Preoperative assessment for cardiac surgery

Anaesthetic challenges in cardiac surgery are multifaceted. Since patients present with compromised cardiovascular reserve and multiple co-morbidities, a thorough preoperative assessment and meticulous anaesthetic plan is essential. This targets anaesthetic history, physical examination and analysis of investigations, routine and specific to the cardiovascular system. Special models exist for risk stratification to aid perioperative planning, surgical decision making, benchmarking and quality assurance. This article provides an overview of history, examination and preoperative management of patients undergoing cardiac surgery. Scoring systems and practical investigations are reviewed.     

Prevalence of oral lesions in relation to habits: Cross-sectional study in South India.

BACKGROUND: Smoking, drinking and chewing tobacco product, common habits in India have been positively associated with oral lesions. No study has been conducted in this part of Tamilnadu regarding the prevalence of oral lesions in relation to habits. METHODS: A hospital based cross-sectional study was carried out at Ragas Dental College, Chennai. Already existing data of two thousand and seventeen consecutive patients from sub-urban areas of Chennai, who attended the outpatient department, at Ragas Dental College, for dental complaints during a period of three months in 2004, who underwent oral examination and interviewer based questionnaire was used. RESULTS: Oral soft tissue lesions were found in 4.1% of the study subjects. The prevalence of leukoplakia, OSF and oral lichen planus was 0.59%, 0.55%, and 0.15% respectively. The prevalence of smoking, drinking alcoholic beverages and chewing was 15.02%, 8.78% and 6.99% respectively. Smoking and chewing were significant predictors of leukoplakia in this population. DISCUSSION: The prevalence of leukoplakia, OSF and oral lichen planus in our study population is similar to those found in other populations. The prevalence of consumption of alcoholic beverages in our study population was higher when compared to the Indian National Sample Survey study. However the prevalence of smoking and chewing was found to be lower. Smokers were more likely to develop smoker's melanosis compared to other lesions. Among those who consumed alcoholic beverages alone, the prevalence of leukoplakia was higher compared to other lesions. OSF was the most prevalent lesion among those who chewed panmasala or gutkha or betel quid with or without tobacco.     

Comparative study of the angle-resolved backscattering properties of collagen fibers in bovine tendon and cartilage

In a biological tissue, light scattering is based on the size and type of scatterers seen as refractive index variations that describe the optical properties shown. In this paper, we have implemented the variable incidence angle technique of multiple angle of illumination experiment on tendon and cartilage samples whose dominant constituents are genetically different types of collagen fibers, type I and type II, respectively. It is found that tendon displays a much greater angular anisotropy in its optical backscattering coefficient than the healthy cartilage. We propose that this is due to a more uniform distribution of fine fibrils than is found in tendon. Rayleigh-Gans approximation is used to give qualitative support to this idea.     

Food allergies--leads from Ayurveda

Food allergy being a common health problem needs attention. The experience of Ayurveda can be utilized to accelerate our understanding and management of food allergies and related phenomenon like allergic tension fatigue syndrome, intolerance and indigestion associated with certain foods. Prevention of food allergies by carefully selecting the foods in accordance with the individual's body constitution and seasonal alterations, is considered as the best strategy in Ayurveda. If possible, the concept of prakriti and properties of food as described in Ayurveda, should be interpreted in modern terminology. Moreover, to scientifically validate them, an appropriate correlation with modern concepts is required along with scientific studies on modern parameters. Rasayanas may also prove helpful in the management of food allergies. It is obvious that there, is an urgent need for multidimensional and planned investigations of these Ayurvedic rasayanas in management of food allergies. The clinical acceptability of rasayanas for the treatment of food allergies entirely rests on such studies. Food intolerance and allergies are common health problems which are difficult to diagnose and still more difficult to treat. This problem is well addressed in Ayurveda and guidelines are available for their management. This paper aims to present the Ayurvedic concepts in the management of food intolerance/ allergies and its correlation with the evidences available from modem scientific laboratories. The understanding of this ancient wisdom may prove to be of immense importance in patient care.     

Electrochromic Response of Nanostructured Poly(3,4‐ethylenedioxythiophene) Films Grown in an Aqueous Micellar Solution

Poly(3,4‐ethylenedioxythiophene) (PEDOT) films have been electropolymerized from an aqueous micellar solution encompassing the monomer (EDOT) and the moieties sodium dodecyl sulfate (SDS) and lithium triflate. The presence of these anionic dopants in the polymer matrix and a doping level of 0.26 have been confirmed by X‐ray photoemission and electron paramagnetic resonance (EPR) spectroscopy. The hydrophobic micellar core encompassing the monomer orchestrates the growth of a uniform homogeneous polymer deposit as electron microscopy and atomic force microscopy studies reveal the film to be composed of a continuous interlinked network of quasi‐spherical grains (50–150 nm in dimensions) and pores alongwith a low surface roughness. The film exhibits a large coloration efficiency of 153 cm² · C^?1 and a transmission modulation of 62% (λ = 632.8 nm), which are manifestations of the open ion‐permeable morphology. The Q_{(inserted/extracted)} ratio ranges between 1.2 and 1.4 when cycled back and forth between the clear and blue states 2 500 times, thereby affirming the suitability of these films for practical electrochromic smart windows.

     

eHealth for Stigma Reduction Efforts Designed to Improve Engagement in Care for People Living with HIV

Purpose of Review

HIV-related stigma remains a significant barrier to engagement in care for persons living with HIV (PLWH) worldwide. This review examines the use of eHealth technologies for reducing stigma as a pathway toward improved engagement in care for PLWH. We provide a brief overview of effective stigma reduction interventions for PLWH, both eHealth and others; identify gaps in the research on use of eHealth technologies for stigma reduction; and suggest potential research avenues moving forward.

Recent Findings

The majority of HIV-related eHealth studies use technology to improve ART adherence. To date, few HIV-related eHealth studies have included any measurement of stigma.

Summary

Given the current narrow evidence base, further research is needed to determine whether eHealth technologies can help to reduce stigma and improve engagement in care for PLWH.