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Objective:The primary objective of the study is todetermine whether the addition of H-ISDN to conventional therapy improves the cardiovascular outcomes and also to assess both short term(1 and 3 months) and long term outcomes(1 year). Materials and Methods:This is a prospective observational study.A total of 82 acute heart failure patients with renal impairment were divided into two groups based on exposure to H-ISDNGroup I-Patients on H-ISDN plus conventional therapyGroup II-Patients on conventional therapy. Followup of all the subjects to study the outcomes of improvement in NYHA class,rehospitalisation and mortality rate at 1 month,3 months and 1 year was done for both the groups. Results:We observed that out of the 82 acute heart failure patients with renal impairment,43 patients were receiving H-ISDN in addition to conventional therapy(Group I) and 39 patients were receiving conventional therapy(Group II) .The length of stay(6.03± 2.906 vs 6.93± 3.845) was shorter in the treated group when compared to the non treated group.A greater difference in reduced hospitalisation was seen at 3 months(2.32% vs 12.82%).The treated group had higher improvement in NYHA class at 1 month(67.44% vs 46.15%), 3 months(51.16% vs 41.02%) and 1 year (44.18% vs 20.51%P=0.023). Conclusion:Acute heart failure patients with renal impairment have poor prognosis. Randomised controlled trials are required to validate if the use of H-ISDN is associated with better outcomes in AHF patients.

Aim: To design, synthesize and perform computational study on a few Novel pyrazol-3-one derivatives. Study design: Experimental study. Methodology: A series of 6-aryl substituted pyrimidine azodyes were synthesized by coupling phenyl pyrimidine 2-amine with different aromatic amines. The synthetic compounds were screened for their in-vitro antioxidant and anti-inflammatory activities. The Computational study of designed compounds was done by OCHEM, Molinspiration cheminformatics, Datawarrior, and Swiss ADME. DPPH assay was used to determine the antioxidant activity and heat hemolysis method for anti-inflammatory activity. Results: Molinspiration, Data Warrior, Ochem which are helpful to predict molecule general properties, bioactive scores, toxicity, and drug-likeness. Data Warrior results inferred that the compounds possess moderately active towards mutagenic (compound 2, 11), reproductive (compound 6, 7, 8), and highly active towards Tumorogenic (compound 2) toxicities. OCHEM results showed that most of the synthesized compounds were found to be non-inhibitors of all the subtypes of cytochrome P450 except compound 8. All compounds under this study were effective scavengers of free radicals except the compounds 1, 2, 6, 10. Invitro Anti-inflammatory studies have shown that the compounds (6, 7, 8, 9, 13) active toward heat hemolysis. Conclusion: The synthesized compounds were comprehensively studied and targets were identified rendering them as lead molecules for further development of newer agents with greater efficacy and safety.

Transdermal administration of drug is generally limited by the barrier function of the skin vascular system are one of the most controversial method for transdermal delivery of active substance. transdermal drug delivery system is designed to deliver biological active agents through the skin, principally by diffusion for local internal if not systemic effects. The transdermal delivery system was relaunched after the discovery of elastic vesicles like transfersome, ethosome, cubosome, phytosome etc. Transfersomes are a form of elastic or deformable vesicle, which were introduced in the early 1990s. Elasticity is generated by incorporation of edge activator in lipid bilayer structure. Drug absorbed and distributed into organs and tissue and eliminated from the body it must pass through one or more biological membranes at various locations such movement of drug across the membrane is called as drug transport for the drug delivery to cross the body it should pass through the membrane barrier. This concept of drug delivery system was designed in attempt to concentrate the amount of drug in the remaining drug; therefore, the phospholipid-based carrier system is of considerable interest in the era.

Background RCTs that have shown improvement in coefficient of fat absorption with pancreatic enzyme replacement therapy (PERT) have seldom evaluated the impact on overall nutritional status. Objective In this study we evaluated factors responsible for persistence of malnutrition after PERT. Methods In this cross-sectional observational study, patients were enrolled based on predefined enrolment criteria. Patients were divided into those taking PERT regularly (Group A), irregularly (Group B) and not taking (Group C) for at least 3 months. Comprehensive evaluation of anthropometric measurements, nutritional assessment and dietary intake was performed. Malnutrition was measured using the Subjective Global Assessment (SGA) tool. Relationship between PERT status, dietary intake and nutritional status were evaluated using standard statistical methods. Logistic regression was performed to identify factors associated with persistence of malnutrition after PERT. Results 377 patients with CP and 50 controls were included. 95 (25.2%) patients with CP were in Group A, 106 (28.1%) in Group B and 176 (46.7%) in Group C. 130 (34.5%) patients were malnourished, of which 76 (58.5%) were continuing PERT. There were no differences in clinical and biochemical nutritional markers between Groups A, B, and C. Calorie deficit and daily intake of calorie, protein, carbohydrates and fats were not different between those with and without PERT, but was significantly less in those with malnutrition. Logistic regression demonstrated inadequate dietary intake as independent risk factor for persistence of malnutrition. Conclusion Even though PERT is effective in PEI, comprehensive nutritional assessment, personalized nutritional counselling and therapy along with PERT is mandatory.

A series of 6-aryl substituted pyrimidine azodyes were synthesized by coupling of phenyl pyrimidine 2-amine with different aromatic amines. The synthetic compounds were screened for their in-vitro antioxidant and anti-inflammatory activities. The characterization of the synthesized compounds was carried out by IR, 1H NMR, 13C NMR and Mass spectrophotometry. Computational study of designed compounds was done by OCHEM, Molinspiration cheminformatics, Datawarrior, and Swiss ADME. DPPH assay was used to determine the antioxidant activity and heat hemolysis method for anti-inflammatory activity.

Objective: A sharp increase in chronic diseases for elderly patients has been observed in recent years resulting in polypharmacy, which may lead to drug-drug interactions (DDI’s), drug-related problems, adverse drug reactions (ADR’s), and many more issues in these patients. The present study was conducted to assess the clinical consequences of polypharmacy and its prevalence in the older adult population. Methods: Our work is a prospective, observational study carried out in a tertiary care teaching hospital. The polypharmacy prescriptions were identified (taking at least five medications), and drug-drug interactions were detected by Micromedex® DrugReax® System 2.0 version. The medication profiles were also checked for inappropriate prescribing according to Beers Criteria 2015. Results: In the study, the mean age of patients was found to be 72.4±8.8 years. Most of the patients (81.8%) had more than two and less than five diseases. The mean number of drugs prescribed in all the prescriptions was found to be 7.4±2.6. According to Beers Criteria-2015, 3.83% of the total medications prescribed were inappropriate, 74.1% of moderate DDI’s were observed in patients, and 50.2% of the DDI’s observed theoretically were documented as fair. Conclusion: The impact of polypharmacy on consequences such as the length of stay, DDI’s, and DRP’s was also found to be significant. This study concludes that the medication profile of older adult patients should be assessed regularly for the rationality of drug therapy to maximize the therapeutic response positively with the lowest number of medications possible.

Colonization of the gut by microbes depends on a number of factors including age, diet, genetic makeup, gender, geographic location, and health status of an individual. India is a megadiverse country and includes 4 biodiversity hot spots. These features, along with the transitioning Indian sociodemographic profile, make the gut microbiota of Indian subjects an interesting area to study. In this review, we critically discuss the present status of the gut microbiome in the Indian population and its difference from other populations. We also discuss the aberrations in the available study designs that could introduce heterogeneity. An ideal study to evaluate the core gut microbiota of healthy Indians should involve a large homogeneous population across the country and use the same technology and data analytics tools. The "Landscape of Gut Microbiome-Pan India Exploration" (LogMPIE) is such a study that confirmed the most predominant organisms in Indians to be Prevotella copri and Faecalibacterium prausnitzii.

Objective: Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) in CKD, choosing antihypertensive strategies with the highest nephro-protective effect is crucial for preventing or reversing end-stage renal disease (ESRD) progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact of clinical use of antihypertensive drug therapy in patients with CKD and ESRD. Methods: It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-dialysis dependent (NDD) and dialysis-dependent (DD) CKD. This study was conducted for six months in the Nephrology department, Osmania General Hospital, Hyderabad, India. The data collected and entered into Microsoft Excel (2007) and mean, SD and range were calculated using SPSS version 25. Results: Antihypertensive drugs were prescribed alone or in combination based on the co-morbidities associated with CKD and HTN. Loop diuretics (Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66%+DD = 27.45%) of which calcium channel blockers+loop diuretic+sympatholytic accounts for 19.16% (NDD = 5.88%+DD = 13.73%). Conclusion: The practice of prescribing antihypertensive drugs for the management of HTN and to achieve BP targets in CKD and ESRD remains uncertain. The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better delivery of evidence-based treatment.

Hematopoietic stem/progenitor cell gene therapy (HSPC-GT) results in the engraftment of genetically modified microglia-like cells (MLCs) in the brain. While HSPC-GT has shown a clear neurological benefit in the clinic for specific rare diseases, the nature of MLC engraftment in the brain and the functional characteristics of MLCs remain contentious. Here we comprehensively characterized how different routes of administration affect the engraftment and biodistribution of genetically engineered HSPC-derivatives in mice. Using high-throughput single-cell profiling, we show that MLCs bear a transcriptional signature similar to resident microglia rather than invading macrophages. However, MLCs could clearly be distinguished from resident microglia by expression of a specific set of genes. Finally, in murine models of Parkinson’s disease and frontotemporal dementia, we demonstrate that MLCs can provide therapeutically relevant levels of protein to the brain, thereby potentially opening avenues of HSPC-GT to address the underlying disease etiology of these and other similar disorders.

Background and Objectives: Diabetes is a chronic disorder and requires long-term therapy. Lack of adherence to anti-diabetic medication causes suboptimal glycemic control and can lead to treatment failures, development of complications, and increased mortality. The objective of the study was to determine the adherence of medications among type 2 diabetes mellitus patients. To evaluate adherence to therapy and study factors associated with nonadherence and adherence in patients with type II diabetics mellitus. Materials and methods: A cross-sectional, observational study was conducted for a period of 6 months in three hospitals .A total of 200 type II diabetic patients, who were on anti- diabetic drug therapy for at least 6 months, were enrolled. Blood glucose was measured and details of drug therapy were noted. Medication adherence was assessed using Morisky Medication Adherence Scale and adherence scores were calculated. Results: Only 15% had high medication adherence, while 24% had moderate and 61% had low medication adherence. Only 30% were having optimally controlled glycemic levels, whereas 70% were having uncontrolled glycemic levels. Medication adherence scores were lower (reflecting lower adherence) in type II patients with uncontrolled glycemic levels than those having optimally controlled glycemic levels, but this difference was not statistically significant. Interpretation and Conclusion: Overall, the medication adherence was low in type II diabetic patients. The study shows that to improve medication adherence, better counseling and health education of patients are required. Although most patients were adherent to therapy, adherent patients are more likely to achieve glycemic control than no nadherent patients. Greater efforts are needed to facilitate diabetes self management behaviours to improve patient outcomes. There is a need for regular monitoring of patient adherence to medication and initiate steps to improve the adherence to anti dabetic medication. Therefore, counselling and health education of the patients related to medication adherence and strateagies to increase drug availability need to be improved.

Lateral Epicondylitis (LT) term was used previously thinking that it as an inflammatory condition, but it is tendinosis of Common extensor tendons of the forearm due to overuse. The incidence of the condition is about 4000 - 7000 per year in the general population in the United States. Conventional treatments practiced on the concept of inflammation have shown forty to eighty percent of unsuccessful results. Individuals with lateral epicondylosis may have symptoms like pain during activity, weakness, swelling and functional disability. The primary objective of the study is to find out the effectiveness of oscillating energy manual therapy (OEMT) compared with muscle energy technique (MET) on functional outcome in subjects with lateral epicondylosis. Total of 30 subjects with unilateral lateral epicondylosis was selected and was divided into two groups of 15 each in a group. Group A (received oscillating energy manual therapy) and Group B (received muscle energy technique). NRS (Numerical Rating Scale), Grip Strength and PRTEE (Patient Rated Tennis Elbow Evaluation) scale were measured pre and post-treatment for both the groups and also at follow up of the sixth week. Muscle energy technique group showed improvement in pain levels, muscle strength and functional activities. The statistical analysis demonstrated that results were more significant in group B at 4th week and also at follow up with a mean difference of (2.3) for NRS, (57.4) for PRTEE and (5.9) for grip strength than group A.

Background and aim. Class II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible. Methods. Pre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age = 10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test. Results. The cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p

We hypothesized that the gut microbiome in patients with diabetes secondary to chronic pancreatitis (Type 3c) is different from those with Type 1 and Type 2 diabetes. This was a cross-sectional preliminary study that included 8 patients with Type 1, 10 with Type 2, 17 with Type 3c diabetes and 9 healthy controls. Demographic, clinical, biochemical, imaging and treatment data were recorded and sequencing of the V3–V4 region of the bacterial 16SrRNA was done on fecal samples. Bioinformatics and statistical analyses was performed to evaluate the differences in the diversity indices, distance matrices, relative abundances and uniqueness of organisms between the types of diabetes. There was significant difference in the species richness. Beta diversity was significantly different between patients with Type 3c diabetes and the other groups. 31 genera were common to all the three types of diabetes. There was significant differences in the species level taxa between Type 3c diabetes and the other groups. The unique bacterial species signature in Type 3c diabetes compared to Type 1 and Type 2 diabetes included Nesterenkonia sp. AN1, Clostridium magnum, Acinetobacter lwoffii, Clostridium septicum, Porphyromonas somerae, Terrabacter tumescens, and Synechococus sp.

Highlights • The effect of Co-NPs was evaluated for biochemical enzymatic toxicity. • Aspartate aminotransferase (ASAT) and Alanine aminotransferase (ALAT) enzymes in serum, liver, and kidney of rats were used. • The levels of enzymes were increased significantly after being exposed to Co-NPs. • The elevated level of these enzymes can be useful in the diagnosis of any toxic injury., Cobalt nanoparticles (Co-NPs) have been extensively used in clinical practices and medical diagnosis. In this study, the potential toxicity effects of Co-NPs with special emphasis over the biochemical enzyme activities, such as aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) in serum, liver, and kidney of Wistar rats were investigated. This toxicity measurement of nanomaterials can support the toxicological data. The biochemical enzymatic variations are powerful tools for the assessment of toxicity. ASAT and ALAT enzymes have been widely used to predict tissue-specific toxicities associated with xenobiotic. The biochemical changes induced by Co-NPs have significance in their toxicological studies because the alterations in biochemical parameters before clinical symptoms indicate either their toxicant safety or detrimental effect. Herein, Co-NPs with particle size

Classification of Motor Imagery (MI) Electroencephalography (EEG) signals has always been an important aspect of Brain Computer Interface (BCI) systems. Event Related Desynchronization (ERD)/ Event Related Synchronization (ERS) plays a significant role in finding discriminant features of MI EEG signals. ERD/ERS is one type and Evoked Potential (EP) is another type of brain response. This study focuses upon the classification of MI EEG signals by Removing Evoked Potential (REP) from non-discriminant MI EEG data in filter band selection, called REP. This optimization is done to enhance the classification performance. A comprehensive comparison of several pipelines is presented by using famous feature extraction methods, namely Common Spatial Pattern (CSP), XDawn. The effectiveness of REP is demonstrated on the PhysioNet dataset which is an online data resource. Comparison is done between the performance of pipelines including proposed one (Common Spatial Pattern (CSP) and Gaussian Process Classifier (GPC)) as well as before and after applying REP. It is observed that the REP approach has improved the classification accuracy of all the subjects used as well as all the pipelines, including state of the art algorithms, up to 20%.

According to a recent report by the Iranian industrial organization, over 1700 Industrial and Engineering Brick Manufacturing (IEBM) industries are currently running in Iran, using the same method in common use worldwide. The present research study used a combination of a literature review, existing research reports, and a model of assessment among the four main kinds of IEBM industries to estimate the profit of IEBM using Wastewater Treatment Plant (WWTP) sludge as a model. Paying attention to differences in brick manufacturing practices among the many published papers, we summarized the available standard procedures and methods. Both the paired test and t-test analyses revealed a significant difference among parameters such as initial feed, employees, power, water, fuel, and land (pvalue ≤ 0.001) for the four main types of IEBM industries in Iran. The evaluation identified a priority hierarchy among factors: employees> land > initial feed > water > power > fuel. Therefore, automation in this industry is recommended. Next, two models were developed to estimate the profit of a WWTP and Four Main Brick Manufacturing Industries (FMBMI) using released sludge from the WWTP.

As a motto of framing the strategies to minimise the deterioration in steel reinforced concrete structures as well as the fact that the work carried out with polymers are rare and scanty, polyesters namely Poly (Glycerol azealate) (PGAZ) and 4-(1-(4-methoxy phenyl) cyclo hexyl)phenyl 9-oxodecanoate (MPOD) were synthesised and evaluated for rebar corrosion in simulated concrete pore solution (SCP) for the first time at selected concentrations of 10, 100, 1000 ppm levels with an aid of electrochemical impedance and potentiodynamic polarisation techniques. Nyquist plots favoured increased Rct values suggesting the formation of barrier. Tafel plots represented cathodic inhibition. The experimental datas were best fitted with Langmuir adsorption isotherm facilitating monolayer adsorption. Both the methods employed were in good agreement with each other favouring maximum inhibition efficiency of 71.81% for MPOD and minimum of 57.64% for PGAZ primarily due the difference in aromatic sites as revealed in mechanism.

Background: Helicobacter pylori, the cause of most peptic ulcer diseases, infects approximately 50% of the population worldwide. Indian data on cost and effectiveness of the standard first-line therapies for H. pylori eradication are scarce. Thus, the present study was aimed at comparing the cost and efficacy of two standard first-line therapies: Regimen I comprising pantoprazole (40 mg) plus amoxicillin (750 mg) plus clarithromycin (500 mg) (PAC) and Regimen II comprising rabeprazole (20 mg) plus amoxicillin (625 mg) plus metronidazole (200 mg) (RAM). Methodology: This prospective, observational, bottom-up study collected demographic, economic, diagnostic, and therapeutic data from 60 H. pylori-positive patients. The study was carried out for 6 months in the Gastroenterology Department of a Tertiary Care Hospital in Hyderabad, Telangana, India. Results: Health-care system perspective was used to account for direct costs. Average cost per patient for complete H. pylori eradication was Rs. 10,221 and Rs. 8568 for Regimen I and Regimen II, respectively. Inpatient cost was considerably higher than the outpatient cost. Diagnostic costs ranked first in direct costs, followed by hospitalization costs, medication costs, and finally, physician's office visit cost. Individual patient's costs difference between two regimens was found to be statistically significant. Overall, Regimen I proved to be more efficacious than Regimen II, but Regimen II proved to be more cost-effective than Regimen I. Furthermore, incremental cost-effectiveness analysis revealed additional cost of Rs. 127 per patient if the patient was treated with Regimen I instead of Regimen II. Conclusion: Our study showed that Regimen II (RAM) was more cost-effective than Regimen I (PAC), but PAC achieved faster H. pylori eradication than RAM. We assume that this study provides local clinical data as to which regimen may be useful in a particular patient. National Level Clinical Trials are required to further ascertain this conclusion.

Stevens Johnson Syndrome is an unlikely, lethal, severe skin and mucosal hypersensitive reaction of delayed type, identified by detachment of epidermis, necrosis of mucosa with stomatitis and purulent conjunctivitis requiring prompt medical intervention. Drugs like antibiotics, anticonvulsants and oxide inhibitors are the vital cause of developing Stevens Johnson syndrome. A 12 year old female patient was admitted in pediatric department with the chief complaints of oral lesions on the bilateral buccal mucosa and hard palate causing difficulty in opening mouth and swallowing since 10 days. Past medical history revealed that the patient had fever and sore throat and was prescribed tablet amoxyclav (amoxicillin – clavulanic acid) by a local medical practitioner, after that patient developed ulcer in the buccal cavity and around the lips. The patient was managed with cephalosporin antibiotic (ceftriaxone), betadine mouthwash, candid ointment, nutritional supplements and systemic steroids (dexamethasone). Naranjo causality assessment score was 6 in our patient and amoxicillin clavulanic acid induced Stevens Johnson syndrome was probable and moreover on severity assessment by Hartwigs Severity Assessment Scale the severity level for the suspected adverse drug reactions was 5 therefore amoxicillin clavulanic acid induced Stevens johnson syndrome was a severe adverse drug reaction. Early detection of symptoms of Stevens johnson syndrome followed by prompt withdrawal of offending drug and timely management can improve the clinical condition of patients. Key words: Amoxicillin - clavulanic acid, Hartwigs Severity Assesment Scale, Stevens Johnson Syndrome, Hypersensitivity reaction, Naranjo Causality Assessment.

Aim: To evaluate the antibiotic usage in skin and soft-tissue infections (SSTIs) and to study the sensitivity pattern of identified microorganisms from antimicrobial susceptibility testing (AST) data. Materials and Methods: This was a cross-sectional study carried out in the Inpatient Department of General Surgery at Owaisi Hospital & Research Center, Hyderabad, for 6 months to collect 50 swab samples aseptically from the subjects with diverse SSTIs at the day of admission before the administration of antibiotics, and AST was done using Kirby Bauer disc diffusion method based on the guidelines of Clinical Laboratory Standard Institute (CLSI). Results: Of the 50 swab samples, 43 were culture positive and 7 were culture negative, and the highest number of cases was of cellulitis (14.28%). The most commonly isolated pathogen was Staphylococcus aureus (30.23%). On the basis of antibiotic sensitivity testing, we found that Ciprofloxacin was the most potent drug, followed by Ceftriaxone and Amikacin, for overall bacterial isolates. In our study, the treatment adhered to IDSA guidelines in 50% of cases and we found that many antibiotics were resistant. In cases of gangrene and abscess, a striking deviation from the guidelines (60% and 77.7%, respectively) was seen. Conclusion: This study guided us toward an appropriate treatment plan for the management of some SSTIs. The disproportionate and tedious use of antibiotics should be abstained as this may drive the evolution of resistant microorganisms that are even more difficult to get rid of.

Background: Hand washing is viewed as most cost effective intervention for reducing global infections like diarrhoea, acute respiratory tract infections. According to WHO estimates, 3.8 million children aged less than five die each year from diarrhoea and ARI. WHO defines hand washing as washing hands with soap and water (HWWS) thoroughly following the five critical moments i.e. after defecation, after cleaning child’s bottom who had defecated, before cooking, eating and feeding child. Objectives of the study was to study the socio demographic profile of mothers, to study the hand washing practices among mothers having children under 5 years of age and factors influencing them and to impart knowledge about the importance of hand washing Methods: A community based descriptive cross sectional study was undertaken on mothers randomly selected in rangampet, urban field practising area of KMC, Warangal. A total of 150 mothers were interviewed using a pre-designed semi-structured questionnaire. The data was analyzed using SPSS version 22.00. Results: Mothers who washed their hands with soap and water after defecation (79.3%) and after cleaning child’s bottom (82.7%) before cooking (44.7%), before eating (44.7%) and before feeding the child (41.3%). The women who didn’t wash their hands properly (used only water) after defecation (20.7%) and after cleaning a child who has just defecated (17.3%) cited the absence of soap or water at the designated site of hand washing as the reason for not doing so. 78.7% have told that hand washing is important in prevention of diseases. 16.7% have given the response that they don’t know the importance of hand washing. Conclusions: The study shows hand washing after critical moments is critically low. It can be suggested that interventions by educating target an increase in hand washing practices. Innovative social marketing approaches may help in adoption of proper hand washing behaviour.

Introduction: Diabetes mellitus (DM) is a chronic disease characterized by high blood glucose levels due to absolute or relative circulating insulin levels. Plants represent a major potential source of drugs for treating diabetes. The study of plants having antidiabetic activity may give a new approach in the treatment of DM. Aim: This study was aimed to investigate the glucose utilization capacity of bioactivity-guided fractions of Barleria prionitis and Hyptis suaveolens. Materials and Methods: The dried coarse powdered plant material was extracted in aqueous ethanol by cold maceration; further, ethanolic extracts were fractionated using solvents of varying polarity and were investigated in isolated rat hemidiaphragm using 0.1% and 0.2% concentrations of plant extracts. Results: The tested fractions of both plants showed significant and dose-dependent increased glucose uptake capacity and was found to be maximum with petroleum ether and aqueous ethanolic extracts of both plants; 0.2% concentration of both plant extracts is superior in activity when compared to 0.1% of the test extracts. H. suaveolens has produced more glucose utilization capacity when compared to B. prionitis. Conclusion: The activity of H. suaveolens is comparable to standard insulin (P < 0.01). Both the plant materials have some extra pancreatic mechanism like glucose uptake by peripheral tissue.

Background: Anemia is a condition that is marked by low levels of hemoglobin in the blood. Iron is a key component of hemoglobin, and iron deficiency is estimated to be responsible for half of all anemia globally. The present study was conducted to find out the prevalence of anemia among undergraduate students of (17-21 years) in Hyderabad city, India.Methods: A cross-sectional study was conducted in different UG colleges in urban areas of Hyderabad for 3 months and a total 57 women participants were selected to volunteer study. All participants underwent screening using anthropometry with haemoglobin estimation using Sahli’s method. The 24-hour dietary recall was also recorded and analysed to assess the nutritional adequacy of the diet.Results: Prevalence rate of iron deficiency anemia was found to be 57.89 per cent, of the total 54.38 per cent were mild anemic and 3.51 percent were moderately anemic. Conclusions: Nutritional anaemia is one of the most preventable forms of anaemia if resources available individualize therapy focusing on the confluence of various causative factors should be implemented.

Drug utilization evaluation of hepatoprotective drugs is important in view of the spectrum of effect and associated risks with their therapy. The study was designed to evaluate the effects and adverse effects of hepatoprotective agents. A prospective, observational study was carried out for a period of 6 months at Osmania General Hospital (a tertiary care hospital). 120 patients were evaluated receiving corticosteroids, pentoxifylline, ursodeoxycholic acid for observing a trend in hepatic parameters and its outcomes. Ursodeoxycholic acid (81.66%) was the most commonly prescribed drug in almost all cases of alcoholic liver diseases followed by pentoxifylline (10%) in hepatorenal syndrome and then prednisolone (8.33%) in fatty liver. 67 cases were reported to have the significant drop in liver transaminases and bilirubin levels. Ursodeoxycholic acid resulted in a drop of 25% serum bilirubin and 35% drop in serum ALT (alanine transaminase) and 33% drop in serum AST (aspartate transaminase) in patients in a time gap of 1 week. Among 120 cases 94 were males (78.05%) and 26 females (21.04%) and maximum patients with alcoholic liver disease belonged to age group of 30-40 years (27.6%). Ursodeoxycholic acid (300 mg once daily) is used as an off-label drug for all types of alcoholic liver disease and also for viral hepatitis. Though Ursodeoxycholic acid showed a significant drop in liver transaminases and serum bilirubin levels in cirrhotic patients a better alternative lie in liver transplantation as long as they remain abstinent from alcohol. Keywords: Alcoholic liver diseases, Hepatoprotective agents, Liver transaminases, Bilirubin, Paired t-test.

Leukemias with MLL translocations are often found in infants and are associated with poor outcomes. The pathogenesis of MLL-fusion leukemias has been linked to upregulation of HOX/MEIS1 genes. The functions of the Hox/Meis1 complex in leukemia, however, remain elusive. Here, we used inducible Meis1-knockout mice coupled with MLL-AF9 knockin mice to decipher the mechanistic role of Meis1 in established MLL leukemia. We demonstrate that Meis1 is essential for maintenance of established leukemia. In addition, in both the murine model and human leukemia cells, we found that Meis1 loss led to increased oxidative stress, oxygen flux, and apoptosis. Gene expression and chromatin immunoprecipitation studies revealed hepatic leukemia factor (HLF) as a target gene of Meis1. Hypoxia or HLF expression reversed the oxidative stress, rescuing leukemia development in Meis1-deficient cells. Thus, the leukemia-promoting properties of Meis1 are at least partly mediated by a low-oxidative state, aided by HLF. These results suggest that stimulants of oxidative metabolism could have therapeutic potential in leukemia treatment.

The Langendorff’s isolated perfused small mammalian heart represents the optimal compromise in the conflict between the quantity and quality of data that can be acquired from an experimental model versus its clinical relevance, especially in relation to ischemia-reperfusion injury. We analyzed the important recent, as well as standard older articles to highlight the importance of Langendorff’s isolated heart technique using the rat as an experimental animal model. The retrograde perfusion of isolated rat heart preparation is the most commonly used technique in cardiovascular research experiments with many advantages. The longevity of this preparation is one of the main advantages. From the moment an ex vivo preparation is established, it starts to deteriorate and the rate will depend on number of factors such as the skill of the operator, the species of animal, age, initial heart rate, choice and composition of the perfusion fluid, flow rate, presence or absence of various drugs, preload pressure, and the temperature at which the studies are carried out. Recently, various techniques and variables measured have undergone modifications. This review article has attempted to address many of the issues, developments, and applications which will assist investigators to make the best possible use of this experimental model using the rat.

The ability to accurately and easily locate sentinel lymph nodes (LNs) with noninvasive imaging methods would assist in tumor staging and patient management. For this purpose, we developed a lymphatic imaging agent by mixing fluorine-18 aluminum fluoride-labeled NOTA (1,4,7-triazacyclononane-N,N',N''-triacetic acid)-conjugated truncated Evans blue ((18)F-AlF-NEB) and Evans blue (EB) dye. After local injection, both (18)F-AlF-NEB and EB form complexes with endogenous albumin in the interstitial fluid and allow for visualizing the lymphatic system. Positron emission tomography (PET) and/or optical imaging of LNs was performed in three different animal models including a hind limb inflammation model, an orthotropic breast cancer model, and a metastatic breast cancer model. In all three models, the LNs can be distinguished clearly by the apparent blue color and strong fluorescence signal from EB as well as a high-intensity PET signal from (18)F-AlF-NEB. The lymphatic vessels between the LNs can also be optically visualized. The easy preparation, excellent PET and optical imaging quality, and biosafety suggest that this combination of (18)F-AlF-NEB and EB has great potential for clinical application to map sentinel LNs and provide intraoperative guidance.

The aim of present experiment was t o develop validated UV spectroscopic method for simultaneous estimation of Omeprazole and Diclofenac in bulk and pharmaceutical formulation. Area under curve (Method 1) , simultaneous equation (Method 2) and absorbance ratio (Method 3) were developed for the determination of Omeprazole and Diclofenac in their combined capsule formulation without prior separation. The solutions of standard and sample were prepared in methanol for all the methods . Quantitative determination of the drugs was performed at the wavelength ranges of 291 - 311 nm and 271 - 291 nm ( method 1), at 301 and 281 nm (method 2) and 301 nm and 295 nm (method 3) for Omeprazole and Diclofenac respectively. The Proposed methods were ev aluated for the different validation parameters like precision, reproducibility, linearity and accuracy as per ICH guidelines. L inearity was observed in the range of 5 - 25 μg/ mL for Diclofenac and 1 - 5 μg/ mL for Omeprazole with correlation coefficient of 0.998 and 0.999 for Omeprazole and Diclofenac respectively. These methods are simple, precise, sensitive and applicable for the simultaneous determination of these drugs in pure powder and formulation.

Aim Nephrotic syndrome is one of the most commonly diagnosed primary kidney diseases and its progressive forms can lead to chronic kidney disease and or end-stage renal disease. Steroid-resistant nephrotic syndrome is defined by resistance to standard steroid therapy and it remains one of the most intractable causes of kidney failure. Mutations in NPHS2, which encodes for podocin, an integral membrane protein of the glomerular epithelial cells (podocytes), represent a frequent cause of steroid-resistant nephrotic syndrome worldwide. This study was aimed at screening for known NPHS2 mutations in Indians with nephrotic syndrome. Methods We screened a cohort of 484 subjects from the southern Indian population for the presence of four missense mutations G92C, P118L, R138Q and D160G within the NPHS2 gene using tetra primer ARMS PCR. Results Our results revealed that these mutations were seen only among the patients (14.02%) and were absent in the controls, suggesting their disease-causing nature. Further categorization revealed that these mutations were together responsible for 18.5% of steroid-resistant cases in our study group. Conversely, the studied mutations were not found in the controls as well as in the patients with steroid-sensitive nephrotic syndrome. Conclusion This is the first such report from India. More studies are warranted to establish the frequency of NPHS2 mutations in the Asian–Indian population and such analysis may help in developing mutation(s)-specific therapeutic interventions in the future.

Three rapid, simple, inexpensive, precise, and accurate spectrophotometric procedures were developed for the determination of Perindopril erbumine (PPE) using cobalt-thiocyanate, citric acid and 2,3- dichloro-5,6-dicyano benzoquinone in bulk sample and in dosage forms. The procedures are based on the coordination complex of the drug (electron donor) and the chromogenic reagents used. The colored products are extracted into non aqueous solvents and measured spectrophotometrically at the optimum ?maxfor each complex. Regression analysis of Beer-Lambert plots showed good correlation in the concentration range of 30-70 µg mL?1, 4-20 µg mL?1 and 20-60 µg mL?1 for cobalt-thiocyanate, citric acid and 2,3- dichloro-5,6-dicyano benzoquinone, respectively. The apparent molar absorptivity, Sandell’s sensitivity, detection and quantification limits were calculated. The developed methods were successfully applied for the determination of PPE in bulk and pharmaceutical formulations without any interference from common excipients and hence can be used for their routine analysis. Keywords: Perindopril erbumine; Spectrophotometry; Cobalt-thiocyanate; Citricacid-acetic anhydride. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i2.16106 J. Sci. Res. 6 (2), 319-327 (2014)

The objective of the present investigation was to prepare bilayer tablets of Glimepride and Metformin HCL in combination. Metformin hydrochloride and Glimepiride are oral hypoglycemic drug and effectively used in treatment of diabetes mellitus (type-2 diabetes). The main aim of the present study was to formulate Metformin hydrochloride sustained release and Glimepride immediate release matrix tablets as a dosage form by different polymers such as HPMC, Povidone, Lactose Monohydrate, Ethylcellulose, Microcrystalline Cellulose and study the invitro release patterns of the drug. In the present study bilayer tablets Glimepride prepared by direct compression method and Metformin prepared by wet granulation technology. The prepared tablets were evaluated for various physicochemical parameters such as drug-excipient interaction by FTIR,flow properties, hardness, weight variation, friability, and in vitro dissolution studies optimised based on desired sustained release time (16hrs) and acceptable floating properties The FTIR study revealed that there is no drug-excipient interaction. During preformulation it has been observed that there is no drug- drug and drug excipient interaction, so the excipients which have been selected for the formulation are compatible with the drugs. This system provides zero order or near zero order release for IR layer and SR layer provides Higuchi model.

The transcription factor Meis1 is expressed preferentially in hematopoietic stem cells (HSCs) and overexpressed in certain leukemias. However, the functions of Meis1 in hematopoiesis remain largely unknown. In the present study, we found that Meis1 is required for the maintenance of hematopoiesis under stress and over the long term, whereas steady-state hematopoiesis was sustained in the absence of Meis1 in inducible knock-out mice. BM cells of Meis1-deficient mice showed reduced colony formation and contained significantly fewer numbers of long-term HSCs, which exhibited loss of quiescence. Further, we found that Meis1 deletion led to the accumulation of reactive oxygen species in HSCs and decreased expression of genes implicated in hypoxia response. Finally, reactive oxygen species scavenging by N-acetyl cysteine or stabilization of hypoxia signaling by knockdown of the von-Hippel-Lindau (VHL) protein led to reversal of the effects of Meis1 deletion. The results of the present study demonstrate that Meis1 protects and preserves HSCs by restricting oxidative metabolism.

The surgical team always tries to provide consistently low incidence of major complications for patient undergoing any operation. Recognizing patients at high risk of developing a complication will contribute substantially to quality of operation and of cost reduction in surgery. In operating room, surgical apgar score (SAS) has helped surgeons for objective assessment of the operative course for postoperative prognostication instead of their "gut- feeling". Here we prospectively evaluated postoperative complications according to SAS. This was a hospital based, single centre longitudinal prospective observational study from October 2014 to March 2015 including 66 patients. There was significant association between type of risk group according to SAS and occurrence of complication (P

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor belonging to the Per-Arnt-Sim (PAS) family of proteins. The AHR is involved in hematopoietic stem cell (HSC) functions including self-renewal, proliferation, quiescence, and differentiation. We hypothesize that AHR impacts HSC functions by influencing genes that have roles in HSC maintenance and function and that this may occur through regulation of bone marrow (BM) niche cells. We examined BM and niche cells harvested from 8-week-old AHR null-allele (KO) mice in which exon 3 was deleted in theAhrgene and compared these data to cells from B6 control mice; young and old (10 months) animals were also compared. We report changes in HSCs and peripheral blood cells in mice lacking AHR. Serial transplantation assays revealed a significant increase in long term HSCs. There was a significant increase in mesenchymal stem cells constituting the endosteal BM niche. Gene expression analyses of HSCs revealed an increase in expression of genes involved in proliferation and maintenance of quiescence. Our studies infer that loss of AHR results in increased proliferation and self-renewal of long term HSCs, in part, by influencing the microenvironment in the niche regulating the balance between quiescence and proliferation in HSCs.