Assessment of anaemia and nutritional status of antenatal women attending a tertiary care hospital.

Aim: The aim of this study was to assess and grade anaemia in antenatal women at a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 151 participants over 4 months at All India Institute of Medical Sciences (AIIMS), Rishikesh, a tertiary care hospital in Uttarakhand, India. Extensive work on quantifying daily nutritional intake and requirement was done to estimate antenatal women's nutritional status suffering from anaemia. Results: The proportion of anaemia among pregnant women was 37.09%, with mean haemoglobin of 11 g/dl, mode and median of 11.3 g/dl with higher and moderate anaemia than mild. It was in direct proportion with the number of abortions, gravid status and trimester of pregnancy. There was a protein deficit of 30-60% in 73.2% of the anaemic patients. Iron tablets were taken regularly by 85.5% of anaemic patients and 87.1% of non-anaemic patients. None of the anaemic patients met their 100% calorie requirement. The least calorie deficit was found to be 14.4%. A calorie deficit of 30-60% was found in 75% of the anaemic patients. Patients with severe anaemia had a calorie deficit of 40-60%. Discussion: Poverty, ignorance and non-availability of resources are the key factors underlying this condition. The lacunae in the delivery chain of beneficence to antenatal women offered by the government need to be looked at. Family planning has a pivotal role in controlling anaemia, as a high frequency of abortions and pregnancies were associated with anaemia.

Triad of palpitation, angina, and murmur in a non-cardiac patient.

The triad of palpitation, angina, and murmur is a classical feature of cardiac pathology. However, their presence sometimes uncovers a thyroid etiology. Identification well in time decreases out-of-pocket expenditures on illness and suffering. We report a case of a 40-year-old woman who presented with fever with chills, vomiting, palpitations, and shortness of breath for the past month. Also, she described chest pain as typical of angina. Multiple diagnoses were made elsewhere, but none of the treatments resulted in the resolution of symptoms. ST changes were suggestive of ischemic pathology, cardiac MRI done showed up hypertrophied myocardium. After a negative blood culture for infective endocarditis and serology sought for fever work-up, suspicious cardiac examination with a murmur, and an abnormal thyroid profile with a thyroid scan, led to a diagnosis of Graves' disease. This case defines the triad in a noncardiac patient and emphasizes what a thyroid disease does to the heart.

Steroid harms if given early in COVID-19 viraemia.

COVID-19 is a biphasic illness with an initial viraemia phase and later effective adaptive immune phase, except in a minority of people who develop severe disease. Immune regulation is the key target to treat COVID illness. In anticipation, an elderly man self-medicated himself with dexamethasone on the day of symptom onset of a flu-like illness, took other symptomatic measures and was tested positive for SARS-CoV-2. His condition deteriorated with each passing day resulting in hospitalisation. He demanded oxygen and declared as severe COVID. With supportive treatment, he recovered after the 20th day of illness. Immunosuppression and anti-inflammation are likely to benefit when the immune response is dysregulated and turning into a cytokine storm. A medication that has saved many could be the one predisposing to severity if taken as a preventive measure, too early in the disease course, especially the viraemia phase.

Comparative study of leaching of silver nanoparticles from fabric and effective effluent treatment.

Nano silver (Ag(n)) is employed as an active antimicrobial agent, but the environmental impact of Ag(n) released from commercial products is unknown. The quantity of nanomaterial released from consumer products during use should be determined to assess the environmental risks of advancement of nanotechnology. This work investigated the amount of silver released from three different types of fabric into water during washing. Three different types of fabric were loaded with chemically synthesized Ag nanoparticles and washed repeatedly under simulated washing conditions. Variable leaching rates among fabric types suggest that the manufacturing process may control the release of silver reaching the waste water treatment plants. In an attempt to recover the Ag(n) for reutilization and to save it from polluting water, the effluents from the wash were efficiently treated with bacterial strains. This treatment was based on biosorption and was very efficient for the elimination of silver nanoparticles in the wash water. The process ensured the recovery of the Ag(n) leached into the effluent for reutilization, thus preventing environmental repercussions.