Open Access Systematic Review Article
Sickle cell disease is a genetic haemoglobin disorder affecting millions of people worldwide. Pain is one of the most commonly reported complication of sickle cell disease. Pain is further classified into two categories acute pain and chronic pain. Chronic pain is associated with more serious complications. Management of pain has a significant impact on quality of life of sickle cell disease patients. The purpose of this research is to review the available information about acute and chronic pain management in sickle cell disease. The best treatment for both acute and chronic pain requires a customized, varied approach. This approach combines therapeutic, non-pharmacological therapies, as well as integrated therapies as per the specific needs of each patient. Opioids are effectively used in management of the pain of sickle cell disease and their use is supported by literature especially in chronic pain. Methadone, ketamine, and nitrous oxide are also used to manage pain. For the treatment of acute pain, nonsteroidal anti-inflammatory medications, short-acting opioids, and adjuvants are used effectively in clinical practice. Opioids have become the recommended treatment for pain in sickle cell disease, and many chronic pain patients are sustained on opioid therapy for the rest of their lives. However, the distinction between acute and chronic opioid therapy modalities is blurred in sickle cell disease due to the association between recurring acute pain and chronic pain. Limited literature is available regarding management guidelines and therapeutic strategies so more clinical research and trials are needed in future to design and study effective management strategies for both acute and chronic pain.
Open Access Short Research Article
Aims & Objectives: Implant therapy has become a significant part of day-to-today dental practice. Adequate knowledge of diagnostic as well as therapeutic options is therefore necessary for all general dental practitioners. The present study is designed to evaluate and assess the knowledge, attitude and practice of practitioners about the prosthetic phase of dental implant. As the dental implant therapy is emerging in Vidarbha region of India and lack of studies evaluating the same, we recommend that awareness regarding prosthetic phase will allow practitioners to offer extensive treatment options for patient with missing teeth using dental implants.
Materials and Methods: This is an observational questionnaire survey conducted among 210 General Dental Practitioners in Vidarbha Region of India. A google form validated questionnaires distributed to assess their knowledge, attitude and practice among the study participants. Data were analysed using SPSS 22.0 version software.
Results: A total of 210 dentists, nearly 69% of the participants had good knowledge of prosthetic phase of implant and majority of practitioners in the study had positive attitudes and practices toward the prosthetic phase of implant placement. Results were significant for KAP but co-relation between them was statistically not significant (p=0.12).
Conclusion: In overall, practitioners have a significant level of knowledge about the prosthetic phase of an implant. There is a limitation of practise and exposure of dentists in this field of prosthetics because the majority of practitioners have not placed enough implants. Implant training and prospective prosthetic rehabilitation are thus adjuvant learning aids that will improve general dental practitioners' knowledge, attitude, and practice.
Open Access Minireview Article
Hashimoto's thyroiditis (HT) may affect the epidemiology, pathogenesis, diagnosis, clinical course and prognosis of differentiated thyroid cancers (DTC).In this study, our aim is to increase awareness in these cases by revealing the different aspects of DTCs found with HT compared to only DTCs. For this purpose, current studies with HT+DTC cases were reviewed, compared, evaluated, and their differences from DTC cases were revealed. It was determined that HT+DTC cases showed different epidemiological features compared to only DTC cases. Ultrasonography is still the most effective noninvasive diagnostic method in HT+DTC cases. Many studies have shown that the presence of HT positively affects the clinical course and prognosis of DTC. HT+DTCs shows different epidemiological features from DTCs and HT significantly affects the pathogenesis, diagnosis, clinical course and prognosis of DTCs.
Open Access Original Research Article
Aim: To analyse hematological parameters in Cerebrovascular disease
Study design :A retrospective study
Place of Study: The study was carried out in Saveetha Medical College and Hospital, Tamil Nadu, India.
Methodology: This is a retrospective study conducted in Saveetha medical college and hospital during the period of December 2020 and May 2021. The study includes 260 cases, of which 130 CVA patients and 130 control group was taken. Haematological parameters were obtained using Sysmex Automated Analyzer XN-1000.
Statistical analysis was done by SPSS software version 23, with descriptive and independent t test. The level of significance was taken as p value<0.05
Results: CVA are due to two main causes, ischaemic (63.84%) and haemorrhagic infarct (36.15%) The age ranges from 47-69 among stroke subjects. The mean age of control(38.80±12.40years) and CVA group(58.177±11.78years). Both ischaemic and haemorrhagic infarcts are more common among male. On haematological parameters study, analysis showed platelet was increased in CVA than control group. RBC, PCV, MCV, MCHC, TC, neutrophil, lymphocyte, eosinophil, basophil are significant. Haemoglobin, MCH, RDW and monocyte revealed no significance.
Conclusion: In this study, haematological parameters of ischemic CVA patients were greatly altered. The presence of persistently altered status of haematological parameters cerebral ischemic event indicate that these parameters can be considered a simple inflammatory indicator during the development of ischemic damage.
Open Access Original Research Article
Aims: To assess the levels of stress, anxiety, depression among the general population during COVID-19 pandemic and to compare the levels of psychological morbidities, between two different geographical locations in India.
Study Design: Cross-sectional observational study
Place and Duration of Study: Kerala and Tamil Nadu, between March 2021 and August 2021.
Methodology: A total of 522 participants got enrolled for the study, while 505 participants comprising 256 males and 249 females were selected, based on inclusion and exclusion criteria. Depression, Anxiety and Stress Scale (DASS-21) was used to assess the level of distress experienced by the study population.
Results: The sample size was calculated to be around 385 fixing a 95% confidence interval, 5% margin of error with a population proportion of 50% and of unlimited population size. Depression level among male (38%) was slightly higher than female population (37%). Anxiety levels were similar among the male (42%) and female (42%). Stress level was found to be slightly higher in female (22%) than in male (19%). State wise comparison showed that the people of Tamil Nadu had slightly higher level of depression (44%), anxiety (49%) and stress (26%) than the people of Kerala. The parameter of anxiety seemed to be higher when compared with depression and stress. 38% of the population suffered from all the 3 mental health conditions. 32% had at least 2 mental health related trouble. 11% had no mental health issue.
Conclusion: The study reveals that COVID pandemic had definitely created a lot of psychological instability amongst the general public. Our findings propose that constructing a sense of self-management among the general population through providing proper awareness about psychological morbidities and develop necessary interventions that can improve the mental health of vulnerable groups which may be crucial in ensuring preparedness for high contesting environments and adjustments during such pandemic experiences.
Open Access Original Research Article
Traditional teaching approaches are giving way to new ones in medical education. Residents' interest in readily available educational resources is causing instructors to rethink their teaching strategies. This study aims to find which of these ways of learning is preferred by residents. A descriptive survey study was distributed among emergency residents who doing their program in Riyadh during the period from April 2021 to September 2021. All Saudi board emergency medicine residents R1, R2, R3, R4, and post-training residents within the last two years in Riyadh were included. Data were collected using an electronic survey (SurveyMonkey) using a validated questionnaire. This study analyzed 202 residents and post-graduated and ER residents regarding their learning sources and preferences. Participants were at different levels of training as 23.8% were in their first year of residency, 22.8% were in their second year, 19.3% were in their third year, 22.3% were in their fourth year and 11.9% finished their training during the last two years. The majority of the participants 57.4% claimed that they spend 1-2 hours of their extracurricular time on educational material.
Open Access Original Research Article
The improved synthesis of Flecainide acetate (I) is conferred in this article. The chief intent to present this article is to identify and synthesis of the process related impurities of Flecainide acetate.
The article also provides the complete study and characterization of the process impurities. Most of the impurities are the in-situ generated intermediates which are tend to carryforward to the final step of synthesis. The more interesting part is the formation of 2,5 –bis (2,2,2-trifluoroethoxy)-N-((4-methylpiperidine-2-yl) methyl) benzamide impurity during Flecainide acetate synthesis.
The article confers the synthesis of 2,5 –bis (2,2,2-trifluoroethoxy)-N-((4-methylpiperidine-2-yl) methyl) benzamide and its control in Flecainide acetate.
Open Access Review Article
Acne is the most prevalent skin disorder affecting primarily adolescents and young adults. Side effects of acne, such as scarring, dyspigmentation, and low self-esteem, can cause severe morbidity. Isotretinoin is a medication that is used to treat severe acne. The medicine was licensed by the Food and Drug Administration in 1982 to treat severe nodular acne that had been resistant to other treatments, including systemic antibiotics. Other indications of isotretinoin include moderate acne, cutaneous T-cell lymphomas, neuroblastoma, and the prevention of squamous cell carcinoma in high-risk patients. Rosacea, folliculitis, and pyoderma faciale have all been treated with isotretinoin. Some side effects are also associated with the use of isotretinoin including teratogenicity the most severe one. The purpose of this research is to review the available information about indication, contraindication, complication and monitoring of Isotretinoin. Various dermatological conditions are also treated with isotretinoin apart from the common indication of acne. Complete blood count along with the lipid profile, and liver function test are monitored in patients on isotretinoin therapy. Dry lips and dry skin are among the common side effects of isotretinoin. Due to the severe complication of teratogenicity isotretinoin is contraindicated among pregnant women. Evidence from the literature suggests that isotretinoin is the effective medication in treatment of acne and low dose of isotretinoin does not cause any complication. Evidence-based guidelines and strategies for safety and efficacy of isotretinoin can be developed by further clinical research and trials.