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Keywords: Serum Calcium infection under the skin purchase 200mg ofloxacin with mastercard, subclinical and overt hypothyroidism antimicrobial pillows cheap ofloxacin uk, tribal belt antibiotics for acne tetralysal generic 400 mg ofloxacin with mastercard, women, Midnapore. Previous studies have showed that thyroid disorders affectscalciumlevelsinblood,butnoclearinformation hasyetbeingobtained. Phone:+919830983496,+919830519741 shown different calcium levels in Hyperthyroidism, very few studies have compared the calcium levels in Subclinical and Overt Hypothyroidism. A study had showed that hypothyroidism does not cause any abnormality in serum Calcium levels and was found to be associated with low trabecular resorption surface and increased bone cortical thickness№. Although progression of subclinical to overt hypothyroidism is very high in prospective studies with10yearsoffollowupperiodІ,ourswasaonetime study diagnosing subclinical and overt hypothyroidism. Thyroid hormones are known to have its effect on 140 Indian Journal of Public Health Research & Development, January 2019, Vol. The inclusion criteria of selecting the study groupwerenon-pregnantandnonlactatingfemales,not taking any medicine for thyroid disorders or taking any calcium supplements. They had no parathyroid or any renal dysfunction and were not taking any drugs that couldaffecttheirbloodcalciumlevels. Theserumcalciumwasmeasured by ion selective electrode method and was analyzed by chemical analyzer. Descriptivestatisticalanalysis was performed to calculate the mean and corresponding standard database. Pearson correlation coefficient was calculated to find correlation between two variables. Free T4 levels showed positivecorrelationwithserumcalciumlevelsinEuthyroid, SubclinicalandOvertHypothyroid,butthecorrelationwas significantonlywithfreeT4levelsinOverthypothyroidism whileallothervalueswerenotsignificant. In this study in both subclinical and overt hypothyroidism, calcium levels showed significant decrease P<. This decrease in calcium levels might be due to defective mobilization of calciumfrombone. Howevercomparingthecorrelation of thyroid hormones with calcium levels in individual groupswefoundfreeT4tobesignificantwithcalcium levels only in overt hypothyroidism. This also supports the theory that thyroxine hormone is responsible for releasing calcium from bone cells and as it level in overt hypothyroidism decreases so the calcium level in serum also decreases. Though Al-Hakim showed significant decrease in calcium levels in hypothyroid cases which issimilartoourfindings,therewassignificantdecrease in calcium levels between subclinical and overt hypothyroidism also. This might be due to the prompt action of the parathormone action to normalize the calcium levels. Serumlevelsoflipids,calcium and magnesium in women with hypothyroidism and cardiovascular diseases, J lab physicians 2009;1(2):49-52 7. Assessment of serum levels of calcium and phosphorus in Sudanese patient with hypothyroidism. Inthisresearch paperwewilltrytoanalysishowthewhistle-blowerpolicyadoptedbyhealthcareindustryinIndiawhich are playing crucial role so for. This is a quantitative study where researchers used exploratory research design to analyse various factors required for whistleblowing. Amit Kumar Pandey Assist Professor AmityBusinessSchool,AmityUniversityNoida Email:[email protected] Do investigations from individuals which are often referred as whistle-blower really tell corporate malpractices especially which are hidden in nature or are sources creditable enough to investigate, we know government do itself carry out investigation to check thesameespeciallyinallegationfor,manufacturingof fake generic products and failure to maintain quality standards9. Many cases explain that fraud can be when health institution provides certain service to its patients but charges a higher price for the single set of services by issuing separate bills which is known as upcoming but when there is group of related services is billed in single bill is referred as unbounding. It is also seen that a hospital or the doctor given a finance bribes for prescribing medicines generally such practices are not allowedlegally. Ontheotherhand,wehavefraudswhich off-labelmarketthishappenwhenmedicinesaremade with any compliance of drug regulator of the country; it istheseareaswherewhistle-blowersaysitsproblematic area to disclosure11. So,whentobelievethatwhistle-blowersinformation firstsourcecanbeinternalreportswhenlargeofdoctors or employers of the hospital establish a mechanism more ofconfidentialtypeofreportingsystemwherethrough easy channels within the internal environment of the organisation. Secondly proper handling of evidence such invoices, bills, agreements, payment information, etc.

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Methodology: the study was conducted using pre experimental one group pretest-posttest design antibiotic for pneumonia order ofloxacin with visa. Conclusion: Thestudyconcludedthatstructuredteachingprogrammewaseffectiveforhighschoolstudents to antibiotic resistance fact sheet quality ofloxacin 200 mg gain knowledge regarding obesity and its consequences treatment for dogs gum disease generic 200 mg ofloxacin mastercard. In additiontothis;culturalfactorssuchasdietarypractices, attitudes towards food are changing which ultimately contribute to the prevalence of incidence of obesity. Adolescence is generally understood as the period of transition from childhood to adulthood. Adolescentisfrequentlyexposedtorapidly- 48 Indian Journal of Public Health Research & Development, January 2019, Vol. Inthepast10 years the prevalence of obesity has increased by 10­ 40%inthemajorityofAsiancountries. Obesity is responsibleforabout80%ofcasesoftype2diabetes, 35%ofIschemicHeartDiseaseand55%ofhypertensive disease among adults in India. Studies revealed that adolescents will often experiencing social problems, prejudice and discrimination; not only from general public,butalsofromhealthprofessionalsandthismay make them reluctant to seek medical advice. So it is important to educate about obesity and its consequences and how to maintain weight in order to improve their health. Findings related to socio demographic variables of High School Adolescents: In the present study it was found that out of 120 Private high school adolescent,60(50%)ofthesubjectswereinthe age group of 14 years and 60 (50%) in the age groupof 15years. Majority of adolescents belonged to Hindu religion72(60%)&minimumwasJainreligion7 (5. Most of the adolescents getting information from neighbor, friends, family members 45 (37. Findings related to pre test and post test knowledge scores of high school adolescents: Basedontheanalysispretestknowledgescores of high school adolescent, revealed that most of them 30 (25%) had poor knowledge, 69(57. Post test knowledge scores of high school adolescent, revealed that most of them 118(98. Findings related to the Effectiveness of planned teaching programme in terms of gain in knowledge regarding obesity & its consequences: In the present study comparison of pretest and post test knowledge regarding Obesity &itsconsequencesamongadolescentsinselected high schools revealed that the post test score was significantly higher than the pretest score. The structured questioner method is used in the study consist of two section, sectionA consisted of 9 questionseekingthedemographicdataofthesubjects. Section B consists of 30 multiple choice items related to knowledge items with 4 options. The collected data was tabulated and analyzed in terms of descriptive and inferential statistics. Findings related to association of knowledge of Private high school adolescent with selected demographic variables: Chi-square test was computedtofindouttheassociationofknowledge of private high school adolescent with selected demographic variables. Hence, there was no statistically significant association between knowledge and selected demographic variables. Post test results showed that there is significant improvement in the level of knowledge regarding obesity & its consequences among adolescents, it can be concluded that structured teaching programmewasaneffectivemethodofteaching high school adolescents to improve knowledge on obesity&itsconsequences. In the pre test knowledge scores of high school adolescent, revealed that most of them 30 (25%) had poorknowledge,69(57. Overall pre test knowledge of high school adolescentsregardingobesity&itsconsequences 50 Indian Journal of Public Health Research & Development, January 2019, Vol. Reportshaveshownhealthissuessuchasheadache,dizzinessandlocal burning after prolonged cell phone usage. The present study was conducted to evaluate the awareness about cellphoneradiationsandtheireffectsamongstudentsfromSymbiosisInternational(DeemedUniversity) hill base campus. The study was conducted in a cross sectional descriptive manner using Google forms and perception questionnaire. However the increased use ofcellphonesisaccompaniedwithdetrimentaleffects of emitted radiations on human health as well as the ecosystem on the whole. The health hazards reported duetoradiationsfromcellularphonesincludeheadache, infertility, ear problems, depressive tendency, fatigue, sleeping disorder, difficulty in concentration and cardiovascular problems (2-12). However,majorityofphoneusersarestill widely unaware of the harmful effect of radiations on their bodies. Neeti Sharma Assistant Professor SymbiosisSchoolofBiologicalSciences, SymbiosisInternational(DeemedUniversity),Pune,India Email:neeti. Table 1: General information of mobile usage among participant students (a) General information on mobile phone usage a.

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For left-sided bleeding xtenda antibiotic purchase ofloxacin once a day, however antibiotics for acne bactrim ofloxacin 400 mg online, the endotracheal tube cuff should be placed in the trachea virus updates buy ofloxacin 400 mg with visa, and a balloontipped catheter (eg, Fogarty-type 14F balloon) is used to seal the left main bronchus while the right lung is selectively ventilated. This method permits ventilation of the entire right lung, including the right upper lobe, because its opening is usually close to the carina and is frequently blocked by the insertion of an endotracheal tube into the right mainstem bronchus. Placement of the balloon-tipped catheter may be difficult while there is active bleeding. Although the use of double-lumen endobronchial tubes for split lung ventilation during thoracic surgery has been advocated to separate the bleeding lung from the nonbleeding lung, these tubes are not placed easily by inexperienced persons and are subject to displacement even if situated properly. In addition, the two lumens are small, which limits the amount of blood that can be suctioned. Both Carlens-type double-lumen tubes and newer plastic double-lumen tubes with soft low-pressure tracheal and bronchial cuffs have been used to achieve lung separation in hemoptysis, but only experienced personnel familiar with these devices should be asked to insert them. To maintain the position of these tubes, patients generally require heavy sedation and sometimes even paralysis. Bronchial Artery Embolization-Bronchial arteriography and selective bronchial artery embolization with artificial material (eg, polyvinyl alcohol, steel coils, and gelatin sponge) have greatly changed the management of severe hemoptysis. Control of bleeding is achieved with a high degree of success in patients with a variety of causes of hemoptysis. Bronchial artery embolization is performed by identifying bronchial arteries leading to the affected side, the usual patterns consisting of one or two bronchial arteries on each side arising from the aorta between the fifth and sixth thoracic vertebrae. Branches of these arteries also may supply anterior spinal arteries and intercostal arteries. Complications of this procedure include distal arterial embolization if the catheter is not placed far enough into the selected artery and spinal cord damage if embolization is performed into a branch supplying both the bronchial artery and the spinal cord. If performed with proper care, this procedure is highly effective and may lead to long-term resolution of hemoptysis as well as short-term control prior to definitive therapy. Estimates of immediate control of bleeding by bronchial arterial embolization range as high as 90% of patients. Recurrent bleeding after successful embolization may suggest the need for repeat embolization in the same or other areas. In some patients with chronic inflammatory lung disease, identification of collateral arterial vessels may be important. In one study, lasting control of hemoptysis was achieved in 82% of patients during follow-up for as long as 24 months. Surgical Treatment-Surgical resection of the bleeding lobe or segment in patients who can tolerate the procedure removes the threat of recurrent bleeding. Earlier reports of mortality rates higher than 30% from resectional surgery in massive hemoptysis are now considered to be due to ongoing bleeding, poor pulmonary function, and failure of preoperative localization of the bleeding site. Local control of bleeding by airway management or bronchial artery embolization allows surgery to be performed under more controlled conditions, and emergency surgery is now quite rare, with a corresponding decrease in surgical deaths. On the other hand, many patients with severe hemoptysis will not be surgical candidates because of extensive bilateral lung disease and severe reduction of lung function. Of the remainder, medical management is usually adequate to control bleeding, and early surgical therapy is reserved for those with progressive aspiration of blood or inability to control bleeding. There is debate about prophylactic surgical resection after severe hemoptysis has resolved. Recurrent bleeding is common after medical management in some series (25­40%), and death from hemoptysis has occurred during the initial bout of hemoptysis without warning or during a recurrent bout after bleeding had apparently ceased. This risk of recurrent life-threatening hemoptysis has prompted some to perform elective resectional surgery in all patients with hemoptysis in whom surgery is deemed tolerable. However, while there is nearly universal agreement that surgery is indicated for recurrent hemoptysis from a tuberculous or other cavity in which a mycetoma is identified, prophylactic surgery is not universally recommended. Potential candidates for resection include those with well-localized disease, adequate pulmonary function, minimal pleuropulmonary adhesions, and a high likelihood of recurrence. Results of surgical resection should be compared with the increasingly longterm experience with arterial embolization (nonsurgical management) for hemoptysis. Fartoukh M et al: An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: A case series from a referral centre.

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Critical care therefore is directed toward ameliorating the damage done by cellular breakdown antibiotic resistance warning buy discount ofloxacin 400 mg on line. Correction of electrolyte abnormalities and prompt treatment of hyperkalemia through brisk diuresis and administration of insulin and glucose can prevent fatal cardiac arrhythmias bacteria on the tongue ofloxacin 400mg sale. Adequate fluid volume and the administration of mannitol-a free-radical scavenger and osmotic diuretic-is the best strategy to antibiotics for sinus infection didn't work ofloxacin 400mg for sale correct acidosis and to prevent acute renal failure caused by myoglobin precipitates. Local mechanical factors are also important to prevent skin and soft tissue breakdown. The extremity should be kept warm but must not be heated in an effort to restore flow because this will increase the metabolic rate, further the lactic acidosis, and contribute to tissue destruction. Other vascular precautions include keeping linens suspended with a bed cradle and positioning the patient in reverse Trendelenburg. In patients who have not undergone fasciotomy, frequent and careful assessment of the lower extremities is warranted. In the event that a compartment syndrome is diagnosed, prompt decompression is required to preserve tissue viability. Analgesia must not be increased to the point that symptoms are masked and a reliable neurologic examination cannot be obtained. Short-acting intravenous agents such as fentanyl have been used with success, provided that the dose is regulated so as not to obscure worsening of symptoms. Current devices in various stages of clinical trials include rheolytic, clot aspiration, and microfragmentation catheters. Working Party on Thrombolysis in the Management of Limb Ischemia: Thrombolysis in the management of lower limb peripheral arterial occlusion: A consensus document. Both the mortality rate and the need for amputation are directly related to the duration of ischemia. A recent study found that no amputations were required when surgery was undertaken within 2 hours compared with a 44% amputation rate when operation was delayed up to 7 days. The mortality rate was 10% in patients with symptoms present for less than 2 hours and 32% in those whose symptoms were present for up to 8 hours. Coexisting cardiopulmonary complications were the underlying cause of most fatalities, especially in patients with acute arterial thrombosis in contrast to peripheral embolism. Current Controversies and Unresolved Issues the cause of ischemic injury remains unclear. While it is logical to assume that hypoxia is the culprit, investigations have shown that most of the tissue damage actually occurs during the time of reperfusion. A recent canine study found that 3 hours of partial ischemia resulted in more tissue damage than the same period of complete ischemia. Furthermore, the extent of postreperfusion damage can be decreased by graded reflow. These investigations suggest that scavengers of free radicals may be useful in the treatment of acute vascular insufficiency. Although numerous investigations have been undertaken, little improvement has been made over the last 2 decades in morbidity and mortality associated with surgical thrombectomy in this fragile patient group. What is needed is an ideal therapeutic option that achieves rapid blood flow and is minimally invasive. Overall risk for the development of deep venous thrombosis is less than 2%, and the chance of proximal progression is less than 1%. They also may have risk factors such as cancer, obesity, varicose veins, bed rest, or cardiac failure. If prophylaxis is not given, the risk for development of deep venous thrombosis is between 10% and 40% and that of proximal propagation is between 2% and 8%. They undergo extensive abdominal or pelvic procedures for advanced disease or for some orthopedic indication. Proximal extension occurs in 10­20%, leading to fatal pulmonary embolism in up to 5%. Risk factors for the development of venous thrombi and recommended prophylaxis are listed in Table 29­7. Thrombophlebitis is venous thrombosis that follows inflammation of the vessel wall.

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