Appropriateness of Helicobacter pylori eradication therapy in gastroenterology patients of a tertiary care hospital

Recommended and widely used first-line treatment of Helicobacter pylori consists of a proton pump inhibitor, clarithromycin, and amoxicillin/metronidazole. Recent reports suggest an increase in resistance to these antibiotics, especially to clarithromycin which has adversely affected the effectiveness of this standard regimen, hence levofloxacin containing regimens have also been introduced. Our objective was to assess the appropriateness of clarithromycin and levofloxacin containing regimens for H. pylori eradication by considering the factors such as dose, duration of treatment, patient medication adherence, and H. pylori induced symptom relief. In this prospective observational study, 120 patients were enrolled on the basis of H. pylori induced symptoms, positive campylobacter-like organism (CLO) test, or histology proven H. pylori infection. Besides socio-demographic characteristics, endoscopic findings, CLO test results and H. pylori induced symptom eradication were documented. Majority of the patients (85.83%) received an eradication regimen consisting of clarithromycin + amoxicillin + pantoprazole and the remaining patients were prescribed levofloxacin containing regimens. H. pylori eradication regimen containing clarithromycin was more effective in symptom control. Based on both symptom relief and a negative CLO test on treatment completion, only 40% of the patients received benefit from the regimens. Moreover, overall therapy was unsatisfactory due to inappropriate dose, duration, or sub-optimal adherence.

Phytochemical Profiling Using Lc-Q-Tof-Ms Analysis And In Vitro Antioxidant Activity Of A Rare Salt-Secreting Mangrove Aegialitis Rotundifolia Roxb. Leaves Extract

Objective: The present work deals with the qualitative study of the phytoconstituents present in Aegialitis rotundifolia Roxb., ethanolic leaves extract and evaluate its antioxidant properties in vitro. Methods: The qualitative phytochemical analysis of the extract was performed first using preliminary phytochemical tests and then by liquid chromatography quadrupole-time-of-flight mass spectrometry (LC-Q-TOF-MS). The antioxidant properties were investigated comprehensively using seven in vitro models viz., 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, nitric oxide (NO) scavenging, hydrogen peroxide (H2O2) scavenging, superoxide (SOD) radical scavenging, lipid peroxidation (LPO) assay, reducing power (RP), and total antioxidant activity. Results: The preliminary phytochemical analysis revealed the presence of several important phytochemical groups whereas the LC-Q-TOF-MS analysis detected 25 phytoconstituents in the extract mostly belonging to flavonoids and alkaloids. The test extract showed strong dose-dependent antioxidant activity in all the seven in vitro models, however, the activity of the extracts was slightly lower compared to the reference standard ascorbic acid. Conclusion: The test extract showed strong antioxidant properties which could be possibly due to the phytoconstituents detected in the extract.

Correlation of obesity & comorbid conditions with chronic venous insufficiency: Results of a single-centre study

Background & objectives: Chronic venous insufficiency (CVI) is a common clinical problem among obese patients. This study was conducted to evaluate the impact of body mass index (BMI) and associated morbidities such as diabetes, hypertension and hypothyroidism on venous disease clinical scores as per Clinical, Etiological, Anatomical, Pathological (CEAP) classification. Methods: In this study, adult patients with BMI more than 30 kg/m2 with signs of CVI were evaluated clinically and by using Duplex ultrasonography of venous system. The patients with C0, C1, C2, C3 and C4, C5, C6 clinical scores in CEAP classification were grouped as lower and higher clinical scores of CVI, respectively. Results: Of the 200 enrolled patients, 147 (73.5%) were males and were associated with higher grades of clinical scores (P=0.051). Superficial venous system was involved in 96 per cent patients and 91 per cent patients had reflux in the sapheno-femoral junction. A negative association was observed between hypertension and male gender (P=0.001). Higher BMI was associated with higher clinical scoring (P=0.053). BMI >40 kg/m2 was associated with primary aetiology (P=0.007) of CVI. There was no correlation between superficial, deep or perforator incompetence with BMI (P=0.506). Duplex-confirmed significant reflux was observed in patients with higher BMI (P=0.006). Age and BMI were positively correlated with clinical score (r=0.176; P=0.013 & r=0.140; P=0.049), respectively. Interpretation & conclusions: Our findings indicated that elderly male patients with high BMI seemed to be at a higher risk of advanced clinical grades of CVI. The impact of comorbid conditions such as diabetes, hypertension and hypothyroidism on CVI could not reach at significance in the present study.

Psychiatric morbidity in married females living away from their spouses attending the psychiatry clinic in a tertiary care, teaching hospital.

Background: In India economic problems like dowry and related issues play a major role in the problems of marriage and separation The aim of the present study is to assess the psychological impact on married females who living away from their spouses, and comparison of the psychiatric morbidity with the married women who are living with their spouses. Methods: A total of 35 subjects were included in the study. Intake proforma was specially designed for study and the questions were divided into 4 subscales (somatic complaints anxiety/insomnia social dysfunction and severe depression). Results: The study clearly revealed that the occupational separation has a significant negative impact on the marital quality of the women spouses of men working abroad or living away. Comparison with the marital quality of the control group, the group does not have the separation; the study group differs significantly in marital quality. The factors such as social support from family and friends, the stay of the study group with parents or in-laws, and duration of pre-separation, the study proved that there is no significant difference exists on the marital quality of the study group based on these factors. Conclusions: The numbers of females who were separated from their spouses are more likely to have psychiatric illnesses due the additional work load of looking after the children and managing the household activities. The study also found that the females staying with their parents after the separation from their spouses were less likely to have a severe psychiatric morbidity as they felt comfortable due the cooperation from their parents.

Synthesis and characterization of Interpenetrating polymer network microspheres of acryl amide grafted Carboxymethylcellulose and Sodium alginate for controlled release of Triprolidine hydrochloride monohydrate.

Interpenetrating polymer network [IPN] microspheres of acrylamide (AAm) grafted on Carboxymethyl cellulose (CMC) and Sodium alginate (NaAlg) microspheres were prepared by water-in-oil (W/O) emulsion method. These microspheres were loaded with Triprolidine hydrochloride monohydrate (TPH) and cross-linked with glutaraldehyde. The prepared microspheres were characterized by Differential scanning calorimetry (DSC), Scanning electron microscopy (SEM) and Laser particle size analyzer. DSC thermo grams of TPH loaded AAmg- CMC/NaAlg IPN microspheres confirmed the molecular level distribution in the polymer matrix. SEM of the microspheres suggested the formation of spherical particles. Swelling experiments on the microspheres provided important information on drug diffusion properties. Release data have been analyzed using an empirical equation to understand the nature of transport of drug containing solution through the polymeric matrices. The controlled release characteristic of the matrices for TPH was investigated in pH 7.4 media. Particle size and size distribution of the microspheres was studied by laser light diffraction particle size analyzer. Drug was released in a controlled manner upto 12 h.

Interpenetrating polymer network of cross-linked blend microspheres for controlled release of Acebutolol HCl.

Carbohydrate polymeric blend microspheres consisting of chitosan (CS) and poly (vinyl alcohol) (PVA) were prepared by water-in-oil (W/O) emulsion method. These microspheres were crosslinked with glutaraldehyde and loaded with Acebutolol HCl, an anti hypertensive drug. The microspheres were characterized by Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), X-Ray diffraction (X-RD) and Scanning electron microscopy (SEM).The FTIR spectroscopy explains the crosslinking between the CS-PVA. DSC& X-RD indicated the molecular level distribution of Acebutolol HCl drug in the polymer matrix. The SEM of the microspheres suggested the formation of spherical particles. Swelling experiments on the microspheres provided important information on drug diffusion properties. Release data have been analyzed using an empirical equation to understand the nature of transport of drug containing solution through the polymeric matrices. The controlled release characteristic of the matrices for Acebutolol HCl was investigated in pH 7.4 media. The results indicate that the drug was released in a controlled manner up to 10 h.

Millennium stress and mental health

We all talk about stress, but we are not very clear about what it is! Stress may result from both desirable andundesirable events in life. It is not possible to imagine life without stress, as it is a part and parcel of everybody'slife. Stress is a source of problem only when we cannot cope up with it. Individuals may react differently to thesame stressful situation. Thus it is our perception and reaction to the event which determines the stress, ratherthan the event itself. One's reaction to stress can affect his mental and physical health; so it is very importantto learn how to deal effectively with stress as it occurs.