Eco-safe composite edible coating of hydrocolloids with papaya leaf extract improves postharvest quality and shelf life of papaya fruit under ambient storage.

Papaya postharvest management using low-temperature storage is discouraged as it is a tropical fruit. Extensive research is going on to preserve papaya quality at ambient storage using edible coatings and its composites. The present investigation examined the effects of an eco-safe composite edible coating consisting of hydrocolloid carboxymethyl cellulose (CMC) (1%), guar gum (1.5%), xanthan gum (0.3%), and Gum Arabic (10%) combined with papaya leaf extract (PLE) (1:1 ratio by volume) applied as dip treatment on "Red Lady" papaya fruit at ambient storage condition. Among all the attempted treatments, "PLE incorporated with CMC (1%)" was found to be the best, as the treated fruit exhibited the highest levels of biochemicals, whereas the lowest levels of physiological and enzymatic activity, which positively affected the shelf life. The "CMC + PLE" treatment enhanced the fruit gloss score by 70.1%, phenolics by 6.1%, ascorbic acid by 22.3%, total carotenoid content by 7.4%, and fruit predilection score by 22.0% over the control fruit. However, it lowered (controlling) the physiological loss in weight by 51.0%, decay incidence by 66.6%, and polygalacturonase and pectin methylesterase activity by 24.92% and 35.29%, respectively, over control. Moreover, this treatment exhibited the highest fruit purchase predilection score and prolonged the storage life for >3 days on the physiological loss standard basis (≤10%). This study indicates that "CMC (1%) with PLE (1:1)" composite coating application on papaya under ambient conditions might be an effective, environmentally friendly, and health-friendly way to retain the quality and extend the storage life.

Correlation of Serum Nt-Pro Bnp Levels and Myocardial Performance Index in Asymptomatic Type 2 Diabetics for Assessment of Myocardial Ischaemia.

Diabetes mellitus is a global health problem. Cardiovascular events accounts for approximately 50 percent of mortality amongst the diabetics. Diabetics often present with silent myocardial ischaemia, since myocardial ischaemia is a strong trigger of N-terminal pro-B-type natriuretic peptide (NT-proBNP) release, we hypothesized that NT-proBNP might be useful in the early diagnosis. This study also evaluates whether any correlation exits between NT-proBNP levels and myocardial performance index (MPI). MATERIAL: This case control study was done on 30 patients with type 2 diabetes and similar matched group of 30 controls. Investigations like fasting and postprandial sugar level, kidney function test, HBA1c, lipid profile and NT-ProBNP levels were done. TMT was done to diagnose silent MI. Echocardiography was performed to assess MPI. The outcome measures were cut off levels of NT-ProBNP for predicting silent myocardial ischaemia based on TMT. P<0.05 was considered as significant. OBSERVATION: NT-proBNP (pg/mL) was significantly increased in Diabetics in comparison to controls (595.33±464.48 vs 110.97 ± 34.81, p <.0001). MPI was significantly higher in diabetics (0.54±0.08 vs 0.33±0.02, p<.0001), and NT-proBNP showed significant positive correlation myocardial performance index (r= 0.726, p<0.0001). Silent MI was seen in 18(60%) patients which was based on TMT testing. Compared to those without silent MI, patients with silent MI had higher NTproBNP levels (795.5 vs 106, p value=0.0001) and higher MPI (0.59 ± 0.06 vs 0.46 ± 0.05, p value<.0001). A cut off of NT-pro BNP(pg/ mL) of >152 predicted silent MI in 93.33% cases with 100% sensitivity, 83.33% specificity, 90% PPV and 100% NPV. CONCLUSION: NT-proBNP is a novel marker with positive correlation with MPI. It may be used as an independent predictor for silent MI in diabetics, thereby helping in reduction and treatment of CVD among them. Thus, it is suggested to screen all asymptomatic diabetics for underlying myocardial ischaemia by MPI, preferably, or by NTproBNP levels.

Coronary risk variables in young asymptomatic smokers.

BACKGROUND AND OBJECTIVES: Smoking plays a dominant role in premature atherosclerosis particularly among males in South Asian countries. It initiates and promotes atherosclerosis by altering cardiac haemodynamics, causing dyslipidaemia and producing oxidative damage. Not much information is available from our country. We therefore undertook this study to see the effect of smoking on electrocardiogram (ECG), blood pressure, lipids, apolipoprotein B level and free radical activity in young asymptomatic male smokers. METHODS: The study included 100 consecutive male subjects (50 smokers and 50 non smokers) aged 30-40 yr. Smoking profile, detailed cardiovascular assessment including ECG and lipid profile were evaluated in each subject. RESULTS: Of the 50 smokers, 22 (44%) had grade I hypertension as against 5 of 50 non smokers. Sinus tachycardia (10%) and P-pulmonale (8%) were the only notable ECG abnormalities. Dyslipidaemia was detected in 92 per cent smokers and 48 per cent non smokers (P<0.001). Total serum cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides and apolipoprotein B levels were significantly higher (P<0.001) in smokers compared to non smokers. LDL-cholesterol was > or =135 mg/dl in 94 per cent dyslipidaemic smokers. However, no significant difference was found in high density lipoprotein (HDL)-cholesterol. Smokers had significantly higher serum malondialdehyde levels (P<0.001) and low superoxide dismutase (P<0.001) compared to non smokers. INTERPRETATION AND CONCLUSION: Our data indicate that young asymptomatic male smokers tend to have hypertension, dyslipidaemia and increased production of free oxygen radicals, perhaps by attenuation of oxidative stress by cigarette smoking. This makes them prone for premature coronary artery disease. However, the findings need to be confirmed on a larger sample.

Association of the PIM3 allele of the alpha-1-antitrypsin gene with chronic obstructive pulmonary disease.

OBJECTIVE: The study investigated the association of genetic polymorphism of the alpha1AT gene with COPD. DESIGN AND METHODS: The mutations and polymorphism of alpha1AT gene were investigated by DNA sequence analysis using polymerase chain reaction. RESULTS: The frequency of the PIM3 allele in COPD patients was found to be significantly higher than the controls (P < 0.0001). Five SNPs, including a novel SNP (24_25insA), were observed near the junction of exon-intron I. The occurrence of these SNPs didn't show any association with COPD. However, the PIM3 allele of the alpha1AT gene was found to be associated with COPD. CONCLUSION: The PIM3 allele of the alpha1AT gene is found to have an association with the pathogenesis of COPD in the Indian population.

Comparison of EMLA cream versus placebo in children receiving distraction therapy for venepuncture.

UNLABELLED: Eutectic mixture of local anaesthetics (EMLA) cream is used routinely as a local anaesthetic prior to venepuncture in children. Despite this, however, a significant proportion of children will still be distressed. Cognitive-behavioural interventions, such as distraction by breathing and blowing exercises, have been used and found to be helpful as alternative coping strategies. There is, however, a paucity of data regarding effectiveness. We have evaluated the efficacy of distraction therapy as a coping strategy before and during venepuncture, and in these children evaluated the need for EMLA using a prospective, randomized, double-blind, placebo-controlled clinical trial. Twenty-eight children attending for venepuncture were recruited, median age 6 y (range 4-8 y), and randomly allocated to receive either EMLA or a placebo cream. All were given distraction therapy prior to and during the procedure by a play specialist. Venepuncture was carried out by one investigator. A modified paediatric pain assessment chart was used for objective pain score at the end of the procedure. After one exclusion, the treatment group (17 children) and the placebo group (10 children) were similar: median age of 6 and 7 y (range 4-8), median baseline and post-procedure heart rate and oxygen saturation. The median (interquartile range) for total pain score in the treatment group was 1 (0 to 4.5) and in the control group 1 (0 to 2.3). There was no significant difference in pain score between the two groups (Mann-Whitney test, p = 0.7). The 95% confidence interval for the difference in pain score was -1.0 to +3.0. CONCLUSIONS: The low pain score in both groups suggests the effectiveness of distraction therapy, although factors such as skill of the operator and previous experience of the patient group are of relevance. There was no significant difference in the pain score between the EMLA and placebo groups, suggesting that in this age group if carefully selected children receive distraction during venepuncture EMLA may not be necessary.

Unscheduled return visits within 72 hours to an assessment unit.

Unscheduled return visits were looked at to determine the quality of care and safety of patients in a paediatric assessment unit. The reasons for unscheduled return visits were also investigated. Two per cent of patients discharged from the unit returned, the main reason being parental perception of illness. There were only two patients re-referred by their family doctor. These findings have implications for clinical care and education.