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Biomedical subjects

J Richard

Publications and source records attributed to J Richard.

At least 271 records · Page 15Linked to original sources

Duodenal ulcer perforation: have H2 receptor blockers reduced mortality?

Elective surgery for peptic ulcer is becoming rare with the use of more effective medical therapy. However, life threatening complications have not reduced in number. A retrospective study was carried out to compare perforation rates per 10,000 admissions, mortality rates from perforated duodenal ulcers per 10,000 admission and the proportion of patients with perforated duodenal ulcer who died, before and after the introduction of H2 receptor blockers in a large teaching hospital in South India. Perforation rates were not significantly different between the two periods under study. There was a small, but statistically significant (p = 0.047) drop in mortality per 10,000 admissions and a significant drop in proportion of patients with perforated ulcer who died (p = 0.028). Inspite of effective medical therapy, there is a subset of patients with duodenal ulcer who continue to perforate. Efforts should be directed towards identifying this subset and offering them early surgery. Mortality rates have not changed significantly.

Duodenal Ulcer↗

A supercritical fluid-based coating technology 1: process considerations.

A novel solvent-free particle coating process, based on the solvent properties of supercritical fluids (SCF) is described. It consists of dissolving one or more coating materials in supercritical CO(2) and then adjusting T/P conditions in the autoclave so that the coating material becomes insoluble in the CO(2). This insolubilization step causes a coating to deposit on the surface of suspended particles. This process has been applied to bovine serum albumin and sugar granules. Coating was effective, but different morphologies were obtained depending on the coating material used. A discontinuous coating has been made using trimyristin, since this material precipitates as micro-needles. Conversely, a smooth, regular coating has been obtained with a commercially available mixture of glycerides and glyceride esters of PEG (Gelucire 50/02) acting like a film-forming agent.

Capsules↗

Grip and pinch strength in relation to function in denervated hands.

A study was conducted in the Schieffelin Leprosy Research and Training Centre, Karigiri, Tamil Nadu, from March to September 2000 to find out the relationship between grip and pinch strengths and basic activities of daily living (BADL) in leprosy patients. Sixty-two patients (mean age: 36.1 years) suffering from impairment of motor nerve function in one or both hands were included in the study. Grip strength and pinch strength, namely pulp-to-pulp pinch strength, lateral pinch strength, tripod pinch strength, were measured using a hydraulic hand dynamometer and a pinch gauge. BADL was assessed using Karigiri activities of daily living rating scale. Frequency table, mean, median, range, standard deviation, correlation and multiple regressions were used in analysis. The results showed that there was a highly significant correlation (p < 0.001) between the grip and pinch strength and BADL. Multiple regression analysis showed only tripod pinch strength had a significant, independent influence on the BADL. Other two pinch strengths and grip strength were not significant. These results suggest that there is a significant relationship between the grip and pinch strengths and BADL. The tripod pinch strength is the most important hand strength contributing to the problems in BADL. In a measure of association between impairment and disability, the results revealed that out of 62 patients with physical impairment of the hand, 59 (95.2%) had experienced disabilities. This indicated that, despite impairment, 4.8% do not have any disabilities.

Activities of Daily Living↗

Knowledge and practice of eye-care among leprosy patients.

In one hundred and thirty leprosy patients attending the Schieffelin Leprosy Research and Training Center, Karigiri, Tamil Nadu, India, the knowledge, attitude and practice of eye-care were ascertained using a questionnaire developed by Mathews & Mangalam. 74.6% the patients surveyed were aware of the disease, 60% knew about the early signs of leprosy, 74.6% considered leprosy curable and 36.9% knew the duration of treatment with MDT. Less than half of the patients (40.8%) knew that blindness occurred in leprosy and was preventable. More males had this knowledge (46.5%) than females (22.6%) (P = 0.001). Knowledge on how to take care of the eyes (26.9%), that eyes become anaesthetic due to leprosy (27.7%), and that precautions should be taken if sensation is lost (27. 7%) was very poor. Knowledge on prevention of damage in eyes (57.7%) and the fact that rubbing eyes could cause damage (55.4%) was found in more than half the patients. More males (64.6%) had knowledge on the prevention of damage in eyes than females (35.5%) (P = 0.008). Only 25.4% of the patients tried some measures to prevent eye injury, 21.5% used home remedies and all had the help of family members in their eye-care. More males (26.3%) used home remedies than females (6.5%). The older age group had better knowledge on taking care of the eyes than those aged 40 and below (P = 0.026). Although more patients with existing complications knew to take care of their eyes than those who did not have complications, the knowledge and practice of eye-care in both these groups were poor. Knowledge of leprosy in illiterate patients was not different from those who had some formal schooling, but the practice of eye-care differed significantly (P = 0.02). Health education must be undertaken to increase the knowledge of eye-care among leprosy patients, especially among illiterate persons, women and younger patients.

Adolescent↗

[Gerodontics and geriatric psychiatry].

Some of the important points in geriatric psychology and geriatric psychiatry (such as vocabulary and base line concepts, old myths in geriatrics, reference models, principle of action, therapeutic procedures, nasalgraphy, pluri, inter and transdisciplinarity) will be developed for the dentist practicing geriatric dentistry. Knowledge of these concepts should provide the basis for an effective association with the psychiatrist, in order to enhance better care for the elderly. Two types of approaches of the elderly, well known of the geriatric psychiatrist will be developed. The cognitive and motory approaches will be set as examples capable of helping the exchange between the two specialties.

Aged↗

[Mood and insulin-dependent diabetes. Value of the Von Zerssen test].

At the end of a week of education, 120 diabetics (I.D.D.M.) checked the list of items from the Von Zerssen's test. This self evaluation test classifies the mood in to depression (13%), anxiety (27%), normal (39%) and euphoria (21%). The ages of the patients and the duration of their diabetes were irrelevant to the results. But, according the type of diabetes, the results become: discovery of I.D.D.M.: depression (4%), anxiety (35%), normal (35%), euphoria (26%); I.D.D.M. (former N.I.D.D.M.): depression (16%), anxiety (28%), normal (31%), euphoria (25%); I.D.D.M. ancient: depression (15%), anxiety (23%), normal (45%), euphoria (17%).

Adolescent↗

[Sleep in Pick disease].

19 polygraphic sleep recordings from 12 patients with Pick's Disease, including four histologically proved cases, were compared to those of an age-matched control group. Symptoms had been present for a mean 8 years, the patients being aged 59 to 78 (mean 70.5 years). All sleep stages could be identified. Total sleep time was reduced and the number of awakenings was sharply increased. High proportion of stage 1 contrasted with the reduction in the other sleep stages with disappearance of stage 4 in advanced cases. REM Sleep was identified in all recordings, although reduced as a function of the length of the illness; its production as a function of total sleep time was not different from that of the control. REM Sleep appeared often fragmented and with a remarkably short latency, reminiscent of that observed in severely depressed patients.

Aged↗