Healthcare policies and programmes for older persons: Exploring awareness among stakeholders.

BACKGROUND: Human rights are for all, regardless of age. The older adults are seen as vulnerable because biological, psychological and social ageing predispose the ageing person to frailty, infirmity, and in many cases dependency, setting the older person apart from the rest of the population in need of special protection and rights. Although the implementation of legislation, policies, and a package of integrated programmes and projects to cater to the needs of older persons had helped them to uplift their status, more has to be done to stem the increase of the reach of laws in a more fruitful manner. AIM: To develop a colloquial structured Healthcare Policies & Programmes Awareness Questionnaire and assess the awareness about the government healthcare provisions and benefits available for senior citizens among health professionals, older patients, and their caregivers. METHODS: This study was conducted in two phases, the development of the questionnaire consisting of relevant healthcare national policies and programmes followed by a cross sectional pilot study on 335 participants. RESULTS: The level of awareness was only 45.6% among health professionals followed by 26.4% & 22.2% of awareness among the caregivers and the older adults respectively. CONCLUSION: There is a huge gap between the healthcare providers and healthcare takers knowledge due to which the preventive and promotive care of older adults is poor in our country. There is a need to strengthen institutions and mechanism that can more systematically promote interaction between researchers, policymakers and other stakeholders who can influence the uptake of the research findings in a synergistic manner.

Nano cellulose dispersed chitosan film with Ag NPs/Curcumin: An in vivo study on Albino Rats for wound dressing.

With an aim to develop chitosan film with controllable swelling behavior and maximum antimicrobial efficacy, we hereby report cellulose nano crystals loaded chitosan films with Curcumin/Ag nano particles embedded as strong antimicrobial agents. The CNC had average size of 40-90nm with poly dispersity index of 3.641. The TEM analysis of Ag NPs, produced via DMF reduction, revealed a particle size range of 15-25nm. The Surface Plasmon resonance (SPR) of these Ag NPs shifted from 380 to 440nm, with the increase in concentration of Ag (I). The TGA of the film samples Ch/CNC, and Ch/CNC (Ag463/Cur450) exhibited% weight loss of around 95 and 80 respectively, thus indicating higher stability due to presence of Ag NPs. In XRD analysis 2θ reflections at 38.12, 44.28 and 66.46°, confirmed the presence planes (1 1), (2 0) and (2 0) respectively. In skin irritation test, the mean Erythema scores observed after 72h was zero for both the Curcumin and Ag NPs/Curcumin loaded films. The percent wound reduction, observed for the film samples Ch/CNC (Cur450) and Ch/CNC (Ag NP463/Cur450) was 57.8 and 97.2 respectively, indicating better suitability of Ag NPs/Curcumin loaded film.

Controlled release of Doxycycline from gum acacia/poly(sodium acrylate) microparticles for oral drug delivery.

In the present work, Doxycycline loaded gum acacia (GA)/poly(sodium acrylate) (SA) hydrogels were prepared for the oral drug delivery of model drug Doxycycline. The hydrogels were characterized by X-ray diffraction analysis (XRD), Fourier transform infrared spectroscopy (FTIR) scanning electron microscopy (SEM) and Zeta potential. The dynamic release of Doxycycline was investigated in the physiological fluids at 37°C. Various kinetic models such as Power function model, Schott model and Higuchi model were applied to interpret the release data. Schott model was found to be most fitted. The Doxycycline loaded hydrogels were tested for their antibacterial action against E. coli.

Dynamic release of gentamicin sulfate (GS) from alginate dialdehyde (AD)-crosslinked casein (CAS) films for antimicrobial applications.

In the present work, antibiotic drug gentamicin sulfate (GS) has been loaded into alginate dialdehyde-crosslinked casein (CAS) films for wound dressing applications. The films have been characterized by Fourier transform infrared spectroscopy, X-ray diffraction analysis and scanning electron microscopy. The dynamic release of model drug GS has been investigated in the physiological fluid at 37 °C. The drug release data has been interpreted in the terms of various kinetic models such as Power function model, first order model and Schott model. The release data was found to be well fitted by Schott model. The various diffusion coefficients are also evaluated. The adsorption of model therapeutic protein BSA on the film has been investigated. The maximum adsorption is found to be 5.7 mg/cm2.The films were tested for their antibacterial and anti-fungal action. Finally, the in vivo wound healing study was carried out on Albino wistar rats.

Egg production performance, egg yolk antioxidant profile and excreta concentration of corticosterone in golden pheasants (Chrysolophus pictus) fed diets containing different levels of green vegetables.

In order to study the effect of feeding graded levels of green vegetables on egg production performance and egg yolk antioxidant status, 27 female golden pheasants (GP) were randomly distributed into three groups of nine each in an experiment based on completely randomized design. The diets of the birds in groups T1 , T2 and T3 contained 1.4%, 2.7% and 5.0% of green vegetables respectively. Feeding of experimental diets started on 12th February (day 1) and was continued till 30 June 2012. Average number of eggs laid and egg mass produced by the hens in group T3 was higher (p < 0.004) than those of T1 and T2 . Hen day egg production was lowest (p < 0.001) in group T1 . Roche yolk colour score was highest (p < 0.01) in T3 followed by T2 and was lowest in T1 . Other external and internal egg quality parameters were similar among the groups. Total antioxidant capacity (TAC) of egg yolk was higher (p < 0.04) in group T3 as compared to other two groups. Egg yolk concentration of total carotenoids, ß-carotene, total sulfhydryl, protein-bound sulfhydryl and non-protein-bound sulfhydryl was higher (p < 0.05), whereas concentration of malondialdehyde was lower (p < 0.024) in group T3 as compared to other two groups. Excreta concentration of corticosterone was highest (p < 0.012) in T1 , followed by T2 , and was lowest in T3 . Egg yolk concentration of TAC and TSH was positively and that of malondialdehyde was negatively correlated with carotenoids intake. Excreta concentration of corticosterone was negatively correlated with carotenoids intake. It was concluded that incorporation of green vegetables in the diet at 5% on dry matter basis would improve egg production, egg yolk antioxidant status and the ability of the captive GP to combat stress.

Synthesis of nanosilver loaded chitosan/poly(acrylamide-co-itaconic acid) based inter-polyelectrolyte complex films for antimicrobial applications.

In the present work, AgNPs loaded chitosan/poly(acrylamide-co-itaconic acid) inter-polyelectrolyte complex (IPC) films have been prepared for antimicrobial applications. The AgNPs-loaded IPC films have been characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), Transmission electron microscopy (TEM), Scanning electron microscopy (SEM), Thermogravimetric analysis (TGA) and Surface plasmon resonance (SPR). Particle size of synthesized AgNPs was found to be in the range 10-30nm. These films exhibited a remarkable antibacterial property against strong pathogen E.Coli, thus offering their candidature for antimicrobial applications.

Swelling behavior of cross-linked dextran hydrogels and preliminary Gliclazide release behavior.

In this study, dextran (Dex) has been cross-linked with epichlorohydrin (Ech) to yield cross-linked hydrogels. These gels were characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) analysis, Thermogravimetric analysis (TGA), and Scanning electron microscopy (SEM). The water absorption behavior of gels was studied in simulating gastric fluid (SGF) and simulating intestinal fluid (SIF) at 37°C. The data was interpreted by various kinetic models. The swelling was found to be totally diffusion controlled. The equilibrium data was also used to calculate network parameters. The antidiabetic drug Gliclazide (Glz) was loaded to the gels and its release was investigated in the media of varying pH, to mimic transition from mouth to colon. Finally, the in-vivo study on "Albino Wistar rats" was carried out to investigate the efficiency of the formulations. The drug-loaded hydrogel was found to be quite effective in reducing the glucose level at lower administration frequency as compared to the plain drug.

Synthesis, characterization and antimicrobial applications of zinc oxide nanoparticles loaded gum acacia/poly(SA) hydrogels.

In this work, zinc oxide nanoparticles were synthesized in-situ within the gum acacia/poly (acrylate) hydrogel network using hydrothermal approach. The synthesized zinc oxide nanoparticles were characterized by Surface plasmon resonance (SPR), X-Ray diffraction (XRD) analysis, Fourier transform infrared (FTIR) spectroscopy and Scanning electron microscopy (SEM). The water absorption behavior of ZnO/GA/poly(SA) hydrogels was investigated in the phosphate buffer saline (PBS) of pH 7.4 at 37°C. The water uptake data were analyzed with the help of various kinetic models. Finally, the antimicrobial action of nanocomposites was studied using E. coli as model bacteria.

Influence of dietary protein on serum metabolites and antioxidant status: A study in Chrysolophus amherstiae.

This experiment was conducted to study the effect of feeding graded levels of dietary crude protein (CP) on serum biochemical profile of Lady Amherst's pheasants (LAP). Eighteen male LAP were randomly distributed into three groups of six each in an experiment based on completely randomized design. The CP content of the diets was 13.4%, 16.5%, and 19.1%, in groups I, II, and III, respectively. Serum concentrations of uric acid was lowest (P < 0.05) in group I. Relationship between serum concentration of uric acid and nitrogen intake was linear (R(2) = 0.39, P < 0.01). Concentrations of other serum metabolites and enzymes were similar among the groups. Serum concentration of triiodothyronine (T3 ) was highest (P < 0.05) in group I, followed by groups II and III. Total antioxidant capacity (TAC) of serum was lower (P < 0.007), whereas serum concentration of malondialdehyde (MDA) was higher (P < 0.001) in group I as compared to groups II and III. Regression of serum concentration of TAC (R(2) = 0.74, P < 0.01) and MDA (R(2) = 0.39, P < 0.05) was polynomial. Heterophil to lymphocyte ratio was higher (P < 0.007) in group I as compared to groups II and III. Relationship between H/L ratio and nitrogen intake was polynomial (R(2) = 0.69, P < 0.05). Cell mediated immune response measured as foot web index was similar among the groups. Based upon the results, it was concluded that a diet containing 16.5% crude protein would be optimum for improving antioxidant defense and the ability of Lady Amherst's pheasant to combat stress. Zoo Biol. 35:346-354, 2016. © 2016 Wiley Periodicals, Inc.

Water absorption and moisture permeation properties of chitosan/poly(acrylamide-co-itaconic acid) IPC films.

In this work, aqueous solutions of chitosan (Ch) and [poly(acrylamide(AAm)-co-itaconicacid(IA)] have been mixed to yield Ch/poly(AAm-co-IA) Inter-polyelectrolyte complex (IPC) films. The films were characterized by FTIR, X-ray diffraction (XRD) and thermo gravimetric analysis (TGA). There was remarkable increase in the crystalline nature of IPC films. The films were investigated for their water absorption capacity in the physiological fluid (PF) of pH 7.4 at 37 °C. The amount of IA present in the film forming solutions affected the water absorption behavior of the resulting films. The dynamic water uptake data were interpreted by various kinetic models. The effect of pH on the swelling ratio (SR) indicated that the films showed highest swelling in lower as well as higher pH media. The water vapor transmission rates (WVTR) were obtained in the range of 6000-6645 g/m(2)/day.

A green approach to prepare silver nanoparticles loaded gum acacia/poly(acrylate) hydrogels.

In this work, gum acacia (GA)/poly(sodium acrylate) semi-interpenetrating polymer networks (Semi-IPN) have been fabricated via free radical initiated aqueous polymerization of monomer sodium acrylate (SA) in the presence of dissolved Gum acacia (GA), using N,N'-methylenebisacrylamide (MB) as cross-linker and potassium persulphate (KPS) as initiator. The semi-IPNs, synthesized, were characterized by various techniques such as X-ray diffraction (XRD), thermo gravimetric analysis (TGA) and Fourier transform infrared (FTIR) spectroscopy. The dynamic water uptake behavior of semi-IPNs was investigated and the data were interpreted by various kinetic models. The equilibrium swelling data were used to evaluate various network parameters. The semi-IPNs were used as template for the in situ preparation of silver nanoparticles using extract of Syzygium aromaticum (clove). The formation of silver nanoparticles was confirmed by surface plasmon resonance (SPR), XRD and transmission electron microscopy (TEM). Finally, the antibacterial activity of GA/poly(SA)/silver nanocomposites was tested against E. coli.

Controlled release of anti-diabetic drug Gliclazide from poly(caprolactone)/poly(acrylic acid) hydrogels.

Drug Gliclazide (Glz) has limited solubility and low bioavailability. In order to obtain a controlled release of this drug and to improve its bioavailability, the drug has been loaded into poly(caprolactone) (PCL)/poly(acrylic acid) (PAAc) hydrogels, prepared by free radical polymerization of acrylic acid in the presence of poly(caprolactone) in acetone medium using azo-isobutyronitrile as initiator and N,N' methylene bisacrylamide as cross-linking agent. The swelling behaviour of these hydrogels has been investigated in the physiological gastric and intestinal fluids to obtain an optimum composition suitable for delivery of a biologically active compound. The gels were loaded with anti-diabetic drug Glz and a detailed investigation of release of drug has been carried out. Various kinetic models have been applied on the release data. Finally, the Albino wistar rats were treated for Streptozotocin plus nicotinamide - induced diabetes using a Glz-loaded PCL/PAAc hydrogel. The results indicated a fair reduction in the glucose level of rats.

Investigation of curcumin release from chitosan/cellulose micro crystals (CMC) antimicrobial films.

Following the novel 'vapor induced phase inversion' (VIPI) method, we have prepared curcumin loaded chitosan/cellulose micro crystals composite films and characterized them by thermo gravimetric analysis (TGA), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The equilibrium moisture absorption behavior of these films was investigated under different relative humidity (RH) environments and the data obtained was interpreted by the GAB isotherm model successfully. The films were also studied for their curcumin release behavior in the physiological fluid (PF) at 37 °C and the kinetic data obtained was best interpreted by Higuchi model. Finally, the films showed fair antimicrobial action against bacteria and fungi.

Minocycline-loaded cellulose nano whiskers/poly(sodium acrylate) composite hydrogel films as wound dressing.

In this work, antibiotic drug Minocycline (Mic) loaded cellulose nano-whiskers (CNWs)/poly(sodium acrylate) hydrogel films were prepared and investigated for their drug releasing capacity in physiological buffer solution (PBS) at 37 °C. The (CNWs)/poly(sodium acrylate) film, containing 9.7% (w/w) of CNWs, demonstrated Mic release of 2500 µg/g while the plain poly(acrylate) film showed 3100 µg/g of drug release. In addition, with the increase in the concentration of cross-linker N,N'-methylene bisacrylamide (MB) from to, the drug release from the resulting films decreased from 507 to 191 µg/g. The release exponent 'n' for films with different compositions was found in the range of 0.45 to 0.89, thus indicating non-Fickian release mechanism. The Schott model was employed to interpret the kinetic drug release data successfully. The film samples poly(SA) and CNWs/poly(SA) (both not containing drug) showed thrombus formation of 0.010±0.001 g and 0.007±0.001 g, respectively, thus showing the non-thrombogenic behavior. In percent Hemolysis, both of the film samples of 1.136±0.012 and 0.5±0.020, respectively, thus indicating non-hemolytic behavior. In addition, both of the film samples demonstrated protein adsorption of 49.02±0.59µ g/µL and 51.20±0.51 µg/µL per cm(2), thus revealing a fair degree of protein adsorption. Finally, the Mic-loaded films showed fair anti-fungal and antibacterial properties.

Curcumin/cellulose micro crystals/chitosan films: water absorption behavior and in vitro cytotoxicity.

A new technique, called vapor induced phase inversion (VIPI), has been employed to fabricate cellulose micro crystals (CMC)-loaded chitosan (Ch) films. The method involves immediate exposure of CMC-dispersed chitosan solution to NH3 gas. The films were characterized by Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM) analysis. The swelling ratio (SR) of films showed negative dependence on the cellulose content in the films. The dynamic water uptake data were interpreted by various kinetic models. Finally, the release of curcumin from the films was investigated. The CMC-loaded chitosan film showed slower release as compared to the plain chitosan film, suggesting that cellulose micro crystals acted as diffusion barrier. The films were non-cytotoxic, non-thrombogenic and non-hemolytic.

CNWs loaded poly(SA) hydrogels: effect of high concentration of CNWs on water uptake and mechanical properties.

In this work, poly(sodium acrylate) (poly(SA)) hydrogel films, doped with cellulose nano-whiskers (CNWs), are prepared via free radical polymerization of sodium acrylate (SA) in aqueous medium. The CNWs were added into the polymerization feed mixture, in the concentration range of 4.8-24.3 wt% of monomer and the resulting CNWs/poly(SA) hydrogel films were investigated for their water absorbency in the physiological fluid (PF). The addition of CNWs caused a decrease in the equilibrium water uptake. The kinetic water uptake data of all hydrogel samples were best interpreted by the second order kinetic. The water vapor permeation studies were also carried out. The water vapor transmission rate (WVTR) of all the film samples was quite low. The mechanical properties of films such as tensile strength (TS) and percent elongation (PE) varied with the CNWs content. All the film samples showed fair folding endurance (FE), with more than 600 times folding without suffering from any crack.

Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

BACKGROUND: Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. METHODS: A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n = 154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. RESULTS: Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. CONCLUSION: As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

Preparation, characterization and antibacterial applications of ZnO-nanoparticles coated polyethylene films for food packaging.

The present work describes the preparation of ZnO nanoparticles loaded starch-coated polyethylene film. The presence of ZnO nanoparticles was confirmed by surface plasmon resonance (SPR), X-ray diffraction (XRD) studies and transmission electron microscopy (TEM). The ZnO loaded film was tested for its biocidal action against model bacteria Escherichia coli using zone inhibition and killing kinetics of bacterial growth methods. This newly developed material bears potential to be used as food packaging material to prevent food stuff from bacterial contamination.

Autoimmune lymphoproliferative disorder in an adult patient.

A 50-year-old male patient presented with fever, epistaxis and multiple lymphadenopathy since 15 days. In the light of the above presentation a complete workup was initiated to exclude common conditions like tuberculosis, acquired immunodeficiency syndrome, lymphoid malignancy and sarcoidosis. After excluding common conditions a biopsy of cervical lymph node demonstrated reactive lymphadenitis with paracortical hyperplasia. Immunohistochemistry demonstrated double negative lymphocytes (CD4-, CD8-). A diagnosis of autoimmune lymphoproliferative disorder syndrome (ALPS) (probable) was made and patient was started on 1 mg/kg of steroids. Patient showed a dramatic improvement with respect to general wellbeing, fever and regression of lymphadenopathy. This entity of ALPS has been recently identified and classified; most of the reports are from the pediatric population. To the best of our knowledge ours is one of the few cases of this entity being reported in an adult patient from India.