FORMULATION AND EVALUATION OF ANTIMICROBIAL GELS FOR THE TREATMENT OF PARONYCHIA

Objective: The aim of the study was to design and develop a gel based drug delivery system containing combinational drugs (ketoconazole, neomycin sulphate and diclofenac) for the effective treatment of Paronychia.Methods: The drugs used are ketoconazole, neomycin sulphate and diclofenac. The first two drugs provide an antifungal and antibacterial action and the last drug with a pain relieving effect. Two formulations of gels F1 and F2 were prepared using polymers like carbopol 934 and xanthan gum respectively. The amounts of drugs and other ingredients were kept as constant in both formulations. The prepared formulations were then evaluated by visual examination, pH, drug content, spredability, extrudability, drug release study, in vitro antibacterial study, in vitro antifungal study, stability studies and in vivo antibacterial study.Results: The obtained results were analyzed and compared. All the test results were within the accepted limit. The physicochemical properties of the gels were assessed and it was found that the two formulations have enough gel consistency with good spreadability and extrudability. The drug content and drug release studies of the prepared gels were done and the results showed that the all the three drugs were properly loaded into the gel system, with good drug release profile. The antimicrobial activities of the formulated gels were proved by both in vitro antifungal and antibacterial studies. The in vivo antibacterial studies revealed a significant reduction in bacterial count in wistar rats treated with prepared gel when compared with standard drug solution. From among all the developed formulations, F1 formulation with carbopol 934 has got a slight superior property when compared with formulation F2 xanthan gum as gelling agent.Conclusion: On the basis of the evaluation studies it was concluded that the drugs (ketoconazole, neomycin sulphate and diclofenac) were successfully incorporated into the different topical gel preparations with good physicochemical properties and antimicrobial activity. Therefore, it was concluded that our formulae could be very promising topical alternative for the treatment of Paronychia

Effectiveness of the Local Adaptation Plan of Action to support climate change adaptation in Nepal

A key challenge in climate change adaptation in developing countries as a whole, and to handling global change in particular, is to link local adaptation needs on the one hand, with national adaptation initiatives on the other, so that vulnerable households and communities can directly benefit. This study assesses the impact of the Nepal government’s efforts to promote its Local Adaptation Plan of Action (LAPA) and its applicability to other least developed countries (LDCs). Based on data gathered from two field studies in Nepal, the research shows that the Nepal’s LAPA has succeeded in mobilizing local institutions and community groups in adaptation planning and recognizing their role in adaptation. However, the LAPA approach and implementation have been constrained by sociostructural and governance barriers that have failed to successfully integrate local adaptation needs in local planning and increase the adaptive capacity of vulnerable households. This paper describes the mechanisms of suitable governance strategies for climate change adaptation specific to Nepal and other LDCs. It also argues the need to adopt an adaptive comanagement approach, where the government and all stakeholders identify common local- and national-level mainstreaming strategy for knowledge management, resource mobilization, and institutional development, ultimately using adaptation as a tool to handle global change

Machine learning-based meta-classifier for Kharif Bajra (pearl millet) discrimination in the mixed cropping environment using multi-temporal SAR data

Study on pearl millet discrimination in mixed cropping environment was carried out as it forms the major coarse cereal crop in India. The study aims at determining the capabilities of Sentinel-1A SAR data and Machine Learning (ML) algorithms for pearl millet discrimination. Six ML algorithms, that is, k-nearest neighbour (k-NN), Decision Tree (DT), support vector machine (SVM), random forest (RF), multi-layer perceptron (MLP) and Naïve Bayes (NB) were evaluated and compared. Meta-classifier using majority voting technique was proposed by ensembling classifiers (RF, SVM and NB) which were diverse and have comparable accuracies. The diversity assessment was conducted using Cochran Q statistics for ensembling purpose. RF classifier (83.76%) using VH polarization produced better result indicating importance of cross-polarization in crop classification. Further, meta-classifier proposed in the study improved the accuracy to 88.15% (approximately by 5%) and class accuracies of pearl millet resulting in improved discrimination of pearl millet in mixed cropping environment

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status