Role of bundled intervention in reducing surgical site infection rate in gynecologic surgeries

Background: Surgical site infection (SSI) is most common nosocomial infection (15%) among surgical patient’s and contributes significantly to morbidity and mortality. CDC (2015) provides “bundled intervention for prevention of SSI. The present study was planned to evaluate the feasibility and usefulness of these bundled intervention in reducing SSI in our setup. Objectives of this study to study the effect of bundled interventions on SSI in gynaecologic surgery.Methods: A total 50 cases  undergoing gynecological surgery in elective OT included in pilot group and bundled intervention followed  these pilot group cases compared with 50 control group operated in same OT in which bundled intervention not followed outcome measures recorded were Incidence of SSI, type of SSI, need for antibiotic usage, need for secondary suturing, duration of hospital stay.Results: Out of 50 subjects in pilot group, five developed signs and symptoms of SSI giving an SSI rate of 10%. Out of those five, two had superficial SSI and three had deep SSI, none of the patient had organ space SSI.SSI rate in 50 cases operated in the same operating room during the same time period without use of bundled interventions (control group) was 12%.Conclusions: Bundled approach is easy and feasible in all setups. It adds only three extra minutes to the total duration of the surgery with risk reduction of SSI

The Uniqueness of Albumin as a Carrier in Nano Drug Delivery

The quest for precision medicine hinges on targeted drug delivery, minimizing off-target effects while maximizing therapeutic impact. Among nanocarriers, albumin – the most abundant protein in human blood – emerges as a uniquely biocompatible stealth bomber. Its inherent advantages, including exceptional biodegradability, prolonged circulation, and natural affinity for diseased tissues, perfectly align with the goals of personalized medicine. Albumin readily solubilizes poorly soluble drugs, enhancing bioavailability and broadening the therapeutic arsenal. Its versatile surface allows for targeted modifications, enabling dual diagnosis and treatment (theranostics) tailored to individual needs. While challenges remain in optimizing drug loading and targeting specificity, albumin-based nanocarriers hold immense promise for revolutionizing personalized healthcare, delivering potent therapeutics with pinpoint accuracy. The burgeoning field of nanodrug delivery seeks to redefine therapeutic landscapes by engineering nanoscale carriers that meticulously deliver potent drugs to their designated targets, minimizing systemic exposure and maximizing therapeutic efficacy. This pursuit aligns perfectly with the burgeoning field of precision medicine, where personalized treatments demand exquisite control over drug delivery. Within this intricate choreography, albumin, the abundant and versatile protein resident in human plasma, emerges as a maestro, orchestrating a symphony of advantages that make it a prime candidate for nanocarrier construction

Caffeine Levels and Dietary Intake in Smokers with Schizophrenia and Bipolar Disorder

This study investigates the relationship between caffeine levels and dietary intake among individuals with schizophrenia and bipolar disorder who are smokers. The research aims to understand the patterns of caffeine consumption and dietary habits in this specific population. A sample of participants diagnosed with either schizophrenia or bipolar disorder and who smoke will be analyzed to assess their caffeine intake through self-reported measures and biological markers. Additionally, their dietary patterns, including the consumption of caffeine-containing products and nutritional choices, will be evaluated. The findings of this study aim to contribute to a better understanding of the dietary behaviors of individuals with mental health disorders, specifically focusing on caffeine intake among smokers with schizophrenia and bipolar disorder

Targeted Therapies in Cancer Treatment: Unveiling the Latest Breakthroughs and Promising Approaches

This review article delves into the realm of cancer treatment, specifically focusing on targeted therapies. It aims to present the most recent breakthroughs and promising approaches in this rapidly evolving field. Targeted therapies have emerged as a revolutionary approach in cancer treatment, aiming to selectively and precisely attack cancer cells while sparing normal tissues. This article explores various targeted therapy strategies, including monoclonal antibodies, small molecule inhibitors, immunotherapies, and gene therapies. In recent years, there have been significant advancements in understanding the molecular and genetic basis of cancer, which has led to the identification of novel therapeutic targets. The article sheds light on these newly discovered targets and highlights their potential in designing more effective and personalized treatment regimens for cancer patients. Furthermore, the review addresses the challenges and limitations associated with targeted therapies, such as resistance mechanisms and the heterogeneity of tumors. Strategies to overcome these obstacles are discussed, including combination therapies and the development of next-generation targeted agents. The role of precision medicine in cancer treatment is also explored, emphasizing the importance of biomarker-guided therapy selection to optimize treatment outcomes. Additionally, the review touches upon the integration of targeted therapies with conventional treatments, such as chemotherapy and radiation therapy, to enhance overall treatment efficacy. Finally, the article examines ongoing clinical trials and preclinical studies that are investigating cutting-edge targeted therapies, showcasing the potential impact of these approaches in transforming cancer care. In conclusion, targeted therapies in cancer treatment represent a rapidly expanding field with remarkable breakthroughs and promising avenues. Understanding the latest advancements and challenges in this domain is essential to harness the full potential of targeted therapies and ultimately improve patient outcomes in the battle against cancer

Recent trends in the nanozeolites-based oxygen concentrators and their application in respiratory disorders

Medical-grade oxygen is the basic need for all medical complications, especially in respiratory-based discomforts. There was a drastic increase in the demand for medical-grade oxygen during the current pandemic. The non-availability of medical-grade oxygen led to several complications, including death. The oxygen concentrator was only the last hope for the patient during COVID-19 pandemic around the globe. The demands also are everlasting during other microbial respiratory infections. The yield of oxygen using conventional molecular zeolites in the traditional oxygen concentrator process is less than the yield noticed when its nano-form is used. Nanotechnology has enlightened hope for the efficient production of oxygen by such oxygen concentrators. Here in the current review work, the authors have highlighted the basic structural features of oxygen concentrators along with the current working principle. Besides, it has been tried to bridge the gap between conventional oxygen concentrators and advanced ones by using nanotechnology. Nanoparticles being usually within 100 nm in size have a high surface area to volume ratio, which makes them suitable adsorbents for oxygen. Here authors have suggested the use of nano zeolite in place of molecular zeolites in the oxygen concentrator for efficient delivery of oxygen by the oxygen concentrators

ROLE OF MRI IN EVALUATION OF EPILEPSY IN PEDIATRIC AGE GROUP IN A TERTIARY CARE CENTRE OF JHARKHAND, INDIA- A PROSPECTIVE STUDY.

Background: Childhood epilepsy is a prevalent neurological disorder. Imaging, especially MRI of the brain, plays a pivotal role in diagnosing the underlying cause. This study aimed to assess the frequency of causative factors of epilepsy detected in MRI. Materials and Methods: This hospital-based prospective observational study was conducted in the Radiology Department at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India from November 2021 to October 2022 in 100 children of 0 to 12 years of age referred from Pediatrics department for an MRI brain scan. MRI of the brain was performed in all cases and findings were analyzed and causes of epilepsy were assessed. Magnetic resonance spectroscopy (MRS) was also done when required for confirmation of diagnosis. Results: Positive findings in MRI were detected in 87% of children, and no abnormalities were detected in 13%. The majority of children belonged to the age group of 10-12 years (37%) and were predominantly males (66%). The most common cause of epilepsy was infections (27%) followed by hypoxic ischemic encephalopathy (22%). Tuberculoma was the most common infective cause of epilepsy in 59.3%. These were further followed by temporal lobe epilepsy and congenital malformations (11% each). The rest were other miscellaneous and idiopathic causes. Conclusion: MRI findings were specific to various conditions, helping in the localization and characterization of etiologies and playing a significant role in the evaluation of children who were newly diagnosed with epilepsy, especially those with partial seizures. Recommendation: Further research with a larger sample size and meta-analysis is recommended for more conclusive results

A systematic review and narrative synthesis of antenatal interventions to improve maternal and neonatal health in Nepal.

Maternal and neonatal mortality rates remain high in many economically underdeveloped countries, including Nepal, and good quality antenatal care can reduce adverse pregnancy outcomes. However, identifying how to best improve antenatal care can be challenging. To identify the interventions that have been investigated in the antenatal period in Nepal for maternal or neonatal benefit. We wanted to understand their scale, location, cost, and effectiveness. Online bibliographic databases (Cochrane Central, MEDLINE, Embase, CINAHL Plus, British Nursing Index, PsycInfo, Allied and Complementary Medicine) and trial registries (ClinicalTrials.gov and the World Health Organization Clinical Trials Registry Platform) were searched from their inception till May 24, 2020. We included all studies reporting any maternal or neonatal outcome after an intervention in the antenatal period. We screened the studies and extracted the data in duplicate. A meta-analysis was not possible because of the heterogeneity of the interventions and outcomes, so we performed a narrative synthesis of the included studies. A total of 25 studies met our inclusion criteria. These studies showed a variety of approaches toward improving antenatal care (eg, educational programs, incentive schemes, micronutrient supplementation) in different settings (home, community, or hospital-based) and with a wide variety of outcomes. Less than a quarter of the studies were randomized controlled trials, and many were single-site or reported only short-term outcomes. All studies reported having made a positive impact on antenatal care in some way, but only 3 provided a cost-benefit analysis to support implementation. None of these studies focused on the most remote communities in Nepal. Our systematic review found good quality evidence that micronutrient supplementation and educational interventions can bring important clinical benefits. Iron and folic acid supplementation significantly reduces neonatal mortality and maternal anemia, whereas birth preparedness classes increase the uptake of antenatal and postnatal care, compliance with micronutrient supplementation, and awareness of the danger signs in pregnancy

A systematic review and narrative synthesis of antenatal interventions to improve maternal and neonatal health in Nepal.

BackgroundMaternal and neonatal mortality rates remain high in many economically underdeveloped countries, including Nepal, and good quality antenatal care can reduce adverse pregnancy outcomes. However, identifying how to best improve antenatal care can be challenging.ObjectiveTo identify the interventions that have been investigated in the antenatal period in Nepal for maternal or neonatal benefit. We wanted to understand their scale, location, cost, and effectiveness.Study designOnline bibliographic databases (Cochrane Central, MEDLINE, Embase, CINAHL Plus, British Nursing Index, PsycInfo, Allied and Complementary Medicine) and trial registries (ClinicalTrials.gov and the World Health Organization Clinical Trials Registry Platform) were searched from their inception till May 24, 2020. We included all studies reporting any maternal or neonatal outcome after an intervention in the antenatal period. We screened the studies and extracted the data in duplicate. A meta-analysis was not possible because of the heterogeneity of the interventions and outcomes, so we performed a narrative synthesis of the included studies.ResultsA total of 25 studies met our inclusion criteria. These studies showed a variety of approaches toward improving antenatal care (eg, educational programs, incentive schemes, micronutrient supplementation) in different settings (home, community, or hospital-based) and with a wide variety of outcomes. Less than a quarter of the studies were randomized controlled trials, and many were single-site or reported only short-term outcomes. All studies reported having made a positive impact on antenatal care in some way, but only 3 provided a cost-benefit analysis to support implementation. None of these studies focused on the most remote communities in Nepal.ConclusionOur systematic review found good quality evidence that micronutrient supplementation and educational interventions can bring important clinical benefits. Iron and folic acid supplementation significantly reduces neonatal mortality and maternal anemia, whereas birth preparedness classes increase the uptake of antenatal and postnatal care, compliance with micronutrient supplementation, and awareness of the danger signs in pregnancy

Heterologous Expression of Serine Hydroxymethyltransferase-3 From Rice Confers Tolerance to Salinity Stress in E. coli and Arabidopsis

Among abiotic stresses, salt stress adversely affects growth and development in rice. Contrasting salt tolerant (CSR27), and salt sensitive (MI48) rice varieties provided information on an array of genes that may contribute for salt tolerance of rice. Earlier studies on transcriptome and proteome profiling led to the identification of salt stress-induced serine hydroxymethyltransferase-3 (SHMT3) gene. In the present study, the SHMT3 gene was isolated from salt-tolerant (CSR27) rice. OsSHMT3 exhibited salinity-stress induced accentuated and differential expression levels in different tissues of rice. OsSHMT3 was overexpressed in Escherichia coli and assayed for enzymatic activity and modeling protein structure. Further, Arabidopsis transgenic plants overexpressing OsSHMT3 exhibited tolerance toward salt stress. Comparative analyses of OsSHMT3 vis a vis wild type by ionomic, transcriptomic, and metabolic profiling, protein expression and analysis of various traits revealed a pivotal role of OsSHMT3 in conferring tolerance toward salt stress. The gene can further be used in developing gene-based markers for salt stress to be employed in marker assisted breeding programs.HIGHLIGHTS- The study provides information on mechanistic details of serine hydroxymethyl transferase gene for its salt tolerance in rice

A cross sectional study to evaluate antenatal care service provision in three hospitals in Nepal

Background Globally too many mothers and their babies die during pregnancy and childbirth, a key element of optimizing outcomes is high-quality antenatal care (ANC). The Government of Nepal have significantly improved ANC and health outcomes through high-level commitment and investment, but still only 69% attend four recommended antenatal appointments. Objective To evaluate the quality and perceptions of ANC in Nepal to understand the compliance with Nepalese standards. Study Design This cross-sectional study took place at a tertiary referral and private hospital in Kathmandu, and a secondary hospital in Makwanpur. It recruited 538 female inpatients on postnatal wards during the two-week data collection period in May/June 2019. A case note review and verbal survey of women to understand the pregnancy information they received and their satisfaction with ANC was performed. We created a summary score of the completeness of ANC services received ranging 0-50 (50 indicating complete accordance with standards) and investigated the determinants of attending 4 ANC visits and patient satisfaction. Results The median ANC attendance was 4 visits at the secondary and referral hospitals and 8 at the private hospital. 24% attended less than 4 visits. 22% (117/538) attended a first trimester visit and 12% (65/538) attended visits at all points recommended in the standards. Over 90% of women had blood pressure monitoring, hemoglobin estimation, blood grouping and Rhesus typing, HIV and syphilis screening. 50% of women had urinalysis at every visit (IQR 20 to 100). 95% (509/538) reported receiving pregnancy information, but retention was variable: 93% (509/538) received some information about danger signs, 58% (290/502) remembered headaches whereas 98% (491/502) remembered fluid leaking. The ANC completeness score revealed the private hospital offered the most complete clinical services (mean 28.7, SD=7.1) with the secondary hospital performing worst (mean 19.1, SD=7.1). The factors influencing attendance at 4 ANC visits in the multivariable model were beginning ANC in the first trimester (OR 2.74 (95% CI 1.36, 5.52) and having a lower level of education (no-school OR 0.46 (95% CI 0.23, 0.91), Grades 1-5 OR 0.49 (95%CI 0.26, 0.92)). Overall 56% (303/538) of women were satisfied with ANC. The multivariable analysis revealed satisfaction was more likely in women attending the private hospital compared to the referral hospital (OR 3.63 95% CI 1.68 to 7.82) and lower in women who felt the ANC facilities were not adequate (OR 0.35 95% CI 0.21 to 0.63) and who wanted longer antenatal appointments (OR 0.5 95% CI 0.33 to 0.75). Conclusions Few women achieved full compliance with the Nepali ANC standards, however, some services were delivered well. To improve, each antenatal contact needs to meet its clinical aims and be respectful. To achieve this communication and counselling training for staff, investment in health promotion and delivery of core services is needed. It is important that these interventions address key issues, such as attendance in the first trimester, improving privacy and optimizing communication around danger signs. However, they must be designed alongside staff and service users and their efficacy tested prior to widespread investment or implementation