A Review of Corporate Social Responsibility Programmes Conducted in a Large Public Hospital in a Metropolitan City

Background: Through Corporate Social Responsibility (CSR), a company achieves a balance of economic, environmental andsocial objectives and is also mandated by Indian law. CSR can help in strengthening healthcare in public hospitals catering to theneedy population. Aims: This study documents the various CSR activities going on in a large tertiary care teaching and publichospital in a metropolitan city, challenges in their implementation and effectiveness of such activities. Materials and Methods:Cross sectional questionnaire based descriptive study in a large public hospital in Mumbai, India. A questionnaire was distributedto nine departments which had received CSR support in the year 2017-18. Details recorded were the kind of initiatives andamount received, difficulties faced in implementation, mode of implementation, its effectiveness and number of people benefittedby the activity. Results: In all, companies have provided a total funding of Rs.10,18,24,940 in a year. Difficulties were faced dueto lack of knowledge of the procedure and clear guidelines for CSR implementation. Approximately 84,251 indoor patients and20,77,146 OPD patients were directly or indirectly benefited by these activities. Conclusions: Public hospitals are best settingswhere companies can implement their CSR activities for healthcare of the poorer sections of society, thus fulfilling their socialobligations in a fruitful way. In view of the advantages of CSR, a dedicated CSR department and guidelines for CSR utilisationneed to be set up with adequate expertise and responsibilities.

Risk of dementia in patients taking beta blocker as antihypertensive treatment: a cross sectional study

Background: Hypertension is considered to be the third most important disease in the list of diseases in the south Asian region. Several trials have shown active treatment of hypertension reduced the incidence of dementia. This study was adopted to understand the cognitive status of patients using beta blockers for hypertension for a period of more than 5 years.Methods: The study was done during the period of August 2018 and September 2018. Patients taking beta blockers for atleast 5 years were included and was made to take the MMSE test which is scored out of 30 marks containing 11 questions, each of varying marks.Results: In the study, 54 patients were included, 8 out of 54 patients taking beta blockers obtained a score of 30 which is 15% of the study population taking beta blockers, 15 out of 54 patients taking beta blockers obtained a score of 29 which corresponds to 28% of the study population, 21 out of 54 individuals taking beta blockers obtained a score of 28 which is 39% of the population taking it, 7 patients taking beta blockers obtained a score of 27 pertaining to 13% of the population. One patient obtained a score of 26 and two patients scored 25 out of 30. The average score obtained was 28.2963.Conclusions: About 18.5% of the study population had scores below the average value of 28 in this study. This population is at higher risk of developing dementia in the future and need follow up.

The role of platelet indices in ischemic heart disease: a hospital based case control type of study

Background: In developing countries, Ischemic heart diseases (IHD) is one of the leading causes of morbidity and mortality. The underlying pathology of CAD is atherosclerosis. When this atherosclerotic plaque ruptures, platelets play a crucial role in the prothrombotic events and forms a thrombus on this plaque and as a result coronary artery gets occluded causing ischemia and infarction. Platelet contains many chemokines, cytokines and growth factors. Release of these factors along with interaction with endothelial cells and leukocytes promotes inflammation and progression of atherosclerosis. We aimed to investigate the association between platelet volume indices in patients with diagnosis of Ischemic heart disease in comparison with control group.Methods: By using automated cell counter platelet count and platelet volume indices - were compared with Normal healthy or non-cardiac chest pain patients with the use of unpaired t test.Results: In the present study, we demonstrated that platelet count is significantly low and MPV and PDW are significantly high in Ischemic heart disease as compared to patients with noncardiac chest pain or healthy subjects. The correlation of MPV with PC revealed an inverse correlation between the patients of IHD and healthy or non-cardiac chest pain patients which is statistically significant.Conclusions: The platelet volume indices are an important, simple, effortless and a cost-effective tool useful in predicting the development of an acute coronary event sometimes in the near future and therapeutic modification for improved patient’s cardiovascular care.

A rare case of multilocular cystic renal neoplasm of low malignant potential diagnosed on intra-operative fine needle aspiration cytology

Multi-locular Cystic Renal Cell Carcinoma (MCRCC) is now considered as Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) in World health organisation classification (WHO) 2016. It is usually seen in elderly people where it can mimic most of the time as benign cystic lesion. Authors are reporting a case of MCRNLMP in a 70 year male diagnosed intraoperative with the help of Fine Needle Aspiration Cytology (FNAC). Radiological and other clinical findings are in favour of cystic renal lesion. And it is very important to differentiate it from conventional renal cell carcinoma which requires radical nephrectomy. So, radiological finding and FNAC is instrumental in diagnosing this rare case which require different mode of surgical management.

Stability indicating method development and validation for simultaneous estimation of atorvastatin calcium and celecoxib in bulk and niosomal formulation by RP-HPLC

The present work describes development and validation of a specific, sensitive, precise and stability-indicating high-performance liquid chromatographic method of analysis of atorvastatin calcium and celecoxib, both as a bulk drug and in niosomal formulation. The analysis has been performed by using Cosmosil-C18 column (4.6 mm´250 mm, 5 m) at 25 °C using acetonitrile: ammonium acetate buffer pH 5.0: methanol (50:25:25 v/v/v) as mobile phase. The detection was carried out at 277nm with a flow rate of 1.0mL/min. The retention times of Atorvastatin calcium and Celecoxib were 6.195 and 3.989min, respectively. The method was validated according to ICH guidelines, for specificity, precision, linearity, accuracy and robustness. Atorvastatin calcium and Celecoxib were subjected to stress conditions of hydrolysis, oxidation, photolysis and thermal degradation. The degradation was observed in oxidation and acid hydrolysis. The linearity for atorvastatin calcium and celecoxib were in the range of 100-500 µg/mL. The recovery study of atorvastatin and celecoxib were found to be in the range of 98.96 - 99.92% and 98.90-100%, respectively. The proposed method was validated and successfully applied to the estimation of Atorvastatin calcium and Celecoxib in combined in-house niosomal formulation.

O presente trabalho descreve o desenvolvimento e a validação de método de análise por cromatografia de alta eficiência específico, sensível, preciso e indicador de estabilidade de atorvastatina cálcica e celecoxibe, ambos como fármaco e como formulação niosômica. A análise foi realizada utilizando coluna Cosmosil-C18 (4,6 mm´250 mm, 5 m) a 25 °C, e acetonitrila: tampão acetato de amônio pH 5,0: metanol (50:25:25 v/v/v) como fase móvel. A detecção foi realizada a 277 nm, com fluxo de 1,0 mL/min. Os tempos de retenção de atorvastatina cálcica e de celecoxibe foram 6,195 e 3,989 min, respectivamente. O método foi validado de acordo com as regras da ICH para especificidade, precisão, exatidão e robustez. A atorvastatina cálcica e o celecoxibe foram submetidos a condições de estresse por hidrólise, oxidação, fotólise e degradação térmica. A degradação foi observada por oxidação e hidrólise ácida. Observou-se a linearidade da atorvastatina cálcica e do celecoxibe na faixa de 100-500 µg/mL. A recuperação da atorvastatina e do celecoxibe foi observada na faixa de 98,96-99,92% e 98,90-100%, respectivamente. O método proposto foi validado e aplicado com sucesso para a determinação de atorvastatina cálcica e celecoxibe em formulação niosômica caseira combinada.

Utility of penicillin allergy testing in patients presenting with a history of penicillin allergy

BACKGROUND: Current statistics show that approximately 10% of patients claim to be allergic to penicillin yet only 10% of these have demonstrable allergy. The most appropriate and cost-effective antibiotics are sometimes withheld on the basis of patient history of drug allergy. OBJECTIVE: Investigation of IgE hypersensitivity and delayed hypersensitivity in patients with a history of penicillin allergy to a teaching hospital allergy clinic. METHODS: Patients underwent skin prick and intradermal testing (IDT) with major and minor penicillin determinants. Those with negative skin tests were administered a three-day oral challenge. Demographic and clinical details about the reactions were noted. RESULTS: One hundred twenty eight patients underwent testing, of these, one hundred and ten had self-reported histories of penicillin allergy and eighteen were referred because of other antibiotic allergies. Seventeen patients with self-reported penicillin allergy had either positive skin tests or oral challenge results, corresponding to 15% of patients having proven allergy. None reacted on skin prick testing, four reacted to IDT, thirteen reacted to oral challenge (five immediate and eight delayed). Analysis of clinical histories showed that patients with a well-defined history of allergy and a history of anaphylaxis were more likely to have a positive test compared to patients with vague histories. Skin testing proved to be less sensitive than oral challenge. CONCLUSION: A minority of patients presenting with a history of penicillin allergy have evidence of immune-mediated hypersensitivity (17/110, 15%) in this study. Of these, eight out of seventeen (47%) had delayed reactions, demonstrating the usefulness and discriminating power of objective testing, which must include three-day oral challenge. Discriminating factors for immune-mediated allergy from patient history were a clear description of the original reaction and a history of anaphylaxis. Negative allergy testing enables the use of penicillin as first-line treatment when necessary and this can significantly reduce costs of antibiotics.

Prevalência, severidade e características da cárie precoce na infância em crianças de 3 a 6 anos de idade de mysore, karnataka, india / Early childhood caries prevalence, severity and pattern in 3-6 year old preschool children of mysore city, karnataka

Objetivo: Determinar a prevalência, severidade e características da cárie precoce na infância em Crianças de 3 a 6 Anos de idade de Mysore, India. Método: Dez pré-escolas, cinco públicas e cinco privadas foram aleatoriamente selecionadas de cinco diferentes áreas da cidade de Mysore. Um total de 500 crianças e seus pais/responsáveis foram incluídas no estudo. A ocorrência de cárie precoce na infância foi diagnosticada com o uso dos critérios NIDCR. A existência de cárie dentária foi feita com o uso dos índices ceo-d e ceo-s.Resultados: A prevalência de cárie precoce foi de 56,6% com um ceo-d e ceo-s médios de 2,20 e 2,97, respectivamente. Do total de crianças, 56% dos meninos e 57,1 % das meninas estavam afetadas. Não se verificou diferença na prevalência de cárie entre os estudantes da rede pública e privada. Cerca de 94,84% do total do ceo-d envolvia o componente cariado. O arco superior foi mais afetado (29,32%) do que o inferior (26,14%). As superfícies oclusais foram as mais afetadas (46%) e as menos afetadas foram as superfícies lisas (16%). Os molares inferiores foram os mais acometidos (39,42%) e os incisivos inferiores os menos afetados (1,84%). Conclusão: O aconselhamento oral deve ser iniciado aos seis meses quando da erupção dos primeiros dentes decíduos.

Objective: To determine Early Childhood Caries (ECC) prevalence, severity and pattern in preschool children of Mysore City, Karnataka. Methods: A total of 10 preschools, five government and five private were selected randomly from 5 different sectors in Mysore. A total of 500 children and their parents were included in the study. Early Childhood caries was diagnosed using NIDCR definition. Dental caries status was recorded using dmft and dmfs indices. Results: The results show that early childhood caries prevalence in 3-6 year old preschool children was 56.6% with a mean dmft and dmfs of 2.20 and 2.97 respectively. Out of the 500 children, 56% males and 57.1 % females were affected .There was no difference in caries prevalence between children of government and private preschools. 94.84% of total dmf was comprised of decayed component. Maxillary arch was affected more (29.32%) than the mandibular arch (26.14%).The most affected surfaces were the occlusal surfaces (46%) and least affected were the smooth surfaces (16%). Mandibular posteriors were affected the most (39.42%) and lower incisors were the least affected (1.84%). Conclusion: The results support the view that oral counseling should begin within 6 months of eruption of 1st primary tooth.

Qualidade de vida relacionada à saúde bucal (OHRQoL) em pacientes usando aparelho ortodôntico fixo em Pimpri, Pune, Índia - um estudo transversal / Oral health related quality of life (OHRQoL) amongst patients wearing fixed orthodontic appliance in Pimpri, Pune, India - a cross sectional study

Objective: To assess the prevalence of oral impacts on daily performances and influence of grades of malocclusion on OHRQoL in patients wearing fixed orthodontic appliance, and to assess the other potential factors (Gender, Socio-economic status, wiring technique of appliance, Operator choice) which are influencing the oral impacts in patients with fixed orthodontic appliance. Methods: 130 participants, 14-22 years old, were selected by convenience sampling from the Department of Orthodontics and Dentofacial Orthopedics of the Dental College, Pune and from three private practitioners. Only those wearing fixed orthodontic appliances since the past 6 months were included. Face to face structured interviews were conducted to collect information about impacts, using the Oral Impact on Daily Performances (OIDP). Pre-treatment casts of participants were examined to record the malocclusion status using Index of complexity, outcome and need (ICON). Comparison was done between OIDP and ICON scores, and other co-variables. Results: The prevalence of oral impacts was 86.92%. 55.35% of the participants had an impact on three or more daily performances, commonly eating, social contact, cleaning teeth, speaking (78.46%, 51.53%, 45.38%, and 40.76% respectively). Only ICON scores had an influence on OIDP scores (p less than 0.05). Conclusion: Severity of malocclusion has great impact on OHRQoL during fixed orthodontic treatment.

Objetivo: Avaliar a prevalência de impactos bucais no desempenho diário e a influência da gravidade da má oclusão na qualidade de vida relacionada à saúde bucal em pacientes usando aparelho fixo ortodôntico e avaliar os outros fatores potenciais (sexo, status sócio-econômico, técnica de construção do aparelho, escolha do operador), que influenciam o impacto odontológico em pacientes com aparelho ortodôntico fixo. Método: 130 participantes, de 14 a 22 anos de idade, foram selecionados por amostragem de conveniência, no Departamento de Ortodontia e Ortopedia Facial da Faculdade de Odontologia, Pune e em três consultórios privados. Apenas aqueles que utilizavam aparelhos ortodônticos fixos há pelo menos seis meses foram incluídos. Entrevistas face a face estruturadas foram conduzidas para coletar informações sobre os impactos, usando o Impacto Odontológico no Desempenho Diário, (OIDP). Modelos da fase pré-tratamento dos participantes foram avaliados para registrar a condição da má oclusão por meio do Índice de complexidade, resultado e necessidade (ICON). A comparação foi realizada entre os escores do OIDP e do ICON e outras co-variáveis. Resultados: A prevalência de impactos oral foi 86,92%. 55,35% dos participantes apresentaram um impacto em três ou mais desempenhos diários, comendo freqüentemente, contato social, limpando os dentes, falando (78,46%, 51,53%, 45,38% e 40,76%, respectivamente). Apenas os escores do ICON influenciaram nos escores do OIDP (p menor que 0,05). Conclusão: A gravidade da má oclusão tem grande impacto sobre a qualidade de vida relacionada à saúde bucal durante o tratamento ortodôntico fixo.

Neuroprotective role of Melatonin against aluminum-induced oxidative stress in the hippocampus of mouse brain.

We evaluated the effect of melatonin (Mel) in male albino mice which received aluminum acetate (Al) for 6 weeks (3.5 mg/kg body weight) (b.w.) i.p. five times per week. Moreover mice received Mel (7mg/kg b.w.i.p. 5 days/week) for 6 weeks. At the end of the treatment hippocampus was removed and processed to examine the oxidative stress markers. Following Al exposure oxidative stress increased significantly, estimated by increased thiobarbituric acid reactive substances (TBARS) and decrease in the activity of antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), reduced glutathione (GSH),glutathione peroxidase (GPx) and glutathione-s-transferase (GST). Al+Mel treatment significantly prevented the aluminum induced decrease in antioxidant enzymes as well as decrease in TBARS. Histopathological evidence in the hippocampi revealed the protective effect of melatonin against Al induced damage in light and transmission electron microscopic (TEM) studies. These results supported that melatonin suppresses the oxidative stress. This may result from the higher efficacy of melatonin in scavenging various free radicals and also because of its ability in stimulating the anti oxidant enzymes.