Trauma y autodestrucción psicológica: Una visión general del exasperante desequilibrio emocional en El ídolo invisible de la luz de K R Meera

The present article discusses trauma and its impact on human emotions, particularly on women, in literature, with a focus on K R Meera's novel, The Unseeing Idol of Light. The research paper highlights the rise of trauma theory in literature and explores the cultural and psychological influence of trauma in literature. It also analyses the characters in the novel through the lens of emotional imbalance and interdependency and examines the interrelation between vision, love, and trauma. The prevalence of negative emotions over positive emotions in the novel has been discussed. The paper emphasises the importance of mental stability in contemporary society and discusses various themes such as psychic changes, loss, longing, and transformation. The researcher aims to analyse and relate the selected work with critical thinking to shed light on the cultural and psychological impressions of literature.El presente artículo analiza el trauma y su impacto en las emociones humanas, particularmente en las mujeres, en la literatura, con un enfoque en la novela de K R Meera, The Unseeing Idol of Light. El artículo de investigación destaca el surgimiento de la teoría del trauma en la literatura y explora la influencia cultural y psicológica del trauma en la literatura. También analiza los personajes de la novela a través de la lente del desequilibrio emocional y la interdependencia, y examina la interrelación entre la visión, el amor y el trauma. También se discute la prevalencia de las emociones negativas sobre las emociones positivas en la novela. El documento enfatiza la importancia de la estabilidad mental en la sociedad contemporánea y discute varios temas como los cambios psíquicos, la pérdida, el anhelo y la transformación. El investigador tiene como objetivo analizar y relacionar la obra seleccionada con el pensamiento crítico para arrojar luz sobre las impresiones culturales y psicológicas de la literatura

Formulation Development and Invitro Evaluation of Mouth Dissolving Tablets of Sertraline Hcl by Direct Compression Method

The present study involves formulation and evaluation of immediate release tablets of Sertraline. Endeavours with respect to Direct compression method used for formulating tablets was best suitable to achieve 100% results. Preformulation studies involving organo-leptic bulk density, angle of repose, tapped density, compressibility index, hausner ratio, melting point range, pH and solubility were carried out as per USP specifications. Drug excipients compatibilities were carried out physical, which showed no siginificant change in any way to the mixture. Polymers such as Polyplasdone (Crospovidon-XL), Croscarmellose Sodium (CCS), Sodium Starch Glycolate (SSG) were utilized in the trails. All the physical evaluations carried in preformulation studies were carried out on all the three different polymers utilized. All the formulations exhibited values within the acceptable range. Tablets were evaluated for weight variations, hardness, friability, thickness and Dissolution studies. Release studies were carried out in 7.4 pH Saline, for 20 minutes. Evaluated samples for all the three polymer systems. Results indicated that formulation F12, gave 98.14% release within 8 minutes which is formulated with Crospovidon-XL alone. Assay was carried out for formulation F12 and was found to be 96.12%. Remaining formulations gave fluctuating release profiles. The formulation F12 was considered to be better among the trails accomplished

Feto-maternal outcome in patients with couvelaire uterus: a 3 year study in a tertiary care hospital in rural Karnataka, India

Background: Couvelaire uterus also known as uteroplacental apoplexy is a life threatening condition where abruptio placenta causes bleeding that penetrates into the uterine myometrium. It can only be diagnosed on direct visualization. Therefore, its occurrence is perhaps under reported and underestimated in the literature. The objective of this study was to determine the risk factors for couvelaire uterus and feto-maternal outcomes associated with couvelaire uterus in comparison with patients who presented with abruption without couvelaire uterus in a tertiary care hospital in rural Karnataka.Methods: All women who had abruptio placenta who were delivered by cesarean section were included in the study. Cases were women with couvelaire uterus and controls were women without couvelaire uterus observed intraoperatively during cesarean section.Results: Patients without couvelaire uterus had significantly more vaginal bleeding (22.2% vs 75%). However, patients with couvelaire uterus had a higher incidence of PPH (66.7% vs 28.6%), need for blood transfusion (5.9±3.2 pints vs 1.6±1.8 pints), DIC (22.2% vs 14.3%), maternal mortality (5.6% vs 0) and adverse neonatal outcome.Conclusions: We conclude that patients with couvelaire uterus had an increased risk of maternal complications such as postpartum hemorrhage and disseminated intravascular coagulation which resulted in increased need for blood transfusion, prolonged hospital stay and maternal morbidity and mortality. Present study further highlights that adverse neonatal outcomes such as low birth weight, low Apgar score and neonatal death were more frequently associated with couvelaire uterus. Thus, the presence of couvelaire uterus may be considered as a severe form of abruption and such patients should be anticipated for higher incidence and risk for maternal and neonatal morbidity

A clinical study of blunt trauma abdomen

OBJECTIVES: 1. To find out age and sex distribution of blunt trauma abdomen. 2. To study the etiology of blunt trauma abdomen. 3. To study the modes of presentation, investigations and management for different organ injuries. 4. To study the morbidity and mortality of blunt trauma abdomen. BACKGROUND: Abdominal trauma is a preventable cause of trauma- related deaths. Blunt abdominal trauma is a hard encounter because clinical signs may not be obvious. In view of its increasing incidence, diagnostic and treatment issues, this dissertation has been chosen. METHODOLOGY: 50 consecutive cases of blunt trauma abdomen presenting to Government Royapettah Hospital from April 2014 to September 2014 were prospectively studied. Patients with head, chest and orthopaedic injuries that require immediate surgical intervention were excluded from the study. Various parameters were analysed, i.e., age, sex, etiology, latent period, symptoms, signs, different organ injuries, investigations, treatment, operative procedures, complications, duration of stay in hospital, outcome and inferences made. RESULTS: Blunt trauma abdomen was common in 3rd decade (26%), predominantly affecting males (80%). Road traffic accident was the commonest etiology (50%). 50% presented within 4 hours of injury. Pain (100%) and tenderness (98%) were the commonest presentation. 60% had intra-abdominal injuries. Spleen was commonly involved in 28%. USG and CECT were 73.3% and 100% sensitive, respectively. X-Ray was 85.7% sensitive in detecting bowel injuries. 56% were managed conservatively. 8% underwent splenectomy, the commonest procedure. Surgical site infections were seen in 18%. 72% were discharged without any complications. 6% died due to complications. CONCLUSION: Preventing road traffic accidents can considerably reduce blunt trauma abdomen. Clinical suspicion is more important which could be complemented with investigations. In haemodynamically stable patients with low-grade injuries, conservative management can be tried with careful monitoring

The role of ascorbic acid in corneal endothelial protection during small incision cataract surgery.

INTRODUCTION: Modern cataract surgery aims to achieve an unaided visual acuity with rapid post surgical recovery and minimal surgical complications. This has been made possible with a smaller incision size, appropriate use of ophthalmic viscosurgical devices (OVD) and irrigating solutions, better instrumentation and technology. The advantages associated with phacoemulsification have made it the ideal technique for cataract surgery and the preferred one where resources are available. However, this technique cannot be employed as the standard procedure in developing countries due to certain reasons. Manual small incision cataract surgery offers similar advantages with the merit of wider applicability, better safety, a shorter learning curve and lower cost. AIM OF STUDY: To determine the role of ascorbic acid in corneal endothelial protection during manual small incision cataract surgery (SICS). Primary objective: To compare the corneal endothelial cell loss after manual SICS with and without ascorbic acid Secondary objectives: To compare the morphology of corneal endothelial cells before and after manual SICS, with and without ascorbic acid To compare the central corneal thickness before and after manual SICS, with and without ascorbic acid. MATERIALS & METHODS: 1. Information sheet 2. Consent form 3. Slit lamp biomicroscopy for anterior segment examination and grading of cataract 4. Schiotz tonometer for intra ocular pressure measurement 5. Non-contact specular microscope (Topcon SP – 2000P) for corneal endothelial analysis and central corneal thickness measurement. 6. Biochemistry department of the Institute for blood glucose estimation 7. Parentral ascorbic acid (1 ampoule containing 100mg in 5 ml) 8. Ringer‟s lactate solution as sterile intraocular irrigating solution RESULTS: 150 patients were enrolled in the study, of which 75 were enlisted to receive lactated ringer’s solution without ascorbic acid (control group) and the remaining 75 to lactated ringer’s solution with ascorbic acid (interventional group) as the intraocular irrigating solution during manual SICS. All patients were reviewed on the first post operative day and 1 week after surgery. DISCUSSION: L-Ascorbic acid, an antioxidant present abundantly in aqueous humor is thought to confer protection against the harmful effects of photochemical and oxidation reactions involving oxygen and its radicals. During manual SICS, this antioxidant is lost with aqueous humor and is replaced with irrigating solution which doesnot contain ascorbic acid thereby rendering the postoperative endothelium to greater oxidative stress and damage. The damage is increased further by the release of inflammatory mediators and exposure to sunlight following cataract surgery. CONCLUSION: Ascorbic acid has a protective effect over the human corneal endothelial cells during manual SICS. The protective effect is due to its free radical scavenging properties thus protecting the endothelium from oxidative damage. Ascorbic acid was used in a constant concentration of 0.2mg/ml throughout the study. Further studies are warranted to find out the optimal and most effective concentration of ascorbic acid that could be combined with the intraocular irrigating solution. The follow up period of this study was short. Further studies with long term follow up can establish the reversal of post operative corneal swelling and factors influencing it, in addition to the long term effects of oxidative damage on the corneal endothelium

Comparison of thyroid hormone status between pre-eclampsia and normotensive pregnancy after 37 weeks

Background: Preeclampsia is the leading cause of maternal mortality in developing countries and is associated with a fivefold increase in perinatal mortality. The mechanism of hypothyroidism in pre-eclampsia is controversial and may be related to decreased plasma protein concentrations and increased endothelin levels.Methods: This was a prospective comparative study in 100 women; out of them, 50 were normal pregnant women in the control group and 50 preeclamptic women in the case group. Thyroid hormones, total FT3, FT4 and TSH were analyzed in these subjects. The cases of pre-eclampsia characterized by elevation of blood pressure of more than 140 mmHg systolic or more than 90 mmHg diastolic with proteinuria (more than 300 mg/l in 24 hours specimen) after 37 weeks of gestation in previously normotensive nonproteinuric pregnant women.Results: Incidence of hypothyroidism is high in the study group (30%) compared to the control (14%). Furthermore, the maximum subjects were observed with euthyroidism 43 (86%) in the control group, whereas subclinical hypothyroidism 23 (46%) was observed highest in the preeclamptic group. Out of the 50 preeclamptic patients, 13 (26%) belonged to the severe whereas 37 (74%) belonged to the mild pre-eclampsia group.Conclusions: The study concluded that the pre-eclamptics have a higher incidence of hypothyroidism (SCH) in contrast to the normotensive women, and there is a correlation between the severity of pre-eclampsia and hypothyroidism

Study of histopathological findings and clinical presentation in post-menopausal bleeding

Background: Aim of the research was to study the clinical significance of post-menopausal bleeding in terms of its risk factors, malignancy incidence, and histopathological evaluation for the cause of the post-menopausal bleed.Methods: This prospective observational study was conducted in the department of gynecological in Kanyakumari Government Medical College in 100 post-menopausal bleeding per vaginam. Evaluated by history, clinical examination, and investigations like transvaginal sonography, endometrial biopsy, and cervical biopsy for all subjects, the specimens collected will be sent to the pathology dept for examination and reporting. A total of 17% of patients were observed with an enlarged uterus and 42% scanty uterine curettings.Results: The maximum number of patients, 29%, were reported in the age group of 50 to 55 years with an average age of 54.27 years. Para 2 parity (49%) and body mass index (BMI) value 21 to 30 (60%) were reported maximum in all subjects. Hypertension (17%) was reported as a major risk factor for endometrial carcinoma. Most of the patients were found with simple hyperplasia without atypia 34 (34%), followed by atrophic endometritis 32 (32%), and minimum patients have observed complex hyperplasia with atypia 4 (4%).Conclusions: The symptom indicating endometrial pathology in post-menopausal women is uterine bleeding. The incidence of a malignant cause of post-menopausal bleeding increases as the time lapse between menopause and the onset of bleeding increases. Atrophic endometritis (atrophic vaginitis) was found to be a major cause of post-menopausal bleeding. Post-menopausal hyperplasia carries a more serious threat of cancer than does premenopausal hyperplasia

An analytical study to evaluate the association between fundus fluorescein angiographic changes in diabetic maculopathy and dyslipidaemia

INTRODUCTION: Diabetic retinopathy (DR) is a leading cause of visual disability and blindness among Diabetics. It is a major microvascular complication of diabetes and is frequently accompanied by lipid exudation. Dyslipidemia leads to the development of hard exudates and Clinically Significant Macular Edema (CSME) which interferes with vision. The elevated lipid levels are associated with endothelial dysfunction and play an important role in the pathogenesis of Diabetic Retinopathy, especially in the breakdown of blood-retinal barrier. It’s important to find an association between serum lipid profile with diabetic retinopathy and its severity. The current study was undertaken to determine the association of serum lipid profile with diabetic maculopathy, the development of hard exudates and to assess the subsequent Fundus Fluorescein Angiographic(FFA) features. AIMS AND OBJECTIVES: To study the relationship between Fundus Fluorescein Angiographic patterns of diabetic maculopathy and serum lipid levels. To evaluate the relationship between serum lipid levels and retinal hard exudates in patients with diabetic retinopathy. MATERIALS AND METHODS: A total of 50 patients with diabetic retinopathy attending the O.P.D of the Department of Ophthalmology of Government Rajaji Hospital Madurai for ophthalmic evaluation detected to have Diabetic Maculopathy, will be included in this study, for a study period of 6months. A detailed history will be taken. Detailed Ophthalmological examination will be done. Fundus examination with direct, indirect ophthalmoscope and slit lamp biomicroscopy with 90 D lens for grading of diabetic retinopathy and macular assessment will be done and Fundus photograph will be taken. Investigations like complete hemogram, urine examination, Biochemical tests-FBS, PPBS, HBA1C, lipid profile, serum creatinine will be recorded and ECG will be done. Medical fitness for performing the procedure will be taken. Patient will be explained about the procedure and proper written consent will be taken prior to performing Fundus Fluorescein Angiography. RESULTS: In our study, majority of the Diabetic Maculopathy patients were between the range of 50-60 years of age, with a slight male preponderance and most of the patients with a sedentary lifestyle developed dyslipidaemia. Among the 50 patients with Diabetic Maculopathy, lipid profile revealed that 19 patients had normal lipid levels and 31 were dyslipidaemic (18 with hypercholesterolemia, 4 with high LDL and 9 with high triglycerides). The FFA findings showed two main patterns (Ischemic Maculopathy indicated by large Foveal Avascular Zone and Blocked Fluorescence due to accumulation of Hard exudates). The FFA findings of Blocked fluorescence were seen more statistically significant among those dyslipidemic patients who had high cholesterol wih a p value of 0.042. But the relation between high triglycerides and high LDL to the presence of Blocked Fluorescence in FFA was not statistically significant (p value 1.00) CONCLUSION: With the advent of modernisation and westernisation among Indians, the eventual weight gain and sedentary lifestyle, the advantage of efficient glucose metabolism has been lost and the incidence of diabetes has increased. The significant association between hypercholesteremia and CSME goes in accordance with the study by Al-Bdour et al Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR) and CURES eye study. The present study underlines the role of elevated serum lipids in the onset of diabetic macular oedema and hard exudates. The analysis of the severity of hard exudates and edema in relation to lipid fractions in patients with diabetic maculopathy showed that total cholesterol was significantly higher in such patients. Hyperlipidaemia is a risk factor for the development of hard exudates in patients with diabetic maculopathy. The current treatment for diabetic retinopathy is laser photocoagulation. With the advent of systemic lipid lowering therapy over the last two decades, there may be potential for medical therapy also to control dyslipidemic in diabetics thus reducing their progression to macular edema. The present study demonstrated statistically significant correlation between diabetic maculopathy and hypercholesterolemia (p value 0.042). Thus strict lipid control can help in improving the quality of life and vision among people with type 2 diabetes who are more prone to develop Diabetic Macular Edema