A Cross-Sectional Study to Assess the Knowledge Regarding Rights and Responsibilities of Nurses at a Selected Tertiary Care Hospital

.Health care system could not function efficiently, if nurses were not present to perform their part. Nurses do their work responsibly and passionately to serve the mankind and the needy ones. Sense of responsibility makes a person more accountable to their duty, while the knowledge of the rights gives personal security and confidence. It is essential for the nurses to be well aware of their rights and responsibilities to provide comprehensive care to the patients. A cross-sectional survey was carried out at AIIMS, New Delhi, to assess nurses'#39; knowledge regarding rights and responsibilities. Convenient sampling was used to select 210 samples from ICU, ward, OPD, OT and emergency department. Structured knowledge questionnaire was used to collect the data. The study found that nurses had good knowledge regarding nurse'#39;s rights (mean score 27'plusmn;3.7). Similarly the nurses were well aware of their responsibilities with mean knowledge score of 15'plusmn;1.29. Knowledge regarding the rights of the nurses was significantly associated with age (p=0.034), educational qualification (p=0.018) and years of experience (p=0.003) whereas knowl- edge regarding the responsibility of the nurses was independent of socio-demographic variables; 65.7 percent of subjects had attended empowerment programmes. To conclude, nurses were well aware about their rights and responsibilities. Formal educational and empowerment programme are proved to be helpful in enhancing their knowledge. Therefore, the employers should plan an ongoing, appropriate empowerment programme for the nurses to keep them updated.

Impact of ferulic acid and resveratrol on the effectiveness and safety of sunscreen

Abstract The combination of avobenzone (AVO) and octyl ρ-methoxycinnamate (OMC) is widely used to ensure broad-spectrum photo-protection because they absorb UVA and UVB, respectively. However, they are thermally and photo unstable because they degrade and undergo photo- tautomerization and trans-cis isomerization, thus reducing their photo-protection efficacy during UV exposure. This study aimed to evaluate the potential use of the antioxidants ferulic acid and resveratrol as stabilizing substances in AVO and OMC mixtures in solution or emulsion. The effects of both antioxidants on the thermal/photo-stability and suppression of the filter singlet state, besides skin permeation, were evaluated. Both antioxidants contributed to preserving OMC and AVO during the thermal stability test, which relates to the maintenance of photo-protection even after storing the formulations at high temperatures. Nevertheless, although resveratrol retained part of the OMC trans isomer and suppressed the AVO singlet state when exposed to UV, no contribution to photo-protection stability was observed, contrary to expectations. Regarding the permeation assay, the addition of both antioxidants was accompanied by a reduction of AVO permeation, while resveratrol increased OMC permeation. Thus, the chemical and physicochemical properties of these antioxidants impacted their efficacy and safety profiles; therefore, further studies are required to establish the real cost-benefit ratio for their use in sunscreens.

The Effect Of Virtual Reality - Head-Mounted Display In Autism Spectrum Disorder -A Systematic Review

Background: Virtual reality has been a focus of evidence-based studies in educating autistic children for more than a couple of decades. It is suggested that the evolving technology creates a real-world that targets social and life skills training in a very safe, controllable, and repeatable scenario. The development of affordable head-mount displays leads a pivotal role in its wide range acceptability. The paper aims to discuss these concerns in detail. Design/methodology/ approach: Focused on the empirical studies that used VR among children with Autism, a systematic search of the electronic document was done. The literature review identified limited studies in this area characterized byFindings: types of application, individual differences of participants, and the technology implemented. Research limitations/implications: It is essential to have more studies in the educational settings with the use of technology to substantiate the recommendations that could be made on its implementation, results, and reliability.

Prevalence of Covid-Appropriate Behaviour (CAB) and its Related Factors among General Public Residing in Central Kerala

Background of the Problem The world is being challenged by Covid-19 outbreak that results in a universal concern and eco-nomic hardship. It is a leading public health emergency across the globe in general and in developing countries in particular. Strengthening good preventive behaviour is the best way to tackle this pandemic (Mehanna et al, 2020). In India, to a great extent, these Covid-appropriate behavioural changes are attributed to the combination of health promotional activities, motivational efforts, and enforcement/regulations by the Government of India (Shahnazi et al, 2020).

Immunohistochemical expression of cyclooxygenase-2 in oral lichen planus and normal oral mucosa

Background: Oral lichen planus (OLP) is a chronic inflammatory disease for which the pathogenesis is complex and not fully understood; autoimmunity has been suggested as a causative factor. World health organization (WHO) has classified OLP as a potentially malignant lesion. Cyclooxygenase-2 (COX-2) is an inducible key enzyme that generates prostanoids which play a critical role in inflammation, immunopathology; also considered as a malignant potential marker. Aims: The present study was conducted to analyze and compare epithelial COX-2 expression in OLP clinical subtypes and normal oral mucosa to evaluate its role in the pathophysiology of the disease process. Methods: This retrospective immunohistochemistry (IHC) study was performed on tissue sections of 30 OLP and 10 normal oral mucosae for COX-2 expression. Statistical Analysis Used: Descriptive and comparative statistical methods were done using 'one-way Analysis of Variance (ANOVA), 't' and Chi-square tests. Results: All the OLP showed epithelial COX-2 expression; strong expression was noted in 80% of the OLP while normal oral mucosa sections showed no expression. Cox-2 expression was significantly higher in erosive lichen planus compared to reticular lichen planus. Conclusions: Strong expression of COX-2 in OLP suggested its important role in pathogenesis. Although COX-2 has been connected to malignant development and autoimmunity, as the malignant development in OLP is quite rare, this study suggests that increased levels of COX-2 seen here may support an autoimmune cause of the disease process.

RP-HPLC simultaneous quantification of rutin, avobenzone, and octyl methoxycinnamate in the presence of hydroxypropyl β-cyclodextrin (HPβCD) and sulfobutyl ether β-cyclodextrin (SBEβCD)

Abstract Development and validation of a simple and fast method of high-performance liquid chromatography with diode array detection (HPLC-DAD) for the simultaneously analysis of rutin, avobenzone, and octyl p-methoxycinnamate is presented. These substances were separated using a Kromasil C18 (250×4.6 mm, 5 μm) column, methanol: water (88:12 v/v) as the mobile phase, and a flow rate of 0.8 mL min−1. The experiment was performed at room temperature and elution was under isocratic conditions. Quantification was performed by external calibration at the wavelength of 325 nm. The validated parameters included linearity, selectivity, precision (repeatability), intermediate precision, accuracy, limit of detection, limit of quantification and robustness. The results of validation were statistically treated using the Action Stat version 3.5.152.34. The selectivity was also evaluated in the presence of two cyclodextrins (2-hydroxypropyl-β-cyclodextrin and β-cyclodextrin sulfobutyl ether sodium). The absence of parallelism between the curves of octyl p-methoxycinnamate in the absence and presence of the β-cyclodextrin sulfobutyl ether sodium in the mobile phase revealed interference from this matrix, thereby indicating the necessity of validating the method in the presence of this, and other matrices. The proposed method was selective, linear, precise, accurate, and robust for the simultaneous determination of rutin, avobenzone, and octyl p-methoxycinnamate.

A rare presentation of Guillain-Barre syndrome with GQ1b positivity: A case report

Rationale: To report a case of cervicobrachial variant of acute inflammatory demyelinating polyneuropathy presenting with papilledema and GQ1b positivity. Patient concern: A 35-year-old female, 68 days postpartum, presented with headache, vomiting, and gait difficulty in swallowing with bilateral upper limb weakness and difficulty in walking, 13 days after ChAdOx1 nCoV-19 vaccination. Diagnosis: Guillain-Barre syndrome with GQ1b positivity. Intervention: Five cycles of plasmapheresis were given. Outcome: The patient's clinical condition improved. Palatal weakness improved and she could walk without support. There were mild sensory symptoms involving upper limbs which gradually improved. Lessons: AIDP should be considered in case of weakness following ChAdOx1 nCoV-19 vaccination. Albumino-cytological dissociation and anti-GQ1b positivity are needed to confirmed the diagnosis.

Role of probiotics and synbiotics on inhibiting Streptococcus mutans level in saliva of children A randomized controlled trial

Background: Probiotics and synbiotics through its direct and indirect interactions interferes with biofilm formation, competes with oral microorganisms thereby creating better oral health. Aim: This study aims to assess the effectiveness of Probiotics and Synbiotics on inhibiting Streptococcus mutans level in saliva of children after 15 days of daily intake of probiotic and synbiotic curd. Methodology: A double-blind randomized controlled trial was planned. Salivary samples at baseline were collected from forty children in the age group of 6–12 years who were divided into two groups of 20 each to receive probiotic and synbiotic curd respectively for 15 days. Salivary samples were collected after intervention and S. mutans levels were estimated. Statistical Analysis: The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 22. Intra- and inter-group comparison of mean S. mutans levels for both the groups were done using the paired and unpaired t-test respectively. The statistical significance was set at P ? 0.05. Results: A statistically significant reduction in salivary S. mutans counts was observed in both the groups after 15 days (P < 0.001). A significantly higher inhibition of S. mutans growth was present in the probiotic compared to synbiotic group (P < 0.001). Conclusion: Probiotics and Synbiotics were effective in inhibiting salivary S. mutans level of children. However, inhibition of S. mutans growth was found to be better in children who consumed Probiotic curd than the Synbiotic curd.

Infective larvae of Haemonchus contortus found from the base to the top of the grass sward / Larvas infectantes de Haemonchus contortus são encontradas da base até o topo da forragem

Abstract The resistance of gastrointestinal nematodes (GIN) of sheep to anthelmintic treatment has motivated researchers to seek alternatives to reduce the use of these drugs in sheep farming and decontaminate pastureland based on knowledge about the survival dynamics of larvae. The aim of this work was to evaluate the migration of the infective larvae (L3) of Haemonchus contortus at different times of the day, strata, and sward heights, with and without shade after the deposition of contaminated sheep feces. The grass species used here was Cynodon dactylon cv. Tifton 85 in four treatments: low sward height shade; low sward height sunshine; high sward height shade; and high sward height sunshine. The number of L3 recovered from the pasture at different times of the day did not differ. The highest number of L3 recovered was in shade. The number of L3 at different times and strata occurred uniformly, confirming that L3 remain in the same place after migrating from dung at the hottest times of the day. Infective larvae of H. contortus were able to migrate across all the strata regardless of the time of day in the summer season in humid subtropical climate.

Resumo A resistência dos nematódeos gastrintestinais (NGI) de ovinos aos tratamentos com anti-helmíntico tem estimulado os pesquisadores a buscar alternativas para reduzir o uso desses medicamentos na ovinocultura e descontaminar pastagens com base no conhecimento sobre a dinâmica de sobrevivência das larvas. O objetivo do trabalho foi avaliar a migração das larvas infectantes (L3) de Haemonchus contortus em diferentes horários do dia, estratos, e alturas do pasto, com e sem sombra, após a deposição de fezes de ovinos contaminadas. A espécie forrageira utilizada foi Cynodon dactylon cv. Tifton 85 em quatros tratamentos: pasto baixo sombra; pasto baixo sol; pasto alto sombra; e pasto alto sol. Não houve diferença na recuperação de L3 no pasto nos diferentes horários. As maiores recuperações foram encontradas na sombra. O número de larvas recuperadas nos diferentes horários e estratos ocorreu de forma uniforme, confirmando que as L3 podem permanecer no mesmo local, após migrar do bolo fecal, nos horários mais quentes do dia. Larvas infectantes de H. contortus foram capazes de migrar por todos os estratos, independentemente da hora do dia no verão em clima subtropical úmido.

Characterization and identification of ascorbyl methylsilanol pectinate for cosmetic formulations application

The ascorbyl methylsilanol pectinate (AMP) presents the same functional properties of ascorbic acid (AA). Besides antioxidant and depigmentant activity, the AMP presents silanol in its chemical structure. The aim of this work was to characterize and indentify the AMP alone and in cosmetic formulations. The following techniques were employed: Fourier Transform Infrared Spectrophotometry, particle size distributions, in vitro antioxidant activity with 2.2-diphenyl-1-picrylhydrazyl (DPPH) and Oxigen Radical Absorbance Capacity Assay and High Performace Liquid Chromatography (HPLC) (developed and validated method) for the active ingredient; Microscopy, HPLC and Normal Stability Assay (NSA) for the emulsions. Particle size distributions results showed that the average size of AMP was 1.0 µm and polydispersity index was 0.1. In DPPH assay AA and AMP were statistically the same. The value of ORAC obtained for AMP was 0.74 and for AA in the literature was 0.95. In the NSA the formulations were stable in conditions of 5.0 and 45.0 ± 2.0 ºC for 90 days. Adequate stability at ambient temperature out of reach of light was also observed. Thus, this works presented an acceptable method for quantification of AMP alone and in cosmetic formulations. AMP was an adequate choice for the incorporation in emulsions with antioxidant efficacy.

An Analytical Study on Communication Abilities and Schooling in Children with Cochlear Implantation

Background: As per the World Health Organization 2018, the new estimate of disabling of hearing loss is 466 million people.The State Initiative on Disabilities Survey (2015), Kerala, India, indicates that 2.32% of populations in Kerala, India, are affectedby some form of disabilities. Among them, 60,925 are hearing disabled based on the definition of hearing impairment in thePersons with Disabilities Act 1995. A cochlear implant (CI) is a surgically implanted electronic device that provides a sense ofsound to a person with severe to profound sensorineural hearing loss in both ears.Need for the Study: Even though the Sruthitharangam scheme was started by the Government of Kerala, India, in 2012, no studywas carried out to estimate the outcomes in terms of usage of CI, education placement, and mode of communication after CI surgery.Aims and Objectives: The aim of the study was to investigate the usage of CI, communication abilities, and schooling in CIchildren who have undergone surgery under Kerala Government free CI program. The current study was to report the usageof cochlear implantation, the education status, and mode of communication of the children who had undergone, free of cost CIsurgery from June 2012 to December 2015 in Kerala, India.Materials and Methods: The demographical data were collected from the register maintained at Government Medical College,Kozhikode, Kerala, India. The study was a cross-sectional study and the data were collected through the telephonic interview of 114parents or caregivers among 132 parents who had undergone free CI surgery from June 2012 to December 2015 at GovernmentMedical College Kozhikode. Eighteen parents or caregivers could not be contacted due to unavailability or change of contact numberand data collection was possible only for 114 parents among the 132 parents. All the children had attended a minimum of 2 years ofpost-implantation Auditory-Verbal Habilitation (AVH) from Sruthitharangam empanelled centers. Each subject was asked questionsto understand the current usage of the device, the mode of communication, type of schooling, and associated issues that affect theprognosis of CI is also considered. The obtained responses were scored accordingly and tabulated for further statistical analysis.Observations and Results: The result reveals that among the 114 CI recipients, 93.8% (107 recipients) were using CI and 6.14%(seven recipients) were non-users. These data found that all children were enrolled in school and attending in variety of educationalsettings. In that, 82.45% (94 children) were attending mainstream education and 17.54% (20 children) were going to specialschools. On further analysis of the communication, abilities showed that the majority of the children (75.43%) communicated orally,21.05% of them communicated through total communication and 3.5% of them used sign language.Conclusions: Kerala government Sruthitharangam CI program aid the majority of the children with severe to profoundsensorineural hearing loss in acquiring oral communication skills and also benefiting integration in normal schools. Steps shouldbe taken to reduce the number of non- users and also plan new strategies for better normal school integration for CI childrenunder the government scheme

Conventional TBNA with 19 G TBNA Needle in Diagnosis of Mediastinal Lymph Nodes – Diagnostic Yield and Safety with 19G TBNA Needle

Introdution: As the practice of TBNA becomes more widelyaccepted, it has also revived a longstanding question on theoptimum size of needle and whether larger needle with corebiopsy is of any additional benefit. In routine practice 19Gneedle is rarely used even in large nodes as it is perceivedto be technically difficult and likely to give a poor yield ofrepresentative tissue. We report our experience with yield andsafety using 19G needle for Conventional TBNA.Material and methods: Eighteen patients with largemediastinal nodes (short axis > 25 mm) underwent 19GConventional TBNA and station 4R and/or stations 7 werepunctured respectively.Results: Out of Eighteen patients, core biopsy material wasinadequate or unrepresentative in 14 / 18 cases and cytologymaterial was unrepresentative in 2 patients. A diagnosiswas reached in 16 of 18 patients by smear cytology and in14 cases by histology. Out of eighteen patients, 12 patientshad Granulomatous etiology, 2 had poorly differentiatedadenocarcinoma, 1 had Malignant Round Cell Tumor, and onepatient had reactive lymphadenitis.Conclusion: The 19G TBNA procedure is effective and safe,and can be a cost-saving alternative to surgical mediastinalexploration. It should be performed after careful case selectionduring initial diagnostic bronchoscopy and familiarizationwith the technique should not be neglected in trainingprogrammes and workshops.

Bronchoscopic Analysis in Sputum Smear Negative Pulmonary Tuberculosis Patients A Hospital based Study

Introduction: India has the highest burden of TB cases inthe world, majority of them are pulmonary tuberculosis.The method of choice for diagnosis of PTB is microscopicexamination of AFB by sputum smear. However, 30 to 50%of patients with pulmonary tuberculosis can have negativesputum report or may not produce sputum. Flexible fibreopticbronchoscopy can provide excellent material for diagnosis forpatients with suspected sputum smear negative pulmonarytuberculosis. Study aimed to evaluate the role of fiberoptic bronchoscopy in sputum smear negative pulmonorytuberculosis.Material and methods: Forty suspected cases of pulmonaryTB with clinical and radiological evidence of tb and sputumsmear negative on 2 occasions were selected for thisprospective nonrandomised observational study. Detailedexamination of the bronchial tree was done and specimensincluding bronchial aspirate and lavage was collected andsend for investigations. Post bronchoscopy sputum (PBS) wasalso collected and sent for smear microscopy.Results: In our study of 40 patients, tuberculosis wasconfirmed in 13 (32.50%) by smear examination of AFB inBroncho alveolar fluid and by post bronchoscopy sputumsmear examination in 3/40 (7.5%) cases. A definitive diagnosisof tuberculosis was possible in 23 (57.5%) of the 40 patientsby AFB culture by BACTEC MGIT960.Conclusion: Fibreoptic bronchoscopy with post bronchoscopysputum,BAL and BAL AFB culture is a useful tool fordiagnosis and can thereby prompt treatment of sputum smearnegative pulmonary tuberculosis patients.

The burden of caesarean section and its determinants from a tertiary care hospital, Thrissur, Kerala, India

Background: Caesarean section is a surgical procedure done when vaginal delivery is contraindicated. The prevalence of caesarean section in Kerala showing an increasing trend. Even though the caesarean section is an emergency lifesaving procedure, various other factors like socio-demographic determinants, economic factors and patient’s or clinician’s preferences also influence this increasing trend. The present study was undertaken to compare the various determinants of caesarean section with normal delivery from a tertiary care hospital in Thrissur district.Methods: A hospital-based case control study was done taking mothers who had undergone caesarean section as cases and mothers who had undergone normal delivery as controls during two-month period. The sample size was calculated using the formulae: (Zα + Zβ)2x2xPQ/d2, and the calculated sample size was 88. The various determinants used were socio-demographic, obstetrics and cultural determinants.Results: In this study, it was found that the most common indications for C-section were previous C-section, PPROM and foetal distress. There was a statistically significant association between obstetrics determinants like complications during pregnancy, number of USG taken, period of gestation with mode of delivery. The present study also shows that mothers with educational status up to graduate/PG have lesser incidence of caesarean section. There was a statistically significant association between delivery date close to holidays/festival days and C-section.Conclusions: It is necessary to have health awareness sessions to pregnant mothers about the complication of pregnancy, benefits of normal delivery and complications of C-sections in-order to reduce the patients’ preference for C-section.

A Comparative Study Of Pulmonary Function Tests Between Normal Male Sedentary And Tennis Players

Background: In the assessment of the respiratory system, pulmonary function tests (PFTs) have achieved a lot of importancenowadays due to an increase in the cardiorespiratory disease and to a steep rise in air pollution. These functional tests andtheir parameters tend to have a relationship with lifestyle such as regular exercise and non-exercise. Hence, the present studywas undertaken to assess the effects of exercise in tennis players on the respiratory system which are compared with normalhealthy sedentary individuals.Aim of the Study: The aim of this study was to determine and compare the differences between the pulmonary functions ofhealthy individuals playing regular tennis for 2 h daily and normal sedentary individuals.The Objective of the Study: The study included 39 tennis players playing regular tennis for 2 h and 37 normal sedentaryindividuals who are not interested in any sports or games actively.Materials and Methods: PFTs such as forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratoryflow (PEF), VC, and maximum voluntary ventilation (MVV) of the study group were included in the study. The results wereanalyzed with standard spirometer. The arithmetic means and standard deviations of data have been obtained in the statisticalevaluation. As a result of the findings obtained, independent sample t-test has been applied.Observations and Results: No significant difference has been found among the age, height, body weight, body mass index,FEV1, and PEF values of the groups at the end of the test (P > 0.05); however, a significant difference has been found amongMVV, FVC, and VC values.Conclusions: Final analysis of the study showed that no difference is present between the FEV1 and PEF values of tennisplayers who have long-term and regular exercises and sedentary individuals. However, there is a significant difference amongMVV, FVC, and VC values between the two groups. Therefore, it has been found that the pulmonary capacities (MVV, FVC,and VC) of individuals having regular exercises have higher values than that of sedentary individuals.

​Correlation Between Fundamental Speech Frequencies (F0) And Serum Testosterone Levels In Patients With Puberphonia Attending A Tertiary Care Hospital

Background: voice in humans is susceptible to the hormonal changes throughout life right from the puberty until old age. Thyroid,gonadal, and growth hormones have varied impact on the structure and function of the vocal apparatus. Voice changes are observedduring physiological states such as puberty and menstruation. Puberphonia is defined as an inappropriate use of high-pitched voicebeyond pubertal age in males which is usually seen in the immediate postpubescent period when the male vocal mechanism hasundergone significant changes in size and function caused by hormonal changes. Endocrine evaluations in puberphonia by astuteclinical observers who make out the changes in the voice are required to develop a system of diagnosis and assessment of prognosis.Aim of the study: The aim of the study was to analyze the relationship between serum testosterone levels and fundamentalfrequencies (F0) of patients with puberphonia.Materials and Methods: A total of 43 patients aged between 14 and 18 years with puberphonia were included in the study.They were subjected pubertal history taking and an ENT evaluation with a stroboscope to obtain visual assessment of the vocalcords. The mucosal wave, vibratory symmetry, and amplitude; type of glottic closure; hyperfunction; arytenoids movement andsymmetry; ventricular movement, etc., were evaluated using stroboscopy including patient’s fundamental frequency (F0) duringsustained phonation. The relationship between circulating levels of serum testosterone and the fundamental frequencies ofpuberphonia patients was analyzed. Serum testosterone was evaluated by quantitative high-performance liquid chromatographytandem mass spectrometry method in this study. Serum levels of testosterone more than 165 ng/dL in children aged 14–15 years;testosterone levels higher than 619 ng/dL in children aged 15–16 years; and higher than 733 ng/dL in children aged 16–17 yearswere taken as abnormal. All the data were analyzed using standard statistical methods.Observations and Results: Among the 43 patients, the incidence was equal in all age groups between 14 and 17 years. Therewas no statistical significance in relation to socioeconomic status, the presence of secondary sexual features, personality, andparent domination among the groups. However, residing in urban locality was statistically significant over residence in the rurallocality among the patients with puberphonia with P = 0.042 and 0.038, respectively. The overall F0 mean value for the studygroup was 196.56. The relationship between mean F0 values and mean serum Testosterone levels were analyzed using Chisquare test and observed that there was statistical significance between the values in all the age groups of the study (P < 0.05).Conclusions: There was a negative relationship between circulating levels of serum testosterone and fundamental frequency(F0). Higher testosterone levels are indicating lower fundamental frequency, although the magnitude of the relationship waslarger than previously observed studies in literature. It is thought that male voices may have deepened over the course ofevolution to signal dominance and/or to increase the speaker’s attractiveness. Findings confirm that vocal frequencies mayprovide an honest signal of the speaker’s hormonal quality.

Nanoemulsion containing caffeine for cellulite treatment: characterization and in vitro evaluation

The Ginoide Hydrolipodystrophy (GHLD), commonly known as cellulite, occurs in 80-90% of the female population after the puberty period and comes from a metabolic modification in the cutaneous adipose tissue. Caffeine has been used in topical formulations due to its lipolytic action. We studied a nanoemulsion (F3) containing caffeine with two surfactants (oleth-3 and oleth-20) by emulsification method by phase inversion temperature inversion (PIT). The polydispersion indices (PDI) showed the reduced deviation of 0.1. The mean droplet size was ~ 40 nm. The evaluated constant of Ostwald, in the refrigerator condition was the most favorable during the stability test. In the In Raman spectroscopy assay, the caffeine bands found in F3 were compatible with those found in the caffeine solution (1337, 652.5 and 558.2 cm-1). There was no interaction of caffeine anhydrous with other ingredients in nanoemulsion. In the in vitro safety assay the result of 1.4 ranked the F3 as slightly irritating. In the natural membrane, cutaneous permeation test (human skin) permeate concentrations did not exceed the saturation concentration of the PBS buffer (48.96 µg/3 mL). The caffeine solution and F3 permeated statistically equal, but the nanoemulsion visually and sensorially improved the caffeine precipitation.

Perfil dos pacientes submetidos à adenoidectomia e/ou amigdalectomia no Hospital do Servidor Público Municipal de São Paulo nos anos de 2015 a 2017 / Profile of patients undergoing adenoidectomy and/or tonsillectomy at the Hospital do Servidor Público Municipal de São Paulo from 2015 to 2017

RESUMO Introdução: A hipertrofia adenoamigdaliana é um dos distúrbios mais frequentes nos consultórios otorrinolaringológicos e a adenoamigdalectomia é a cirurgia mais realizada por estes profissionais. As indicações para adenoamigdalectomia são: obstrução das vias aéreas superiores, disfagia e alteração na fala, crescimento facial anormal e alterações dentárias. Objetivos: Traçar o perfil epidemiológico dos pacientes submetidos à adenoidectomia e/ou amigdalectomia no Serviço de Otorrinolaringologia do Hospital do Servidor Público Municipal de São Paulo. Métodos: Foi realizado um estudo descritivo e retrospectivo, com análise dos prontuários dos pacientes submetidos à cirurgia de janeiro de 2015 a março de 2017. Resultados: Foram analisados 68 pacientes, sendo 70% submetido à adenoamigdalectomia, 51,47% tinham idade entre 0 e 5 anos, não houve predominância entre os sexos e a principal indicação foi a respiração bucal. Conclusão: A avaliação do perfil desses pacientes segue parcialmente o que foi visto na literatura disponível. Palavras-chave: Tonsilectomia; adenoidectomia; epidemiologia; hipertrofia; terapêutica

A Questionnaire Based Observational Study On Polypharmacy In Elderly People Living In Urban And Rural Areas

Introduction: Polypharmacy is defined as taking more than five drugs per day, every day. Polypharmacy in elderly is becoming more common because of increased number of chronic diseases with which an elderly person suffers given the longer life expectancy in modern times. The major concern about polypharmacy in elderly is prescription cascade. Drug interaction and adverse drug reactions are misinterpreted and misdiagnosed as another health problem. This will lead to one more prescription. Quality of life of an elderly person is compromised with polypharmacy though it prolongs life expectancy. Method: Questionnaire based cross sectional study conducted on both urban and ruralpopulation. Institutional ethics committee permission has been taken. Oral consent has been taken from the subjects and only their information has been used in this study.Subjects aged more than 60 years have been considered for the study. Bed ridden patients, hospitalized patients and elderly people with acute illness were excluded from the study. Results: Data was collected from 134 subjects. Number of subjects: urban participants were 64 and rural participants were 70. Male and female were included. Prevalence of polypharmacy observed in this study was 40% in urban participants and 23% in rural participants. It was observed that, among elderly participants on polypharmacy 75% faced adverse drug reactions and 60% were subjected to prescription cascade. Among the elderly participants taking less than 5 drugs per day, 50% faced adverse drug reactions and 12% were subjected to prescription cascade. Discussion: Adverse drug reactions and prescription cascade are main complications of polypharmacy in elderly people. Prescription review, counseling, life style modification and carefully supervised deprescription are some of the available solutions to solve the complications due to polypharmacy