Design, Characterization and Anti-ulcerogenic Effect of Amoxicillin trihydrate Thiolated Chitosan Mucoadhesive Microspheres for Effective Treatment of H. pylori

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Gastroretentive Mucoadhesive Microsphere for the Management of Gastric Infection

Gastric infections are mostly triggered by Helicobacter pylori (H. pylori), a fungus that colonizes the stomach mucosa of more than 50% of the inhabitants of the world. Chronic H. Pylori diseasewas associated with stomach diseases such as peptic ulcer, chronic gastritis and stomach adenoc arcinoma. Current therapy for eradication relies on antibiotic-based therapies that are ineffective in about 20% of patients. Traditional method constraints optimize the creation of new techniques for fast, consistent and cost-effective H diagnosis. Infection with pylori. Wide-ranging study has been carried out over the previous few centuries to create a type of gastro-retentive dosage (GRDF). This sort of dosage form can advance the delivery and efficiency of stomach-active medicines because the GRDF enables the medication to remain in the stomach for a sufficient time period. Various methods were used to develop effective GRDFs such as high-density systems, low-density systems, swelling and expansion systems, hydrodynamically balanced systems, superporous hydrogels,. However, there are both merits and demerits in these kinds of schemes. Intra-individual and inter-individual dissimilarities are obstacles to the growth of effective GRDFs in gastric physiology. Examples of these individual differences include gastric pH and gastric motility that have a notable effect on the moment of stomach retention and delivery of drugs. Some of these obstacles can be overcome by developing a novel mucoadhesive microsphere. The mucoadhesive microsphere is characterized by close contact of the MDF with the mucosal layer, thereby increasing the localized absorption of the drug. H2Receptor antagonists (H2RAs) have become first-line therapy for acid related peptic disease and GRDF especially designed for H2RAs and drugs against H. pylori, including specific targeting systems and leading to a marked development in the quality of life for a large number of patients. In this relationship, new formulations with improved absorption, improved bioavailability and improved acid-suppressing regimens are welcome Keywords: H. pylori, gastro-retentive dosage, mucoadhesive microspher

Spinal Shock: Clinical Pearls

Spinal shock is a clinical manifestation following injury to the spinal cord resulting from multiple mechanisms. It is a complex phenomenon with flaccid paralysis, absent anal wink, and bulbocavernosus reflex. Management strategy for such patients includes rapid evaluation and treatment strategies to minimize the impact of secondary spinal cord injury. The advanced trauma life support (ATLS) guidelines provide the basis for rapid assessment and stabilization of A (Airway), B (Breathing), and C (Circulation) before dealing with the neurological deficits under the primary survey. The emergence of better radiological investigations has been pivotal in categorizing spinal syndromes and reaching a precise diagnosis. Early initiation of treatment measures results in better neurological and functional recovery with minimal residual deficits. The role of steroids in spinal shock has been a highly debated topic, and the timing of surgery is variable, intending to eliminate the secondary injury. Clinical differentiation between neurogenic and hypovolemic shock is vital, enhancing the quality of care with realistic outcome expectations

Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for study of the liver

Hepatic encephalopathy (HE) is a major complication that develops in some form and at some stage in a majority of patients with liver cirrhosis. Overt HE occurs in approximately 30-45% of cirrhotic patients. Minimal HE (MHE), the mildest form of HE, is characterized by subtle motor and cognitive deficits and impairs health-related quality of life. The Indian National Association for Study of the Liver (INASL) set up a Working Party on MHE in 2008 with a mandate to develop consensus guidelines on various aspects of MHE relevant to clinical practice. Questions related to the definition of MHE, its prevalence, diagnosis, clinical characteristics, pathogenesis, natural history and treatment were addressed by the members of the Working Party

The perceived impact of the Covid-19 pandemic on medical student education and training – an international survey

Abstract: Background: The Covid-19 pandemic led to significant changes and disruptions to medical education worldwide. We evaluated medical student perceived views on training, their experiences and changes to teaching methods during the pandemic. Methods: An online survey of medical students was conducted in the Autumn of 2020. An international network of collaborators facilitated participant recruitment. Students were surveyed on their perceived overall impact of Covid-19 on their training and several exposure variables. Univariate analyses and adjusted multivariable analysis were performed to determine strengths in associations. Results: A total of 1604 eligible participants from 45 countries took part in this survey and 56.3% (n = 860) of these were female. The median age was 21 (Inter Quartile Range:21–23). Nearly half (49.6%, n = 796) of medical students were in their clinical years. The majority (n = 1356, 84.5%) were residents of a low or middle income country. A total of 1305 (81.4%) participants reported that the Covid-19 pandemic had an overall negative impact on their training. On adjusted analysis, being 21 or younger, females, those reporting a decline in conventional lectures and ward based teaching were more likely to report an overall negative impact on their training (p ≤ 0.001). However, an increase in clinical responsibilities was associated with lower odds of participants reporting a negative impact on training (p < 0.001). The participant’s resident nation economy and stage of training were associated with some of the participant training experiences surveyed (p < 0.05). Conclusion: An international cohort of medical students reported an overall significant negative impact of the Covid-19 pandemic on their undergraduate training. The efficacy of novel virtual methods of teaching to supplement traditional teaching methods warrants further research

NUTRITIONAL STATUS OF RURAL PRIMARY SCHOOL CHILDREN AND THEIR SOCIO-DEMOGRAPHIC CORRELATES: A CROSS-SECTIONAL STUDY FROM VARANASI

Research question: What is the nutritional status of primary school children in rural area of Varanasi and what factors are associated with malnutrition? Objective: To assess the nutritional status of primary school children in rural Varanasi and to find out various socio-demographic correlates of nutritional status. Study Design: Descriptive cross sectional study. Setting: Four primary schools from Chiraigaon Community Development Block of Varanasi were selected for study purpose. Participants: Eight hundred and sixteen students from four schools were involved in the study. Results: Out of total 816 study subjects 429 or 52.6% (201 boys and 228 girls) were underweight and 75 or 9.2% (39 boys and 36 girls) were stunted. Educational status of the parents was found to be significantly associated with the nutritional status of school children Conclusion: As the literacy status of the parents has been revealed to be strongly associated with nutritional status of children, there is an increasing need to focus the efforts towards the parents to improve the nutritional status of primary school children

NUTRITIONAL STATUS OF RURAL PRIMARY SCHOOL CHILDREN AND THEIR SOCIO-DEMOGRAPHIC CORRELATES: A CROSS-SECTIONAL STUDY FROM VARANASI

Research question: What is the nutritional status of primary school children in rural area of Varanasi and what factors are associated with malnutrition? Objective: To assess the nutritional status of primary school children in rural Varanasi and to find out various socio-demographic correlates of nutritional status. Study Design: Descriptive cross sectional study. Setting: Four primary schools from Chiraigaon Community Development Block of Varanasi were selected for study purpose. Participants: Eight hundred and sixteen students from four schools were involved in the study. Results: Out of total 816 study subjects 429 or 52.6% (201 boys and 228 girls) were underweight and 75 or 9.2% (39 boys and 36 girls) were stunted. Educational status of the parents was found to be significantly associated with the nutritional status of school children Conclusion: As the literacy status of the parents has been revealed to be strongly associated with nutritional status of children, there is an increasing need to focus the efforts towards the parents to improve the nutritional status of primary school children