Study of Vitamin D Status in Hypertension and It’s Complications

INTRODUCTION: Cardiovascular disease is the leading cause of mortality in developing as well as developed counties. Hypertension is one of the modifiable risk factors for Cardiovascular disease and any new modifiable risk factors associated with prevention of this condition is important public health factor which can have global impact on mortality and morbidity. Vitamin D is a steroid prohormone synthesized in the skin. There is evidence from animal and clinical studies that vitamin D has role in the activation of renin-angiotensin-aldosterone system. This study is conducted to find if there is any relationship between vitamin D and hypertension and its complications. AIM AND OBJECTIVES: 1. To compare vitamin D level in hypertensive and normotensive patients. 2. To compare Vitamin D level in newly diagnosed hypertensive patients and in those with long standing hypertension. 3. To find out the relationship between vitamin D deficieny and complications of hypertension. MATERIALS AND METHODS: STUDY CENTRE: Tirunelveli Medical College, Tirunelveli. STUDY DURATION: 2 years. STUDY DESIGN: Case control study. SAMPLE SIZE: 50 patients : 50 controls. INCLUSION CRITERIA: Patients with newly diagnosed systemic hypertension attending hypertension OPD and those who are admitted in the medical wards with complications of hypertension and willing to participate in the study after getting informed consent. EXCLUSION CRITERIA: ◈ All cases of secondary hypertension. ◈ Patients already taking Vitamin D supplements. ◈ Patients already taking Calcium supplements. ◈ Patients who are not willing to participate in the study. ◈ Patients who are diagnosed to have chronic kidney disease. ◈ Patient who are diagnosed to have chronic liver disease. DATA COLLECTION METHODS: Collection of data as per proforma with consent from patients with systemic hypertension in Tirunelveli Medical College medicine wards and in hypertension OPD. SELECTION CRITERIA: SYSTEMIC HYPERTENSION: DEFINATION OF HYPERTENSION ACCORDING TO JNC 8. • Systolic blood pressure more than or equal to 140. • Diastolic blood pressure more than or equal to 90. DIABETES: DIAGNOSTIC CRITERIA ACCORDING ADA RECOMENDATIONS • Random blood sugar of 200mg/dl with symptoms of diabetes. • Fasting blood sugar of more than or equal to 126mg/dl. • Postprandial blood sugar of more than or equal to 200. • HBA1c more than or equal to 6.5%. Random is defined as with no regard to time since last meal. Fasting is defined as no food intake for at least 8 hours. OBESITY: Body mass index of more than 25kg/sq.m. MICROVASCULAR COMPLICATIONS: Retinopathy – Retinal changes in fundus examination. Nephropathy – Presence of microalbumin by urine dipstick method. Left ventricular hypertrophy - presence of LVH in ECG and /or Echocardiography. MACROVASCULAR COMPLICATIONS: Coronary artery disease – History, Ecg, ECHO abnormalities. Cerebrovascular accidents - History, Examination and Imaging studies. VITAMIN D ESTIMATION: METHOD – CALORIMETRIC METHOD: Estimation is done using 25(OH) vitamin D Enzyme Linked Immunosorbant Assay (ELISA) kit. Dissociation buffer is added to wells coated with donkey anti-sheep IgG antibody. Samples and standards are then added to it to dissociate vitamin D from its binding protein. It is followed by addition of a solution of alkaline phosphatase conjugated 25(OH) vitamin D3 followed by sheep monoclonal antibody to 25(OH) vitamin D. The mixture is incubated at room temperature, during which the antibody binds the vitamin D in the sample in a competitive manner and by itself is conjugated with anti sheep IgG antibody. The plate is then washed leaving the complex bound with vitamin D from sample. A substrate containing pNpp solution is then added, which initiates an alkaline phosphatase catalysed reaction that generates an yellow colour in the solution. The resulting yellow colour is read at 450nm. The amount of signal is inversely proportional to the amount of 25(OH) vitamin D in the sample. REFERENCE VALUES: Normal level of vitamin D : 30-100 ng/ml, Insufficiency : 6 – 29ng/ml, Deficiency : <6 ng/ml, Toxicity : > 100ng/ml. RESULTS: ◈ Vitamin D level is significantly lower in hypertensives on comparing with the age and sex matched controls of normotensives. ◈ There is inverse correlation between the chronicity of hypertension and the level of vitamin D CONCLUSION: Vitamin D levels are significantly lower in hypertensive patients when compared to the normotensives and it also correlates with the chronicity of hypertension. But we could not find the correlation between vitamin D levels and complications of hypertension

Attitude towards mental illness among doctors and nurses in a tertiary care centre, Pondicherry, India

Background: Stigma can prevent care and treatment of mentally ill. About 54% of diagnosable mental disorders are seen in primary care settings. There is a gross underestimation of psychiatric morbidity among patients by substantial proportion of non-psychiatric clinicians. Hence there is a need to assess the attitude towards mental illness among doctors and staff nurses. The objectives of the study were to assess the attitude towards mental illness among doctors and nurses, to compare the attitude between doctors and nurses, to find if there is any correlation between duration of training or posting and attitude, to find if educational status had any influence on attitude, to find if there is any gender influence on attitude. Methods: It is a cross sectional descriptive study conducted in a private medical college, Pondicherry among doctors and nurses who had completed their under graduation with a sample size of 221 (Doctors-120, Nurses-101). The instruments used were a semi-structured demographic profile and 34 items of OMICC (Opinion About Mental Illness in Chinese Community). The data was entered in Microsoft Excel 2013 analyzed using descriptive statistics, unpaired t-test, pearson’s correlation coefficient.Results: Only 25% of doctors and 4.9% of nurses positive attitude when overall score was considered. Doctors group had higher positive attitudes compared to nurses in domains separatism, stereotyping, benevolence and stigmatisation.Conclusions: There was no correlation between duration of psychiatry posting and attitude

A study on virulence factors and antimicrobial resistance pattern among enterococci isolated from various clinical specimens from a tertiary care hospital

Background: Enterococci, adult faeces commensal are important nosocomial pathogens. E. faecalis is the most common cause of infection, followed by E. faecium. In the past two decades, they have developed resistance to many commonly used antimicrobial agents. Understanding virulence factors and monitoring antimicrobial resistance among Enterococci is essential for controlling the spread of bacterial resistance and important for epidemiological surveillance within the hospital environment. The aim of the study is to evaluate antibiotic resistance and virulence factors exhibited by Enterococcus sp.Methods: One hundred consecutive isolates of Enterococci isolated from different clinical samples of patients attending AVMC and H, a tertiary care center at Pondicherry in a period of 20 months were included in the study. Enterococcus sp were identified as per standard conventional bacteriologic methods and detected for the production of virulence factors such as Hemolysin production, Gelatinase production. Antimicrobial susceptibility testing was carried out by disc diffusion method and MIC of vancomycin and teicoplanin was determined by E-test strips.Results: Among 100 Enterococcal isolates included in the study, 81% were E. faecalis and 19% were E. faecium which were isolated from urine (44%), Pus (51%) and others specimen (5%, which includes blood 80% and drain tube 20%). In this study, overall 15% of E. faecalis and 1% of E. faecium showed hemolysin production and Gelatinase was produced by 6% of E. faecalis and 4% of E. faecium. Majority of E. faecalis and E. faecium strains isolated in our study, had increased sensitivity were to be exhibited for Linezolid, Vancomycin followed by high level gentamycin and high degree of resistance to penicillin, ciprofloxacin and cotrimoxazole. Analyzing the results of MIC of vancomycin and teicoplanin, 5 isolates were classified phenotypically as VanB phenotype that possess only moderate to high levels of vancomycin resistance and one isolate obtained from drain tube which showed MIC of vancomycin as 120µg/ml and teicoplanin 16µg/ml was grouped into VanA.Conclusions: Though the prevalence of vancomycin resistant Enterococcci (VRE) is very low in our study, yet regular monitoring of vancomycin resistance is very crucial for early detection, treatment, application of preventive and control measures and most importantly to check the spread of virulent multidrug resistant Enterococcus species

Assess the Levels of Dependence And Severity of Psychiatric Illness Among Adolescent Boys Addicted to Marijuna

Marijuana refers to the dry leaves, flowers, stems, and seeds from cannabis sativa or cannabis India plant; it is a psychoactive sedative drug. Adolescent age group is more likely to use cannabis in the form of Marijuana and experience many psychiatric illness problems from use. A recent survey from partnership at drug free shows that about 10% of teens smoke cannabis at least 20 times each month. The main objective of the study is to assess the dependency and associated psychiatric illness among adolescent people at selected area. The sampling sizes of 100 were recruited in purposive sampling technique; descriptive study was used along with structured MEEQ questionnaires. In study results shows that level of dependency were 46% adolescents are short term dependent to marijuana, 36% are moderate level of dependent to marijuana, and 23% adolescents are long term dependent to marijuana. There is a significant association between the level of dependency state of marijuana and the psychiatric illness such as visual hallucination, auditory hallucination, improved memory and learning ability at (p<0.05)

A STUDY ON IMPORTANCE OF ENTREPRENEURSHIP SKILL DEVELOPMENT PROGRAMME (ESDP) FOR SUSTAINABLE GROWTH OF MSMEs IN INDIA

The Entrepreneurship and Skill Development Program (ESDP) was launched by the Ministry of Micro, Small and Medium Enterprises (MSME) to build the capacities and skills of Indian entrepreneurs, both current and future ones. One of the many initiatives offered by the Ministry of MSME, it aims to increase the capacity of young people to take on challenges and create successful businesses across the nation. There are various activities under the plan that are coordinated in Industrial Training Institutes (ITIs), Polytechnics, and other specialized institutions/business colleges where there is talent available to influence teenagers toward self-employment. One of the essential elements for the development of any area is having an adequate supply of skilled human resources. Today, the problem is fundamentally linked to the employability problem rather than the lack of employment opportunities. This is a major problem in many developing countries where young children are taught, but they need skills that will help them become prepared for the workforce. Hence, the current study has been done with a view to give an analytical outline of the importance of ESDP for the sustainable growth of MSMEs in India

Chemical profiling of fern Cheilosoria mysurensis (Wall. ex Hook.) Ching & Shing and its biological activity

Cheilosoria mysurensis (Wall. ex Hook.) Ching &amp; Shing, a medicinal fern traditionally used to treat burns, throat pain and bone fracture. There is no any scientific report regarding anticancer studies of this species. The aim of the study was to find out the chemical components through GC/MS analysis with their antioxidant and cytotoxic activity. GC-MS analysis shows primary ingredients viz, Cis-9, 10-epoxyoctadecan-1-ol and Oxiraneundecanoic acid, 3-pentyl-, methyl ester, trans were present. High free-radical scavenging activity has been discovered in 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and showed the IC50 value of 52.13±0.33. Furthermore, C. mysurensis also showed good cytotoxic effects against DLA and EAC cell lines with values of 72.9% and 79.5% at 200 µg/ml dose respectively. Overall findings suggested that the identified chemical compounds proved to be rich in antioxidant property. Further, this fern can be a good resource for pharma industry to produce novel anti-cancer drugs

Complication of Salmonella Bacteremia in a Case of Treated Fungal Endophthalmitis

This is to report a case of bacteremia caused by Salmonella typhi in a treated unilateral fungal endogenous endophthalmitis in an 18-year-old male from one of the South Asian countries. Microbiological and molecular investigations were carried out on the eviscerated material and routine blood culture was carried out. Direct examination of eviscerated material revealed the presence of fungal filaments. However, Salmonella typhi was isolated from both specimens, which was confirmed by Polymerase chain reaction targeting the 16SrRNA gene, sequencing, and random amplification of polymorphic DNA showed that they belonged to the same clone. The presence of Salmonella bacteremia in a treated unilateral fungal endophthalmitis, among young adult patients is rare and systemic symptoms should be investigated

NAVIGATING RESILIENCE: ANALYZING GOVERNMENT POLICIES FOR FOSTERING SUSTAINABLE MSME GROWTH IN INDIA

The Micro, Small, and Medium Enterprise (MSME) sector stands as a pivotal pillar within the Indian economy, contributing to 48% of the nation's production output and providing employment to a staggering 110 million individuals. The pervasive impact of the pandemic has inevitably reverberated across the economic landscape, although its full extent remains shrouded in uncertainty. Particularly, the small-scale enterprises that play a crucial role in India's manufacturing and service domains have borne the brunt of this impact. The year 2020 witnessed an unprecedented deceleration in revenue, with the MSME sector grappling with severe challenges in maintaining operational continuity. In response to this crisis, the government took affirmative action aimed at rejuvenating the beleaguered sector, offering targeted support to MSMEs. This concerted intervention proved to be a significant impetus, infusing hope and vitality into these enterprises. Consequently, a comprehensive evaluation of the barriers encountered, a candid exposition of these hurdles, and the formulation of a robust strategy to surmount the pandemic-induced turmoil have become imperative. In light of this exigency, the researcher undertakes a rigorous analytical investigation into the government's policies crafted to ensure the sustainable growth of MSMEs in India. By distilling insights from diverse sources, a holistic understanding of the challenges faced by MSMEs and the efficacy of governmental interventions is pursued

Device Closure of Superior Sinus Venosus Atrial Septal Defects: A single centre experience

Sinus venosus atrial septal defects present a wide variety of anatomical features and are frequently associated with partial anomalous pulmonary venous drainage of one or more right pulmonary veins. Surgical correction used to be the standard treatment. In recent times, transcatheter correction of superior sinus venosus atrial septal defects has come into vogue. The transcatheter closure of these defects with covered stents at a tertiary care centre in Oman between 2018 and 2023 is reported. Keywords: Heart Septal Defects, Atrial; Vena Cava, Superior; Endovascular Procedures; Stents; Cardiac Catheterization; Echocardiography, Transesophageal; Oman

System for Monitoring and Identifying theft from Domestic Water Supplies

This system for monitoring and identifying theft from domestic water supplies utilizes advanced sensors and machine learning algorithms to detect and analyze patterns of water usage, identifying anomalies and potential instances of theft. The system can be easily installed and integrated into existing water supply infrastructure, allowing for real-time monitoring and analysis of water usage data. By providing actionable insights and alerts, the system enables water supply companies to quickly respond to instances of theft, reducing losses and ensuring a more equitable distribution of resources. It utilizes various sensors and algorithms to detect anomalies in water usage patterns, which could indicate theft. The system includes a dashboard that allows water supply companies to monitor usage and receive alerts in real-time. By using this system, water supply companies can improve their efficiency, reduce water losses, and save costs associated with theft. The system is easy to install and can be integrated with existing water supply networks. The system has the potential to significantly reduce water losses due to theft, improving water supply sustainability and reducing costs for water providers. The system has the potential to significantly reduce water losses due to theft, improving water supply