Changes in bone marrow in malaria-a prospective study of 47 cases

Background: Bone marrow aspiration done in cases of repeated fever, fever of unknown origin, pancytopenia to detect Malaria parasite in bone marrow.  The study was undertaken to evaluate the role of bone marrow aspiration in establishing the etiology of Plasmodium vivax in cases of pancytopenia or thrombocytopenia in recurrent fever or fever of unknown origin.Methods: Patients of different age groups presenting with recurrent fever or fever of unknown origin with pancytopenia or thrombocytopenia from Jan 2015 to Oct 2017. Out of the 108 bone marrow aspirations abiding the above criteria 47 showed presence of Plasmodium vivax trophozoites in bone marrow.Results: The age of patients varied from 8 months to 65 years. 47 cases showed presence of Plasmodium vivax trophozoites, mainly with hyperplastic marrow showing normoblastic and megaloblastic hyperplasia, presence of hemophagocytosis in 6 cases and also 2 cases showing increase in plasma cells.Conclusions: Bone marrow aspiration studies are of vital importance in diagnosing malarial infection in endemic areas as being one of the cause of pancytopenia or thrombocytopenia

Comparison of efficacy of injection ferric carboxymaltose and iron sucrose in moderate anaemia in pregnancy

Background: Prevalence of anaemia in pregnant women is 14% in developed and 58-89.6% in pregnant Indian women. Parenteral iron is seems to be an option in the treatment of moderate iron deficiency anaemia which allow high doses of iron to be administered rapidly, in those who are intolerant to oral iron, have  poor compliance to oral iron or gastrointestinal disorder. The objective was to compare the efficacy of newer drug, inravenous ferric carboxymaltose (FCM) with intravenous iron sucrose.Methods: Group A were given injection FCM and group B were given injection iron sucrose. FCM was given in one or two sittings depending on iron requirement and iron sucrose was given in divided doses. Haemogram was done at baseline and on day 3 and 21 and at 12 weeks. All the observations were tabulated and analysed.Results: The mean rise in haemoglobin values from baseline in the FCM group was 0.20±0.06 at 3rd day, 2.03±0.47 at 3 weeks, 3.86±0.53 at 12 weeks compared to iron sucrose group, which was 0.11±0.08 at 3rd day, 1.51±0.39 at 3 weeks, and 3.22±0.54 at 12 weeks, which was statistically significant and showed that the haemoglobin levels were increased more in FCM group. Target haemoglobin was achieved in 92% women in FCM group and 78% women in iron sucrose group.Conclusions: Women in the FCM group achieved significantly higher haemoglobin level than in iron sucrose group. It was given in fewer sittings, hence was more convenient with better efficacy

Wound grading and surgical site infection following caesarean section

Background: Surgical site infection (SSI) following caesarean section can adversely influence the postpartum period for the women. The objective of the study was to study the extent of infection and the microbiological flora in cases of surgical site infection following caesarean section.Methods: Women undergoing caesarean section amongst women admitted in labour ward were followed till discharge for any surgical site infection Detailed assessment of the wound was done. Any discharge if present was taken for culture.Results: 88.88% had normal wound healing, implying no infection. Of those with abnormal wound, 22% had serosanguinous or purulent discharge. Most had superficial incisional SSI. Enterococcus faecalis and Staphylococcus were the commonest organisms grown on culture.Conclusions: All surgical site infections should be looked into as early as possible and managed appropriately

Comparison of the various diagnostic criteria used in polycystic ovary syndrome

Background: Polycystic Ovary Syndrome (PCOS) represents one of the major causes of infertility in women. Various criteria are set to diagnose PCOS, some over diagnose and some underdiagnose it. The objective of the study was to compare the various criteria used for the diagnosis of PCOS: NIH 1990 criteria, Rotterdam 2003 criteria and AE-PCOS Society 2006 criteria.Methods: This was a cross-sectional study conducted over a period of one year. Patients with suspicion of PCOS were selected. After complete history and examination, blood samples were collected and androgen levels were measured. They were labeled as PCOS based on their fulfillment of the criteria as per Rotterdam, NIH and AE-PCOS Society.Data was analysed and conclusions drawn.Results: Of the participants, 25.7%, 28.5%, and 62.8% were diagnosed with PCOS using NIH, AE-PCOS Society, and Rotterdam criteria, respectively. Phenotypes that included hyperandrogenism and/or hyperandrogenemia as part of their criteria showed increase in values of DHEAS and S. testoterone as compared to the normoandrogenic phenotype included in only the Rotterdam criteria.Conclusions: It is crucial to establish the diagnostic criteria for PCOS and initiate early treatment as this may play a role in the prevention of metabolic and cardiovascular diseases

A Novel Coronavirus (nCOV- 2019): A Pandemic Severe Respiratory Tract Infections by SARS COV-2 in Human

Novel Coronavirus Disease 2019 (nCOV 2019) or Coronavirus is one which is associate communicable disease amongst variety of viruses that causes cold, fever, difficulty in breathing and ultimately death. The viruses cause metabolism infections, together with the mundane cold, that square measure usually delicate, although a lot of occasional forms like respiratory illness caused by SARS-CoV-2, the illness is that the reason for the 2019–20 coronavirus irruption. It’s primarily unfolded between individuals by diminutive droplets from infected people once they breathe or cough. Individuals could have few symptoms or develop febrility, cough, and shortness of breath. Whereas Feb 2020, different countries together with European country Asian Countries enclosed within the list. Antiviral drugs being tested embrace antimalarial drug, the ribonucleic acid enzyme substance remdesivir, and triazavirin, Umifenovir (Arbidol) and darunavir were planned. Remdesivir and antimalarial drug effectively inhibit the coronavirus in vitro. Favilavir approved as experimental corona virus drug. The objective of this review article to provide basic knowledge & preliminary opinion and to provide an advice which can be proved as the best mantra for defeating nCOV. Thus this review aims to throw light to the new and exciting areas of Virology,  Replication  cycle of corona virus ,  sign & symptoms and diagnosis, Spreading of corona virus, Structural biology of corona virus, the ways of treatment with  alternative medicines  other than antiviral drugs,  and prevention in its early stage of COVID-19 , and also Current Research on Corona. Keywords: Coronavirus, 2019-nCOV2, 2019–20 coronavirus irruption, SARS, WHO, Public Health Emergency of International Concern (PHEIC), replication of corona virus

and Validation of Hptlc Method for the Simultaneous Estimation of Ascorbic Acid and Gallic Acid in Amla Juice Preparation

The aim of this study was to asses a simple, selective, precise, and reproducible high performance thin-layer chromatography (HPTLC) method for the simultaneous estimation analysis of ascorbic acid (AA) and gallic acid (GA) in amla juice preparation. The aluminium-based pre-coated TLC plates (Silica gel G 60F 254) were used for the HPTLC fingerprinting analysis. The chromatograms of samples were developed in twin trough glass chamber pre-saturated with mobile phase (toluene: ethyl acetate: methanol: formic acid; 3:3:2:1, v/v/v/v) at room temperature (25 ± 2°C). The densitometric analysis was carried out in absorbance mode at 254 nm. The optimized mobile phase showed compact spots of AA and GA at 0.59 and 0.86 Rf respectively. The linear regression analysis data for the calibration plots of AA and GA showed good linearity (r2= 0.992 and 0.996 respectively) with respect to peak area in the range of 200-1400 ng/spot. The method was validated as per International Conference on Harmonization (ICH) guidelines. The limits of detection and quantification (40 and 140 ng/spot, respectively) were also established. The proposed method has shown the excellent recovery (98.97–99.89%), which supports the suitability of the method for the analysis of AA and GA in the amla juice and other preparations containing these ingredients. Keywords: Amla juice, Ascorbic acid, Gallic acid, HPTLC, ICH guidelines, Validation

Formulation Design and Pharmaceutical Considerations for Paediatric Patients: Current Status and Future Dimensions

Present day’s conventional pediatrics doses forms are not very attractive towards the children. Due to various reasons such as larger size, bitter taste etc. pediatrics patients rejects the present conventional doses form in many cases. So, there is need for development of some attractive and effective dosage form for children. Present day’s conventional pediatrics doses forms are not very attractive towards the children. Due to various reasons such as larger size, bitter taste etc. pediatrics patients rejects the present conventional doses form in many cases. So there is need for the development of some unconventional dosage forms that proves to be attractive towards the paediatrics populations. This review provides possible advantages and disadvantages of the present conventional dosage forms available for children. Hence present review introduces to various alternatives and unconventional dosage forms viz. effervescent granules / tablets, oral disintegrating tablets and medicated candies and their advantages and disadvantages. Keywords: Effervescent granules, effervescent tab, medicated candy, Oral disintegrating tablet and pediatrics

Formulation and Evaluation of Novel Herbal Formulations Incorporated with Amla Extract for Improved Stability

The objective of the present study was to formulate effervescent and fast dispersible granules by incorporating the fruit extract of Emblica officinalis as an alternate of liquid herbal juices available in market. Amla juice was extracted manually and then subjected to preliminary phytochemical screening which indicates the presence of alkaloids, glycosides, flavonoids, carbohydrates, phenolic compounds, proteins and phytosterols. Lyophilized amla powder was used to formulate effervescent and fast dispersible granules which were further optimized on the basis of concentration of superdisintegrants and effervescent producing agents like croscarmellose sodium, sodium starch glycolate, sodium bicarbonate and citric acid. Powdered formulations were then evaluated on basis of their flow properties like angle of repose, bulk density, tapped density, carr’s index, hausner’s ratio, effervescent cessation time and disintegration time. Among all the effervescent formulations F2 was found to be optimum as it was having least disintegration time of 22 seconds and showed excellent flow properties. In case of the fast dispersible formulations the optimum strength were shown by formulations F9 having croscarmellose with least disintegration time of 52 seconds. Total phenolic content of fresh amla juice were found to be 8.94 mg GAE/100 gm and estimation of ascorbic acid and gallic acid in lyophilized amla powder and developed formulations was carried out by HPTLC. In vitro antioxidant activity of lyophilized amla powder was evaluated by DPPH radical scavenging assay. IC50 value of lyophilized amla powder was found to be 32 ± 0.25 ug/ml calculated in comparison to standard ascorbic acid possessing IC50 value of 25.80 ± 0.2 ug/ml.  Results of present study reveals that developed formulations may serve as alternate product with better quality, consistency and stability in comparison to available herbal liquid formulations. Keywords: Anti-oxidant, Dispersible granules, Effervescent granules, Emblica officinalis

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

Changes in bone marrow in malaria-a prospective study of 47 cases

Background: Bone marrow aspiration done in cases of repeated fever, fever of unknown origin, pancytopenia to detect Malaria parasite in bone marrow.  The study was undertaken to evaluate the role of bone marrow aspiration in establishing the etiology of Plasmodium vivax in cases of pancytopenia or thrombocytopenia in recurrent fever or fever of unknown origin.Methods: Patients of different age groups presenting with recurrent fever or fever of unknown origin with pancytopenia or thrombocytopenia from Jan 2015 to Oct 2017. Out of the 108 bone marrow aspirations abiding the above criteria 47 showed presence of Plasmodium vivax trophozoites in bone marrow.Results: The age of patients varied from 8 months to 65 years. 47 cases showed presence of Plasmodium vivax trophozoites, mainly with hyperplastic marrow showing normoblastic and megaloblastic hyperplasia, presence of hemophagocytosis in 6 cases and also 2 cases showing increase in plasma cells.Conclusions: Bone marrow aspiration studies are of vital importance in diagnosing malarial infection in endemic areas as being one of the cause of pancytopenia or thrombocytopenia