Monday, 31 July 2017

Country Kids Less Likely to Develop Bowel Disease Than Their City Cousins


Individuals in provincial territories might be less inclined to create fiery gut illnesses than those in urban areas, Canadian analysts report. "Our discoveries demonstrate that youngsters, especially those less than 10 years old, encounter a defensive impact against IBD in the event that they live in a rustic family," said examine creator Dr. Eric Benchimol. "This impact is especially solid in kids who are brought up in a country family in the initial five years of life," said Benchimol, a pediatric gastroenterologist at Children's Hospital of Eastern Ontario in Ottawa. 

These are essential discoveries, Benchimol said in a doctor's facility news discharge, noticing their past work demonstrates the quantity of exceptionally youthful kids determined to have IBD has bounced in the previous 20 years. IBD - which incorporates crohn's ailment and ulcerative colitis - is a deep rooted condition that causes aggravation in the stomach related tract, bringing about perpetual looseness of the bowels, blood in the stool, stomach agonies and weight reduction. 

The scientists took a gander at more than 45,500 IBD patients in Canada. More than 6,600 were from provincial homes while very nearly 39,000 were living in urban regions. The decreased danger of IBD among provincial inhabitants was particularly striking among kids and teenagers, the analysts said. "The discoveries additionally fortify our understanding that natural hazard factors that incline individuals to IBD may have a more grounded impact in kids than grown-ups," Benchimol included. The examination just finds a relationship between nation life and diminished IBD chance. In any case, "we've realized that notwithstanding hereditary hazard factors, ecological components have been related with the danger of creating IBD," Benchimol said. 

The scientists said early life introduction to a country domain may change the intestinal "microbiome," alluding to the trillions of microorganisms and different organisms that occupy the human gut.

Wednesday, 26 July 2017

Body Image and Weight Concern among Pakistani Adolescent Females


Body image is usually measured in terms of weight status of an individual revealing its association with body satisfaction status. It has been observed in numerous cultural communities that a direct relationship between weight status and body dissatisfaction begins to develop in children entering puberty. This study was conducted among the female adolescents of Islamia Girls College Quetta. The participants included in this study were selected randomly keeping the sample size 100. Study was conducted with the help of a self-developed validated questionnaire and measured BMI category to find association between weight status and body dissatisfaction. Obtained results revealed that a high percentage of female adolescents were obese (62%) and (27%) were under the category of underweight because of their mal adaptive eating patterns leading to increased level of body dissatisfaction and also because of high levels of internalization and social comparison.

Schilder defined body appearance as a psychosocial aspect in which an individual forms a picture of his or her body in the mind. Body image influence many features of human behaviour such as feelings emotions, mindset, relationships etc. Therefore, effects of body image on an individual’s personality is prominent and extensive.Body image is usually measured in terms of weight status of an individual revealing its association with body satisfaction status. It has been observed in numerous cultural communities that a direct link between weight status and body dissatisfaction begins to develop in children entering puberty. Body image is perceived on the basis of individuals weight whether he or she is underweight, over or obese and usually a fat body has been discouraged or criticized among adolescent. A number of studies confirmed that overweight or obese adolescence indicates high levels of body dissatisfaction in both sexes. There may be a number of sociocultural and physical factors such as malnourished diet, decreased exercise and unhealthy weight control responsible for weight gain in adolescents leading to body dissatisfaction. 

Due to lack of reliability in measurement scales, we face a number of limitations in terms of socio-cultural background of the studied participants in investigating body image and body dissatisfaction relationship. Presently in Pakistan there is insufficient understanding and scarce literature available about how and when exactly weight concern is established in female adolescents. Therefore in this study we aimed to describe body image size perception among Pakistani adolescent females and its affiliation with weight status.Adolescent female students of Islamia Girls College Quetta was included in this study. Informed consent was obtained from these students selected at random keeping the sample size 100. Study was conducted with the help of a self-developed validated questionnaire designed to find information about eating patterns of individual participants and their perception regarding their body image. BMIs of the individuals 

Tuesday, 25 July 2017

Noise Pollution a Problem in Black Urban Neighborhoods


Commotion contamination levels are most noteworthy in dark neighborhoods in isolated urban areas in the United States, another investigation appears. Specialists took a gander at 13 years of data accumulated from over the United States. They found as rates of Asian, dark or Hispanic inhabitants rose, so noised levels amid both day and night. Neighborhoods with no less than 75 percent dark inhabitants had middle evening commotion levels 4 decibels higher than neighborhoods with no dark occupants. 

The investigation likewise found that areas with large amounts of destitution and low levels of training had abnormal amounts of commotion. "We've realized that poor groups and groups of shading are likely more presented to poisonous landfills and air contamination, however as of not long ago we truly have not heard much about commotion contamination," said consider creator Joan Casey. She's a postdoctoral researcher at the University of California, Berkeley and made her remarks in a college news discharge. 

"The reliable variations in clamor contamination crosswise over spaces in our examination shocked us," she included. "This is yet another investigation that demonstrates that groups of shading bear a lopsided weight of contamination," said think about co-creator Rachel Morello-Frosch, an educator at the University of California, Berkeley. The examination additionally found that white individuals living in more isolated urban areas were presented to more commotion than white individuals living in less isolated urban areas. 

In more isolated urban communities, activity is a noteworthy wellspring of commotion, the investigation found. "In more isolated urban areas, you see racial abberations paying little heed to the isolation level of the city," Morello-Frosch said. "In any case, what you likewise observe is that urban communities that are more isolated have higher commotion levels generally for everyone," she said. 
"I feel that the inventive piece about this work is that we additionally demonstrate that social disparity, or isolation, exacerbates the situation for everyone," she said.

Monday, 24 July 2017

False Positive and False Negative Results in Diagnosis of Helicobacter Pylori Infection Can be Avoided by A Panel of Serum Biomarkers

Helicobacter pylori (HP) management (including diagnosis and therapy) has been exhaustively reviewed in several reports. These reports are unanimous in that several clinical conditions seriously hamper the diagnostic value of the two most commonly used HP tests: 13C-Urea Breath Test (UBT) and Stool Antigen test (SAT), both false-negative and false-positive results being not uncommon. Basically, these false-negative results are due to decreased bacterial loads in the stomach mucosa, and include the following clinical conditions: 1) use of PPI medication; 2) use of antibiotics; 3) bleeding peptic ulcer; 4) atrophic gastritis (AG; with or without intestinal metaplasia); 5) gastric cancer; 6) MALT lymphoma, and 7) partial gastrectomy. Since the late 1990’s, it has been well established that UBT also gives false-positive results in cases where urease-producing bacterial species are colonizing an acid-free stomach due to AG or a long term use of proton pump inhibitors (PPI). It is to be emphasized that neither UBT nor SAT (or HP serology) is capable of diagnosing AG, caused by HP infection or autoimmune disease, thus missing the patients at high risk for important clinical sequels of AG: I) gastric cancer (GC), ii) esophageal cancer, iii) vitamin-B12 deficiency (due to malabsorption), and iv) malabsorption of calcium, iron, magnesium and certain medicines.

The understanding on the important role played by Helicobacter pylori (HP) infection in pathogenesis of gastric cancer (GC) and peptic ulcer disease has increased progressively since the discovery of the bacteria in 1984 by Marshall and Warren. According to the current concepts, GC develops from HP-infection through precursor lesions of progressively increasing severity: mild, moderate and severe atrophic gastritis (AG), ac companied by intestinal metaplasia (IM) and dysplasia. This sequence of events is generally known as the Correa cascade, and estimated to be involved in around 50% of GC cases, particularly the intestinal type of GC . In parallel with the increased understanding of the pathogenetic mechanisms, also the management of HP- infection has undergone substantial development during the past decade.

In this context, management also covers the complex topics related to the diagnosis of HP-infections. Much of this favorable development can be attributed to the European Helicobacter Study Group that took its first initiative in 1996 in Maastricht to gather dedicated experts in the field to review and discuss all relevant clinical data to arrive at recommendations for the clinical management of HP infection. Since then, these Maastricht conferences have been repeated every 4-5 years. Each of these conferences has yielded a Consensus Report, the latest being the 4th in order, published in 2012. Attempts to standardize HP management (diagnosis and treatment) within countries have led to several national guidelines. In all these reports, considerable attention has been paid to different diagnostic methods available for HP detection, also including comprehensive review of the advantages and limitations of each technique and their utility in different settings, all based on updated literature.  

Thursday, 20 July 2017

The Praxitype and Phenotype Hierarchies Exemplified by NF1


The canonical Central Dogma declared the relationship between a gene (DNA locus), the RNA transcript and the protein product: Gene → mRNA → Protein. This Central Dogma approach was casually adopted to explain genetic disease and, as well, genetic traits in general: Mutant Gene (Allele) → Aberrant mRNA → Abnormal Protein, the latter accounting for the overall phenotype. A popular truncated version of Central Dogma representation used to explain genetic disease oversimplified both the physical dynamics and the underlying logic: Mutant Allele(s) → Mutant Phenotype (γ → φ). Knowledge of a mutant gene (allele) foretold the disease phenotype. As simple as that! For many reasons, not the least of which is our recent understanding and characterization of epigenetics and related disciplines, there is much more to pathogenic schemata than change in the nucleotide base sequence in a genetic locus. It is not just the mutant gene, but how that mutant gene is physically and chemically manifest, that is, put into practice. The word designating this notion of putting a gene into practice is Praxitype. The Praxitype consideration is implicit in various relevant phrases, such as “Metabolome” and “Interactome” and so on.

The notion or the various phenomena of “putting a gene into practice” is designated by the term, Praxitype (π),etymologically consistent with the terms Genotype (γ) and Phenotype (φ). Thus, the over-simplified formulaic expression γ → φ necessarily becomes γ → π → φ. In turn, the major efforts in characterizing how a gene (wildtype or mutant) manifests as a trait (normal, variant or pathological) must now focus on the Praxitype. Just what are the conditions and factors that account for HOW the gene is realized as a phenotypic trait (element)? For example, what are the general and specific roles of epigenetic silencing, microRNAs, post-translational modification (e.g., phosphorylation), protein sequestration or turnover, etc.? Specifically, the progression, γ → π → φ, is not just a matter of the passage of time, it is a matter of the details of various mechanisms employed over time. On the other hand, a disorder’s progression over time is often overlooked, for example, that an NF1 neurofibroma is the “same” at all time periods: no, it changes and for at least some changes, the praxitype must be considered. 

(element)? For example, what are the general and specific roles of epigenetic silencing, microRNAs, post-translational modification (e.g., phosphorylation), protein sequestration or turnover, etc.? [4, 5, 8] Specifically, the progression, γ → π → φ, is not just a matter of the passage of time, it is a matter of the details of various mechanisms employed over time. On the other hand, a disorder’s progression over time is often overlooked, for example, that an NF1 neurofibroma is the “same” at all time periods: no, it changes and for at least some changes, the praxitype must be considered.  

Wednesday, 19 July 2017

Mindfulness Diminish Psychological Distress in Depressed Patients: A Sign of Mental Health

Mindfulness seems to be associated with improved mental health. This study investigated the relationship of mindfulness with psychological distress among depressed patients. Participants were 150 depressed patients and purposively selected those completed the Freiburg Mindfulness Inventory (Walach et al., 2006) and Kessler Psychological Distress Scale (Kessler). Findings revealed that mindfulness was negatively correlated with psychological distress among depressed patients. Regression analysis shows the impact of mindfulness on psychological distress among depressed patients. The findings provided gender differences in mindfulness but no differences were founded for psychological distress in depressed patients.

Mindfulness defined as an awareness that comes forth by paying concentration to the purpose at here and now and without any judgmentally on the ongoing experience. Being aware of the present moment without judging, reflecting or thinking is being mindful or mindfulness. Demonstration of mindfulness is direct attention to ongoing moments and mental state, yet seek after in experiential instead of systematic preparing. Mindfulness pertains to corroborated consciousness and concentration on the present moment and to ongoing experiences. Mindfulness is one form of awareness but varies reflection, self-observing, and requirement for discernment that all are from other forms of awareness and defined by rational, logical and analytical forms of processing information.

According to Germer three interconnected elements of mindfulness. Firstly, mindfulness implies a feeling of awareness. That feeling of awareness is deliberately instead of blur. Secondly, this clear awareness depends on the current experience. Put differently, people feel cognizant about their instantaneous background and of the environment and not immediately draw the attention to the events of the past and opportunities for the future. Thirdly, an awareness of the continuing experience not to be judge, assess and intricate. It means that the considerations, emotions, sensations, and desires are all acknowledged instead of assessed. A term of mindfulness can be utilized in various contexts. That is, mindfulness alludes to a portrayal of some express a state described as a feeling of uncritical attention to current experience. On the other hand, mindfulness symbolize as an intervention, the more often with meditation in which people learn how to mention this state of consciousness. Certainly, mindfulness is not a state, underpinning selfregulation but it as a mental process or acceptance. For the cognizant of natural tendencies of the humans and gives them a pause to change their reaction, mindfulness will be very helpful. A variety of different mindful practices are available that are focused on coercing attention to a specific internal or external experience. Following your breath, thoughts, or focusing on a specific body part are internal experiences and focusing on a certain sound or listening for any sound you hear considering as external experiences.

Tuesday, 18 July 2017

A Review on Transdermal Spray: Formulation Aspect

Transdermal spray offers numerous advantages over the other conventional transdermal drug delivery forms such as gel, ointment and patches, in terms of its cosmeceutical appearance, ready availability for application, flexibility in dosage design, less occurrence of skin irritation and faster drying rate from the application site due to the use of volatile solvent. However, compared to other transdermal drug delivery dosage forms, transdermal spray has the least and limited number of products approved for marketing. Among the drugs are, Evamist®, an estradiol formulation approved in 2007 by the FDA followed by Axiron® a non-spray solution to treat low testosterone in men and Recuvyra®, a pain reliever solution indicated for dogs. This review article focuses current status on the formulation and evaluation of transdermal spray in the background of the role and effects of its composition specially the selection of drugs, volatile solvents, penetration enhancers and film forming polymer, etc. The limitation of transdermal spray highlighted in this review is the concern of its use, especially, the third party exposure particularly for endocrinology indication. Moreover, transdermal spray is also restricted in drugs with large doses due to the limited diffusivity into the skin. The difficulty of exploiting hydrophilic drugs like peptides, macromolecules and new genetic treatments using DNA or small-interfering RNA (siRNA) into transdermal spray formulations is also a limitation that needs to be explored in depth.

Transdermal drug delivery (TDD) is one of the alternative modes of drug administration preferred over oral and injections. This is due to its distinct advantages such as avoidance of first pass metabolism relating to oral administration, provision of steady state drug-plasma concentration, improvement of patient adherence, prevention of potential gastrointestinal (GI) adverse effects and reduction of medical waste of hypodermic needles in low resource settings. The skin provides a large surface area suitable for absorption and the noninvasive procedure for the transdermal drug system such as a patch that enables a continuous intervention with the applied medication. The amount of drug delivered through the skin and the obtained therapeutic effect depends on the ability of the drug to permeate through the skin. The permeation of the drug into the skin is restricted by the stratum corneum (SC), the outermost layer of the skin, which is surrounded by a lipid region. Numerous approaches like iontophoresis, sonophoresis, electroporation, use of chemical permeation enhancers (PE), microniddle, and the use of lipid vesicles have been studied for the last 30 years to break the barrier properties of SC and some of them have produced commercial success.

The development of the transdermal delivery system can be classified into three generations. The first generation consists of low-molecular weight, lipophilic, and low dose drugs. The second generation uses permeation enhancement methods such as conventional chemical PEs, iontophoresis, and non- cavitational ultrasound in order to increase the drug permeability through the SC. The selection of PE was carried out carefully according to several criteria; i) enhanced permeation ability without causing permanent disruption in the structure of the stratum corneum, ii) ability to enhance transdermal flux in maximum amount iii) permeation ability without causing any injury to the deeper tissues. The third generation focuses more on giving the effects on the stratum corneum by incorporating microneedles, thermal ablation, microdermabrasion, electroporation and cavitational ultrasound.

Friday, 14 July 2017

Advances in the Care of Diabetes and Cancer


At first glance, it may appear that diabetes and cancer are unrelated; However, as with other non-communicable diseases, the number of patients with diabetes and cancer is continuously increasing, especially in low- and middle-income countries; And according to recent studies, people with type 1 and type 2 diabetes are more commonly diagnosed with cancer - and are more likely to die of cancer - than people without diabetes. The relationship between the two diseases is stronger among certain types of cancer, including kidney, pancreatic, breast and colorectal cancer.

occur in developing countries. Cancer is among the leading causes of morbidity and mortality worldwide, with approximately 14 million cases and 8.2 deaths each year. The proportion of diagnosed cancers in low- and middle-income regions, such as Africa, Asia, South America, and Central America, is estimated to account for about 70% of all cases worldwide. Without early detection and timely diagnosis both patients with diabetes and those with cancer are at risk of being diagnosed at advanced stages, reducing their chances of managing the disease. Limited access to diagnostic tools and innovative and quality medicines is a very important barrier in reducing the increasing impact of diabetes and cancer in lowand middle-income countries.

Prevention and treatment of non-communicable diseases, such as cancer and diabetes, can only be achieved through the joint efforts of health professionals, governments and regulatory agencies, insurers and individuals themselves. The health industry also plays an important role in gaining better access to diagnostic tools and innovative treatments. We must be aware of this responsibility and commit ourselves to the constant search for new ways to transform health care and achieve great successes and better outcomes for patients in Latin America. There are certain pharmaceutical companies that are already working and research is under way to restore lost beta cells - which produce insulin and allow the body to regulate blood sugar levels - in patients with type 1 diabetes. The study is still in its early stages, but results suggest that an oral drug could help treat or cure type 1 diabetes.

Thursday, 13 July 2017

A Cross-Sectional Prospective Study of Glycated Hemoglobin (Hba1c) and Fasting Blood Glucose (Fbg) Level In Both Diabetic and Non-Diabetic Patients in Context to Nepalese General Population


Blood samples were tested for Fasting Blood Glucose (FBG) and Glycated Haemoglobin (HbA1c) from 75 patients visiting the OPD at Dhulikhel Hospital, Dhulikhel, Kavre, Nepal from 1st August 2010 to 30th October 2010. In the total sample of 75, 49 (65.3%) were male, 26 (34.7%) were female. The age range from 23 to 81 years the mean ± SD of age was found to be 54.81 ±12.287. The mean ± SD of HbA1c was found to be 7.43 ± 2.324 and for fasting blood sugar the mean ± SD was found to be 155.91 ± 67.931. Pearson correlation between fasting blood sugar and HbA1c was found to be (r= 0.683), which indicates the strong and positive correlations and the P value for these variables was (P<0.01 i.e. 0.000000000153), which was significant. Taken together our cross sectional study demonstrates that the HbA1c has a very good correlation with FBG level.

The term Diabetes Mellitus (DM) describes a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Several distinct types of DM exist and are caused by a complex interaction of genetics, environmental factors, and life-style choices. Depending on the etiology of the DM, factors contributing to hyperglycemia may include reduced insulin secretion, decreased glucose utilization, and increased glucose production. The effects of diabetes mellitus include long-term damage, dysfunction and failure of various organs. The long–term effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction. People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease.

The burden of type 2 diabetes has a rising trend in the world. The worldwide prevalence of diabetes among general population was estimated at 150 millions in 1995, and this is projected to increase to 300 million by 2025 [4]. Developing countries such as most of the Asian countries are experiencing an accelerated rate in this issue. It is estimated that about one third of people with type 2 diabetes might be undiagnosed until the complications are developed. 

Monday, 10 July 2017

The Relationship Between Colonic Diverticulosis and Soybean-Like Small Round Stool

Although phenomena and manifestations may often be encountered in routine practice, there are often instances where the cause or identity of those phenomena and manifestations is unclear. Soybean-like small (about 1 cm) round stool (SLSRS) is often encountered during colonoscopy (CS) (Figure 1). The current study examined the causal relationship between such stools and diverticula, and the results are discussed herein.

Subjects were 78 patients who underwent CS by the authors at Kumagaya Surgery Hospital from October 2014 to June 2015. The number of diverticula in the colon, the location of diverticula, the number of bowel movements prior to CS, and the presence or absence of SLSRS were examined in these patients. The causal relationship between diverticula and SLSRS was also examined. Preparations for CS at Kumagaya Surgery Hospital were as follows.

Diverticula were present in 30 of the 78 patients (38.5%). The male:female ratio for patients with diverticula was 24:6 as compared to 28:20 for patients without diverticula. The average age of the patients with diverticula was 66.7 ± 13.2 years as compared to 60.4 ± 17.0 years in those without diverticula. Patients with diverticula had an average of 9.8 ± 3.7 bowel movements prior to CS while patients with no diverticula had an average of 9.1 ± 3.0 bowel movements. Of the 30 patients with diverticula, 12 patients had 1-5 diverticula, 11 had 6-10 diverticula, and 7 had 11 or more diverticula.

SLSRS is often encountered during CS. Such stool is often noted when diverticula are present. In light of their shape, such stool is presumably produced when feces is caught and forged in diverticula. However, no studies have reported data indicating a causal relationship between diverticula and such stool. Small and round stool is referred to as “stool in separate hard lumps,” so there is no consistent designation for these stools in practice. The cathartic and prokinetic agents taken prior to CS do not cause SLSRS to lose their shape. Such stool remains in the colon during CS, where it is often encountered. SLSRS was noted irrespective of the location and number of diverticula.  

Friday, 7 July 2017

Marsupialization of Skene’s Gland Cyst

A 24 year-old woman presented to the Female Pelvic Medicine and Reconstructive Surgery clinic with a chief complaint of “a vaginal bulge”. In addition, she reported discomfort of during sexual intercourse, interrupted voiding and deviation of urinary stream. On examination, a 3x3 cm, cystic mass was observed to the left of the urethral meatus. No evidence of infection was noted and post void residual was 10cc. Diagnosis was cystic Skene’s gland. Initial conservative management and observation were not effective. The patient underwent marsupialization of the Skene gland cyst. This included a circular incision on the vaginal epithelium overlying the cystic gland which included both vaginal epithelium and underlying cystic wall.

Skene’s glands are bilateral and located at the bottom of the distal urethra. The glands help to lubricate the urethral meatus. Obstruction of the ducts leads to the formation of cyst. The cyst may present as a small, cystic mass, just lateral or inferolateral to the urethral meatus and it can become inflamed or infected. As Skene’s ducts are embryologically derived from the urogenital sinus, these cysts are lined by stratified squamous epithelium. 

Differential diagnoses of paraurethral cysts include urethral diverticulum (most common), vaginal cysts (Skene’s gland cyst), fibromuscular tissue, leiomyomata, ectopic ureteroceles, vaginal squamous cell carcinomas or infected granuloma. Skene’s gland cysts are differentiated from urethral diverticulum by location of the cyst: lateral location (skene’s gland cyst) vs suburethral location (diverticulum). When conservative managements are not effective, excision and marsupialization are the surgical options for Skene’s gland cyst. The reason why marsupialization was done for this case, instead of excision, was because the cyst was elongated along the urethra and the excision would have damaged the surrounding tissue if the cystectomy was performed. Marsupialization of Skene’s gland cyst can be a good surgical option with excellent clinical outcome. 

Thursday, 6 July 2017

FDA Widens Access to 'Cooling Cap' to Stop Hair Loss in Cancer Patients


More tumor patients might have the capacity to avoid male pattern baldness amid chemotherapy treatment. A cooling top endorsed in 2015 for use in bosom disease patients has won extended endorsement from the U.S. Sustenance and Drug Administration. The DigniCap Cooling System would now be able to be utilized for patients with strong tumors, the FDA declared. The PC controlled top contains fluid that circles and cools the scalp, narrowing veins. This decreases the amount of the chemotherapy drugs achieve hair follicle cells, the FDA said. 

Cooling likewise diminishes movement of hair follicles and moderates cell division. The outcome: Chemo drugs don't influence them to such an extent, as indicated by the FDA. Male pattern baldness is a typical reaction of chemotherapy, particularly amid treatment of most strong tumor growths. Hair may drop out at the same time, little by little or turn out to be thin. It's typically impermanent - and annoying. "We are satisfied to extend the utilization of this item for growth patients with strong tumors to possibly limit chemotherapy-incited male pattern baldness. Dealing with the symptoms of chemotherapy is a basic part to general wellbeing and personal satisfaction," said Dr. Binita Ashar in a FDA news discharge. 

Ashar coordinates the Division of Surgical Devices in the FDA's Center for Devices and Radiological Health. Be that as it may, the top isn't for everybody. It may not work with some treatment regimens. What's more, it ought not be utilized on kids, patients with specific diseases, and those having particular sorts of chemotherapy, the FDA said. What's more, the organization stated, the top might be not be suited for patients with chilly affectability or helplessness to frosty related wounds. Regular reactions of the top incorporate cool actuated migraines, neck and shoulder uneasiness, chills and torment. Wearing it is not liable to cause chemotherapy medications to miss some malignancy cells in the scalp, as indicated by the FDA. In any case, the long haul impacts of scalp-cooling and danger of growth spread have not been completely contemplated, the office said.

Tuesday, 4 July 2017

Herding CATS: ED CT Utilization Pilot Study: Provider Factors

There is a growing world-wide literature concerning the increased use of computerized tomography (CT) scan examinations in the emergency department setting. The reasons for the increased rates seen have been predominantly attributed to the role of CT in providing rapid and accurate diagnostic imaging. [Oh] As Chang et al point out, “CT is a useful diagnostic tool for the differential of many acute conditions, rendering it an ideal and integral diagnostic tool in the ED setting.” [Chang] Other driving forces to CT utilization have been discussed in the literature. “Factors cited for this trend include a need for rapid, accurate diagnosis, a general trend towards less invasive testing, and increasing concern about malpractice litigation and an increasing public awareness of, and often desire for, CT scanning capabilities.” [Lee] On the other hand, “CT becomes a source of concern to the medical community from the perspective of increased cost and radiation dose to the patient population.” [Oh] This has led to studies of CT utilization. Research has included a number of provider related factors, including provider experience and gender. The purpose of this study was to look at the relationship of overall CT utilization, defined as the number of studies per 100 patients, by provider experience, gender and directorship experience.

The purpose of this study was to look at the relationship of attending emergency physician experience, gender, and department director experience to the percent overall utilization of CT scans. The data was part of ongoing administrative and management work of the department of emergency medicine. The data collected was from a six month period, from January 1, 2016 to June 30, 2016, comprising approximately 74,000 patient visits. CT scan percent utilization was defined as the total number of ED CT scans ordered per 100 patient visits. Department director experience was defined as current.

There were 30 attending emergency physicians in the cohort. Data was coded after entry into the database. The overall CT utilization was 31.8%, with a minimum of 17% and a maximum of 52% [95% CI 28.9-34 %]. The range was 35%. The median (31.5%) was almost identical to the mean, suggesting a normal distribution of the data [Table 1]. This was confirmed with the Anderson-Darling statistic. The standard deviation was 7.62 and the variance was 58.12%. There was a 205% difference between the utilization rates of the highest and the lowest provider. 

Monday, 3 July 2017

Why People With Autism Avoid Eye Contact


In the event that you know somebody with a mental imbalance, you've likely seen that they once in a while look at individuals without flinching. Presently, new research recommends why that is so. "As opposed to what has been thought, the evident absence of relational enthusiasm among individuals with a mental imbalance is not because of an absence of concern," said consider co-creator Dr. Nouchine Hadjikhani. "Or maybe, our outcomes demonstrate that this conduct is an approach to diminish an obnoxious extreme excitement originating from overactivation in a specific piece of the mind," she said. 

Hadjikhani is chief of neurolimbic look into at Massachusetts General Hospital's Center for Biomedical Imaging. While staying away from eye contact is frequently viewed as an indication of social or individual lack of concern, many individuals with extreme introvertedness say eye contact causes them distress or stress, the examination creators noted. The new research follows the issue to some portion of the mind that triggers children's regular fascination in countenances and people groups see feelings in others. It's known as the subcortical framework, and it's actuated by eye contact. To take in more, the examination creators checked mind action while individuals with and without a mental imbalance taken a gander at pictures of appearances either unreservedly or when confined to seeing just the eye zone. 

Both gatherings demonstrated comparative levels of mind movement when seeing photos of the whole face. Be that as it may, when members with extreme introvertedness were demonstrated just the eye zone, their subcortical cerebrum framework was overactivated, the discoveries appeared. This was particularly genuine when they saw dreadful appearances, additionally with cheerful, furious and unbiased ones. The discoveries could prompt more successful approaches to draw in individuals with a mental imbalance, as indicated by Hadjikhani. 

"Compelling youngsters with extreme introvertedness to investigate somebody's eyes in behavioral treatment may make a considerable measure of uneasiness for them," she said in a clinic news discharge. "An approach including moderate habituation to eye contact may enable them to defeat this eruption and have the capacity to deal with eye contact over the long haul, consequently evading the falling impacts that this eye-shirking has on the advancement of the social mind," Hadjikhani proposed.