills that arose from interacting with others and learning ICT

Rare case of immune mediated cutaneous leucoclastic vasculitis with pancytopenia in a rheumatoid arthritis patient with chronic cytomegalovirus infection

Acute febrile illnesses with systemic involvement can present significant diagnostic and therapeutic challenges, particularly in patients with multiple comorbidities. This case report highlights a complex presentation of acute febrile illness with pancytopenia and immune-mediated cutaneous vasculitis in a patient with type II diabetes mellitus. A 52-year-old male with a known history of type II diabetes mellitus presented with fever, decreased oral intake, loose stools, oral ulcers, dysphagia, and rashes over the trunk and abdomen for four days. Upon admission to the ICU, extensive diagnostic evaluations were performed, revealing significant hematological, biochemical, and serological abnormalities. Imaging studies and histopathological examinations were conducted to further investigate the underlying etiology. Laboratory findings indicated pancytopenia, acute kidney injury, and hyperkalemia. Infectious disease workup was largely negative, except for a positive CMV IgG. Imaging studies revealed medical renal disease, and a skin punch biopsy confirmed cutaneous leukocytoclastic vasculitis. Bone marrow biopsy suggested bone marrow suppression. Multidisciplinary management, including dialysis, IV fluids, antibiotics, blood transfusions, steroids, and Ganciclovir, led to the patient’s gradual improvement and stabilization. The comprehensive diagnostic and therapeutic approach in this case underscores the importance of considering immune-mediated etiologies in patients with atypical presentations. Multidisciplinary collaboration was crucial in managing the multifaceted clinical condition of the patient. Early recognition and prompt multidisciplinary management are essential in similar cases. Extensive diagnostic evaluations should be performed to identify the underlying causes, and immune-mediated etiologies should be considered in complex presentations. Further research is recommended to explore optimal management strategies for such multifaceted conditions.

Platinum based doublet cross over therapy for advanced stage non small cell lung cancer? A better survival option

Platinum based doublet chemotherapy namely the cisplatin/carboplatin based etopiside or gemcitabine therapy forms the therapy of choice, for patients with advanced non small cell carcinoma of the lung. Here we report two cases were unusual cross over was done from gemcitabine-to cisplatin-doublet chemotherapy resulting in unexpectedly better clinical and radiological response

Evaluation of the plantar fascia in patients with diabetes mellitus : the role of sonoelastography

Purpose: It has been postulated that hyperglycaemic non-enzymatic glycation of proteins with subsequent accumulation of glycosylated end-products in tissues like the plantar fascia (PF) contributes to the development of foot ulcers in diabetics. The present study evaluates the spectrum of sonoelastographic findings in the plantar fascia in patients with type 2 diabetes mellitus (DM). Material and methods: A total of 81 patients and 32 healthy volunteers were included in the study. PF thickness was registered 1 cm distal to the attachment at the calcaneus. Greyscale ultrasonographic examination was followed by strain elastography of the PF based on which PF were qualitatively categorized into 3 grades (hard, intermediate, soft) depending on their predominant colour. Results: Patients were found to have thicker PF than healthy volunteers (p < 0.0001). Grade 2 (intermediate elasticity) PF was the most common type seen in both groups (48.44% of healthy volunteers and 57.25% of patients). However, a greater number of patients (36.64%) had grade 3, i.e. soft PF as compared to healthy volunteers (9.38%). Conclusions: To conclude, there is thickening and softening of the PF in patients with type 2 DM, supporting the hypo thesis that diabetes-induced changes occur in the tissues of the foot

Challenges of Second-hand Smoke: Are We Asking the Right Questions?

Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions

Statistically significant association of the single nucleotide polymorphism (SNP) rs13181 (ERCC2) with predisposition to Squamous Cell Carcinomas of the Head and Neck (SCCHN) and Breast cancer in the north Indian population

<p>Abstract</p> <p>Background</p> <p>Non-synonymous single nucleotide polymorphisms (SNPs) within vital DNA repair genes may cause reduction of activity leaving the genome unrepaired resulting in genomic instability and cancer.</p> <p>Materials and methods</p> <p>The present endeavour involved study on the association of the SNP rs13181 (Lys751Gln/A18911C) in the Nucleotide Excision Repair (NER) pathway gene ERCC2 (excision repair cross-complementing rodent repair deficiency, complementation group 2) with the risks of Squamous Cell Carcinomas of the Head and Neck (SCCHN) and Breast cancer using a case-control based association study among 685 (400 controls and 285 SCCHN-affected cases) and 395 (227 normal healthy female controls and 168 breast cancer cases) ethnically-matched samples, respectively from north India using Polymerase Chain Reaction followed by Restriction Fragment Length Polymorphism (PCR-RFLP) analysis.</p> <p>Results</p> <p>Results showed significant association of rs13181 homozygous mutant (CC) [Odds Ratio (OR) 4.412, 95% Confidence Interval (CI) 2.413 to 8.068], heterozygous (AC) (OR 2.086, 95% CI 1.246 to 3.492) and combined mutant (AC + CC) (OR 2.672, 95% CI 1.647 to 4.334) genotypes with predisposition to Breast cancer. Statistically significant increase in SCCHN risk was also associated with the mutant genotypes of rs13181 (ERCC2), viz. homozygous mutant (CC) (OR 1.680, 95% CI 1.014 to 2.784), heterozygous (AC) (OR 1.531, 95% CI 1.092 to 2.149) and combined mutant (AC + CC) (OR 1.560, 95% CI 1.128 to 2.158) genotypes.</p> <p>Conclusion</p> <p>The results of this case-control study indicate that the polymorphism rs13181 might be a risk factor for predisposition towards SCCHN and breast cancer among north Indian subpopulations.</p

Diagnostic accuracy of magnetic resonance imaging in the evaluation of pulmonary infections in immunocompromised patients

Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI) for diagnosing pulmonary infections in immunocompromised adults. Material and methods: Computed tomography (CT) and MRI chest were performed in 35 immuno-compromised patients suspected of pulmonary infection. The MRI sequences that were performed included axial and coronal T2 half-Fourier acquisition single-shot turbo spin-echo (HASTE), spectrally attenuated inversion recovery (SPAIR), true fast imaging with steady-state free precession (TRUFI), and three-dimensional fast low angle shot (3D FLASH) using breath-hold and respiratory triggered BLADE (proprietary name for periodically rotated overlapping parallel lines with enhanced reconstruction). The presence of nodules, consolidations, and ground-glass opacities was evaluated. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for MRI using CT scan as a reference standard. Results: The sensitivity of MRI in nodule detection was 50% overall and 75% for nodules measuring more than 5 mm. Consolidation was detected with 100% sensitivity. Sensitivity and PPV for the detection of ground-glass opacities (GGOs) were 77.7% and 53.8%, respectively. T2 HASTE axial had the fewest image artefacts. Respiratory triggered MR pulse sequence did not add any significant diagnostic information as compared to the non-respiratory triggered MR pulse sequences. Conclusions: Sensitivity for detecting small nodules and GGOs on MR is poor; CT scan remains the imaging modality of choice for the evaluation of pulmonary infections in immunocompromised patients. However, MRI can be used in the follow-up imaging of these patients

Follow-up assessment of pulmonary functions in mechanically ventilated children after discharge from pediatric intensive care unit: A developing country perspective

Background: There is a paucity of data on the pulmonary function tests (PFTs) in pediatric mechanically ventilated patients, especially in a developing country setting. Materials and Methods: This prospective study was carried out in the pediatric intensive care unit over 15 months. The PFTs were measured using spirometry at discharge, at 3 and 6 months. Results: Of 32 eligible children, 20 (mean age 9 ± 2.62 years) completed the 6-month follow-up. The most common indications for mechanical ventilation were respiratory (45%) and neurological (35%) causes. At the end of 6 months, 65% children had abnormal lung function (restrictive pattern). Patients with longer duration of ventilation, high peak pressures, and high fractional inhaled oxygen had a trend toward more abnormality in the lung function. Conclusions: Pediatric mechanically ventilated patients developed restrictive pulmonary defects after discharge that gradually improved over time. The majority was asymptomatic and reported no lifestyle limitations. There is a need for longer follow-up studies to assess the lung function and clinical condition postdischarge

A study to compare ramosetron and ondansetron for prevention of post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia

Background: The incidence of nausea and vomiting following laparoscopic cholecystectomy is very high. 5-hydroxytryptamine receptor antagonists are drug of choice for prevention of post-operative nausea and vomiting (PONV) because of their good efficacy and very few side effects in comparison to other antiemetics. Aims and Objectives: This study was undertaken to compare the efficacy and safety of intravenous ramosetron 0.3 mg and ondansetron 8 mg for prevention of PONV in patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials and Methods: One hundred patients between 18 and 70 years of age with American Society of Anesthesiology Grade I and II scheduled for elective laparoscopic cholecystectomy were randomly divided into two groups of 50 patients each. Group A patients were given injection ondansetron 8 mg and Group B patients were given injection ramosetron 0.3 mg approximately 5 min just before the induction of general anesthesia. Results: Difference in Nausea, vomiting/retching, and PONV score assessed at 4, 8, 12, and 24 h interval postoperatively in both groups was found to be statistically insignificant (P>0.05). The severity of nausea was assessed by visual analogue scale at various time intervals and use of rescue antiemetics in both the groups were found statistically insignificant. Incidence of side effects was also comparable in both the groups. Conclusion: Ramosetron and ondansetron are equally effective for prevention of PONV in patients who underwent elective laparoscopic cholecystectomy under general anesthesia when used prophylactically. Both drugs are safe and have low incidence of side effects