Biogenic synthesis of AuNPs using Solanum virginianum L. and their antibacterial, antioxidant and catalytic applications.

Biogenic synthesis of nanoparticles is gaining popularity worldwide because of being ecofriendly as well as economical, with minimal production of hazardous by-products. The present study was targeted to determine the antibacterial, free radical scavenging and catalytic activity of gold nanoparticles synthesized from Solanum virginianum L. (Sv-AuNPs). After addition of auric chloride, the color of aqueous plant extract changed from light yellow to purple-red, indicating the formation of nanoparticles. A strong peak at 536 nm affirmed synthesis of Sv-AuNPs, and negative zeta potential (- 30.7) indicated their being wrapped in anions. They exhibited face-centered cubic and crystalline nature as revealed by X-ray diffraction. Elemental composition of Sv-AuNPs was ascertained by energy-dispersive X-ray spectroscopy, and a sharp peak at 2.2 keV confirmed the presence of gold. The shape of Sv-AuNPs synthesized was spherical with size ranging from 29.1 ± 1 nm to 51.2 ± 0.7 nm. Antibacterial potential was evaluated against E. coli, C. violaceum, K. pneumoniae, P. aeruginosa, B. subtilis, M. smegmatis, and S. aureus and was found to be greater than aqueous plant extract. Sv-AuNPs exhibited antioxidant potential comparable to ascorbic acid, demonstrating their vital role in the prevention of reactive oxygen species related diseases. Apart from their pharmaceutical potential, these nanoparticles also exhibited promising catalytic efficacy. They degraded harmful dyes i.e. 4-nitro phenol (4-NP) and congo red (CR) at a very low concentration of 50 µg/ml. This is the first report on the antibacterial, antioxidant, and catalytic properties of Sv-AuNPs and we hope it will lead the way for nanoparticles multifunctionality.

Long umbilical cord and its mysterious demeanour: A case report.

True knots in the umbilical cord are rare, affecting approximately 1% of all pregnancies. The diagnosis may be missed antenatally during routine ultrasonography. Many known predisposing factors are associated with true knotting. In the majority of cases, it has no bearing on foetal outcome, but may rarely be linked to intra-uterine foetal death.

Assessment of airway parameters in obstetric patients and comparing them at different phases in the perinatal period: A prospective observational study.

Background and Aims: Airway changes occur in different stages of pregnancy. We aimed to evaluate the changes in the upper airway in obstetric patients during pregnancy, labour and after delivery using multiple airway indices and identify the predictive factors of these changes. Methods: This observational study was conducted on 90 parturients aged >20 years, having monofoetal pregnancy. The patient's weight was noted, airway assessment including Mallampati grading (MPG), and thyromental distance (TMD), sternomental distance (SMD), neck circumference (NC) and Wilson's risk score were measured in the second trimester of pregnancy (T0), between 32 and 34 weeks of gestation (T1), at the time of admission for safe confinement, between 38 and 40 weeks of gestation (T2), 2 h after delivery of baby (T3) and, 24 h after delivery (T4). Unpaired t-test and analysis of variance test were applied. Results: Changes in mean (standard deviation [SD]) weight, recorded from T0 to T2, were from 56.96 (10.77) to 65.322 (11.49) kg (P = 0.001). A rise of one or two grades in MPG was detected as the pregnancy progressed, and a decrease of one grade was noted after delivery. A significant decrease in mean (SD) TMD was noted from 6.88 (0.65) to 6.36 (0.62) cm from T0 to T2 (P = 0.001). SMD also decreased in a similar manner as TMD. NC increased from T0 to T3 and then decreased at T4 (P = 0.004). Conclusion: Following the second trimester of pregnancy, MPG increased by either one or two grades, with a decrease in TMD and SMD and an increase in NC.

To study the awareness about solid waste management rules among nursing professionals in a tertiary care hospital in India.

Background: In India, on an average, 0.5-0.99 kg/person/day general solid waste is produced which is higher (i.e. 0.1-0.49 kg per person per day) than solid waste generated in low-income nations and lower than in developed countries (1.5 kg per day). The Government of India has issued guidelines for the management of a different kind of hospital waste from time to time including Solid Waste Management (SWM) Rules in the year 2016 and is mandatorily applicable to all organizations including the hospitals. Objective: We conducted this study to assess the knowledge and awareness among nursing professionals regarding various provisions of solid waste management rules, 2016. Methods: It was a cross-sectional study done on nursing professionals across all seniority and from various specialties and super specialty departments. A pretested questionnaire comprising 20 questions was used as a study tool. Results: There were a total of 550 participants. The mean knowledge count of the respondents was 9.487273 (1.00-14.00). The mean score was 59.3% of the overall achievable score. In the subgroup analysis, respondents above 60 years of age, married, females, urban residents, nursing sisters scored better than the middle-aged professionals, unmarried, males, rural residents, and staff nurses. Conclusions: This study has given insight into various domains of SWM rules, 2016 where nurses performed well and those where considerable gaps exist. The health care workers are more aware of biomedical waste (M&H) rules, and the solid waste management rules are new to them. It is recommended that the biomedical waste management training program must include training on general solid waste management rules.

To study the knowledge about the handling of biomedical waste among health-care workers in a COVID-19 hospital setting.

BACKGROUND: The unexpected increase in COVID-19-related waste and its inappropriate disposal had blown up the threat of retransmission of this infection and adversely impacted the environment. The aim of this study was to evaluate the existing knowledge about the handling of biomedical waste (BMW) in the COVID-19 Hospital setting among health-care workers (HCWs). MATERIALS AND METHODS: It was a prospective cross-sectional study done for 3 months, i.e., October 2020-December 2020 among nursing professionals across all seniority posted in COVID hospital. A pretested questionnaire comprised 20 questions was used as a study tool. RESULTS: The response rate of our study was 94%. The mean age of respondents was 33.97 years, and the mean length of service was 8.32 years. The study revealed that the respondents had a mean knowledge score of 12.21 (Median 12, standard deviation 2.129 and 95% confidence interval of 11.92-12.51). CONCLUSIONS: There is consensus among the researchers/scholars that COVID-BMW hazards are much more significant than regular BMW. Therefore, its awareness among the HCWs can be a panacea for safer handling of BMW generated in COVID Hospital.

COVID-19 suspicion and diagnosis in pregnancy: A big conundrum!

Introduction: This article aims to discuss all the challenges faced in the diagnosis of coronavirus disease 2019 (COVID-19) in pregnancy, isolation of suspected and positive patients, their management, and the strategies to prevent the transmission of infection among the healthy population and medical fraternity. The diagnosis of COVID in pregnancy is influenced by many factors, including normal physiological changes in pregnancy, comorbid conditions associated with pregnancy, and the presence of asymptomatic infection in patients. Suspicion of COVID-19 in pregnant females is of utmost importance at a primary health center for risk mitigation of exposure to medical personnel. Material and Methods: A retrospective study was carried out in the labour room in a tertiary care center in India. Two groups were made, suspected COVID and confirmed COVID in pregnant patients. The case records were analysed. Results: Out of a total of 5164 admissions, 95 patients were admitted as suspected (1.8%), but only two patients were COVID-positive amongst them. 84% of COVID-positive patients were asymptomatic. Fever was the most common symptom in both groups (P-value: 0.15). Preeclampsia and anaemia were the most common comorbidities in both groups, not statistically significant. There were 32% of intensive acre unit (ICU) admissions in suspected COVID patients, and 77% of them were having respiratory distress. Conclusion: COVID-19 presents as an asymptomatic infection in most pregnant patients. Physiological changes to the cardiorespiratory and immune systems along with associated comorbidities in pregnancy, increase a woman's susceptibility and delay diagnosis. Consideration of patients as suspected COVID at triage stations on the basis of only contact or travel history poses a great burden on the health care system. Although triage is an essential tool to identify symptomatic COVID patients, universal testing strategies should continue simultaneously. Streamlining medical care professionals into self-sufficient teams ensures adequate clinical coverage amongst the suspected COVID, confirmed COVID, and routine labour room admissions.

Antimicrobial and Antioxidant Potential of Vernonia Cinerea Extract Coated AuNPs.

ABSTRACT: Green synthesis of nanoparticles is an important tool to reduce the harmful effects associated with traditional methods. In the present investigation, we have synthesised gold nanoparticles (AuNPs) using aqueous extract prepared from fresh aerial parts (leaf and stem) of Vernonia cinerea as bioreducing agent. The visual indication of change in colour from pale yellow to brown to ruby-red indicated the successful formation of the AuNPs. Characterization of nanoparticles was carried out by UV-visible spectroscopy, X-ray crystallography (XRD), Transmission electron microscopy (TEM) and Energy dispersive X-ray analysis (EDX). UV-Vis spectra showed a specific peak at 546 nm which was the initial confirmation of the biosynthesized AuNPs. TEM images showed spherical and triangular shape of AuNPs with an average size of 25 nm. From FTIR spectrum, different functional groups were identified that could be responsible for the formation, stabilization, and capping of biosynthesized AuNPs. Aqueous plant extract and biosynthesised AuNPs were separately tested for their antimicrobial activity against six bacterial strains and four fungal strains. Biosynthesised AuNPs (2 mg/ml) showed significantly high zone of inhibition against the selected bacterial strains as compared to the aqueous plant extract. Maximum zone of inhibition (18.2 mm) was observed with AuNPs against Streptococcus pyogenes whereas comparatively less value (12.5 mm) was recorded with the plant extract. Interestingly, the inhibitory activity observed against bacterial strains was even better than ampicillin. Antifungal activity recorded with AuNPs (5 mg/ml) was maximum (17.4 mm) against R. oryzae and it was higher than positive control (17.00 mm) and plant extract (13.2 mm).The present study clearly showed that AuNPs coated with Vernonia cinerea extract were as good as positive control in inhibiting bacterial and fungal growth. In addition, these AuNPs also showed good antioxidant potential which was comparable to ascorbic acid. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12088-021-00976-w.

Adnexal Torsion: A Retrospective Analysis From a Tertiary Care Teaching Hospital in Northern India.

Background Adnexal torsion is an acute gynecological emergency presenting with acute abdomen which can be missed owing to non-specific symptoms. Among reproductive-age women, conservative surgery is preferred. The present study was a retrospective analysis of adnexal torsion cases reported to a tertiary care teaching hospital in Northern India. The purpose of the study was to describe the demography, clinical features, diagnostic and treatment modalities, and prognosis of adnexal torsion cases. Methods Surgically proven adnexal torsion case records were retrieved and data were entered in an excel sheet from a period of two and half years from January 2018 to June 2020. Results There were 28 cases with an age range of 7-85 years (median age 24 years) with lower abdominal pain and nausea/vomiting symptoms. The majority were in the reproductive age group (71.4%). A Colour Doppler was done which detected 75% (12/16) of the ovarian torsion cases. The size of the adnexal torsion was 5-10 cm in 60.7% with right-sided torsion seen in 57.14%. Detorsion and salpingo-oophorectomy was done in 14 (50%) and 11 (39.2%) cases, respectively. Histopathological examination revealed hemorrhagic/necrotic infarcts (54.2%) and dermoid cysts (33.3%). Conclusions Owing to non-specific symptoms, adnexal torsion is diagnosed with strong clinical suspicion as routine ultrasonography diagnosed only 7.1% in the present study. Conservative surgery is preferred in the reproductive age group.

To Study the Awareness about Universal Health Precautions among Nursing Professionals in a Medical College Hospital of India.

BACKGROUND: The universal health-care precautions (UHP) aim at preventing health-care workers contact with blood and other body fluids by performing various infection control practices such as handwashing, wearing gloves and mask, safe disposal of infectious waste, and safe cleansing of used instruments. OBJECTIVE: The study was conducted to assess the knowledge and awareness among nursing professionals regarding UHPs. METHODOLOGY: It was a cross-sectional study done on nursing professionals across all seniority and from various specialties including superspecialties. A pretested questionnaire consisting of 25 questions was used as a study tool. RESULTS: There were a total of 550 respondents. The mean knowledge score of the respondents was 17.31 (range: 6-24). The mean score was 69.25% of the total achievable score. In the subgroup analysis, respondents above 60 years of age, married, females, urban residents, and nursing sisters scored better than the middle-aged professionals, unmarried, males, rural residents, and staff nurses. CONCLUSION: The study concludes important clues for further research and interventions. As the nursing professionals are learning about UHP from practical exposure rather than formal teaching, it is pertinent to address this issue through well-planned formal sessions of training workshops and lecture discussions.

Tubal sterilisation without consent: a case report.

INTRODUCTION: Tubal sterilisation is practised all over the world. This safe, easy and highly effective, long-term method for birth control can be carried out during the hospital stay for either a normal delivery or caesarean section. In India, female sterilisation accounts for 37.3% of all methods of family planning.

Efficacy of combined hormonal vaginal ring in comparison to combined hormonal pills in heavy menstrual bleeding.

OBJECTIVE: To compare the efficacy, acceptability and compliance of combined hormonal vaginal ring (CVR), with combined hormonal pills (CHP) in patients with heavy menstrual bleeding (HMB). STUDY DESIGN: This prospective study was conducted in 50 women with HMB in age group of 25-40 years. Patients were divided in two groups of 25 each and followed for six treatment cycles. In each group, cycle comprised of three weeks of CVR (releases 15µg of EE and 120µg of the etonogestrel per day) or CHP (containing 30µgm of EE and 150µgm of LNG) use, followed by one ring or pill free week. After each cycle, patients were evaluated about the amount of blood loss and duration of bleeding by the pictoral blood assessment chart (PBAC), early bleeding (EWB), continued bleeding (CWB), intermenstrual bleeding, intended bleeding, compliance, and user acceptability. The collected data were analyzed using the Chi square test, t-test and ANOVA test. RESULT: Reduction in PBAC score for CVR (70.73%) and CHP group (70.02%), duration of bleeding and incidence of EWB was comparable among the two groups. The incidence of intermenstrual bleeding was lower in CVR than in CHP group in cycle 3 and 4 with significant p value. The incidence of CWB was significantly lower and the incidence of intended bleeding pattern in CVR group was significantly higher in cycle 3, 4, 5 and 6, signifying better cycle control. Compliance was also higher in CVR (88%) than CHC (75.33% of all cycles). CONCLUSION: This trial suggests that both the CVR and CHP are very effective short-term treatments for HMB in reproductive age group. However, women had better cycle control and compliance with CVR. This may be an attractive option among the wide variety of medications used to treat HMB.

Lack of detectable allergenicity in genetically modified maize containing "Cry" proteins as compared to native maize based on in silico & in vitro analysis.

BACKGROUND: Genetically modified, (GM) crops with potential allergens must be evaluated for safety and endogenous IgE binding pattern compared to native variety, prior to market release. OBJECTIVE: To compare endogenous IgE binding proteins of three GM maize seeds containing Cry 1Ab,1Ac,1C transgenic proteins with non GM maize. METHODS: An integrated approach of in silico & in vitro methods was employed. Cry proteins were tested for presence of allergen sequence by FASTA in allergen databases. Biochemical assays for maize extracts were performed. Specific IgE (sIgE) and Immunoblot using food sensitized patients sera (n = 39) to non GM and GM maize antigens was performed. RESULTS: In silico approaches, confirmed for non sequence similarity of stated transgenic proteins in allergen databases. An insignificant (p> 0.05) variation in protein content between GM and non GM maize was observed. Simulated Gastric Fluid (SGF) revealed reduced number of stable protein fractions in GM then non GM maize which might be due to shift of constituent protein expression. Specific IgE values from patients showed insignificant difference in non GM and GM maize extracts. Five maize sensitized cases, recognized same 7 protein fractions of 88-28 kD as IgE bindng in both GM and non-GM maize, signifying absence of variation. Four of the reported IgE binding proteins were also found to be stable by SGF. CONCLUSION: Cry proteins did not indicate any significant similarity of >35% in allergen databases. Immunoassays also did not identify appreciable differences in endogenous IgE binding in GM and non GM maize.

Assessment of allergenicity to fungal allergens of Rohtak city, Haryana, India.

Fungal spores are known as one of the important bioparticles causing allergic manifestation in human beings. Hence, knowledge of season and prevalence of the airborne allergens to which the patients are exposed is a prerequisite for proper diagnosis and treatment of allergic disorders in hypersensitive individuals. Keeping this in view, aerial survey was performed in the atmosphere of Rohtak city for 2 consecutive years (March 2008-February 2010), using a volumetric petri plate sampler. A total of 45 fungal spore types were recorded during the survey period. In the present study, February-April and July-November were identified as the peak seasons for Rohtak city. Cladosporium was the main contributor to the total fungal load with 25.14% followed by Alternaria (18.05%), Aspergillus niger (7.66%), Curvularia (5.31%), and Epicoccum (5.29%). Fifteen dominant viable fungal spore types were represented in the form of a fungal calendar. An attempt has also been made to assess the allergenicity of some of the fungal types recorded from the atmosphere of Rohtak city. The magnitude of variations observed in markedly positive skin reactions (2+ and above) varied from 17.3 to 2.3%. Penicillium oxalicum showed a markedly positive reaction in maximum number of patients (26; 17.3%) followed by Rhizopus nigricans (23; 15.3%). ELISA was performed with the sera of patients showing markedly positive skin reactions and the sera were classified into four groups based on percent binding. The majority of the sera showed 0-15% binding to different antigenic extracts, while sera showing >60% binding were least in number. Greater than 30% binding was observed against antigens of Rhizopus nigricans, Epicoccum purpurascens, Penicillium oxalicum, Curvularia lunata, Aspergillus flavus, Candida albicans and Neurospora sitophila. The concordance between positive skin reaction and serum-specific IgE antibodies ranged from 16.7 to 69.2%.

Conservative management of fetus papyraceus: a report of two cases.

The term fetus papyraceus is used to describe a mummified fetus associated with multiple gestations where one fetus dies and is flattened between the membranes of living fetus and uterine wall. Though the maternal and fetal complications in affected cases can be severe, we report of two cases of fetus papyraceus managed conservatively without any complications. Successful outcome is related to careful monitoring during pregnancy.

Uterus didelphys with partial vaginal septum and distal vaginal agenesis: an unusual anomaly.

Complex malformations of female genital tract are not so common. Their correct identification is of paramount importance for appropriate management. A thorough knowledge of embryology, pre-operative imaging with MRI and examination under anaesthesia is essential to identify accurately the constellation of anomalies and to plan appropriate management. This case reports the coexistence of Müllerian abnormality with vaginal agenesis in an 18 years old girl which was managed by dissecting the lower half of vagina and pull-through vaginoplasty.

A randomised study to evaluate the efficacy and safety of placentrex injection in patients suffering from pelvic inflammatory disease.

To evaluate the efficacy of placentrex injection along with oral doxycycline against oral doxycycline in pelvic inflammatory diseases, a comparative study was undertaken among two groups of patients comprising 60 in each at Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak during the period April 2010 to April 2012. It was observed remission of symptoms and signs was better noticed among the group of patients receiving placentrex + doxycycline than those getting only doxycycline. Placentrex is safe with less side-effects and inexpensive.

Urinary Ascites following Mini Lap Tubectomy: A Rare Occurence.

Iatrogenic bladder injury is a known complication of laparoscopic and gynecological surgeries with an incidence of 1.5 per 1000 cases. Urinary ascites is a result of undiagnosed iatrogenic bladder injury during pelvic surgeries. We report a rare case of urinary ascites following mini lap tubectomy on the eighth postoperative day. After the diagnosis was made, conservative management was done for the patient, to which she successfully responded.

Isolated breast metastasis from granulosa cell tumor of the ovary.

Granulosa cell tumors of the ovary are rare neoplasms arising from sex-cord stromal cells. These tumors usually present with stage I disease as they are frequently associated with hormonal effects. Only a small percentage of such tumors metastasize and the common sites of metastasis are lung, liver, and brain. Granulosa cell tumor of ovary metastasizing to breast has never been reported in literature. We present such a case of ovarian granulosa cell tumor with metastasis to the breast, which was the presenting symptom. The patient was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy which was followed by chemotherapy. The patient is relapse free 2 years after completion of treatment.

Multiple bladder calculi: a rare cause of irreducible uterine prolapse.

BACKGROUND: A vesical calculus in a prolapsed cystocele is rare. OBJECTIVE: To highlight bladder calculi as a cause of irreducible uterine prolapse. CASE REPORT: A case of irreducible total uterine prolapse caused by multiple vesical calculi is presented. Bladder stones were removed through vaginal cystolithotomy followed by vaginal hysterectomy. CONCLUSION: In cases of acute irreducible pelvic organ prolapse, the possibility of bladder stones should be kept in mind and X-ray pelvis including the prolapsed mass should be done to confirm the diagnosis.