Introduction:In India, knowledge and awareness regarding prescription drugs is lacking. Of these, corticosteroids are one of the most widely used drugs and also one with an array of side effects. Therefore, discretionary use of these prevalent drugs must be emphasized to the general public. Thus, the present study was undertaken to determine knowledge and awareness regarding corticosteroids among people visiting the General OPD and evaluate the effectiveness of a novel steroid educational module. Materials and Methods: A cross sectional study was conducted in a total of 328 people visiting the General OPD after Ethics permission. After taking informed consent, a pre-validated questionnaire (CVR =0.62-1, CVI=0.9) was administered. 96 participants having low baseline knowledge regarding steroids from enrolled 328 participants were administered the module. Paired-t test was used for pre and post-interventional analysis. Results: Out of 328 participants, only 17.1% (56/328) knew about steroids. Of those, only 14% (8/56) said that their source of information was doctor, 51.78% (29/56) didn't know any therapeutic use of steroids, and 71.5% (40/56) didn't know any side effects. The pretest score was 0/11 for all 96 participants, the post-test score was an average of 5.16. The p value obtained was statistically significant (0.0001). Knowledge regarding uses, side effects and formulations of steroids increased from 0 to 77.1%, 58.3% and 76% respectively. Conclusion: The knowledge and awareness of participants regarding steroids was negligent. In our study, Informative educational module used was observed to be very effective.
Stability plays a vital role in any robotic system. Its significance increases in systems related to health and medicine. For rehabilitation devices meant for Spinal Cord Injury (SCI) patients, stability is crucial and key element in ensuring patient safety and the usefulness of the devices. In this study, kinematics, force analysis, and the static tip-over stability of a device for rehabilitation of paraplegic patients is discussed. Kinematics modeling and static force analysis provide critical information about position and loading at different points on the device. Force-Angle Stability Criterion is used to find the static tip-over stability of the device while the patient is on board the device. The Criterion relies on the support boundary, tip-over mode axes, and the Center of Mass (COM) of the complete system. The Criterion is sensitive to the COM position and therefore is more suitable for the application. The linear actuator mounted on the device causes the end effector of the device to move. The patient, strapped with the end effector, in turn moves from sitting position to standing position. The study focuses on the analysis of stability based on changing COM during this motion. The results verify that although the system is well within the stability bounds, it is more stable as it moves from sitting position to standing position.
Background: The WHO classification of non-pituitary neuroendocrine tumors (NETs) includes grading (Ki67 proliferation index and mitosis index) and staging, and has been shown to be associated with outcome in this patient population. Neuroendocrine tumors show different somatostatin receptor (SSTR) subtypes expression, but their role has not been considered in tumor progression and prognosis. We hypothesize patients with non-pituitary NET, whose tumor tissues have higher specific SSTR2 expression patterns will experience better outcomes when treated with Somatostatin Analogues (SSA) compared to those with lower or absent SSTR2 expression. Methods and patients: City of Hope patients with non-pituitary NET who received SSA (Octreotide and Lanreotide) for over 1 year as treatment. The progression free survival was based on imaging studies (MRI, CAT scan of index tumor) on RECIST criteria, and expression of SSTR2 on the tumor obtained by surgery at the time of diagnosis. Immunohistochemical staining with a monoclonal antibody to SSTR2 performed at core pathology lab at City of Hope. H-scoring (intensity of immunostaining and percent of SSTR2 expression) was performed by one pathologist, and divided into four categories of 0-4. Pearson Chi-square test was used to assess the correlation between the SSTR2 score and 1-year progression. Outcome Measures: The effect of SSA therapy on 1 year progression-free survival (PFS), among patients with high intensity and percent of SSTR2 expression on the resected tumor tissue was compared to those with low or absent SSTR2 expression. Patient population: Of the 297 patients identified with non-pituitary neuroendocrine tumor, 70 patients satisfied the inclusion criteria and a total of 52 patients had data that was completely available for analysis. Results: Mean age of study subjects was 61+1.8 years. 26 were female and 26 were male. The primary sites for NET were: pancreas 17, jejunum 16, ileum 9; paraganglioma and pheochromocytomas 3, lung and thymus 3, gastric 2, and medullary thyroid carcinoma 1. The one-year progression was not significantly different among those with low and absent SSTR2 compared to high expression of SSTR2. Step wise analysis based on the scoring of the SSRT2 did not show significant 1 year progression. Age was not associated with PFS. However, the need for additional therapy (liver embolization, surgical resection) was signigicantly reduced amongst patients with presence of SSTR2. Conclusion: In this preliminary study there was no significant association between SSTR2 expression and Progression free survival, however the need for additional therapy in patients on somatostatin analogues were reduced among subjects with presence of SSTR2 expression
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