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Metastatic Renal Cell Carcinoma in the Sinonasal Region
No full textSinonasal region is an exceptional site for metastatic tumors. Renal cell carcinoma is known to metastasise to the most unusual sites, the sinonasal region being one of them. Clear cell carcinoma is its most common histologic variant. A sixty year old male presented with epistaxis and nasal obstruction. Clinical examination and CT scan revealed a vascular tumor in the right nasal cavity and maxillary sinus. The tumor was resected and sent for histopathological examination. A diagnosis of metastatic clear cell renal cell carcinoma was made and confirmed with immunohistochemistry (IHC). The pathologic diagnosis was made without prior knowledge of the primary tumor in the kidney. Very few cases of metastatic renal cell carcinoma in the sinonasal region have been reported in literature. We present this case to document its occurrence, highlight the rarity and briefly discuss the differential diagnoses of clear cell carcinoma in the sinonasal area, based on morphology and IHC
Study of Knowledge, Perceptions and Practices Related to Blood Donation Among the Healthcare Support Staff of a Tertiary Care Hospital in Gujarat, India
No full textBackground: There is a serious mismatch between demand and availability of blood in our country. One of the important factors motivating people for donating blood is their interaction with staff of health facilities including support staff. The knowledge and perceptions of support staff about blood donation have not been studied adequately. Methodology: Data was collected from randomly selected 100healthcare support staff using a pretested questionnaire. The questionnaire was based on prior qualitative analysis of perceptions of few of the potential participants. Results: 91% of the respondents felt that blood donation was not safe. Only 16% had adequate knowledge about eligibility for blood donation and all of them were females. 39% respondents had donated blood themselves and 79% had family history of blood donation. None of the socio-demographic factors except young age were found to be associated with better knowledge or positive perceptions about blood donation. Many among those who had donated blood also did not perceive blood donation as safe. Apprehension about blood being not properly used and not having been approached by anyone were commonest reasons for not donating. Conclusions: The knowledge about safety, eligibility and motivation for blood donation is very poor among the healthcare support staff. Efforts must be made to educate these employees and promote voluntary blood donation among them. Various incentives as suggested by employees themselves and several international bodies may be considered to promote blood donation among healthcare support staff
Perineal Aggressive Angiomyxoma: A Rare Presentation
No full textAggressive angiomyxoma(AA) is defined as benign neoplasm but has infiltrative potential into skeletal muscle and fat. Aggressive angiomyxoma is a rare neoplasm with about 150 reported cases so far. It is most often found in women in reproductive age with a peak incidence in the fourth decade of life. Aggressive angiomyxoma is most often found in or in proximity to the lower pelvis, more specifically perineum, vulva, vagina or inguinal regions. Most AA are big, often more than 10 cm in largest diameter. Radical surgery with wide margins is the treatment of choice. The prognosis is very good here. Because of its rarity and unique presentation we are reporting a case of a huge perineal AA in a 42 years female which presented as a tumour coming out of the breach in skin. She underwent surgery, wide local excision and after 7 months follow-up is free of tumor
Prevalence of Hypertension and Association of Obesity with Hypertension in School Ggoing Children of Surat City, Western India.
No full textPurpose: The association of obesity with hypertension has been recognized for the decades which are the important risk factors for the cardiovascular disease. So the purpose of the present study was to determine association of obesity with hypertension in school going children of Surat. Methodology: School going children aged between 12-18 years, of five schools in Surat were selected for the study. Height and weight were measured and BMI was calculated. Blood pressure measurements were taken as per recommendation of American heart society and family history of hypertension has also been assessed. Hypertension was considered if blood pressure is more than 95th percentile according to the update of task force report and Obesity was diagnosed by BMI for age. Results: Of 682 children, 8.94% were obese and 20.09% were hypertensive. Conclusion: Obesity is strongly associated with hypertension in children and both together may risk factors for later coronary disease
Dealing with the uncertainties of climate engineering: Warnings from a psychological complex problem solving perspective
No full textDecision-makers in the context of climate politics are confronted with considerable uncertainties due to the complexities inherent in the relevant natural and social systems. Nonetheless, pressure on decision-makers to find solutions to dangerous climate change is rising due to the inertia in the climate system. Considering these pressures, technological options (climate engineering) have been proposed to counteract the effects of climatic change. However, introducing options that bear their own scientific uncertainties means further adding to the complexity of the situation. By adopting the psychological perspective of complex problem solving research, we analyze one frequently neglected source of uncertainty with regard to climate engineering: errors of the political problem-solver in his interaction with the situational demands of complex problems. More specifically, we examine the psychological sources for human error that are common in dealing with the uncertainties implied in this type of problem. We will conclude from the complex problem solving perspective that a consideration of climate engineering in the context of climate change can provide a dangerous illusion of controllability
Socio Demographic Factors Determining the Adequacy of Antenatal Care among Pregnant Women Visiting Ekiti State Primary Health Centers.
No full textA cross sectional study was conducted in Primary Health Centers among pregnant women to elucidate adequacy of antenatal care across different socio demographic variables. Four hundred respondents were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the adapted antenatal care exit interview form of the Safe Motherhood Needs Assessment package. Data was analyzed using descriptive statistics and Chi square test. Adequacy of antenatal care in this study was measured by the single adequacy indicators which are duration of pregnancy at entry into antenatal care and number of antenatal visits; which are particularly suitable for developing countries. Age of respondents, means of transportation to the PHCs, occupation, location and level of education of the respondents were found to be determinants of whether the pregnant women attended their first antenatal visit in the first trimester, similarly, age of the respondents was a predictor of whether the women made up to four antenatal visits by their third trimester. Occupation and level of education were determinants of whether or not the pregnant women made their first antenatal visits at the first trimester. More respondents who were not working and those who were unskilled workers made their first antenatal visit at the first trimester compared to those who were skilled workers; work place policies and the fact that antenatal booking are made on weekdays and at work hours may hinder or be discouraging to the working class mothers
A Decomposition Approach for a New Test-Scenario in Complex Problem Solving
No full textOver the last years, psychological research has increasingly used computer-supported tests, especially in the analysis of complex human decision making and problem solving. The approach is to use computer-based test scenarios and to evaluate the performance of participants and correlate it to certain attributes, such as the participant's capacity to regulate emotions. However, two important questions can only be answered with the help of modern optimization methodology. The first one considers an analysis of the exact situations and decisions that led to a bad or good overall performance of test persons. The second important question concerns performance, as the choices made by humans can only be compared to one another, but not to the optimal solution, as it is unknown in general.\ud
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Additionally, these test-scenarios have usually been defined on a trial-and-error basis, until certain characteristics became apparent. The more complex models become, the more likely it is that unforeseen and unwanted characteristics emerge in studies. To overcome this important problem, we propose to use mathematical optimization methodology not only as an analysis and training tool, but also in the design stage of the complex problem scenario.\ud
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We present a novel test scenario, the IWR Tailorshop, with functional relations and model parameters that have been formulated based on optimization results. We also present a tailored decomposition approach to solve the resulting mixed-integer nonlinear programs with nonconvex relaxations and show some promising results of this approach
Spontaneous Bacterial Peritonitis Presenting as Acute Abdomen in a Patient with Chronic Kidney Disease
No full textSpontaneous bacterial peritonitis (SBP) is a relatively common problem in adult patients with liver cirrhosis. The complication of SBP in adults with chronic kidney disease on maintenance hemodialysis is, however, extremely rare. To best of our knowledge this is probably the first case report
Psychiatry: Whither to?
No full textIncreasing division of specialisation in modern medicine has specifically unwrapped the issues of challenges of mental health. This article highlights the importance of primary care mental health, problems of awareness and under detection. Finally, challenges in the current status of mental health are highlighted
Assessing the Level of Disability, Deep Cervical Flexor Endurance and Fear Avoidance Beliefs in Bankers with Neck Pain
No full textObjective: To assess the level of disability, the deep cervical flexor endurance and fear avoidance beliefs (FAB) in bankers with neck pain and to find a correlation between disability and deep cervical muscle endurance, FAB and disability, FAB and deep flexor muscle endurance. Methods: It was an observational study. The Subjects who had neck pain and minimum 5 years’ experience as a Banker participated in the study. Total 100 subjects were selected. All the subjects were assessed for their disability by the neck pain and disability score (NPDI), their deep cervical flexor endurance using Pressure Biofeedback using Cranio-Cervical flexion test (CCFT) and Fear Avoidance Belief by using questionnaire( FABQ). Results: It was found that bankers have a moderate level of disability. The results showed an elevated fear avoidance belief with a mean value of FABQ-PA 21.61±4.42 and FABQ-W 37.81± 5.69. The results indicated that a negative correlation was found between NPDI and CCFT (r=0.855). A positive correlation was found between NPDI and FABQ-PA(r=0.337), FABQ-W(r=0.500). In the present study a negative correlation was found between CCFT and FABQ-W(r=0.553), FABQ-PA (0.348) and positive correlation (r=0.540) was found between FABQ-PA and FABQ-W. Conclusion: The present study concluded that there was a significant level of disability and significantly decreased endurance level and increased fear avoidance beliefs (both work and physical activity related) among bankers with neck pain. In addition to that there was a significant correlation found between NPDI and CCFT, NPDI and FABQ, CCFT and FABQ, FABQ-W and FABQ-PA