Aguilargorman1327
The pinnacle of success achieved by the medical science and the benefits accrued to the patients have become possible through the medical research where human participants in the research are exposed to hazards inherent to the experiments. To protect the human subjects and to maintain high ethical standards, the World Medical Association has adopted "The Declaration of Helsinki" in 1964. After two years of consultation with the experts throughout the world, the seventh revision of the Declaration was adopted on 19th October 2013 in Brazil. The aim of this article is to review the seventh revision of the Declaration of Helsinki in relation to medical research involving human subjects and highlight the amendments made in the latest revision which are relevant to clinical research in human subjects. The latest revision has made four substantial changes on the existing Declaration, whch include dealing with the compensation of the trial-related injuries, approval of use of placebos in the clinical trials, protection of vulnerable groups and the post-trial provisions. The implications of these amendments in the clinical research are highlighted. Keywords Consent; Declaration of Helsinki; ethics; experimental medicine; research; seventh revision.BACKGROUND Rheumatoid arthritis and Periodontitis both are chronic destructive inflammatory disorders characterized by dysregulation of the host inflammatory response and increase in localized and systemically circulating pro-inflammatory cytokines. The objective of this study was to determine prevalence of periodontitis among Rheumatoid Arthritis patients in our setup. METHODS A crossectional study was done in 43 cases of diagnosed Rheumatoid Arthritis patients visiting to department of Orthopedics of Bir Hospital during the period of July 2016 to January 2017 were examined for presence of periodontitis and its severity. A descriptive questionnaire was also prepared concerning age, sex, personal history. Parameters to be measured were Plaque Index, Gingival Index, Pocket Depth and Clinical Attachment Level. RESULTS Prevalence of periodontitis among Rheumatoid Arthritis patients was found to be 86.04% (37) with Mild periodontitis in 9%(4), Moderate periodontitis 56% (24)and severe periodontitis in 21% (9). The commonest age group was 50.41±9. with male to female ratio of 13 Conclusions Periodontitis was common in Rheumatoid Arthritis in our set up. Moderate periodontitis was more frequent. Periodic oral examination of patients with Rheumatoid Arthritis is required to improve periodontal health.BACKGROUND The liver is most frequently injured solid organ in abdominal trauma. The non-operative management is the standard treatment for hemodynamically stable patients. This study analyse the epidemiological aspects, injury patterns, treatment modalities and outcome in patients with liver injuries only and associated injuries outside the liver. METHODS This was a retrospective study in patients with liver injuries admitted from 1st March 2014 to 31st January 2019 at Chitwan Medical College and Hospital, Nepal. The patients were divided into two groups. Group A consisted of isolated liver injury and Group B liver injury with associated injury of other organs. Data were analysed by using descriptive statistics and Mann-Whitney U test. RESULTS A total of 61 patients were admitted with liver injury. There were 18 (29.5 %) patients with liver injury alone (group A) and 43 (70.5 %)liver injury associated with other organs (group B). Low grade liver injuries were 48 (78.7 %) and high grade 13 (21.3 %). The operative management was done for one liver injury with biliary peritonitis in group A. In group B, 16 patients required laparotomy and operative management for associated abdomen injuries. CONCLUSIONS Non-operative treatment modality in hemodynamically stable patients with isolated liver injuries was safe and effective.BACKGROUND Anterior cruciate ligament is one of the commonly injured ligaments in knee. The shape and dimension of the femoral notch has been linked with the risk of anterior cruciate ligament injury. The aim of this study was to study the risk of Anterior cruciate ligament injury with notch morphology in the Nepalese population. selleckchem METHODS This study is a case control study. Cases undergoing arthroscopic surgery at 2 tertiary level centers were enrolled. Patients with arthroscopic confirmation of Anterior cruciate ligament tear were taken as case and those without tear were taken as control. Axial Magnetic resonance Imaging sequence was used to study notch. Sections at the level of popliteal groove was taken for study and shapes were identified as A, U and W type, and notch width index was calculated. These variables were correlated with presence or absence of Anterior cruciate ligament tear. RESULTS Out of 118 cases, 59 had tear, and 59 had no tear. Tear was found in 74% of Type A notch compared to 30.15% in Type U notch. The femoral notch width index was low in 42.59% of A type notch patients compared to 20.63% with U type notch. Analysis of notch width index among patients with Anterior cruciate ligament tears, showed that 40.67% of Anterior cruciate ligament torn knee had narrow notch compared to 22% in non- injured group, which was statistically significant. CONCLUSIONS Type A notch and narrow notch both are risk factors for Anterior cruciate ligament tear.BACKGROUND Disturbances of the autonomic nervous system play a crucial role in the pathogenesis and clinical course of many diseases. Sympathetic response is an exaggerated response to stress. Studies have shown that enhanced sympathetic response to stress is an indication of prehypertensive states. Young offspring of hypertensive parents are a good model for assessing sympathetic reactivity prior to clinical hypertension. The aim of this study is to compare the sympathetic response in normotensive offspring of both hypertensive and normotensive parents. METHODS 100 young normotensives, non-smoking and healthy students (male and female) of Manipal College of medical science with a family history of hypertension and 100 young normotensives students, non-smoking and healthy with a negative family history of hypertension were enrolled in the study. Blood pressures at rest and after Isometric hand grip test and cold pressor test were measured. Statistical analysis was done to compare the blood pressure at rest and after isometric hand grip exercise and cold pressor test using independent t test.