Effect of Hyperglycemia on the Duration of Hospital Stay and Rate of Mortality in Patients of Chronic Obstructive Pulmonary Disease in Acute Exacerbation: A 1-year Hospital-based Observational Study

Background: Chronic obstructive pulmonary disease (COPD) is not only a respiratory disease but is also a systemic disease associated with comorbidities such as diabetes mellitus (DM), hypertension, osteoporosis, etc. Diabetes being one of the comorbidities, COPD is thought to be a causative factor for developing insulin resistance. Similarly, poor glycemic control is associated with worsened COPD outcomes. Thus, this study has been taken up to analyze the effect of hyperglycemia on the duration of hospital stay and rate of mortality, and other outcomes in patients with COPD with exacerbation. Methods: It was an observational study conducted for 1 year in KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, Karnataka, India. A total of 84 patients were enrolled and divided into two groups based on the mean random blood sugar (RBS) levels. Group I had 40 patients with mean RBS <250 mg/dL and group II had 44 patients with mean RBS ?250 mg/dL. Outcomes and variables of the patients with COPD were compared between both groups. Results: Patients in group II had poor outcomes compared to group I. The mean duration of hospital stays in groups I and group II were 5.43 and 7.34, respectively, with a significant p < 0.0001. The mean duration of intensive care unit (ICU) stay was 3.33 and 4.47 in groups I and II, respectively, which was statistically significant. The rate of mortality in groups I and II was 5.00 and 11.36%, respectively. Conclusion: Patients with hyperglycemia had an increased duration of hospital stay and rate of mortality. Optimal glycemic control plays a significant role in patients with COPD in reducing the severity of exacerbation and mortality.

Nurse-led translational research: An emerging field in multidisciplinary research

Translational research is well-known concept in healthcare still nurse-led translational research is an emerging area of multidisciplinary nursing research. This study intends to offer an in-depth look at translational research and the process for its applications in nursing education, practice, and research. Nurses, educators, researchers, and policymakers will better understand nurse scientists’ expanded role in education and clinical practice. This paper will assist the nurse educators, researchers to stay informed of translational research and its nursing impact. To develop a narrative synthesis study, a detailed systematic literature review was conducted in Pub Med, Web of Sciences, Scopus, ProQuest, Ovid using the keywords “translational research,” “nursing,” “implementation science,” “barriers in translational research” themes generated in selected paper are discussed in detail in this paper. 32 articles were found to be relevant to discuss the concepts of translational research in nursing practices. In contrast to basic research, translational research works cooperatively to assess the efficacy of evidence from the bench to the bed, from one realm to another. It requires the transparent method for dealing with roadblocks, such as following evidence-based recommendations while assessing evidence, so that policymakers can determine whether to embrace them for the development of the health-care system. Nurse-led translational research under the direction of a nurse scientist has the potential to advance nursing excellence in both clinical and community health settings.

Visceral obesity assessment in type 2 diabetes mellitus using a body shape index may be better as compared to body mass index

Background: Body mass index (BMI) is being widely used to assess obesity and associated cardiovascular risk but found to be deficient ofassessing visceral obesity for which ABSI was developed. Aim and objectives were to determine a body shape index (ABSI) as a better marker than BMI in assessing visceral obesity in type 2 diabetes mellitus (T2DM) patients.Methods: The present cross-sectional study consisted total 150 patients over 40year age, both male (90) and menopaused female (60). USG was used to measure the visceral obesity.Results: The area under the ROC curve (AUROC) for BMI (kg/m²) predicting V/S fat ratio: >2.5 vs V/S fat ratio: <2.5 was 0.593 (95% CI: 0.5-0.685), thus demonstrating poor diagnostic performance compared to ABSI which was 0.815 (95% CI: 0.748-0.882), thus demonstrating good diagnostic performance. Conclusions: ABSI was better in assessing visceral obesity compared to BMI so can be used along with other markers in assessing cardiovascular risk.

DIFFERENTIAL EXPRESSION OF MICRORNAs IN LUNG CANCER: A REVIEW ARTICLE

MicroRNAs (miRNAs) are small non-coding RNA molecules of approximately 16-24 nucleotide length. The miRNA biogenesis is a 2 step cleavage process mediated by Dorsha and Dicer. The nuclear cleavage by Dorsha / DiGeorge syndrome critical region 8 (DGCR8) generates 60-70 nucleotide long precursor microRNA (pre-miRNA). Furthermore, the pre-miRNA is exported to the cytoplasm by exportin 5 to be cleaved by Dicer. This resultant miRNA is further processed to generate a mature miRNA and get assembled into a RNA-induced silencing complex (RISC). Hence leading to transcriptional repression of the target mRNAs. It has been reported that one miRNA may target many genes accounting from a few to as many as thousands. Lung cancer (LC) ranks third worldwide and is marked by poor prognosis. The early staged LC patients usually exhibit no symptoms and the condition worsens till the time of first diagnosis. Therefore, studies are required to outline good early detecting and surveillance biomarkers for LC. Several evidences support the role of miRNAs in the pathogenesis of LC. They show differential expression pattern i.e. may be either upregulated or downregulated. The oncogenic miRNAs remain upregulated while the tummor suppressive miRNAs remain downregulated. In LC miRNAs are the important factors for tumour initiation, differentiation, apoptosis, proliferation as well as tumor progression. Thus, this review article focuses on the diagnostic significance of miRNAs in LC

A Cross Sectional Study to Evaluate Decision to Delivery Interval in Emergency Caeserian Section at a Tertiary Care Hospital

Background:One of the main factors affecting maternal morbidity and mortality is the decision to delivery interval (DDI) that is, the time taken from the decision to take the patient up for caesarean section to the delivery of the fetus. Method:This is a retrospective observational study conducted over a period of twelve months where 370 patients were studied. Results:No delay was seen in 49.2% cases whereas most delay was noted after decision by obstetricians to transfer patient to OT(22.2%). Conclusion:In order to get favourable maternal and fetal outcome decision to delivery interval should be within 30 minutes and this can be made possible if factors like results of blood investigations and cross matching of blood can be made available on time.

Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study was to estimate the maternal and perinatal outcome in pregnancies at and beyond 41weeks of gestation. It was a prospective study of 140 patients with pregnancy beyond Methodology:41weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop's score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, perinatal and neonatal morbidity, perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results:Out of 140 patients, majority was the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7% respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and labour induction should be considered at 41weeks to prevent maternal and perinatal complications.

Cassia Fistula: Botany, Phytochemistry And Pharmacological Leverages-A Review

Cassia fistula Linn. is also called a “golden shower”. It is aboriginal to India, Sri Lanka and diffused in various countries, including Mexico, China, Mauritius, East Africa, South Africa, and West Indies. Plant and its parts, such as bark, fruit, leaves, and seeds, are used traditionally to cure diseases. Traditionally the plant possesses hepatoprotective, antipyretic, anti-inflammatory, leukotriene inhibition, antitussive activity, antioxidant, wound healing, hypo-lipidemia, anticancer, antidiabetic, central nervous system activity, antiulcer, antibacterial, antifertility, larvicidal and ovicidal, antifeedant, laxative, anti-epileptic, antimicrobial, urease inhibition, antifungal, anti-tobacco mosaic virus activities. The review contains botanical information, constituents and pharmacological leverages of the plant. The review draws attention towards the traditional, phytochemical and pharmacological knowledge accessible on Cassia fistula Linn, which would be beneficial for research scholars to develop novel chemical entities. This review article is written after studying most of the journal’s articles, which were published between 1998 to 2019.

A Study of Clinical Profile and Outcome in Acute Viral Hepatitis E.

Introduction: Hepatitis E is the most common cause of acute viral hepatitis in the adult population in India. Acute viral hepatitis E (HEV) is generally mild and self-limiting and resolves within six weeks, with no chronic sequelae. Pregnant women are at increased risk with the risk increasing as the pregnancy progresses near term. Methods: We performed a prospective study of 100 patients who presented to Dept. of Medicine, Civil Hospital, Ahmedabad with jaundice (IgM anti-HEV positive) during 2011-2012 and data were analyzed for the clinical profile and outcome of HEV. Results: The most common age group affected was 21-30 years with overall M:F ratio of 3.4:1. Most common presenting symptom was jaundice (100%) followed by nausea/ vomiting (87%). On presentation, serum bilirubin level was elevated in 89% patients with SGPT raised in 86%. PT was prolonged in 39% patients. Anemia (Hb < 7) was seen in 17% while 9% of patients had renal involvement. Hepatic encephalopathy was seen in 15%. In this study, 12 women were pregnant in whom IUD occurred in 66% with maternal mortality in 33%. Overall mortality was 7%. Conclusion: We found that majority of cases were cured with supportive treatment while risk of mortality and morbidity was more in pregnant women.

A pilot study to determine genetic polymorphism in Mycobacterium tuberculosis isolates in Central India.

This study was carried out to identify predominant spoligotypes responsible for transmission and prevalence of tuberculosis in central India since there is no data available about the genetic biodiversity of Mycobacterium tuberculosis isolates from patients with tuberculosis in this region. 35 strains of Mycobacterium tuberculosis were subjected to spoligotyping according to the standard protocol. A total of 25 strains out of the 35 (71.42%) could be grouped in to 6 clusters. The largest cluster comprised 8 isolates. Unique (Non-clustered) spoligotypes were seen in 10 isolates, Nine strains did not match the data base (Spol DB-4 data base). The results indicate that there may be a number of orphan strains unique to this geographical area. Further studies on a larger sample size derived from this area would help us delineate the epidemiology of Mycobacterium tuberculosis infection in this area.

Tannase production by Penicillium atramentosum KM under SSF and its applications in wine clarification and tea cream solubilization

Tannin acyl hydrolase commonly known as tannase is an industrially important enzyme having a wide range of applications, so there is always a scope for novel tannase with better characteristics. A newly isolated tannase-yielding fungal strain identified as Penicillium atramentosum KM was used for tannase production under solid-state fermentation (SSF) using different agro residues like amla (Phyllanthus emblica), ber (Zyzyphus mauritiana), jamun (Syzygium cumini), Jamoa (Eugenia cuspidate) and keekar (Acacia nilotica) leaves. Among these substrates, maximal extracellular tannase production i.e. 170.75 U/gds and 165.56 U/gds was obtained with jamun and keekar leaves respectively at 28ºC after 96 h. A substrate to distilled water ratio of 1:2 (w/v) was found to be the best for tannase production. Supplementation of sodium nitrate (NaNO3) as nitrogen source had enhanced tannase production both in jamun and keekar leaves. Applications of the enzyme were studied in wine clarification and tea cream solubilization. It resulted in 38.05 percent reduction of tannic acid content in case of jamun wine, 43.59 percent reduction in case of grape wine and 74 percent reduction in the tea extract after 3 h at 35ºC.

Crown augmentation using modified bilayered restoration for anchorage: a case report.

An ankylosed tooth can be suitable for obtaining orthodontic anchorage. However, if such a tooth lacks adequate clinical crown height, the anchorage will not be effective. In those situations surgical luxation or restorative crown augmentation is suggested. This case report is about the restorative treatment of an ankylosed, infraoccluded tooth to enhance the anchorage for forced orthodontic eruption of impacted maxillary canines. A crown augmentation in the form of a modified bilayered (sandwich) restoration using GIC, Composite resin and Silver amalgam on left maxillary first molar (26) was successful in sustaining the anchorage for forced eruption and alignment of impacted canines.

Refractory anaemia with excess blasts (RAEB) in a child--an unusual clinicohaematological presentation--a case report.

Myelodysplastic syndrome (MDS) is a disease of elderly patients but, rarely can be encountered in pediatric age group. The present case of MDS (RAEB subtype) was reported in a child who presented with proptosis and unique and rare feature of haemophagocytosis by myeloid series of cells.

Cytological diagnosis of adenoid cystic carcinoma breast--a case report.

The cytologic features of a case of adenoid cystic carcinoma of breast diagnosed on fine needle aspiration cytology (FNAC) in a 52 years old female are described. FNAC was carried out on outer quadrant of breast. The characteristic cytological features were numerous single to branching small round to Avoid cells at places forming microacini. Numerous pink hyaline globules of variable sizes were seen along with finger like projections containing basement membrane material.

Psychiatric morbidity in displaced leprosy patients.

One hundred confirmed leprosy patients, all of them migrated from elsewhere, were examined for psychiatric co-morbidity. Forty-six of them were from an 'ashram' and the others were from a slum area. 76% of the patients were found to be having psychiatric illness. Of these, 55% were having neurotic depression and 21% had anxiety neurosis. Single, unemployed, socio-economically backward and patients with physical deformities were suffering significantly more often with psychiatric symptoms. Psychiatric morbidity was found to be more frequent in the patients staying in slum than in those in the 'ashram' where they had some security.

GABA/BZ-and NMDA-receptor interaction in digoxin-induced convulsions in rats.

Digoxin (7.5 micrograms icv) induced 'pop-corn' type of convulsions and 100% mortality. The GABA-ergic agents produced varying degree of protection against digoxin-induced neurotoxicity. Diazepam (4 mg/kg) offered significant protection whereas pentobarbital (5 mg/kg) and baclofen (5 mg/kg) markedly reduced per cent mortality, but ethanol (2 g/kg), progabide (50 mg/kg) and muscimol (0.5 mg/kg) as well as GABA (50 mg/kg) could not offer significant protection in doses used. GABA-ergic agonists; GABA, baclofen, diazepam and pentobarbital when administered along with MK-801 (0.5 mg/kg) a non-competitive NMDA antagonist, a potentiation of anticonvulsant action of MK-801 was observed. MK-801 showed potent anticonvulsant profile in dose range (0.25-1 mg/kg) studied. A synergistic influence of Mg2+ and K+ ions on NMDA receptor antagonism was also observed. A role of GABA-ergic facilitation and NMDA antagonism as a potential anticonvulsant approach in digoxin-induced convulsions in rats has been suggested.