The Significance of Serum C-Reactive Protein Estimation in Acute Meningitis in Adults

INTRODUCTION: The evolution of clinical signs and symptoms produced by meningitis or encephalitis varies greatly. Few conditions in medicine require as rapid and accurate therapeutic intervention as acute pyogenic meningitis and viral meningitis, yet meningitis can also occur in chronic and recurrent forms. The major problem presented by patients with meningitis is rapid determination of its aetiology, the specific basis on which selection of potentially effective antimicrobial therapy is predicted. Thus, the clinician must sort out the form of clinical presentation, assess the rapidity of its evolution, and make a specific aetiological diagnosis. The examination of cerebrospinal fluid is an essential and often critical tool in the evaluation and management of patients with meningitis. If interpreted carefully, the cerebrospinal fluid (CSF) analysis, can be very helpful in guiding the diagnostic evaluation and management of patients. Although examination of a Gram’s stain of spinal fluid often defines the causative agent, this is not always the case. Cultures have the draw back of the time required, 24 to 48 hours or more to become positive, an unacceptable delay in initiating the treatment. AIM OF THE STUDY: To evaluate the efficacy of serum C-Reactive Protein in differentiating bacterial meningitis from viral meningitis. MATERIALS AND METHODS: Fifty cases with definite clinical signs and symptoms of acute meningitis admitted in Govt. Stanley Hospital, Chennai during the period August 2005 to September 2006 were taken up for the study. The results were correlated with the results of S-CRP levels and the cases were differentiated into bacterial meningitis or meningitis due to other causes. Inclusion Criteria: 1. Above 12 years of age. 2. History suggestive of meningitis. 3. Neck Rigidity. CONCLUSION: 1. Estimation of C-reactive protein in serum is the cheapest, sensitive and specific test to differentiate bacterial from viral infections. 2. It is a simple qualitative as well as quantitative test and can be done as a bed side investigation. 3. With serum C-reactive protein, a definite aetiological diagnosis can be made rapidly at the time of admission itself. 4. A serum CRP level of less that 6 mg/l with clinical signs of meningeal infection is a definite indicator of viral meningitis. 5. A serum CRP level of more than 48 mg/l with clinical signs of meningeal infection is a definite indication of bacterial meningitis. 6. Preadmission treatment with steroids cause a fall in CRP levels in bacterial meningitis. 7. Serum CRP has 68% predictive value in adults. 8. The rapid differentiation facilitates an early, accurate and appropriate therapy thereby reducing the morality and morbidity rates, the overall cost of the treatment and the duration of hospitalization. 9. Serum CRP can be used as the best and most sensitive bedside prognostic indicator of bacterial infections. 10. Meningeal infections have a definite male predominance. 11. Altered level of consciousness at the time of admission is associated with bad prognosis and high case fatality rate (28%). 12. Fever is the commonest presenting feature followed by altered sensorium, symptoms of increased intracranial tension and seizure. Among neurological deficits, hemiparesis, VIth cranial nerve palsy and VIIth cranial nerve palsy were found to be common. 13. The earlier the recognition of bacterial meningitis and more rapid the institution of antimicrobial therapy the better the chance of a favourable outcome. 14. Therefore, the serum C-reactive protein estimation is most useful in differentiating bacterial meningitis from viral meningitis, especially for developing countries like India, even in peripheral health centres

SILVER NANOPARTICLES FROM TRIANTHEMA PORTULACASTRUM: GREEN SYNTHESIS, CHARACTERIZATION, ANTIBACTERIAL AND ANTICANCER PROPERTIES

ABSTRACTObjective: In this study, silver nanoparticles (SNPs) were synthesized using an aqueous extract of Trainthema portulacastrum and silver ions (Ag+)which have been proven against certain pathogenic bacterial strains and hepatocellular carcinoma (HepG2) cell line.Methods: The bio fabricated nanoparticles were confirmed by surface plasmon resonance which were characterized by biophysical measuresutilizing the ultraviolet-visible spectroscopy, scanning electron microscopy (SEM), energy dispersive X-ray, and transmission electron microscope(TEM), Fourier transform infrared spectroscopy, particle size analyzer, and X-ray diffraction. Antibacterial efficacy against Enterobacter aerogens,Proteus mirabilis, Escherichia coli, Staphylococcus epidermis, and Bacillus subtilis. The effect of SNPs tested against HepG2 and NIH/3T3 cell lineexhibits a dose-dependent toxicity.Results and Conclusion: The SEM and TEM images confirmed the presence of spherical and hexagonal shape (0.3-4 μm) of nanocrystalline particleswith the size range of 11.5-29.2 nm. The average particles size of SNPs is 190.3±17.0 nm. Antibacterial activity was carried out by agar well diffusionmethod against different pathogenic bacteria of which B. subtilis showed a significant zone of inhibition 8.66 mm and 12.0 mm for aqueous plantextract and synthesized SNPs. The effect of SNPs tested against HepG2 and NIH/3T3 cell line exhibits a dose-dependent toxicity. In case of HepG2, thecell viability was decreased to 50% (IC50) at the concentration of 173.8±0.84 μg/mL. From the results, it can be concluded that the SNPs fabricatedusing green synthesis method will be a promising candidate in the biomedical field, due to its high bioactive properties.Keywords: Silver nanoparticles, Trainthema portulacastrum, Antibacterial activity, Cytotoxic activity

The impact of stress on low level employees of star hotels with special reference to chennai

Stress is normal parts of life that can either help us learn and grow or can cause us significant problems. It is a condition or feeling experienced when a person perceives that “demands exceed the personal and social resources the individual is able to mobilize.” The extra-organizational stress, organizational stress and group stress were perceived to be the stressful. The study helps to identify the level of stress, stress due to changing work place, sources of stress at work and provide suitable suggestions to reduce it. The study considering as descriptive study, the primary data’s are collected from the low level employees of Hotel Savera. The sample size is taken for the study is 113. The data are collected through scheduled that are having 28 questions. 5 point scale is used to find out the factors for stress. The statistical tool chi-square is used for analyzing the data. The major findings are Extra-organizational and group stress mostly affected the stress level the suggestions are made based on the findings. The management can reduce the stress among the employees through conducting various programs like vocational tours, cultural programs, sports, classes for yoga and meditations, meeting, and counseling

Emotional intelligence among middle school teachers With reference to nagapatinam district, Tamil Nadu

The main aim of education is the all round holistic development of the students. In the pursuit of this goal, the teachers play a significant role. Emotionally Intelligent teachers help students with Improved Motivation, Enhanced Innovation, Increased Performance, Effective Use of Time and Resources, Improved Leadership Qualities and Improved Team Work .An effective, successful teacher is largely one who can handle his or her negative feelings in an authentic, real and healthy way. The present study aims at studying the level of emotional intelligence of the teachers at middle schools in Nagapatinam district, Tamil Nadu. The size of the sample for the study consisted of 300 teachers selected from the middle schools of Nagapatinam district, Tamil Nadu, Randomly and also as per the author’s convenience. At last the overall finding of the study was when compared with men middle school teachers the female teachers are lack in only one specific emotional intelligence area that is they always think about their home problems in the work place or vice vers

The impact of stress on low level employees of star hotels with special reference to chennai

Stress is normal parts of life that can either help us learn and grow or can cause us significant problems. It is a condition or feeling experienced when a person perceives that “demands exceed the personal and social resources the individual is able to mobilize.” The extra-organizational stress, organizational stress and group stress were perceived to be the stressful. The study helps to identify the level of stress, stress due to changing work place, sources of stress at work and provide suitable suggestions to reduce it. The study considering as descriptive study, the primary data’s are collected from the low level employees of Hotel Savera. The sample size is taken for the study is 113. The data are collected through scheduled that are having 28 questions. 5 point scale is used to find out the factors for stress. The statistical tool chi-square is used for analyzing the data. The major findings are Extra-organizational and group stress mostly affected the stress level the suggestions are made based on the findings. The management can reduce the stress among the employees through conducting various programs like vocational tours, cultural programs, sports, classes for yoga and meditations, meeting, and counseling

Emotional intelligence among middle school teachers With reference to nagapatinam district, Tamil Nadu

The main aim of education is the all round holistic development of the students. In the pursuit of this goal, the teachers play a significant role. Emotionally Intelligent teachers help students with Improved Motivation, Enhanced Innovation, Increased Performance, Effective Use of Time and Resources, Improved Leadership Qualities and Improved Team Work .An effective, successful teacher is largely one who can handle his or her negative feelings in an authentic, real and healthy way. The present study aims at studying the level of emotional intelligence of the teachers at middle schools in Nagapatinam district, Tamil Nadu. The size of the sample for the study consisted of 300 teachers selected from the middle schools of Nagapatinam district, Tamil Nadu, Randomly and also as per the author’s convenience. At last the overall finding of the study was when compared with men middle school teachers the female teachers are lack in only one specific emotional intelligence area that is they always think about their home problems in the work place or vice vers

Fox’s Head or Lion’s Tail? Work Life Balance of Women Entrepreneurs in Agriculture and farm Ventures and its Antecedent Effect on Quality of Life

Purpose: The objective of this study was to identify the factors that influence work life balance of women entrepreneurs in the field of agriculture and allied products and how the family demands affect their work-life balance. Further, the paper explores the conflict between parental demand and running a business.   Theoretical framework: Literature review points out that despite, an increase in the number of women entrepreneurs over the years, according to the (Global entrepreneurship monitor report, 2020), fewer women pursue entrepreneurship due to various challenges of managing personal and business responsibilities and striking the right balance. Work-life balance is frequently examined in the context of human resource management (Etienne St-Jean and Duhamel M.,2020)but not much has been explored in an entreprenurial context.Hence this study is to investigate and understand the influence of various factors affecting work life balance from an entrepreneurial standpoint.   Design/methodology/approach: Triangulation method was used for the study by utilizing both quantitative and qualitative data. The researchers developed a questionnaire to measure work-life balance experienced by women entrepreneurs with 12 independent variables to measure the dependent variable work-life balance.The sample consisted of 450 women agripreneurs   Findings: The findings reveal that the age of the children is a major determinant of the extent of parental demand a woman goes through in her life and family support systems are critical in reducing overlap and conflict between the life domains. A positive spillover between the domains significantly enhances quality of life of women entrepreneurs.   Research, Practical & Social implications: We suggest a future research into other Personality traits and macro environmental factors which can have a bearing on work life balance of women entrepreneurs which would enable an inclusive entrepreneurial ecosystem.   Originality/value: The researchers have concluded that positive spillover between the domains significantly enhances quality of life of women entrepreneurs

Bicycle handlebar injuries in children: Is “ring sign,” an indicator of intra‑abdominal organ injuries?

Background: Children are vulnerable to a wide range of bicycle-related traumatic injuries. Bicycle handlebar injuries often causediagnostic dilemma and delay in diagnosis due to trivial nature of the incident. Objectives: To study the bicycle handlebar injuriesin children and their management. Materials and Methods: A retrospective review of all the children with blunt abdominal injuriessecondary to bicycle handlebar injuries at our institution, between April 2011 and March 2015 was done. The patient medical recordswere examined, and all the data pertaining to the demographic information, clinical history, hematological investigations, imagingstudies, operative technique, post-operative recovery and complications, and duration of hospitalization were obtained. Results: Duringthe study period of 48-month, 26 children with blunt abdominal injuries were treated at our institution. Among these patients, 7 childrenhad bicycle handlebar abdominal injuries. All 7 patients were male. Mean age of the patients was 9.6 years (range 5-12 years). Theaverage time gap between trauma and presentation to our institution was 46 h (range 22-96 h). All the 7 children had circular patternedabrasion of the bicycle handlebar over the abdominal wall. Mean duration of hospital stay was 16.1 (range: 9-28) days, and the averageduration of follow-up was 35.6 months (range 7-55 months). Conclusion: “Ring sign” indicates a higher probability of associated intraabdominalinjury, and these children should be thoroughly evaluated and managed with close observation, repeated clinical examination,appropriate imaging studies, and surgical or endoscopic intervention as required

Bedside reduction of gastroschisis: A feasible option

Background: Gastroschisis is a common neonatal malformation, with an incidence of 0.4-3 per 10,000 live births worldwide.Objective: This study was planned to assess the feasibility of bedside reduction of gastroschisis (BRG) in the neonatal intensive care unit(NICU) at our institution. Materials and Methods: Retrospective analysis of newborns with gastroschisis managed at our institutionbetween September 2008 and May 2013. Initial bedside reduction in NICU was attempted in all the neonates procedure was done underlocal anesthesia. Incision was extended transversely on the lateral aspect when required. Gradual reduction of bowel loops done withmonitoring of parameters. Complete abdominal wall closure in multiple layers/skin closure only was done based on intra-abdominaltension. The final outcome was recorded. Results: During the study period of 60-month, 10 children were treated for gastroschisis atour institution. The sex ratio among them was 8:2 in favor of males. The average age was 23 h (range: 4-72 h). The average birth weightof the babies was 2290 g (range: 1700-2600 g). Six patients were in the high-risk group and 4 in the low-risk group. The BRG wassuccessful in 7 patients and a silo was placed in 3 patients who did not tolerate BRG. General anesthesia was required in 3 patients onlyfor subsequent repair. The overall survival was 70%. Conclusion: BRG is a feasible and safe option. Selective use of silo, gradual stagedbowel reduction, and delayed primary closure of the defect can be done on the bedside when attempted BRG is unsuccessful

In silico and in vitro analysis of quorum quenching active phytochemicals from the ethanolic extract of medicinal plants against quorum sensing mediated virulence factors of Acinetobacter baumannii

Inhibition of quorum sensing called quorum quenching (QQ) is now extensively utilized in the prevention of bacterial infections. In the present study, in silico and in vitro analysis of quorum quenching (QQ) or anti-Quorum sensing (QS) activity of ethanolic extract of medicinal plants against QS mediated virulence factors of human pathogenic bacteria Acinetobacter baumannii has been investigated. The effect of plant extracts on QS by acyl homoserine lactone (AHL) has been carried out by quantification of secreted AHL by high-pressure liquid chromatography (HPLC). Measurement of QQ activity was determined by maximum inhibition of virulence factors and AHL production which was recorded in E. globules and A. indica extracts. In silico analysis was studied with possible bioactive compounds in the ethanolic extract of respective plant material that were characterized by gas chromatography equipped with mass spectroscopy (GCMS) against the enzyme responsible for the production of signaling molecule which mediates QS AHL synthase. Distinct reduction of all the QS-mediated virulence factors was recorded in the E. globules and A. indica. Among the different bioactive compounds, the ethanolic leaf extract of E. globules of GCMS analyzed compound, Hexadeconoic acid, 1-(hydroxymethyl), 1, 2-ethannediyl ester interacted with 1KZF protein (AHL synthase) and showed binding energy of −11.2 kcal/mol to MET 42 and TYR 54. Phytochemicals mediated inhibition of AHL synthase activity which was responsible for AHL production would suggest the possible utilization of plant extracts as an antibacterial agent to fight against disease-causing pathogenic bacteria