Prédicteurs de mortalité précoce en cours d'hospitalisation des enfants malnutris aigus sévères de 0-59 mois au CHU Sourou Sanou, Bobo-Dioulasso / Predictors of early mortality during hospitalization of severe acute malnourished children aged 0-59 months at CHU Sourô Sanou, Bobo-Dioulasso

Objectifs : étudier les facteurs de risque de mortalité des enfants malnutris aigus sévères (MAS) dans les 72 premières heures d'hospitalisation. Méthode : Nous avons mené une étude rétrospective sur des données d'enfants MAS de 0-59 mois, hospitalisés du 1er juin 2016 au 31 mai 2019 au CHUSourô Sanou (CHUSS) de Bobo-Dioulasso. Une régression logistiquea été réalisée pour déterminer les facteurs de risque de décès. Les variables avec un odds ratio (OR) >1, et p 3s [OR :3.55, 95%IC: 1.50-8.27], le sepsis [OR : 3.39, 95%IC: 1.33-8.50], étaient les facteurs de risque prédictifs de mortalité. Conclusion : Une formation et supervision continue du personnel soignant sur la prise en charge des urgences pédiatriques, l'utilisation du protocole OMS de prise en charge de la MAS, la disponibilité de kits d'urgence pourraient améliorer la prise en charge des MAS. Mots clés : Mortalité, précoce, MAS, BoboDioulasso

Objectives: to study risk factors for mortality in SAM children within the first 72 hours of hospitalization. Methods: We conducted a retrospective study on data from 0-59-month-old SAM children hospitalized from June 1th, 2016, to May 31th, 2019, at CHUSourô Sanou of Bobo-Dioulasso. A logistic regression was performed to determine risk factors for death. Variables with odds ratio (OR) > 1, and p 3seconds [OR :3.55, 95%IC: 1.50-8.27], sepsis[OR :3.39, 95%IC: 1.33-8.50]were the risk factors predictive of mortality. Conclusion: Training and ongoing supervision of healthcare staff in the management of paediatric emergencies, the use of the WHO SAM management protocol and the availability of emergency kits could improve SAM management

Comparison of Demography, Resource Utilization and Outcomes of COVID 19 patients admitted during First and Second waves at a tertiary care institute in Kanyakumari, South India

Introduction: The novel Coronavirus disease 19 (COVID-19) affected India, predominantly in two time periods – the first wave from March to December 2020, and the second wave that raged from April to July 2021. Although the time duration of second wave was shorter than the first, the onslaught of the disease was much more severe during the second wave. Objective: To compare the demographic characteristics and clinical outcomes of COVID-19 patients admitted during the first and second pandemic waves. Method: Demographic characteristics, duration of hospitalization, critical unit admission, and mortality data of 137 and 345 COVID-19 positive individuals, from first and second waves respectively, were retrospectively analyzed in a teaching hospital in South India. Descriptive statistics, Independent t test, chi square tests and regression analysis were used for statistical analysis, with significance level prefixed at 5%. Results: Median age of hospitalisation was 46.2 years and 48.39 years during first and second waves respectively, with male preponderance in second wave. There was a statistically significant difference in mean duration of stay (9.04 days v/s 7.53 days), mean Spo2 at admission (98.4% v/s 96.6%), ventilation requirement (1.5% v/s 8.7%), oxygen requirement and ICU care between the two waves.Conclusion: During the second COVID wave, significantly higher hospitalisation rates, intensive care requirements and inpatient mortality was observed. Elevated C Reactive Protein levels, lymphocytopenia, history of diabetes and other co-morbidities were associated with poor outcomes in both waves.

Correlation of oxidative stress and metabolic risk factors in apparently healthy adults

Background: Diabetes, hypertension, obesity, and dyslipidemia, all are the risk factors of metabolic syndrome (MS). Various studies have shown that each risk factor is associated with increased inflammation. hsCRP is a non-specific, sensitive inflammatory marker that is raised in various inflammatory conditions. Similarly, glutathione is an antioxidant which binds with ROS produced during inflammation and reduces damage caused by ROS. Aims and Objectives: This study has been planned to find the correlation between oxidative stress and metabolic risk factors in apparently healthy adults. Materials and Methods: We recruited apparently healthy adults (n = 120) and measured waist circumference, blood pressure, lipid profile, Fasting blood sugar, serum GSH, and hsCRP in all the subjects. Seventy-seven subjects were found to have at least one or more metabolic risk factors (Group A) according to NCEP ATP III criteria with waist circumference >90 cm for male and >80 cm for female and 43 were without any metabolic risk factors (Group B). Thereafter, we compared the serum levels of hsCRP and serum GSH with persons having one or more risk factors for MS. Results: In this study, we observed that subjects with metabolic risk factors were having more oxidative stress indicated by increased hsCRP (4783.1 ± 2060.21) and low serum GSH (3.17 ± 0.81) in comparison to controls (1640.5 ± 547.47 and 4.79 ± 0.77, respectively). This increase in hsCRP and decrease in GSH in case group was statistically significant. We also found the higher basal hsCRP levels in control group as per AHA/CDC study. Conclusion: We observed in this study that Indians without any risk factors for MS have relatively higher CRP levels and are at intermediate risk for cardiovascular disease. It was also observed that as the number of metabolic risk factors increases, the levels of hsCRP increases, and serum GSH decreases. This indicates that more risk factors are associated with higher oxidative stress.

Análisis de la heterogeneidad en revisiones sistemáticas de cardiología publicadas entre 2000-2005 y 2011-2016 / Analysis of heterogeneity in cardiology systematic reviews published be-tween 2000-2005 and 2011-2016 / Análise da heterogeneidade em revisões sistemáticas de cardiologia publicadas entre 2000-2005 e 2011-2016

Introducción: la cardiología es una de las especialidades médicas que cuenta con más revisiones sistemáticas y metanálisis. Estudiar la metodología de las revisiones y anali­zar su heterogeneidad estadística es fundamental para garantizar su validez científica. Objetivo: describir la comparación de medidas de asociación, modelos estadísticos y grado de heterogeneidad en metanálisis de revisiones sistemáticas de intervenciones farmacológicas en cardiología, publicadas entre 2000-2005 y 2011-2016. Metodología: estudio analítico basado en la descripción y comparación de métodos estadísticos de revisiones sistemáticas de intervenciones farmacológicas en cardiología, publicadas en la biblioteca Cochrane. Para las variables cualitativas se estimaron frecuen­cias absolutas y relativas, mientras que para las cuantitativas se determinaron medias y desviaciones estándar, o medianas y rangos intercuartílicos, según su distribución. Para establecer la diferencia de medias se realizó la prueba t de Student y para la diferencia de proporciones el Chi cuadrado. Resultados: se incluyeron 54 revisiones sistemáticas, con un total de 1053 metanálisis, 6 revisiones con 240 metanálisis entre 2000-2005 y 48 revisiones con 813 metanálisis entre 2011-2016. La mayoría de metanálisis utilizaron el tratamiento estándar como grupo de comparación (56.6%), midieron desenlaces cualitativos nominales (86.3%), determinaron riesgos relativos (63.3%) y aplicaron modelos de efectos fijos (57.8%). En 2011-2016 se encontró una media del Índice de Higgins 17.5 menor que en 2000-2005 (p<0.05). Conclusión: se evidenció una disminución de la heterogeneidad estadística y un aumento en la implementación de modelos de efectos aleatorios, lo que da cuenta de una mayor rigurosidad a la hora de demostrar resultados verdaderamente significativos.

Introduction: cardiology is one of the medical specialties with the most systematic reviews and meta-analyses. Studying the methodology of the reviews and analyzing their statistical heterogeneity is essential to guarantee their scientific validity. Objective: to describe the comparison of association measures, statistical models and degree of heterogeneity in meta-analyses of systematic reviews of pharmacological interventions in cardiology, published between 2000-2005 and 2011-2016. Methodology: analytical study based on the description and comparison of statistical methods of systematic reviews of pharmacological interventions in cardiology, published in the Cochrane library. For the qualitative variables, absolute and relative frequencies were estimated, while for the quantitative ones, means and standard deviations, or medians and interquartile ranges, were determined, depending on their distribution. The Student's t test was used to establish the difference in means and the Chi square for the difference in proportions. Results: 54 systematic reviews were included, with a total of 1.053 meta-analyses, 6 reviews with 240 meta-analyses between 2000-2005, and 48 reviews with 813 meta-analyses between 2011-2016. Most meta-analyses used standard treatment as the comparison group (56.6%), measured nominal qualitative outcomes (86.3%), determined relative risks (63.3%), and applied fixed-effect models (57.8%). In the 2011-2016 period, an average of the Higgins Index was found to be 17.5 lower than in the 2000-2005 (p<0.05). Conclusion: there was evidence of a decrease in statistical heterogeneity and an increase in the implementation of random effects models, which accounts for greater rigor when it comes to demonstrating truly significant results.

Introdução: a cardiologia é uma das especialidades médicas com mais revisões sistemáticas e metanálises. Estudar a metodologia das revisões e analisar sua heterogeneidade estatística é essencial para garantir sua validade científica. Objetivo: descrever a comparação de medidas de associação, modelos estatísticos e grau de heterogeneidade em metanálises de revisões sistemáticas de intervenções farmacológicas em cardiologia, publicadas entre 2000-2005 e 2011-2016. Metodologia: estudo analítico baseado na descrição e comparação de métodos estatísticos de revisões sistemáticas de intervenções farmacológicas em cardiologia, publicadas na biblioteca Cochrane. Para as variáveis qualitativas foram estimadas frequências absolutas e relativas, enquanto para as quantitativas foram determinadas médias e desvios padrão, ou medianas e intervalos interquartis, dependendo de sua distribuição. O teste t de Student foi utilizado para estabelecer a diferença de médias e o qui-quadrado para a diferença de proporções. Resultados: foram incluídas 54 revisões sistemáticas, com um total de 1053 meta-análises, 6 revisões com 240 meta-análises entre 2000-2005 e 48 revisões com 813 meta-análises entre 2011-2016. A maioria das metanálises usou tratamento padrão como grupo de comparação (56.6%), mediu resultados qualitativos nominais (86.3%), determinou riscos relativos (63.3%) e aplicou modelos de efeito fixo (57.8%). Em 2011-2016, a média do Índice de Higgins foi 17.5 menor do que em 2000-2005 (p<0.05). Conclusão: evidenciou-se uma diminuição da heterogeneidade estatística e um aumento da implementação de modelos de efeitos aleatórios, o que confere maior rigor na demonstração de resultados verdadeiramente significativos.

The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant / 医学前沿

In this study, we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation (TR), taking into account its dynamic nature, after biatrial orthotopic heart transplant (OHT). All consecutive adult patients undergoing biatrial OHT (1984-2017) with an available follow-up echocardiogram were included. Mixed-models were used to model the evolution of TR. The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality. In total, 572 patients were included (median age: 50 years, males: 74.9%). Approximately 32% of patients had moderate-to-severe TR immediately after surgery. However, this declined to 11% on 5 years and 9% on 10 years after surgery, adjusted for survival bias. Pre-implant mechanical support was associated with less TR during follow-up, whereas concurrent LV dysfunction was significantly associated with more TR during follow-up. Survival at 1, 5, 10, 20 years was 97% ± 1%, 88% ± 1%, 66% ± 2% and 23% ± 2%, respectively. The presence of moderate-to-severe TR during follow-up was associated with higher mortality (HR: 1.07, 95% CI (1.02-1.12), p = 0.006). The course of TR was positively correlated with the course of creatinine (R = 0.45). TR during follow-up is significantly associated with higher mortality and worse renal function. Nevertheless, probability of TR is the highest immediately after OHT and decreases thereafter. Therefore, it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.

Plant stem cell extract from Coffea canephora shows antioxidant, anti-inflammatory, and skin regenerative properties mediated by suppression of nuclear factor-κB

Plant cell cultures have become a promising production platform of bioactive compounds for biomedical and cosmetic uses in the last decades. However, the success so far has been limited. The study aimed to evaluate the effectiveness of this unique biotechnology process to obtain a bioactive stem cell extract of Coffea canephora (SCECC) with antioxidant, anti-inflammatory, and regenerative properties. Total phenolic and flavonoid contents were determined in the SCECC by spectrophotometry. The chemical composition of the extracts was characterized by mass spectrometry. Antioxidant activity was evaluated using the colorimetric methods of free radical scavenging 2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and the ferric reducing ability of plasma (FRAP). The anti-inflammatory activity was determined in lipopolysaccharide-stimulated RAW 264.7 macrophages through the production of superoxide anion (O2•-), nitric oxide (NO), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and the activity of nuclear factor kappa B (NF-κB). Moreover, the ability of SCECC to stimulate the proliferation and migration of fibroblasts was assessed. Five compounds were tentatively identified, two flavonoids, two phenolic acids, and one sugar. High phenolic content and antioxidant activity were observed in the SCECC. SCECC promoted the proliferation and migration of fibroblasts and suppressed the pro-inflammatory mediators O2•-, NO, TNF-α, and IL-6 in a dose-dependent manner. Moreover, SCECC inhibited the NF-κB transcription factor. Therefore, we obtained evidence that the extract from C. canephora stem cells can be used as a natural agent against skin damage. Hence, it could be of interest in cosmetics for preventing skin aging.

Compliance and perception towards COVID-19 preventive protocols among hospital staff in a tertiary health facility, Southwest Nigeria

Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (JuneOctober, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance. Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops. However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829). Conclusion: Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility. The government or hospital authority make sure that necessary steps to further boost compliance are taken

Do static and dynamic pupillary parameters differ according to childhood, adulthood, and old age? A quantitative study in healthy volunteers

Purpose: We aimed to evaluate the normative pupillometry values and mean pupil dilatation speed in healthy individuals in different age groups in our study. Methods: The study group included 180 eyes of 90 healthy volunteers in different age groups. Group 1 consisted of 30 participants between the ages of 6 and 18, group 2 consisted of 30 participants aged 19–40, and group 3 consisted of 30 participants aged 41–75. Scotopic, mesopic, photopic, and dynamic measurements were taken with automatic pupillometry of Sirius Topographer (CSO, Firenze, Italy). The mean pupil dilation speed at the 18th second was calculated according to dynamic measurements. Results: Group 1 had a significantly larger pupil diameter than groups 2 and 3 in all static and dynamic parameters, and the mean pupil dilation speed was the highest among the groups (P < 0.001 for all static and dynamic parameters). In addition, group 2 had a significantly larger pupil diameter than group 3 (P < 0.001 for all static and dynamic parameters) and the mean pupil dilation speed was faster than group 3 (P = 0.027). Conclusion: We have presented the static and dynamic parameters and the mean speed of pupil dilatation at the 18th second with automatic pupillometry in healthy individuals in childhood, adulthood, and old age. More studies with higher participants and younger age children are needed.

A questionnaire-based study on knowledge and awareness about clinical trials among medical students

Background: Clinical trials (CTs) play a significant role in timely enhancement of health-care quality. It aids us to find an effective and safe treatment. Clinical research is rapidly developing in India and more graduates from medical, paramedical, and other scientific fields are enrolling for clinical research training. Aims and Objectives: The aims of this study were to know the knowledge and awareness of CT among undergraduate medical students. Materials and Methods: This was a cross-sectional and questionnaire-based study conducted among medical students at a tertiary care hospital in South India from January to February 2022. These questions were designed for assessing knowledge and awareness about CT. After validation, students were administered the questionnaire through the Google form. The data were recorded and analyzed using Microsoft Excel (2019 version) and the results are explained in frequency and percentage. Results: A total of 296 students were sent Google form-based questionnaire, out of which 278 responded with completely filled up questionnaire, giving a response rate of 94%. About 82% reported correctly that healthy normal human volunteers participate in phase 1 of CT. Majority of the students (95%) were aware what is informed consent. Only 98 (35%) students were aware that the request for authorization to conduct CT is given in form 44 as per drugs and cosmetics act. Around 43.16% responded correctly about the time period taken for completion of CT, majority of the students (90%) knew who is responsible for conduction of CT. One hundred and seventy (61.15%) reported correctly that adverse drug effects and new indication or use of the drug is studied in phase 4 and majority were aware that phase 4 is also known as post marketing surveillance. In the study, 204 (73.4%) students were aware that innovatory company of a new drug has to take approval from Institutional Review Board or Institutional Ethics Committee before phase 0 of clinical trial. Majority 240 (86.33%) of the students were aware what is pharmacovigilance. The last question in our study was to assess student’s interest in taking up clinical research in future, only 41% of students showed interest in choosing clinical research as a career option. Conclusion: In the present study, undergraduate medical students’ knowledge regarding clinical trial was average and limited number of students expressed their interest in conduct of CT. A scientifically conducted research helps in evidence-based medicine, which, in turn, improves the patient care and promotes health. A great number of medical students may pursue research in future; hence, it is crucial for medical students to be knowledgeable about clinical research. Therefore, formal, educative, and regular training of medical students is required for choosing clinical research as a career option and conduct high-quality research.

Cytogenetic study in sand spiders (Sicariidae) from the brazilian Caatinga: sex chromosome system diversity in closely related species / Estudio citogenético en arañas de arena (Sicariidae) de la Caatinga brasileña: diversidad del sistema de cromosomas sexuales en especies estrechamente relacionadas

ABSTRACT In this study, we investigated the chromosomes of three species of Sicarius spiders from the Brazilian Caatinga, using classical and molecular cytogenetic techniques. Based on the phylogenetic approach, we also discussed about the variation of diploid number, types of sex chromosome system and changes in the localization of ribosomal genes of Scytodoidea. Sicarius are Synspermiata spiders that together with the genera Loxosceles and Hexophthalma constitute the family Sicariidae. In this group, the available cytogenetic data showed a low diploid number range (2n♂=18 to 2n♂=23) and the presence of only multiple sex chromosome systems (X1X2Y and X1X20). Mitotic metaphase cells exhibited 2n♂=16+X1X2Y for Sicarius cariri and S. ornatus, and 2n♂=18+XY for S. tropicus. In these species, silver impregnation revealed nucleolar organizer region (Ag-NOR) on the terminal region of pair 1. In S. ornatus and S. tropicus, the results obtained with fluorescent in situ hybridization (FISH) using 18S rDNA probe were similar to Ag-NOR, however in S. cariri, the ribosomal sites were localized in the terminal region of the X1 sex chromosome. In this work, we presented the first description of a simple sex chromosome system for Sicariidae, helping to understand how the XY sex chromosome system evolved from the X1X2Y system. Additionally, FISH data incongruous with Ag-NOR indicate that the cytogenetic studies in Sicariidae allow investigating the relation between the karyotype evolution and the distribution and the activity of rDNA genes.

RESUMEN En este estudio, investigamos los cromosomas de tres especies de arañas Sicarius de la Caatinga brasileña, utilizando técnicas de citogenética clásica y molecular. Usando un enfoque filogenético, también discutimos la variación del número diploide, los tipos de sistema cromosómico sexual y los cambios en la localización de los genes ribosómicos en Scytodoidea. Los Sicarius son arañas Synspermiata que, junto con los géneros Loxosceles y Hexophthalma, constituyen a la familia Sicariidae. En este grupo, los datos citogenéticos disponibles mostraron un rango de número diploide bajo (2n♂=18 a 2n♂=23) y únicamente la presencia de sistemas de cromosomas sexuales múltiples (X1X2Y y X1X20). Las células mitóticas en metafase mostraron 2n♂=16+X1X2Y para Sicarius cariri y S. ornatus, y 2n♂=18+XY para S. tropicus. En estas especies, la impregnación de plata reveló la región organizadora nucleolar (Ag-NOR) en la región terminal del par 1. En S. ornatus y S. tropicus, los resultados obtenidos con la hibridación in situ fluorescente (FISH) utilizando la sonda de ADNr 18S fueron similares a los de Ag-NOR, sin embargo, en S. cariri los sitios ribosomales se localizaron en la región terminal del cromosoma sexual X1. En este trabajo, presentamos la primera descripción de un sistema cromosómico sexual simple para Sicariidae, ayudando a entender cómo el sistema cromosómico sexual XY evolucionó a partir del sistema X1X2Y. Además, los datos de FISH incongruentes con Ag-NOR indican que los estudios citogenéticos en Sicariidae permiten investigar la relación entre la evolución del cariotipo y la distribución y la actividad de los genes de ADNr.

The relationship between erythema nodosum and prognosis in systemic sarcoidosis: a retrospective cohort study

Abstract Background: Erythema Nodosum (EN) is the most common skin manifestation in sarcoidosis and has often been associated with a good prognosis. Objectives: To compare the clinical characteristics and treatment-related features in patients with sarcoidosis according to whether or not EN was seen as a presenting symptom at the time of diagnosis. Methods: A 20-year single-center retrospective study was performed. The following two groups were identified: one group with EN as one of the presenting symptoms at the time of diagnosis of sarcoidosis (EN group) and a second group without EN as a presenting symptom at diagnosis (non-EN group). The clinical characteristics and treatment modalities were collected from the medical records. Results: A total of 122 patients (31 in the EN group, 91 in the non-EN group) were included. Radiological stages of pulmonary disease were significantly lower in the EN group. Articular involvement was more common in the EN group (p = 0.001), whereas other systemic organ involvements (p = 0.025), especially neurological involvement (p = 0.036), were significantly more common in the non-EN group. In the EN group, a higher percentage of patients were managed without systemic therapy (71.0% vs. 54.9%) and spontaneous remission was more frequent (25.0% vs. 14.1%), however, this wasn't statistically significant. Study limitations: Retrospective design. Conclusions: The lower radiological stage of pulmonary sarcoidosis and lower frequency of systemic organ involvement in patients with EN augment the prognostic value of EN highlighted in the literature. However, this study couldn't confirm that the patients with EN would need less systemic therapy in the course of their disease.

Serum homocysteine level as a predictive marker in patients of coronary artery disease � A study of 150 cases

Background: Coronary Artery Disease (CAD) has a high prevalence in Asian Indians. The Acute Myocardial Infarction (AMI) or Ischemic Heart Disease is rapidly increasing in India and in the developing countries. India is on an epidemiological threshold of experiencing significant increase in cardiovascular diseases. This predilection to Coronary Heart Disease is attributable to a clustering of various risk factors. The factors implicated include: The lifestyle modifiable risk factors such as smoking, obesity, physical inactivity and those modifiable by lifestyle as well as pharmacotherapy such as lipid disorder, hypertension, and insulin resistance. The non-modifiable risk factors include age, sex and genetics. These are reasonably well established. The high rate of coronary heart disease however cannot be explained by the presence of these conventional risk factors alone. Of all the ethnic groups, people of Indian origin have one of the highest incidences of CAD. Aim and Objective: To study and establish correlation of Hyperhomocysteinemia with various coronary risk factors such as Age, Sex, socioeconomic status, and other lifestyle factors such as occupation, smoking, alcohol, tea/coffee, Dyslipidemia, hypertension, obesity and diabetes. Materials and Methods: The study was conducted in the department of Pathology at M.P. Shah Government medical college and Guru Gobind Singh hospital, Jamnagar- Gujarat; it was undertaken over a period of two years from August-2018 to August-2020. A total of 150 patients receiving In-patient care in the hospital were selected to enter the study. This was a cross-sectional study. Detailed clinical history and other important parameters as well as findings of all the concerned patients were collected. Estimation of serum homocysteine level done of all 150 patients. Results: This study was conducted in 150 patients admitted at a tertiary care center in Saurashtra region, for a duration of two years from August 2018-August 2020. The study was a cross-sectional study and included 150 patients who were diagnosed cases of coronary artery disease or Ischemic Heart Disease or previous history of Cardiac arrest. This study showed a male preponderance of coronary artery disease. Hyperhomocysteinemia is found to be an important risk factor in patients with younger age presenting with CAD. Conclusion: In this study, we showed that elevated level of homocysteine is significantly associated with CAD risk independent of other risk factors. Positive correlation was established between hyperhomocysteinemia and major traditional risk factors of Coronary artery disease mainly - Dyslipidemia, diabetes, hypertension and obesity and were proved statistically significant.

Knowledge, attitude, and practice on adverse drug reaction monitoring among health-care professionals in a tertiary care hospital

Background: Pharmacovigilance has constantly gained importance in the past 15 years, relating to absolute amount of adverse drug reactions (ADRs) and to the fact that several hospital admissions are due to ADRs. Knowledge of ADRs and practice of pharmacovigilance by healthcare professionals will definitely help to evaluate the quality of pharmacotherapy in hospitals and effectively decrease the occurrence of ADRs. Aims and Objectives: The objectives are as follows: (1) To assess the knowledge, attitude, and practice of health care professionals (HCPs) toward ADR monitoring and (2) to assess the causation of underreporting of ADRs. Materials and Methods: This study was a cross-sectional questionnaire-based study. The questionnaire was distributed to 328 HCPs which included al doctors, nurses and pharmacists serving in ESIC Medical College and Hospital, Kalaburagi. HCPs who did not give consent to fill the questionnaire were excluded from the study. Results: The response rate was 82.92%. In our study, only 25.75% were aware that ADR reporting is to be done by doctors, nurses and pharmacists, and 40.44% felt that ADR reporting should primarily done by doctors alone. Overall participants who knowledge about ADRs and pharmacovigilance were 48.8%. Although 75.7% participants agreed that ADR reporting is important, over 76.5% HCPs felt that reporting ADR would be an obligation. In this study 12.5% HCPs have ever reported ADR despite having experienced one during their clinical practice. Majority of the HCPs had a belief that a single ADR reporting would not change the ADR database; hence, this could be one of the reasons for low rate of reporting ADRs. Conclusion: In our study, though the level of knowledge and attitude toward ADR reporting was adequate among the HCPs, there was poor practice of ADR reporting. Necessary measures to be taken to create awareness among HCPs about Pharmacovigilance Programme in India. They should be trained to spontaneously report ADRs.

Antiemetic Efficacy of Prophylactic Ondansetron Versus Ondansetron with Dexamethasone Combination Therapies in Women Undergoing Breast Surgeries: A Randomized Controlled Trial

Objective: To compare the prophylactic antiemetic efficacy of ondansetron monotherapy with that of the combination of ondansetron and dexamethasone in the prevention on postoperative nausea and vomiting (PONV) in breast surgeries by observing the incidence of PONV, assess the percentage of participants requiring rescue antiemetics, know the side effects of drugs, and analyze the effect of the surgical duration of breast surgeries. Methods: The group ondansetron (O) received 0.1 mg/kg IV ondansetron and the other group (ondansetron and dexamethasone combination, OD) received 0.1 mg/kg IV ondansetron and 0.1 mg/kg of dexamethasone. The incidence of PONV in the first 24 h, percentage of population receiving rescue antiemetics, surgical duration, and hemodynamic parameters were noted. Results: In the 0 h to 6 h postoperative period, 38.9% of participants of group O had PONV, whereas only 13.9% in group OD had PONV, which was statistically significant (P < .016). About 30.6% of study population in group O and 8.3% in group OD required rescue antiemetics which was statistically significant (P = .017). Surgical duration of more than 120 min had a statistically significant higher incidence of PONV in the O group with a P-value of .048. Conclusion: The combination of prophylactic ondansetron with dexamethasone is more efficacious than ondansetron alone for the prevention of PONV in women undergoing breast surgeries.

Repeated use of fibrin sealants kept at room temperature in conjunctival autografting: An animal study

Purpose: In this study, our aim was to investigate if fibrin adhesives used in conjunctival wound surgery with autologous conjunctival grafts could be used repeatedly at different times after surgical opening. Methods: 40 New Zealand rabbits were used in the study. These animals were divided into four groups, each consisting of 10 rabbits, and hence 20 eyes. In the first group (control group), Tisseel fibrin sealant was used on the day the eye was first opened surgically; in the second group, it was used on the seventh day; on the third group, it was used on the 14th day; and in the fourth group, it was used 28 days after surgical opening. The graft from the inferior bulbar conjunctiva was attached using Tisseel fibrin glue to the superior scleral bed at the location where the superior bulbar conjunctiva was excised in the same eye. Results: No microbial growth was detected in the cultures of the samples tested. There were two partial graft loss in group 2 and there was one partial graft loss in each group of the other groups, and further total graft loss was present in one rabbit in group 3. None of the rabbits had any complications like granuloma, Corneal dellen or infection. Conclusion: Based on these results, fibrin sealants can be used repeatedly by storing them at room temperature. Repeated use of fibrin adhesives will reduce the cost of ophthalmologic surgeries and non?ophthalmologic surgeries

Is Maternal Anemia among Tribal Women being Neglected? A Study from Southern Rajasthan

Poor birth outcomes have been linked to maternal anemia. Tribal women are at higher risk of malnutrition and disease due to sociocultural barriers and poor educational status. The data on the prevalence of maternal anemia and its associated factors among pregnant tribal women are limited. A community‑based cross‑sectional study was conducted among 429 pregnant tribal women for maternal anemia from August 2021 to June 2022. A structured questionnaire was employed to collect sociodemographic data. The prevalence of anemia was 85.7%, with a mean hemoglobin level of 9.21 ± 1.3 g/dL. On applying WHO 2011 anemia criteria for pregnant women, 25.0% had mild anemia, 73.4% had moderate anemia, and 1.6% had severe anemia. The significant factors associated with anemic condition were household condition, monthly income, and husband’s occupation. The higher prevalence of anemia among pregnant tribal women is alarming that necessitates a rethinking of health infrastructure and outreach in tribal dominant areas.

Decoding placental pathology: Usage of a comprehensive checklist and scoring system for reporting of placentas in the hypertensive disorders of pregnancy

Introduction/Context: Hypertensive disorders of pregnancy (HDP) are major complications of pregnancy and seen in about 5% to 10% of all pregnancies. Among these, pre-eclampsia is a leading cause of perinatal and fetal morbidity and mortality. It is a multifactorial and multisystemic disorder that results in a variety of histomorphologic features, some of which may be missed if a diligent examination is not performed. Aims and Objectives: The present study aimed to propose a checklist and novel scoring system to ensure comprehensive placental examination. We also aimed to evaluate the correlation, if any, between histopathological and morphometric findings in HDP and with fetal growth. Materials and Methods: A total of 100 placentas of women diagnosed with hypertensive disorders of pregnancy were included in our cross-sectional, observational study. Morphometric features and histological features that are known to be seen in HDP were analyzed, and each of them was given a numerical score based on their severity. Statistical Analysis Used: Pearson correlation coefficient test was applied to correlate these findings, and ANOVA test was used to assess the correlation of these findings with fetal growth restriction (FGR). Results: More than 50% of the placentas studied recorded maximum scores for weight and volume. At least 25% of the placentas showed the presence of all histo-pathological features under study. The association of total morphometric and histological scores was not found to be statistically significant (P-value = 0.239). We found a significant difference between means of morphometric scores of cases with normal fetal growth and cases showing FGR (P-value = 0.008). Conclusion: Uneven distribution and presentation of the lesions in these cases may lead to the absence of correlation between morphometry and histopathology, as seen in our study. Morphometric derangements in the placenta correlate with FGR. Our proposed checklist and scoring system can be utilized to standardize reporting of placental specimens in the evaluation of placentas with HDP, in order to facilitate and standardize the placental reporting.

Asynchronous e-learning in microbiology for undergraduate medical students

Background: The most common teaching method in medical institutes in India and throughout the globe is standard lesson-based teaching. E-learning is the use of internet technology to facilitate conscious learning and increase knowledge and competences, notably during the COVID-19 epidemic. Aim and Objectives: The aim of study was to develop a module for an interactive disease-based e-learning teaching session to impart knowledge to undergraduate medical students regarding the microbiological diagnostic techniques for enteric fever/the given organism with objectives of the study was (i) to investigate how Phase II MBBS students feel about e-learning; (ii) to evaluate the impact of this intervention on students; and (iii) to encourage application of this imparted knowledge and skill for rapid, precise, and early diagnosis of the disease. Material and Methods: The research was conducted at the department of microbiology. This was done for the session 2020–2021 of Phase II undergraduate students. All the second professional MBBS were enrolled in the study n = 229 and were better informed about the definition of e-learning. The course material was provided in the form of PowerPoint presentations, questionnaires, and text questions using Google Docs. Students provided feedback in the form of a semi-structured pre-validated set of questions at the conclusion of the week, and the collected data were quantitatively analyzed. There were both closed-ended and open-ended questions in the survey. Results: The results of the feedback questionnaire revealed that the program was of benefit to the students. Nearly 77% of students felt the new teaching and learning method enhanced their grasp of the courses and that the issues presented were important to them. Conclusion: The students responded in a positive way to the new teaching and learning method. It was informative, applicable, and effective to the students. It also increased the level of communication and feedback between teacher and students. To conclude, in the medical program, e-resources may be used to enhance conventional lesson-based instruction.