Profile of dermatology inpatients and admissions over a four year period in a tertiary level government teaching hospital in North India

Background: Although dermatology is mostly an outpatient specialty, some patients with severe skin disease need hospital admission for management. There is a paucity of data regarding the profile of these dermatology in-patient admissions. Aims: We studied the profile of patients admitted to the dermatology ward of our tertiary care government hospital in North India. Methods: This was a retrospective analysis of discharge sheets of patients admitted in the dermatology ward from January 1, 2014 to December 31, 2017. Results: Discharge sheets of 2032 admissions for 1664 patients were analyzed. The most common diagnoses in the admitted patients were immunobullous disorders (576, 28%), connective tissue diseases (409, 20%), infections, including leprosy and sexually transmitted infections (179, 8.8%), psoriasis (153, 7.5%) and reactive arthritis (92, 4.5%). The mean duration of admission was 13.95±11.67 days (range 1-118 days). Two hundred and fifty-six patients (15.38%) were re-admitted, accounting for 368 (18.11%) re-admissions. Patients with immunobullous disorders (OR 1.72, 95% CI 1.29-2.28) and psoriasis (OR 1.62, 95% CI 1.02-2.55) were more likely to be re-admitted. Adult patients, those who were admitted for more than four weeks, those who had comorbidities, and those who developed a complication during the hospital stay also had a greater likelihood of being re-admitted. Limitations: The retrospective design of the study, and the non-availability of data regarding transfers to other specialties or intensive care units and deaths were the main limitations of this study. Conclusion: This study describes the profile of patients admitted in a dermatology ward of a tertiary care centre center in North India. The patient profile and admission characteristics associated with a higher probability of re-admission were identified.

Combination therapy with lansoprazole and cholecalciferol is associated with a slower decline in residual beta-cell function and lower insulin requirements in children with recent onset type 1 diabetes: results of a pilot study

Abstract Objective To investigate the effects of combination therapy with cholecalciferol and lansoprazole on residual β-cell function and glycemic control in children with new-onset type 1 diabetes. Methods Children aged 6-12 years with type 1 diabetes were allocated to receive cholecalciferol and lansoprazole (Group 1) or no treatment (Group 2). Children were maintained on their respective insulin regimens and kept records of blood sugar and insulin doses taken. Children were followed at three-month intervals for six months. Changes in mean fasting C-peptide and HbA1c levels, daily insulin doses, fasting blood glucose and mean blood glucose levels from baseline to end of the study were analyzed. Results Twenty-eight children (14 per group) met the eligibility criteria. Fasting C-peptide levels decreased significantly from baseline to study end in both groups (mean decrease -0.19±0.09ng/mL and -0.28±0.08ng/mL, p=0.04 and p=0.001; Group 1 and Group 2 respectively). However, fasting C-peptide level drop was significantly smaller in Group 1 compared to Group 2 (30.6% and 47.5% respectively; p=0.001). Likewise, daily insulin doses decreased significantly in both groups (-0.59±0.14units/kg and -0.37±0.24units/kg respectively; p=0.001). All patients recruited completed the study. No adverse events were reported. Conclusion Combined therapy with cholecalciferol and lansoprazole for six months was associated with smaller decline in residual β-cell function and lower insulin requirements in children with new-onset type 1 diabetes. Preliminary findings of this small-scale study need to be confirmed by larger studies. Registry of Clinical Trials (www.ctri.nic.in) under number REF/2021/03/041415 N.

Ficus carica hairy roots: In vitro anti-leishmanial activity against Leishmania major promastigotes and amastigotes

Objective: To investigate the biochemical capacity, and in vitro inhibitory effects of hairy roots from two cultivars of Ficus carica L. (Sabz and Siah) on Leishmania major promastigotes and amastigotes. Methods: In the hairy roots, the activity of antioxidant enzymes compared to normal leaves and roots, and the presence of some phenolic compounds in comparison with fruits were investigated. The IC 50 values of hairy roots in promastigotes was determined by tetrazolium-dye 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and trypan blue assays. By calculating the infectivity index of peripheral blood mononuclear cells (PBMCs), the leishmanicidal activity (IC 50 values) of hairy roots for amastigotes was estimated. The effects of hairy roots (IC 50 values) treatment on the levels of IFN-γ and iNOS expression, intracellular reactive oxygen species, and iNOS protein expression in infected-PBMCs were determined. Results: Based on antioxidant enzyme assays and high performance liquid chromatography analysis, hairy roots exhibited high antioxidant capacity and contained high levels of phenolic compounds. According to the results of tetrazolium-dye 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and trypan blue assays, the hairy root extracts of both cultivars showed considerable dose-dependent inhibitory effects against Leishmania major promastigotes. Depending on the concentration and exposure time, treatment of infected-PBMCs with hairy root extracts caused the generation of a significant reactive oxygen species, up-regulation of IFN-γ and iNOS genes expression, and high value of iNOS protein compared to controls. Conclusions: The findings of this study suggest that the hairy roots of Ficus carica can be considered as a promising natural source of antileishmanial agents.

Ficus carica hairy roots: In vitro anti-leishmanial activity against Leishmania major promastigotes and amastigotes

Objective: To investigate the biochemical capacity, and in vitro inhibitory effects of hairy roots from two cultivars of Ficus carica L. (Sabz and Siah) on Leishmania major promastigotes and amastigotes. Methods: In the hairy roots, the activity of antioxidant enzymes compared to normal leaves and roots, and the presence of some phenolic compounds in comparison with fruits were investigated. The IC 50 values of hairy roots in promastigotes was determined by tetrazolium-dye 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and trypan blue assays. By calculating the infectivity index of peripheral blood mononuclear cells (PBMCs), the leishmanicidal activity (IC 50 values) of hairy roots for amastigotes was estimated. The effects of hairy roots (IC 50 values) treatment on the levels of IFN-γ and iNOS expression, intracellular reactive oxygen species, and iNOS protein expression in infected-PBMCs were determined. Results: Based on antioxidant enzyme assays and high performance liquid chromatography analysis, hairy roots exhibited high antioxidant capacity and contained high levels of phenolic compounds. According to the results of tetrazolium-dye 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and trypan blue assays, the hairy root extracts of both cultivars showed considerable dose-dependent inhibitory effects against Leishmania major promastigotes. Depending on the concentration and exposure time, treatment of infected-PBMCs with hairy root extracts caused the generation of a significant reactive oxygen species, up-regulation of IFN-γ and iNOS genes expression, and high value of iNOS protein compared to controls. Conclusions: The findings of this study suggest that the hairy roots of Ficus carica can be considered as a promising natural source of antileishmanial agents.

Clinical Profile and Outcome of Young Patients with Extrahepatic Biliary Obstruction at A High-Volume Tertiary Care Centre in Northern India

Background and Aim: The etiology of extrahepatic biliary obstruction (EHBO) ranges from benign disorders to pancreaticobiliary malignancy. We studied the demographic, clinical, laboratory, and endoscopic features of young patients with EHBO undergoing Endoscopic retrograde cholangiopancreatography (ERCP). Methods: We retrospectively analyzed one-year data of ERCP procedures performed on adult patients under 40 years of age. The diagnosis was based on a clinical and radiological basis with histopathological confirmation. Results: A total of 180 patients were included with a mean(±SD) age of 33.4(±5.8, range: 15-40) years, and 67.8% being female. Benign (67.2%) findings included choledocholithiasis (57.8%), benign biliary stricture (9.44%, post cholecystectomy stricture 82.3%), and malignant (32.8%) causes were gallbladder carcinoma (24.4%), cholangiocarcinoma (4.4%), periampullary carcinoma (2.8%), pancreatic head carcinoma (1.1%). Clinical presentation included jaundice (66.1%), pain abdomen (59.4%), pruritis (26.1%), weight loss (19.4%), anorexia, fever, and cholangitis (24.44%). Mean bilirubin levels (16.9 ±6.8 vs 4.6 ±4.1 mg/dl) and alkaline phosphatase (1170 ± 260.7 vs 439.3 ± 362.7 IU/mL) were higher in malignant causes, in comparison to benign. Stone retrieval using balloon during ERCP was successful in 79% of cases. Large (>15 mm) or impacted stones or those with biliary stricture failed stone extraction. In gallbladder carcinoma, adequate endoscopic biliary drainage was achieved in 68% of patients. Endoscopic biliary drainage was achieved in 75%, 80%, and 50% cases of cholangiocarcinoma, periampullary carcinoma, and pancreatic head carcinoma, respectively. Conclusion: Choledocholithiasis and gallbladder carcinoma are the most common benign and malignant causes of EHBO in young patients. The successful endoscopic therapeutic intervention could be achieved in most patients.

Systemic Scleroderma with Complete Heart Block

For patients with Systemic Sclerosis (SSc), cardiac involvement (CI) is directly caused by myocardial fibrosisor ischemia or is secondary to pulmonary arterial hypertension1 Here we present a similar case of a femalepatient aged 45 yr old female who presented with complaint of recurrent syncopal attacks, and difficulty inswallowing food and liquids. She had typical CREST Syndrome manifestations with complete heart block(CHB). For which pacemaker implantation was done.

Seroprevalence of IgG Antibodies for Dengue among Blood Donors

Dengue fever is endemic India and the prevalence of dengue is on the rise owing to various social and economic factors. Prevalence of asymptomatic dengue infection varies widely from less than 1 % to 80 % in India. Transfusion transmissible dengue has been reported in different parts of the word. Prevalence of subclinical dengue among blood donor poses a threat to the blood supply leading to transfusion transmissible dengue. We wanted to estimate the prevalence of IgG antibodies for Dengue in the blood donor population. METHODSSix hundred and eight whole blood donors were included in the study during the period January 2017 to October 2018. Donor registration and education was done as per the national guidelines. Donors who gave a history of previous dengue or symptoms consistent with dengue were excluded from the study. Serum samples from whole blood donors were tested for IgG antibodies using ELISA technology. RESULTSOf the total of 608 donors, 602 were male donors and 55 % of the donors were in the age group 21 - 30 years. Majority (69 %) of the donors were from urban locations. Anti IgG antibodies for dengue were present in 4.14 % of donors of which 38 % of donors were in the age group 31 - 40 years. Three hundred and eighty-four donors revealed history of fever, myalgia and headache in the past one year. No statistical significance was found between fever, myalgia and the presence of IgG anti-dengue antibodies. CONCLUSIONSThe subclinical or asymptomatic prevalence of dengue infection is low when compared to other studies in other parts of the country. Enquiring into donor history for history of dengue or symptoms of dengue and deferring such donors for a recommended period will prevent transfusion transmissible dengue.

Relationship of serum vitamin D with hepatic fibrosis in patients with chronic hepatitis C

Background: Serum vitamin D concentration is proposed to have an important role on outcome in patients with chronic hepatitis C virus (HCV) infection. A few studies have shown an inverse association of vitamin D level with stage of fibrosis. The aim of the present study was to verify whether serum vitamin D level is an independent predictor of significant hepatic fibrosis.Methods: Seventy-two treatment naive chronic HCV subjects and 40 healthy age and sex matched controls were included in the study. A serum vitamin D level was assessed in both HCV subjects and controls, and liver biopsy was performed in all HCV subjects to assess for stage of fibrosis.Results: Serum vitamin D levels were significantly lower HCV patients in comparison to age and sex matched controls (18.04±6.92 versus 21.53±8.2, p<0.01). Most common genotype in HCV patients was genotype 3 (62.5%) and blood transfusion was the most common mode of transmission (28%) followed by intravenous drug user (IVDU) (17%). The HCV patients with vitamin D level <20 ng/ml had higher metavir score as compared to vitamin D≥20 ng/ml (1.67±0.66 versus 2.5±0.67, p<0.001). Both univariate and multivariate analysis performed using logistic regression revealed that vitamin D<20 ng/dl is a significant negative predictor of liver fibrosis (p<0.05).Conclusions: Chronic HCV patients had significantly lower vitamin D levels as compared to healthy controls. Serum vitamin D was a negative predictor of stage of fibrosis in patients with chronic hepatitis C.

Estimation of In-vitro Plasma Protein Binding of Ampicillin in Horses Based on Spectrophotometric Method

Estimation of plasma protein binding (PPB) is of paramount importance in the pharmacokinetics characterization of drugs, as it can cause significant change in volume of distribution, clearance and half-life of the drug. Ampicillin (α-amino benzyl penicillin) is most commonly used drug in equine practice. This study was conducted to determine the extent of PPB of ampicillin in apparently healthy horses (n=6). A simple spectrophotometric method was applied for the determination of ampicillin at 320 nm wavelength, based on acid degradation product of penicillin at 75°C in presence of citrate buffer (pH 5.2) and traces of copper salt. In the study, it was observed that this method permits the detection of ampicillin to a level not beyond 1.0 μg/ml. Various concentrations of ampicillin (3.125, 6.25, 12.5, 25, 50, 100 μg/ml) were prepared in triplicate in pooled plasma collected from healthy animals. In vitro binding of ampicillin to plasma proteins was determined by employing the equilibrium dialysis technique. The study revealed that the plasma protein binding of ampicillin was to the extent of 12.8 ± 0.07 %. Binding capacity of ampicillin to plasma protein (βi) and dissociation rate constant of protein-drug complex (Kβ) in the present study were 0.34 × 10-6 ± 0.02 × 10-6 mol.gm-1 and 0.003 × 10-9 ± 0.0003 × 10-9 mol, respectively in horses. Hence, the study concluded that usage of spectrophotometric method helps in quick, cost effective and efficient results in estimation of PPB for ampicillin

HLA- A & B Association in Psoriasis in Tamil Speaking South Indian Population.

Psoriasis is an auto-immune skin disease affecting skin, nails and joints. The association of HLA with psoriasis is already established with HLA- C*06 known to be associated strongly with the disease. We wanted to determine the HLA -A & HLA-B pattern and its association with psoriasis in a Tamil speaking ethnic population.METHODSA total of 100 psoriasis patients attending the Dermatology OPD at SRMC were taken up for the study. This was a case control study and hence 100 voluntary blood donors donating at the SRMC Hospital blood bank were taken up for study as controls. Voluntary blood donors are considered as healthy normal individuals and hence chosen as controls. All the 100 patients and 100 controls were typed for HLA (Human Leucocyte Antigen) - A & B by PCR-SSP (Polymerase Chain Reaction-Sequence Specific Primers) and the results were analysed statistically using OpenEpi software (2 X 2 table). The Odds Ratio (OR), p (probability) value, and 95% confidence interval were the statistical tests which were studied.RESULTSHLA-A*02, 24 and HLA-B*35 were found to be strongly associated with psoriasis among Tamil speaking ethnic population.CONCLUSIONSThere are different HLA – A & B alleles associated with psoriasis in Tamil ethnic population in comparison with other ethnic studies

A prospective study to determine the accuracy of triple test score in breast lump

Background: Breast cancer is the most common cancer in women worldwide. The commonest mode of presentation of diseases of the breast is lump. It is the most common site-specific cancer in women. Triple test score which includes clinical breast examination, mammogram, FNAC score. A simple non-invasive but reliable test can make a huge difference in management between benign and malignant lumps. Aims and objectives of the study were to differentiate between benign and malignant lesions based on TTS and correlated the accuracy of triple test score with histopathology report, and plan the management accordingly.Methods: A prospective study was carried out in which TTS was calculated by summation of individuals’ scores of all three components and compare with histopathology report.Results: In present study of 74 patients (age group of 30 to 65 years), based on TT score 52 benign, 12 malignant, and 10 suspicious (neither benign nor malignant). But the final histopathological result showed 59 as benign and 15 as malignant, which is in concordant with TTS, which shows the accuracy of up to 100%. Out of 10 (suspicious) which were dis-concordant, 7 are benign and 3 are malignant on histopathology.Conclusions: By use of the triple test score and its interpretation, definitive treatment can be initiated, which would reduce the need for unnecessary biopsy and its ability to predict benign lump, can avoid major surgery.

Role of subcutaneous vacuum suction drain in prevention of abdominal wound complication in emergency laparotomy

Background: Some of the most common wound complications following laparotomy include hematoma formation, seroma formation, wound infection, burst abdomen and wound dehiscence. Closed-suction drains (CSDs) help to drain any wound collection and also reduce any dead space in the wound thereby promoting healing and preventing complication.Methods: We conducted a prospective study and included patients presenting with acute abdomen in emergency department. Patients were selected as per inclusion and exclusion criteria. Two groups (group A and B) with equal number of patients were created based on closed envelope technique. CSD was placed in the wound of patients in group A. Wound healing and complications were compared between the two groups.Results: 50 patients were included in the study with 25 in each group. Hematoma formation was found to be significantly more among group B (24.0%) compared to group A (4.0%). Seroma formation (p value =0.03917), SSI rate (p value =0.039) and wound dehiscence/burst abdomen (p value =0.0415) was more in group B than group A. The mean wound healing time (days) and mean hospital stay (days) was significantly more in group B.Conclusions: Placing a subcutaneous vacuum suction drain at the time of abdominal wall closure during emergency laparotomy results in better wound healing and reduces postoperative wound complication, hospital stay time, morbidity and also decreases overall healthcare cost.

Association of HLA-C 06 with Psoriasis in a Tertiary Care Hospital.

Prevalence of psoriasis is 1-3% in India. HLA-C*06 has been shown to be strongly associated with psoriasis in different ethnic populations. This study was carried out to determine the association of HLA-C in psoriasis patients in a south Indian ethnic population.METHODSA total of 200 samples were included in the study. In all, 100 psoriasis patients and 100 healthy controls were studied. HLA-C typing was done by PCR-SSP method. Results were analysed statistically using open epi software (2 X 2 table). The Odds ratio (OR), p (probability) value, and 95% confidence interval were the statistical tests applied and analysed.RESULTSA total of 14 different HLA-C alleles were identified in both 100 cases and 100 controls. Among the 14 different HLA-C alleles, the alleles which were found to be strongly associated with psoriasis which were statistically significant were both HLA-C*06 and HLA-C*07. HLA-C*06 was found to be present in 52% of the patients and HLA-C*07 was found to be present in 33% of the patients. HLA-C*06 was found to be strongly associated with the disease in 52% of the patients.CONCLUSIONSThis study confirms HLA-C*06 association with psoriasis which is in concordance with other previous studies.

Patient counseling for chronic liver disease patients with anxiety and depression: A cross-sectional study

Anxiety and depression were interlinked with the severity of liver diseases. Patients should know the true severity ofthe disease and patient counseling helps them. This was a cross-sectional study carried out on 100 patients sufferingfrom chronic liver disease. Child Turcotte Pugh score was used to calculate the severity of the disease. HospitalAnxiety and Depression Scale was used to calculate the anxiety and depression of patients. Non-parametric tests areused to find out the association. The level of significance was p < 0.05. The mean age group of patients was 47.29± 13.17 years. The three most presenting clinical signs and symptoms according to their occurrence was abdominalpain (74%), edema (58%), and ascites (51%). The median Child Turcotte Pugh score was 9 corresponds to class B.We observed highly significant association (p < 0.01) between total bilirubin (p < 0.0001), albumin (p < 0.0001),and the severity and prognosis of the disease. We observed a higher percentage of patients with borderline abnormalanxiety (61%) and depression (51%) in our study. High-risk patients were made aware of the severity of the diseaseand consequences thereafter, provided with patient counseling along with a list of deaddiction centers. Integrating apsychologist can benefit patients struggling with deaddiction of alcohol.

Step up approach for the management of late presentation of pancreatic trauma patients

Background: Pancreatic injuries are usually subtle to identify by different diagnostic imaging modalities and these injuries are often overlooked in cases with extensive multi-organ trauma. Our study was conducted to evaluate the outcome of a step-up approach in the management of pancreatic trauma patients with late presentation.Methods: The study included 15 patients who presented with grade III AAST delayed presentation of pancreatic trauma from September 2017 to 2019. In our step-up approach 2 staged procedure was done, firstly laparotomy with necrosectomy along with closure of proximal pancreatic duct with external drainage of pancreatic duct, in second stage Roux-en-Y pancreaticojejunostomy was done to drain the remnant pancreas as a definitive procedure 3 to 6 months after initial procedure.Results: In our study, blunt trauma abdomen (83.30%) (n=10) was the most common mode of injury. The main reason for delay in diagnosis of pancreatic trauma was delayed presentation of patient (83.3%) (n=10). Total of 4 patients were admitted to intensive care unit (ICU) at the time of admission. 10 patients underwent both the stages of step up approach management among which one patient had pancreatic fistula as a complication (n=1) (10%) and one patient had post-operative abscess as a complication (n=1) (10%). No mortality was noted in our study.Conclusions: The step-up approach discussed above proves to be beneficial towards management of patients with delayed presentation of pancreatic trauma in our setting.

Prevalence of Hypertension in Children 10-18 Years of Age in Private Schools of Delhi and Their Associated Risk Factors.

Prevalence of non-communicable diseases were considered to be rare in children. But they have increased recently in developing countries, with increase in the prevalence of paediatric overweight and obesity. Body Mass Index (BMI) is commonly used to define overweight and obesity. Positive associations have been repeatedly reported between BMI and Hypertension.METHODSWe have conducted an observational cross sectional study of hypertension in 1250 students in the age group of 10-18 years studying in class 6 to 12 during school hours from July 2013 to June 2014. The values were recorded in multiples of 2 mmHg and levels greater than 95th percentile of age and gender were considered using the definition of the fourth report of NHBPEP. The association of risk factors were also evaluated.RESULTSOut of a total 1250 children, 239 (19.1%) had systolic hypertension, and 216 (17.3%) has diastolic hypertension. Prevalence of overweight and obesity were 11.8% and 7.5% respectively. Highly significant statistical association was found between body mass index (BMI) and both systolic and diastolic hypertension (p value 0.001).CONCLUSIONSPrevalence of both systolic and diastolic hypertensions were significantly high in overweight and obese children in comparison to normal weight children. Strong positive association was found between body mass index (BMI) and both systolic and diastolic hypertension. Association of other risk factors such as sex, family history, dietary habits like junk food intake and extra salt intake, were also observed

A Prospective Study to Evaluate the Post-Operative Wound Dehiscence Rate after Midline Laparotomy for Emergency or Elective Surgery: An Hospital Based Study

Background: The present study was undertaken to assess theproportion of Burst abdomen in post midline laparotomypatients, using Interrupted X suture versus Continuous suturetechnique in sheath closure.Materials & Methods: A comparative prospective hospitalbased study done on 50 patients reporting to the Surgery dept.,RVRS Medical College and attached groups of MahatmaGandhi Hospital, Bhilwara, Rajasthan. After taking writteninformed consent and were equally divided into all cases eachin the study group (interrupted X suture) and control group(continuous suture). All the patients scheduled to undergo amidline laparotomy for emergency or elective reasons. Patientsyounger than 18 years of age, patients who had undergone aprevious laparotomy for any condition (or had a incisionalhernia or burst abdomen at presentation) and patients whorequired a re – exploration in post op course were excludedfrom the present study.Results: Our study showed that the mean age of patients was45 years in both groups. Male to female ratio was 2.5:1 ininterrupted X-suture group and 1.5:1 in continuous suturegroup. The 40% dirty wound was found in interrupted X-suturegroup and 32% continuous suture group. Because interruptedsuture use more in dirty wound during patients selection. Thewound infection, dehiscence and incisional hernia were mostlyoccurred in continuous suture group as compared tointerrupted X-suture group.Conclusion: We concluded that the wound infection,dehiscence and incisional hernia were mostly occurred incontinuous suture group as compared to interrupted X-suturegroup in our study.

Role of semi-purified andrographolide from Andrographis paniculata extract as nano-phytovesicular carrier for enhancing oral absorption and hypoglycemic activity / 中草药·英文版

Objective: Andrographis paniculata is a well-known medicinal plant in Southeast Asia, India and China. The plant contains andrographolide (AN), a very important phytochemical used in various health problems. However, AN is low in oral absorption bioavailability of AN due to the rapid clearance and high protein binding capacity. Methods: The present study was aimed to develop a nano-phytovesicular formulation of semi-purified AN extracts from a naturally occurring phospholipid (soya phosphatidylcholine) in order to increase the oral absorption and antihyperglycemic activity in rats. Results: The nano-phyto vesicle of semi-purified AN extracts equivalent to 25 mg /kg AN significantly protected the hyperglycemic condition of rats. The in vitro and in vivo experiments results proved that the nano- phytovesicular system of plant extracts containing AN produced better oral absorption, bioavailability and improved antihyperglycemic activity compared with that of free AN at dose of 50 mg/kg. Conclusion: Hence, the prepared semi-purified extract nano-phytovesicular system is helpful in solving the problem of rapid clearance of AN.

Effect of Artificial Ageing Using Different Wood Chips on Physico-chemical, Sensory and Antimicrobial Properties of Apple Tea Wine

Abstract: Freshly prepared apple tea wine (a combination of tea extract and apple juice) is having yeasty and dull flavour, which needs to be improved to increase the acceptability of this product. Therefore, an attempt has been made for artificial ageing of apple tea wine using different wood chips to improve its physico-chemical, sensory and antimicrobial attributes. Different types of wood chips (Quercus spp., Bombax spp. and Acacia spp.) were added respectively (2.5 g/L to the freshly prepared apple tea wine) and allowed for ageing in carboys for the six months at the room temperature. The influence of each wood species on physico-chemical, sensory and antimicrobial attributes was tested upto 6 months of storage. Storage intervals significantly affected all the physico-chemical attributes (except total sugars, volatile acidity, and antioxidant activity), whereas, the addition of wood chips affected titratable acidity, ethanol, higher alcohols, total phenols, and amino acid. Cluster analysis of the physico-chemical attributes data revealed the same and showed that storage intervals exerted more effect on the physico-chemical and antimicrobial properties of the apple tea wine rather than the wood chips. The antimicrobial activity of 6 months aged wine was low as compared to the fresh wine. Among all the wood chips, apple tea wine aged with Quercus spp. possesses a significantly higher score (according to desirability) than the wine aged with other wood chips and control. In nutshell, apple tea wine matured with Quercus spp. wood chips for 6 months were the best with improved physico-chemical and sensory attributes.

Assessment of knowledge, attitude and practices of universal precautions among medical and nursing students

Background: Universal precautions is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens. The CDC recommends Standard Precautions for the care of all patients, regardless of their diagnosis or presumed infection status. Health care personals are at risk of being exposed to blood-borne pathogens. The aim of the study to determine the knowledge, attitude and practice of medical and nursing students towards universal precautions.Methods: A cross-sectional survey was carried out at S. S. Institute of Medical Sciences and Research Centre, Davangere, Karnataka. The participants were medical and Nursing undergraduate students. A questionnaire was prepared based on the WHO and CDC guidelines on Universal Precautions and was validated and pre-tested before finalization. Degree of knowledge was ascertained by means of yes-no questions on each item being evaluated.Results: All students were aware of Universal precautions, but soundness of their knowledge is very poor. Compliance in Universal precautions is good to average in nursing students but poor to average in medical students.Conclusions: It can be concluded that interventions to improve Universal precautions among medical students, nursing students urgently needed. So, there is a need for developing strategies to promote the use of Universal precautions which take into account behaviour change and accuracy of knowledge including its integration into practice. Teaching universal precautions early in their curriculum is necessary for better learning and practices during their posting.