BackgroundTuberculosis (TB) is a disease of global concern, especially in countries like India. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) differ a lot when it comes to presentations, treatment, and outcomes. The biochemical and hematological test can serve as a marker reflecting the response to treatment in various types of TB, resulting in a better prognosis. Therefore, this study was conducted to compare the biochemical and hematological profiles in patients of extrapulmonary and pulmonary tuberculosis in adults and children. MethodsTB cases were divided into four categories: PTB adult, EPTB adult, PTB pediatrics, and EPTB pediatrics. Forty-nine patients in each category were selected, resulting in a total of 196 patients. The sample size was met via convenience sampling. A total of 27 parameters were compared. Mann-Whitney U tests were used for statistical analysis. ResultsIt was observed that serum calcium levels in PTB cases (11.65, 1.15; median and inter-quartile range (IQR), respectively) were significantly different from those in EPTB cases (9.18, 1.03; p<0.001). The median serum sodium levels in EPTB cases (139.49, 6.86) were higher than in PTB cases (130.10, 5.77; p<0.001). For total platelet count levels, a significant difference was observed between PTB (337.00, 180.75) and EPTB cases (278, 159.25; p=0.006). In EPTB cases, the total red blood count (RBC) count levels (4.47, 0.96) were higher than in PTB cases (4.24, 0.89; p=0.036). Biochemical and hematological parameters between pediatrics and adult age groups were compared, and it was observed that the median values (IQR) of serum phosphorus, total white blood cells (WBC), and platelet count in pediatric cases were 5.16 (1.09), 14.75 (6.03), and 350.00 (155.75), respectively, and were higher from those in adult cases 3.78 (0.97); 8.35 (6.66) and 264 (181.5), respectively (p<0.001). For serum creatinine levels, a significant rise was observed between PTB 0.54 (0.19) and EPTB cases 0.57 (0.16) (p<0.001). It was also observed that alanine transaminase (ALT) levels were higher in adults (18.90 (17.83)) than in the pediatric age group (24.70 (28.67); p=0.042) while alkaline phosphatase (ALP) was higher in the pediatric age group (108.95 (78.37)) than in adults (94.25 (47.92); p=0.003). ConclusionSerum calcium levels and total WBC counts were higher in PTB cases, while the levels of serum sodium and total RBC counts were higher in EPTB cases. ALT, serum phosphorus, total WBC counts, and total platelet counts were higher in the pediatric age group, while ALP, serum urea, and creatinine levels were higher in adults. Increased tissue damage and severity of disease in the pediatric age group, reactive thrombocytosis due to biogenesis in lungs, and abnormal anti-diuretic hormone secretion in PTB cases may be possible explanations for these findings. These findings may help clinicians in the early identification of potential complications, and further studies on these parameters should be conducted.
Background: Prescriptions are an important link between physicians and patients. Any medication therapy can become ineffective if not communicated properly to the pharmacist and patient. Therefore, it’s important to maintain the quality of prescription-writing. Thus, we conducted a prescription audit in a tertiary-care hospital.Methods: 413 prescriptions having 1683 drugs were selected by convenience sampling. Adherence to 4 quality parameters, namely mention of date, allergy status, date of next visit, and whether or not the prescription was signed legibly, were observed for each prescription. 5 parameters viz. whether or not the drug was written in capital letters, whether the generic name of the drug was mentioned, and prescription of drug schedule, dose, and duration were evaluated for each drug separately. Frequency tables and appropriate bar plots were created.Results: Dates were mentioned in all prescriptions. There were 4.07±0.44 (mean±SD) drugs per prescription. Using capital letters and generic names was observed for 12% and 21% of the drugs. Dose, duration, and schedule were written for 51.4%, 98.6% & 98.7% drugs respectively. The next visit was mentioned in 61.7% cases. 21.8% prescriptions were signed legibly and only 0.5% prescriptions had allergy status.Conclusions: A significant scope of improvement was observed in signing the prescription legibly, mentioning next visit, using generic names, writing the drug names in capital letters, drug doses, and mentioning allergy status. Conducting regular audit-feedback-audit loops will improve the quality of health care delivery in a practical manner.
Wernekink commissure syndrome (WCS) is an extremely rare midbrain syndrome, in which there is the selective destruction of the decussation of the superior cerebellar peduncle, which commonly presents with bilateral cerebellar signs. We describe a case of WCS with Holmes tremor in a patient having an undiagnosed involuntary movement disorder since childhood following an undocumented case of meningitis. The patient presented with sudden onset gait instability with bilateral cerebellar signs (more prominent on the left side), Holmes tremor in bilateral limbs, slurred speech, and marked dysarthria. No ophthalmoplegia or palatal tremors were noted. The patient was conservatively managed along the lines of a stroke, and there was a marked improvement in cerebellar signs and Holmes tremor with time but no evolution (improvement or worsening) was observed in the involuntary movements of limbs and face that were present before the onset of WCS.
Introduction Fidget spinners have gained explosive popularity. Polarizing anecdotal accounts of their effects have been given but very few studies have been conducted to assess their effect. Thus, this study was undertaken to observe the effect of using fidget spinners on various aspects of cognition. Methods We selected 30 healthy individuals and following the recording of baseline scores in various cognitive function tests, they took these tests before & after a particular intervention (i.e., using fidget spinners) daily for a total of 9 days over the course of three weeks, at the end of which, an end-assessment was done. A follow-up was conducted after a period of 3 weeks post-discontinuation of fidget spinners. Results Significant improvement was observed in digit symbol matching, picture pairs, multiple object tracking, and fast choice tests (p < 0.001). A sustained effect was observed when the follow-up scores were compared to baseline and end-assessment scores. Conclusion While there was little to no change in fluid intelligence and response speed, using fidget spinners resulted in sustained improvement in processing speed, visual episodic memory, working memory, visuospatial attention, and inhibitory control. Regular use of fidget spinners might improve various aspects of cognition and benefit countless individuals.
Introduction and aim. Substance abuse and its associated problems are a global concern. Young adults, particularly college- going students, remain among the highest at-risk groups for various substance use disorders. So, this study was conducted to find out the prevalence of substance use and its correlates among undergraduate (UG) university students. Material and methods. We did an online cross-sectional survey among 1003 undergraduate university students across India using a pre-structured, self-reported questionnaire consisting of basic demographic details, standard tool (WHO-ASSIST), and the results were tabulated. A multivariable binary logistic regression analysis was performed to find out the correlates of substance use and Pearson correlation to find a correlation between ASSIST scores. Significance was attributed to a p-value <0.05. Results. A total of 320 (31.9%), 167 (16.7%), and 125 (12.5%) among 1003 students used alcohol, tobacco, and cannabis respectively. 70 (21.9%), 116 (69.5%), and 62 (49.6%) were at moderate-high risk of abuse for alcohol, tobacco, and cannabis respectively. There was a strong positive statistically significant (p<0.001) correlation between all three substance-specific scores (Pearson’s Coefficients r = 0.643, 0.763, and 0.725 respectively). Conclusion. One, two, and three out of every ten students used cannabis, tobacco, and alcohol respectively. Many of them fall into the moderate-high risk category. The data suggest that a student at high risk for any one substance is also at a higher risk of using another substance as well. This calls for an integrated ‘bundle’ approach to focus on all substances together as one unit.
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