Institutional Disrespect and Abuse during Health-Care Utilization in Public Health Facilities of Tamil Nadu: A Facility-Based Cross-Sectional Survey

Background: Disrespect and abuse have a negative impact on the quality of care provided in the public health facilities, thereby impacting the public health‑care utilization of the patients. Objectives: This study aims to capture the burden and determinants of disrespect and abuse faced by the patients who seek care from public health facilities in Tamil Nadu. Methods: This study was conducted among 4917 participants at outpatient and inpatient levels in 18 public health facilities across six districts in Tamil Nadu. Institutional disrespect and abuse were reported as proportion with 95% confidence interval (CI). Logistic regression model was done to assess the determinants of institutional disrespect and abuse. Results: Overall, the proportion of participants facing some form of institutional disrespect and abuse was 9.8% (95% CI: 9.0%–10.6%). Elderly patients (≥60 years) (adjusted odds ratio [aOR] = 2.71; 95% CI: 1.27–5.76), widowed/separated/divorced (aOR = 1.99; 95% CI: 1.11–3.57), patients with higher educational qualification (aOR = 1.82; 95% CI: 1.25–2.64), patients belonging to the richest quintile in terms of socioeconomic status(aOR = 4.96; 95% CI: 3.59–6.84), and patients having some form of chronic disease (aOR = 1.37; 95% CI: 1.07–1.75) had significantly higher odds of facing institutional disrespect and abuse. Conclusion: Almost one in ten patients visiting secondary and tertiary care public health facilities in Tamil Nadu had faced some form of disrespect during their hospital visit/stay. The findings from our study should be taken up and further qualitative exploration to identify the reasons for such disrespectful care and corrective solutions should be suggested.

Elicitation effect on the production of asiaticoside and asiatic acid in shoot, callus, and cell suspension culture of Centella asiatica

Centella asiatica is an important medicinal plant which contains various phytocompounds. Asiatic acid and asiaticosideare two major compounds which are responsible for its various pharmaceutical activities. The present study analyzesthe effect of elicitor, i.e., methyl jasmonate on the synthesis of asiaticoside and asiatic acid (ATA) in shoot, callus, andcell suspension cultures of C. asiatica. A high-performance liquid chromatography analysis showed that the elicitationwith 100 µM concentration of methyl jasmonate enhanced asiaticoside content by 69-fold in callus culture, 39-fold inshoot cultures, and ATA by 1.9-fold in cell suspension culture. Thus, elicitation with methyl jasmonate is an effectivemethod of increasing the rate of biosynthesis of asiaticoside and ATA in plant cell cultures of C. asiatica

Ruptured hydatid cyst of lung.

We report a case of 26 year old woman who had ruptured hydatid cyst of the right lung. The chest radiograph and CT features were suggestive of a ruptured hydatid cyst with detached and collapsed endocyst within the exocyst. Intraoperatively communication between cyst and bronchus could be demonstrated. Interesting CT appearance and demonstrable communication of cyst with bronchus is the reason for this case report.

Polymorphisms at GSTM1 and GSTP1 gene loci and risk of prostate cancer in a South Indian population.

Inter-individual differences in cancer susceptibility may be mediated in part through polymorphic variability in the bioactivation and detoxification of carcinogens. The glutathione S-transferases (GSTs), which are active in detoxification of wide variety of carcinogens, have been consistently implicated as cancer susceptibility genes in this context. We here assessed the association of GSTM1 and GSTP1 polymorphisms with susceptibility to prostate cancer in a case-control study of 75 patients and 100 age-matched controls in a South Indian population. The GSTM1 null polymorphism was detected by PCR and the GSTP1 Ile105Val polymorphism by PCR-RFLP using peripheral blood DNA.There was no significant link between the null genotype of GSTM1 and risk of prostate cancer (OR-1.79; 95% CI-0.78-4.11; P-0.18). However, the GSTP1 Ile/Val genotype was significantly associated with a decreased risk for prostate cancer (OR-0.36; 95% CI-0.18-0.73; P<0.001). Analysis of the variant GSTM1 and GSTP1 genotypes in combination did not reveal any significant difference between cases and controls, even with a stratified analysis tumor grades. Thus our study indicates that the GSTP1 Ile/Val genotype may decrease risk of prostate cancer in the South Indian population.

Squamous cell carcinoma in untreated psoriasis: a case report.

Skin cancer developing after treatment for psoriasis is seen more often than expected, however, there has been no report of cutaneous squamous cell carcinoma developing in a case of untreated psoriasis. Here, a case has been reported where an untreated psoriasis lesion progressed on to develop squamous cell carcinoma, with a brief review of literature.

RH-5992--an ecdysone agonist on model system of the silkworm Bombyx mori.

RH-5992 is a novel synthetic non-steroidal ecdysteroid agonist with a high selectivity towards Lepidopteran species. The effect of ecdysone agonist RH-5992 on larval period, larval weight, silk gland weight and haemolymph protein profile were examined in the model organism, the larvae of silkworm, Bombyx mori. The LD50 values were found to be 16.21 and 12.01 micrograms/larva for 72 and 96 hr respectively. In the present study, three sublethal concentrations of 1/5th, 1/10th and 1/20th of LD50 at 72 hr were selected and applied on the mid-dorsal line of the silkworm B. mori. The maximum mortality of 35% was observed in the group which received the highest (3.2 micrograms/larva) concentration of RH-5992. The mortality rate was found to be dose dependent as well as time dependent. Interesting results were observed in haemolymph profile of the RH-5992 treated larvae as staining intensity of 30 kDa protein decreased significantly whereas the effect was not marked on other major proteins like storage proteins and vitellogenin polypeptides. From the results, it is confirmed that RH-5992 causes changes in larval characters and protein profile of silkworm B. mori. It is proposed that RH-5992 may cause negative effect specifically on reproductive characters like development of ovary and egg production due to decrease in 30 kDa protein.

Changes in embryonic protein profile and economic characters of Bombyx mori (Lepidoptera:Bombycidae) following UV irradiation.

Eggs of B. mori were irradiated with UV (254.4 nm wavelength) for different durations. Increase in the time of exposure to UV decreased the percentage hatchability of the eggs, cocoon and pupal weights. The shell weight remained unaltered proving the stability of silk gland DNA. Irradiation of eggs also delayed the degradation/utilization of the embryonic proteins, viz. vitellin (heavy and light subunits), egg-specific protein and 30K protein.

Ampicillin pharmacokinetics in Indian geriatric subjects.

Ampicillin elimination was studied in geriatric and younger subjects, 10 in each group. The geriatric subjects had higher serum concentration and elimination half-life of the drug. The plasma clearance and urinary excretion of the drug were significantly reduced in them when compared to younger subjects. Urinary excretion of the drug had significant correlation with creatinine clearance of the subjects.