HAILEY-HAILEY DISEASE – A CASE REPORT

Hailey-Hailey disease (HHD) is a rare autosomal dominant skin condition discovered in 1939 by Hailey brothers. Prevalence is found to be around 1 in 50,000 and is relatively uncommon in India. First onset of disease occurs between 20 to 40 years of age, usually presented in the 3rd and 4th decades of life. Here, we report a case of a 50-year-old female who presented with clinical features of the HHD and showed greater response to the treatment

NEONATAL SEPSIS: ANTIBIOTIC SENSITIVITY & RESISTANCE PATTERN OF COMMONLY ISOLATED PATHOGENS IN A NEONATAL INTENSIVE CARE

Neonatal bacterial sepsis is one of the major causes of morbidity and mortality in neonates. Bacterial pathogens and drug resistance are different in hospitals of each country. In this study we identified bacterial pathogens and its sensitivity and resistance pattern for various antibiotics in the neonatal intensive care unit (NICU) in Amrita Institute of Medical Sciences (AIMS), kochi during September 2011 to April 2012. A total of 150 newborns admitted in the NICU with symptoms/signs of bacteremia/septicemia or developed sepsis during their stay in NICU were included in the study. 57 (38%) out of 150 patients admitted during the study period had proven sepsis confirmed by positive blood culture. Gram negative organisms accounted for 87.72 % of all positive cultures. Among the culture positive specimens, Klebsiella pneumoniae (45.61 %) and Coagulase Oxidase Negative Staphylococcus (CoNS) (12.28%) were the commonly isolated gram negative and gram positive organism respectively

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Microwave Assisted Biosynthesis of Silver Nanoparticles Using the Rhizome Extract of Alpinia galanga and Evaluation of Their Catalytic and Antimicrobial Activities

Biomediated methods are considered to be a safer alternative to conventional physicochemical methods for the fabrication of nanomaterials due to their eco-friendly nature. In the present study, silver nanoparticles (AgNPs) were synthesized by microwave irradiation using aqueous rhizome extract of the medicinal plant Alpinia galanga. The nanoparticles were also synthesized under ambient condition without the assistance of microwave radiation and the former method was found to be much faster than the latter. The silver nanoparticles were characterized by UV-vis., FTIR, XRD, and HR-TEM analysis. UV-vis. spectroscopic studies provided ample evidences for the formation of nanoparticles. The FTIR spectrum confirmed the presence of plant phytochemicals as stabilizing agent around the AgNPs. XRD and HR-TEM analyses clearly proved the crystalline nature of the nanoparticles. From the TEM images, the nanoparticles were found to be roughly spherical in shape with an average diameter of 20.82 ± 1.8 nm. The nanoparticles showed outstanding catalytic activity for the reduction of methyl orange by NaBH4. The AgNPs were also evaluated for their antimicrobial activity by well diffusion method against S. aureus, B. subtilis, V. cholera, S. paratyphi, and A. niger. They were found to be highly toxic against all the tested pathogenic strains

Impact of student migration from India to United Kingdom

A community sample of Indian students in the United Kingdom were interviewed to analyse how transition from India to the United Kingdom had affected them. For the project, we interviewed six individuals of similar age in order to figure out similarities and differences in their response. The themes analysed further after conducting the interviews were: biggest change, challenges, experiences (positives/negatives of coming to the UK), discrimination (bullying/racism), development and opportunities. Language barriers and culture shock were the biggest struggles according to the respondents, due to different ethnic backgrounds, cultures and values.

A STUDY OF CLINICAL PHARMACIST INITIATED INTERVENTION FOR THE OPTIMAL USE OF MEDICATIONS IN A NEONATAL INTENSIVE CARE UNIT (NICU) OF A TERTIARY CARE HOSPITAL, SOUTH INDIA

Objective: Various strategies to reduce errors have been described in adult and pediatric patients, but there are few published data on their effect in the NICU. The study was carried out to assess the impact of a clinical pharmacist-initiated intervention for the optimal use of medications in NICU.Methods: A prospective, non-experimental, Interventional study was conducted, with a sample size of 150 patients, admitted to the NICU during a period of 7 mo.Results: A total of 87 Drug-related problems (DRPs) were identified from 80 patient case records. Most of the pharmacist-initiated interventions carried out in this study resulted from Dose/frequency inappropriate (40.22%) followed by Administration errors (31.05%) and Drug Interactions (17.24%). The acceptance rate of recommendation and change in drug therapy was found to be high 68.97%. Most of the pharmacist interventions were seen to have moderate significance in grade.Conclusion: This study demonstrates that the physician's acceptance rate of pharmacist intervention is high. The physician acceptance rate of documented clinical pharmacist interventions indicated that specialist medical colleagues considered most of the interventions appropriate. This suggests that a joint effort between physicians and pharmacist is possible that provides a safer system, improved pharmaceutical care and better resource utilization.Â