Prescription pattern and rationality of antihypertensive drugs in patients of type 2 diabetes with hypertension: a pilot study

Background: As presence of hypertension (HTN) in type 2 diabetes significantly increases risk of morbidity and mortality, its control with rational use of antihypertensives is essential. Authors performed this study to understand the current prescribing pattern of antihypertensives in patients of type 2 diabetes and their assess the rationality to recommendations of JNC-8 guidelines.Methods: Authors performed a cross sectional survey of prescription of diagnosed patients of diabetes with HTN at a tertiary care hospital. Prescription of patients attending medicine OPD were scanned. Data was collected over 2 month and analyzed with descriptive statistics.Results: In 76 patients analysed, mean age was 54.9±9.3 years and 51.3% were females. Insulin and oral antidiabetic agents were prescribed in 16 (21.1%) and 73 (96.1%) patients respectively. One, two, three and four antihypertensive drugs were prescribed in 44 (57.9%), 28 (36.8%), 3 (3.9%) and 1 (1.3%) patients respectively and 24 (31.6%) of them were fixed dose combinations. Among antihypertensives, angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), thiazide diuretics, beta blockers (BBs) and calcium channel blockers (CCBs) were present in 29 (38.2%), 26 (34.2%), 22 (28.9%), 21 (27.6%) and 14 (18.4%) respectively. In individual drugs, ramipril (28.9%) was most common followed by telmisartan (26.3%), hydrochlorothiazide (26.3%), atenolol (16, 21.1%) and amlodipine (17.1%) were frequently prescribed. In adjuvant drugs, antiplatelet (52.6%) and statins (56.6%) were common. This pattern of prescription was as per the recommendations of recent JNC-8 guidelines for treatment of hypertension.Conclusions: ACEIs/ARB are the most preferred for HTN treatment in type 2 diabetes mellitus. Prescription of antihypertensives in our set up was rational as per JNC-8 recommendations

Development of Moisture Prediction Model for Tea using Electrical Impedance Spectroscopy

Moisture is the most essential parameter for tea leaves for storage and consumption stage as it affects the physical and chemical aspects of tea leaves with which it relates the stability and freshness the tea leaves for a long time. The most essential parameter which affects the quality of tea leaves is moisture for post harvesting, processing, storage and transport. The main aim of this study is to development procedure for moisture content measurements of fresh tea leaves using measurement acquired by electrical properties. Method This relation is obtained the frequency range within between 100 kHz to 300 MHz and moisture content ranges between 2%-75%. A good relation between moisture content and correlate with variations in electrical properties viz. IZI, Ѳz, R, Cp, Cs has been observed by partial least square regression technique. Result Moisture prediction model was developed by applying electrical properties and that the new technique it was observed more accuracy obtained using a single parameter as compared with that moisture measurement. Conclusion the model which is developed can evaluated with in performance the moisture content a commercial moisture meter which is expected

Density Independent and Temperature Compensated Moisture Prediction Model for Agricultural Products Using Impedance Analyzer: A Review

Agricultural products play an essential role in stabilizing the country economy. Third largest sector of Indian economy is agricultural products. In agricultural products the important factor for post harvesting, processing, storage and transport, is moisture, which affect their quality. In modern agriculture fast, non-destructive and reliable sensing technique for determination of moisture content in agricultural crops is required to prevent the losses and to improve efficiency of production. Various techniques are available for moisture sensing in agricultural products and better results have been achieved with use for these techniques. The performance of developed method for moisture sensing is comparable with that of commercial moisture meter. The most reliable solution for measuring the moisture content of agricultural products and non-destructive method is use of bulk density dielectric function. This paper reviews the area of moisture determination methods for various agricultural products and summarizing the various electrical methods for moisture determination

Development of a photometric system for continuous flow analysis

Most chemical analyses carried out in a clinical laboratory are colorimetric. An improved photometric system is described where a tungsten lamp is the light source, a photo-diode is the detector and a microcontroller 8051 is used for processing and displaying absorbances. The performance characteristics of the instrument are reported. The parameters investigated are photometric linearity, precision and instrumental drift

Arthroscopic fixation of anterior cruciate ligament tibial avulsion fractures: the suture “bridge” pull out technique and evaluation of results

Background: Tibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. Operative treatment is indicated for type 2, 3 and 4 fractures. Arthroscopic fixation is the preferred method and numerous fixation options are described. The purpose of this study is to evaluate the results of a new technique of arthroscopic fixation.Methods: A retrospective study was done involving twelve patients having displaced ACL tibial avulsion fractures. The arthroscopic suture “bridge” pull out technique was used to fix these fractures. Patient symptoms like knee pain, locking, clicking, sensation of giving way and clinical signs like tenderness, range of motion, Mc Murray’s test, stability test and Lysholm knee scores were evaluated pre operatively and post operatively at 3 months and 6 months. Patient satisfaction was noted at latest follow up.Results: One patient had type 2, 7 patients had type 3 and 4 patients had type 4 tibial ACL avulsion fractures. All the fractures united and all patients achieved full knee range of motion by 2 months post-operative. The clinical symptoms and signs improved post operatively. The mean Lysholm knee score at 3 months follow up was 88.8 and at 6 months follow up were 98.8. At latest follow up, all the patients were satisfied with their knee function. Conclusions: The arthroscopic suture “bridge” pull out technique is an effective method for fixation of ACL tibial avulsion fractures with respect to knee stability, range of motion and resumption of pre injury activity level

Effect of feeding cauliflower leaf meal on blood-biochemical, immunity status and carcass characteristics of growing goat kids

An experiment was conducted to evaluate the effect of feeding cauliflower leaf meal (CLM) on blood biochemical, immunity status and carcass characteristics of growing goat kids. Fifteen male non-descript goat kids of 6-8 months of age were divided equally into three groups (T0, T1 and T2). T0 group was fed with basal diet and T1 and T2 group were fed with 20 and 30% CLM in concentrate mixture for 120 days. The Hb, PCV, DLC, TLC, albumin, globulin, total protein, A:G ratio, Ca, P, Urea N and glucose levels were comparable among all groups of goat kids. However, total cholesterol was significantly lower in T1 and T2 group. The enzymatic profile including ALT, AST and ASP levels were comparable among all groups of kids. The serum antioxidants such as glutathione peroxidase and catalase were significantly higher in T2 group as compared to T1 and control group without affecting superoxide dismutase level. The thyroid hormones were non-significant among all groups of kids. The humoral and cell mediated immunity was improved in CLM fed group of kids. The carcass characteristics and meat composition were comparable among all groups of kids while TBAR value was lower in T2 group. Therefore, it may be concluded from the study that 20-30% CLM in concentrate mixture reduces the total cholesterol level, increases serum catalase and glutathione peroxidase level and improved keeping quality of meat, cell mediated and humoral immunity status of growing goat kids

Relation of COVID-19 with acute ischemic bowel disease: A retrospective observational study

Introduction: COVID-19 is a serious respiratory disease caused by SARS-CoV-2, aside from the respiratory system, the gastrointestinal system is the most common site of SARS-COV-2 infection. The study aimed to assess relation between COVID and ischemic bowel disease by analysing length of hospital stay and mortality rates between COVID and non-COVID groups. Methods: The study was conducted from June 2020 to November 2021 in the surgical wards of Seth GS Medical College and KEM Hospital, Mumbai. Included patients presented to emergency room with acute abdomen which diagnosed as acute ischemic bowel disease during the period of study and then compared the outcomes between COVID and non-COVID groups. Results: Out of 40 patients, 16 had no history of COVID and remaining 24 had either previous history of COVID or diagnosed presently with COVID. In both COVID and non-COVID population, distribution of comorbidities were almost equal exception being stroke, where both the cases had previous history of COVID, diabetes was the most common comorbidity in both the groups followed by hypertension. Patients with active COVID infection had higher mortality of 75% (3 out of 4) followed by patients with past history of infection with mortality rate of 65% (13 out of 20) whereas the mortality rate in non-COVID patients were 37.5% (6 out of 16). Conclusion: Ischemic bowel disease among COVID-19 patients is rare, but its association with high mortality rates and prolonged length of stay necessitates clinical suspicion and prompt intervention

Impact of a centralized osteoporosis coordinator on post-fracture osteoporosis management: a cluster randomized trial

SUMMARY: We conducted a cluster randomized trial evaluating the effect of a centralized coordinator who identifies and follows up with fracture patients and their primary care physicians about osteoporosis. Compared with controls, intervention patients were five times more likely to receive BMD testing and two times more likely to receive appropriate management. INTRODUCTION: To determine if a centralized coordinator who follows up with fracture patients and their primary care physicians by telephone and mail (intervention) will increase the proportion of patients who receive appropriate post-fracture osteoporosis management, compared to simple fall prevention advice (attention control). METHODS: A cluster randomized controlled trial was conducted in small community hospitals in the province of Ontario, Canada. Hospitals that treated between 60 and 340 fracture patients per year were eligible. Patients 40 years and older presenting with a low trauma fracture were identified from Emergency Department records and enrolled in the trial. The primary outcome was ‘appropriate’ management, defined as a normal bone mineral density (BMD) test or taking osteoporosis medications. RESULTS: Thirty-six hospitals were randomized to either intervention or control and 130 intervention and 137 control subjects completed the study. The mean age of participants was 65 ± 12 years and 69% were female. The intervention increased the proportion of patients who received appropriate management within 6 months of fracture; 45% in the intervention group compared with 26% in the control group (absolute difference of 19%; adjusted OR, 2.3; 95% CI, 1.3–4.1). The proportion who had a BMD test scheduled or performed was much higher with 57% of intervention patients compared with 21% of controls (absolute difference of 36%; adjusted OR, 4.8; 95% CI, 3.0–7.0). CONCLUSIONS: A centralized osteoporosis coordinator is effective in improving the quality of osteoporosis care in smaller communities that do not have on-site coordinators or direct access to osteoporosis specialists

First 230 GHz VLBI Fringes on 3C 279 using the APEX Telescope

We report about a 230 GHz very long baseline interferometry (VLBI) fringe finder observation of blazar 3C 279 with the APEX telescope in Chile, the phased submillimeter array (SMA), and the SMT of the Arizona Radio Observatory (ARO). We installed VLBI equipment and measured the APEX station position to 1 cm accuracy (1 sigma). We then observed 3C 279 on 2012 May 7 in a 5 hour 230 GHz VLBI track with baseline lengths of 2800 M$\lambda$ to 7200 M$\lambda$ and a finest fringe spacing of 28.6 micro-arcseconds. Fringes were detected on all baselines with SNRs of 12 to 55 in 420 s. The correlated flux density on the longest baseline was ~0.3 Jy/beam, out of a total flux density of 19.8 Jy. Visibility data suggest an emission region <38 uas in size, and at least two components, possibly polarized. We find a lower limit of the brightness temperature of the inner jet region of about 10^10 K. Lastly, we find an upper limit of 20% on the linear polarization fraction at a fringe spacing of ~38 uas. With APEX the angular resolution of 230 GHz VLBI improves to 28.6 uas. This allows one to resolve the last-photon ring around the Galactic Center black hole event horizon, expected to be 40 uas in diameter, and probe radio jet launching at unprecedented resolution, down to a few gravitational radii in galaxies like M 87. To probe the structure in the inner parsecs of 3C 279 in detail, follow-up observations with APEX and five other mm-VLBI stations have been conducted (March 2013) and are being analyzed.Comment: accepted for publication in A&

Georeferenced soil information system: assessment of database

Land-use planning is a decision-making process that facilitates the allocation of land to different uses that provide optimal and sustainable benefit. As land-use is shaped by society–nature interaction, in land-use planning different components/facets play a significant role involving soil, water, climate, animal (ruminant/ non-ruminant) and others, including forestry and the environment needed for survival of mankind. At times these components are moderated by human interference. Thus land-use planning being a dynamic phenomenon is not guided by a single factor, but by a complex system working simultaneously,which largely affects the sustainability. To address such issues a National Agricultural Innovation Project (NAIP) on ‘Georeferenced soil information system for land-use planning and monitoring soil and land quality for agriculture’ was undertaken to develop threshold values of land quality parameters for land-use planning through quantitative land evaluation and crop modelling for dominant cropping systems in major agro-ecological sub-regions (AESRs) representing rice–wheat cropping system in the Indo-Gangetic Plains (IGP) and deep-rooted crops in the black soil regions (BSR). To assess the impact of landuse change, threshold land quality indicator values are used. A modified AESR map for agricultural landuse planning is generated for effective land-use planning