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Hierarchical nanostructures play an important role in environmental clean-up and sustainability applications. The magnetic and photocatalytic characteristics of flower-like Mn-doped α-Fe2O3 nanostructures were prepared by using a polyol-assisted hydrothermal method. Crystallite sizes are in the range of 35-42 nm, and the existence of 3D hierarchical nanostructures was observed in FESEM pictures. The optical band gap energy varies between 2.08 and 2.16 eV, while XPS examination exposes the ions' charge states and validates Mn3+ inclusion in the Fe3+ lattice. At room temperature, the addition of Mn to α-Fe2O3 results in a spin disorder ferromagnetism and coercivity of about 600 Oe was achieved. Methylene blue (MB) dye solution degraded by 92% when 2.5% Mn doped with α-Fe2O3 under visible conditions for 120 min irradiation time.
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AIM: The aim of this study was to describe factors affecting nursing education and labour markets in countries in East, Central, and Southern Africa, and critical areas for investment. BACKGROUND: An understanding about the relationship between the supply of nurses (determined by types of educational programmes, and the quantity and quality of nurse graduates), and workforce demand is critical to health policy development. METHODS: Six focus groups and 14 key informant interviews with nursing leaders and experts were conducted. Participants included government chief nursing officers, registrars of regulatory bodies, association leaders and heads of nursing education. The data were transcribed, coded and analysed using inductive techniques. FINDINGS: Participants discussed challenges and strengths of nursing education, school and regulatory infrastructure, financing mechanisms for the nursing workforce, the state of nursing jobs and scope of nursing practice. CONCLUSION: Strengthened regulations and leadership are needed to improve investment in nursing, the quality of nursing education, and working conditions and to promote the achievement of better health outcomes. IMPLICATIONS FOR NURSING POLICY: Clarifying scope of practice for nurses in the health sector and creating competency-based requirements is important. Governments should establish positions that align with updated competencies and provide fair and safe working conditions. The current and ongoing investment case for nursing requires improved data systems and a commitment to use labour market data for decision-making.
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Educação em Enfermagem , Enfermeiros Administradores , Recursos Humanos de Enfermagem , Humanos , Liderança , Recursos HumanosRESUMO
Here we report a unique plant-insect interaction between the leafhopper Aloka depressa (tribe Phlogisini) and the host liana, Diploclisia glaucescens, from a Botanic Garden located at the southern edge of Western Ghats in India. Field observations and SEM micrographs were employed to derive evidences on this rare plant-insect interaction. 20-Hydroxyecdysone (20E), insect moulting hormone, was detected and quantified in the host plant D. glaucescens using HPTLC-densitometry. 20E was isolated and characterized from D. glaucescens using column chromatography, 1H-, 13C-NMR and HR-MS. 20E was also detected in A. depressa excrement using HPTLC-densitometry. The leafhopper A. depressa is functioning as a 'sharpshooter' drawing nutrients from the host liana, D. glaucescens, and flinging the waste fluid as droplets through their tail ends. SEM micrographs of A. depressa revealed its external morphological features, characteristic of a sharpshooter. We quantified 20E (0.44-1.44%, dry wt.) in various parts of D. glaucescens. 20E (1.47%, dry wt.) was also detected in the excrement of A. depressa. This plant (D. glaucescens)-insect (A. depressa) association crucially is not damaging the host liana. Considering the diseases caused by sharpshooting leafhoppers in the Americas, this association and the survival of the host plant (D. glaucescens) is illustrating a unique plant-insect interaction.
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Hemípteros , Menispermaceae , Animais , Jardins , Menispermaceae/químicaRESUMO
Vanadium-doped α-Fe2O3 nanoparticles (VFO nanoparticles) were prepared by polyol-assisted hydrothermal method. The impact on the structure, optical, magnetic and photocatalytic properties of α-Fe2O3 nanoparticles were studied by varying the vanadium concentration from 1 to 5%. XRD analysis confirms the presence of hematite phase with hexagonal structure and estimates the nanocrystals size as â¼26-38 nm. FESEM and TEM reveal the formation of 3D flower-like morphology bundled with 2D nanoflakes. The estimated band gap energy was in the range 2.01 eV-2.12 eV. XPS study shows the presence of vanadium in V4+ oxidation state in VFO nanoparticles. VSM study shows a non-saturated hysteresis loop with weak ferromagnetic behavior for all the VFO nanoparticles. 5% V doped α-Fe2O3 nanoparticles (5%VFO nanoparticles) exhibited superior visible light driven photocatalytic activity compared to other samples.
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Nanopartículas , Vanádio , Luz , Nanopartículas/química , Polímeros , Vanádio/químicaRESUMO
A 45-year-old lady presented with left lower quadrant abdominal pain and hematochezia of 1 month duration. She had Copper-T, an intrauterine contraceptive device (IUCD) inserted in the immediate post-partum period 25 years ago elsewhere and was lost to follow up. CT abdomen done 2 weeks earlier before reporting to us revealed a migrated and translocated IUCD embedded in the right lateral wall of the rectum. On colonoscopy, an area of friable mucosal nodule was noticed in the right lateral wall 10 cm from the anal verge but the IUCD was not visible intraluminally. Fluoroscopy showed the horizontal limb lying in close approximation with the rectal wall and the vertical limb of the IUCD embedded at the site of mucosal nodule in the rectum. After a careful endoscopic mucosotomy, the vertical limb was exposed and the Copper-T in its entirety was retrieved using a polypectomy snare. The mucosal defect was closed with hemoclips. She became asymptomatic after the procedure.
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Colonoscopia/métodos , Corpos Estranhos/cirurgia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/cirurgia , Dispositivos Intrauterinos/efeitos adversos , Reto/cirurgia , Cirurgia Assistida por Computador/métodos , Dor Abdominal/etiologia , Feminino , Fluoroscopia , Corpos Estranhos/diagnóstico por imagem , Migração de Corpo Estranho/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The fundamental tool for preventing and controlling healthcare-acquired infections is hand hygiene (HH). Nonetheless, adherence to HH guidelines is often low. Our goal was to assess the effect of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach (IMHHA) in three intensive care units of three INICC member hospitals in two cities of India and to analyze the predictors of compliance with HH. From August 2004 to July 2011, we carried out an observational, prospective, interventional study to evaluate the implementation of the IMHHA, which included the following elements: (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance and (6) performance feedback. The practices of health care workers were monitored during randomly selected 30-min periods. We observed 3612 opportunities for HH. Overall adherence to HH increased from 36.9% to 82% (95% CI 79.3-84.5; P=0.0001). Multivariate analysis indicated that certain variables were significantly associated with poor HH adherence: nurses vs. physicians (70.5% vs. 74%; 95% CI 0.62-0.96; P=0.018), ancillary staff vs. physicians (43.6% vs. 74.0%; 95% CI 0.48-0.72; P<0.001), ancillary staff vs. nurses (43.6% vs. 70.5%; 95% CI 0.51-0.75; P<0.001) and private vs. academic hospitals (74.2% vs. 66.3%; 95% CI 0.83-0.97; P<0.001). It is worth noticing that in India, the HH compliance of physicians is higher than in nurses. Adherence to HH was significantly increased by implementing the IMHHA. Programs targeted at improving HH are warranted to identify predictors of poor compliance.
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Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Fidelidade a Diretrizes , Higiene das Mãos , Terapia Comportamental/métodos , Estudos de Coortes , Países em Desenvolvimento , Feminino , Pessoal de Saúde , Humanos , Índia , Controle de Infecções/métodos , Unidades de Terapia Intensiva , Masculino , Estudos ProspectivosRESUMO
BACKGROUND: Surgical site infections are a threat to patient safety. However, in India, data on their rates stratified by surgical procedure are not available. METHODS: From January 2005 to December 2011, the International Nosocomial Infection Control Consortium (INICC) conducted a cohort prospective surveillance study on surgical site infections in 10 hospitals in 6 Indian cities. CDC National Healthcare Safety Network (CDC-NHSN) methods were applied and surgical procedures were classified into 11 types, according to the ninth edition of the International Classification of Diseases. RESULTS: We documented 1189 surgical site infections, associated with 28 340 surgical procedures (4.2%; 95% CI: 4.0-4.4). Surgical site infections rates were compared with INICC and CDC-NHSN reports, respectively: 4.3% for coronary bypass with chest and donor incision (4.5% vs 2.9%); 8.3% for breast surgery (1.7% vs 2.3%); 6.5% for cardiac surgery (5.6% vs 1.3%); 6.0% for exploratory abdominal surgery (4.1% vs 2.0%), among others. CONCLUSIONS: In most types of surgical procedures, surgical site infections rates were higher than those reported by the CDC-NHSN, but similar to INICC. This study is an important advancement towards the knowledge of surgical site infections epidemiology in the participating Indian hospitals that will allow us to introduce targeted interventions.
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Infecção Hospitalar/epidemiologia , Hospitais , Infecção da Ferida Cirúrgica/epidemiologia , População Urbana , Feminino , Humanos , Índia/epidemiologia , Controle de Infecções , Estudos ProspectivosRESUMO
The antigenic composition of Cysticercus cellulosae cysts excised from infected pig and autopsied human brain was analysed by crossed immunoelectrophoresis with an intermediate gel technique using rabbit hyperimmune serum. Normal pork muscle and human brain antigen were used to differentiate parasite derived components from that of host. Attempts were made to look for the rich source of parasitic immunodominant antigens by analysing preparations of different parts of cyst namely scolex and fluid using rabbit hyperimmune serum. Twenty three antigenic components were identified in sonicate extract of porcine cyst, of which 15 were parasite derived. On comparison with antigens of whole cyst sonicate, scolex showed 10, cyst fluid 9 and human cyst sonicate 11 parasite derived antigens. Serum and cerebrospinal fluid (CSF) of neurocysticercotic patients reacted with 12 parasite derived antigens of porcine cyst sonicate (PCS) in a heterogenous manner. It was also noticed that human cyst sonicate (HCS) lacked 4 of the parasite derived antigens present in the PCS.
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Antígenos de Helmintos/análise , Encefalopatias/diagnóstico , Cisticercose/diagnóstico , Cysticercus/imunologia , Taenia/imunologia , Animais , Antígenos de Helmintos/líquido cefalorraquidiano , Humanos , Imunoeletroforese BidimensionalRESUMO
An unusual case of neurotuberculosis presenting with tuberculous meningitis, tuberculous abscess and multiple tuberculomas is reported. The patient showed a dramatic response and resolution of tuberculomas with antituberculous therapy only after excision of the abscess.
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Antituberculosos/uso terapêutico , Tuberculose Meníngea/tratamento farmacológico , Adolescente , Humanos , Masculino , Radiografia , Tuberculose Meníngea/diagnóstico por imagem , Tuberculose Meníngea/cirurgiaRESUMO
Brucellosis is a zoonotic disease and is endemic in Saudi Arabia. Many hematological complications have been reported. We report a case of selective thrombocytopenia in an expatriate from Bangladesh. Patient responded well to antibrucella and steroid treatment.
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Brucelose/complicações , Doenças Endêmicas , Trombocitopenia/etiologia , Adulto , Bangladesh/etnologia , Brucelose/diagnóstico , Brucelose/epidemiologia , Diagnóstico Diferencial , Humanos , Masculino , Arábia Saudita , Trombocitopenia/diagnósticoRESUMO
Brucellosis, which is endemic in Saudi Arabia, can present as a disease with multisystem involvement. Occasionally the organisms invade the central nervous system producing varied neurological manifestations. Often the clinical diagnosis of neurobrucellosis is not straight forward and is obscure. Certain criteria have to be fulfilled for the definitive diagnosis of neurobrucellosis. We report 2 cases of neurobrucellosis which were encountered for the first time during the past 10 years at this hospital.
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Brucelose/complicações , Brucelose/diagnóstico , Meningoencefalite/microbiologia , Adulto , Anorexia/microbiologia , Antibacterianos , Brucelose/tratamento farmacológico , Brucelose/epidemiologia , Brucelose/metabolismo , Diagnóstico Diferencial , Quimioterapia Combinada/uso terapêutico , Doenças Endêmicas/estatística & dados numéricos , Feminino , Cefaleia/microbiologia , Humanos , Masculino , Arábia Saudita/epidemiologia , Vômito/microbiologiaRESUMO
Full text is available as a scanned copy of the original print version.
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Full text is available as a scanned copy of the original print version.
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Full text is available as a scanned copy of the original print version.
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Brucellosis, which is endemic in Saudi Arabia, can present as a disease with multisystem involvement. Occasionally the organisms invade the central nervous system producing varied neurological manifestations. Often the clinical diagnosis of neurobrucellosis is not straight forward and is obscure. Certain criteria have to be fulfilled for the definitive diagnosis of neurobrucellosis. We report 2 cases of neurobrucellosis which were encountered for the first time during the past 10 years at this hospital.
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Endoscopic obturation of gastric varices using tissue adhesive glues like cyanoacrylate is an accepted modality for the treatment of gastric varices. This study was undertaken to determine whether it was possible to predict immediate puncture site bleed on withdrawal of needle catheter during endoscopic glue injection without lipiodol. We prospectively analyzed 100 consecutive patients with cirrhosis who underwent glue injection. Glue injection was successful in all the patients. Immediate puncture site bleed was observed in only four cases and all of them correlated with negative catheter pull sign and positive red catheter sign. Catheter pull sign and red catheter sign were excellent predictors of immediate puncture site bleed during endoscopic glue injection and should be routinely tested.
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Varizes Esofágicas e Gástricas/terapia , Óleo Etiodado , Hemostase Endoscópica/métodos , Punções/efeitos adversos , Adesivos Teciduais/administração & dosagem , Adolescente , Adulto , Idoso , Contraindicações , Feminino , Seguimentos , Hemorragia Gastrointestinal/terapia , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India. METHODS: This was a prospective, before-and-after cohort study of 35650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network). During the intervention, the INICC approach was implemented, which included a bundle of interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback. Random effects Poisson regression was used for clustering of CLABSI rates across time periods. RESULTS: During the baseline period, 9472 central line (CL)-days and 61 CLABSIs were recorded; during the intervention period, 80898 CL-days and 404 CLABSIs were recorded. The baseline rate was 6.4 CLABSIs per 1000 CL-days, which was reduced to 3.9 CLABSIs per 1000 CL-days in the second year and maintained for 36 months of follow-up, accounting for a 53% CLABSI rate reduction (incidence rate ratio 0.47, 95% confidence interval 0.31-0.70; p=0.0001). CONCLUSIONS: Implementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up.