Research & reviews a journal of health professions (vol4, issue1) by STM Journals Publication

Research & Reviews: A Journal of Health Professions (RRJoHP) ISSN : 2348-9537

Jan - April 2014

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Prof.(Dr.) Jugal Kishore

Prof. Nirmal Kumar Ganguly

Professor Community Medicine, Maulana Azad Medical College, India.

President Jawaharlal Institute of Postgraduate, Institute of Medical Education and Research Distinguished Biotechnology Research Professor, Department of Biotechnology, National Institute of Immunology, New Delhi, India.

Dr. Sanjay P. Zodpey MD, PhD Director, Indian Institute of Public Health - Delhi, Director, Public Health Education Public Health Foundation of India, New Delhi, India.

Dr. Kaushik Sankar Bose Department of Anthropology, Vidyasagar University, Midnapore, India.

Abdulrahman Obaid Musaiger Director of Arab Center for Nutrition, Bahrain Professor of Nutrition and Public Health, University of Bahrain, Bahrain.

Swinder Pal Singh Human Biology Department, Punjabi University, Patiala, India.

Mohan Chander Prasant Professor in Dental College Ams Aosmi, India.

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STM JOURNALS

I take the privilege to present the hard copy compilation for the [Volume 4 Issue (1)] of Research & Reviews: A Journal of Health Professions (RRJoHP). The intension of RRJoHP is to create an atmosphere that stimulates creativeness, research and growth in the area of Health Professions. The development and growth of the mankind is the consequence of brilliant Research done by eminent Scientists and Engineers in every field. RRJoHP provides an outlet for Research findings and reviews in areas of Health Professions found to be relevant for National and International recent developments & research initiative. The aim and scope of the Journal is to provide an academic medium and an important reference for the advancement and dissemination of Research results that support high level learning, teaching and research in the domain of Health Professions. Finally, I express my sincere gratitude and thanks to our Editorial/ Reviewer board and Authors for their continued support and invaluable contributions and suggestions in the form of authoring writeups/ reviewing and providing constructive comments for the advancement of the journals. With regards to their due continuous support and co-operation, we have been able to publish quality Research/Reviews findings for our customers base. I hope you will enjoy reading this issue and we welcome your feedback on any aspect of the Journal.

Dr. Archana Mehrotra Director STM Journals

Research & Reviews: A Journal of Health Professions

Contents

1. Clinical Spectrum and Prognosis of Patients with Septic Shock M Rajneesh Reddy, B Raj Kumar Prakash, M Vinod, P Jayaram, A Satya Prasad, MF Gopinath

2. Guidelines for Withdrawal of Anti-Epileptic Drugs in Seizure-Free Patients Lomati Venkata Pavan Kumar Reddy, Lomati Sandya, Lomati Vidya

3. Living with Infertility: A Review Poonam Sheoran, Jyoti Sarin

4. Road Accidents among Adolescents Gaurav Kohli, Malar Kodi Aathi, Manu Sethi

5. Socio-Economic Status and Patient Rehabilitation in India: A Community Physiotherapist's Odyssey Pavithra Rajan

Research & Reviews: A Journal of Health Professions ISSN: 2348-9537 Volume 4, Issue 1 www.stmjournals.com

Clinical Spectrum and Prognosis of Patients with Septic Shock M Rajneesh Reddy*, B Raj Kumar Prakash, M Vinod, P Jayaram, A Satya Prasad, MF Gopinath Mamatha Medical College, Khammam, Andhra Pradesh, India

Abstract Septic shock is the leading cause of mortality in hospital patients. Closer observation and early treatment can influence the outcome. The present study is undertaken to study the pattern of sepsis and the factors affecting morbidity and mortality in adult patients with septic shock in the ICU. Adult patients admitted in ICU, Mamata General Hospital, Khammam, with diagnosis of sepsis during one-year period from August 2012 to September 2013 were included in the study and patients with no evidence of infection and nosocomial sepsis were excluded from the study. Blood samples and the samples from suspected primary foci were collected for culture and sensitivity. Patients were followed for a minimum of 28 days from the time of diagnosis. During the study period, 50 patients fulfilled the inclusion and exclusion criteria. 74% of patients were males and 26% females and mean age was 54.68 years. Incidence of sepsis was the highest in patients aged 65â&#x20AC;&#x201C;74 years, 44% had severe sepsis and 16% had septic shock, and mortality was 31% and 75% respectively. Most common organ dysfunction was renal followed by cardiovascular and respiratory involvement. The commonest focus of sepsis was respiratory tract followed by urinary tract. Prognosis is good in initial stages of sepsis and worse in septic shock. Hence, early recognition and prompt treatment are of paramount importance.

Keywords: Septic shock, sepsis, mortality, ICU, renal, cardiovascular, respiratory

Research & Reviews: A Journal of Health Professions ISSN: 2348-9537 Volume 4, Issue 1 www.stmjournals.com

Guidelines for Withdrawal of Anti-Epileptic Drugs in Seizure-Free Patients Lomati Venkata Pavan Kumar Reddy*, Lomati Sandya, Lomati Vidya Department of Pharm-D, P. Rami Reddy Memorial College of Pharmacy, Kadapa-516003, India

Abstract The ultimate goal of epilepsy treatment is to become seizure free and live a healthy life without the need to take antiepileptic drugs may cause several tricky and sometimes serious side-effects. There is no class I evidence that is based on randomized doubleblind trials for withdrawal of antiepileptics in adults who become seizure-free while taking such drugs. Whether or not antiepileptic drugs should be withdrawn after a patient has been seizure-free is a challenging concern for several years. Certain studies advise that the total risk of seizure recurrence is approximately 30%, if treatment is withdrawn. The clinical factors associated with a greater chance of successful withdrawal include childhood onset epilepsy, monotherapy, being seizure-free for more than two years, a normal electroencephalogram prior to drug withdrawal, normal neuroimaging and normal intellect. Withdrawal should be gradual and take place over roughly 6 months. Several useful review articles, guidelines, and meta-analyses have been published on the subject of antiepileptic drug withdrawal. Tapering the dose plays essential role in while withdrawal of an antiepileptic drug. The discontinuance of antiepileptic drugs may be patient or parent/guardian meets a profile by considered the physician.

Keywords: Antiepileptic drugs, epilepsy, seizure-free, withdrawal

Research & Reviews: A Journal of Health Professions ISSN: 2348-9537 Volume 4, Issue 1 www.stmjournals.com

Living with Infertility: A Review Poonam Sheoran*, Jyoti Sarin Principal, MM Institute of Nursing, Mullana, Ambala, India

Abstract Human fertility is one of the most complex processes. It is influenced by a set of social and biological factors. Most couples achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. Infertility refers to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term. In India, one in every five couples is childless. The infertility experience involves many hidden losses for the individuals, their loved ones and society as a whole. The society often fails to recognize the grief caused by infertility; therefore, individuals denied parenthood often tend to hide their sorrow. Infertility exerts a negative psychological impact on individuals and couples. The extent of the impact, however, may vary which is influenced by a number of factors such as desire for a child/family; past experience; family history; relationships past and present; diagnosis; cultural beliefs; and treatment outcome. Fortunately, the development of assisted reproduction technique (ART) methods in the recent years has made parenting possible for a substantial number of infertile couples.

Keywords: Fertility, infertility, psychological impact, assisted reproductive technique

Research & Reviews: A Journal of Health Professions ISSN: 2348-9537 Volume 4, Issue 1 www.stmjournals.com

Road Accidents among Adolescents Gaurav Kohli1*, Malar Kodi Aathi1, Manu Sethi2 1

M. M. Institute of Nursing, M. M. University, Mullana, Ambala (Haryana)-133207, India 2 Mai Bhago College of Nursing, Tarantaran (Punjab)-143401, India

Abstract A systematic investigation will provide dynamic understanding about the road accidents, incidence, causes and actions for traffic safety among adolescents according to demographic and clinical data on all accident victims admitted age between 12 and 20 years. There were 257 (95.2%) males and 13 (4.8%) females. There were 12 (4.4%) deaths, 9 (75%) due to traumatic brain injuries [1]. Due to vast mechanization of today’s world, youngsters have been provided so many facilities. On one hand all these things are new, fast, attractive, and adventurous and time-saving but on the flip side all these things are very harmful to new generation. While planning traffic safety initiatives, policy makers and leaders need to recognize children’s vulnerabilities as well as their inexperience, developmental needs and exuberance for life. Road crashes are not “accidents” we need to challenge the notion that traffic crashes are unavoidable and make room for a proactive, preventive approach to reducing death on the roads. Doing is a better route to better traffic safety [2].

Keywords: Road traffic accidents, adolescents, traffic safety, crashes, fatalities, speed, safety rules, safety signs

Research & Reviews: A Journal of Health Professions ISSN: 2348-9537 Volume 4, Issue 1 www.stmjournals.com

Socio-Economic Status and Patient Rehabilitation in India: A Community Physiotherapistâ&#x20AC;&#x2122;s Odyssey Pavithra Rajan* Research Associate, Institute for Social and Economic Change, Bangalore, India Abstract Rehabilitation of patients belonging to lower socio-economic status in India can be challenging. This is due to many reasons. Some of the commonly found causes are lack of adequate health care facilities, patient overload and lack of skilled physiotherapists and lack of awareness among the patients. Given the time and resource constraints in a country like India, it is important to look for cost-effective solutions that could help in alleviation of the symptoms of these patients. One of the cost-effective ways to tackle these issues could be greater emphasis on community-based rehabilitation as opposed to institution-based rehabilitation. There are various advantages of community-based rehabilitation, taking into consideration its cost-effectiveness and time-saving strategies. It can thus be concluded that community-based rehabilitation could be viewed as an effective solution to tackle health issues affecting larger populations, especially those that lack access to institution-based health care facilities.

Keywords: Rehabilitation, health care, physiotherapist, community-based rehabilitation, institution-based rehabilitation