Search

Background: Stroke is a significant global cause of both mortality and morbidity. Cardioembolic stroke comprises 15-30% of all cases of ischemic stroke. Limited clinical studies have been conducted on cardioembolic stroke, particularly in the context of India. The objective of our study was to analyze the demographic, risk factor, and clinical characteristics of patients with cardioembolic stroke in Central India. Methods: A prospective study was conducted at the Inpatient Department of teaching hospital in Central India collecting necessary information and data from all cases diagnosed as cardioembolic stroke. Results: 325 patients were diagnosed to have acute Ischemic stroke. Of the 38 patients (11.6%) diagnosed with cardioembolic stroke, 17 (46%) were females. Mean age was 53.5±12.2 years. Occurrence of cardioembolic stroke was seen to be higher (71% vs 28.9%, p value<0.0001) in patients of older age group (46 years or more). A significant proportion of patients of the older age group (37%) had hypertension (p value=0.0048). Coronary artery disease (CAD) was the most prevalent cardiac disorder, observed in 21 patients (55.2%), valvular heart disease in 11 patients (28.9%) and atrial fibrillation in 7 patients (18.4%). Limb weakness (84.2%) and Middle Cerebral Artery (MCA) territory (73.6%) infarct were observed in majority of the patients. Conclusions: Prevalence of cardioembolic stroke in this region is lower than reported worldwide. While male predominance of cardioembolic stroke was noted, old age and hypertension were the major vascular risk factors identified. CAD was the major source of cardioembolism. [ABSTRACT FROM AUTHOR]

Background: On 11th March 2020, WHO declared Covid-19 as the global pandemic; affecting over 200 countries world-wide. the clinical features ranges from mild flu like symptoms to seveare illness like ARDS and septic shock. Clinicians are looking for are the reliable prognostic marker that may identify the patients who are at risk & need prior treatment. Neutrophil lymphocyte ratio(NLR) & platelet lymphocyte ratio (PLR) are emerging out to be the important prognostic markers in the developing countries like India where limited resources are available. These markers are the important biomarkers which help in triaging the patients. Objective: 1. To determine the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in COVID 19 patients on day one of ICU admission and before discharge. 2. To correlate neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with the severity of illness in COVID 19 patients. 3. To correlate neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with the respiratory support given to patients during the hospital stay. Method: It is a retrospective study and included two months data of covid positive patients admitted in ICU. A total of 200 cases that were RTPCR positive or RAT positive recorded with their clinical history. For all cases NLR & PLR were evaluated at the time of admission and before discharge and results were recorded. Clinical complains, age, gender and comorbid conditions were analyzed by cross tabulation to assess their relationship with NLR & PLR. Result: Out of 200 cases 119cases were males and 81 were females. Maxium deaths were noted in the age group of 40 to 60 years. There was no significant difference between the outcome of the disease in males and females. The most common complaint at the time of admission was breathlessness followed by fever. Hypertension was the most common co-mordidity amongst thepatients. NLR & PLR of the Covid positive patients were raised in the patients who died as compaired to the patients who were discharged from the hospital. Conclusion: In this study, it has been found that the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in COVID-19 patients are increasing in diseased individuals and ratios are decreasing in discharged people. NLR and PLR prognostic biomarkers emerged out be cost-effective, readily available biomarker to access the severity of illness in COVID-19 patients, especially in the countries with low medical resources, for the better outcome of the patients. [ABSTRACT FROM AUTHOR]

Background: Platelet‐rich fibrin (PRF) is a second‐generation platelet concentrate with multiple applications in wound healing and regeneration in both periodontitis and diabetes. However, the three dimensional (3‐D) structure and cytokine content of PRF might be altered in patients suffering from either/both of the chronic inflammatory conditions, ultimately influencing the efficacy of PRF as a biomaterial for regenerative medicine. Aim: The aim of the present study was hence to evaluate the effect of both these chronic inflammatory diseases on the 3‐D structure of PRF membrane. An attempt was also made to compare the growth factor content between the plasma and RBC ends of the prepared PRF gel. Materials & Methods: L‐PRF was prepared for twenty participants, healthy (5), periodontitis (5), T2DM (5) and T2DM with periodontitis (5). Porosity and fiber diameter of PRF membranes was visualized under FE‐SEM and measured using ImageJ Software. PDGF‐BB and TGF‐β1 levels in PRF gel were assessed by ELISA. Results: The average diameter of fibrin fibers under FE‐SEM was 0.15 to 0.30 micrometers. Porosity was higher at the plasma end (p = 0.042). Red blood cell (RBC) end of the membrane had thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities. Healthy subjects had the least porous PRF compared to subjects with either/both of the chronic conditions. PDGF‐BB levels were similar along all the four groups. TGF‐β1 levels were highest in healthy subjects. Discussion: 3‐D structure and growth factor content of PRF are influenced by a person's periodontal and/or diabetic status. The RBC end of the PRF membrane, as compared to the plasma end, has thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities, and hence should be favored during periodontal regenerative procedures. Conclusion: Both periodontitis and diabetes have a significant influence on the 3‐D structure and growth factor content of PRF produced. [ABSTRACT FROM AUTHOR]

Background & Method: The aim of the study is to find the correlation of the clinical findings with the hematological findings in patients with bleeding manifestations. A blood pressure cuff inflates around the upper arm of patient. While the cuff is on the arm, a prick is given on the fingertip. It is just deep enough to cause a tiny amount of bleeding. The blood pressure cuff is immediately deflated. Blotting paper is touched to the cuts every 30 seconds until the bleeding stops. The time taken for the cuts to stop bleeding is recorded. Result: Idiopathic thrombocytopenic purpura is more common in females (78%, as compared to males (22%). Similarly Systemic diseases causing bleeding manifestations are more common in females (63%) as compared to males (37%). But the same is not true in case of Aplastic anemia where males (71%) are more commonly affected than females (62%). While in case of haemophilia, the disease is 100%prevalent in males with 0% females. Conclusion: It is also our observation that many patients having hemostatic disorders do not necessarily have prolonged bleeding or clotting time which means that hemostasis is dependent on many other unknown in vitro (technical considerations) or in vivo (over the counter drugs) factors. Among the bleeding disorders platelet disorders (74%) are more common than coagulation disorders (15%). 87% cases are found to share clinical & hematological findings while no correlation seen in 13% cases. [ABSTRACT FROM AUTHOR]

This article attempts to analyse the impact of bank size, both absolute and systemic, on performance in terms of returns and risk and business model in terms of activity mix. The sample includes 550 firm year observations of commercial banks in India between 2006 and 2016, spanning a time period of 11 years. On the performance front, the results indicate that neither of the size measures affects the return on assets or ROE of either public or private sector banks. On the other hand, the absolute size reduces the risk of bank insolvency. At the business model level, the proportion of fee-based and net-interest income decreases with increasing absolute size and increases with increasing systemic size. Conversely, the proportion of interest income increases with increasing absolute size and decreases with increasing systemic size. This highlights the banks' increasing reliance on non-traditional sources of income with increasing systemic size in the Indian context. [ABSTRACT FROM AUTHOR]

1. Along with understanding sources for rising cancer prevalence among Veterans of Native Hawaiian/Pacific Islander heritage, participants will be able to identify strategies to address geographic, logistical, and financial challenges, as well as effects of historical trauma, that may be exacerbating cancer health disparities. 2. By using an indigenous framework to health, participants will learn to culturally adapt clinical practices to address mistrust and build a therapeutic relationship with Veterans of Native Hawaiian/Pacific Islander heritage. Cancer health disparities experienced by Veterans who are Native Hawaiian/Pacific Islander (NH/PI) can be related to socioeconomic disadvantages, exposures, and lifestyle. Disparities may be perpetuated by present-day geographic, logistic, and financial barriers, as well as historical trauma. VHA clinicians suggested strategies to culturally adapt care, and we can use an indigenous health framework to promote equitable cancer and palliative care. Veterans of Native Hawaiian/Pacific Islander (NH/PI) heritage have a high risk of developing cancer and related complications which may be amplified by barriers to cancer and palliative care. This ongoing study applies a mixed method, community-based participatory research approach to understanding healthcare needs of Veterans with cancer who are NH/PI. The study is guided by a community advisory board. Through snowball sampling and outreach, we targeted recruitment to ethnically diverse, multidisciplinary clinicians in a major Veterans Health Administration (VHA) medical center in Northern California and ambulatory clinics in the US-affiliated Pacific Islands (USAPI) between 3/2023-9/2023. Participants completed 45-minute semi-structured interviews to assess barriers and facilitators to cancer care and palliative care. Interviews were transcribed verbatim, de-identified, and deductively then inductively analyzed using rapid analysis matrices and dual coder review in Atlas.ti v23. Participants included 15 physicians, nurses, social workers, and clinical psychologists specializing in primary care, palliative care, and oncology, self-identifying as White, Asian American, NH/PI, and Multiracial. Preliminary analyses demonstrate the following barriers to accessing cancer and palliative care: 1) geographic, logistical, and financial challenges arranging long distance travel over an ocean with a "patient [who] needs to fly" that may get "ill on the flight"; 2) problems managing pain due to stoicism, misinformation as "people are still very anxious about" opioids, and constraints among VHA specialty care clinicians in the USAPI, 3) broadband infrastructure limitations leading to poor telehealth access; and 4) trauma, mistrust, and "tension from how Hawai'i [and other islands were] acquired by the United States." VHA clinicians discussed systemic, cultural, and historical barriers to cancer and palliative care while highlighting Veteran resilience and the promise of telehealth. An indigenous framework for health can help culturally adapt clinical practice and promote access to equitable health services for Veterans of NH/PI heritage. Diversity, Equity, Inclusion, Belonging, Justice Scientific Research [ABSTRACT FROM AUTHOR]