Healthcare Seeking Behaviour of Hospitalised COVID-19 Patients During Second Wave in Tertiary Care Hospital of Northern India

Background: The Coronavirus Disease (COVID-19) pandemic continues its deadly reign all over the world. Devising effective strategies for detecting and controlling the infection has become ever more critical. Effective prevention and control of the pandemic is entirely dependent on human behavior in terms of practicing preventive and curative measures. During the second wave of COVID-19, people’s perceptions of preventive and curative measures changed. Objective: To study healthcare-seeking behavior of hospitalized COVID-19 patients. Methods: Hospitalized patients due to COVID-19 in the month of March, April and May of 2021 were included in the study. Their attendants/close relatives were contacted telephonically to know about the admitted patients’ healthcare-seeking behavior. Verbal consent was taken from attendants before the commencement of the interview, followed by informing them about the purpose of the interview. Results: Amongst the subjects, there were more males than females (67.5 vs 32.4%), age ranged between 18 to 88 with a mean value of 56.61 ± 14.7 years. Self-medication was significantly associated with study subjects’ mortality (p=0.03). Conclusion: Elderly people were having higher mortality rate than their younger counterparts. People were hesitant to visit primary care physicians after having symptoms of COVID-19.

Optimized biotransformation of acid-treated water melon peel hydrolyzate into ethanol / Biotransformação otimizada de hidrolisado de casca de melancia tratada com ácido em etanol

Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.

Hoje, o foco global da pesquisa é explorar a solução da crise energética e da poluição ambiental. Como em outros países agrícolas, grandes quantidades de cascas de melancia (WMP) são descartadas como resíduos no meio ambiente no Paquistão, mas a gestão adequada desses resíduos é a mais recente solução para salvar o meio ambiente da poluição. O trabalho enfatiza o papel das leveduras etanologênicas para utilizar açúcares significativos presentes no WMP para fermentação de bioetanol de baixo custo. A hidrólise de ácido clorídrico diluído de WMP foi realizada em condições otimizadas empregando RSM (metodologia de superfície de resposta) e seguindo o projeto de composto central (CCD). Este projeto experimental é baseado na otimização da etanologenesis envolvendo alguns parâmetros independentes importantes, como hidrolisado de WMP e razão de meio sintético (X1), temperatura de incubação (X2) e temperatura de incubação (X3) para rendimento máximo de etanol explorando o padrão (Saccharomyces cerevisiae K7) também como leveduras experimentais (Metchnikowia cibodasensis Y34). Os resultados revelaram que os rendimentos máximos de etanol obtidos a partir de S. cerevisiae K7 foi de 0,36 ± 0,02 g / g de açúcares redutores, enquanto M. cibodasensis Y34 rendeu 0,40 ± 0,01 g de etanol / g de açúcares redutores. O isolado de levedura M. cibodasensis Y34 apareceu como um etanologeno promissor e incorpora um potencial prospectivo para a valorização fermentativa de WMP em bioetanol.

Optimized biotransformation of acid-treated water melon peel hydrolyzate into ethanol

Abstract Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.

Resumo Hoje, o foco global da pesquisa é explorar a solução da crise energética e da poluição ambiental. Como em outros países agrícolas, grandes quantidades de cascas de melancia (WMP) são descartadas como resíduos no meio ambiente no Paquistão, mas a gestão adequada desses resíduos é a mais recente solução para salvar o meio ambiente da poluição. O trabalho enfatiza o papel das leveduras etanologênicas para utilizar açúcares significativos presentes no WMP para fermentação de bioetanol de baixo custo. A hidrólise de ácido clorídrico diluído de WMP foi realizada em condições otimizadas empregando RSM (metodologia de superfície de resposta) e seguindo o projeto de composto central (CCD). Este projeto experimental é baseado na otimização da etanologenesis envolvendo alguns parâmetros independentes importantes, como hidrolisado de WMP e razão de meio sintético (X1), temperatura de incubação (X2) e temperatura de incubação (X3) para rendimento máximo de etanol explorando o padrão (Saccharomyces cerevisiae K7) também como leveduras experimentais (Metchnikowia cibodasensis Y34). Os resultados revelaram que os rendimentos máximos de etanol obtidos a partir de S. cerevisiae K7 foi de 0,36 ± 0,02 g / g de açúcares redutores, enquanto M. cibodasensis Y34 rendeu 0,40 ± 0,01 g de etanol / g de açúcares redutores. O isolado de levedura M. cibodasensis Y34 apareceu como um etanologeno promissor e incorpora um potencial prospectivo para a valorização fermentativa de WMP em bioetanol.

Optimized biotransformation of acid-treated water melon peel hydrolyzate into ethanol / Biotransformação otimizada de hidrolisado de casca de melancia tratada com ácido em etanol

Abstract Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.

Resumo Hoje, o foco global da pesquisa é explorar a solução da crise energética e da poluição ambiental. Como em outros países agrícolas, grandes quantidades de cascas de melancia (WMP) são descartadas como resíduos no meio ambiente no Paquistão, mas a gestão adequada desses resíduos é a mais recente solução para salvar o meio ambiente da poluição. O trabalho enfatiza o papel das leveduras etanologênicas para utilizar açúcares significativos presentes no WMP para fermentação de bioetanol de baixo custo. A hidrólise de ácido clorídrico diluído de WMP foi realizada em condições otimizadas empregando RSM (metodologia de superfície de resposta) e seguindo o projeto de composto central (CCD). Este projeto experimental é baseado na otimização da etanologenesis envolvendo alguns parâmetros independentes importantes, como hidrolisado de WMP e razão de meio sintético (X1), temperatura de incubação (X2) e temperatura de incubação (X3) para rendimento máximo de etanol explorando o padrão (Saccharomyces cerevisiae K7) também como leveduras experimentais (Metchnikowia cibodasensis Y34). Os resultados revelaram que os rendimentos máximos de etanol obtidos a partir de S. cerevisiae K7 foi de 0,36 ± 0,02 g / g de açúcares redutores, enquanto M. cibodasensis Y34 rendeu 0,40 ± 0,01 g de etanol / g de açúcares redutores. O isolado de levedura M. cibodasensis Y34 apareceu como um etanologeno promissor e incorpora um potencial prospectivo para a valorização fermentativa de WMP em bioetanol.

Curcumin Reverses The Scopolomine-Induced Cognitive Impairment By Inos And Acetylcholinesterase Inhibition In Rodent Model Of Schizophrenia

Schizophrenia is a severe neuro-developmental psychiatric disorder. Curcumin is a polyphenolic compound extracted from turmeric. It is known for its antioxidant, anti-inflammatory, neuroprotective, and precognitive properties. The purpose of the current study was to evaluate the role of curcumin in scopolamine induced cognitive impairment in animal model of schizophrenia. The elevated plus-maze test was utilised to study the curcumin effect on learning and memory. Curcumin (100 mg/kg, i.p.) was administered daily for 28 days in animals. Behavioural tests such as transfer latency (TL) and spontaneous alteration behaviour was assessed after the last dose of curcumin on the 28th day, followed by biochemical estimations. Present study reported that curcumin showed anti-amnesic effect in animal models of cognitive impairment of schizophrenia. Curcumin reduced the TL compared to toxic control group (scopolamine per se) (P <0.001) in elevated plus maze. In spontaneous alteration behaviour test, curcumin significantly increased percentage alteration and possible alteration as compared to toxic control group (P <0.001). A significant change in acetyl cholinesterase activity, nitrate and oxidative parameters was observed, thus, confirming its anti acetyl cholinesterase, NOS (nitric oxide synthase) inhibition and antioxidant properties (P <0.05). The present study put forward the claim of curcumin as a new and safer therapeutic alternative for the treatment of cognitive impairment in Schizophrenia. The underlying mechanism of this potential effect may be related to anticholinesterase and nitric oxide synthase inhibition activity of curcumin. Further research is warranted for confirming the suggested pathways accountable for memory alleviating effects of curcumin in Schizophrenia.

Compliance and awareness of Cigarettes and Other Tobacco Products Act among tobacco sellers in urban Ludhiana

Background: Tobacco use is one of the major preventable causes of deaths globally. Although India responded early to combat this global problem by implementing Cigarettes and Other Tobacco Products Act (COTPA), there is a need to evaluate its implementation. Objective: The objective of this study was to assess the compliance and awareness of the tobacco vendors to Section 5 (Point of sale advertisements of Cigarettes and Other Tobacco Products) and Section 6 (Prohibition on sale to minors and within 100 yards of educational institutes) of COTPA. Materials and Methods: The present study was a community-based cross-sectional study. All tobacco selling stores located within 100 yards distance from 58 educational institutes in urban Ludhiana were assessed for compliance to Section 5 and 6 provisions of COTPA. The study also assessed awareness regarding COTPA legislation among the tobacco vendors available in these tobacco selling stores. Data were collected using a semi-structured questionnaire. The questions were asked to determine the level of awareness of COTPA among the tobacco vendors. Results: Around 42.0% of the educational institutes had tobacco stores located within 100 yards and only around 25.0% of educational institutes had mandatory signage prohibiting ban on selling tobacco products displayed outside institutions. Most of the tobacco outlets (77.7%) were permanent, exclusive tobacco sellers (72%) and had displayed the products enabling easy access to minors. Majority (89%) of the vendors knew about an act regarding tobacco products. However, only 19.4% and 25% of vendors were aware of ban on selling tobacco products within the radius of 100 yards of educational institutions and to minors, respectively. Conclusion: Strict enforcement of the provisions of COTPA around educational institutes to reduce easy access of tobacco products to minors and strengthening awareness generation activities by involving key stakeholders is needed.

Impact of infant & young child feeding & caring practices on morbidity

Background: Around 5.9 million children still die every year before reaching their fifth birthday. Child morbidity and mortality due to preventable causes remains high in developing countries. Aim & Objective: To find out the relationship of morbidity with child rearing practices and sociodemographic characteristic. Material and Methods: To cover a sample size of 400 in urban health center area population under 5 children every alternate family was selected by systematic random sampling from the total of 1867 registered families at urban health center. The data was obtained by the interview of mothers and examination of children using predesigned and pretested Questionnaire. The data thus collected, was first coded and then transferred to a master chart on Microsoft Excel sheet, from which distribution as well as co-relation tables were prepared, analyzed and statistically evaluated by SPSS version 20.0.Result: In the present study, the overall fortnightly incidence of morbidity among under 5 children was found to be 65.3% (boys – 64.2%, girls – 66.5%). Exclusive breastfeeding (p < 0.001); time of initiation of breastfeeding (p < 0.001); complementary feeding (p < 0.05) and hand washing practices (p < 0.001) are statistically significant predictors of child morbidity Conclusion: We need comprehensive child health care programme having all three promotive, preventive and curative services.

Student perception of peer teaching and learning in pathology: A qualitative analysis of modified seminars, fishbowls, and interactive classroom activities

Context: Peer-assisted teaching and learning (PTL) is being experimented in different medical universities worldwide. It is a learner-centered approach involving students through active learning strategies. Aims: To study the student perception of PTL in methods such as group-led seminars and fishbowls, in classroom through various interactive activities; compare and find out the student acceptability and efficacy of each of these methods in learning conceptual topics such as various types of anemia. Subjects and Methods: Medical students of second-year professional course were subjected to PTL in classroom during allotted teaching hours for 10 successive sessions using group-led modified seminars, fishbowls, and different formality-level interactive activities such as street plays, prop sessions, quiz sessions, to make them understand the clinical features and presentation of different types of anemia through understanding of etio-pathogenesis. To ascertain the aspects that influenced learning, focus group discussions were conducted in small groups consisting of 14 students and one facilitator in each group. Qualitative thematic analysis was performed on transcripts of the audio recordings by authors. Results: The emerging themes from qualitative analysis of transcripts were pertaining to teacher, student, and organization. We found motivation, interest, and involvement of peer teacher, student behavior and collaboration, contact time between students and facilitator, preparation time, coherence with other curricular activities, group size and composition, suitability of topic for the kind of activity, and availability of material for preparation as few sub-aspects affecting learning. Conclusion: For PTL to be effective, adequate transfer of knowledge through good peer teacher involvement, learner receptiveness, and adequate contact time is needed. Proper preparation with suitability of topics for the type of activity, alignment of seminars with other activities, and course coherence are prerequisites for the same.

Comparative pharmacognostical & pharmaceutical evaluation of Vyaghri haritaki avaleha - an ayurvedic formulation .

Kasa is well-defined clinical condition in Brihadtrayi, clearly correlate with cough and its pathophysiology exactly correlates with the mechanism of cough reflex in contemporary medical science. Everywhere, Paediatric Outdoor Patients Department (OPD) has more than half of the total patients having respiratory tract complaints. So, to treat the disease Kasa, Vyaghri Haritaki Avaleha (VHA) was taken from Bhaishajya Ratnavali. The present work was carried out to standardize the raw drugs & finished product-VHA with comparing API standards and previous research work done in same institute to conform its identity, quality and purity of the final product. The pharmacognostical work reveals that presence of Epidermis, Cork, Pericycle, Phloem etc. from Kantakari; Lignified fibre, Stone cells etc. of Haritaki; Aluerone grains, Prismatic crystals etc. of Shunthi observed microscopically. Organoleptic features of VHA made out of the crude drugs were within the standard range. The pH value of VHA was 4.5, Water soluble extract was 71.9 %w/w, Loss on drying was 30.41 %w/w, Reducing sugar was 27.92 %w/w and High Performance Thin Layer Chromatography (HPTLC) at 254nm and 366nm resulted into 2 & 5 spots respectively

Bursectomy for gastric cancer: What does the evidence indicate.

Radical resection of the bursa omentalis (radical bursectomy) as part of a curative resection for gastric cancer has been advised for close to a century. However, the postulated associated morbidity and lack of a clear benefit in terms of survival preclude its routine use. To objectively review the available evidence on the role of bursectomy as part of a curative resection for gastric cancer. A systematic search of the scientific literature was carried out using Embase, PubMed, MedLine and the Cochrane central register of controlled trials for the years 1965‑2013 to obtain access to all publications, especially randomized controlled trials (RCTs), systematic reviews and meta‑analyses involving bursectomy in gastric cancer with the appropriate specific search terms, namely, “bursectomy,” “stomach cancer,” “gastric cancer,” “survival,” “morbidity,” “outcomes” and “RCTs”. Using the above search strategy, a total of 29 publications was retrieved of which five publications were identified describing bursectomy and its outcomes in gastric cancer. These included three retrospective cohort studies and two publications from a single RCT. Bursectomy do not appear to add the morbidity or mortality of the overall surgery. However, it did not appear to significantly improve overall survival neither in the retrospective cohort studies nor in the only RCT. The evidence to date is insufficient to suggest any additional benefit of routine bursectomy to a radical gastrectomy with D2 lymphadenectomy for gastric cancer. Results of an on‑going RCT are awaited to determine if bursectomy may further improve overall survival in patients with advanced T‑stage of disease.

Important Herbs in Treatment of Cancer.

Cancer is a major public health burden in bath developed and developing countries. Plant derived agents are being used for the treatment of cancer. Reservoir of bioactive compounds exists in many species of plants of Earth, only a small percentage of which have been examined and continued to be an important source of anticancer agents. Worldwide effects are ongoing to identify new anticancer compounds from plants. With the current decline in the number of new molecular entities from the pharmaceutical industry, novel anticancer agents are being sought from traditional medicines. In recent years owing to the fear of side effects people prefer more and more use of natural plant products for cancer. This article reveals a detailed review of important herbs in cancer from Indian medicinal plants which will be useful to treat various types of cancer. It will be helpful to explore the medicinal value of the plants and for the new drug discovery from them for the researchers and scientists around the globe.

Maternal and Neonatal Outcome in Patients with History of Previous One Cesarean Section.

Background : Cesarean section has become the most common operation in obstetric practice. A critical evaluation of the attitude towards the liberalization of the indications for cesarean section is warranted. The present study was conducted to determine the maternal and neonatal outcome of pregnancy among women with one previous cesarean section in relation to vaginal delivery, repeat cesarean section, maternal complications and neonatal complications. Aims and Objectives : To determine the maternal and neonatal outcome of pregnancy with previous one cesarean section. To estimate the rate of repeat cesarean section and vaginal deliveries in our population. Research Question : What is the maternal and neonatal outcome in women with history of previous one cesarean section? Study Design : Prospective Study. Study Participants : All women with term pregnancy, with previous one lower segment cesarean section and single live fetus in cephalic presentation. Statistical Analysis : Simple percent and proportions, Chi Square test.

Pantothenate Kinase Associated Neurodegeneration: A Case Report.

Pantothenate kinase-associated neurodegeneration (PKAN) is a form of neurodegeneration with brain iron accumulation (NBIA), formerly called Hallervorden-Spatz syndrome. PKAN is the first described inborn error of coenzyme A metabolism. PKAN encompasses two clinical subtypes, classic and atypical. We here report an eight year girl diagnosed as classic PKAN. We also review the literature about PKAN.

Knowledge, attitude and practices about leprosy among medical officers of Hyderabad urban district of Andhra Pradesh.

In India, MDT was implemented through vertical programme staff of the National Leprosy Eradication Programme till the year 2001, when it was integrated into general health services (GHS). Human resource development of GHS is a vital, preparatory action for successful integration of leprosy into GHS. District Technical Support Teams (DTST) have been formed with responsibility for building the capacity of medical and paramedical staff of urban health posts (UHPs). In this context, it is necessary to know the current levels of Knowledge, Attitude and Practices (KAP) about leprosy prevailing among health staff at a given point in time, so that required knowledge and skills can be imparted, if need be. The present study is an attempt in this direction for assessing the KAP status of health staff working in Hyderabad city. 402 staff members (352 females and 50 males) working in urban health posts, the Employees State Insurance Corporation and the Central Government Health Services dispensaries in Hyderabad urban district in Andhra Pradesh were included in the study carried out in 2004 in order to assess KAP, and some operational parameters. A questionnaire was used to elicit responses of 110 medical officers in urban Hyderabad and the data were analysed and discussed. Medical officers have shown consistent higher knowledge on leprosy, followed by nursing staff as compared to other paramedical workers Only 40% of the medical officers had the opportunity of seeing at least 1 case of leprosy in their practice. Medical Officers who received training in leprosy and possessed reference material on leprosy have shown higher knowledge and practice. More than half of the study subjects did not have specific training in leprosy. Two major operational problems expressed by the medical officers were managing big crowds in OPD and time lost in meetings. 96 (87.3%) of 110 medical officers felt integration of leprosy services into general health services can be effectively implemented. 78 (71%) expressed that a leprosy patient with severe reaction needed priority attention at the out-patient department indicating good understanding of reactions in leprosy and a positive attitude towards such patients. There is a need to organize training at regular intervals to cover new persons as well as reinforcing and updating the knowledge of those already trained.

Ultrasonographic evaluation of common duct diameter in pre and post cholecystectomy patients.

Thirty four patients with gall bladder disease and normal common duct were investigated prospectively by ultrasonography just before cholecystectomy and at periodic intervals of 1 months, 2 months, 3 months and once in 4-6 months after cholecystectomy. The pre and post cholecystectomy common duct diameters were measured at each visit and compared with each other to determine the statistical significance. No significant change (p > 0.05) occurred in common duct diameter following cholecystectomy.

Evaluation of prochlorperazine buccal tablets (Bukatel) and metoclopramide oral tablets in the treatment of acute emesis.

The dizziness associated with vertiginous disorders is often accompanied with nausea and/or vomiting. Antiemetic effect of prochlorperazine (PCZ) is diminished by its low bioavailability owing to a significant gastric and hepatic first pass effect. This effect could be further diminished by likelihood of regurgitation of nauseating patients further limiting the therapeutic effect of oral PCZ. A buccal preparation achieves higher plasma concentrations through direct systemic absorption. In this study buccal prochlorperazine (Bukatel) was compared for its efficacy and tolerability with commonly used metoclopramide. Bukatel was well tolerated and well rated by both patients and investigators with no adverse effects on buccal mucosa and causing less drowsiness and sedation. Results indicate that Bukatel is safe and effective for the treatment of nausea and/or vomiting in patients suffering from vertiginous disorders and could be safely and strongly recommended as an alternative to less bioavailable and indiscriminately used oral metoclopramide tablets.