Ethanobotanical, phytochemical and pharmacological properties of Zizyphus nummularia (Burm. F.): A Review

Zizyphus nummularia (Burm. F.), Family: Rhamnaceae, is widely distributed in dry regions of India. It is a bushy weed used as folk medicine. The plant is valued for its nutritional edible fruits. Traditionally, it is used in mental retardation, fever, diarrhea, dysentery. The plant has been evaluated for various pharmacological activities such as anti-inflammatory, anthelmintic, antibacterial, antifertility activity. Present review discusses phytochemistry and pharmacological aspects of the drug

Changes in colour and mechanical properties of wood polypropylene composites on natural weathering

This comparative study focused on understanding the effect of coupling agent and particle size on weathering behaviour of wood polypropylene composite. Two coupling agents, namely maleic anhydride grafted polypropylene and m-TMI (m-Isopropenyl-a,a- dimethylbenzyl isocyanate) grafted polypropylene were used in preparation of the composites. The composites were exposed to outdoor conditions for one year and changes in surface colour and mechanical properties were measured after 2, 4, 8 and 12 months of natural weathering. During the initial four months of weathering considerable colour change was observed with increase in lightness.  Mechanical properties were unaffected largely for the initial four months and thereafter started declining.  Overall, tensile strength decreased by about 15 % and flexural strength decreased by about 8 % after one year of weathering. The flexural modulus also decreased by about 10 %. Wood particle size was found to affect the aesthetic and strength of the composites after natural weathering. Coupling agents had a positive impact on mechanical properties however their influence on weathering degradation was not noticeable

Access to Computer Technologies at Home Improves Wages in the Marketplace

This study suggests that having access to a computer and the Internet at home leads to better wages. We normally have the idea that people with higher wages have computers and Internet access at home. But with declining prices of home PCs and the increasing importance of Internet, this no longer seems to be the case. The new owners of PC today are considerably poorer and less educated than in the past. People with access to a PC and Internet at home appear to earn 8.6% more than their counterpart. This result seems to suggest that University policies requiring students seeking professional degrees like MBA to own a laptop or Home PC has merit and this policy could be extended to cover undergraduate students also. Universities could also provide dial-in-server access to their recent graduates for a specified period of time to boost their placement statistics

FORMULATION AND EVALUATION OF CLOBETASOL-17-PROPIONATE-LOADED CARBOXYMETHYL CHITOSAN NANOPARTICLE

Objective: Formulation and evaluation of clobetasol-17-propionate-loaded carboxymethyl chitosan nanoparticle. Psoriasis is a chronic skin disorder caused due to the autoimmune factors. It has a detrimental psychological and physiological impact on patients due to the emergence of apparent skin. The systemic therapy with anti-psoriatic drugs such corticosteroids, immunosuppressant, and gene suppressors causes severe side effects. As a result, increasing the effectiveness and safety of the aforementioned medicines when applied topically would be extremely useful in avoiding the side effects associated with the systemic route of administration. Methods: Chitosan (CS) has not been widely used in the clinic applications but due to its limited solubility and poor mechanical characteristics. CS, on the other hand, is chemically changed to form carboxymethyl (CMC), which is soluble at both neutral and basic pH. Chemical modifications can also be used to attach different functional groups and control hydrophobic, cationic, and anionic properties. CMC is a promising carrier that might possibly traverse the thick scales of psoriatic skin since it is a penetration enhancer that allows drug diffusion through either the transcellular or paracellular pathways. Comparative study is done using CMC as a polymer and CD as a polymer. Results: CP-loaded CMC nanoparticles show better result results than CP-loaded CD polymer. Conclusion: Clobetasol-17-propionate-loaded carboxymethyl chitosan nanoparticle shows better results with improved solubility

When Losses Loom Even Larger: the Moderating Role of Relationship Norms

Title: When Losses Loom Even Larger: The Moderating Role of Relationship NormsAuthors' names: Pankaj Aggarwal, University of TorontoMeng Zhang, University of TorontoAbstract: People are loss averse when their pain of losing something exceeds their joy of gaining it. This research proposes a moderator of loss aversion: the type of relationship norms salient at the time the loss or gain is experienced. We suggest that norms of communal relationship (based on concern for the partner) relative to an exchange relationship (based on quid pro quo) lead to greater loss aversion. Across three studies, relationship norms were both measured and manipulated. Support for the thesis is provided by assessing the degree of loss aversion using the typical endowment effect and gambling tasks

Developing public health capacities of Frontline Public Health Workforce in Uttarakhand

Recent COVID-19 pandemic has highlighted the importance of increase in the ability of public health workforce to detect and respond to the public health threats. For timely implementation of an adequate response and mitigation measure, the standardized and sustainable capacity building programme for frontline public health workforce is the need of hour. National Center for Disease Control (NCDC), Ministry of Health and Family Welfare, in partnership with U.S. Centers for Disease Control and Prevention (CDC), developed a three-month in-service Basic Epidemiology Training programme. This is a tailor-made programme for frontline public health workforce to strengthen epidemiological skills. This training was a practical interactive approach to field epidemiology for three months on the job training for frontline public health workforce that addressed the critical skills needed to conduct surveillance effectively at the local level while focusing on improving disease detection, reporting and feedback. The training also demonstrated the role of learning model in form of interaction between the mentor and the mentees. The importance of handhold support given by the mentors to the mentees in quality outbreak investigations and documentation

Causal ambiguity: deciphering the etiology of secondary thrombotic microangiopathy with systemic lupus erythematosus and vivax malaria

Hemolytic uremic syndrome (HUS) falls under the spectrum of thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and thrombi in small vessels leading to end-organ damage. It's classified into typical HUS (caused by Shiga toxin-producing E. coli), atypical HUS (due to uncontrolled complement activation), and secondary HUS (sHUS) linked with coexisting conditions. We present a compelling case of a 21-year-old female with fever, jaundice, anemia, thrombocytopenia, and oliguric acute kidney injury (AKI), ultimately diagnosed with Plasmodium vivax malaria. Despite adequate antimalarial therapy, the patient's clinical trajectory remained intricate, characterized by sustained hematological abnormalities and renal dysfunction. A comprehensive assessment revealed Coombs-negative hemolytic anemia. Subsequently, a renal biopsy confirmed TMA. Considering the rarity of vivax malaria causing TMA, an autoimmune workup was conducted, suggesting systemic lupus erythematosus (SLE). Systemic autoimmune disease-associated HUS (SAID-HUS) is a rare entity that exhibits diverse clinical presentations, with SLE being best-described etiology in literature. SLE-associated HUS was considered and was managed with steroids and hydroxychloroquine resulting in significant renal and hematological improvement. This report underscores significance of assessing autoimmune factors in case of secondary TMA, while also shedding light on evolving understanding of vivax malaria's potential relationship with TMA

Hospital acquired acute renal failure

Background: Acute renal failure has continued to attract interest and stimulate investigators .This is in part, a reflection of many clinical entities that can result in an acute renal failure. HAARF is an important cause of morbidity and mortality and is associated with the ten fold increase in the risk of death during the hospitalization.14 Despite advances in diagnosis and management it still carries a high mortality. HAARF is associated with grave consequences. Some of the clinical setting leading to HAARF can be limited by monitoring of renal function, better control of infection, avoiding nephrotoxic drugs and initiation of therapy at the earliest. Present study is proposed to evaluate the incidence, etiological factors and measures to reduce the incidence of HAARF.Methods:All patients were admitted to RPGMC from Dec. 2010 to APRIL 2014. They were screened for the development of the ARF during their hospital stay. The parameters of Prakash et al. were taken for the diagnosis of HAARF.  Results:In our present study HAARF was diagnosed in 88 patients of 56904 admission during 40 month period, representing 0.15% of the admission. Predisposing factors were present in 64 % of the patients. They were elderly age >60 years (22.72%), DM (13.64%), pre-existing renal disease (13.64%) and HTN (4.54%). It was due to nephrotoxic dugs in 45.45%, decreased renal perfusion in 22.72%, infections in 13.64%, hepatorenal syndrome 9.09% surgery in 4.54% and Weil’s disease in 4.54 %. Among the nephrotoxic drugs antibiotics were the most common and NSAIDs were the second most common etiological factors. Decrease renal perfusion secondary to volume depletion and heart failure were equally responsible for HAARF in 9.09% each. Septicemia was responsible for 4.54% of cases. Oliguric renal failure was seen in the 31.82% where as nonoliguric renal failure was seen in 50% of cases. Great majority of non oliguric renal failure was due to nephrotoxic drugs. Oliguric patients have longer duration of hospital stay and high mortality as compared to the non oliguric renal failure. A high s. creatinine and high urea levels at the time of admission were associated with the earlier development of HAARF. Oliguria and anuric patients had a longer duration of hospital stay. Overall mortality of HAARF was 18.18% and nephrotoxic drugs responsible for one half of the total mortality.Conclusion:High risk group patients for HAARF needs meticulous monitoring during hospital stay. Hospitalized patients on nephrotoxic drugs should have frequent renal function tests. Proper fluid and electrolyte balance in hospitalized patients needs special emphasis to avoid HAARF.   

Development of the Indian Reference Case for undertaking economic evaluation for health technology assessment

Background: Health technology assessment (HTA) is globally recognised as an important tool to guide evidence-based decision-making. However, heterogeneity in methods limits the use of any such evidence. The current research was undertaken to develop a set of standards for conduct of economic evaluations for HTA in India, referred to as the Indian Reference Case. Methods: Development of the reference case comprised of a four-step process: (i) review of existing international HTA guidelines; (ii) systematic review of economic evaluations for three countries to assess adherence with pre-existing country-specific HTA guidelines; (iii) empirical analysis to assess the impact of alternate assumptions for key principles of economic evaluation on the results of cost-effectiveness analysis; (iv) stakeholder consultations to assess appropriateness of the recommendations. Based on the inferences drawn from the first three processes, a preliminary draft of the reference case was developed, which was finalised based on stakeholder consultations. Findings: The Indian Reference Case provides twelve recommendations on eleven key principles of economic evaluation: decision problem, comparator, perspective, source of effectiveness evidence, measure of costs, health outcomes, time-horizon, discounting, heterogeneity, uncertainty analysis and equity analysis, and for presentation of results. The recommendations are user-friendly and have scope to allow for context-specific flexibility. Interpretation: The Indian Reference Case is expected to provide guidance in planning, conducting, and reporting of economic evaluations. It is anticipated that adherence to the Reference Case would increase the quality and policy utilisation of future evaluations. However, with advancement in the field of health economics efforts aimed at refining the Indian Reference Case would be needed. Funding: This research received no specific grant from any funding agency, commercial, or not-for-profit sectors. The research was undertaken as part of doctoral thesis of Sharma D, who received scholarship from the Indian Council of Medical Research (ICMR), New Delhi, India