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1.
Torsades de pointes with prolonged QTc interval is a form of ventricular tachycardia. Many predisposing factors have been identified and hypocalcemia is among the rare ones. Our case illustrates that though rare, hypocalcemia might manifest as torsades de pointes with prolongation of QTc interval. Early diagnosis and management of dyselectrolytemia can prevent these patients from catastrophic torsades de pointes.  相似文献   
2.
Using communication accommodation theory as a framework, this study explores and compares communication patterns of international medical graduate (IMG) physicians and United States medical graduate (USMG) physicians in intergroup, interpersonal, and intercultural context. Given that every fourth doctor practicing medicine in the U.S. is an internationally trained physician (AMA-IMG, 2010) an examination of the influence on patient-provider communication involving IMG physician and comparison with USMG physician is warranted. In a national survey of IMG and USMG physicians, the participants self-reported their perceptions of communication behaviors they used during a medical interaction. Although no difference was found between IMG and USMG physicians use of communication accommodation strategies during medical interaction, IMG physicians reported practicing significantly more relational communication than their U.S. counterparts. USMG physicians reported greater difficulty in communication owing to differences in culture than IMG physicians. Implication of findings for patient-centered communication, patient-physician relationship, and communication skills training is discussed.  相似文献   
3.
Oximes such as pralidoxime chloride reactivate acetylcholinesterase. However their role in management of organophosphate poisoning is controversial. The study was carried out to find effectiveness of pralidoxime chloride (2-PAM) in regenerating red cell acetyl cholinesterase in first 24 h following administration of it in dose recommended by WHO. Eight patients with OPP [chlorpyriphos (3), phorate (3), dichlorvos (1) and monocrotophos (1) who fulfilled the criteria for inclusion were investigated. In addition to decontamination and atropine, all these patients were administered 30 mg/kg body wt of 2-PAM as bolus dose followed by 7.5 mg/kg body wt/h with maximum dose being 500 mg/h as continuous infusion till first 24 h. Red cell AChE activity was estimated every 15 min for first 4 h, one hourly for next 4 h and then 2 hourly till 24 h and subsequently without 2-PAM every 12 h till 7 days or discharge or death which ever earlier. In all the patients maximum increase in activity was observed in first 4 h following which rise was very slow despite continued 2-PAM infusion and reaching a steady state in 20 h in all the cases. The increase in red cell AChE activity observed in diethyl group at 24 h of 2-PAM infusion was 154% vs. 81% in dimethyl group. At 7 days the increase in activity was 215% vs. 118% respectively. However on multiple repeated ANOVA, no statistically significant difference was observed between diethyl and dimethyl groups at admission and discharge (P > 0.05). Similarly no significant difference was observed in three groups when patients were categorized according to WHO classification of organophosphates (P > 0.05). The maximum increase in red cell AChE activity occurs in first 4 h of 2-PAM administration followed by a slow increase despite 2-PAM infusion till 24 h.  相似文献   
4.
The main objective of study is to estimate and extract various significant Demand Pull (DP) practices influencing Sustainable Development in Indian manufacturing industries. The study critically examines the effectiveness of DP strategies in manufacturing enterprises. An extensive survey of 92 companies has been executed for this study, to identify improvements made by DP practices to achieve sustainable development in manufacturing industries. The companies in the survey include medium- and large-scale manufacturing enterprises. The correlations between various DP practices and sustainable development parameters are evaluated and validated using various numerical methods and tools. The focus of the paper is on the distinguishable contributions made by DP practices like stringent implementation of government regulations, transforming capabilities, unionized labor and customer attributes towards achieving sustainable development in manufacturing industries. The inter-relationships between different DP practices with sustainable development parameters have been evaluated, to efficiently manage the objectives of sustainability and growth. However, it is also acknowledged that manufacturing enterprises need to work more actively on managing certain practices of DP. In the present study the contributions of DP practices are investigated to accomplish sustainable development in manufacturing industries. Though, issue-wise independent examination can also be organized to compute the effectiveness of DP strategies towards achieving sustainable development and quality under specific orientations. The research gives priority to enhancement in planning among various DP practices and sustainable development indicators in the industries, to impart DP as an important practice to meet the challenges of competent markets worldwide. It has been exhibited from the observations that adequate DP strategies can efficiently contribute towards recognition of sustainable development to compete in the highly progressive global market. The results of various inter-relationships among DP practices and sustainable development parameters represent the effectiveness of DP practices for accomplishment of social as well as organizational objectives. The paper examines that DP practices are significant initiatives employed by the manufacturing organizations for performance improvement and sustainable development. The paper peeks into the study to find out DP issues that need to be assessed efficiently by companies to avail the benefits of sustainable development to meet the challenges posed by international markets.  相似文献   
5.
Coronavirus disease 2019 (Covid-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic disease which has affected more than 6.2 million people globally, with numbers mounting considerably daily. However, till date, no specific treatment modalities are available for Covid-19 and also not much information is known about this disease. Recent studies have revealed that SARS-CoV-2 infection is associated with the generation of thrombosis and coagulopathy. Fundamentally, it has been believed that a diverse array of signalling pathways might be responsible for the activation of coagulation cascade during SARS-CoV-2 infection. Henceforth, a detailed understanding of these probable underlying molecular mechanistic pathways causing thrombosis in Covid-19 disease deserves an urgent exploration. Therefore, in this review, the hypothetical crosstalk between distinct signalling pathways including apoptosis, inflammation, hypoxia and angiogenesis attributable for the commencement of thrombotic events during SARS-CoV-2 infection has been addressed which might further unravel promising therapeutic targets in Covid-19 disease.  相似文献   
6.
The present work was undertaken to study interrelation of Fibrinogen, Lp(a) and LVMI in Type II diabetes patients with or without nephropathy. 100 Type II Diabetic patients attending OPD/IPD of DMC&H, Ludhiana were included. They were divided in two groups. Group I: 50 patients without microalbuminuria (MAU). Group II: 50 patients with MAU. Fibrinogen (Clauss method), Lp(a) and MAU were estimated on Multichannel Autoanalyzer Hitachi-911 (Roche). LVMI was estimated by echocardiography using formula of Devereux and Reicheck. Type II diabetes patients with MAU had significantly raised levels of Fibrinogen, Lp(a), and LVMI as compared to normoalbuminuric diabetics (P < 0.01). Group II patients had positive correlation between Lp(a) and LVMI but no relation between Fibrinogen and LVMI. MAU, marker of microangiopathy, is associated with higher Fibrinogen and Lp(a) levels. This becomes basis of increase cardiovascular risk as demonstrated by higher mean LVMI in Group II patients.  相似文献   
7.
HbA1c is used extensively for the diagnosis and management of diabetes mellitus. It constitutes 80% of glycated HbA1(Glycated haemoglobin(GHb)A), and depends upon blood glucose and RBC life span. RBC life span varies with anemia, leading to a consequent alteration in the HbA1c value irrespective of the circulating blood glucose concentration. But to the best of our knowledge no Hb cut offs have been derived for appropriate interpretation of HbA1c. The prevalence of anemia in Indian population is nearly 40% as per its definition by WHO—Hb < 12 g/dL in females and < 13 g/dL in males—with most cases attributable to nutritional deficiencies. Hence, we aimed to identify Hb cut-off for accurate interpretation of HbA1c in presence of deficiency anemias. Partial correlation between random blood glucose (RBG) and HbA1c was studied in 1312 subjects, 470 of whom had deficiency-related anemia]. The data was adjusted for age, sex and Hb. Partial correlation between RBG and HbA1c was highly significant (p < 0.0001) till Hb of 8.1 gm/dL. Significance reduced to p = 0.003 and p = 0.006 as the cut off of Hb reduced to 7.1 gm/dL and 5.0 gm/dL, respectively, but was not lost. Hence, caution in interpretation of HbA1c is not required till an Hb of 5 g/dL.  相似文献   
8.
In this paper, we reflect upon how dialogs and debates in a non-governmental organization (NGO) – CARE India in the context of a girls’ education project shaped staff members’ understandings of gender justice. As CARE India staff shared their experiences in the field, in the organization, and in domestic spaces during gender training sessions and other forums, their different politics in these spaces shaped how they translated global discourses of gender justice to produce fluid, contested, and contextual understandings. While these dialogs included the voices of diverse social actors in identifying the capabilities needed for gender justice in education, they were often reframed by local NGO actors.  相似文献   
9.
The study examined the extent that teacher–student relationships (TSR) influenced basic psychological needs, engagement, and student growth using the self‐systems process model as a framework using structural equation modeling. Based on prior research, it was hypothesized that context (TSR) influenced self (basic psychological needs), which influenced action (engagement), and consequently, influenced outcome (student score and grade point average‐GPA). The findings of the study supported prior research that a TSR positively influenced levels of engagement in the classroom and, consequently, student outcomes as measured by classroom grade point average (GPA) and standardized assessment results. Using an identical methodological setup that substituted student growth percentiles (SGP) for scale scores, it was determined that TSR, basic psychological need satisfaction, and level of engagement do not influence SGP. Implications and potential contributions are discussed.  相似文献   
10.
We present an innovative course-based undergraduate research experience curriculum focused on the characterization of single point mutations in p53, a tumor suppressor gene that is mutated in more than 50% of human cancers. This course is required of all introductory biology students, so all biology majors engage in a research project as part of their training. Using a set of open-ended written prompts, we found that the course shifts student conceptions of what it means to think like a scientist from novice to more expert-like. Students at the end of the course identified experimental repetition, data analysis, and collaboration as important elements of thinking like a scientist. Course exams revealed that students showed gains in their ability to analyze and interpret data. These data indicate that this course-embedded research experience has a positive impact on the development of students’ conceptions and practice of scientific thinking.  相似文献   
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