Spatio-temporal analysis of the visceral leishmaniasis in the state of Alagoas, Brazil / Análise espacial-temporal da leishmaniose visceral no estado de Alagoas

Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.

A leishmaniose visceral é uma doença tropical negligenciada. Foram avaliadas a distribuição espacial dos casos de leishmaniose visceral no estado de Alagoas. Todos os casos de LV, registrados pela secretaria de saúde, foram analisados e georreferenciados. Entre 2008 e 2017, 97,1% dos municípios apresentaram classificação esporádica de transmissão. Com a evolução temporal, a incidência de casos de leishmaniose visceral se concentrou na maioria dos municípios da microrregião de Santana do Ipanema-AL. A análise espaço-tempo, se considerada, pode promover o aprimoramento das ações de vigilância e controle da leishmaniose visceral.

Quality of life of women from a quilombola community in northeastern Brazil

Abstract Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices.

Resumo As comunidades quilombolas, estão presentes em diversos estados brasileiros, vivendo em condições de saúde mais precárias. Isto ocorre por conta do isolamento geográfico, das limitações de acesso e da falta de qualidade no serviço quando este é prestado. Nesse sentido, o objetivo do estudo foi analisar a qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro. Estudo observacional, transversal e descritivo. Foram entrevistadas 160 mulheres adultas, através de um formulário para a coleta de perfil e do questionário de Qualidade de Vida WHOQOL bref. Foi observado que as mulheres tinham em média 40,7 anos (±17,25), casadas, autodeclaradas negras, com fundamental incompleto, do lar, sem renda, com moradia de alvenaria, própria, com até 6 cômodos, abastecidas por caixa de água comunitária, tratada. A Qualidade de Vida, apresentou escores medianos nos domínios: físico (3,18), psicológico (3,4), relações sociais (3,45) e meio ambiente (2,59). Com a realização desta pesquisa foi possível caracterizar a comunidade quilombola de Santa Luzia do Norte-AL quanto as dificuldades de acesso a saúde e geração de renda, fatos que repercutem na sua condição de saúde. Os problemas descritos neste estudo podem contribuir para que ações de saúde sejam planejadas e efetivadas com o intuito de melhorar as condições socioeconômicas e de saúde nessa comunidade, considerando-se o contexto social, político e ambiental, valorizando seus saberes e práticas tradicionais.

Spatio-temporal analysis of the visceral leishmaniasis in the state of Alagoas, Brazil

Abstract Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.

Resumo A leishmaniose visceral é uma doença tropical negligenciada. Foram avaliadas a distribuição espacial dos casos de leishmaniose visceral no estado de Alagoas. Todos os casos de LV, registrados pela secretaria de saúde, foram analisados e georreferenciados. Entre 2008 e 2017, 97,1% dos municípios apresentaram classificação esporádica de transmissão. Com a evolução temporal, a incidência de casos de leishmaniose visceral se concentrou na maioria dos municípios da microrregião de Santana do Ipanema-AL. A análise espaço-tempo, se considerada, pode promover o aprimoramento das ações de vigilância e controle da leishmaniose visceral.

Quality of life of women from a quilombola community in northeastern Brazil / Qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro

Abstract Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire - bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices.

Resumo As comunidades quilombolas, estão presentes em diversos estados brasileiros, vivendo em condições de saúde mais precárias. Isto ocorre por conta do isolamento geográfico, das limitações de acesso e da falta de qualidade no serviço quando este é prestado. Nesse sentido, o objetivo do estudo foi analisar a qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro. Estudo observacional, transversal e descritivo. Foram entrevistadas 160 mulheres adultas, através de um formulário para a coleta de perfil e do questionário de Qualidade de Vida WHOQOL - bref. Foi observado que as mulheres tinham em média 40,7 anos (±17,25), casadas, autodeclaradas negras, com fundamental incompleto, do lar, sem renda, com moradia de alvenaria, própria, com até 6 cômodos, abastecidas por caixa de água comunitária, tratada. A Qualidade de Vida, apresentou escores medianos nos domínios: físico (3,18), psicológico (3,4), relações sociais (3,45) e meio ambiente (2,59). Com a realização desta pesquisa foi possível caracterizar a comunidade quilombola de Santa Luzia do Norte-AL quanto as dificuldades de acesso a saúde e geração de renda, fatos que repercutem na sua condição de saúde. Os problemas descritos neste estudo podem contribuir para que ações de saúde sejam planejadas e efetivadas com o intuito de melhorar as condições socioeconômicas e de saúde nessa comunidade, considerando-se o contexto social, político e ambiental, valorizando seus saberes e práticas tradicionais.

Knowledge and Awareness about Chair-Side Diagnostic Techniques for the Screening of Suspicious Oral Lesions among General Dental Practitioners - A Cross-Sectional Survey

Introduction: General dental practitioners (GDPs) play an important role in screening and early detection of oral potentially malignant disorders (OPMD) and oral cancer. Aim: This survey aims to assess the knowledge and awareness of general dental practitioners about chairside diagnostic techniques for screening of inflammatory oral lesions, potentially malignant lesions and oral cancer. Materials and Methods: GDPs (n=125) were surveyed about their knowledge about chairside diagnostic techniques for early detection and screening of suspicious oral lesions. The interview was based on a pre-structured questionnaire containing 14 closed ended questions. Chi square test was used for evaluating the association of survey parameters. Result: 95.2% of dentists do diagnosis and management of suspicious oral lesions along with chief complaints. There is a strong association between the educational status of GDPs and their method for management of suspicious oral lesions (p=0.002). 84.5% of the postgraduate GDPs are aware of chemiluminescence methods than graduate level GDPs (p =0.0009). Majority of the graduate GDPs are unaware of VELScope(p=0.0009). Usage of all non-invasive techniques was found to be less among graduate GDPs (p=0.002). Conclusion: The overall awareness of the dentists involved in the study were good and postgraduate GDPs are more aware and practically ahead about the non-invasive diagnostic techniques than graduate GDPs.

Evaluation of the Biochemical, Physicochemical and Microbiological Quality of Soft Drinks Sold in Some Elementary School of Williamsville (Abidjan, Côte d’Ivoire)

The sale of soft drinks in and around primary schools is recurrent in Côte d'Ivoire. The objective of this work is to evaluate the rate of some biochemical and physicochemical parameters and the health risks related to the consumption of soft drinks. The biochemical and physicochemical parameters were determined according to the standard SOXHLET technique, that of Kjeldhal and also that described by Dubois et al in1956. Potentially pathogenic and pathogenic germs were enumerated and researched according to reference methods described by AFNOR. The moisture content of the different beverages ranged from 3.9±0.05 to 3.2±0.05, and the sugar content from 26.06±2.05 to 5.96±1.60. For the acidity, the higher value was 0.93± 0.15 (Bissap juice) and the lowest was 0.64± 0.02 (Tamarind juice). For proteins, the high value was 44.15 ± 0.11 (Milk Mint Juice) and the low value was 38.15 ± 0.11 (Ginger Juice). As for dry matter, the highest value was found in ginger juice (44.76 ±0.02) and the lowest in bissap juice (40.96 ±0.01). Soft drinks sold in Williamsville schools contain such potentially pathogenic species as Staphylococcus aureus and Bacillus cereus with a wide range of loadings in the drinks. Escherichia coli was not identified. No Salmonella was observed in the different soft drinks analyzed. The presence of potentially pathogenic germs could pose a danger to school children.

COVID-19 Pandemic and the Role of Control Room in the Tertiary Care Hospital

COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.

Effect of Dasapaka Bala Taila Yonipooranam in Atrophic Vaginitis - A Case Report

Atrophic vaginitis is a common condition that occurs in post menopause due to the deficiency of estrogen. The condition Atrophic vaginitis is defined as atrophy of the vaginal epithelium due to decreased estrogen levels. This common menopausal condition which is often underreported and under diagnosed is caused by estrogen related changes to the vaginal epithelium and can adversely affect quality of life. Atrophic vaginitis is a common condition in postmenopausal women experience due to estrogen deficiency that causes involution of the vaginal tissue, leading to vaginal dryness, burning sensation in vagina and dyspareunia, the atrophy of the vulvovaginal structures occurs due to estrogen deficiency. Among them Sushka yoniroga can be most suitably correlated with Atrophic vaginitis. The management principle of Atrophic vaginitis includes Vathika yoniroga chikitsa, along with Sthanika chikitsa. Treatment mainly aims at Vatapittasamana, Brimhana, Balya and natural supplementation of estrogen containing drugs. Sthanika chikitsa like Yonipooranam, Pichu dharanam, etc can be done in Atrophic vaginitis. Sthanika chikitsa which is of prime importance in the management of Streeroga facilitates absorption of drugs through the vagina as the walls and adjacent tissues are highly vascular, where the medicines are administered intra vaginally. In the present case, Yonipoorana as Sthanika chikitsa as tried. A 54 year old lady was presented with complaints of burning sensation in vagina and pain during sexual intercourse. The vaginal examination was painful and the walls are found inflamed, she was diagnosed with Atrophic vaginitis. She was sent to cytological screening. The reports revealed high grade parabasal cells and low grade superficial cells. The maturation index was found 60/25/5 vaginal pH was 5.3. Pap smear was done which was negative for intraepithelial lesion or malignancy. Dasapaka Bala tailam was administered intravaginally for 7 days in 3 consecutive months. During follow up she was relieved from the symptoms like burning sensation in vagina and pain during sexual intercourse. From this case report, it shows that Yonipoorana with Dasapaka Bala tailam is effective for the management of Atrophic vaginitis.

Effect of Bhandira (Clerodendrum Viscosum) in Cervical Intraepithelial Neoplasia

Cervical Intraepithelial Neoplasia is precursor or pre-invasive lesions of cervical squamous cell cancers. These are classified based on the degree of disruption in epithelial differentiation. Sexually transmitted HPV are the most important risk factor for CIN and Invasive cervical cancers. A pre-post interventional study was conducted in Govt. Ayurveda College Hospital for Women and Children, Poojappura, Thiruvananthapuram, to assess the effect of Bhandira in CIN. Objectives were, to evaluate the effect of Bhandira churna pancake and Bhandira churna yoni pratisarana on CIN, and also to study its effect on HPV infection and associated complaints like discharge per vaginum, vulval itching, burning sensation, lower abdominal pain and dyspareunia. Females of age group 20-50 years with CIN, confirmed by Pap smear and Colposcopy were included. The patients received treatment with Bhandira churna pancake internally and Bhandira churna as Yoni pratisarana for 3 months and follow up was done after 3 months. Outcome variables were changes in Pap smear and Colposcopy findings- regression, persistence or progression and changes in associated symptoms. Data were analyzed by Wilcoxon’s signed rank test and McNemar’s test. The treatment was effective with high statistical significance in making changes in Pap smear and Colposcopy findings (p<0.01) and also in reducing the associated symptoms.

An Update on the Pharmacological Aspects of Vaccines and Antivirals for the Management of Monkeypox

Monkeypox is a self-limiting zoonotic disease caused by the monkeypox virus belonging to the genus of orthopox viruses. Initially considered an ‘African disease’, this infection has crossed the boundaries to affect other continents and it has raised tremendous concerns among the general public as well as the medical fraternity all over the world, particularly because of the lack of specific vaccinations and drugs for the management of the illness. Epidemiological evaluation of the current infection has reported that it is mainly transmitted through sexual contact in bisexual men, mostly whites, and in those with pre-existing human immunodeficiency virus infection. The most common presentations were skin rash, anogenital lesions, or mucosal lesions along with systemic symptoms. It has been established that the vaccines and drugs approved for the management of smallpox could be used for the management of the current monkeypox outbreak. Vaccinia Immune Globulin (VIG) and vaccines like JYNNEOS and ACAM2000 and antiviral drugs like tecovirimat, cidofovir (CDV), and brincidofovir are being considered for those patients with serious diseases. It is imperative for physicians to understand the pharmacological aspects of these drugs for delivering better care to patients with monkeypox, which is eventually essential for the containment of this infection. This review covers updates on vaccines as well as drugs for the prevention and management of monkeypox.

Evaluation of antioxidant, photoprotective and antinociceptive activities of Marcetia macrophylla extract: potential for formulation of sunscreens / Avaliação da atividade antioxidante, photoprotetora e antinociceptiva de Marcetia macrophylla: potencial formulação fotoprotetora

The antioxidant, photoprotective and antinociceptive Marcetia macrophylla active extract was investigated as an active ingredient in a sunscreen cream formulation. Thus, the M. macrophylla extract showed IC50 of 3.43 mg/ml of the antioxidant (DPPH∙ scavenging test) and Sun Protection Factor of 20.25 (SPF/UV-B, at 250 µg/ml) and UV-A of 78.09% (photobleaching trans-resveratrol test). The antinociceptive activity was superior to all standards tested using the in vivo acetic acid-induced writhing test (99.14% at the dose of 200 mg/kg) and the high-performance liquid chromatography coupled with diode array detector and mass spectroscopy multi-stage (HPLC-DAD-MS/MS) enabled the structural characterization of the quercetin-3-O-hexoside, quercetin-3-O-pentoside and quercetin-3-O-desoxihexoside. The pharmaceutical formulation containing the Marcetia macrophylla crude active extract was prepared and the physicochemical tests (organoleptic characteristics, pH analysis and centrifugation), the in vitro UVB (sun protection factor, SPF) and UVA (β-carotene) using the spectroscopic method were investigated. The formulation showed satisfactory results concerning the physicochemical parameters evaluated and active against the UV test. Thus, M. macrophylla showed biological activities with potential use in pharmaceutical preparations.

O extrato bruto de Marcetia macrophylla mostrou atividade antioxidante, fotoprotetora e antinociceptiva, sendo em seguida investigado como ingrediente ativo em uma formulação fotoprotetora. Assim, o extrato de M. macrophylla apresentou atividade antioxidante com IC50 de 3,43 mg/mL (teste de sequestro do DPPH∙) e Fator de Proteção Solar de 20,25 (FPS/UV-B, 250 µg/mL) e UV-A de 78,09% (teste de fotobranqueamento do trans-resveratrol). A atividade antinociceptiva usando o teste in vivo de contorções abdominais induzidas por ácido acético foi superior a todos os padrões testados (99,14% na dose de 200 mg/Kg). A análise por cromatografia líquida de alta eficiência acoplada a detector de fotodiodos e espectroscopia de massas multi-estágio (CLAE-DAD-EM/EM) possibilitou a caracterização dos flavonoides quercetina-3-O-hexosídeo, quercetina-3-O-pentosídeo e quercetina-3-O-desoxihexosídeo. A formulação farmacêutica contendo o extrato ativo bruto de Marcetia macrophylla foi preparada e os testes físico-químicos (características organolépticas, análise de pH e centrifugação), o UVB in vitro (fator de proteção solar, FPS) e UVA (β-caroteno) foram investigados. A formulação apresentou resultados satisfatórios frente aos parâmetros físico-químicos avaliados e ativos contra UV. Assim, M. macrophylla apresentou atividades biológicas com potencial uso em preparações fitofarmacêuticas.

Evaluation of antioxidant, photoprotective and antinociceptive activities of Marcetia macrophylla extract: potential for formulation of sunscreens

Abstract The antioxidant, photoprotective and antinociceptive Marcetia macrophylla active extract was investigated as an active ingredient in a sunscreen cream formulation. Thus, the M. macrophylla extract showed IC50 of 3.43 mg/ml of the antioxidant (DPPH scavenging test) and Sun Protection Factor of 20.25 (SPF/UV-B, at 250 µg/ml) and UV-A of 78.09% (photobleaching trans-resveratrol test). The antinociceptive activity was superior to all standards tested using the in vivo acetic acid-induced writhing test (99.14% at the dose of 200 mg/kg) and the high-performance liquid chromatography coupled with diode array detector and mass spectroscopy multi-stage (HPLC-DAD-MS/MS) enabled the structural characterization of the quercetin-3-O-hexoside, quercetin-3-O-pentoside and quercetin-3-O-desoxihexoside. The pharmaceutical formulation containing the Marcetia macrophylla crude active extract was prepared and the physicochemical tests (organoleptic characteristics, pH analysis and centrifugation), the in vitro UVB (sun protection factor, SPF) and UVA (-carotene) using the spectroscopic method were investigated. The formulation showed satisfactory results concerning the physicochemical parameters evaluated and active against the UV test. Thus, M. macrophylla showed biological activities with potential use in pharmaceutical preparations.

Resumo O extrato bruto de Marcetia macrophylla mostrou atividade antioxidante, fotoprotetora e antinociceptiva, sendo em seguida investigado como ingrediente ativo em uma formulação fotoprotetora. Assim, o extrato de M. macrophylla apresentou atividade antioxidante com IC50 de 3,43 mg/mL (teste de sequestro do DPPH) e Fator de Proteção Solar de 20,25 (FPS/UV-B, 250 µg/mL) e UV-A de 78,09% (teste de fotobranqueamento do trans-resveratrol). A atividade antinociceptiva usando o teste in vivo de contorções abdominais induzidas por ácido acético foi superior a todos os padrões testados (99,14% na dose de 200 mg/Kg). A análise por cromatografia líquida de alta eficiência acoplada a detector de fotodiodos e espectroscopia de massas multi-estágio (CLAE-DAD-EM/EM) possibilitou a caracterização dos flavonoides quercetina-3-O-hexosídeo, quercetina-3-O-pentosídeo e quercetina-3-O-desoxihexosídeo. A formulação farmacêutica contendo o extrato ativo bruto de Marcetia macrophylla foi preparada e os testes físico-químicos (características organolépticas, análise de pH e centrifugação), o UVB in vitro (fator de proteção solar, FPS) e UVA (-caroteno) foram investigados. A formulação apresentou resultados satisfatórios frente aos parâmetros físico-químicos avaliados e ativos contra UV. Assim, M. macrophylla apresentou atividades biológicas com potencial uso em preparações fitofarmacêuticas.

Evaluation of antioxidant, photoprotective and antinociceptive activities of Marcetia macrophylla extract: potential for formulation of sunscreens / Avaliação da atividade antioxidante, photoprotetora e antinociceptiva de Marcetia macrophylla: potencial formulação fotoprotetora

Abstract The antioxidant, photoprotective and antinociceptive Marcetia macrophylla active extract was investigated as an active ingredient in a sunscreen cream formulation. Thus, the M. macrophylla extract showed IC50 of 3.43 mg/ml of the antioxidant (DPPH∙ scavenging test) and Sun Protection Factor of 20.25 (SPF/UV-B, at 250 µg/ml) and UV-A of 78.09% (photobleaching trans-resveratrol test). The antinociceptive activity was superior to all standards tested using the in vivo acetic acid-induced writhing test (99.14% at the dose of 200 mg/kg) and the high-performance liquid chromatography coupled with diode array detector and mass spectroscopy multi-stage (HPLC-DAD-MS/MS) enabled the structural characterization of the quercetin-3-O-hexoside, quercetin-3-O-pentoside and quercetin-3-O-desoxihexoside. The pharmaceutical formulation containing the Marcetia macrophylla crude active extract was prepared and the physicochemical tests (organoleptic characteristics, pH analysis and centrifugation), the in vitro UVB (sun protection factor, SPF) and UVA (β-carotene) using the spectroscopic method were investigated. The formulation showed satisfactory results concerning the physicochemical parameters evaluated and active against the UV test. Thus, M. macrophylla showed biological activities with potential use in pharmaceutical preparations.

Resumo O extrato bruto de Marcetia macrophylla mostrou atividade antioxidante, fotoprotetora e antinociceptiva, sendo em seguida investigado como ingrediente ativo em uma formulação fotoprotetora. Assim, o extrato de M. macrophylla apresentou atividade antioxidante com IC50 de 3,43 mg/mL (teste de sequestro do DPPH∙) e Fator de Proteção Solar de 20,25 (FPS/UV-B, 250 µg/mL) e UV-A de 78,09% (teste de fotobranqueamento do trans-resveratrol). A atividade antinociceptiva usando o teste in vivo de contorções abdominais induzidas por ácido acético foi superior a todos os padrões testados (99,14% na dose de 200 mg/Kg). A análise por cromatografia líquida de alta eficiência acoplada a detector de fotodiodos e espectroscopia de massas multi-estágio (CLAE-DAD-EM/EM) possibilitou a caracterização dos flavonoides quercetina-3-O-hexosídeo, quercetina-3-O-pentosídeo e quercetina-3-O-desoxihexosídeo. A formulação farmacêutica contendo o extrato ativo bruto de Marcetia macrophylla foi preparada e os testes físico-químicos (características organolépticas, análise de pH e centrifugação), o UVB in vitro (fator de proteção solar, FPS) e UVA (β-caroteno) foram investigados. A formulação apresentou resultados satisfatórios frente aos parâmetros físico-químicos avaliados e ativos contra UV. Assim, M. macrophylla apresentou atividades biológicas com potencial uso em preparações fitofarmacêuticas.

Engineering Parameters Responses during Extrusion Processing of Noodles Analogue from Water Yam, Yellow Maize, and African Yam Bean Flour Mixture

This study investigated the effect of extrusion process on engineering properties of noodles analogue from water yam, yellow maize, and African yam bean. Flour blend from water yam, yellow maize, and African yam bean were produced using the standard method of dry milling and was used to extrude noodles analogue using a brabender single screw laboratory extruder (Duisburg DCE 330 model) fitted with 3.0mmdie nozzle diameter. A central composite rotatable design (CCRD) with three variables, namely barrel temperature, feed moisture content and screw speed and five level coded – a, -1, 0, +1,, +a, was used for the study and data was generated at (p<0.05). Results of result of the engineering properties of noodles analogue showed that toque ranged from 22.4 to 60.50Nm/s, mass flow rate ranged from 33.90 to 109g/min-1, specific mechanical energy ranged from 100.19 to 385.97kj/kg, and the residence time ranged from 22 to 55s in this study. The CCRD was effective in explaining the effect of the process conditions on noodles analogue as influenced by barrel temperature, feed moisture content, and screw speed of the extruder. The data obtained from the study could be used for control of product characteristics.It was generally observed that the changing of feed moisture content, barrel temperature, and screw speed influenced an acceptable torque, mass flow rate, and residence time during the extruder operation. The noodles analogue produced at this cheap machine operating conditions could be projected for commercial production.

Clinical and functional outcome of total knee arthroplasty in osteoarthritic patients at a tertiary care center in Kerala: a prospective study

Background:Osteoarthritis affects the knee joint more frequently than any other joint. Osteoarthritis is a chronic joint disease that affects the older age group, women more frequently, and is associated in 90% of cases with a varus deformity of the knee. The following study was conducted to evaluate the functional outcome of total knee arthroplasty in osteoarthritis using the knee society score.Methods:The study was conductedin patients treated for osteoarthritis of the knee joint at Jubilee Mission Medical College and Research Institute, Thrissur, Kerala during the period from December 2019 to March 2022. Thirty patients diagnosed with osteoarthritis of the knee joint were taken into the study, all were undergone total knee arthroplasty. Patients were followed up at 4 weeks, 12 weeks, and 24 weeks.Results:The sample consisted of thirty osteoarthritic patients with 8 males and 22 were females. The patients' ages ranged from45-75 years. Among these 30 patients, 14 involved the right side, and 16 involved the left knee joint. The mean pre-operative knee clinical score was 36.93 which was improved to post-operative 84.70 following total knee arthroplasty. The mean pre-operative knee functional score was 16.83 which was improved to post-operative 71.17 following total knee arthroplasty.The outcome was rated as per knee society score. We got excellent results in 25 cases (83%), good in 3(10%), and fair in 2 patients (7%) according to knee clinical score whereas 8 excellent (27%), 16 good (53%), 5 fair (17%) and 1 poor(3%) results were found according to knee functional score.Conclusions:Total knee arthroplasty shows drastic improvement in the functional ability of the patient and the ability of the patient to get back to a pre-disease state, which is mainly because of pain-free joint movements, reflected by the improvement in the post-operative knee clinical score and knee functional score.

Vayasthapana Gana Ksheerapaka in Perimenopausal Symptoms - A Case Report

Perimenopause is the transition period from reproductive to non-reproductive phase. It usually begins with menstrual cycle irregularity and extends to one year after permanent cessation of menstruation. There is manifestation of varied physical, psychological and somatic symptoms. Menopause may be correlated to Rajakshaya. It usually occurs as part of the ageing process and is the period of transition from Pitta predominant middle age to vata predominant old age. Treatment in modern medicine includes hormone replacement therapy and use of anti-depressants etc. Acharyas mention Jara among Swabhavabala pravritta Vyadhi, and its management is to be done with drugs having Rasayana property. Here we present a 48-year-old lady who presented with complaints of hot flushes, severe sweating especially during night hours, reduced sleep, irritability, multiple joint pain, loss of interest in most daily activities and stress incontinence. Vayasthapana gana was administered as Ksheerapaka. Vayasthapana gana include ten drugs which are Rasayana, Medhya, Tridosha samana and possess anti-oxidant, free radical scavenging and anti-stress activity. Ksheera is Vata pitta samana, Rasayana, and Jeevaneeya. Vayasthapana gana ksheerapaka is given in the dose of 48ml twice daily one hour before food for thirty days. After treatment intensity of these symptoms were reduced. Follow up was done thirty days after stopping the medication, here also intensity of these symptoms remained less when compared to before treatment. Here we reviewed the probable role of Vayasthapana gana ksheerapaka in alleviating perimenopausal symptoms.

Ayurvedic Management of Primary Dysmenorrhea with Abhayatrivrudadi Kashayam- Case Report

Dysmenorrhea, one of the most prevalent gynaecological problems in young women, particularly among teenagers, characterized by painful menstruation severe enough to prevent a person from doing day-to-day activities. It is the main factor behind young women's missed job and school days of teenagers. Primary dysmenorrhea is widely prevalent in more than 70% of teenagers and 30 -50% of menstruating women. Among Yonirogas, Udavarta yonivyapat is a condition characterized by painful menstruation and the relief of discomfort following blood discharge, which is typical of primary dysmenorrhea. In modern medical science, various forms of treatments are available for the relief of Primary dysmenorrhea which includes antispasmodic, analgesics, prostaglandin synthesis inhibitors, hormonal therapy etc. Reluctance of young girls and ladies to adopt the hormone therapies bring them to Ayurvedic treatment or any other alternative treatment of their choice. Ayurvedic management aims at vatanulomana through Snehana, Swedana, Vasti along with Samana oushadha which can alleviate Vata. Abhayatrivrudadi kashaya mentioned in the context of Udavarta chikitsa from Chikitsa manjari consists of Abhaya, Trivrut, Kulatha, Pippali and Eranda taila. Properties of this yoga include Vatanulomana, Sulaghna and Udavartahara. An 18 year old girl complained with severe pain during menstruation, low back ache, nausea and vomiting came to the OPD of Prasutitantra & Streeroga, Government Ayurveda College, Tripunithura is taken for this study. It is evident from the case study that Abhayatrivrudadi kashaya is effective in the management of primary dysmenorrhea.

Burden of sickle cell disease in tribal students in Maa-Baadi institutions in southern Rajasthan - A pilot study

Background & objectives: Sickle cell disease (SCD), an inherited disorder of erythrocytes, is highly prevalent in the tribal population of India. The tribal population of India is approximately 100 million and it is necessary to identify the magnitude of this problem. Furthermore, the prevalence of the disease is unknown among the five million tribal people of southern provinces of Rajasthan. In this study, we intended to determine the prevalence and characteristics of sickle cell disorder among the tribal inhabitants of southern Rajasthan. Methods: This cross-sectional study was conducted among the tribal students of the Maa-Baadis and hostels situated in the five tribal sub-plan districts of Rajasthan. Maa-Baadi centres are located in every village, whereas for every four to five villages, one hostel is allocated to accommodate the tribal students. The screening for SCD was done by solubility test and electrophoresis was used for confirmation. Results: A total of 36,752 tribal students were screened from 1,006 Maa-Baadi centres and 243 hostels. The prevalence of SCD among the tribal students was 5.8 per cent. The prevalence of heterozygous and homozygous conditions was 5.61 and 0.17 per cent, respectively. Among the five sub-plan districts, the highest prevalence was observed in Sirohi district (10.5%) followed by Banswara (7.42%), Udaipur (6.53%), Pratapgarh (5.51%) and Dungarpur (1.89%). Among the four major tribes belonging to these districts, the highest prevalence was recorded in Garasia tribes (13.81%). The history of leg ulcers and the mean pulse rate were significantly high in SCD individuals. Interpretation & conclusions: SCD is a significant problem among the tribes of southern Rajasthan, with the highest prevalence among the Garasia tribe. The present study recommends that a structured screening programme targeting the entire tribal population with appropriate counselling as well as providing treatment through the existing health system is the need of the hour.

Preparedness of primary & secondary care health facilities for the management of non-communicable diseases in tribal population across 12 districts in India

Background and objectives: Non-communicable diseases (NCDs) are highly prevalent in the tribal populations; however, there are limited data regarding health system preparedness to tackle NCDs among these populations. We estimated the availability of human resources, equipment, drugs, services and knowledge of doctors for NCD management in the selected tribal districts in India. Methods: A cross-sectional survey was conducted in 12 districts (one from each State) with at least 50 per cent tribal population in Andaman and Nicobar Islands, Himachal Pradesh, Madhya Pradesh, Odisha and eight northeastern States. Primary health centres (PHCs), community health centres (CHCs) and district/sub-district hospitals (DHs) were surveyed and data on screening and treatment services, human resources, equipment, drugs and information systems indicators were collected and analysed. The data were presented as proportions.Results: In the present study 177 facilities were surveyed, including 156 PHCs/CHCs and 21 DHs. DHs and the majority (82-96%) of the PHCs/CHCs provided outpatient treatment for diabetes and hypertension. Overall, 97 per cent of PHCs/CHCs had doctors, and 78 per cent had staff nurses. The availability of digital blood pressure monitors ranged from 35 to 43 per cent, and drugs were either not available or inadequate. Among 213 doctors, three-fourths knew the correct criteria for hypertension diagnosis, and a few correctly reported diabetes diagnosis criteria. Interpretation & conclusions: The results of this study suggest that the health system of the studied tribal districts was not adequately prepared to manage NCDs. The key challenges included inadequately trained workforce and a lack of equipment and drugs. It is suggested that capacity building and, procurement and distribution of equipment, drugs and information systems to track NCD patients should be the key focus areas of national programmes

Non-communicable diseases as a major contributor to deaths in 12 tribal districts in India

Background & objectives: Non-communicable diseases (NCDs) are the leading cause of death in India. Although studies have reported a high prevalence of NCD in tribal populations, there are limited data pertaining mortality due to NCDs. Therefore, in this study we estimated the proportion of deaths due to NCDs among 15 yr and older age group in tribal districts in India. Methods: We conducted a community-based survey in 12 districts (one per State) with more than 50 per cent tribal population. Data were collected using a verbal autopsy tool from the family member of the deceased. The estimated sample size was 452 deaths per district. We obtained the list of deaths for the reference period of one year and updated it during the survey. The cause of death was assigned using the International Classification of Diseases-10 classification and analyzed the proportions of causes of death. The age-standardized death rate (ASRD) was also estimated. Results: We surveyed 5292 deaths among those above 15 years of age. Overall, NCDs accounted for 66 per cent of the deaths, followed by infectious diseases (15%) and injuries (11%). Cardiovascular diseases were the leading cause of death in 10 of the 12 sites. In East Garo Hills (18%) and Lunglei (26%), neoplasms were the leading cause of death. ASRD due to NCD ranged from 426 in Kinnaur to 756 per 100,000 in East Garo Hills. Interpretation & conclusions: The findings of this community-based survey suggested that NCDs were the leading cause of death among the tribal populations in India. It is hence suggested that control of NCDs should be one of the public health priorities for tribal districts in India.