End-of-life decisions as bedside rationing. An ethical analysis of life support restrictions in an Indian neonatal unit.

INTRODUCTION: Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? METHOD: A seven-step impartial ethical analysis, including outcome analysis of four accepted priority criteria: severity of disease, treatment effect, cost effectiveness and evidence for neonates born at 28 and 32 GAW. RESULTS: The ethical analysis sketches out two possibilities: (a) It is not ethically permissible to limit treatment to neonates below 32 GAW when assigning high weight to health maximisation and overall health equality. Neonates below 32 GAW score high on severity of disease and efficiency and cost-effectiveness of treatment if one gives full weight to early years of a newborn life. It is in the child's best interest to be treated. (b) It can be considered ethically permissible if high weight is assigned to reducing inequality of welfare and maximising overall welfare and/or not granting full weight to early years of newborns is considered acceptable. From an equity-motivated health and welfare perspective, we would not accept (b), as it relies on accepting the lack of proper welfare policies for the poor and disabled in India. CONCLUSION: Explicit priority processes in India for financing neonatal care are needed. If premature neonates are perceived as worth less than other patient groups, the reasons should be explored among a broad range of stakeholders.

Antibacterial activity directed isolation of compounds from Punica granatum.

Chemical investigation of the methanolic extract of pomegranate fruit following antibacterial activity directed isolation led to the isolation of pelargonidin-3-galactose, cyanidin-3-glucose, gallic acid, quercetin, and myricetin. All these compounds exhibited substantial activity against species of corynebacteria, staphylococci, streptococci, Bacillus subtilis, Shigella, Salmonella, Vibrio cholera, and Escherichia coli. However, all these compounds were more active against Gram-positive species. On comparing the activity of all the isolated pure compounds, it was found that gallic acid showed the highest antibacterial activity against all the tested sensitive strains and the activity of the remaining pure compounds was almost same due to the structural similarities of the compounds. The reason for antibacterial activity of all pure compounds was attributed to their phenolic structure.

A sensitive novel staining agent for the resolved proteins on PAGE.

A more sensitive, stable and fast-reacting dye was isolated from the bark of Ratanjot by a simple solvent extraction procedure at high pH. The dye produced sharp, clear distinct stable bands of known proteins when resolved on polyacrylamide gel electrophoresis (PAGE) using sodium dodesyl sulfate (SDS), showing a rapid and strong affinity with protein molecules. Not only did proteins from peanut, separately stained with the new dye and Coomassie Brilliant Blue R-250, produce rapid comparable results, but also the protein bands were easily visualized and were less diffusible with clearer boundaries in the case of the new staining agent.

Action of sorbic acid on Staphylococcus metabolism: a microcalorimetric investigation.

Effect of sorbic acid, an antimicrobial food preservative, on the cellular metabolism of Staphylococcus aureus was observed microcalorimetrically. The highly reproducible and characteristic thermograms of the microorganism were affected significantly by the preservative in a concentration dependent manner. Both the peak heat and total heat dissipation profiles were affected by 50% at the maximum permitted concentration (0.2%) for use in foods.

A plant dye from Lawsonia inermis for protein staining after polyacrylamide gel electrophoresis.

A reddish-brown dye was isolated from the leaves of Lawsonia inermis by extraction with calcium hydroxide (pH 11-12). A 3.6% crude extract in ethanol/water, 1:1 v/v, was used for direct staining, without fixation, of bovine serum albumin, casein and human serum proteins, following polyacrylamide gel electrophoresis in cylindrical gels. After staining for 30 min the gels were destained for 1/2-2 h with 7% acetic acid at 60 degrees C. Protein staining with Amido Black 10B and Coomassie Brilliant Blue R-250, according to standard protocols, required destaining for 24 h and more to obtain a comparably cleared background. Staining with the plant dye and Coomassie Brilliant Blue had a similar overall staining sensitivity but some minor components of human serum showed different staining characteristics with each of the two dyes. Staining with the plant dye excels over standard staining by speed and simplicity.

Effects of Wearing a Helmet on Thermal Balance While Cycling in the Heat.

In brief: Many cyclists refuse to wear helmets because they produce discomfort and drag. To determine the effects of wearing a helmet on thermal balance and rating of perceived exertion while cycling in the heat, six male competitive cyclists aged 19 to 32 rode a stationary bicycle attached to a road-racing simulator in an environmentally controlled chamber for two hours at 70% V O2 max. Measurements were taken of rectal and skin temperatures, V O2, heart rate, sweat rate, and rating of perceived exertion. The results showed that (under the experimental conditions used) wearing a helmet while cycling in the heat does not alter thermal balance or cardiovascular strain compared with not wearing a helmet.

Effect of sugar mill effluent on oxygen uptake and carbon dioxide output of rice (Oryza sativa L.c.v. Mushoori) seedlings.

The effects of a sugar mill effluent on respiration of rice (Oryza sativa L.c.v. Mushoori) seedlings have been investigated. Each experiment consisted of two parts, the effect of various concentrations of the effluent and the time-dependent changes induced by the undiluted effluent. A marked increase in the rate of respiration was noticed upon treatment with various concentrations of the effluent. The time-dependent changes in the respiratory rate were about threefold with the 12 hr of treatment, and thereafter a rapid loss was noticed. Additionally, the respiratory quotient was studied to elucidate the nature of the metabolism of seedlings as influenced by the effluent.