Development of unique buttermilk by incorporation of Moringa

The present investigation was aimed at formulating a fermented beverage with incorporation of Moringa Pod Powder (MPP) to develop therapeutic buttermilk. Dahi (prepared from standardized milk) mesophilic/ thermophilic dahi culture. Optimisation of the product formulation was done by using Response Surface Methodolo-gy (RSM) with central composite rotatable design (CCRD) with varying levels of MPP, total milk solids (TMS) in but-termilk and acidity of dahi. It was found that 5.60 % TMS, 0.90 % acidity of dahi and 1.92 % MPP gave the most acceptable product with a desirability of 0.917 which is very high. From amongst various stabilizers, it was found that a blend of 0.04 % pectin and 0.015 % carrageenan most suitable and addition of salt, sugar and spices blend @ 0.5 %, 4.0 %, 0.5% respectively were most acceptable. The proximate chemical composition of Moringa Pod Buttermilk (MPBM) was 11.77 % total solids, 1.51 % protein, 1.84 % fat and 0.89 % ash. One serving size (300 g) of MPBM could be an "excellent source of calcium" having 21 % Daily Value (DV). The product could be labelled as "a good source of Vitamin A, calcium and iron" providing 10, 18 and 11 % DV respectively. MPBM was found to have consid-erable amount of Potassium and Vitamin C and fiber (9.0, 9.0 and 6.5 % DV respectively). The shelf-life of the prod-uct was 20 days under refrigeration (7±2?C). The developed product is rich in fiber and iron, that is conventionally deficient in milk and hence makes the developed product complete food

Laparoscopic surgery for Crohn’s disease: a meta-analysis of perioperative complications and long term outcomes compared with open surgery

BACKGROUND: Previous meta-analyses have had conflicting conclusions regarding the differences between laparoscopic and open techniques in patients with Crohn’s Disease. The objective of this meta-analysis was to compare outcomes in patients with Crohn’s disease undergoing laparoscopic or open surgical resection. METHODS: A literature search of EMBASE, MEDLINE, The Cochrane Central Register of Controlled Trials and the US National Institute of Health’s Clinical Trials Registry was completed. Randomized clinical trials and non-randomized comparative studies were included if laparoscopic and open surgical resections were compared. Primary outcomes assessed included perioperative complications, recurrence requiring surgery, small bowel obstruction and incisional hernia. RESULTS: 34 studies were included in the analysis, and represented 2,519 patients. Pooled analysis showed reduced perioperative complications in patients undergoing laparoscopic resection vs. open resection (Risk Ratio 0.71, 95% CI 0.58 – 0.86, P = 0.001). There was no evidence of a difference in the rate of surgical recurrence (Rate Ratio 0.78, 95% CI 0.54 – 1.11, P = 0.17) or small bowel obstruction (Rate Ratio 0.63, 95% CI 0.28 – 1.45, P = 0.28) between techniques. There was evidence of a decrease in incisional hernia following laparoscopic surgery (Rate Ratio 0.24, 95% CI 0.07 – 0.82, P = 0.02). CONCLUSIONS: This is the largest review in this topic. The results of this analysis are based primarily on non-randomized studies and thus have significant limitations in regards to selection bias, confounding, lack of blinding and potential publication bias. Although we found evidence of decreased perioperative complications and incisional hernia in the laparoscopic group, further randomized controlled trials, with adequate follow up, are needed before strong recommendations can be made

Effect of storage on composition, physico-chemical, rheology, sensory and microbiological quality of Indian cookie Rava Burfi

In the present study, changes in compositional, physico-chemical, rheological, sensory and microbial properties (SPC, coliform count and yeast and mould count) of rava burfi packed in composite polyethylene terephthalate (PET)/low density polyethylene (LDPE) film was monitored during storage at room temperature (30± 2 °C) and refrigerated temperature (7±2 °C) on every 3 rd for room temperature and on every 7th day for refrigerated temperature of storage till the products became unacceptable. All the changes related to composition, acidity, water activity, Free Fatty Acid (FFA), soluble nitrogen, 5-Hydroxy Methyl Furfural (HMF) and Thiobarbituric Acid (TBA), rheological, sensory and microbiological properties of rava burfi were found to be significantly (P<0.05) affected by storage period (i.e. 9 days at room temperature (30±2 °C) and 35 days at refrigerated (7±2°C) temperat ure). During storage period there was a decrease in moisture content (2.5 to 3.0%) and water activity and an increase in fat, protein, lactose, ash, added sugar, acidity, FFA, soluble nitrogen, TBA and HMF both at ambient (30±2 °C) a s well as at refrigerated (7±2°C) temperature. Changes in rhe ological attributes at both ambient and refrigerated temperatures of storage indicated that there was an increase in hardness, gumminess, chewiness and adhesiveness whereas there was decrease in cohesiveness and springiness values. The sensory scores in terms of flavour, body and texture, colour and appearance and overall acceptability were found to be significantly (P<0.05) decrease with progressive increase in storage period. The shelf life of rava burfi was found to be 9 days at room temperature (30±2 °C) and 35 days at refrigerated (7±2°C) temperature

Adsorptive column studies for removal of acid orange 7 dye using bagasse fly ash

319-327Increasing industrialization creates a large scale of pollution and affects the availability of usable water. Dyes in wastewater are a visible pollutant, difficult to treat, and are toxic in nature. Amongst all the physicochemical methods, adsorption is the extensively applied process for the aqueous removal of dye. In the present study; the Bagasse Fly Ash (BFA) is used as an adsorbent for aqueous removal of Acid Orange dye in packed bed adsorption technique. The packed bed studies for different bed heights, influent concentration and flow rate are performed. The efficacy of packed columns is investigated using different models namely Bed depth service time, Thomas, Wolborsaka, Yoon-Nelson, and Bohart-Adams Models. The maximum adsorption capacity of BFA for 50% saturation of column is calculated to be 38 (mg/g) which shows BFA as a good adsorbent for dye removal

High reprint orders in medical journals and pharmaceutical industry funding: case-control study

Objectives To assess the extent to which funding and study design are associated with high reprint orders

Novel insights into the cardio-protective effects of FGF21 in lean and obese rat hearts

Aims: Fibroblast growth factor 21 (FGF21) is a hepatic metabolic regulator with pleotropic actions. Its plasma concentrations are increased in obesity and diabetes; states associated with an increased incidence of cardiovascular disease. We therefore investigated the direct effect of FGF21 on cardio-protection in obese and lean hearts in response to ischemia. Methods and Results: FGF21, FGF21-receptor 1 (FGFR1) and beta-Klotho (βKlotho) were expressed in rodent, human hearts and primary rat cardiomyocytes. Cardiac FGF21 was expressed and secreted (real time RT-PCR/western blot and ELISA) in an autocrine-paracrine manner, in response to obesity and hypoxia, involving FGFR1-βKlotho components. Cardiac-FGF21 expression and secretion were increased in response to global ischemia. In contrast βKlotho was reduced in obese hearts. In isolated adult rat cardiomyocytes, FGF21 activated PI3K/Akt (phosphatidylinositol 3-kinase/Akt), ERK1/2(extracellular signal-regulated kinase) and AMPK (AMP-activated protein kinase) pathways. In Langendorff perfused rat [adult male wild-type wistar] hearts, FGF21 administration induced significant cardio-protection and restoration of function following global ischemia. Inhibition of PI3K/Akt, AMPK, ERK1/2 and ROR-α (retinoic-acid receptor alpha) pathway led to significant decrease of FGF21 induced cardio-protection and restoration of cardiac function in response to global ischemia. More importantly, this cardio-protective response induced by FGF21 was reduced in obesity, although the cardiac expression profiles and circulating FGF21 levels were increased. Conclusion: In an ex vivo Langendorff system, we show that FGF21 induced cardiac protection and restoration of cardiac function involving autocrine-paracrine pathways, with reduced effect in obesity. Collectively, our findings provide novel insights into FGF21-induced cardiac effects in obesity and ischemia

Growth characteristics in individuals with osteogenesis imperfecta in North America: results from a multicenter study.

PurposeOsteogenesis imperfecta (OI) predisposes people to recurrent fractures, bone deformities, and short stature. There is a lack of large-scale systematic studies that have investigated growth parameters in OI.MethodsUsing data from the Linked Clinical Research Centers, we compared height, growth velocity, weight, and body mass index (BMI) in 552 individuals with OI. Height, weight, and BMI were plotted on Centers for Disease Control and Prevention normative curves.ResultsIn children, the median z-scores for height in OI types I, III, and IV were -0.66, -6.91, and -2.79, respectively. Growth velocity was diminished in OI types III and IV. The median z-score for weight in children with OI type III was -4.55. The median z-scores for BMI in children with OI types I, III, and IV were 0.10, 0.91, and 0.67, respectively. Generalized linear model analyses demonstrated that the height z-score was positively correlated with the severity of the OI subtype (P < 0.001), age, bisphosphonate use, and rodding (P < 0.05).ConclusionFrom the largest cohort of individuals with OI, we provide median values for height, weight, and BMI z-scores that can aid the evaluation of overall growth in the clinic setting. This study is an important first step in the generation of OI-specific growth curves

Socio-Economic Inequalities in the Use of Postnatal Care in India

OBJECTIVES: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. METHODS AND FINDINGS: Rich-poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007-08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. CONCLUSIONS: PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy interventions

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London