Extraction of geraniol from palmarosa oil using hydrotropic solvents / Extracción de geraniol del aceite de palmarosa utilizando solventes hidrotrópicos

The extraction of geraniol from palmarosa oil using hydrotropic solvents was investigated. Palmarosa oil possesses an appealing rose aroma and properties like anti - inflammatory, antifungal, and antioxidant due to the presence of geraniol. The extraction of geraniol from palmarosa oil by using distillation methods like steam dis tillation and fractional distillation was a laborious process. So hydrotropes were tried for extraction. The geraniol yield and purity depend on parameters like concentration of hydrotrope, solvent volume ratio, and time period. Using the Box Benkhem Desig n (BBD), the extraction process was optimized. One of the major advantages of using hydrotropic solvents is that they were classified as green solvents, and recovery of solvents is also possible. To reduce the extraction time probe sonication is carried ou t. Different hydrotropic solvents with probe sonication are done on palmarosa oil by altering various process parameters to study the separation, yield, and purity.

Se investigó la extracción de geraniol del aceite de palmarosa utilizando solventes hidrotrópicos. El aceite de palmarosa posee un atractivo aroma a rosa y propiedades antiinflamatorias, antifúngicas y antioxidantes debido a la pr esencia de geraniol. La extracción de geraniol del aceite de palmarosa mediante métodos de destilación como la destilación por vapor y la destilación fraccionada ha sido un proceso laborioso. Por lo tanto, se probaron los hidrotropos para la extracción. El rendimiento y la pureza del geraniol dependen de parámetros como la concentración del hidrotropo, la relación de volumen del solvente y el período de tiempo. Se optimizó el proceso de extracción usando el diseño Box Benkhem (BBD). Una de las principales v entajas de usar solventes hidrotrópicos es que se clasifican como solventes verdes y también es posible recuperar los solventes. Para reducir el tiempo de extracción, se lleva a cabo una sonda de ultrasonido. Se realizan diferentes solventes hidrotropos co n sonda de ultrasonido en el aceite de palmarosa alterando varios parámetros del proceso para estudiar la separación, el rendimiento y la pureza.

Knowledge, attitudes and practices of resident doctors and interns on safe blood transfusion practices: a survey-based study

ABSTRACT Introduction: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. Methods: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. Result: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. Conclusion: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.

SCN1A Gene Mutations in Indian Children With Epilepsy: Single Center Experience

Objective: To study prevalence of SCN1A gene mutations in complex seizure disorders. Methods: Retrospective laboratory based study on samples sent for molecular diagnosis in complex seizure disorders. Exome sequencing was performed. Phenotype- genotype correlation was done for patients showing variants in SCN1A gene. Results: 364 samples were evaluated; of which, 54% were of children below 5 years of age. SCN1A mutations were seen in 50 samples of patients with complex seizure disorders; 44 variants were identified. Types of seizure disorders commonly associated were Dravet syndrome and genetic epilepsy with febrile seizures. Conclusions: SCN1A mutations are common in complex seizure disorders, especially Dravet syndrome. Early identification of SCN1A gene in etiology is important for selection of correct antiepileptic and counselling.

ChatGPT for Veterinary Anatomy Education: An Overview of the Prospects and Drawbacks / ChatGPT para la Educación en Anatomía Veterinaria: Una Descripción General de las Perspectivas y los Inconvenientes

SUMMARY: The integration of artificial intelligence in veterinary medical education has the potential to revolutionize the way students learn veterinary anatomy. ChatGPT, launched by OpenAI in November 2022, has been the fastest-growing artificial intelligence (AI) application as a learning tool in the past few months. ChatGPT is a virtual assistant that provides students with detailed and relevant anatomical knowledge based on internet sources. Apart from the advantages of ChatGPT in veterinary anatomy education, the challenges and limitations must also be considered, as highlighted in this letter. Further research and evaluation are necessary to ensure the optimal integration of the ChatGPT tool into veterinary anatomy education. ChatGPT can provide students with valuable insights and educational support but cannot replace hands-on experiences; dissection-based laboratory sessions remain essential for developing practical skills and spatial understanding in veterinary anatomy education.

La integración de la inteligencia artificial en la educación médica veterinaria tiene el potencial de revolucionar la forma en que los estudiantes aprenden anatomía veterinaria. ChatGPT, lanzado por OpenAI en noviembre de 2022, ha sido la aplicación de inteligencia artificial (IA) de más rápido crecimiento como herramienta de aprendizaje en los últimos meses. ChatGPT es un asistente virtual que brinda a los estudiantes conocimientos anatómicos detallados y relevantes basados en fuentes de Internet. Además de las ventajas de ChatGPT en la educación en anatomía veterinaria, también se deben considerar los desafíos y las limitaciones, como se destaca en esta carta. Se necesitan más investigaciones y evaluaciones para garantizar la integración óptima de la herramienta ChatGPT en la educación en anatomía veterinaria. ChatGPT puede proporcionar a los estudiantes información valiosa y apoyo educativo, pero no puede reemplazar las experiencias prácticas. Las sesiones de laboratorio basadas en disecciones siguen siendo esenciales para desarrollar habilidades prácticas y comprensión espacial en la educación de la anatomía veterinaria.

Minimal Intubating Dose of Succinylcholine: A Comparative Study of 0.4, 0.5 and 0.6 mg/kg Dose

Muscle relaxants are integral part of modern balanced anesthesia and succinylcholine, a depolarizing drug, is in use despite its adverse effects. The excellent intubating condition, fastest onset and shortest duration of action make it an excellent choice for anesthesiologists. The conventional dose of 1.5-2 mg/kg is commonly used for obtaining relaxation for intubation. This study was conducted with much smaller dose of succinylcholine as 0.4, 0.5 and 0.6 mg/kg to evaluate the acceptable intubating dose at 60 seconds, which was unlikely to have any untoward/side effects.

DIGITAL SEARCH ADVERTISING – THE ROLE OF POST-CLICK FACTORS IN GENERATING PURCHASE CONVERSIONS

A lot of research is available on the effectiveness of search as an advertising channel. Most of these studies tend to treat a click on a search ad as a binary event. All of them study the events leading to the click. This paper goes beyond this to study the post click actions taken by a user subsequent to clicking on a search ad, and refers to those actions as depth of interaction, and testing the variables that have an effect on the nal outcome. We use a prescriptive research design employing binary logistic regression analysis. Results indicate that the duration of time spent, device used, and recency of visit have a very high positive effect on the nal outcome.

Abuse with impunity in sports: Some reflections

With the conviction of a US gymnastics coach on criminal sexual conduct and other charges, our attention is inevitably drawn to the sporting world in India. The case points to the imperative need for regulations, mandates and ethical codes to protect athletes, especially elite performers under pressure to win. As is now evident, authoritarian structures that do not allow athletes a voice are perfect locations for abuse. An examination of the state of ethical codes and regulations in sports in India is long due. This short essay looks at the issues that must find space in public discussion and in the deliberations of sporting bodies, with a particular emphasis on the role of the medical profession in sports.

Clinical characteristics, etiological profile, treatment and long term outcomes in patients with non ischemic systolic heart failure; Himachal Pradesh heart failure registry (HP–HF registry)

Background: The data on clinical characteristics, treatment practices and out comes in patients with Nonischemic Systolic Heart Failure (NISHF) is limited. We report clinical characteristics, treatment and outcomes in patients with NISHF. Methods: 1004 patients with NISHF were prospectively enrolled and their demographics, clinical characteristics, and treatment were recorded systematically. Patients were followed annually for a median of 3 years (1 year to 8 years) for allcause death, major adverse cardiovascular events (MACE); composite of all-cause death, hospitalization of heart failure, and or for stroke. Results: Patients of NISHF were middle-aged (58.8±16.2 years) population with severely depressed left ventricular ejection fraction (29.3±7.02%) and 31.1% had symptoms of advanced Heart failure. Hypertension (43.6%), obesity and or overweight (28.0%), Diabetes (15.0%), and valvular heart disease (11.8%) were the common risk factors. The guideline directed medical treatment was prescribed in more than 80% of the study cohort. Incidence of all cause death and MACE was 7 (6.8, 8.8) per 100 person years and 11(10, 13) per 100 person years respectively. The cumulative incidence of deaths and MACE was 35% (30%, 40%) and 49% (44%, 53%) at 8 years of follow-up. Conclusions: Patients of NISHF were middle-aged population with severely depressed LV systolic function with significant incident morbidity and mortality. Early detection of risk factors and their risk management and enhancing the use of guideline directed treatment may improve the outcomes. Keywords: Non-ischemic systolic heart failure, risk factors, outcomes, guideline directed treatment

Prevalence, awareness, treatment, control and correlates of prevalence and control of hypertension among older adults in Kerala: A mixed methods study

Introduction: We conducted this study among older adults with the following objectives: (1) To find out the prevalence, awareness, treatment and control of hypertension, (2) To understand the factors associated with hypertension prevalence and control. Methods: A mixed-methods study employing a sequential explanatory design was conducted with a survey of 300 participants aged _x0001_60 years, and 15 in-depth interviews. Blood Pressure (BP) and waist circumference were measured using standard protocol. Survey data were analysed using univariate and multivariate procedures. In-depth interviews were analysed employing thematic analysis. Results: Hypertension prevalence was 72.3% (95% CI ¼ 67.1e77.2), 68.2% (CI ¼ 61.8e74.2) were aware, 65.4% (CI ¼ 59.0e71.6) were treated and 24% (CI ¼ 18.6e29.9) achieved adequate control. Inadequate physical activity [(adjusted odds ratio (AOR)] ¼ 2.34; CI ¼ 1.19e4.59), current alcohol use (AOR ¼ 2.28; CI ¼ 1.06e4.91) and self-reported diabetes (AOR ¼ 2.02; CI ¼ 1.15e3.52) were associated with hypertension prevalence. Those who reported diabetes (AOR ¼ 2.72, CI ¼ 1.34e5.55), with education level up to high school (AOR ¼ 2.58, CI ¼ 1.11e6.00) and who were in the age group 60e70 years (AOR ¼ 2.14, CI ¼ 1.09e4.20) were more likely to have controlled hypertension compared to their counterparts. From the in-depth interviews it was found that availability and accessibility of services, family support, financial wellbeing, habits and beliefs and conducive environment played a role in hypertension diagnosis and management. Discussion: Prevalence of hypertension was high in this population along with poor control. Efforts are required to improve hypertension control focussing on older adults with low education and those who are aged 70 years and above

Application of the Milan System for Reporting Salivary Gland Cytology and Risk Stratification by Cytohistological Correlation

Introduction:Salivary gland neoplasms are uncommon tumors comprising <3%–10% of all head‑and‑neck neoplasms. Recent WHO classification of salivary gland tumor added many newer entities; however, no definite risk‑stratification system is specified to predict the likelihood of malignancy for each diagnostic category. The present study is designed to evaluate the salivary gland aspirates using the Milan System for Reporting Salivary Gland Cytology for reporting correlating with histological diagnosis which will lead to determine the malignancy risk for each diagnostic category. Risk of malignancy is calculated by the ratio of cytopathology cases with a malignant histopathology to the total number of cytopathology cases with follow‑up histopathology for that particular category. MaterialsandMethods: The present study was a cross‑sectional study done prospectively over a period of 2 years, and a total of 72 participants were selected. This study characterized the cytological features of spectrum of salivary gland lesions varying from benign to malignant. The lesions were evaluated and classified cytologically according to “the Milan System for Reporting Salivary Gland Cytopathology” for reporting salivary gland neoplasms. Histopathological correlation was done with cytological diagnosis wherever possible. Results: In our study of 72 patients with salivary gland lesions with the mean age of the patient being 50.6 years and maximum number of lesions involved the parotid gland followed by the submandibular gland and sublingual gland. Majority of the lesions in the present study were nonneoplastic in nature followed by lesions benign in nature. Malignant lesions were least common in occurrence. Among 72 cases, majority of the cases were seen in Milan category II (nonneoplastic) consisting of 34 cases (47.2%), followed by 31 cases (43.1%) in Milan category IV (benign). Final diagnostic categorization of 72 cases of salivary gland lesions was done according to the Milan system and the histopathological correlation was available in 23 of these cases. Out of the 34 cases in Milan system category II (nonneoplastic), histopathological evaluation was done in 2 cases. Both the cases were benign in nature, 31 cases in Milan system category IV (benign) histopathological evaluation was done in 16 cases where 15 cases were benign in nature and 1 lesion was malignant. Four cases were put in category VI of the Milan system, histopathological evaluation was done in all the 4 cases which were all malignant in nature. Conclusion: The current study validates fine‑needle aspiration cytology as a cost‑effective and noninvasive procedure for differentiating between benign and malignant lesions of the salivary gland, information of critical importance when determining the patient’s next course of treatment.

Endogenous fungal endophthalmitis following COVID-19 infection with microbiological and molecular biological correlation – A report of two cases

This case report describes three eyes of two patients, who were diagnosed to have endogenous fungal endophthalmitis post coronavirus disease 2019 (COVID-19) infection. Both patients underwent vitrectomy with intravitreal anti-fungal injection. Intra-ocular samples confirmed the fungal etiology by conventional microbiological investigations and polymerase chain reaction in both cases. The patients were treated with multiple intravitreal and oral anti-fungal agents; however, vision could not be salvaged.

Incidence, determinants, and outcomes of recovered left ventricular ejection fraction (LVEF) in patients with non-ischemic systolic heart failure; a hospital-based cohort study

Background: The data on incidence of recovered Left Ventricular Ejection Fraction (LVEF) and outcome in patients with non ischemic systolic heart failure is limited. We report the incidence, determinants and mortality in patients with recovered LVEF. Methods: The 369 patients with HFrEF with LVEF of less than 40% of non ischemic etiology with available follow up echocardiography study at one year were enrolled. The baseline data of clinical characteristics and treatment was recorded prospectively and were followed up annually for mean of 3.6 years (range 2 to 5 years) to record all cause death and LVEF measured echocardiographically. The recovered, partially recovered and no recovery of LVEF was defined based on increase in LVEF to 50% and more, 41% to 49% and to persistently depressed LVEF to 40% or lower respectively. Results: The LVEF recovered in 36.5%% of the cohort at 5 years. The rate of recovery of LVEF was slower in patients with no recovery of LVEF at one year compared to cohort with partially recovered LVEF (18% vs.53%) at five year. The Baseline LVEF was significantly associated with recovered LVEF, odd ratio (95% C.I.) 1.09(1.04, 1.14). The cumulative mortality at five years was significantly lower in cohort with recovered LVEF (18.1% vs. 57.1%). Conclusions: One third of the patients had recovered LVEF and was significantly associated with baseline LVEF and lower mortality rate.

Chondromyxoid Fibroma of Clavicle Presenting as Radiological Disappearance of Bone

Case?Presentation Chondromyxoid fibroma (CMF) is a relatively rare bone tumor of cartilaginous origin and it comprises less than 1% of all primary bony tumors. Clavicle is an unusual site of involvement for any bone tumor and may produce diagnostic dilemma. Approximately only 1% of all primary bone tumors may involve the clavicle. The literature on clinical features and outcome of CMF clavicle remains sparse. Conclusion?We present an unusual case of CMF clavicle in which the medial aspect of the clavicle gradually disappeared on radiographs. CMF should be included in the differential diagnoses of disappearing bone disease.

Imaging in Covid-19 associated mucormycosis: a case series

Introduction: Mucormycosis is a very rare saprophy?c, opportunis?c fungal infec?on with high morbidity and mortality. With the Covid-19 pandemic, there is a sudden increase in the incidence of this disease due to causes not clearly known. Methods: Retrospec?ve clinic-radiological analysis of a series of seven microbiologically confirmed cases of Covid19 associated mucormycosis (CAM) treated at our ter?ary care center in 2021 was done. Results: All pa?ents were middle-aged with a mean age of 47 years. All pa?ents had poor glycemic control. Three pa?ents were on oxygen support and were given steroids during Covid-19 treatment. Symptoms were facial pain, swelling, headache, eyelid swelling, and nasal block. All pa?ents underwent contrast MRI to study the extent of ?ssue involvement. MRI helped in complete surgical debridement with minimal deformity. Conclusion: Judicious use of immunosuppressants and strict glycemic control vital during covid-19 treatment. Contrast MRI is the inves?ga?on of choice to iden?fy the extent of involvement in surgical planning.

A study of prevalence and comparison of anxiety and depression among separated, divorced and widowed females in the rural population

Background: Psychological distress is an important immediate outcome of the death of a spouse or divorce, which may arise because of financial and emo?onal challenges and can lead to adverse health outcomes with more stress, anxiety, depression, and social isola?on than the general popula?on. Methods: Cross-sec?onal study among separated, divorced, and widowed females from two rural villages. All eligible par?cipants were screened for depression and anxiety using DSM 5 criteria. The severity of depression was assessed using the Hamilton depression ra?ng scale (HDRS) and for anxiety, the Hamilton anxiety scale (HAMA) was used. Results: Out of 162 women, 30% had mild depression whereas 42% of widow and divorced women had moderate levels of depression but it is in 50% of separated women. Severe and very severe level of depression was in around 20% of widowed and divorced women compared to 16% of separated women. There was no anxiety in around 80% of divorced and widowed women whereas 24.3% of separated women had severe anxiety. On regression analysis, separated women, dependent women, and those with less than two years of dura?on of separa?on had higher levels of depression and anxiety. Conclusion: The prevalence of Depression and Anxiety is more common in all three groups. Moderate to severe Depression is around 75% among divorced/separated and widowed females but moderate to severe anxiety was more in separated women compared to widowed women. Dependency and the early phase of widowhood/separa?on were also important associated factors.

Angiotensin Receptor-Neprilysin Inhibitor Therapy and Cardiac Remodeling in Heart Failure: Consensus Statement from India

Adverse cardiac remodeling refers to progressive structural and functional modifications in the heart because of increased wall stress in the myocardium, loss of viable myocardium, and neurohormonal stimulation. The guideline-directed medical therapy for Heart failure (HF) includes Angiotensin receptor-neprilysin inhibitor (ARNI) (sacubitril/valsartan), ?-blockers, sodium-glucose co-transporter 2 (SGLT2) inhibitors, and mineralocorticoid receptor antagonists (MRA). ARNI is under-prescribed in India despite its attractive safety and efficacy profile. Therefore, the consensus discusses objectives and topics related to ARNI in the management of cardiac remodeling, and experts shared their views on the early timely intervention of effective dosage of ARNI to improve the diagnosis and enhance mortality and morbidity benefits in cardiac reverse remodeling (CRR).

Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India

Background & objectives: A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present study estimated the proportion of heteroresistance among MTB in clinical samples of presumptive drug-resistant tuberculosis (TB) patients in Central India. Methods: A retrospective analysis of data generated from line probe assay (LPA) at a tertiary care hospital in Central India between January 2013 and December 2018 was carried out. A heteroresistant MTB in a sample was indicated by the presence of both wild-type and mutant-type patterns on an LPA strip. Results: Data analysis was carried out on interpretable 11,788 LPA results. Heteroresistance in MTB was detected in 637 (5.4%) samples. Of these, heteroresistance in MTB was detected in 413 (64.8%), 163 (25.5%) and 61 (9.5%) samples with respect to rpoB, katG and inhA genes, respectively. Interpretation & conclusions: Heteroresistance is considered a preliminary step in the development of drug resistance. Delayed or suboptimal anti-tubercular therapy in patients with heteroresistance of MTB may elicit full clinical resistance and negatively impact the National TB Elimination Programme. Further studies are, however, needed to determine the impact of heteroresistance on treatment outcomes in individual patients.

Challenges of Second-hand Smoke: Are We Asking the Right Questions?

Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions

Pulmonary Hydatid without Liver Involvement: A Case Series

Pulmonary hydatid is not a rare disease. But raising a suspicion for its diagnosis is limited. There are limited approaches for the diagnosis and treatment of the same. We present here four cases of pulmonary hydatid, without liver involvement, with emphasis on how it was misdiagnosed and received multiple treatment and landed into complications. Most of our cases presented with cough, sputum and hemoptysis. For these nonspecific signs and symptoms, patient is generally treated on a different line of diagnosis. Two of the cases were already treated for abscess and fungal infection. One of the patients was on antitubercular treatment. One of our cases was secondarily infected with aspergilloma. One of the cases was referred to oncologist to start chemotherapy. Interestingly, to raise a suspicion, none of our cases had liver involvement. A detailed history revealed expectoration of white salty material in sputum, living with sheep and dog and expectorating grape-like vesicles in sputum. History helped us to put hydatid as one of our differentials. Echinococcal serology was positive in three cases. Only three cases had on-table appearance of hydatid cyst. All four cases underwent surgical management for complete cure. There is need for strong suspicion and a detailed history and proper set of investigations help in timely diagnosis and management of pulmonary hydatid disease.