Implementation of a sleep telemedicine protocol at the Milwaukee VAMC was associated with increased efficiency of sleep services. Timeliness of sleep management interventions for sleep apnea improved in spite of the increased volume of service.
Purpose of review Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation because of airway and/or alveolar abnormalities. Symptoms include dyspnea, cough, chronic sputum production. As the third-ranked cause of death as well as disability-adjusted life years (DALYs), it poses a significant burden on patients, families, healthcare system and society. Regular physical activity is linked to decrease in morbidity and mortality associated with COPD, but implementation remains challenging. There is a need for community-based interventions that promote physical activity. Yoga and Tai Chi are widely available in the community and have been shown to be beneficial in patients with COPD as well as many of the co-morbid conditions associated with COPD. Recent findings Yoga and Tai Chi have been found to be more effective than usual care in COPD with clinically meaningful improvements in 6-min walk distance (6MWD), forced expiratory volume in 1 s (FEV1), and health-related quality of life (HRQoL). They have also been found to be comparable to pulmonary rehabilitation interventions. Summary Yoga and Tai Chi provide community-based options for patients with COPD to improve their physical activity, quality of life, and pulmonary function.
Congenital cardiac disease is one of the most common developmental anomalies in children. Higher caries prevalence and gingivitis compared to healthy children have been shown in children with congenital heart disease which has a significant implication in the medical care of these patients associated with bacteraemia and endocarditis. Sialic acids being terminal sugar components and marker of chronic inflammatory response are found to be present at higher levels in children with poor oral health status. So the present study aimed to evaluate the oral health status and salivary sialic acid levels among the children with congenital heart disease and normal healthy siblings. A total of 71 children with heart diseases aged 6-10 years attending various heart institutes were examined for oral hygiene status, gingival status and dental caries status by using modified WHO oral assessment form. A case-matched control group of 50 children were also examined. Salivary flow rate, pH and sialic acid levels were measured after saliva collection. The results were subjected to Unpaired t test and Pearson’s Correlation Coefficient Test. The salivary pH, salivary flow rate, dental caries status, oral hygiene and the gingival status were significantly compromised with a positive correlation with the sialic acid levels in saliva, leading to increased treatment needs in the study group. Therefore the amount of sialic acid in the saliva can be a useful index of the severity of oral disease.
BACKGROUND Thyroid dysfunction is very common in India. Among the thyroid disorders, it has been found that there is an increase in prevalence of Subclinical Hypothyroidism rather than Hypothyroidism in India. Although it has been three decades since universal salt iodization program was introduced in our country and a transition from iodine deficient to iodine sufficient state was considered to be attained in our country, the prevalence of thyroid disorders is still found to be increasing. Therefore, we aim to find the prevalence of various thyroid dysfunctions among the young adults so that early intervention can prevent the complications associated with thyroid disorders. MATERIALS AND METHODS This study was done on 100 first year medical students of PES institute of medical Sciences and research who were willing to participate in the study. Ethical clearance was taken from the institutional ethical committee. Written consent from the subjects was taken and 5 ml venous blood sample was collected from each subject after an overnight fasting. Free T4 (FT4) and Thyroid stimulating hormone (TSH) levels were estimated by Enzyme linked immuno-fluorescent assay (ELFA) using Biomeriex VIDAS instrument. Based on the levels of TSH and FT4 the students were categorized as Euthyroid, Hypothyroid, Subclinical Hypothyroid, Hyperthyroid or Subclinical Hyperthyroid. RESULTS Among 100 students involved in our study, 22 were males and 78 were females. 89% of the participants were found to be euthyroid. Prevalence of Subclinical Hypothyroidism was 8% and Prevalence of Subclinical Hyperthyroidism was 3%. It was found that all the cases of Subclinical Hypothyroidism and Subclinical Hyperthyroidism were females. CONCLUSION Early detection of thyroid disorders especially Subclinical Hypothyroidism and Subclinical Hyperthyroidism can prevent the complications associated with it.
BACKGROUNDSubclinical thyroid disorders with altered Thyroid Stimulating Hormone (TSH) level, yet normal circulating levels of free thyroid hormones (FT4) include subclinical hypothyroidism and subclinical hyperthyroidism. The prevalence of subclinical thyroid disorders is found to be increasing in our country and subclinical hypothyroidism is known to be linked with hypercholesterolemia. Hence, we intend to find the prevalence of subclinical thyroid diseases and its association with lipid profile. MATERIALS AND METHODSThis study was done on 253 female medical students of PES institute of medical Sciences and research who were willing to participate in the study. Free T4 (FT4) and Thyroid Stimulating Hormone (TSH) levels were estimated by Enzyme Linked Immuno-Fluorescent Assay (ELFA). Lipid Profile of the subjects including total cholesterol, serum triglyceride, HDL, LDL, VLDL was estimated using VITROS instrument. Based on the levels of TSH and FT4 the students were categorized as euthyroid, subclinical hypothyroid and subclinical hyperthyroid. RESULTSThe prevalence of subclinical hypothyroidism and subclinical hyperthyroidism was found to be 8.3% and 1.58% respectively among the study population. A statistically significant decrease in FT4 levels as the TSH levels increased was seen. As the TSH value increased, HDL levels significantly decreased, and the LDL levels were found to be increased significantly.
The objective of the present study was to evaluate the association between the dental arch dimensions and the incisal abnormalities or anomalies, to the consonant mis-articulations in children with unilateral cleft palate with the involvement of lip, before and after surgical correction.50 Non-syndromic children with unilateral cleft palate belonging to various experimental groups and 25 non-cleft children (control group) between the age group of 7-9 years were selected for the study. Dental arch dimensions were measured on the dental casts & the selected consonants were evaluated from all the four groups, by 3 qualified speech pathologists and then statistically analyzed. Reduction in the dental arch dimensions was observed in children with untreated cleft palate which further decreased after surgery. The correct production of all the selected consonants /ta/, /da/, /tha/, /dha/, /na/, /na/, /la/, /sa/ and /sha/ which was observed to be 15% in the untreated CP group, improved upto 52.4% after surgical correction in spite of the reduction in the dental arch dimensions. Speech analysis showed a high percentage of distorted sounds were maximum in untreated CP patients which decreased in surgically treated CP patients. Substituted sounds which was found to be absent in untreated cleft palate patients was observed in children who had undergone surgical correction of the palate Conclusion: the reduced arch dimensions and incisal abnormalities may be contributing factors which do not allow 100% normal speech in children with oral clefts.
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