Cytotoxic and microbial studies of mixed metal complexes

Breast cancer and its treatment have become a prominent and challenging problem today. The increasing multidrug resistance to microbial pathogens is the root cause of breast cancer. Women suffering from cancer showed high levels of E. coli and S. aureus. In the last few decades, there has been a considerable need in the medical field for the discovery of new compounds endowed with antimicrobial activity, despite the fact that several antibiotics and chemotherapy drugs are currently accessible. Substantial research was conducted, particularly on transition complexes as metal-based drugs in pharmacological applications to provide therapeutic options. The synthesis, characterization, antibacterial activity, and cytotoxic activity of copper complexes with specific ligands of amino acids such as tyrosine and arginine are discussed in this work.

Role of doppler ultrasonography in prediction of adverse perinatal outcome in intrauterine growth retardation (IUGR)

Introduction: A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through the blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. Objective of current study was to determine and compare accuracy of various Doppler parameters for perinatal outcome - Umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) for predicting adverse perinatal outcome in patients of intrauterine growth retardation. Materials and methods: A total of 172 singleton pregnancies between 33 to 36 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery and ductus venosus. Patients kept under surveillance till confinement. According to increasing severity of Doppler indices categorized the cases into six grades from grade 0 to grade 5.Duration of this study was two years, from December 2019 to November 2021. Results: Out of 172 cases, 146 were live born and 26 were neonatal death. There were 7 cases of intrauterine death of fetuses and 5 were still born. Out of the live born 27 had increased perinatal morbidity like poor APGAR score, development of necrotizing enterocolitis, hypoxic ischemic encephalopathy, meconium aspiration syndrome, hyperbilirubinemia, and prolonged admission in neonatal care unit for reasons like sepsis / birth asphyxia. Conclusion: Absent end diastolic flow (EDF) / reversal in umbilical artery had high positive predictive value in predicting adverse fetal outcome. Ductus venosus changes seem to be an ominous sign of a severely compromised fetus with poor perinatal outcome. Doppler investigation of the MCA, UA and DV plays an important role in monitoring the compromised fetuses and helps to determine the optimal time of delivery.

Spectrum of Bacterial Pathogens in Critical COVID-19 Patients Admitted in Intensive Care Units of a Tertiary Care Hospital During the First and Second Wave of the Pandemic

Objective: This study intends to compare the clinical characteristics and the prevalence and spectrum of bacterial pathogens in COVID-19 patients admitted to ICU during the first and second waves at a tertiary care, teaching and referral hospital of eastern India. Method: This is a hospital-based retrospective study which analysed demographic details, clinical profile and bacterial culture results of severe and critically ill COVID-19 patients admitted in intensive care units (ICU) during April -Oct 2020 (1 st wave) and April –July 2021 (2 nd wave). Result: The patients admitted during the 2 nd wave were comparatively older and had multiple comorbidities compared to the 1 st wave. (23.8%) (45/189) and 50% (173/346) of the COVID-19 patients admitted to ICU developed bacterial infection during the 1 st and 2 nd wave respectively. Overall, there was predominance of multidrug resistant Gram negative bacilli in both the waves. There was increased isolation of intrinsic colistin resistant microorganisms. Conclusion: Multidrug resistant Gram negative bacterial infections, remain a dreaded complication in severe and critically ill hospitalised COVID-19 patients requiring ICU care and high usage of colistin spirals the emergence and spread of pathogens intrinsically resistant to colistin.

Evaluation of efficacy of sonosalphingogram for assessing tubal patency in infertile patients with hysterosalphingogram

Introduction: Infertility is a leading psychosocial problem in couples. Diagnostic evaluation of uterine tube is important in the management of infertility. Causes or factors of female infertility can basically be classified regarding whether they are acquired or genetic, age, smoking, sexually transmitted infections (STIs), adhesions in the peritoneal cavity, previous abdomen surgeries, diabetes mellitus, smoking, alcohol, celiac disease, liver and kidney disease and being overweight or underweight can all affect fertility. Proper evaluation of the infertility is needed for better management of the cases of infertility. Aim of the study: To assess the efficacy of Sonosalpingography (SSG) and Hysterosalpingography (HSG) in the diagnosis and management of infertility. Materials and methods: A total 75 cases attending the department with complaint of infertility. Cases between ages 21 years and 44 years were recruited for this study. Duration of this study was two years, from June 2016 to May 2018. All the cases were undergone with baseline transabdominal sonogram, real time transvaginal sonography and saline infusion sonography to examine pelvic region of the cases. All the participants had to undergo SSG on 8th day and HSG on 10th day of the menstrualcycle. Data was collected and sensitivity and specificity of SSG over HSG was assessed. Statistical analysis was done by using SPSS software version 14.0. Results: Diagnosis by SSG showed bilateral tubal patency in 83.93% cases and by HSG showed bilateral tubal patency in 75% cases. SSG and HSG both correlated well (95.3%) and both procedures had similar diagnostic accuracy. In this study, positive predictive value was 95.2% and negative predictive value was 94.6%. Sensitivity was 98.3%, specificity 85.6% and accuracy rate of this study was 95.8%. The outcome of this study indicates that there is no statistically significant difference (p=0.338) between the values of SSG and HSG. Conclusion: SSG is cost effective and radiation free procedure. The outcome of SSG is almost similar to the values of HSG.

A Histopathological Study of Congenital Pouch Colon and its Impact on Management

Background: Congenital Pouch colon(CPC) is a rare variant of anorectal malformations (ARM) whose etiopathogenesis and management are not yet standardized. This prospective study seeks to establish the histopathological characteristics and it’s inference on the etiopathogenesis, management and prognosis of CPC. Methods: This was a prospective comparative study including all neonates with CPC and other high ARM. The excised pouch from the neonates with CPC and a strip of sigmoid colon from other high ARM patients were sent for biopsy and the histopathological features compared. Results: Histopathogical abnormalities were seen involving all the layers of the colonic pouch including mucosa, submucosa and muscularis propria. The statistically significant histopathological differences in the colonic pouch as compared to normal sigmoid colon were mucosal necrosis, focal erosions, inflammation and haemorrhage, muscularis mucosa fibrosis, submucosal congestion and haemorrhage, widening, fibrosis and presence of lymphoid follicles and circular and longitudinal muscle disarray and fibrosis. Also seen was a significant inflammatory infiltrate permeating all the layers of the pouch. Conclusion: CPC has histopathological abnormalities in all the layers of the colon. It is thus pathologically abnormal tissue. The widespread inflammatory reaction in all layers of the CPC raises the possibility of some environmental factor having a role in etiopathogenesis of CPC.

Enhancing Farmer Income through Value Addition to Rice in Khammam District, India

Rice is the staple food to half of world’s population providing more than one fifth of the calories consumed worldwide. Cereal grains are rich sources of phenolic compounds present in cell walls that help in combating many life style diseases occurring due to oxidative stress. Rice has been domesticated more than 10000 years ago but even today the farmers prefer selling freshly harvested paddy at a lower price. Few entrepreneurial farmers have come up with the idea of primary processing the paddy as semi polished and brown rice that can fetch them more profits along with providing health benefits. Each Kg of paddy, white, semi polished and brown rice cost Rs. 17 – 18.50, 46 – 48, 58 – 60 and 65 respectively. Similarly, one Kg of brokens get Rs. 15, bran Rs. 12 during season and Rs. 20 during off season. The rice without any processing fetched the farmer profit of about Rs. 24400 to 36000 on an average per acre. But if the farmer subjected the rice to primary processing and sold as white, semi polished or brown rice, the profits generated per acre were Rs. 57156 – 66480 Rs. Rs. 82996 – 102400and Rs. 105910 – 120400 can be generated. As can be seen the decrease in processing produced lower quantity of brokens and bran and income from them was comparatively lower than on processed rice indicating that there can be rise in income with minimal processing with added health benefits. There can an increase in profits by 4 to 5 times due to primary processing benefiting the paddy growers. The white, semi polished and brown rice can increase the income of farmer by 76.92, 127.79 and 161.58% per one bag of paddy weighing 75 Kg. There was a significant decrease in brokens and bran produced in semi polished and brown rice that actually fetch less prize than the actual produce. The growing awareness of consumers towards health foods, improved eating habits and health consciousness is expanding brown rice market at higher compounded annual growth rate (CAGR) compared to overall rice market.

Surgical management of abdominal tuberculosis in a tertiary care referral center

Background: Abdominal tuberculosis encompasses gastrointestinal, visceral and peritoneal forms of tuberculosis in different proportions. Their clinical presentation and radiological findings are varied and non-specific often warranting surgical intervention either for confirmation of diagnosis or for definitive management.  It is not very clear as of now as to which type of patients would require surgical intervention for diagnosis or treatment of abdominal tuberculosis. This study aims to profile such patients accurately to revalidate the need for surgical intervention in cases of abdominal tuberculosis.Methods: This study is a retrospective descriptive observational study wherein the documents of patients whose final diagnosis was confirmed as ‘Abdominal Tuberculosis’ from January 2011 to December 2013 were analysed. Their demographic and clinical profile, hematological, biochemical and radiological investigations including barium meal follow-through, ultrasonography, CT scan abdomen, colonoscopy and biopsy, HIV status and ascitic fluid analysis were analysed. Patients in whom diagnosis was not confirmed by these investigations, and therefore underwent diagnostic laparoscopy or exploratory laparotomy were studied. Simultaneously, patients in whom, the diagnosis was confirmed, but still underwent surgical intervention for therapeutic purposes were also analysed.Results: It was found that 44 out of 54 patients (81.4%) underwent surgical procedure.  28 (52%) required surgical intervention for confirmation of diagnosis (diagnostic procedures: diagnostic laparoscopy- 21 and exploratory laparotomy- 07) while 16 (29.4%) required therapeutic procedures (emergency- 08; elective- 08).Conclusions: In spite of extensive investigations, many patients of abdominal tuberculosis require surgical management either minimally invasive or otherwise, both for confirmation of diagnosis and for definitive management.

Onsite mentoring of special newborn care unit to improve the quality of newborn care

Background: It has been possible to set up special newborn care units (SNCUs) and to improve the survival of newborns in India. However, several challenges remain affecting their effective functioning. Different approaches have been attempted and several policies have also been implemented to address this issue. Objectives: To evaluate the feasibility of implementing best practices in neonatal care by onsite mentoring in an SNCU over 4 months. Methods: The mentoring team was from a tertiary care hospital in Karnataka. The SNCU was functioning at the district hospital, catering to approximately 3500 live births per year. Onsite mentoring was carried out from August 2016 to November 2016. This was a prospective implementation research. Framework focused on infection control, preterm care, care at birth, advocacy for infrastructure and resources, and facility-based refresher training. Results: A total of 16 visits were done by the mentoring team and 2 weeks of in-house residency. There were improvements in hand hygiene compliance from 0% to 87.5%, in cleaner IV site (from 50% to 100%), decreased unnecessary oxygen administration (from 75% to 33.3%), decreased antibiotic usage (from 70.5% to 35.5%), decrease in the number of babies receiving >5 days of antibiotics (from 41.6% to 0%), and increased kangaroo mother care initiation rate from 0% to 41.6%. The facility got level IIA accreditation by the end of the intervention period. Conclusions: Onsite mentorship program of SNCU is feasible and planning should be contextual. With the problems being uniform across most facilities, the model could be replicated across the country.

Studies on features, physical, mechanical, tribological properties and applications of Ti-6Al-4V in aerospace industry

This research article gives an overview of the extensive research of Ti-6Al-4V from past few decades helped in studying about the features, properties, characteristics and application of aerospace industries. The final objective of study is to obtain the inherent advantages of Ti-6Al-4V like low elasticity modulus, high strength, low density and more resistant to fatigue and corrosion that leads to rely on the required knowledge for the employment of application which improves all physical and mechanical properties.

Seroprevalence of syphilis in human immunodeficiency virus patients

Background: Syphilis is a sexually transmitted infection caused by, Treponema pallidum. Syphilis facilitates the transmission and acquisition of human immunodeficiency virus (HIV) and causes transient increase in the viral load. Sexually transmitted infections (STI) are 3-5 times more likely to acquire HIV infection, if exposed to the virus through sexual contact. Aim of the study was to estimate the seroprevalence of Syphilis in HIV patients.Methods: A total of 920 blood samples were collected from HIV patients attending ART (Antiretroviral therapy) centre and were tested for Syphilis by using Rapid Plasma Reagin (RPR) and Treponema pallidum Hemagglutination Assay (TPHA). A total of 100 HIV non-reactive individuals were taken as a control group.Results: Out of 920 samples, 102 (11.1%) were positive for Syphilis. Out of 102 Syphilis seropositive patients, males (76.5%) were more commonly affected in age group of 21-40 years. Both RPR and TPHA were reactive in 46% of cases and only TPHA reactive in 53.9% of cases. Out of 100 HIV non-reactive patients, 5% of patients are reactive for Syphilis.Conclusions: In the present study, prevalence of Syphilis was more in HIV patients compared to HIV non-reactive persons. Persons with HIV infection acquired through sexual route should be screened for Syphilis by one nonspecific test along with specific test to confirm the diagnosis. This will help in proper management of the patients having Syphilis and HIV co-infection.

Role of adipokines, oxidative stress, and endotoxins in the pathogenesis of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

Background: Type 2 diabetes mellitus (T2DM) is associated with chronic inflammation and oxidative stress, implicated in the pathophysiology of non-alcoholic fatty liver disease (NAFLD). Present study aimed to assess the role of adipokines, oxidative stress, and endotoxins in the pathogenesis of NAFLD in T2DM.Methods: Present cross-sectional observational study included healthy controls (n=50; group 1); T2DM patients without NAFLD (n=50; group 2), T2DM patients with NAFLD (n=50; group 3). Study subjects were age and gender matched.Results: Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), high sensitive C-reactive protein (hs-CRP), endotoxin, malondialdehyde (MDA) were significantly elevated and adiponectin, ferric reducing ability of plasma (FRAP), and glutathione (GSH) were significantly lower (p<0.001) in T2DM patients with NAFLD when compared to T2DM patients without NAFLD and controls. Endotoxin showed significant positive correlation with TNF-α (r=0.304; p<0.001), hs-CRP (r=0.193; p=0.018), and MDA (r=0.420; p<0.001), and significant negative correlation with adiponectin (r=-0.406; p<0.001). TNF-α and IL-6 showed significant positive correlation with MDA (r=0.526; p<0.001, r=0.229; p=0.005) and significant negative correlation with adiponectin (r=-0.396; p<0.001, r=-0.318; p<0.001), FRAP (r=-0.418; p<00.001, r=-0.170; p=0.038), and GSH (r=-0.353; p<0.001, r=-0.301; p<0.001).Conclusions: Authors observed elevated endotoxin, oxidative stress, inflammation and lower adiponectin levels in T2DM subjects compared to controls. These changes were more pronounced in T2DM with NAFLD when compared to T2DM without NAFLD.  Lower adiponectin levels were found to be a better predictor of NALFD in T2DM and is associated with oxidative stress and systemic inflammation.

Ferricarboxy maltose to treat iron deficiency anemia in pregnancy: is it a feasible option?

Background: Iron deficiency is a common cause of anaemia in pregnancy which influences the health of mother and developing fetus. Intravenous (IV) iron preparations are considered, when oral iron therapy is ineffective or intolerant. Ferric carboxymaltose is an IV preparation that can be given with ease of administration and better tolerated. The aim of this study was to assess the efficacy and safety of IV ferric carboxymaltose in pregnant mother with all grades of anemia in the second and third trimester.Methods: This is a prospective observational study where 44 pregnant women with iron deficiency anemia [IDA] received ferric carboxymaltose up to 15mg/kg in second and third trimester. The parameters that were taken into account, to assess the effectiveness of the treatment was repeat haemoglobin [Hb] measurements and the subjective sense of wellbeing in the patient. The safety of the drug was analysed by continuous fetal heart rate [FHR] monitoring during the infusion and observation of any adverse reactions.Results: Ferric carboxymaltose intravenous infusion significantly increased Hb levels above baseline values in all women. The Increase in Hb levels were observed at 3- and 6-weeks post infusion therapy. FHR monitoring did not show any drug related unfavourable effect on the fetus. Of the 44 women interviewed, 33 (75%) women reported sense of well-being, 7 (15.9%) women could not feel any difference after the infusion and 4 (9.1%) patients could not comment. No serious adverse effects were noticed but minor side effects occurred in 3 (6.8%) patients.Conclusions: This prospective study showed safety and efficacy of ferric carboxymaltose in pregnancy with IDA which is consistent with available observational data.

In Vivo Evaluation Of Tazarotene Solid Lipid Nanoparticles Gel For Topical Delivery

The purpose of this research work was to develop and optimize the Solid Lipid Nanoparticles (SLNs) of Tazarotene for the effective topical delivery in the treatment of psoriasis. Tazarotene loaded SLNs were prepared by hot homogenization followed by the ultrasonication using Taguchi’s design and based on the results further investigation was made using central composite design. The lipid Dynasan-116, surfactant poloxomer-188 and co surfactant egg lecithin resulted in better percent drug loading and evaluated for particle size, zeta potential, TEM, drug entrapment efficiency, in vitro drug release and stability. All parameters were found to be in an acceptable range. In vitro drug release of optimized SLN formulation (F1) was found to be 98.12 ± 1.52%, whereas pure drug release was 42.12 after 60 min. The optimized formulation was incorporated into the gel. The release rate (flux) of tazarotene across the membrane and excised skin differs significantly. The accumulative amount of Tazarotene in skin from SLN based gel formulation and marketed gel were 41.12 ± 0.12 mg and 30.02 ± 0.04 mg respectively. This result supported our hypothesis made in skin permeation studies on rat skin. From histopathological studies the microscopic observations indicate that the optimized SLN formulation, SLN based gel formulation and marketed gel has no significant effect on the microscopic structure of the skin. The skin-irritation studies indicated that SLN based gel containing Tazarotene did not show any sign of skin irritation as compared to moderate erythema shown by marketed gel formulation (Tazret® gel) after 72 h of application. Thus, SLN based gel formulation demonstrated advantage over marketed formulation in improving the skin tolerability of Tazarotene indicating their potential in improving patient acceptance and topical delivery of Tazarotene.

Estimation of boswellic acids in herbal formulations containing Boswellia serrata extract and comprehensive characterization of secondary metabolites using UPLC-Q-Tof-MSe / 药物分析学报

Boswellia serrata is a widely used herb in Indian systems of medicine and is well known for its potential medicinal properties. A chromatographic method was developed for the analysis and quantification of six boswellic acid marker compounds, i.e., keto boswellic acid (1), 3-O-Acetyl 11-keto β-boswellic acid (2), ɑ-Boswellic acid (3), β-Boswellic acid (4), 3-O-Acetyl-ɑ-boswellic acid (5) and 3-O-Acetyl-β-boswellic acid (6) in commercial herbal products containing B. serrata as an ingredient. Combining UPLC with Q-Tof-MS/MS makes the better identification of secondary metabolites and adulterants in the herbal formulations containing B. serrata in rapid time using fragmentation approach than the traditional approaches. In this study quantification of boswellic acids with UPLC-PDA method was performed as per the pharmacopeia guidelines. Furthermore, minor phytochemical constituents were identified and characterized with the help of LC-Q-Tof-MS/MS fragmentation data and various isoforms of boswellic acids and tirucallic acids in B. serrata oleo-gum-resin extract were identified.

Assessment Of Powered (MICRO Debrider) Instruments In Endoscopic Sinus Surgery

Background: Endoscopic Sinus Surgery (ESS) is the surgical practice of alternative for Sinonasal Polyposis (SP). Blood loss throughout Endoscopic Sinus Surgery be able to stop the flow of surgical procedure. The normal instruments grip and rip diseased tissues along with regular tissues causing amplified intra operative bleeding important to decreased visibility and therefore less accurate surgery. Microdebriders be extensively worn now a day in Endoscopic Sinus Surgery. This study is made to assess the advantages of microdebrider in Endoscopic Sinus Surgery in terms of blood loss throughout surgery, visibility of the field during surgery, duration of surgery and post operative healing. Methods: This is a potential study done in GEMS hospital, Srikakulam, over a period of October 2017 to September 2018. Patients who were diagnosed as sinonasal polyposis and underwent endoscopic sinus surgical procedure with microdebrider were taken into study and the outcome were documented and analyzed in terms of blood loss during surgery, visibility throughout surgery, time interval of surgery and post operative healing. Results: Out of 30 patients, majority of the patients had an average blood loss of 180 ml and preoperative visibility of grade 2 and standard duration of surgery of 60 minutes. the majority of the patients had grade Apost operative healing Conclusions: The use of microdebrider leads to contented surgical procedure and decreased rate of intra-operative complications and likely instrument in the practical endoscopic sinus surgery for the management of sinonasal polyposis

Cetrimide‑chlorhexidine‑induced multiorgan failure in surgery of pulmonary hydatid cyst.

Savlon (0.5% cetrimide/0.05% chlorhexidine) is used as a scolicidal during surgery of hydatid cysts. It is considered a safe and effective agent. However, there are no recommendations for the appropriate concentration or dosage of these agents. Previously reported to cause severe metabolic acidosis, its effects on the pulmonary system have not been explored. We present a case of acute lung injury and respiratory distress along with acute cardiopulmonary distress, severe metabolic acidosis, and renal failure following its use during surgical removal of pulmonary hydatid cyst. The agent may act as a chemical sclerosant causing pulmonary parenchymal damage through bronchial openings present in the pericyst. Till safe dose limits are known, use of this agent should be limited, especially in large or multiple cyst surgery.

Pure neuritic leprosy: Current status and relevance.

Pure neuritic leprosy has always been an enigma due to its clinical and management ambiguities. Although only the Indian Association of Leprologist’s classifi cation recognizes ‘pure neuritic leprosy’ as a distinct sub group of leprosy, cases nonetheless are reported from various countries of Asia, Africa, South America and Europe, indicating its global relevance. It is important to maintain pure neuritic leprosy as a subgroup as it constitutes a good percentage of leprosy cases reported from India, which contributes to more than half of global leprosy numbers. Unfortunately, a high proportion of these patients present with Grade 2 disability at the time of initial reporting itself due to the early nerve involvement. Although skin lesions are absent by defi nition, when skin biopsies were performed from the skin along the distribution of the affected nerve, a proportion of patients demonstrated leprosy pathology, revealing sub-clinical skin involvement. In addition on follow-up, skin lesions are noted to develop in up to 20% of pure neuritic leprosy cases, indicating its progression to manifest cutaneous disease. Over the decades, the confi rmation of diagnosis of pure neuritic leprosy has been subjective, however, with the arrival and use of high-resolution ultrasonography (HRUS) for nerve imaging, we have a tool not only to objectively measure and record the nerve thickening but also to assess the morphological alterations in the nerve including echo texture, fascicular pattern and vascularity. Management of pure neuritic leprosy requires multidrug therapy along with appropriate dose of systemic corticosteroids, for both acute and silent neuritis. Measures for pain relief, self-care of limbs and physiotherapy are important to prevent as well as manage disabilities in this group of patients.