Understanding and Prevention of Catheter Associated Urinary Tract Infections (CAUTIs)

Abstract The project goal is to reduce and eliminate CAUTI occurrences on the med-surgical unit by increasing staff knowledge on CAUTIs and applying the ANA CAUTI prevention tool to improve patient outcomes. The project objectives are (1) enhanced staff knowledge about CAUTIs, (2) staff adherence to the implemented the ANA CAUTI prevention tool, and (3) maintained CAUTI rate below benchmark. The CNL role in the project is to function as an educator and outcomes manager, which serves as the foundation for the project. The department consists of a 34-bed med-surgical unit with the adult patient population mix of oncology, surgical, and cardiac patients. The unit currently utilizes the ANA CAUTI Prevention Tool; however, the rate of CAUTIs continues to increase. The current CAUTI rate for the medical-surgical unit is 1.52 for year 2017 which is above the national benchmark through National Healthcare Safety Network (NHSN). The project goal is to decrease or eliminate CAUTI rate on the unit by 54% for 2018 to bring the rate below the benchmark. The risk factors from root-case, stakeholders and SWOT analysis are categorized into four categories such as human factors, environmental factors, administrative factors and material factors. The project status is in progress. The evaluation plan includes data collection, data analysis, and data comparison. The CAUTI incidences will be measured and collected by infection control daily audit tool explicitly created to CAUTIs. The infection control nurse will be responsible for obtaining this information. Data analysis includes Catheter days, indications, and compliance with ANA tool will be measured through chart review by CAUTI task force and infection control daily audit. The risk analysis department will compare the data to evaluate the quarterly trend and address barriers. The data will help evaluate the reduction in CAUTI rate and staff compliance with ANA CAUTI prevention tool. The project will be sustained through (1) stakeholders’ support, (2) CAUTI task force involvement, (3) by using ANA CAUTI prevention tool appropriately, (4) providing continuous education support, (5) address barriers and challenges and (6) staff recognition. The frontline nursing staff can make the most difference through sound knowledge of CAUTIs, current practice guidelines, and ANA prevention tool

Association between different degrees of hypothyroidism and serum lipids

The association between overt hypothyroidism (OH) and altered lipid profile is well known, however the significance of dyslipidemia in subclinical hypothyroidism (SCH) remain controversial. Therefore, this study was conducted to determine any association between lipid profile and different degrees of thyroid dysfunction. Thyroid and lipid profile parameters were analysed in 58 patients with overt (TSH ≥ 10.0 μIU/L and/or abnormally low fT4 and fT3 levels) and 87 patients with subclinical hypothyroidism (TSH 6.0-9.9 μIU/L with normal fT4 and fT3 levels) in this case-control study. These were compared with 100 age- and sex-matched euthyroid controls. It was found that only mean serum level of total cholesterol in patients with SCH was significantly high from that in controls (p=0.045). Other lipid parameters did not show any statistical significance. Whereas patients with OH had statistically significant higher levels of total cholesterol (p<0.001), triglyceride (p<0.05), LDL-C (p<0.001) and VLDL-C (p<0.05). There was also an increase in HDL-C in both SCH and OH group though not significant statistically. In conclusion, lipid profile is not much deranged in SCH whereas OH is a major cause of secondary dyslipidemia which may lead to increased risk of coronary artery disease. Therefore, thyroid hormone replacement would be most beneficial in patients with OH instead of SCH. However, patients with SCH should be monitored for deterioration of thyroid function and dyslipidemia at regular intervals.Keywords: Cholesterol; Dyslipidemia; HDL cholesterol; Hypothyroidism; SubclinicalInternet Journal of Medical Update 2012 July;7(2):3-

Influence of thyroid hormones on biochemical parameters of liver function: a case-control study in North Indian population

Normal level of thyroid hormones is important for normal hepatic function and thyroid dysfunction may modulate metabolic function of liver. The purpose of this study is to determine whether liver function is associated with subclinical and overt hypothyroidism. Thyroid and liver function tests were evaluated in 47 patients with overt (TSH ≥10.0 mIU/L) and 77 patients with subclinical hypothyroidism (TSH 6.0-9.9mIU/L) and compared with 120 age-matched euthyroid controls. Subjects with overt hypothyroidism had significantly raised serum ALT, AST, ALP and total protein levels as compared to controls whereas subclinical hypothyroid patients had significantly increased levels of serum ALT, ALP and total protein. Further, TSH showed significant positive correlation with AST and ALP values whereas fT3 and fT4 had a negative correlation with AST in overt hypothyroidism. Thus, overt hypothyroid state is associated with significant derangement in biochemical parameters of liver function. Hence, liver function should be regularly monitored in hypothyroid patients

Rational Mutational Analysis of a Multidrug MFS Transporter CaMdr1p of Candida albicans by Employing a Membrane Environment Based Computational Approach

CaMdr1p is a multidrug MFS transporter of pathogenic Candida albicans. An over-expression of the gene encoding this protein is linked to clinically encountered azole resistance. In-depth knowledge of the structure and function of CaMdr1p is necessary for an effective design of modulators or inhibitors of this efflux transporter. Towards this goal, in this study, we have employed a membrane environment based computational approach to predict the functionally critical residues of CaMdr1p. For this, information theoretic scores which are variants of Relative Entropy (Modified Relative Entropy REM) were calculated from Multiple Sequence Alignment (MSA) by separately considering distinct physico-chemical properties of transmembrane (TM) and inter-TM regions. The residues of CaMdr1p with high REM which were predicted to be significantly important were subjected to site-directed mutational analysis. Interestingly, heterologous host Saccharomyces cerevisiae, over-expressing these mutant variants of CaMdr1p wherein these high REM residues were replaced by either alanine or leucine, demonstrated increased susceptibility to tested drugs. The hypersensitivity to drugs was supported by abrogated substrate efflux mediated by mutant variant proteins and was not attributed to their poor expression or surface localization. Additionally, by employing a distance plot from a 3D deduced model of CaMdr1p, we could also predict the role of these functionally critical residues in maintaining apparent inter-helical interactions to provide the desired fold for the proper functioning of CaMdr1p. Residues predicted to be critical for function across the family were also found to be vital from other previously published studies, implying its wider application to other membrane protein families

Clinical pattern of recurrent herpes simplex keratitis

<b>Purpose</b>: To document the clinical pattern in recurrent herpes simplex disease. <b>Methods</b>: Eyes with clinically documented pattern of corneal manifestation on more than one occasion were analysed. For each eye recruited, the clinical pattern of the disease at each recurrence of herpes simplex corneal disease, age, disease-free intervals, triggering factors, laterality and steroid abuse were noted and evaluated. <b>Results</b>: For an average follow up of 6.9 years, a recurrence rate of 0.6 episodes per year was observed. Disease-free intervals of 75.7 months for epithelial herpes simplex disease was considerably longer than the 21.3 months observed for stromal disease. Clinical pattern of recurrence was of the same type following first episode of disciform keratitis, epithelial keratitis and endothelitis in 84&#x0025;, 72.7&#x0025;, and 75&#x0025; of the eyes respectively. <b>Conclusion</b>: Herpes simplex disease often recurs in the same manifest clinical pattern as the first episode. This clinical evidence provides additional support for the potential role of herpes simplex biotypes in determining manifestation of clinical disease pattern

Biofortification of Rice to Augment Iron Availability for Better Health of Population

Aim: Rice is one of the largely consumed cereal and masses have been expressed anemia conditions. Iron augmentation of rice varieties had been carried out by agronomical biofortification as established an easy way to reach the poor rural masses for enhancing the concentration of particular minerals. Methodology: Six rice varieties were evaluated during kharif in the net houses of the Department of Chemistry and Biochemistry, CCS HAU augmented with 0 mM 0.1m 0.5 mM Ethylene diamine tetra acetic acid (EDTA-Fe(II)). Reactive Oxygen Species (ROS) related metabolites along antioxidative metabolites were estimated in grains, upper shoots &amp; lower shoots. Results: Roots of HBC19 and Palman579 and lower and upper shoots of PUSA1121 contained higher iron. Highest iron in dehusked grains was recorded in Palman579 followed by HBC19, PUSA1121, HKR120, Super and Govind. Production of toxic super oxide radical (O2- ) and hydrogen peroxide (H2O2) and lipid peroxidation (MDA),&nbsp; enhanced in all the varieties with increase in Fe concentration. Antioxidative metabolites’ contents (ascorbic acid and glutathione) and activities of antioxidative enzymes [super oxide dismutase (SOD), catalase (CAT), peroxidase (POX), ascorbate peroxidase (APX) and glutathione reductase (GR)] invariably increased with increasing iron treatment in both root and shoot. Interpretation: Less accumulation of reactive oxygen species along with the gradual increase in antioxidative metabolites’ contents and enzymes’ activities at higher iron treatments suggest that a better ROS scavenging ability to restrict the damage to cellular membranes due to lipid peroxidation may be responsible for the adaptation of these varieties at high iron levels