Partnership of obstetrician and neonatologist to improve neonatal outcome in peri-viable and premature babies: a cross sectional survey

Background: Collaboration between obstetricians and paediatricians/Neonatologists provides the best quality care to infants and their mothers. Present study was conducted to evaluate the practices of obstetricians and neonatologists’ partnership to improve neonatal outcome.Methods: Present cross-sectional, observational study was conducted on 50 Obstetricians and 50 paediatricians/ neonatologists during October 2021 to evaluate the practices of obstetricians and neonatologists’ partnership to improve neonatal outcome.Results: In present study, among 50 obstetricians and 50 pediatricians/ neonatologists, all i.e., 100 (100%) feel that partnership of obstetrician and neonatologist in managing pre-viable pregnancy improves neonatal outcome. Among 50 obstetricians, all i.e., 50 (100%) said that they will explain the need for caesarean section and if necessary classical caesarean section. All said they will explain the need and advantages of steroids. Among 50 pediatricians/ neonatologists, majority i.e., 44 (88%) said that they will explain the need for caesarean section and if necessary classical caesarean section. All said they will explain the need and advantages of steroids. Among 50 obstetricians, majority i.e., 45 (90%) said that they will explain thoroughly the risk to the baby, survival, short term complications and disability, 30 (60%) each said that they will explain thoroughly the risk of RDS, need of resuscitation, need of NICU for baby, uncertainty of hospital stay and outcome. Among 50 pediatricians/ neonatologists, all i.e., 50 (100%) each said that they will explain thoroughly the risk to the baby, survival, short term complications and disability, the risk of RDS, need of resuscitation, need of NICU for baby, uncertainty of hospital stay and outcome. Expressions of pediatricians/ neonatologists were significantly different on counselling aspects of mother and baby.Conclusions: In present study, majority of obstetricians and pediatricians/ neonatologists were of opinion that partnership between them surely improves neonatal outcome in peri viable and preterm babies. 

Design of anti-fungal agents by 3D-QSAR

An increase in the number of invasive fungal infections especially in immunocompromised patients is increasing the mortality rate worldwide. Due to the emergence of drug-resistant fungi, the currently available antifungal drugs have become ineffective. Because no alternative treatment is available, some existing drugs are still used. Therefore, there is a need to design and develop novel and effective anti-fungal drugs. Molecular docking and 3-dimensional quantitative structure-activity relationship (3D-QSAR) methods have been useful approaches for the design of novel molecules. A set of 30 molecules reported in the literature containing azoles and non-azoles have been used in this study to derive 3D-QSAR.CoMFA and CoMSIA models for the most active compound and least active compounds have been developed. The structural requirements were obtained by analysing the contour maps. The partial least square analysis for CoMFA and CoMSIA showed a significant cross-validated correlation coefficient of 0.625 and 0.67 and a non-cross validated correlation coefficient of 0.991 and 0.99, respectively. The model was validated by observing the predicted correlation for test molecules with the value of 0.699 and 0.659, respectively

Assessment of menopausal symptoms using modified menopause rating scale among urban women doctors of India

Background: The study was conducted to assess the commonly reported menopausal symptoms among urban women doctors using modified menopause rating scale (MRS).Methods: The study was carried out in the society by google link. Convenient sample of 100 women doctors were included in the study. Menopausal symptoms were assessed using modified MRS.Results: In present study, 3 (3%) female doctors had premature menopause, 5 had menopause at 40-44 years, 15 (15%) had menopause at 45-49 years, 77 (77%) had menopause while no patient had menopause after 55 years. Hot flushes were seen in 70 (79%) women, heart discomfort/ palpitation was seen in 2 (2%) women, muscle and joint problems were seen in 30 (30%) women, sleeping problems were seen in 20 (20%) women. Depressive mood was seen in 2 (2%) women, irritability was seen in 12 (12%) women, an anxiety was seen in 22 (22%) women while physical and mental exhaustion was seen in 34 (34%%) women. Sexual problems were seen in 32 (32%) women, bladder problems were seen in 8 (8%) women dryness of the vagina was seen in 35 (35%) women (Table 6).Conclusions: Hot flushes and joint problems were the most common followed by urogenital symptom, sleep disturbance, and anxiety in the study. Menopausal symptoms were less prevalent. Busy schedule, self-confidence due to independent nature and constructive work might be the reason

Screening for Diabetes and Hypertension in a Rural Low Income Setting in Western Kenya Utilizing Home-Based and Community-Based Strategies

BACKGROUND: The burdens of hypertension and diabetes are increasing in low- and middle-income countries (LMICs). It is important to identify patients with these conditions early in the disease process. The goal of this study, therefore, is to compare community- versus home-based screening for hypertension and diabetes in Kenya. METHODS: This was a feasibility study conducted by the Academic Model Providing Access to Healthcare (AMPATH) program in Webuye, a town in western Kenya. Home-based (door-to-door) screening occurred in March 2010 and community-based screening in November 2011. HIV counselors were trained to screen for diabetes and hypertension in the home-based screening with local district hospital based staff conducting the community-based screening. Participants \u3e18 years old qualified for screening in both groups. Counselors referred all participants with a systolic blood pressure (SBP) ≥ 160 mmHg and/or a random blood glucose ≥ 7 mmol/L (126 mg/dL) to a local clinic for follow-up. Differences in likelihood of screening positive between the two strategies were compared using Fischer\u27s Exact Test. Logistic regression models were used to identify factors associated with the likelihood of following-up after a positive screening. RESULTS: There were 236 participants in home-based screening: 13 (6%) had a SBP ≥ 160 mmHg, and 54 (23%) had a random glucose ≥ 7 mmol/L. There were 346 participants in community-based screening: 35 (10%) had a SBP ≥ 160 mmHg, and 27 (8%) had a random glucose ≥ 7 mmol/L. Participants in community-based screening were twice as likely to screen positive for hypertension compared to home-based screening (OR=1.93, P=0.06). In contrast, participants were 3.5 times more likely to screen positive for a random blood glucose ≥ 7 mmol/L with home-based screening (OR=3.51, P CONCLUSION: Community- or home-based screening for diabetes and hypertension in LMICs is feasible. Due to low rates of follow-up, screening efforts in rural settings should focus on linking cases to care

Strengthening Referral Networks for Management of Hypertension Across the Health System (STRENGTHS) in western Kenya: a study protocol of a cluster randomized trial

BACKGROUND: Hypertension is a major risk factor for cardiovascular disease (CVD), yet treatment and control rates for hypertension are very low in low- and middle-income countries (LMICs). Lack of effective referral networks between different levels of the health system is one factor that threatens the ability to achieve adequate blood pressure control and prevent CVD-related morbidity. Health information technology and peer support are two strategies that have improved care coordination and clinical outcomes for other disease entities in other settings; however, their effectiveness and cost-effectiveness in strengthening referral networks to improve blood pressure control and reduce CVD risk in low-resource settings are unknown. METHODS/DESIGN: We will use the PRECEDE-PROCEED framework to conduct transdisciplinary implementation research, focused on strengthening referral networks for hypertension in western Kenya. We will conduct a baseline needs and contextual assessment using a mixed-methods approach, in order to inform a participatory, community-based design process to fully develop a contextually and culturally appropriate intervention model that combines health information technology and peer support. Subsequently, we will conduct a two-arm cluster randomized trial comparing 1) usual care for referrals vs 2) referral networks strengthened with our intervention. The primary outcome will be one-year change in systolic blood pressure. The key secondary clinical outcome will be CVD risk reduction, and the key secondary implementation outcomes will include referral process metrics such as referral appropriateness and completion rates. We will conduct a mediation analysis to evaluate the influence of changes in referral network characteristics on intervention outcomes, a moderation analysis to evaluate the influence of baseline referral network characteristics on the effectiveness of the intervention, as well as a process evaluation using the Saunders framework. Finally, we will analyze the incremental cost-effectiveness of the intervention relative to usual care, in terms of costs per unit decrease in systolic blood pressure, per percentage change in CVD risk score, and per disability-adjusted life year saved. DISCUSSION: This study will provide evidence for the implementation of innovative strategies for strengthening referral networks to improve hypertension control in LMICs. If effective, it has the potential to be a scalable model for health systems strengthening in other low-resource settings worldwide

Growth inhibition of fouling bacteria and diatoms by extract of terrestrial plant, Derris scandens (Dicotyledonae: Leguminocae)

229-230Methanol extract of terrestrial plant, Derris scandens Benth, was found to inhibit growth of four diatoms and 7 bacterial species of fouling community. The concentrations required to bring about 100% inhibition of growth of the diatoms ranged between 200 to 300 mu g.ml(-1), whereas, the bacterial inhibition zone around the disc containing about 600-800 mu g of extract ranged between 1-5 mm. The results suggest that the crude extract of the plant is nontoxic and possesses both antibacterial and antialgal properties. Therefore, the extract promises to be a potential source of natural biocide for fouling organisms

Design of anti-fungal agents by 3D-QSAR

744-754An increase in the number of invasive fungal infections especially in immunocompromised patients is increasing the mortality rate worldwide. Due to the emergence of drug-resistant fungi, the currently available antifungal drugs have become ineffective. Because no alternative treatment is available, some existing drugs are still used. Therefore, there is a need to design and develop novel and effective anti-fungal drugs. Molecular docking and 3-dimensional quantitative structure-activity relationship (3D-QSAR) methods have been useful approaches for the design of novel molecules. A set of 30 molecules reported in the literature containing azoles and non-azoles have been used in this study to derive 3DQSAR. CoMFA and CoMSIA models for the most active compound and least active compounds have been developed. The structural requirements were obtained by analysing the contour maps. The partial least square analysis for CoMFA and CoMSIA showed a significant cross-validated correlation coefficient of 0.625 and 0.67 and a non-cross validated correlation coefficient of 0.991 and 0.99, respectively. The model was validated by observing the predicted correlation for test molecules with the value of 0.699 and 0.659, respectively