Government Royapettah Hospital

Pharmacological management of osteoarthritis: Position statement of the Indian Orthopaedic Rheumatology Association - Osteoarthritis (OA) is the most common form of arthritis in the general population, accounting for more pain and functional disability than any other musculoskeletal disease. There remains a paucity of effective and safe pharmacologic options for the management of OA, with oral and topical nonsteroidal anti-inflammatory drugs (NSAIDs) being the primary medications recommended. Therefore, nutraceuticals and supplements have emerged as possible adjuncts or alternatives. Undenatured collagen type II has been studied for its potential benefits during OA supportive care in preclinical and clinical studies, demonstrating positive results with substantially lower therapeutic doses. This review article aims to provide a scientific rationale for a treatment algorithm for the management of OA, including analgesics and nutraceuticals such as undenatured collagen type II and other nutrients. Keywords: Osteoarthritis, Oral analgesia, Non-surgical management, Topical medication, Intra-articular delivery, Nutraceuticals, Undenatured type II collagen

Background: In the era of evidence-based medicine, a sound knowledge of expected complications is essential in surgical practice. Understanding and stratifying patients based on an objective scoring method is imperative in both patient education and surgical team preparedness. Among the variety of scoring systems used to identify the “high-risk” patient, POSSUM scoring is the most widely used. Methods: This was a descriptive study done on 154 patients who underwent midline laparotomy in this institute from October 2016 to October 2017. Patients undergoing laparotomy were sampled by using purposive sampling and their physiological severity score on admission and operative severity score at the end of 30 days were calculated. The morbidity and mortality rates were compared with the POSSUM score predicted rates. Results: In the elective surgery group morbidity rates were higher in patients with higher POSSUM scores but due to low overall morbidity conclusions could not be drawn. while in the emergency group, POSSUM-predicted morbidity correlated well with observed results. The low mortality rates in the entire study population precluded meaningful analysis. Conclusion: POSSUM has been proven to be one of the best scoring systems that could predict morbidity and mortality risk with reasonable accuracy. POSSUM scoring system has an undeniable advantage in our set-up for better patient counseling, improving the surgical outcomes in both emergency and elective wards and better management of limited resources and manpower.

Time is an important resource to be managed effectively. In modern era, Time is considered as energy, power and effective management of time can potentially lead to growth and positive outcomes in life. Realizing this value, NEP2020 has laid emphasis on developing soft skills among students. Time is associated with the culture of thinking and in this century, students are expected to grab their opportunities, work for their goal, and execute them on time in a consistent manner. This culture of productive time needs to be imbibed in the learner. This article is an attempt to sensitize how and why time management is crucial and lack of management is seriously affecting students’ career and life.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that causes significant physical disability, and it affects women three times more commonly than men. It is often seen in their childbearing years. Data on the annual incidence of the disease also suggests a very high percentage in the child-bearing age group. So understanding their problems and finding a solution will be critical for a health care professional taking care of them. Decisions about parenthood also become challenging, as they are affected by perceptions of their disease state, health care needs, and complex pharmacological treatments. There is undoubtedly a clear need to support these vulnerable women through this important period of their lives. The management of RA has revolutionized in recent years. The availability of novel therapies, such as biological agents and treatment paradigms, has substantially improved treatment outcomes for patients with RA. Unfortunately, data on the safety of many of these medications is limited, and many may be contraindicated during pregnancy and breastfeeding. To stabilize the disease before conception and to modify the drug regime, coordinated and careful planning is needed. Recent studies showed that only 20-40% of patients with RA achieve remission by the third trimester. Although 50% may be considered to have low disease activity, nearly 20% will have worse or moderate-to-high disease activity during pregnancy and may require further therapeutic intervention. Many women commonly report postpartum relapses, making them unable to properly care for themselves and their children. A lot of women can find it difficult to access information that could help them plan for pregnancy, lactation, and early parenting concerning their chronic conditions. The accessibility and variety of the pharmacotherapeutic agents support disease control optimization before conception and contribute to the success of the female raising of children, but they should be provided with a detailed understanding of their risks and safety in the setting of pregnancy and breastfeeding. It is a hard nut to crack for healthcare providers to use individualized treatment plans not only for treating active disease but also for maintaining disease www.jchr.org

Objectives: In India, children under 5 years of age suffer from varying degrees of malnutrition. As the severity of undernutrition increases, risk of other diseases increases exponentially. The aim of this study was to identify etiological factors for severe acute malnutrition (SAM) in children aged 6 months to 5 years. Methods: This was a cross-sectional descriptive study conducted at Department of Pediatrics of a rural tertiary care center, Tamil Nadu, India, between January and December 2020. All children with SAM in the age group of 6 months to 5 years were included in the study while children with secondary causes of malnutrition were excluded. Sociodemographic data were entered in preformed proforma. Nutritional status was assessed using the World Health Organization (WHO) standard growth charts. Descriptive data were given in summary statistics while Student’s t-test and Pearson’s Chi-square test were used for analyzing variables. p<0.05 was considered statistically significant. Results: Among 111 children included, mean age was 25.2±15.7 months, 55.85% were females, mean height was 82.4±12.0 cm, 85.58% were from lower socioeconomic status, and mean duration of hospital stay was 5.9±2.5 days. Mothers were the caregivers in 80.18%, 63.96% were unaware of breastfeeding practices, and 59.46% had exclusively breastfed for <3 months. Complementary feed was unsatisfactory in 77.48%, and 75.67% of children were given cow’s milk but inadequate. As maternal age increased, awareness of breastfeeding (p=0.0005) and complementary feeding (p=0.0005) significantly increased. The mean weight at admission was 8.09±2.25 kg which increased to 8.26±2.25 kg and was significant (p=0.0005). Conclusion: As mothers were the primary caregivers but with poor awareness on breastfeeding practices, awareness campaigns targeting mothers will be more effective. As awareness on breastfeeding and complementary feeding increased with increasing maternal age, age of childbirth can be increased to more than 20 years.

FTIR spectroscopy might be the right method to be focused as a diagnostic tool in detecting various diseases / clinical conditions by analyzing various functional groups concern with different components. The chemical bonding stretches reveal biochemical composition in blood/serum, different tissue homogenate including liver, kidney, heart, skeletal muscle, etc., helps in determining the detection and severity of various disease conditions. FTIR- ATR spectroscopic techniques were employed to evaluate biomarkers by studying the variations on biomolecule composition in blood/serum and organs of control and experimental animals. The absorbance peak ratio for serum of Wistar rats induced with hyperbilirubinemia was studied and I 1453/I1076 considered as a biomarker to evaluate hyperbilirubinemia in male Wistar rats induced with phenylhydrazine. Similarly, the peak ratio absorption with FTIR-ATR spectral studies for I2931/I1453, I2879/I1240, I 1634/I1538 and I1395/I1040 shows that the organs like liver and kidney were highly significant in evaluating hyperbilirubinemia in male Wistar rats induced with phenylhydrazine. FTIR-ATR can be an alternate as well as an additional tool in clinical diagnostics compared to other techniques for understanding the biological nature of the disease condition for prognosis and management.