Research, knowledge, and technological advances have promoted minimally invasive image-guided diagnostic and therapeutic intervention. Such interventions are increasingly performed for musculoskeletal diseases by radiologists within outpatient settings. The objective of this study was to ascertain levels of safe practice among musculoskeletal radiologists in the United Kingdom and the Indian public health-care system, as defined by access to spinal surgeons and anesthetists during radiological spinal procedures. An online cross-sectional survey of eight questions (multiple choice and free text) was circulated among musculoskeletal radiologists in the UK and India, to evaluate: (i) Image-guided practice among musculoskeletal radiologists. (ii) Types of interventions undertaken. (iii) Practice setting. (iv) Availability of supportive, backup access to spinal surgery services. A total of 53 replies were received of which 43 (81.1%) were from musculoskeletal radiologists who perform spinal interventional procedures. Spinal biopsies and injections were the most common procedures performed by the 43 eligible radiologists (79.1% and 74.4%, respectively), with vertebroplasty and sacroplasty performed by only 16.3% and 11.6%, respectively. Less than half (46.5%) of musculoskeletal radiologists performing interventional procedures did so within a hospital setting with both a spinal surgeon and an anesthetist on site, 20.9% had an anesthetist on site but no spinal surgeon and 16.3% had neither on-site. Minimally invasive image-guided diagnostic and therapeutic intervention is a niche sub-specialty practiced by a few musculoskeletal radiologists. Enhanced resource allocation, skills training, and multidisciplinary service provision will ultimately minimize existing deficiencies, improving patient-related clinical outcomes, and quality of care.
{"title":"Safe radiological spinal intervention: A multicenter snapshot survey of musculoskeletal radiologists in the UK and India","authors":"A. Aslam, K. Iyengar, G. Sharma, R. Botchu","doi":"10.25259/ijms_183_2022","DOIUrl":"https://doi.org/10.25259/ijms_183_2022","url":null,"abstract":"\u0000\u0000Research, knowledge, and technological advances have promoted minimally invasive image-guided diagnostic and therapeutic intervention. Such interventions are increasingly performed for musculoskeletal diseases by radiologists within outpatient settings. The objective of this study was to ascertain levels of safe practice among musculoskeletal radiologists in the United Kingdom and the Indian public health-care system, as defined by access to spinal surgeons and anesthetists during radiological spinal procedures.\u0000\u0000\u0000\u0000An online cross-sectional survey of eight questions (multiple choice and free text) was circulated among musculoskeletal radiologists in the UK and India, to evaluate: (i) Image-guided practice among musculoskeletal radiologists. (ii) Types of interventions undertaken. (iii) Practice setting. (iv) Availability of supportive, backup access to spinal surgery services.\u0000\u0000\u0000\u0000A total of 53 replies were received of which 43 (81.1%) were from musculoskeletal radiologists who perform spinal interventional procedures. Spinal biopsies and injections were the most common procedures performed by the 43 eligible radiologists (79.1% and 74.4%, respectively), with vertebroplasty and sacroplasty performed by only 16.3% and 11.6%, respectively. Less than half (46.5%) of musculoskeletal radiologists performing interventional procedures did so within a hospital setting with both a spinal surgeon and an anesthetist on site, 20.9% had an anesthetist on site but no spinal surgeon and 16.3% had neither on-site.\u0000\u0000\u0000\u0000Minimally invasive image-guided diagnostic and therapeutic intervention is a niche sub-specialty practiced by a few musculoskeletal radiologists. Enhanced resource allocation, skills training, and multidisciplinary service provision will ultimately minimize existing deficiencies, improving patient-related clinical outcomes, and quality of care.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"208 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91470367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr. Jason Fung presents a novel, comprehensive model of obesity that delivers unexpected insights into healthy eating in this highly accessible and challenging book. Dr. Fung is a nephrologist (kidney doctor) who launched the Intensive Dietary Management program in Toronto. Dr. Jason Fung is regarded as a member of the foremost experts on intermittent fasting, a subject I knew very little about before going through his book. His intermittent fasting approach is his trademark prescription for obesity and type 2 diabetes individuals. Dr. Fung discusses utilizing intermittent fasting to end the cycle of insulin resistance and achieve a healthy weight.
{"title":"The obesity code: Book review","authors":"Jonnalagadda Vihari","doi":"10.25259/ijms_154_2022","DOIUrl":"https://doi.org/10.25259/ijms_154_2022","url":null,"abstract":"Dr. Jason Fung presents a novel, comprehensive model of obesity that delivers unexpected insights into healthy eating in this highly accessible and challenging book. Dr. Fung is a nephrologist (kidney doctor) who launched the Intensive Dietary Management program in Toronto. Dr. Jason Fung is regarded as a member of the foremost experts on intermittent fasting, a subject I knew very little about before going through his book. His intermittent fasting approach is his trademark prescription for obesity and type 2 diabetes individuals. Dr. Fung discusses utilizing intermittent fasting to end the cycle of insulin resistance and achieve a healthy weight.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73667838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How informed are patients after informed consent process","authors":"P. Panda, A. Gulia","doi":"10.25259/ijms_203_2022","DOIUrl":"https://doi.org/10.25259/ijms_203_2022","url":null,"abstract":"","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84861753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tanaya Kulkarni, K. Sharadhini, A. Guha, S. Kulkarni
We present a case of spontaneous pneumorrhachis associated with minimal pneumomediastinum from a tertiary care cancer hospital in Mumbai. A 16-year-old boy who was a case of Hodgkin lymphoma undergoing chemotherapy presented to the physician with complaints of cough associated with white-colored sputum and chest pain. Computed tomography of the chest done to rule out infection revealed pneumorrhachis, that is, air lurking in the spinal canal. Radiological and laboratory investigations were done to rule out crucial and life-threatening differentials. The patient was kept on observation, and finally, we figuratively cleared the air around the finding of “air in the spinal cord.” This is the first reported case in the literature of pneumorrachis in a patient with Hodgkin’s lymphoma.
{"title":"Clearing the air around spontaneous pneumorrhachis","authors":"Tanaya Kulkarni, K. Sharadhini, A. Guha, S. Kulkarni","doi":"10.25259/ijms_326_2021","DOIUrl":"https://doi.org/10.25259/ijms_326_2021","url":null,"abstract":"We present a case of spontaneous pneumorrhachis associated with minimal pneumomediastinum from a tertiary care cancer hospital in Mumbai. A 16-year-old boy who was a case of Hodgkin lymphoma undergoing chemotherapy presented to the physician with complaints of cough associated with white-colored sputum and chest pain. Computed tomography of the chest done to rule out infection revealed pneumorrhachis, that is, air lurking in the spinal canal. Radiological and laboratory investigations were done to rule out crucial and life-threatening differentials. The patient was kept on observation, and finally, we figuratively cleared the air around the finding of “air in the spinal cord.” This is the first reported case in the literature of pneumorrachis in a patient with Hodgkin’s lymphoma.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82124225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Jebaraj, Kanagalakshmi Vellaiputhiyavan, V. Mohan, Reginald Alex
Musculoskeletal disorders (MSDs) are the most common occupational health problem accounting for a larger number of compensation days and disability among workers. An invisible workforce of female domestic workers (FDWs) is involved in back-breaking jobs in the informal job sectors, and yet, there are no studies to quantify their work-related MSD’s (WMSDs). The objective of the study is to determine the prevalence of WMSDs among FDWs employed at private houses in Bengaluru, South India. A cross-sectional study was conducted among 408 randomly selected FDWs with a comparative group. The trained interviewer assessed WMSDs using a standardized Nordic Musculoskeletal questionnaire and psychosocial distress using the general health questionnaire–12. A high prevalence of WMSD was reported in the neck (19.6%), shoulder (23.8%), elbow (12%), upper back (31.9%), and ankle (26%) in domestic workers than the non-domestic workers. Age above 37 years (AOR: 1.77, 95% CI: 1.03–3.06), house cleaning ([>1715 h/year – AOR: 1.30, 95% CI: 0.60–2.84] [1714–555 h/year – AOR: 1.30, 95% CI:0.66–2.59]), and clothing ([Care >1460 h/year – AOR: 2.44, 95% CI: 1.12–5.35] [109–1459 h/year – AOR: 1.98, 95% CI: 0.95–4.10]) were factors associated with neck pain in FDW. Moreover, work experience of more than 10 years (AOR: 2.10, 95% CI: 1.32–3.34) and distress (AOR: 2.13, 95% CI: 1.25–3.61) was a factor associated with lower back pain in FDW. FDWs are substantially affected by WMSDs in the neck and lower back due to house cleaning and clothing care tasks performed in the workplace setting, respectively.
{"title":"Prevalence and risk factors for work-related musculoskeletal disorder among female domestic workers employed in private homes in South India: A cross-sectional study","authors":"P. Jebaraj, Kanagalakshmi Vellaiputhiyavan, V. Mohan, Reginald Alex","doi":"10.25259/ijms_376_2021","DOIUrl":"https://doi.org/10.25259/ijms_376_2021","url":null,"abstract":"\u0000\u0000Musculoskeletal disorders (MSDs) are the most common occupational health problem accounting for a larger number of compensation days and disability among workers. An invisible workforce of female domestic workers (FDWs) is involved in back-breaking jobs in the informal job sectors, and yet, there are no studies to quantify their work-related MSD’s (WMSDs). The objective of the study is to determine the prevalence of WMSDs among FDWs employed at private houses in Bengaluru, South India.\u0000\u0000\u0000\u0000A cross-sectional study was conducted among 408 randomly selected FDWs with a comparative group. The trained interviewer assessed WMSDs using a standardized Nordic Musculoskeletal questionnaire and psychosocial distress using the general health questionnaire–12.\u0000\u0000\u0000\u0000A high prevalence of WMSD was reported in the neck (19.6%), shoulder (23.8%), elbow (12%), upper back (31.9%), and ankle (26%) in domestic workers than the non-domestic workers. Age above 37 years (AOR: 1.77, 95% CI: 1.03–3.06), house cleaning ([>1715 h/year – AOR: 1.30, 95% CI: 0.60–2.84] [1714–555 h/year – AOR: 1.30, 95% CI:0.66–2.59]), and clothing ([Care >1460 h/year – AOR: 2.44, 95% CI: 1.12–5.35] [109–1459 h/year – AOR: 1.98, 95% CI: 0.95–4.10]) were factors associated with neck pain in FDW. Moreover, work experience of more than 10 years (AOR: 2.10, 95% CI: 1.32–3.34) and distress (AOR: 2.13, 95% CI: 1.25–3.61) was a factor associated with lower back pain in FDW.\u0000\u0000\u0000\u0000FDWs are substantially affected by WMSDs in the neck and lower back due to house cleaning and clothing care tasks performed in the workplace setting, respectively.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76556844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Hakak, R. Tadke, A. Faye, S. Gawande, S. Bhave, V. Kirpekar
Patients admitted to the medical intensive care unit (MICU) for various medical morbidities are prone to suffer various psychiatric symptoms. Common conditions for which psychiatric consultation is sought are anxiety, delirium, self-harm attempt, and adjustment disorder. Anxiety is a commonly encountered problem and can affect the treatment outcome and compliance. This study was carried out in the MICU of tertiary care hospital to assess the pattern of anxiety symptoms in patients admitted to the MICU. Sixty patients admitted to MICU were included in the study and assessed using semi-structured pro forma, Hamilton Anxiety Rating Scale (HAM-A), Brief Psychiatric Rating Scale, and Faces Anxiety Scale. Data were statistically analyzed using mean, Chi-square test, t-test, and logistic regression test. The majority of the participants were male, predominantly belonging to the age group of 40–59 years. Most of them had some physical, behavioral, or psychological symptoms of anxiety in a mild form. Although the extent of the anxiety symptoms in most of the patients was mild, a few also reported a moderate level of anxiety. Patients with cardiac and respiratory disorders had higher scores on anxiety rating scales than those with other diagnoses. Male gender, cardiorespiratory disease, and the presence or absence of anxiety had a negative correlation (r = −1.79) whereas gender, disease, and presence of mild or moderate anxiety had no statistical significance. Most of the patients, especially those admitted with cardiac and respiratory disorders, had mild anxiety symptoms. Assessment of anxiety in MICU patients can be an important aspect to prevent or reduce the overall disease burden.
{"title":"Anxiety symptoms in patients admitted in medical intensive care unit: A cross-sectional study","authors":"B. Hakak, R. Tadke, A. Faye, S. Gawande, S. Bhave, V. Kirpekar","doi":"10.25259/ijms_196_2021","DOIUrl":"https://doi.org/10.25259/ijms_196_2021","url":null,"abstract":"\u0000\u0000Patients admitted to the medical intensive care unit (MICU) for various medical morbidities are prone to suffer various psychiatric symptoms. Common conditions for which psychiatric consultation is sought are anxiety, delirium, self-harm attempt, and adjustment disorder. Anxiety is a commonly encountered problem and can affect the treatment outcome and compliance. This study was carried out in the MICU of tertiary care hospital to assess the pattern of anxiety symptoms in patients admitted to the MICU.\u0000\u0000\u0000\u0000Sixty patients admitted to MICU were included in the study and assessed using semi-structured pro forma, Hamilton Anxiety Rating Scale (HAM-A), Brief Psychiatric Rating Scale, and Faces Anxiety Scale. Data were statistically analyzed using mean, Chi-square test, t-test, and logistic regression test.\u0000\u0000\u0000\u0000The majority of the participants were male, predominantly belonging to the age group of 40–59 years. Most of them had some physical, behavioral, or psychological symptoms of anxiety in a mild form. Although the extent of the anxiety symptoms in most of the patients was mild, a few also reported a moderate level of anxiety. Patients with cardiac and respiratory disorders had higher scores on anxiety rating scales than those with other diagnoses. Male gender, cardiorespiratory disease, and the presence or absence of anxiety had a negative correlation (r = −1.79) whereas gender, disease, and presence of mild or moderate anxiety had no statistical significance.\u0000\u0000\u0000\u0000Most of the patients, especially those admitted with cardiac and respiratory disorders, had mild anxiety symptoms. Assessment of anxiety in MICU patients can be an important aspect to prevent or reduce the overall disease burden.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80981682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are four major paradigms in statistics: Frequentist, Bayesian, likelihood, and modeling. A quadrangle approach that makes use of all these four paradigms is proposed to get a complete understanding of any biological phenomenon. Each of these paradigms can be used to study different aspects of a biological phenomenon. The elements are defined here as an observer, observed, and context, and the model generated should have information derived from these three elements. They can be analyzed, respectively, by Bayesian, frequentist, likelihood, and modeling methods. There is a continuous debate on frequentist and Bayesian approaches in statistics. Biologists often use frequentist methods whereas clinicians are interested in Bayesian methods. In this article, the debate on both these approaches has been discussed in light of understanding uncertainty. The Dempster-Shafer theory addresses the relationship between belief and plausibility but has been criticized for producing counterintuitive results in conflict situations. It is argued here that this can be resolved by inferring that frequentist and Bayesian approaches are inverse to each other.
{"title":"Statistical approaches to make sense of data in biology and medicine","authors":"S. Prakash","doi":"10.25259/ijms_197_2021","DOIUrl":"https://doi.org/10.25259/ijms_197_2021","url":null,"abstract":"There are four major paradigms in statistics: Frequentist, Bayesian, likelihood, and modeling. A quadrangle approach that makes use of all these four paradigms is proposed to get a complete understanding of any biological phenomenon. Each of these paradigms can be used to study different aspects of a biological phenomenon. The elements are defined here as an observer, observed, and context, and the model generated should have information derived from these three elements. They can be analyzed, respectively, by Bayesian, frequentist, likelihood, and modeling methods. There is a continuous debate on frequentist and Bayesian approaches in statistics. Biologists often use frequentist methods whereas clinicians are interested in Bayesian methods. In this article, the debate on both these approaches has been discussed in light of understanding uncertainty. The Dempster-Shafer theory addresses the relationship between belief and plausibility but has been criticized for producing counterintuitive results in conflict situations. It is argued here that this can be resolved by inferring that frequentist and Bayesian approaches are inverse to each other.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"78 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87921980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anwesh Reddy Nandigam, S. Gummaluri, Anil Kumar Kancharla, Venkata Naga Sri Harsha Anumolu, Sheema Tasneem Mohammad, Sidhartha SP Behera
COVID-19 pandemic has shown a substantial impact on the entire world both physiologically and psychologically. By the hit of the second wave, which opened dangerous gates for secondary infections, apprehension was carried among health-care sectors. These secondary infections were due to decreased immunity. On the other hand, risk modifiers, such as diabetes and hypertension played a leading role in the mortality rate. A substantial number of studies have not been conducted so far regarding the impact of this second wave on dental healthcare professionals. The present study aimed to evaluate the dental healthcare professionals’ perspective levels during the second wave of the COVID-19 pandemic through a web-based survey. A total of 853 responses were gathered by sending 15 questions in Google forms. Data collected were gathered and subjected to statistical analysis, expressed in frequency distribution and Pearson’s Chi-square test was performed. Data obtained and projected that the study population expressed higher anxiety and stress levels, despite which was many of them showed an inclination to work during these tough times. The knowledge about secondary fungal infections like Mucormycosis, which was caused due to immune suppression, was abundant among the participants. A significant proportion conveyed the ill effect of COVID-19 on clinical practice and academics as well. Dental professionals have shown a positive perspective despite of higher stress levels and being a part of frontline workers, they are much primed to assure, educate, and treat the patients amidst the COVID-19 pandemic.
{"title":"Perspective of dental health-care professionals during the second wave of COVID-19 pandemic: A national online survey","authors":"Anwesh Reddy Nandigam, S. Gummaluri, Anil Kumar Kancharla, Venkata Naga Sri Harsha Anumolu, Sheema Tasneem Mohammad, Sidhartha SP Behera","doi":"10.25259/ijms_324_2021","DOIUrl":"https://doi.org/10.25259/ijms_324_2021","url":null,"abstract":"\u0000\u0000COVID-19 pandemic has shown a substantial impact on the entire world both physiologically and psychologically. By the hit of the second wave, which opened dangerous gates for secondary infections, apprehension was carried among health-care sectors. These secondary infections were due to decreased immunity. On the other hand, risk modifiers, such as diabetes and hypertension played a leading role in the mortality rate. A substantial number of studies have not been conducted so far regarding the impact of this second wave on dental healthcare professionals. The present study aimed to evaluate the dental healthcare professionals’ perspective levels during the second wave of the COVID-19 pandemic through a web-based survey.\u0000\u0000\u0000\u0000A total of 853 responses were gathered by sending 15 questions in Google forms. Data collected were gathered and subjected to statistical analysis, expressed in frequency distribution and Pearson’s Chi-square test was performed.\u0000\u0000\u0000\u0000Data obtained and projected that the study population expressed higher anxiety and stress levels, despite which was many of them showed an inclination to work during these tough times. The knowledge about secondary fungal infections like Mucormycosis, which was caused due to immune suppression, was abundant among the participants. A significant proportion conveyed the ill effect of COVID-19 on clinical practice and academics as well.\u0000\u0000\u0000\u0000Dental professionals have shown a positive perspective despite of higher stress levels and being a part of frontline workers, they are much primed to assure, educate, and treat the patients amidst the COVID-19 pandemic.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"37 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85004497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Factors responsible for causing complications in venomous snakebites are unknown. The present study was planned to identify such factors. This was a prospective and observational study. All patients presenting to the emergency department between April 2016 and August 2017 with venomous snakebites and meeting inclusion/exclusion criteria were enrolled. Patients were divided into two groups based on the presence/absence of complications. Risk factors associated with complications were analyzed. Out of 236 patients screened, 156 were eligible. Mean age was 39.5 ± 15.6; majority (n = 122, 78.2%) were in the age group of 20–59 years; 119 (76.3%) were males. Eighty-eight patients (56.4%) developed complications, of which, cellulitis/compartment syndrome (n = 54, 34.6%) was most common, followed by acute kidney injury (n = 18, 11.5%), coagulopathy/disseminated intravascular coagulation (n = 17, 10.9%), neuroparalysis needing ventilator (n = 12, 7.7%), shock (n = 8, 5.1%), acute respiratory distress syndrome (three patients, 1.9%), and sepsis (one patient, 0.6%). The mortality rate was 1.92%. On univariate analysis, low hemoglobin, elevated neutrophil count, lower lymphocyte count, serum creatinine, initial/total dose of anti-snake venom, and prolonged hospital stay had a statistically significant association with complications. On multivariate analysis, elevated neutrophil count (OR 1.084; 95% CI 0.997, 1.179) and prolonged hospital stay (OR 1.975; 95% CI 1.393, 2.800) were associated with complications. Bite-to-needle time was associated with mortality. The nature of complications depends on composition of venom, and thus varies with geographical region. The Association of neutrophil and lymphocyte counts points to an inflammatory hypothesis. The Association of bite-to-needle time with mortality highlights the early use of antivenom. Awareness of risk factors may guide in predicting complications.
{"title":"Predictors of complications in venomous snakebites","authors":"K. Narvencar, T. T. Favas, A. Dias","doi":"10.25259/ijms_328_2021","DOIUrl":"https://doi.org/10.25259/ijms_328_2021","url":null,"abstract":"\u0000\u0000Factors responsible for causing complications in venomous snakebites are unknown. The present study was planned to identify such factors.\u0000\u0000\u0000\u0000This was a prospective and observational study. All patients presenting to the emergency department between April 2016 and August 2017 with venomous snakebites and meeting inclusion/exclusion criteria were enrolled. Patients were divided into two groups based on the presence/absence of complications. Risk factors associated with complications were analyzed.\u0000\u0000\u0000\u0000Out of 236 patients screened, 156 were eligible. Mean age was 39.5 ± 15.6; majority (n = 122, 78.2%) were in the age group of 20–59 years; 119 (76.3%) were males. Eighty-eight patients (56.4%) developed complications, of which, cellulitis/compartment syndrome (n = 54, 34.6%) was most common, followed by acute kidney injury (n = 18, 11.5%), coagulopathy/disseminated intravascular coagulation (n = 17, 10.9%), neuroparalysis needing ventilator (n = 12, 7.7%), shock (n = 8, 5.1%), acute respiratory distress syndrome (three patients, 1.9%), and sepsis (one patient, 0.6%). The mortality rate was 1.92%. On univariate analysis, low hemoglobin, elevated neutrophil count, lower lymphocyte count, serum creatinine, initial/total dose of anti-snake venom, and prolonged hospital stay had a statistically significant association with complications. On multivariate analysis, elevated neutrophil count (OR 1.084; 95% CI 0.997, 1.179) and prolonged hospital stay (OR 1.975; 95% CI 1.393, 2.800) were associated with complications. Bite-to-needle time was associated with mortality.\u0000\u0000\u0000\u0000The nature of complications depends on composition of venom, and thus varies with geographical region. The Association of neutrophil and lymphocyte counts points to an inflammatory hypothesis. The Association of bite-to-needle time with mortality highlights the early use of antivenom. Awareness of risk factors may guide in predicting complications.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80874947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maanasa Rajagopalan, L. Ranganathan, S. Valarmathi, Srinivas Govindarajulu, S. Seshayyan
The objective of this study was to assess the levels of depression among patients with Parkinson’s Disease (PD), the factors influencing their levels, and determine their influence on their Quality of Life (QoL). The study was conducted at the movement disorders outpatient department, Rajiv Gandhi Government General hospital, where 50 patients with diagnosed PD were enrolled. They were interviewed for their levels of depression and QoL using respective standardized depression and QoL assessment questionnaires. Patients with PD were mostly above the age of 50 and were male. Their levels of depression ranged between normal to mild and borderline depression and their QoL scores were also moderate. Among their QoL domains, the emotional well-being, and cognition of patients were found to be more affected when compared to other domains. The prevalence and severity of depression among patients with PD were mild, but they play an important role in determining their QoL, especially the emotional well-being and cognitive performance of patients.
{"title":"Depression and Quality of Life of Parkinson’s disease patients – A hospital-based cross-sectional study","authors":"Maanasa Rajagopalan, L. Ranganathan, S. Valarmathi, Srinivas Govindarajulu, S. Seshayyan","doi":"10.25259/ijms_77_2021","DOIUrl":"https://doi.org/10.25259/ijms_77_2021","url":null,"abstract":"\u0000\u0000The objective of this study was to assess the levels of depression among patients with Parkinson’s Disease (PD), the factors influencing their levels, and determine their influence on their Quality of Life (QoL).\u0000\u0000\u0000\u0000The study was conducted at the movement disorders outpatient department, Rajiv Gandhi Government General hospital, where 50 patients with diagnosed PD were enrolled. They were interviewed for their levels of depression and QoL using respective standardized depression and QoL assessment questionnaires.\u0000\u0000\u0000\u0000Patients with PD were mostly above the age of 50 and were male. Their levels of depression ranged between normal to mild and borderline depression and their QoL scores were also moderate. Among their QoL domains, the emotional well-being, and cognition of patients were found to be more affected when compared to other domains.\u0000\u0000\u0000\u0000The prevalence and severity of depression among patients with PD were mild, but they play an important role in determining their QoL, especially the emotional well-being and cognitive performance of patients.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88639471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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