Role of lipid profile in proven premature coronary artery disease and its first degree relatives- a tertiary care hospital based study in South-Eastern region of Rajasthan, India

Background: Cardiovascular diseases have become a leading cause of morbidity and mortality in adult population of Indian sub-continent. Aim of the study was to compare the serum lipid patterns in patients with proven premature CAD and its first degree relative in a tertiary care hospital of South-eastern region of Rajasthan, India.Methods: 200 patients with the primary diagnosis of premature coronary artery disease were enrolled. These patients and their 643 first-degree relatives, who were in the coronary age group 25 years and above also enrolled for the purpose of the study. Fasting lipid profile was estimated.Results: 36.5% of the males and 4.5% female patients were having abnormal cholesterol levels. 30.5 % of male of premature CAD were having high LDL levels as compared to only 2.5% of the females (p<0.05). High LDL level was 33.0%. Low HDL cholesterol in CAD patients were in 36.0% of males and 4.0% of the females (p<0.05). High Triglyceride levels (53.5%) in the CAD patients were 46.5% males and 6.5% females. (p<0.05). Irrespective of sex, majority of relatives  (70.7%) were having desirable total cholesterol levels while high total cholesterol was there in only 10.1% of the relatives.21.4% of male relatives of CAD patients were having abnormal LDL levels as compared to 7.4% of the females (p<0.05).Conclusions: For hyper cholestolaemia, routine screening of all adults older than 20 years is recommended. Therapeutic targets for lipid levels are recommended depending on overall risk for patients with CAD or a CAD risk equivalent such as diabetes or peripheral arterial disease.

Prevalence of enterococci and its antibiotic resistance in various clinical samples at tertiary care hospital in Southern Rajasthan, India

Background: Enterococci has been emerging as a major cause of infection and gaining increasing clinical importance due to developing resistance to various antibiotics. Emergence of vancomycin resistant enterococci (VRE) in the recent past has been a concern. Aim of the study was to determine the prevalence of enterococci in tertiary care hospital in Southern Rajasthan, India and observe its antibiotic resistance pattern.Methods: Enterococci strains were isolated from various clinical samples by culture and biochemical methods and its antibiotic susceptibility testing was seen by Kirby Bauer method as per CLSI guidelines.Results: Out of 100 samples, 50% were isolated from urine samples followed by pus and blood. Resistance to all the drugs was observed with least towards Vancomycin (11%), followed by doxycycline (14%).Conclusions: The prevalence of multiple drug resistance enterococci with 11% VRE is observed in present study. The study emphasizes on invitro antibiotic susceptibility testing for clinical samples and also rational drug usage

Can circular healthcare economy be achieved through implementation of sustainable healthcare supply chain practices? Empirical evidence from Indian healthcare sector

Purpose Idea of circular economy defies the classical “make-use-dispose” approach of linear economic model. In the context of health-care industry, it relies heavily on the supply chain practices implemented by industry stakeholders. The purpose of this study is to explore such relationships, study their structure and put it across for attaining sustainability at large. Design/methodology/approach This study is an empirical research conducted on 145 health-care firms. The collected data is analysed to develop structural and measurement model. The five constructed hypotheses are examined and tested through structural equation modelling. Findings The study illustrates the latent relationships that exist among the stakeholders involvement, sustainable supply chain practices, sustainable performance and circular economy for health-care industry. It is found that the adoption of sustainable supply chain practices improves health-care performance, which, in turn, have positive influence on circular economy. Research limitations/implications The structural and measurement model is developed in the context of circular health-care economy. It can be validated or improvised by conducting similar research in other industry using different methods. This research work fulfils the long existing gap in research by offering a linkage between various constructs to achieve health-care circular economy. Based on the research results, future researchers can build theories of circular economy and sustainability for health-care industry. Originality/value The study attempts to study the supply chain ways to achieve circular economy for Indian health-care sector. It considered latent relationships among the set of constructs, which are needed for theory building at later stage

Prevalence of enterococci and its antibiotic resistance in various clinical samples at tertiary care hospital in Southern Rajasthan, India

Background: Enterococci has been emerging as a major cause of infection and gaining increasing clinical importance due to developing resistance to various antibiotics. Emergence of vancomycin resistant enterococci (VRE) in the recent past has been a concern. Aim of the study was to determine the prevalence of enterococci in tertiary care hospital in Southern Rajasthan, India and observe its antibiotic resistance pattern. Methods: Enterococci strains were isolated from various clinical samples by culture and biochemical methods and its antibiotic susceptibility testing was seen by Kirby Bauer method as per CLSI guidelines. Results: Out of 100 samples, 50% were isolated from urine samples followed by pus and blood. Resistance to all the drugs was observed with least towards Vancomycin (11%), followed by doxycycline (14%). Conclusions: The prevalence of multiple drug resistance enterococci with 11% VRE is observed in present study. The study emphasizes on invitro antibiotic susceptibility testing for clinical samples and also rational drug usage. [Int J Res Med Sci 2016; 4(8.000): 3413-3416

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Not AvailableCrop improvement through pre‐breeding utilizes elite lines, germplasm and species of compatible gene pools, but crossing and characterizing the derivatives between incompatible species, especially distant genera or species, is realized to introduce de novo variations that are heritable, stable and especially economically contributing. This is a novel approach to introduce large‐scale de novo variations in crops that can be applied to widening of the genetic base. It helps to introduce heritable and agronomical variations that can be evolved in a short time for use in trait specific breeding programmes. In crosses between incompatible species many times F₁ are delusive appearing like maternal parent. But large variations in F₂ are observed due to genetic changes that include partial or complete elimination of the genome from the paternal parent, reshuffling of the maternal genome leading to several changes that are translated to phenotype. Genome, transcriptome and epigenetic reprogramming is responsible for the above genetic changes. Crossing two distant species can be used as an additional tool in plant breeding

Exploring the Immunomodulatory Aspect of Mesenchymal Stem Cells for Treatment of Severe Coronavirus Disease 19

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an enveloped, positive sense, single stranded RNA (+ssRNA) virus, belonging to the genus Betacoronavirus and family Coronaviridae. It is primarily transmitted from infected persons to healthy ones through inhalation of virus-laden respiratory droplets. After an average incubation period of 2–14 days, the majority of infected individuals remain asymptomatic and/or mildly symptomatic, whereas the remaining individuals manifest a myriad of clinical symptoms, including fever, sore throat, dry cough, fatigue, chest pain, and breathlessness. SARS-CoV-2 exploits the angiotensin converting enzyme 2 (ACE-2) receptor for cellular invasion, and lungs are amongst the most adversely affected organs in the body. Thereupon, immune responses are elicited, which may devolve into a cytokine storm characterized by enhanced secretion of multitude of inflammatory cytokines/chemokines and growth factors, such as interleukin (IL)-2, IL-6, IL-7, IL-8, IL-9, tumor necrosis factor alpha (TNF-α), granulocyte colony-stimulating factor (GCSF), basic fibroblast growth factor 2 (bFGF2), monocyte chemotactic protein-1 (MCP1), interferon-inducible protein 10 (IP10), macrophage inflammatory protein 1A (MIP1A), platelet-derived growth factor subunit B (PDGFB), and vascular endothelial factor (VEGF)-A. The systemic persistence of inflammatory molecules causes widespread histological injury, leading to functional deterioration of the infected organ(s). Although multiple treatment modalities with varying effectiveness are being employed, nevertheless, there is no curative COVID-19 therapy available to date. In this regard, one plausible supportive therapeutic modality may involve administration of mesenchymal stem cells (MSCs) and/or MSC-derived bioactive factors-based secretome to critically ill COVID-19 patients with the intention of accomplishing better clinical outcome owing to their empirically established beneficial effects. MSCs are well established adult stem cells (ASCs) with respect to their immunomodulatory, anti-inflammatory, anti-oxidative, anti-apoptotic, pro-angiogenic, and pro-regenerative properties. The immunomodulatory capabilities of MSCs are not constitutive but rather are highly dependent on a holistic niche. Following intravenous infusion, MSCs are known to undergo considerable histological trapping in the lungs and, therefore, become well positioned to directly engage with lung infiltrating immune cells, and thereby mitigate excessive inflammation and reverse/regenerate damaged alveolar epithelial cells and associated tissue post SARS-CoV-2 infection. Considering the myriad of abovementioned biologically beneficial properties and emerging translational insights, MSCs may be used as potential supportive therapy to counteract cytokine storms and reduce disease severity, thereby facilitating speedy recovery and health restoration

SCOPE: Surveillance of COVID-19 in pregnancy- results of a multicentric ambispective case-control study on clinical presentation and maternal outcomes in India between April to November 2020.

ObjectiveTo determine the clinical manifestations, risk factors, treatment modalities and maternal outcomes in pregnant women with lab-confirmed COVID-19 and compare it with COVID-19 negative pregnant women in same age group.DesignMulticentric case-control study.Data sourcesAmbispective primary data collection through paper-based forms from 20 tertiary care centres across India between April and November 2020.Study populationAll pregnant women reporting to the centres with a lab-confirmed COVID-19 positive result matched with controls.Data qualityDedicated research officers extracted hospital records, using modified WHO Case Record Forms (CRF) and verified for completeness and accuracy.Statistical analysisData converted to excel files and statistical analyses done using STATA 16 (StataCorp, TX, USA). Odds ratios (ORs) with 95% confidence intervals (CI) estimated using unconditional logistic regression.ResultsA total of 76,264 women delivered across 20 centres during the study period. Data of 3723 COVID positive pregnant women and 3744 age-matched controls was analyzed. Of the positive cases 56·9% were asymptomatic. Antenatal complications like preeclampsia and abruptio placentae were seen more among the cases. Induction and caesarean delivery rates were also higher among Covid positive women. Pre-existing maternal co-morbidities increased need for supportive care. There were 34 maternal deaths out of the 3723(0.9%) positive mothers, while covid negative deaths reported from all the centres were 449 of 72,541 (0·6%).ConclusionCovid-19 infection predisposed to adverse maternal outcomes in a large cohort of Covid positive pregnant women as compared to the negative controls