An investigation into the quality of fluting-paper at papermills

Fluting-paper produced to meet the same technical specifications at three of the company’s mills, is viewed as unsatisfactory and inconsistent by some customers. This study investigated whether the company’s fluting-paper met the customers’ needs and investigated the reasons for the customer’s differing perceptions and claims of inconsistent quality. The hypothesis, investigated is therefore “the company produces fluting-paper consistently according to technical specifications that meet the customer needs”. The four objectives of this study investigated customer complaints, related the customer needs to the technical specifications, related the process measure of quality, cull, to the technical specifications and determined the reasons for the customers’ claims of inconsistent quality. The customer complaints investigation revealed differences at the mills and that fifty three percent of customer complaints were technical. The technical category was investigated to reveal “out of specification” paper, moisture, cracking, glueability and winding operations as the biggest problems that contribute to complaints. A customer survey conducted determined the customer needs and the importance of each customer need. The most important customer needs determined were consistent moisture, consistent weight and strength. The most important technical characteristics were determined using a team of technical experts and QFD principles, to be grammage, moisture and porosity. QFD also revealed that there were technical characteristics to describe the customer needs and there were specifications on all technical characteristics, except one new customer need. In the investigation of the process, cull, was consecutively compared to the technical specifications, customer needs and customer complaints using QFD. These investigations showed that tensile strength, tear and porosity were technical specifications for which paper was not culled and some mills cull paper for nontechnical reasons which are not standardized across mills. These disparities are envisaged to realize into the customers claims of inconsistent quality. The results from these four objectives therefore point out that the company does not always produce fluting-paper consistently according to technical specifications that meet the customer needs, and this hypothesis is therefore rejecte

Balloon aortic valvuloplasty in pregnancy with severe aortic stenosis and infective endocarditis

Twenty seven year old lady, previously diagnosed to have aortic stenosis, presented to the obstetric outpatient department at 19 weeks of gestation with fever and breathlessness, NYHA class 4, for one week. Two D Echo revealed left ventricular hypertrophy, a severely stenosed, calcified bicuspid aortic valve, with vegetations on aortic and mitral valves and severe mitral regurgitation. Blood cultures grew nutrionally variant streptococci and she was treated with crystalline penicillin and gentamicin. She stabilised clinically by 21 weeks, by which time, the risk of termination of pregnancy was comparable to continuing the pregnancy. She underwent balloon aortic valvuloplasty. Post balloon aortic valvuloplasty, she was stable. At 34+2 weeks, she underwent emergency LSCS, the indication being intrauterine growth restriction with fetal compromise and breech presentation. She delivered a baby girl, 1.6 kg, Apgar 9 & 10. Our case report highlights the fact that a timely, balloon aortic valvuloplasty can be life saving for patients with pregnancy complicated by severe aortic stenosis and infective endocarditis

Comparative Phyto and Physicochemical Parameters of the Therapeutic Plant Syzygium cumini (L.) Skeels in Jaffna District

Syzygium cumini (L.) Skeels (Myrtaceae) is an evergreen tree, grown widely in Sri Lanka. It is regularly recognized as jambolan, black plum, and jamun. It is an extensively used therapeutic herbal in the treatment of innumerable illnesses, particularly in Diabetes mellitus in traditional medicine. The goal of the research was to compare the phytochemical and physicochemical properties between the different parts of jambolana tree which is naturally found in Sri Lanka. Proximate estimation of physicochemical properties of dried matured different parts as bark, leaves, fruits, and seeds of the Syzygium cumini havebeen done in the current study rendering to the standard protocols recommended by the World Health Organization (WHO) and Association of Analytical Chemist (AOAC). This study includes electrical conductivity value, moisture content, fat content, and different ash contents analysis. It was found that the leaves had the highest electrical conductivity (16.67±1.53) and the bark had the lowest electrical conductivity (2.44±0.03). The moisture content of the bark was lower (11.30±0.44) in comparison tothat of the seeds (16.34±0.43). Furthermore, the bark had the highest fat content (1.02±0.03) and acid insoluble ash (2.65±0.89), when compared to the seeds (0.65±0.01) and leaves (1.00±0.88) respectively. The seeds had the highest pH (5.39±0.08); total ash (2.18±0.06) and water-soluble ash (5.25±0.55), while the fruits had the highest sulphated ash (1.99±0.55). Qualitative inspection revealed that hot ethanolic seed extracts contained high levels of flavonoids, tannins, phenols, glycosides, alkaloids, terpenoids and quinones, in addition to other parts, which also had high levels of alkaloid content (81.06 mg/g). The current study will contribute useful data in the precise documentation and validation of various parts of S. cumini and may aid in removing contaminants in the preparation of nutraceuticals or medicine. Keywords: Medicinal Plant, Parts, Parameters, Physicochemical, Phytochemical, Syzygium cumin

A prospective randomized study: role of enalapril on oxidative stress in newly diagnosed type 2 diabetes mellitus and its correlation with glycaemic status

Background: Oxidative stress is demonstrated the pathological conditions such as Atherosclerosis and diabetes mellitus. It has been suggested to be involved in the pathogenesis of both macro and microvascular complications. This study was designed to evaluate the effect of Enalapril on oxidative stress markers in type 2 diabetic patients.Methods: A Prospective Randomized controlled study was conducted in 75 participants in which 25 healthy volunteers and 50 newly diagnosed DM2 patients who were divided into three groups of 25 in each. In Group II DM2 patients were treated with Metformin alone, in group III DM2 patients were treated with Enalapril and Metformin and 25 healthy volunteers were included in Group I (controls). Oxidative stress parameters, FBS, HbA1c were measured at the time of diagnosis and at 4,8,12 weeks.Results: There was a significant decrease in free radical production (p<0.05) and significant increase in antioxidant enzymes (p<0.001) in both the patient Groups and positive correlation between oxidative stress markers and FBS and HbA1c (p<0.01).Conclusions: Oxidative stress measured as LPO is strictly influenced by glycaemic control. Enalapril and Metformin combination in diabetic patients has more significant effect on decreasing the oxidative stress than Metformin alone

A Study on Secondary Bacterial Infections Associated with Dermatological Lesions and their Antimicrobial Susceptibility Pattern in a Tertiary Care Hospital

INTRODUCTION: Skin and soft-tissue infection is defined as an inflammatory microbial invasion of the epidermis, dermis and subcutaneous tissues. One common etiology of skin and soft tissue infection is the secondary bacterial infection that complicates the skin lesions. The dose, route and duration of the antimicrobial treatment in these patients are predicated with the knowledge of the potential pathogens with their antimicrobial sensitivity. This study was conducted at the Institute of Microbiology, Madras Medical college, Chennai , to isolate the pathogens from patients with secondarily infected skin lesions (Psoriasis, Atopic dermatitis, Pemphigus lesions and Leprosy with infected ulcer) from various sites and to determine their antimicrobial susceptibility pattern . MATERIALS AND METHODS: 200 patients (≥18 yrs) with signs and symptoms of secondary infection of skin lesions attending the department of Dermatology, Rajiv Gandhi Government General Hospital, Chennai were included in the study. Pus and blood samples were collected from these patients and processed by standard microbiological techniques. RESULT: Out of 200 samples 63, 62, 52 and 23 samples were taken respectively from Atopic Dermatitis/Eczema, Pemphigus, Psoriasis and Leprosy with infected ulcer, including 114 inpatiens and 86 outpatients. 88% of samples were positive for culture. Aerobic gram positive organisms accounts for 59.9% followed by aerobic gram negative 37.27% and anaerobic organisms 2.83%. In Atopic Dermatitis/Eczema 57.7% of isolates were Staphylococcus aureus followed by Streptococcus pyogenes, Enterobacteriacea and anaerobic organisms. Most common isolate in Psoriasis was Staphylococcus aureus (64%) followed by Enteric gram negative bacilli and Staphylococcus epidermidis. Pseudomonas aeroginosa (48%) was the most common organism in leprosy with infected ulcer followed by Proteus vulgaris (22%). Blood culture from17 in patients, [11 from Pemphigus (1.77%) and 6 from Psoriasis (1.15%)] resulted in MRSA isolation from two cases of Pemphigus. ESBL producers were 62.5%. All the ESBL producers were sensitive to Imipenem. 64% Staphylococcus aureus were MSSA and 36% were MRSA. All MRSA were positive for mec A gene .MRSA from OP patients (CA MRSA) showed higher positivity for Pvl gene 90% and 22% of MRSA from IP patients (HA MRSA) were positive for Pvl gene. All the Methicillin resistant Staphylococcus aureus were sensitive to vancomycin. CONCLUSION: MRSA with higher rate of resistance to many routinely used antibiotics and Enterobacteriaceae with higher levels of ESBL production were isolated. Hence bacterial culture and sensitivity of specimens from the secondarily infected skin lesions should be performed to confirm the bacterial etiology and to initiate effective antibiotic treatment so as to decrease the morbidity and mortality of these patients, that also limits the misuse of antimicrobials which would prevent the emergence of resistant bacterial strains in the hospital and the community

PHYTOCHEMICAL SCREENING AND COMPARATIVE GC–MS ANALYSIS OF BIOACTIVE COMPOUNDS PRESENT IN METHANOLIC LEAF AND LATEX EXTRACT Calotropis gigantea (L)

Medicinal plants are considered as important source of promising bioactive compounds. Calotropis gigantea is a traditional medicinal plant which is known to have biochemical constituents with potential medicinal properties. Qualitative analysis showed the presence of alkaloids, terpenoids, saponins, tannins and cardiac glycosides and absence of flavonoids in ethanolic extract of C. gigantea, while the chloroform leaf extract showed absence of flavonoids and cardiac glycosides. Bioactive compounds since leaf and latex of C. gigantea utilized GC-MS and activity investigation. The GC-MS investigation uncovered the presence of complete 46 bioactive mixes (24 from leaves and 22 from latex) with significant movement. The majority of the mixes were discovered to be comparable in both leaf and latex, however little variety was likewise seen in their synthetic profile. The concoction mixes saw in just latex were 1-[(T-butyl) dimethyl silyl thin] butane, 1-Hexadecyne, Hexadecane, L-Glutamic corrosive, Phenol-3-isoproxy-5-methyl, Trocosane and Z-1,6-Tridecadiene. Mixes distinguished uniquely from the leaves were Azulene, Benalaxyl, Cis-vaccenic corrosive, Levomenol, Profenofos, β-Tocopherol and β-Sitosterol, while the remainder of the mixes were comparable in both leaf and latex. Major of bioactive compounds presents Gas Chromatography-Mass Spectroscopy (GC-MS) analysis. C. gigantea is a perennial plant abundantly found in all parts of the country (India) and wild in nature. The leaves of the plant were found to contain various primary and secondary metabolites

Association of High Serum Uric Acid Levels in Chronic Liver Disease

INTRODUCTION: In higher animals and humans the serum uric acid is an end product of purine metabolism, excreted mainly through kidneys. Increased serum uric acid levels was thought to be the main reason for arthritis due to crystal deposition in joints, renal stones and other vascular events. More recently, increased levels of serum uric acid levels also involved in the future development of hypertension, cardiovascular disease, kidney disease and metabolic syndrome. Although increased serum uric acid levels are involved in the development of many diseases the following mechanisms included as a cause, they are dysfunction of endothelium, resistance to insulin, systemic inflammation and oxidative stress. Several biological studies shown that increased serum uric acid level have been found to correlate directly with the level of tissue injury. Compared to the serum levels of uric acid, tissue levels of uric acid has better prediction of tissue injury. So serum uric acid may be considered as an indicator of tissue injury Recent studies on serum uric acid have shown an increased serum uric acid levels associated with the development of steatosis of liver in the patients who had Non-Alcoholic fatty Liver Disease (NAFLD) after adjustment for various features of metabolic syndrome. It is proposed that the role of increased uric acid levels in the pathogenesis of liver disease thought to be due to its pro-inflammatory effects, for example, increased levels of uric acid is considered as an important marker in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steato hepatitis (NASH). AIM OF THE STUDY: 1. To assess the prevalence of hyperuricemia in nonalcoholic patients with cirrhosis liver and fatty liver. 2. To study the association of uric acid and various risk factors. 3. To study the usefulness of serum uric acid as an prognostic marker in chronic liver disease. MATERIALS AND METHODS: This is a prospective study conducted on a sample south Indian population admitted in department of medicine and department of gastroenterology during the period of 2013 and 2014. The study includes a standardized questionnaire and examination based on this patients were included in this study. A total number of 100 patients who are all diagnosed to have fatty liver and cirrhosis are included in this study. Patients with prior history of alcoholic liver disease, chronic kidney disease, arthritis, cardiovascular disease and diabetes mellitus, hypothyroidism are excluded. The total number of patients included in this study was 100 out of which 75 are males and 25 are females. INCLUSION CRITERIA: Age of the patients between 30 years to 60 years without the prior history of alcoholism, diabetes mellitus, kidney disease, hypothyroidism, drug intake and cardiac disease. EXCLUSION CRITERIA: 1. Age less than 30 years and more than 60 years, 2. Gout, 3. Chronic alcoholics, 4. Known case of alcoholic liver disease, 5. Chronic kidney disease, 6. Hypothyroidism, 7. Drug intake, 8. Diabetes mellitus, 9. Cardiac disease, 10. Obesity. METHODS: A detailed history was elicited from the patient regarding their present complaints, associated symptoms, alcohol intake, smoking, previous history of hypertension, diabetes mellitus, arthritis, hypothyroidism, any cardiac illnesses and chronic drug intake. On admission routine blood investigations like blood sugar, urea, serum creatinine, liver function test, thyroid profile, lipid profile, ultra sonogram and serum uric acid levels were estimated. Waist circumference in males and females measured. Diabetes was defined as fasting blood sugar >126 mg % and post prandial blood sugar >200 mgs%. Body mass index was calculated as weight in kg/ height in m2. Serum uric acid levels also sent for analysis on the day of admission. The reagent for serum uric acid is uricase and for blood glucose trider method is used. STATISTICAL ANALYSIS: Data analysis was done and the subjects were divided in to two groups. One group with ultrasonagram findings of fatty liver and another group with the findings of cirrhosis of liver. Serum uric acid levels in both the groups are analysed with age and sex. Using the SPSS 20 and sigma stat 3.5 version software, means, standard deviations, range, frequencies, percentages, chi-square and ‘p’ values were calculated. One way ANONA and student’s t test for data and chi square test for consolidation of tables used. A ‘p’ value of < 0.05 was taken as significant relationship. CONCLUSION: Uric acid is an old molecule with many new applications and it has also been studied in various metabolic diseases, cardiovascular diseases and chronic kidney disease. In this study it has been found that uric acid has a significant correlation with BMI, waist circumference and hypercholesterolemia. Hyperuricemia is also associated with both alcoholic and nonalcoholic liver diseases due to increased oxidative stress and inflammatory actions. This study also concluded that hyperuricemia is associated with increased number of cases both with cirrhosis and fatty liver. This clearly indicates that hyperuricemia in fatty liver patients, who are nonalcoholic have considerable risk for future progression to cirrhosis of liver. Because of its association with BMI, waist circumference and hypercholesterolemia, hyperuricemia may be considered as one the risk factor for metabolic syndrome