Procalcitonin-guided antimicrobial stewardship in critically ill patients with sepsis: A pre- post interventional study.

Aim: Injudicious usage of antibiotics has led to the emergence of antibiotic resistance which is a major health-care problem in developing countries such as India. Our aim was to show how antibiotic therapy based on serial procalcitonin (PCT) assay can help in antibiotic de-escalation in septic patients.

Materials And Methods: A pre-post interventional study was conducted among 300 septic patients admitted to an intensive care unit (ICU).

Time to positivity of blood cultures causing candidemia and its relation to mortality.

Background And Objectives: Early diagnosis of candidemia is of vital importance in reducing mortality and morbidity. The main objective of the study was to determine the TTP (Time to Positivity) of different species of causing bloodstream infection and to see whether TTP can help differentiate which is frequently fluconazole resistant from Fluconazole sensitive .

Materials And Methods: TTP (Time to positivity) and AAT (Appropriate Antifungal therapy) were noted for Blood cultures becoming positive for .

Sustainable process for fractionation of lignin by the microwave-assisted chemical additive approach: Towards sugarcane leaf biorefinery and characterization.

The microwave assisted pretreatment on sugarcane leaf (SCL) biomass for delignification was studied to enhance cellulose digestibility. In this work, microwave assisted with additives were used to delignification SCL for maximize sugar yield recovery. Single factorial and Central composite design (CCD) were employed to optimize the microwave assisted pretreatment conditions for improve delignification efficiency and the sugar yield recovery.

Evaluation of the efficacy of tongue swab and saliva as samples for testing COVID-19 infection in symptomatic cases in comparison with nasopharyngeal swab.

COVID-19 caused by SARS CoV-2 continues to be a major health concern globally. Methods for detection of the disease are necessary for public health efforts to monitor the spread of this disease as well as for detecting the emergence of new variants. Collection of Nasopharyngeal swab (NPS), the gold standard sample for the detection of COVID-19 infection by RT-qPCR is invasive and requires the expertise of a trained medical provider.

`A critical review on current status and environmental sustainability of pre-treatment methods for bioethanol production from lignocellulose feedstocks.

Lignocellulosic biomass resource has been widely used as a natural resource for the synthesis of biofuels and bio-based products through pre-treatment, saccharification and fermentation processes. In this review, we delve into the environmental implications of bioethanol production from the widely utilized lignocellulosic biomass resource. The focus of our study is the critical stage of pre-treatment in the synthesis process, which also includes saccharification and fermentation.

Does Timing of Levonorgestrel Insertion in Women with Abnormal Uterine Bleeding Affect its Expulsion and Bleeding Pattern? A Follow-Up Study.

Background: Levonorgestrel Intra Uterine System insertion for contraception is preferred in the follicular phase. However, the ideal time of insertion for Abnormal Uterine Bleeding is not stated clearly. The aim of our study is to find out the effect of timing of insertion on expulsion and irregular bleeding pattern post insertion.

The Predictive Score for Patients Hospitalized With COVID-19 in Resource-Limited Settings.

Background and aims The second wave of coronavirus disease 2019 (COVID-19) has been devastating in India and many developing countries. The mortality reported has been 40% higher than in the first wave, overwhelming the nation's health infrastructure. Despite a better understanding of the disease and established treatment protocols including steroids and heparin, the second wave was disastrous.

Glucocorticoid Use and Misuse in a Rural Community of Kerala, India.

Background: Glucocorticoids (GCs) are anti-inflammatory steroid medications prescribed globally by doctors for various illnesses and they are known to produce quick symptom relief. In India, they are among the cheapest and easily accessible over-the-counter medications. Thus, it can be misused, leading to many life-threatening illnesses such as diabetes mellitus, hypertension, overwhelming infections, Cushing's syndrome, and hypo-adrenal crisis.

Potential Determinants and Effects of Exclusive Breastfeeding Among Infants at a Tertiary Care Center, Kerala, India.

Background: Exclusive breastfeeding (EBF) is the first fundamental right of the child. Globally less than half of the infants are optimally breastfed. Suboptimal breastfeeding can lead to increased respiratory and gastrointestinal infections.

Evaluation of Glucocorticoids Utilization in Central Kerala using Pharmacy Sales Overview.

Background: Misuse of prescription drugs is a major public health problem in India and developing countries. Emerging evidence indicates that glucocorticoids are a class of drugs that are silently misused. These drugs are inexpensive and easily available as over-the-counter drugs in India are widely used by local practitioners and self-prescribed by patients for swift symptomatic relief of febrile illnesses, joint pain, asthma, other respiratory illnesses, and skin diseases.

Psychological distress and burnout among healthcare worker during COVID-19 pandemic in India-A cross-sectional study.

Background: COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India.

Assessment of Squalor in Migrant Colonies of Thiruvalla Province of Kerala, India using Rapid Survey Technique.

Background: Domestic squalor refers to households that are extremely cluttered, in a filthy condition, and where the accumulation of items such as personal possessions, rubbish, excrement and decomposing food creates an environment that jeopardizes the health and wellbeing of the occupant(s). In India, an estimated 258 million are migrants. They are more likely to live in squalor due to inferior socio-economic status and no permanent residence.

Together let us confront it: An outbreak investigation of hepatitis B in Pathanamthitta district, Kerala.

Introduction: Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus (HBV). The established routes of transmission are from mother to infant, sexual contact, and exposure to blood or body fluids. Though HBV is preventable by vaccine and robust infection control practices, outbreaks of HBV infection do occur in India.

Association of screen time with parent-reported cognitive delay in preschool children of Kerala, India.

Background: Screen use is increasing rapidly among preschool children and excess screen use in these children has been associated with cognitive side effects and speech delay. We undertook this study to estimate the risk associated with screen time in children, parental supervision, and parent-reported cognitive development among preschool children aged 2-5 years.

Methods: A cross-sectional study was done between July 2019 and January 2020 involving parents of all students aged 2-5 years, attending 2 kindergarten schools in Thiruvalla using a self-administered questionnaire.

Is performing sacrospinous fixation with vaginal hysterectomy and McCall's culdoplasty for advanced uterovaginal prolapse preferable over McCall's culdoplasty alone?

Purpose Of Study: Advanced uterovaginal prolapse can significantly affect the quality of life in women and usually requires surgical management. McCall's culdoplasty (M) or sacrospinous fixation (SSF) are done at the time of vaginal hysterectomy with pelvic floor repair (VHPFR) to reduce recurrence, but recurrence rates of 15% and 33% have been reported with these procedures respectively. We hypothesize that combining VH-PFR with both McCall's culdoplasty and sacrospinous fixation (VH-PFR-M-SSF) may decrease recurrence rates compared to VH-PFR-M without significantly affecting other perioperative outcomes.

Applying Heart Failure Management to Improve Health Outcomes: But WHICH One?

We report on our learning from many years of research testing the value of nurse-led, multidisciplinary, home-based management of heart failure. We discuss and highlight the key challenges we have experienced in testing this model of care relative to alternatives and evolving patient population. Accordingly, we propose a pragmatic approach to adapt current models of care to meet the needs of increasingly complex (and costly) patients with multimorbidity.

Identification and validation of a factor of commutability between platelet counts performed on EDTA and citrate.

The anticoagulant mostly employed for platelet count is EDTA. The Francophone Group of Cellular Hematology recommends checking of blood smear stained with May-Grünwald Giemsa any thrombocytopenia less than 100 G/L without medical history or whether an alarm is generated by the cell counter. The pseudo-thrombocytopenia (PTP) with EDTA is the best known artifact in platelet count.

Cardiovascular outcomes in patients with intraventricular conduction blocks: A sixteen-year follow-up in a state-wide database.

Background: To assess the adverse clinical effects of left anterior hemiblock alone or in combination with right bundle branch block and of complete left bundle branch block in comparison with isolated right bundle branch block and the relationship of these effects with altered mechanoelectric factors resulting in left ventricular dysfunction.

Methods: In a 16-year follow-up study using a statewide database, we studied the occurrence of mortal and morbid cardiovascular (CV) events among patients without apparent ischemic heart disease who had left anterior hemiblock (LAHB, n=4273, right bundle branch block (RBBB) with LAHB (BFBB, n=1857) and left bundle branch block (LBBB, n=9484 compared to isolated RBBB (n=25288).

Results: After adjustment for demographics, co-morbidities and insurance, LAHB was associated with a significant excess risk of all-cause death (HR 1.

Usefulness of a normal coronary angiogram in patients aged ≥65 years to foretell survival.

A normal coronary angiogram (CA) has been reported to confer a good prognosis. However, how this applies to patients aged ≥65 years is not well known. From 1986 to 1996, 11,625 patients aged ≥65 underwent coronary angiography.

Statin use and fatal prostate cancer: a matched case-control study.

Background: Statins are some of the most commonly prescribed medications in medical practice, and prostate cancer is the most common malignancy among men. Although there has been no consistent evidence that statins affect cancer incidence, including prostate cancer, several reports suggest they may decrease the rate of advanced prostate cancer. However, no study to date has specifically examined statin use and prostate cancer mortality.

Treatments for improving survival of patients with prostate cancer.

Prostate cancer is a heterogeneous disease characterised by a long natural history relative to other solid tumours. With the diagnosis of prostate cancer being made earlier, the emphasis of treatment has shifted from palliation of symptoms to altering disease-related morbidity and mortality and thus improving overall survival. Treatment of prostate cancer increasingly involves an approach that combines local therapies directed at the primary tumour together with systemic therapies to potentiate their effect and to control subclinical metastatic disease.