Paclitaxel delivery by micro/nano encapsulation using layer-by-layer assembly

A novel formulation of paclitaxel (PTX) has been developed by providing multilayer assembly over drug loaded porous CaCO3 microparticles (CaCO3 MP) using combination of biocompatible and biodegradable polyelectrolytes (PE’s). PTX was encapsulated into the nanopores of preformed CaCO3 MP prepared by the co-precipitation method. Infrared (IR) and X-ray diffraction (XRD) provides evidences that PTX has been encapsulated into nanopores of CaCO3 MP and not crystallized on the surface. PTX loaded CaCO3 MP (CaCO3-PTX) was found to be highly stabilized against thermal decomposition as evinced by thermo gravimetric analysis (TGA) indicating decomposition at 600°C and 250°C for CaCO3-PTX and PTX respectively. The multilayer assembly over CaCO3-PTX was effectuated by alternate deposition of protamine sulfate (PRM) and sodium alginate (SA) using LBL technique followed by subsequent core removal [PTX- (PRM/SA)5]. The pay load efficiency of PTX in this system was found to be 78.98±2.14%. The developed system was further evaluated for surface morphology, size and size distribution, surface charge, core removal and layer-by-layer growth due to sequential adsorption of PE’s. The release data of PTX-(PRM/SA)5 was comparable with marketed formulation of PTX (PTX-M) and CaCO3-PTX when performed in simulated intestinal fluid (SIF pH=7.4). The release profile of PTX-(PRM/SA)5 indicates that PEs based multilayer matrix is capable to provide barrier to PTX release as it has been found to follow first order matrix diffusion kinetics with 64±4.8% release within 24 hrs. The t50% of PTX-M, CaCO3-PTX and PTX-(PRM/SA)5 was found to be 70, 90 and 480 minutes respectively. This alternative delivery system of PTX disguised in the form of LBL assembly could have immense application for the treatment of metastasized mammary glands vis-à-vis existing formulation of PTX which is by and large criticized for having certain toxic excipients to be given parentrally. Moreover, the proposed system provides ample of opportunity to modify the surface for targeted application of PTX.
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Dynamic Secure-Aware Real Time Scheduling Algorithm for Packet Switched Network

Now a day wireless networks are mostly preferred over wired networks because wireless networks are flexible and required no wire. If we talk about successful communication then end to end delivery of message is very important. In a heavy loaded networks scheduling of packets are key, by the proper scheduling of packets we can improve the guarantee ratio hence overall performance of the network is improved. If we focus on real time communication then real time packet scheduling plays an important role for enhance the performance of the system. In any network security plays a vital role, to protect the data from intruder and many security threats proper security of data is very important. So we can say that overall performance of the system is a combination of security and scheduling. In this paper we talk about real time packet scheduling in wireless networks. Here we use Dynamic Secure-Aware Real-Time Scheduling Algorithm for Packet Switched Network [DSASA]. This is a dynamic real time packet scheduling technique which reduce packets drop, increase guarantee ratio of data traffic and provide security for data packets

Nurse’s perspective on barriers in the implementation of kangaroo mother care in a tertiary care hospital from North India

Background: Despite the established benefits of kangaroo mother care (KMC), it is not being implemented in all eligible babies. There are several barriers in its implementation including those from the nurses, mothers, and institution. Objective: The objective of the study was to determine the nurse’s perspective on various barriers in the implementation of KMC. Materials and Methods: This was a cross-sectional descriptive study in which data were collected from all the nurses of the Department of Neonatology and Obstetrics in a tertiary care hospital, from North India, over 1 week using a structured pre-tested questionnaire covering barriers in three main domains - mothers (6), nursing staff (7), and institutional (5). Results: There were a total of 40 nurses, who responded to questionnaire; among them, 70% were from neonatology and 30% were from obstetrics. Mean barrier-free score (BFS) (%) was 48.93±14.77 with a range of 29.17–76.39, while median (interquartile range) was 47.22 (44.4–52.4). Mean BFS was found to be statistically significant when compared between maternal and nursing domains (54.5±11.1 vs. 43.3±11.9 vs. 49.0±18.4, p=0.003). Conclusion: The present study shows that the most important barriers in KMC implementation were lack of support to mother, duty schedule of staff, difficulty in convincing, and a private/separate environment for KMC. Therefore, actions need to be taken to overcome these barriers to use this simple intervention with enormous benefits

CLINICAL EVALUATION OF AYURVEDIC FORMULATION OF COLICARMIN PLUS SYRUP ON COLIC, GRIPING PAIN, INDIGESTION, NAUSEA, VOMITING, AND OTHER DIGESTIVE DISORDERS IN PAEDIATRICS AND GERIATRICS PATIENTS.

ABSTRACTObjective: An open label study to assess the effect of colicarmin plus syrup on colic and griping pain, indigestion, nausea and vomiting in children,and geriatric patients.Methods: (a) A study was conducted on 75 number of patients to evaluate the effect of colicarmin plus syrup on colic and griping pain, indigestion,nausea and vomiting in children, and adults, (b) mostly these children were selected from different classes of families, (c) all the patients were checkedon the 1st, 2nd, and 3rd week after starting the therapeutic dose.Dosage schedule: (a) Children: 1 Teaspoonful thrice a day after meals, (b) adults: 2 Teaspoonful twice to thrice a day after meals.Results: (a) Colic and griping pain: In the total duration of treatment, no of patients recovering were 23-on 1st week, 4-on 2 week,overall result is 93.54%, (b) indigestion: In the total duration of treatment, no of patients recovering were 26-on 1stnd week, and 3-on 3 week, 3-on 2 week, and 1-on3rd week, the overall result is 93.75%, (c) nausea and vomiting: In the total duration of treatment, no of patients recovering were 8-on 1 week, 2-on2nd week, and 1-on 3rd week, the overall result is 91.33%.Conclusion: Based on the study, we can conclude that colicarmin plus syrup is an Ayurvedic formulation with benefits such as digestive, carminative,anthelmintic, antiflatulent, antispasmodic, and devoid of side effects.Keywords: Digestive, Carminative, Anthelmintic, Antiflatulent and Antispasmodic.ndstr

Knowledge, attitude, and practice of kangaroo mother care among doctors in a tertiary care hospital from North India

Introduction: Kangaroo mother care (KMC) has been established as having an important role in the care of all the babies; especially, the preterm and low birth weight babies. Successful implementation of KMC depends on knowledge, attitude, and practice (KAP) of healthcare workers, mothers, fathers, and other family members. Objectives: The objectives of the study ws to determine the KAP of KMC among the faculty and residents of the departments of neonatology and obstetrics in a tertiary care hospital. Methods: The study was a cross-sectional descriptive study in which data were collected from departments of neonatology, maternal health, and reproductive health. The study subjects were faculty and residents from both the departments. They were interviewed using a structured pre-tested questionnaire in three domains, knowledge (11), attitude (8), and practice (4). The responses were tested against standard predefined answers and were expressed in percentages. Results: A total number of 25 doctors were interviewed; among knowledge domain, approximately 60% doctors responded correctly for the need of KMC, duration of KMC, feeding during KMC and type of baby’s clothes during KMC. In the domain of attitude, response of KMC for who can give, when to start/stop, position of mother, and feasibility of KMC during non-invasive ventilation was correct for all subjects. For practice aspect, there was a lack of counseling and re-checking, though almost everyone felt the need of separate KMC room and counselor. Conclusions: From the above results, it is apparent that knowledge and attitude, among health-care professionals, is optimum. However, there is lots of scope for filling a few gaps to improve practices and training workshops are required to bring in behavior change among doctors

A retrospective analysis comparing functional and radiological outcomes after treatment of unstable distal radius fractures using volar locked plate versus percutaneous fixation

Background: Distal radius fractures are one of the most routinely encountered injuries in an orthopaedic setting. Despite the wide variety of treatment options available there is still debate about the optimal way to treat these fractures. The aim was to evaluate and compare functional and radiological outcomes of unstable distal radius fractures treated by either by using volar locking compression plating (VLP) or by using percutaneous fixation augmented by Kirschner (K) wires (EF).Methods: A retrospective analysis was carried out on all cases of acute unstable unilateral fracture distal radius who were admitted between January 2015 and December 2017 and were treated either by VLP or EF. QuickDASH score and PRWE were documented at every follow up in OPD at 6 weeks, 6 months and 1 year post-op along with serial X-rays at immediate post-op and 01 year which were then compared.Results: A total of 122 cases of fracture distal radius were selected for study which fulfilled the inclusion criteria out of which 49 were treated by VLP and 73 by EF. There was no statistical difference in QuickDASH, PRWE scores or wrist ROM between two groups at1 year follow up. However VLP group was better in maintaining palmar tilt, radial length and inclination at the end of 1 year.Conclusions: Both VLP and EF show comparable and predictable good outcomes in treating unstable distal radius fractures when measured in terms of ROM and clinically validated patient outcome scores at 01 year follow up with similar rate of complications.

Antifibrotics for COVID-19 related lung fibrosis: Agents with benefits?

Coronavirus Disease-2019 (COVID-19), caused by the novel coronavirus, remains a largely unsolved mystery for researchers around the world as its global onslaught upon mankind continues unabated. To make matters worse, an upcoming and alarming trend that is increasingly being noticed as a post-COVID sequel is that of pulmonary fibrosis. Given the scale of the pandemic, the magnitude of this problem is likely to be high. Extrapolated conclusions from previous studies discussing the beneficial role of antifibrotics in progressive fibrosing interstitial lung diseases provide some hope that these medicines might have a potentially useful role in COVID-19 related lung fibrosis as well. Increased serum levels of inflammatory and pro-fibrotic mediators in COVID-19 patients, similar cytokine profiles in idiopathic pulmonary fibrosis and COVID-19, and broad anti-fibrotic activity of approved antifibrotics irrespective of the underlying etiology, are some of the proposed mechanisms favoring the argument. However, no studies currently support or refute the use of antifibrotics in patients developing post-COVID-19 pulmonary fibrosis. In view of such uncertainties, it is critically important for lung fibrosis networks to conduct well-designed prospective clinical trials addressing this issue to find conclusive answers

Clinical Decision-Making: Developing a 4 C Model Using Graph Theoretic Approach

The purpose of this paper is to propose a graph-theoretic mathematical model to measure how conducive the environment of a hospital is for decision-making. We propose a 4-C model, developed from four interacting factors: confidence, complexity, capability, and customer. In this graph-theoretic model, abstract information regarding the system is represented by the directed edges of a graph (or digraph), which together depict how one factor affects another. The digraph yields a matrix model useful for computer processing. The net effect of different factors and their interdependencies on the hospital's decision-making environment is quantified and a single numerical index is generated. This paper categorizes all the major factors that influence clinical decision-making and attempts to provide a tool to study and measure their interactions with each other. Each factor and each interaction among factors are to be quantified by healthcare experts according to their best judgment of the magnitude of its effect in a local hospital environment.A hospital case study is used to demonstrate how the 4-C model works. The graph-theoretic approach allows for the inclusion of new factors and generation of alternative environments by a combination of both qualitative and quantitative modeling. The 4-C model can be used to create both a database and a simple numerical scale that help a hospital set customized guidelines, ranging from patient admittance procedures to diagnostic and treatment processes, according to its specific situation. Implementing this methodology systematically can allow a hospital to identify factors that will lead to improved decision-making as well as identifying operational factors that present roadblocks