Assessment of maternal serum β hCG level in pregnancy induced hypertension and normotensive patients and to correlate between the level of β hCG with the severity of pre-eclampsia and eclampsia

Background: Hypertensive disorders during pregnancy are one of the most common medical complication seen during pregnancy, affecting around 5-10% of all pregnancies. Spectrum of this disease ranges from mildly elevated blood pressure with minimal clinical significance to severe hypertension with multi organ dysfunction. Pre-eclampsia complicates about 2-8% of all pregnancies. Pre-eclampsia incidence in India is about 8-10%. Various studies have depicted that, there is a strict relationship between PIH and elevated serum β-hCG level.Methods: This one-year prospective case control study toteled 200 pregnant women attending antenatal care and admitted in eclampsia ward fulfiling the inclusion criteria were studied. Serum βhCG levels were estimated by chemiluminescent microparticle immunoassay. Statistical analysis of data was done by student’s t-test and p-value.Results: The mean β hCG level in PIH patients was found to 36851.59 mIU/ml with standard deviation of 22916.58 while the mean β hCG in normotensive patient was 15433.26 mIU/ml with standard deviation of 6861.56. (p <0.001). The mean β hCG level in gestational hypertensive patients was 25206.19 mIU/ml with a standard deviation of 8696.9. The mean β hCG level in pre-eclamptic patients was 61697.67 mIU/ml with standard deviation of 18498.57. The mean β hCG level were 84106.38 mIU/ml with standard deviation of 11295.05 in the eclamptic patient. The above values were statistically significant (p <0.001).Conclusions: We concluded that there was a striking relation between the PIH including pre-eclampsia and eclampsia with the elevated serum βhCG level. Concluding that early detection of altered serum βhCG shell aid in better management of pre-eclampsia and eclampsia cases which would play a pivotal role in improving the maternal and fetal outcome

PRESCRIPTION AUDIT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING INDICATORS FOR INDOOR PATIENTS TREATED UNDER CMAAY/PMJAY INSURANCE SCHEMES IN A TERTIARY CARE TEACHING HOSPITAL

Objective: This study focused on the prescriptions audit of indoor patients treated under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief Minister Arogya Arunachal Yojana (CMAAY) insurance schemes as per the World Health Organization (WHO) prescribing indicators. Materials and Methods: Retrospective cross-sectional study was conducted and the prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 under CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health and Medical Sciences in Arunachal Pradesh. Study was conducted in five departments and Information was collected through the review of case sheets. The post-operative day prescription was analyzed for the patients who have undergone surgery and the patients who were managed conservatively; admission day prescription was analyzed using the WHO core drug prescribing indicators. Following data were analyzed. (1) Average no of drugs prescribed per encounter; (2) percentage of encounter having antibiotic; (3) percentage of drugs prescribed by generic name; (4) percentage of encounters with an injection; and (5) percentage of drugs prescribed from the essential drug list. Results: A total of 960 indoor patients treated under five departments, out of which 359 (37.4%) treated under general surgery, 383 (39.9%) under Obstetrics and Gynecology department, 65 (6.8%) under ENT department, 68 (7.1%) under orthopedics department, and 85 (8.9%) under General medicine department. All departments taken together, the average number of drugs used per patient was 4.91. Antibiotics were prescribed in 92.18% of the total patients when all departments were included, single antibiotic was used in 72.18%, two antibiotics in 17.29%, and three in 2.7% of the total patients. Overall, the generic names were written in 67.3% of the total drugs and the most commonly used route was parenteral route, in about 98.19% of the total prescribed drugs. From the essential drugs list, 89.33% of the total drugs were prescribed. Fixed drug combination was used in 13.59% of the total drugs prescribed. Conclusion: In our study, the percentage of prescriptions with average no of drugs per prescription, antibiotic used, injections used were much higher when compared to the WHO core prescribing indicators. The reason might be because we have analyzed the prescription of indoor patients and most of them were post-operative patients, so it is justified. While prescribing, the physicians and surgeons followed WHO essential drug list but use of generic names was in few prescriptions. The generic name use to be more emphasized, encouraged, and promoted

Clinical outcomes after the recognition and management of Sjögren’s syndrome in children: a Case Study

The most common symptoms of Sjögren\u27s syndrome (SS), a common inflammatory disease, include xerostomia, keratoconjunctivitis sicca, enlargement of the salivary gland, and decreased function of the lacrimal and salivary glands.  Secondary SS occurs in conjunction with inflammatory rheumatic illnesses, whereas primary SS manifests alone. Additionally, symptoms may not necessarily appear at the same time. The variety of symptom manifestation makes first diagnosis more challenging. Trained professionals, like rheumatologists, family doctors, ophthalmologists, and dental specialists, who might somehow focus just on those side effects that fall inside their fields of information, may get an exact portrayal of the patient by utilizing the more as of now refined indicative measures, prompting prior recognizable confirmation treatment of SS

Leadership Strategies for Enhancing Healthcare Workforce Resilience

Introduction: Maintaining a skilled and effective healthcare workforce is essential for providing quality care to patients. The pace and stress of the current environment can make it difficult for healthcare professionals to maintain their resilience. Effective leadership strategies are crucial for driving up workforce resilience and helping healthcare professionals thrive.Methods: So, we conducted a thorough literature search, looking for examples of effective leadership approaches to building healthcare workforce resilience. Multiple databases, including PubMed, CINAHL, and PSYC INFO, were used for the literature search.  Results: We found that several of the strategies that were found to be effective in promoting resilience among the healthcare workforce included fostering a culture of support, encouragement, and empowerment; providing opportunities for self-care, relaxation, and stress management; promoting work-life balance; and ultimately, implementing communication training and mentorship. 4. They were found to improve the resilience of healthcare professionals and mitigate the adverse effects of burnout and stress.Conclusions: Leadership in promoting and normalizing resilience in the healthcare Workforce Understanding and taking action on the identified strategies will help leaders build a supportive working environment focused on improving both employee well-being and the quality of care delivered to patients. More research is warranted to ascertain both the effectiveness of such approaches and create evidence-informed recommendations to support organizational leaders in enhancing workforce resilience

Children with autism spectrum disorder\u27s sleep patterns: a research analysis

Sleep issues are common in young  with autism spectrum disorder (ASD), and although the Children\u27s Sleep Habits Questionnaire (CSHQ) is widely used for assessment, concerns about its ideal variable structure still exist. This research looked at the CSHQ\u27s variable structure in young children with ASD and explored the relationship between CSHQ variables and emotional, cognitive, and behavioral dysregulation. Children with ASD between the ages of 4 and 5 (n = 270) took part in the research. Two previously published CSHQ variable frameworks were tested for  data using confirmatory factor analysis (CFA), and other frameworks were investigated using exploratory factor analysis (EFA). Regression analysis evaluated how differences in dysregulation symptoms were explained by the values of the  variables.previously published frameworks for validated, a novel five-variable system discovered by EFA showed a great fit with the  Although sleep characteristics were not generally linked to autistic symptoms, there was evidence of particular associations between them and aggression, stress, depression, and attention deficit problems. These results highlight how common sleep issues are in young children with ASD and indicate that the recently discovered CSHQ five-variable approach may be useful in future studies

Advancements in Proton and Carbon Ion Therapy for Precision Radiotherapy of Complex Tumors

Precision radiation has changed a lot because of progress in proton and carbon ion therapy. This has made it much easier to treat complicated cancers. These particle treatments are becoming more well known for their ability to give highly targeted radiation doses that cause the least amount of damage to healthy tissues while still effectively targeting cancer. As a type of charged particle therapy, proton therapy uses protons instead of regular X-rays to treat cancer. It does this by taking advantage of the way protons are made, especially their Bragg peak, which is where they release their most energy. This makes it possible to deliver the amount more precisely, protecting healthy cells from too much radiation, especially in places that are hard to reach with regular photon-based treatment. Carbon ion treatment is a more advanced type of particle therapy that uses carbon ions, which are heavier than protons and have more mass and energy. These ions give a higher amount of radiation with more accuracy, which makes it more effective at treating tumors that are resistant to radiation, like those in the head, neck, and brain, as well as juvenile cancers. The biological efficiency of carbon ions is higher because they can hurt cells more severely than protons or regular X-rays. This means that they are better at controlling tumors in many therapeutic situations. Advanced technologies like synchrotrons and cyclotrons have made proton and carbon ion therapy more widely available. This means that patients can get these treatments more easily. Adding high-tech imaging methods like MRI and CT scans has also made these medicines more accurate, letting doctors watch patients in real time and change their treatment plans as needed. Using these technologies along with particle therapy has led to better treatment results, especially for tumors that are complicated and close to important structures

Analyzing the Impact of Digital Health Communication on Patient Engagement and Treatment Adherence

Modern healthcare systems now strongly rely on digital health communication to get patients more engaged in their treatment and assist them to stay with their prescriptions.  Healthcare professionals may now have more tailored and continuous interactions with their patients since so many individuals use mobile applications, telemedicine systems, and digital health data.  With an eye on how technology-based solutions can enable patients to follow their treatment regimens for chronic illnesses and preventative care, this paper investigates how digital health communication influences patient engagement and treatment commitment. This paper examines how well various digital communication technologies text systems, notes, video chats, real-time tracking help patients and medical professionals interact with one another.  The research also examines how successfully digital health technologies enable individuals to follow their treatments as well as how their behaviour, drive, and overall pleasure in regard to care.  This paper uses a lot of current research, polls, and case studies to find the main things that make digital communication work in healthcare. These are ease of use, accessibility, perceived value, and trust in technology.  The results show that digital health communication makes patients more interested by giving them personalised material, letting them connect with healthcare professionals at the right time, and giving them more chances to learn.  Digital platforms have also been shown to help people stick with their treatments by reminding them, tracking their progress, and letting healthcare workers offer real-time support when they are used with personalised treatment plans.  Even though there are benefits, there are still big problems that need to be fixed, like not knowing how to use technology, worries about privacy, and unequal access to digital tools

Comparing Clinical Outcomes and Treatment Efficiency of 3D Conformal and Intensity Modulated Radiotherapy

Recently, a lot of progress has been made in using radiation therapy to treat cancer. The two most common methods are 3D Conformal Radiotherapy (3D-CRT) and Intensity Modulated Radiotherapy (IMRT). Both ways try to give tumors the exact amount of radiation they need while causing as little damage as possible to good cells around them. In this study, the clinical results and treatment effectiveness of 3D-CRT and IMRT are compared in cancer patients with different types of radiation therapy. A historical cohort study included 120 patients from different hospitals. They were split into two groups, with one group getting 3D-CRT and the other IMRT. The main goals of the study were to compare the two groups in terms of tumor control rates, side effects from treatment, and overall survival (OS). The effectiveness of the treatment was also judged by looking at the total time needed for planning and carrying out the treatment, as well as the radiation doses given to both the tumor and healthy cells. Overall, our results showed that IMRT had better tumor control rates than 3D-CRT, with more cases of local control and fewer cases of cancer coming back at treatment sites. When compared to 3D-CRT, the IMRT group had a significantly lower rate of acute radiation-induced effects, such as skin discomfort and stomach problems. Because it can send out very directed radiation beams, IMRT was also linked to less damage to good organs around the tumor, like the spinal cord and lungs. IMRT, on the other hand, needs more complicated treatment planning and takes longer to give than 3D-CRT, which can make prices and resource use go up. Even so, IMRT\u27s higher level of accuracy made it a clear winner when it came to controlling tumors and improving patients\u27 quality of life

ASSESSING RISK FACTORS OF MALARIA IN LAKHIMPUR DISTRICT OF ASSAM

Malaria is a life-threatening parasitic disease transmitted from person to person through the bite of a female Anopheles mosquito. The transmission of malaria can be determined by climatic and host factors. The objective of this paper is to trace the host factors of malaria incidence and also to determine the relationship between climatic factors and malaria incidence in Lakhimpur district of Assam. In order to examine the association between monthly malaria incidence rates and climatic variables, Pearson correlation analysis has been used. Also, Chi-square test for independence of attributes is performed to trace the host factors of malaria incidence. A uctuating trend was observed for reported malaria cases during the years 2000-2011. Both positive and negative correlation have occurred between climatic variable and MIR. Also, we have observed that male is more affected by malaria incidence than female. Among the age groups, the age group 15-39 years was found most affected age group than other age groups. After Chi-square test for independence of attributes we reveal that malaria depends on sex and age. SUMMARY: From our study, we suggest that even if the climatic factors play a primary role for transmission of malaria, sex and age are other important risk factors in characterizing malaria incidence in the district.</jats:p

Drug Utilization Pattern Among Indoor Patients Treated Under CMAAY/PMJAY Insurance Schemes at Tertiary Care Hospital in Arunachal Pradesh, North East India

Background: Drug utilization pattern helps to understand the current trend of the drug used in various conditions by healthcare providers. It also helps in rationalizing budget expenditure on the medication cost. The Chief Minister Arogya Arunachal Yojana/Pradhan Mantri Jan Arogya Yojana (CMAAY/PMJAY) is a cashless scheme run by Govt of Arunachal Pradesh and Govt of India where the surgeries, medicines/surgical items cost are borne by the government. Present study assessed the drug utilization pattern among indoor patients treated under these insurance schemes. Material and Method: Retrospective cross-sectional study was conducted at Tomo Riba institute of Health and Medical Sciences (TRIHMS) in Arunachal Pradesh, North East India. Prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 (for 7 months) under above mentioned insurance schemes. Data was collected through the review of case sheets. For patients who have undergone surgery, the prescription on the post-operative day and for the patients managed conservatively, the prescription on the day of admission was analyzed. Information regarding Name, Age, Gender, Antimicrobial agents, Analgesics, Antiulcer drugs and other drugs given to the patients were collected. Results: A total of 960 patients were treated. 359 patients got benefitted in the insurance scheme by department of General surgery, 383 patients by dept of Obstetrics and Gynecology, 68 patients by orthopedics department, 65 patients by ENT dept, 85 patients by medicine department. Most common antimicrobial agent used were ceftriaxone (54.1%) followed by cefuroxime (17.5%) ,metronidazole (10%) and cefoperazone(7.5%). Some other antimicrobial agents preferred were piperacillin, tinidazole and amikacin. Most common antiulcer drug used was proton pump inhibitor pantoprazole (76.25%). The analgesics commonly used were diclofenac sodium (53.3%) followed by tramadol (30.6%), pentazocine (23.3%) and paracetamol (20.2%). Other drugs commonly used were ondansetron, butrophase and tranexemic acid. Conclusion: From our study, a conclusion can be withdrawn that if few of the antibiotics, analgesic, antiulcer drugs can be made available in the Govt set up through Govt procurement then the institute can work in more cost-effective and economical way.</jats:p