IMPACT OF CRM ON CUSTOMER SATISFACTION WITH REFERENCE TO PRIVATE SECTOR BANKS IN ERODE DISTRICT

After Privatization of Banking sector, the emergence of new banks and the intensity of competition among the banks has been drastically increased. Nevertheless, like olden days, banks are trying hard to source the new customers and to retain, satisfy the existing customer potential. This study was conducted to study whether CRM practice in Private banks impacts the level of customer satisfaction. For that purpose, studying the association between demographic prole of the respondent and level of satisfaction and analyzing the relationship between CRM dimensions and level of satisfaction were set as objectives. The researcher has collected 120 samples from the customers of HDFC and YES bank of Erode. The results of research analysis revealed that, CRM dimensions are positively correlated with customer satisfaction and it is required for the banks in several aspects.

Effect of Brine Concentration on Bacteria Isolated from Leafy Vegetables (Talinum triangulare, Telfairia occidentalis and Vernonia amygdalina)

The effect of brine on bacteria isolated from leafy vegetables was evaluated. Fresh waterleaf (Talinum triangulare), Pumpkin leaves (Telfairia occidentalis) and Bitter leaves (Vernonia amygdalina) including cooking salt were bought from vendors in Mile 3 market, Port Harcourt, Rivers State. Brine concentrations of 1, 2, 3, 4 and 5% were prepared by dissolving appropriate grams of salt in distilled water. Nine millilitres of the respective concentrations were transferred into clean test tubes, labelled, stoppered with foil and autoclaved at 121? for 15 minutes at 15psi. Sterile distilled water served as a control. The test isolates were standardized based on 0.5McFarland and 1mL each was introduced into different brine concentrations. The standard plate count was used to monitor brine effects on isolates and this was done hourly for six hours. Inoculated plates were incubated at 37? for 24 hours. After incubation, enumerated colonies were used to deduce isolate mortality. The total heterotrophic bacterial (THB) load of bitter, Pumpkin and water leaves were 3.49±0.4×106, 3.25±0.4×106 and 1.99±0.2×106 CFU/g, respectively. The staphylococcal counts for bitter, Pumpkin and water leaves were 1.65±0.3×104, 3.13±0.5×104 and 1.55±0.4×104 CFU/g, respectively. Total coliform counts for bitter, Pumpkin and water leaves were 1.52±0.8×105, 2.85±0.1×105 and 1.75±0.6×105 CFU/g, respectively. Staphylococcal counts of pumpkin leaves were significantly (P?0.05) higher than those obtained for bitter leaf and water leaf. There was no significant difference(P>0.05) in the THB and Coliform counts of all samples. E. coli was predominant in Pumpkin and water leaves while Staphylococcus sp was predominant in bitter leaves. The LC50 values for E. coli, Klebsiella, Staphylococcus, and Bacillus sp were; 5.39, 3.88, 1.62, and -0.41mg/ml, respectively. The LC50 showed that the brine was very lethal on Bacillus sp and Staphylococcus sp. High brine concentration is recommended to achieve reduced bacterial load.

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).

Role of Iron Therapy in Heart Failure: A Consensus Statement from India

Iron deficiency (ID) with or without anemia is frequently observed in patients with heart failure (HF). Uncorrected ID is associated with higher hospitalization and mortality in patients with acute HF (AHF) and chronic HF (CHF). Hence, in addition to chronic renal insufficiency, anemia, and diabetes, ID appears as a novel comorbidity and a treatment target of CHF. Intravenous (IV) ferric carboxymaltose (FCM) reduces the hospitalization risk due to HF worsening and improves functional capacity and quality of life (QOL) in HF patients. The current consensus document provides criteria, an expert opinion on the diagnosis of ID in HF, patient profiles for IV FCM, and correct administration and monitoring of such patients.

The Power and Promise of Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure Management: National Consensus Statement

Heart failure (HF) is a huge global public health task due to morbidity, mortality, disturbed quality of life, and major economic burden. It is an area of active research and newer treatment strategies are evolving. Recently angiotensin receptor-neprilysin inhibitor (ARNI), a class of drugs (the first agent in this class, Sacubitril–Valsartan), reduces cardiovascular mortality and morbidity in chronic HF patients with reduced left ventricular ejection fraction (LVEF). Positive therapeutic effects have led to a decrease in cardiovascular mortality and HF hospitalizations (HFH), with a favorable safety profile, and have been documented in several clinical studies with an unquestionable survival benefit with ARNI, Sacubitril–Valsartan. This consensus statement of the Indian group of experts in cardiology, nephrology, and diabetes provides a comprehensive review of the power and promise of ARNI in HF management and an evidence-based appraisal of the use of ARNI as an essential treatment strategy for HF patients in clinical practice. Consensus in this review favors an early utility of Sacubitril–Valsartan in patients with HF with reduced EF (HFrEF), regardless of the previous therapy being given. A lower rate of hospitalizations for HF with Sacubitril–Valsartan in HF patients with preserved EF who are phenotypically heterogeneous suggests possible benefits of ARNI in patients having 40–50% of LVEF, frequent subtle systolic dysfunction, and higher hospitalization risk.

Added Effect of Pratimarsha Nasya with Ksheerabala Taila (14 Aavartita) over Selected Yoga Techniques in Insomnia

Insomnia is a prevalent psycho physiological sleeping disorder, included in the International Classification of Sleep Disorders-2 (ICSD-2). By definition insomnia is a difficulty in initiating or maintaining sleep, or both or the perception of a poor quality sleep. Insomnia leads to various social, interpersonal and occupational impairments. Clinical studies have proven that Yoga is effective in insomnia. Present study was to find out the added effect of Pratimarsha nasya with Ksheerabala taila (14 Aavartita) over selected Yoga techniques in relieving insomnia. As per Acharya Susrutha in Chikitsa Sthana, doing Pratimarsha nasya daily during evening hours (Sayamkala) renders Sukhanidraprabhodanam. A pre-post interventional study was performed in 40 participants both male and female, satisfying the inclusion and exclusion criteria. Out of 40 participants, 20 each were randomly allocated to Group I and Group II. In Group I, Pratimarsha nasya using Ksheerabala taila (14 Aavartita) was administered 1ml in each nostril at evening time along with the practice of selected yoga techniques during morning hours. In Group II, only selected Yoga techniques were advised. The study period was for 30 days. The pre & post changes in mean score value was assessed using Pittsburgh Sleep Quality Index (PSQI) score. The data was analyzed using unpaired t test, and was statistically significant with a p value ?0.01. Thus the added effect of Pratimarsha nasya with Ksheerabala taila (14 Aavrtita) over selected Yoga techniques in insomnia is more effective than selected Yoga techniques alone.

Anti-SARS-CoV-2 inactivated vaccine in patients with ANCA-associated vasculitis: Immunogenicity, safety, antibody decay and the booster dose

Abstract Objective: To evaluate inactivated CoronaVac prime vaccination, antibody decay, booster dose, and safety in ANCA-Associated Vasculitis (AAV) patients. Methods: Fifty-three AAV patients and 106 Controls (CG) received CoronaVac on days: D0 (first dose), D28(second dose), and D210 (booster dose, 32 AAV: 32 CG). The primary outcome was immunogenicity after the second vaccine dose (day 69) assessed by Seroconversion Rates (SC) of anti-SARS-CoV-2 S1/S2 IgG and Neutralizing Antibodies (NAb). Secondary outcomes were safety, immunogenicity (D28/D240), 6-months antibody decay (D210) and the booster dose response (D240). Results: At D69 SC (65.1% vs. 96.8%, p = 0.0001), GMT (21.3 UA/mL vs. 67.7 UA/mL, p < 0.001) and NAb- positivity (53.7% vs. 80.6%, p = 0.001) were moderate but lower in naïve-AAV patients than CG. Patients without SC used more often IS (93.3% vs. 53.3%, p = 0.015), mycophenolate mofetil (20% vs. 0%, p = 0.037) and prednisone (60.0% vs. 28.6%, p = 0.057) than seroconverted. NAb negativity in AAV patients was associated with prednisone treatment (57.9% vs. 18.2%, p = 0.015) and IS (84.2% vs. 55.0%, p = 0.046). Logistic regression analysis models showed that only prednisone was associated with lower seroconversion (OR = 0.2, 0,95% CI 0.05-0.86, p = 0.030) and with lower NAb positivity (OR = 0.2, 0,95% CI 0.05-0.88, p = 0.034). After six months (D69-D210) a decrease in IgG positivity occurred in 32 AAV patients (15.7%, p = 0.074) and 32 CG (18.7%, p = 0.041). For the NAb positivity, the 6-month decrease was not significant (p = 0.114) whereas a major reduction occurred for CG (p < 0.001). A booster dose (D240) resulted in an increment in IgG-positivity (21.9%, p = 0.023) and NAb-positivity (34.4%, p = 0.006) in AAV patients. No moderate/severe adverse events attributable to the vaccine were observed. Conclusion: This study provides novel data on the excellent safety and moderate immunogenicity of CoronaVac in AAV patients. A six-month mild antibody waning was observed with a good response to the booster dose, although levels remained lower than CG (CoronavRheum-NCT04754698).

A Comparative study of Hematological Profile and Etiology of Anemia in Patients From Nutritional Rehabilitation Centre with patients from General Pediatric Ward in M.G.M. Hospital, Warangal

Severe acute malnutrition results in a spectrum of pathological changes in the body including substantial aberrations in hematological system. Aim of the study was to compare children from nutritional rehabilitation center with children from general ward with respect to: hematological profile, prevalence, etiology and severity of anemia. A cross sectional analytical study was done on 350 children aged from 6 to 59 months admitted in M.G.M. Hospital, Warangal. The prevalence of anemia in cases from nutritional rehabilitation center was 89.0% and 45.7% in cases from general ward. 82% cases from nutritional rehabilitation center had microcytic hypochromic picture and 67.4% cases from general ward had normocytic normochromic picture in peripheral smear. Iron deficiency was the most common cause of anemia in both groups, i.e., 92.3% cases from nutritional rehabilitation center and 46.2% cases from general ward. Megaloblastic anemia in 6.5% cases from nutritional rehabilitation center and 7.5% cases from general ward.

An observational study on potential drug-drug interaction among hypertensive patients in a tertiary care hospital

Background: Drug-drug interactions are quite prevalent, especially in the geriatric population with comorbidities. It affects the effectiveness, safety, and tolerability of the medications they use. Aims and Objectives: This study aims to analyze and identify potential drug-drug interactions (pDDIs) in hypertensive patients using Medscape databases. Materials and Methods: A prospective and observational study was conducted in the Hypertension clinic of KMC, Chennai, for 3 months during November 2019–January 2020. Hypertensive patients of both sexes attending hypertension clinics with an age of more than 18 years and taking more than two antihypertensive drugs were included in the study. The use of Medscape databases enabled the appropriate data to be gathered and evaluated for pDDIs. Results: Three hundred patients in all were enrolled for the trial. One hundred and forty out of the 300 patients had pDDIs. Out of 140 patients, the majority (55%) were between the ages of 40 and 60. Males (56.4%) had a higher prevalence of pDDIs than females (43.6%). Atenolol, enalapril, and furosemide were the most frequently used medications in the present study that caused pDDIs, accounting for 29.8%, 19.5%, and 18.6%, respectively. Conclusion: The prevalence of pDDIs was found to be 46.6% overall, and an increase in comorbidities and polypharmacy were revealed to be important risk factors for the emergence of several pDDIs. Most of the antihypertensives were shown to interact frequently with calcium carbonate.

Post-COVID multisystem inflammatory syndrome in adults: a study from a tertiary care hospital in south India

Background & objectives: There are limited data from India on the post-COVID multisystem inflammatory syndrome in adults (MIS-A). The objective of the present study was to evaluate the clinical profile of patients with MIS-A admitted to a tertiary care centre in southern India. Methods: This single-centre retrospective study was conducted from November 2020 to July 2021, and included patients aged >18 yr admitted to the hospital as per the inclusion and exclusion criteria. Results: Nine patients (5 male, mean age 40±13 yr) met the criteria for MIS-A. Five patients had proven COVID-19 infection or contact history 36.8±11.8 days back. All patients were positive for SARS-CoV-2 IgG antibody, negative for COVID-19 PCR, and had negative blood, urine and sputum cultures. All patients had fever and gastrointestinal (GI) symptoms, and five patients had left ventricular dysfunction. All patients had neutrophilic leucocytosis at presentation and elevated biomarkers such as C-reactive protein serum procalcitonin, D-dimer and ferritin. The majority of the patients (7/9 i.e. 77.78%) were treated with intravenous hydrocortisone (50-100 mg q6h-q8h). Six patients recovered completely whereas three patients expired. Interpretation & conclusions: Fever and GI symptoms were the most common presentation of MIS-A. Elevated serum procalcitonin may not be useful in differentiating bacterial sepsis from MIS-A. Most patients responded to corticosteroids.

A Missed Periorbital Foreign Body

Trauma involving the eye, orbital and periorbital regions are commonly seen in cases of road traffic accidents, sports injuries and physical assaults, but cases of intraorbital / periorbital foreign bodies are rare. Early presentation, history of trauma, and imaging help in diagnosis. However, sometimes the diagnosis is missed, particularly in cases with late presentation and a vague history of minor trauma and trauma with a non-metallic foreign body. A missed foreign body may present later with infection, repeated inflammation, ptosis, and proptosis and motility defect, further complicating the management.Here, we present a case of missed foreign body during the primary repair of facial injury in a 32-year male with polytrauma sustained in a road traffic accident. Evidence of foreign body was reported in a CT scan head advised for head injury. Re-exploration of wound and removal of foreign body is performed under local anaesthesia.

Influence of Neuropeptide Y and Neuropeptide Y 2 Receptor Variants in Acute Coronary Syndrome

Abstract Background The neuropeptide Y (NPY) is one of the most abundant neurotransmitters in the nervous system. NPY acts as a potent stimulator of angiogenesis, inflammation, and adipogenesis, through the NPY 2 receptor (NPY2R). Changes in the NPY signaling pathway have been linked to Acute Coronary Syndrome (ACS). Objectives The purpose of this study is to determine the association between variants in the NPY and NPY2R genes, as well as the severity of acute coronary syndrome (ACS). Methods Approximately 221 ACS patients and 278 healthy controls were selected for this study. Four variants in NPY and two variants in NPY2R genes were genotyped using Taqman allelic discrimination and sequencing. The Chi-square and Fisher's exact tests were used to verify the genotype frequencies. The logistic regression analyses were used for the evaluation of the studied variables. Haplotype analysis was used to evaluate the linkage disequilibrium (LD) between the variants (p<0.05). Results An association of NPY c.20T>C variant was found with the ACS group when compared to the healthy group. In the analysis between variants and risk factors in the ACS group, NPY c.84G>A was associated with hypertension. The analysis between TIMI risk showed a significance for NPY c.20T>C between the low and intermediate/high TIMI risk groups. In the haplotype analysis, strong linkage disequilibrium (LD) was found between the variants NPY c.150G>A and NPY c.-485T>C. Conclusion The NPY c.20T>C variant appears to contribute to the development of ACS. The NPY2R c.-1116A>G variant may contribute to the early development of ACS and the NPY c.84G>A variant appears to contribute to the development of hypertension. In addition, the NPY c.20T>C is associated with a protective effect in ACS severity.

Management of Cervical IVDP with Ayurvedic Interventions- A Case Report

Bones and joint disorders are common in the working age population and are conditions that affect passive (bones, joints) and/or active structures of the body (muscles, tendons, ligaments, peripheral nerves) . A 35 year old moderately built young gentle man working as an IT professional, complains of pain on nape of neck and back of the chest since one year. But however pain started radiating to left upper arm since past 4 months, night starts which apparently effecting sleep. Pain gets aggravated by physical activities like continuous sitting posture and gets relieved by analgesics and sleep at Chondroitin Sulphate. Cervical IVDP, can be considered as Apabahuka or Asthi majjagata vata . He was managed with external and internal medications like cervical traction, Lepanam, physio, Gandharvahasthadi kashayam, Sneha panam done with Gugguluthikthakam ghee, purgation done with Gandharvahasthadi erandam and Nasya done with Anutailam and Ksheerabala tailam

Awareness of health care workers regarding COVID-19 vaccine in a tertiary care hospital-a knowledge, attitude, and practice study

Background: Severe acute respiratory syndrome (SARS) coronavirus-2-novel coronavirus termed as COVID 19 is a major outbreak which was deleterious globally created a rapid cases of pulmonary infectious disease that caused the SARS. Building up confidence in vaccination depends on the interaction between public and doctors. Attitude toward usage of vaccination by healthcare workers (HCWs) is a major factor that is associated with general public acceptance of vaccination, fidelity to schedules, and devoid of hesitation/aversion. In addition, vaccinated HCWs also have a perceptible effect of decisiveness in general public to take a vaccine. Aims and Objectives: To understand the knowledge, attitude and practices on COVID vaccine among HCWs. Materials and Methods: This is a hospital-based, observational cross-sectional study done in Hassan Institute of Medical Sciences, Teaching hospital, Hassan. A sample of 340 HCWs who have been vaccinated 1st dose of inactivated COVID Vaccine was taken up for the study. A predesigned questionnaire was prepared and given to all the HCWs in the observation period of 30 min after vaccination. The questionnaire had 13 questions, and the data were collected and analyzed. Data were analyzed by descriptive statistical analysis. Results: This study was done in a district hospital, Hassan, Karnataka with a sample size of 340 HCWs participated in the study and completed the study questionnaire, out of which 146 men (43.4%) and 190 women (56.54%). Willingness to take the vaccine is 96%. 93.4% of HCWs encourage others to take vaccine. Our institution arranged a adverse events following immunization reporting and monitoring team management and 93.9% of the HCWs knew where to report if any adverse events occur in the observation period of 30 min after vaccination and also after going back to their respective homes through a telephone number and also this will help knowing the and acceptability of the vaccines. Conclusion: HCWs play an influential role in general public vaccination program. The information from this study will help to gain more knowledge and also allow the general public to future vaccination acceptability. The approach of HCWs might help in creating awareness and preventing false information about COVID vaccine among general public.

Antifungal Effect of Henna (Lawsonia inermis) Extract on Pathogenic Fungi

The study aimed at undertaking preliminary phytochemical studies and antifungal activities of Lawsonia inermis leaf extracts against clinical Candida isolates from female patients attending Dalhatu Araf Specialist Hospital (DASH) Lafia, Nasarawa State. HVS (High Vaginal Swab) samples were collected from 185 subjects and transported to the laboratory for analysis. Microbial culture and isolations were done on Sabouraud dextrose agar (SDA), Blood agar, Potato dextrose agar (PDA) and Sabouraud dextrose broth. Identification of clinical isolates was done following standard guideline for Candida identification including microscopic, cultural and biochemical characteristics (sugar utilization and fermentation). Antifungal susceptibility tests of the plant extracts at different concentrations were carried out against Candida isolates. Distilled water and ketoconazole drug served as negative and positive control respectively. Zones of inhibitions, the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of the extracts were determined. Data were analysed on the Minitab 16.0 software for descriptive (mean with standard error) and inferential statistics and Chi Square at 95% confidence limit. In conclusion, L.inermis leaf has been shown to have antifungal properties since it contained quality phytochemicals in sufficient quantity that may be explored in the synthesis of drugs against some species of Candida. This finding is crucial in the management and control of candidiasis in the study.

Typhoid Outbreak during the Pandemic of COVID-19 : A Report

Background : In the 19th Week of 2020, Integrated Disease Surveillance Programme (IDSP) noted an unusual increase in the number of fever cases in Routine Syndromic Surveillance. Objectives : The unusual increase of fever cases were investigated to identify the agent, the source of infection and to propose recommendations for control measures. Methods : Active surveillance of fever cases done, blood samples, stool samples and water samples were collected from the affected area. The secondary data of indoor and outdoor patient were collected from the nearest health facilities. Result : It was a single peak outbreak of typhoid, started from 1st May, 2020, had peaked during the 19th Week of May, 2020 and ended on 31st May, 2020. The epicentre of the outbreak was the residential colony of Industrial labour. The outbreak of Typhoid occurred due to conditions generated due to the pandemic of COVID -19. Two sources of active infection were found. First, contaminated supply of drinking water and second a food-handler, who was the carrier of Typhoid. Interpretation and Conclusion : It is a lesson to learn that the local communicable diseases should be monitor during the pandemic. Otherwise, that can cause the situation of co-epidemic

Knowledge, Awareness and Health Seeking Behaviour among Hepatitis patients attending a Tertiary Care Hospital in Delhi

Introduction: People living with Chronic Viral Hepatitis in India often lack awareness about risk factors and prevention. Objective: Objective of this article is to assess the health seeking behaviour of viral hepatitis infected patients attending super specialty hospital in Delhi. Methods: Total 389 patients attending a super specialty hospital in Delhi were interviewed. Results: The first point of contact for the treatment of hepatitis was a private practitioner (71%). Before coming to ILBS, 77.4% visited a private practitioner, followed by (42.7%) Govt. facilities (PHC/CHC/DH/Medical College), 12% visited a AYUSH doctor, about 10% visited either a Vaidya or a Hakim. About 40% believed that HBV is curable and 36.2% respondents thought that HCV is curable. Our findings show that 7.2% respondents have been vaccinated for HBV infection in the past, 20.8% respondents have screened their families for Hepatitis B infections. Conclusion: Need to create awareness about myths, further screening of HBV and HCV infection, early diagnosis and treatment.

Level of Independence and the Mental Status of the Visually Challenged High School Students in Chennai

Background: The purpose of this study is to measure the number of visually impaired students who are capable of doing and managing their own work and also to evaluate their state of mind due to their impairment. The study is also to bring awareness about the rehabilitation centres and special training on mobility for the children. Objective: To find out the level of independence and the mental status of visually challenged students. Methods: This is a descriptive cross-sectional study. Sixty visually impaired students were included in the study by random sampling method. Male students from class 9th to 12th standard were evaluated. Data relevant to the study are gathered by interview schedule method and questionnaire was designed for the study beforehand. Result: It is evident from the current study that 83.3% of the impaired have not been trained to walk independently. Almost 78.3% of the students are not even aware of the rehabilitation centres. However, about 98.3% of students are independent in grooming and washing & also taking care of their personal work. As per the survey, only 26.6 % of students are feeling isolated, whereas, the balance 73.4% students feel very comfortable while dealing with sighted students. About 96.6% feel very happy and satisfied as they get enough support from their parents.

TREATMENT FOR A REFRACTORY CHRONIC TENDOACHILLES TENDINITIS WITH PLATELET-RICH PLASMA INJECTIONS: A CASE REPORT

To define the pain and functional improvement of the patient with chronic Achilles tendinitis treated with a single PRP (platelet-rich plasma) injection. Chronic Tendoachilles tendinitis is a severe cause for a decrease in physical activity and persistent pain. It arises secondary to an account of repetitive use or exaggerated overload. Platelet-rich plasma therapy is used to provide local regenerative healing of the tendon. This report describes a 50-year-old Active female who presented with continuous pain in bilateral Tendoachilles for Approximately 6 years duration. A single Platelet-rich plasma injection is given to the patient with chronic tendoachilles tendinitis to reduce pain and improve function and improved VAS (visual analogue score) score from 9 to 0 seen at 1-year follow-up. The patient has been pain-free for the past 2 years and is back to daily functional physical activity. A single injection of PRP in each tendoachilles distally has shown significant relief in pain and improvement in day-to-day physical activity and a rapid recovery from chronic TA tendinitis.