Background: Infective endocarditis is a microbial infection of endocardial surface of the heart and vegetation is the characteristic lesion of the disease. Mural endocarditis is a condition of rare diagnosis and may be difficult to find vegetation by standard views in transthoracic echocardiography (TTE). Identifying the mural vegetation not only helps to diagnose Infective endocarditis, but also predicts the risk for developing embolism. Aim of this study is to find the occurrence of embolism in patients with mural endocarditis. Method: A Retrospective, observational study was done for IE patients admitted from the year 2012 to 2018, in which total of 58 patients with definite diagnosis of infective endocarditis were identified. Among which 8 patients were excluded based on the exclusion criteria. Results: Total 50 patients were identified with IE, which includes 7 with mural vegetation and 43 without mural vegetation. Cultures were positive in 71.4% and 88.3% IE patients with and without mural vegetation respectively. One patient was found to have corynebacterium species with mural vegetation and embolic stroke, which is a rare occurrence. Among 43 IE patients without mural vegetation, 88.3% patients showed presence of vegetation in echocardiogram. Size of vegetation were 13 ± 6 and 14.6 ± 2.9 mm, respectively (p>0.005). All the patients with mural vegetation and 9.3% from without mural vegetation had cerebral embolic events (p < 0.005). Conclusion: Though mural vegetation is not common, but if present, it helps in diagnosis and also it may predict a propensity for embolism. Our results indicate that in patients with mural endocarditis, the propensity of embolism is more.
The disaster arises when threatsmeet vulnerablepeople who have lowabilityor donothave the abilitytorespondtothethreat. Preparednessisthemost critical phase in the range of disaster management, the inadequacy of disaster preparednessplanning has created acriticalsituation,increasing thesuffering of survivors and loss of life.Thepurposeof this study isto analyse social capital factors that most influence thefamily preparednesstofacetheimpact ofpa nd emi c c o vi d - 1 9 a s disaster inMalangCity.Thisresearch uses descriptive analytic design withCrosssectional study approach.Respondentinthisresearch is112HeadofFamily(KK)byusing systematicrandomsampling.Thisresearch was conductedintwosub-districts namelySukunandDinoyo.Chisquare testresultsshowthatthereis asocialcapital relationship(p=0.000) towardsfamily preparednesstoface the impact ofdisaster inMalangcity.Logisticregression test results show that social capital has the strongeststrengthof relationship(p= 0.024, OR= 2.75) than other factors. Thisresult shows there isa positive relationshipbetween family socialcapitalinfacingp a nd emi c c o v i d -1 9 disaster impact inMalangCity.Thismeansthatgoodsocial capital willincrease the family preparednessinthe face ofdisaster impact.The results of this study are expectedto be the basis and reference materialsfor disaster nursingservicesaswellasthebasisforthelocalgovernment ofMalangto encouragethe positive attitudeof the family towardspreparednessby utilizing socialcapital asan importantcomponentand utilize socialcohesionand social networkindisaster planning andmanagement,willprepare fordisaster. Eliminate theobstaclesofdisasterpreparednesssuchasnegative attitudes toward preparedness, lackofparticipation,unrealistic riskassessme ntwithdisaster preparednesstrainingandcampaigns during pandemic Covid-19.
The particular complication in a newborn baby is jaundice. Jaundice is due to many reasons. An increase in the bilirubin level denotes the presence of jaundice. Neonatal hyperbilirubinemia is most common in the first postnatal week. Early prediction and classification of jaundice are essential to reduce the mortality rate. Diagnosis of the disease using computer vision techniques helps up to achieve accuracy in prediction and classification. The study is essential to extract the information from medical data mining and achieve the goal. Medical data mining involves examining, analyzing, extracting, selecting and classifying the features. Neonatal jaundice severity level is determined by using color card techniques. The treatment suggestion is reported to the physician based on their severity level. It helps the physician to given an appropriate treatment for jaundice. Computer vision and machine learning techniques make the process easy and simple. The optimized method of classification increase accuracy.
Understanding the effects of COVID-19 on the cardiorespiratory system is imperative as it is the primarily affected system of the body. Physiotherapists play a vital role in the treatment of COVID-19 patients; therefore, our study aims to assess the awareness regarding effects of COVID-19 on cardio-respiratory system among physiotherapy students and professionals. A self-structured validated questionnaire was distributed through an online method. A total of 240 participants consisting of physiotherapy professionals, post graduate, interns and under graduate physiotherapy students were included. The study revealed that out of 240 participants, 46 participants (19.16%) had poor, 155 participants (64%) had average and 39 participants had (16.25%) good awareness regarding COVID-19 and its effect on cardio-respiratory system. Both in the professionals and students group, more than half the participants (71.66% and 64.44%) had average awareness and the highest awareness was found to be in the post graduate group i.e., in the good category of about 31.66%. Keywords:
The acute SARS CoV 2 infection causes increased metabolic demand with reduced cardiac reserve, tachypnoea, acidosis, hypoxia causing deleterious effects on cardiac myocytes. Since its heightened sympathetic state these patients are more prone for malignant arrhythmias. The central nervous system involvement of MERS-CoV is mostly caused by the autoimmune reaction against viral antigens rather than viral infection itself. Although coronaviruses can infect the autonomic center in the brainstem, potentially contributing to cardiovascular and respiratory failure, the direct effect of SARS-CoV2 on the autonomic nervous system is not well known yet. The purpose of this review is to emphasise the involvement of autonomic nervous system (ANS) which is an integral part of our human body to adapt for the stressful environment like COVID 19 infection.
Background;Early restoration of coronary flow in STEMI reduces mortality, high thrombus burden has a higher incidence of no-reflow, stent thrombosis, LV dysfunction and mortality, thrombus aspiration can reduce thrombus burden, but recent data suggest higher stroke incidence. Objectives; We aimed in the study to determine the safety of the thrombus aspiration in high thrombus burden lesions in primary PCI for STEMI patients. Methods : One hundred patients were divided into two groups: Group 1: Aspiration catheter was used in 46 patients with high thrombus burden, Group 2: 54 Patients with low thrombus burden, was managed with slandered PCI and thrombus aspiration as bailout only. Group A: patients who developed cerebrovascular stroke, Group B: who didnt develop stroke. Procedural complications and MACE data were obtained and follow up for stroke incidence for 30days. Results: There were no differences between group-1 and group-2, or between group-A and group-B regards ST segment resolution, intra-procedural complications, re-infarction. No differences between group-1 and group-2 regards death and stroke. Group-1 had lower age, higher DM and smoking prevalence, lower EF, and higher wall motion score index (48.76vs53.68, P-value0.003)(29.6%vs54%, p-value0.012)(58%vs33%, pvalue0.011)( 47%vs51%, p-value0.018)(1.35vs1.21, p-value0.0029). Group-A had lower EF, TIMI III flow, higher WMSI, higher no-reflow, and had higher mortality than group-B (34%vs50%, p-value0.0001)(40%vs81.3%, pvalue0.0165)( 1.65vs1.26, p-value0.00015)(60%vs3%, p-value0.00001)(40%vs2.1%, p-value0.011) respectively. Conclusions: Thrombus aspiration didn't cause a significant increase in stroke rate at 30 days. LV systolic dysfunction is an important risk factor for stroke during and after pPCI irrespective of the method of revascularization. The stroke had higher mortality in pPCI patients.
The measurement of anthropometric indices can be used to promote early prevention of Diabetes mellitus (DM) in the Filipino population. This study aims to compare the recommended anthropometric measurements namely body mass index (BMI), waist circumference, waist-to-height ratio (WHR), skin fold thickness, and mid-upper arm circumference (MUAC) of two groups, those with diabetes and those without (control), to predict the health risk status of the Filipino adult population. The results suggest that the parameters such as BMI, waist circumference, and WHR in females proved to be the most accurate to predict the diabetes risk among Filipino females. On the other hand, using the logistic regression model, the BMI, MUAC, and waist circumference indices collectively were found to have significant bearings with regard to the risk of acquiring DM. The Asian cut-off values of 18.5-24.9 kg/m2 for BMI, and < 90cm and < 80cm for waist circumference of male and female respectively, as recommended according to Taiwanese standards, are also said to apply to the Filipino population. This study is perhaps the first study in the Philippines that has relied on actual data gathering instead of using meta-analysis as done in earlier studies. In the wake of higher mortality in the diabetic COVID 19 positive patients, the gathering of baseline data of potential DM patients will help the government/stakeholders to efficiently strategize public health policies related to future preparedness for such pandemics.
Coronavirus disease (COVID-19) is a global pandemic that is highly contagious and has led to increased morbidity and mortality. It is a respiratory tract infection that is caused by a novel coronavirus (SARS-CoV-2). The virus has now affected virtually every country across the world and the number of deaths continues to rapidly increase. Vaccines contain only a part of the same diseasecausing agent that has been killed or made inactive to cause sickness. Most viral diseases have no cure including the COVID-19 disease and because there is no scientifically proven cure for COVID-19, have led to the critical search for a means to salvage the world from this scourge. The result was a vaccine against the disease with the belief that vaccination has saved millions of lives globally.Methods:The aim of this experimental study was to assess the willingness and hesitancy regarding COVID- 19 vaccination among people. The study was a cross-sectional survey using a selfadministered questionnaire among the people. The sample of the study consisted of 500 participants from selected area.The questionnaire was made up of segments that include demographics information, knowledge of the COVID-19 vaccine, its acceptance or hesitancy. Result: The majority of that is 304(60.8%) of participants hesitant regarding COVID- 19 vaccination and 321(64.2%) are moderate level of willingness regarding vaccination. Some of demographical variable find association between the with hesitancy like gender, education ,occupation, Residencem,covid infection, suffering or having any Disease, vaccinated against COVID-19, which one and would you still want this vaccine for yourself.Some of demographical variable find association between the with willingness like Age, Education, Occupation, Type of Family, Residence, you infected COVID-19 infection, vaccinated against COVID-19, which one and would you still want this vaccine for yourself.Conclusion: The study shows that most off participants have a COVID-19 vaccine hesitancy and willingness for various reasons. The study recommends effective education, training, and public enlightenment to change the narrative.
Heart failure (HF) is a complex clinical syndrome resulting from impairment of ventricular filling or ejection of blood. Management of patients with HF still remains a clinical challenge and many current therapies have uncertain impacts on long-term morbidity and mortality. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) were initially developed for their glucose-lowering effect and subsequently have been shown to decrease the risk of Hospitalization for Heart Failure (HHF). After the initial Cardiovascular Outcome Trials (CVOTs) new data have provided the evidence of benefits of these agents in reducing cardiovascular mortality and HHF in patients with Heart Failure with reduced ejection fraction (HFrEF) with or without co-existing Type 2 Diabetes (T2DM). In this narrative review, we have summarized the current therapies in the management of heart failure and clinical evidences with SGLT2i with special focus on Dapagliflozin for clinical outcomes in HFrEF patients. We have also reviewed the latest guidelines that have proposed the use of SGLT2i in the management of HFrEF.
Medical images play a significant role in diagnosis and experimentation. For years, many experimentation and analysis have been made on medical images with a broad scope of achieving the desired results. Medical modalities like MRI, CT, PET, X-Ray, Ultrasound, etc. are popular in representing internal organ pictures of human bodies. Such volumetric images are stored and accessed with a huge demand in storage space. Compressing the images solves the problem of storage and transmission and also become beneficial for the telemedicine application. Since Medical images depict the human body's detailed and vital information, it needs to be compressed without distorting the details present over it. The lossless image compression approach works efficiently in representing the information present on the medical images without distorting the details. Deep learning neural networks proved to be efficient in analyzing the medical images in recent years. Deep Autoencoder attains to be achieving a higher level in dimensionality reduction with retaining the original quality of the input data. Pretraining of the architecture with the Deep Boltzmann Machines makes the algorithm more efficient to achieve a higher compression ratio with a high PSNR value. Analyzing the Deep autoencoder's performance with the other state of the art architecture proves to be efficient with low computational time.
Background:Antenatal care (ANC) is a service provided to pregnant women. The coverage on the first visit of a pregnant woman during pregnancy and the minimum number of 4 contacts during pregnancy are still lower than the national target. Providing quality services needed by pregnant women will make the perception of pregnant women about ANC services better and provide satisfaction to mothers. The number of mothers who do not understand about Antenatal Care visits means that at least 4 contacts during pregnancy have not met the target. The low number of visits by pregnant women for the first time during pregnancy shows that the access of officers to mothers still needs to be improved, the low affordability of Antenatal services, perhaps also due to inadequate service patterns. The low number of contacts made at least 4 times during pregnancy shows the low opportunity to capture and handle high-risk obstetrics so that early detection of complications of pregnant women is not maximally implemented Objective: To determine the perception and satisfaction of patients about the quality of ANC services in Community Health Center in Surakarta. Methods: Qualitative research, by using questionnaire and in-depth interviews. A total of 105 samples were taken randomly from Community Health Center in Surakarta. The data were collected through questionnaires distributed to pregnant women and interviews with 3 pregnant women and 3 midwives. The data were analyzed using Importance-Performance Analysis (IPA). Results:Based on the results of interviews with patients related to their perception and satisfaction, they stated that they have to wait for a long time.Meanwhile, the midwives stated that time constraints were a natural occurrence in ANC services and the ANC services related to the assurance dimension that had been sought by the Community Health Center. Conclusion: Effective communication is a solution for time constraints on ANC services at the Community Health Center so that the midwife services can be better addressed and the needs of pregnant women can be met during ANC
Background: Varicose vein disease is one of the most common health problems faced by vascular surgeons worldwide affecting up to 23% of the adult population.The majority of patients with primary varicose veins have great saphenous vein (GSV) insufficiency.Objective: To determine the feasibility and safety of flush Endovenous laser ablation (EVLA) of the patients with Great saphenous vein (GSV) up to the saphenofemoral junction.Patients and Methods: A prospective study was conducted in the Vascular Surgery Department, Faculty of Medicine, Zagazig University from January to June 2021 including 18 cases.All patients were subjected to detailed history taking, clinical examination, the clinical severity of venous disease was established using CEAP [Clinical, etiological, anatomical & pathological] and VCSS, the effect of disease-specific quality of life was determined using the CIVIQ, Laboratory Investigations and duplex ultrasonography performed for all patients.Results: The operative time ranged from 20 minutes to 40 minutes, with a mean of 30 minutes.Regarding hospital stay, all patients were discharged on the same day of the intervention.Return to normal activity ranged from 7 to 9 days, with a mean of 7.33 +/-1.46.as regard complications; only Ecchymosis in 2 limbs (7%), Temporary numbness at the leg in 3 limbs (11%), and incomplete occlusion in one patient (4 %). Conclusion:The use of a high wavelength (1470nm) with a modified fiber tip with tumescent solution has a crucial role in achieving the best results and minimizing the adverse effects.This allows homogenous destruction of the vein wall exclusively.
Background: Hemorrhoids are swollen veins of the hemorrhoidal plexus that are normally present in the anal canal. Clinically detectable if the supporting connective tissue is compromised. In this study, we focused on the effectiveness and importance of colonoscopy for studying the prevalence of internal hemorrhoids. Objective: The study aimed to evaluate the prevalence of internal hemorrhoids in patients undergoing colonoscopy for different indications. Patients and Methods: This cross-sectional study was conducted in the Elective Gastrointestinal Endoscopy Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University. The study was conducted through the period from March 2021 to Augustus 2021, and including 300 consecutive Egyptian patients who underwent a flexible colonoscopy for different reasons. Results: In the present study, we revealed that hemorrhoids increasing with aging. The diagnostic results were internal hemorrhoids (38.3%), colonic ulcers (11%), inflammatory lesions (7.3%) and mass (7%), diverticular disease (6%), polyps (5.7%), and vascular malformations (1.3%). The complaints of the patients were lower GI bleeding (41.7%). Chronic diarrhea (17.7%), abdominal pain (14.7%), and chronic constipation (13.3%) in the subsequent levels. Also, chronic anemia (6.7%), follow-up colon polyp (5.3%), one patient had weight loss (0.3%) and one patient had anal pain (0.3%). Conclusions: We can conclude a wide prevalence of internal hemorrhoids in patients who underwent colonoscopy for various reasons. Besides, retroflexed colonoscopy can contribute to the study of the prevalence of internal hemorrhoids because it can diagnose even asymptomatic hemorrhoids. In addition, colonoscopy was found to be extremely safe and no complication was detected.
The COVID-19 pandemic has spread to almost all countries of the World and affected people both mentally and economically. The primary motivation of this research is to construct a model that takes reviews or evaluations from several people who are affected with COVID-19. As the number of cases has accelerated day by day, people are becoming panicked and concerned about their health. A good model may be helpful to provide accurate statistics in interpreting the actual records about the pandemic. In the proposed work, for sentimental analysis, a unique classifier named the Sentimental DataBase Miner algorithm (SADBM) is used to categorize the opinions and parallel processing, and is applied on the data collected from various online social media websites like Twitter, Facebook, and Linkedin. The accuracy of the proposed model is validated with trained data and compared with basic classifiers, such as logistic regression and decision tree. The proposed algorithm is executed on CPU as well as GPU and calculated the acceleration ratio of the model. The results show that the proposed model provides the best accuracy compared with the other two models, i.e., 96% (GPU).
Diabetes is a major problem in the world wide. It is a chronic disease. In human body insulin Plays a vital role in blood glucose levels. The Pancreatic gland is in GIT system which produce insulin hormone. It maintains the normal glucose level in blood. Imbalance of insulin levels leads to diabetes. The diabetes characterizes to type 1 is an insulin dependent disease and type 2 diabetes is insulin resistance disorder. Recently gestational diabetes discovered, is caused by genes or imbalance of insulin levels in before labour. To treat the diabetes in present days there is allopathic and herbal medication which drugs are used in now a day for diabetes. Allopathic medicines have therapeutic actions and also these drugs have side effects which leads alteration in body functions furthermore it causes severe health problems for that reason most of people using herbal medicines for treating the diabetes. If any person suffering with diabetes slowly it leads complications in human body. It effects on CNS, kidney and eyes etc. The most common symptoms for diabetes are thirst increases, vision in hazy and fatigue etc. To prevent from the diabetes, use anti-diabetic agents, avoid carbs in diet, eat fiber content food and exercise these activities control the diabetes. Artificial pancreas acts like as pancreas gland it produces the insulin like as natural pancreas gland. To diagnose the diabetes there is 3 main tests. statistical analysis of diabetes is year wise from 2014 upto 2019. Diabetes is controlled by proper medication by patient.
Blood is one of the most demanding sources in clinical and medical aspects due to its vital roles in mans day to-day life. It is highly impossible to survive without it. But in 21st century due to increased population, population aging, generation of new infections and natural disasters increased the cost of storage and maintenance of collected blood. This has directed the world to find an alternate source i.e. artificial blood. Artificial blood is an innovative concept of transfusion of medicine where specifically designed compounds perform the task of transport and delivery of oxygen in the body to replace the functions of allogenic human blood transfusion. It is one of the evolutionary innovations which might lead the way to a new era in medicine. In this review, the importance of artificial blood is high-lighted and also the present status and improvement in the development of artificial blood substitutes mainly focusing on red blood cells substitutes are summarized. In addition, some of the promising benefits and disadvantages of this concept are also elaborated.
Nature is a complex collection of physiological, chemical, and abiotic factors that affect living things and ultimately determine their structure and survival. In today's world conditions are often affected by various factors, such as pollution, population, and many other factors. And it destroys native plants and animals. Increased levels of pollution can lead to various diseases such as heart disease and skin diseases. Jharkhand is a very beautiful nature. Coal mining and profitability may be one of the most polluting tests. Pollution is the main reason why Global is heating its impact on our environment. Environmental change harms humans, wildlife, and the environment. Environmental changes can cause climate change, global climate change, and the destruction of natural resources. It also disrupts normal social and economic processes. Humans are cruelly ruining the environment. The mountains are barren. Due to the constant deforestation, this results in frequent flooding. The environment can cause a pattern of low rainfall, drought, and increased mortality rates. It greatly affects agriculture due to low rainfall and increased pollution can make the land less suitable for growing crops. Jharkhand province is already suffering from over-reliance on mineral resources. In addition, the government's water and water resources are under threat due to industrial and urban growth and inequality in temporary and spatial distribution. So,this research work based on the ecological changes in Jharkhand with a holistic view, focusing on other major regions that are experiencing the most environmental changes in that region.
Surgical site infections (SSI) are infections that occur after surgery with differentiating rates of 14%-16% in patients. According to several health-related studies, its impact is usually due to financial problems and quality of life (21). Therefore, this research aims to determine the attitude, patient safety, and stakeholders factors capable of preventing Surgical Site Infections. This is a qualitative research, with data obtained from SSI patients at PKU Muhammadiyah Yogyakarta Hospital, and analyzed using the multiple regression coefficients. The result showed that the attitude variable in terms of SSI prevention efforts was 51.9%, thereby indicating that the patients were obedient to the use of hand hygiene and personal protective equipment. Meanwhile, regarding patient safety, the value was 36.5%, despite the application of 7 strategies with the majority not properly adhered. Furthermore, the value of stakeholder support was in the medium category (46.1). This is because even though the management has provided adequate infrastructure, there were problems with coordination between units. In conclusion, surgical site infections (SSI) can be prevented by educating health workers on the importance of using protective equipment, hand hygiene, adherence to patient safety standards, and support for stakeholders in constructing infrastructure
Aim: The aim of the present study to clinically evaluation of monolithic zirconia crown. Methods: This prospective study conducted in the, Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India for 18 months. This study based on record evaluation and clinical examination of patients treated with tooth-supported monolithic zirconia single crowns was performed. The inclusion criteria were as follows: age >18 years, need for crown treatment in the permanent teeth, pre-prosthetic treatment completion, low caries activity, good oral hygiene, regular dental check-ups. Results: Thirteen patients (mean age, 53.1±12.0 years; gender, four men and nine women) participated in this study, and 40 monolithic zirconia crowns were provided in total. The mean follow-up time was 2.0 ± 1.0 years (range 0.14.3 years). All patients continuously responded to a request to attend a recall every 3 to 6 months. Only one crown was placed with resin modified glass ionomer cement; the rest of the crowns were placed with resin cement. During this period, clinical complications were found in four crowns, and the details were as follows: 1) fracture of the crown (two crowns), 2) abrasion of the crown (one crown), and 3) fracture of the antagonist tooth (one crown). Of the four cases of failure, three (cases 1, 3, and 4) were treated by the same clinician and the four crowns fabricated by different dental technicians. The crown fractures occurred 0.8 and 1.5 years after placement and propagated medio-distally and buccal lingually from the central occlusion region, respectively. The fractured crowns had a minimum thickness of approximately 0.6 mm, and the antagonist teeth had been restored with a metal inlay and monolithic zirconia crown. In the case of crown abrasions, loss of retention of the crown was caused by the wear of the crown placed in the lower left of the first molar. Its antagonist tooth was a natural tooth. In case 4, chipping of the antagonist tooth occurred 0.1 year after crown placement. In this case, a metal partial- coverage crown was placed on the antagonist teeth. Three of these were placed on the rearmost tooth. The estimated Kaplan-Meier 3.5-year success and survival rates of the 40 monolithic zirconia crowns were 90.5% (95% confidence interval [CI]: 73.197.1) and 92.8% (95% CI: 74.198.3), respectively. Conclusion: Considering the limitation of the study period, our results suggest that the molar application of monolithic zirconia crowns requires detailed attention to interocclusal clearance and whether the antagonist tooth has been partially restored
