A case report on IgA nephropathy in pregnancy

IgA Nephropathy is a primary glomerular disease leading cause of primary glomerulonephritis and one of the important  leading cause of secondary hypertension. Pregnancy causes complex pathological changes in patients with IgA nephropathy affecting the renal function leading to secondary hypertension which in turn affects the prognosis of these patients. The association between chronic kidney disease and increased risk of adverse maternal and fetal outcomes which includes pre-eclampsia, accelerated decline in renal function, intrauterine growth retardation, preterm delivery and fetal death, is well recognised. Management of patients with IgA Nephropathy in pregnancy is challenging and thus authors are discussing here a case with successful outcome. Our patient was a known case of IgA Nephropathy and landed up with complications during pregnancy which was manged successfully.

Recurrent decidual cast with membranous dysmenorrhea

Decidual cast is the entire sloughed endometrium that takes the form of the endometrial cavity. It causes membranous dysmenorrhea because the intact cast passes through an undiluted cervix. It may be associated with ectopic pregnancy, incomplete abortion, non-pregnant state with use of progesterone, Depot medroxyprogesterone acetate (DMPA), rarely with oral contraceptive pills. Authors are reporting a case of recurrent decidual caste formation with membranous dysmenorrhoea in 33 years old women P3L3 who was on norethisterone acetate treatment for a typical uterine bleed (AUB). She presented with heavy menstrual bleeding with severe dysmenorrhea in Gynae causality of ESI Basaidarapur medical college, Delhi. She expelled decidual caste and required therapeutic Dilation and Curettage (D and C) to control bleeding per vaginum. Her histopathology report showed marked decidua like change of the stroma but no villi suggestive of endometrial caste

ROLE OF NANOEMULSION FOR SAFE AND COST-EFFECTIVE DELIVERY OF AMPHOTERICIN B

Amphotericin B is a highly effective antifungal agent and its use has been surged drastically due to its effectiveness against a wide range of fungal infections. It is effective against both topical and systemic infections and even this is the only drug having high efficacy against Leishmania, Candida, Aspergillus and many more. Owing to this, the demand of Amphotericin B is gaining momentum. However, this drug possesses numerous drawbacks like toxicity, poor solubility to name a few, due to which its current use is dwindling. So far the numbers of formulations have been marketed in order to triumph over its toxicity and solubility related issues. Unfortunately, no single study conducted hitherto gain success in overcoming its lethal ramifications. Among all formulations, nanoemulsions are at the top to combat all issues related to this drug. Nanoemulsion has shown enhanced stability, reduced cost and toxicity. This review will assimilate complete information on the use of nanoemulsion based formulations of Amphotericin B, its developed formulations and also will enunciate the important considerations and future perspectives. The complete data have been composed from Google Scholar, ScienceDirect and PubMed using the following keywords

Preparation and Evaluation of Sulfacetamide Sodium Ocusert for Controlled Drug Delivery

The intent of this research was to formulate and evaluate controlled release ocusert of sulfacetamide sodium for the treatment of bacterial conjunctivitis. Ocusert is a sterile preparation having drug as dispersion or as solution in the polymeric base. Prepared Ocuserts were formulated using hydroxyl propyl methyl cellulose K-15 and Ethyl cellulose as polymers at various concentrations and combinations. Polymeric Films were prepared by mercury casting method using different ratios of polymers. Selected physiochemical properties such as thickness, weight, percentage moisture absorption, and in-vitro release and sterility studies of sulfacetamide sodium ocusert were studied and reported that prepared ocusert resolved the problems of poor bioavailability, frequent dosing and wastage of active ingredient. Keywords: Hydroxypropyl methyl cellulose K-15, ocusert, sulfacetamide sodiu

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Hookah use among high school children in an Indian city

Context: Use of hookah is on the rise among youngsters. A growing body of evidence suggests that these children are experimenting with this form of tobacco. Aims: The study was carried out to know prevalence estimates of hookah use and factors associated with it among high school students.Settings and Design: This study adds to the current literature by providing prevalence estimates and factors associated with hookah use among high school students of Indore - a city in central India.Materials and Methods: A cross-sectional survey of 1000 students from high schools was conducted to find hookah users and factors associated with its use. Results: Hookah users in this study population were 7.6%. Most of them first learned about hookah from friends (63.2%). They usually smoked in hookah lounges (85.5%). These children believed that hookah was safer and more socially acceptable than cigarettes.Conclusions: Misperceptions of safety and popularity of hookah among the younger generation are cause for concern. Presence of hookah lounges should be a target for further regulation. Prevention activities are necessary to prevent this rising public health concern