Does Early Fortification of Human Milk Decrease Time to Regain Birth Weight as Compared to Late Fortification Among Preterm Infants? - A Randomized Controlled Trial

OBJECTIVES

To compare the duration required to regain birth weight following early fortification of human milk vs. late fortification among preterm infants.

METHODS

This randomized controlled trial included hemodynamically stable 120 preterm infants (≤32 wk of gestation). The intervention and comparator groups received standard fortification with human milk fortifier when enteral feeds reached 30 ml/kg/d (early fortification) and 80 ml/kg/d (late fortification) respectively. Neonates in both the groups received feed increments as per standard NICU protocol. Anthropometric measurements (weight, length, and head circumference) at birth and during postnatal follow-up were done following standard precautions and plotted on the sex-specific Fenton growth charts. Primary outcome was the mean duration required to regain birth weight. Secondary outcomes included weight gain velocity, linear growth, increase in head circumference and occurrence of sepsis, feed intolerance and necrotizing enterocolitis.

RESULTS

Preterm neonates who received early fortification regained birth weight earlier compared to those in the late fortification group (10.13 ± 2.90 vs. 11.26 ± 3.06, p <0.05). The weight gain velocity, linear growth and increase in head circumference were better in the early fortification group. There was no increased risk of culture proven sepsis, feed intolerance and necrotizing enterocolitis in the early fortification group compared to late fortification.

CONCLUSIONS

Standard fortification with human milk fortifier when enteral feeds reach 30 ml/kg/d helps preterm neonates regain birth weight earlier. Early fortification is well tolerated and safe for the population studied.

Qualitative and Quantitative Evaluation of an Innovative Primary and Secondary Diabetes Clinic in Western Sydney

Introduction

Western Sydney Diabetes (WSD) established an innovative diabetes service in May 2020, using virtual and in-person care, linking primary care with the diabetes specialist team. This study evaluated the service's feasibility using qualitative and quantitative methods.

Method

Evaluation included: 1) thematic analysis of interviews and workshops with patients and health professionals (n = 28); 2) quantitative analysis of records of patients admitted July 2020-June 2021 (n = 110).

Results

Key themes related to 1) benefits: convenient location, access to integrated care, advantages of virtual care; 2) challenges: hard for patients to ask questions, technology issues; 3) confidence: shared care decision making, multidisciplinary team; and 4) future directions: additional multidisciplinary services, expanded insulin stabilisation service, promotion.Improvements between baseline and 3 months included 1.3% reduction in HbA1c (p < 0.05). Sulfonylurea dropped by 25% between initial appointment and follow-up, and GLP1RA/SGLT2i use increasing by 30% (p < 0.05). The clinic covered costs using Medicare billings and Nationally Weighted Activity Units.

Discussion

The findings suggest this integrated care model was feasible and perceived as beneficial by both patients and providers. The clinic offers a promising model of practice that could be developed further to roll out in other regions for rural delivery of care.

Effect of Electronic Infrared Tap With Voice Reinforcement on Hand Hygiene Compliance of Healthcare Personnel

OBJECTIVE

To assess the efficacy of an electronic infrared tap with voice reinforcement to improve hand hygiene compliance among health care workers.

METHOD

This pre-post intervention study used an automated electronic infrared tap with voice reinforcement as intervention in the neonatal intensive care unit (NICU) and the pediatric intensive care unit (PICU). Hand hygiene adherence rates of health care workers were monitored using a video camera.

RESULTS

A total of 2718 hand hygiene events were observed. Baseline rates of hand hygiene (complete or partial adherence rates) were 86.9% in NICU and 81.2% in PICU, that improved to 94.9% for NICU and 92.9% for PICU post-intervention (P=0.001).

CONCLUSION

Use of an electronic infrared (EIR) tap with voice reinforcement in handwashing stations of NICU and PICU improved hand hygiene compliance among health care workers.

Effective adsorption of crystal violet onto aromatic polyimides: Kinetics and isotherm studies

The motive of this work is to synthesis aromatic polyimides by a two-step poly condensation process and the prepared aromatic polyamides (APIs) is been used as an effective functionalized adsorbent for the removal of carcinogenic crystal violet (CV) from aqueous medium. The adsorption efficiency of the APIs was enhanced by incorporation different functional moieties (varying aromatic dianhydrides with -O-, -(CF₃)₂-, -(CH₃)₂-) in the polymer structure. The initial and final concentration of CV was measured using UV-Vis spectrometer. The adsorption process was optimized by varying the parameters such as the effect of solution pH, contact time, initial dye concentration, and adsorbent dosage. Kinetics and isotherms of the adsorption system were appraised using data obtained from effect of contact time and initial dye concentration with corresponding empirical modelling techniques respectively. The evaluated results of the adsorption kinetic studies confirmed that the adsorption of API onto CV is followed a pseudo-second-order kinetic model. The adsorption behaviour and their interactions between APIs and CV are well established. The experimental results of this research output could be confirmed that APIs is a very effective adsorbent for the removal of cationic dye from aqueous.

Biodiesel from plant seed oils as an alternate fuel for compression ignition engines-a review

The modern scenario reveals that the world is facing energy crisis due to the dwindling sources of fossil fuels. Environment protection agencies are more concerned about the atmospheric pollution due to the burning of fossil fuels. Alternative fuel research is getting augmented because of the above reasons. Plant seed oils (vegetable oils) are cleaner, sustainable, and renewable. So, it can be the most suitable alternative fuel for compression ignition (CI) engines. This paper reviews the availability of different types of plant seed oils, several methods for production of biodiesel from vegetable oils, and its properties. The different types of oils considered in this review are cashew nut shell liquid (CNSL) oil, ginger oil, eucalyptus oil, rice bran oil, Calophyllum inophyllum, hazelnut oil, sesame oil, clove stem oil, sardine oil, honge oil, polanga oil, mahua oil, rubber seed oil, cotton seed oil, neem oil, jatropha oil, egunsi melon oil, shea butter, linseed oil, Mohr oil, sea lemon oil, pumpkin oil, tobacco seed oil, jojoba oil, and mustard oil. Several methods for production of biodiesel are transesterification, pre-treatment, pyrolysis, and water emulsion are discussed. The various fuel properties considered for review such as specific gravity, viscosity, calorific value, flash point, and fire point are presented. The review also portrays advantages, limitations, performance, and emission characteristics of engine using plant seed oil biodiesel are discussed. Finally, the modeling and optimization of engine for various biofuels with different input and output parameters using artificial neural network, response surface methodology, and Taguchi are included.

Evaluation of the protective effect of Pterocarpus marsupium on acetic acid-induced ulcerative colitis in rats

The aim of the study was to evaluate the effect of Pterocarpus marsupium (PM) on acetic acid (AA)-induced ulcerative colitis (UC) in rats. The rats were divided into five groups, each having six rats. PM extract 100 mg and 200 mg/kg was given orally to groups four and five, respectively, and standard drug sulfasalazine (100 mg/kg, p.o) to group three. Group two served as UC control animals, and group one control animals received vehicle for 7 days. UC was induced by administering AA (3 % v/v of 2 ml) to all the animals except group one. After 72 h, the animals were killed and the colon was dissected out for microscopic, clinical evaluation, histopathological study and biochemical estimation. PM (100 and 200 mg/kg)-treated group had significantly reduced colon inflammation and mucosal damage. The treatment also normalized the altered antioxidant enzyme levels (LPO, SOD and GSH). Histopathological studies support the effect. The protective effect of PM may be due to antiinflammatory and antioxidant properties.

Non-ulcerative soft tissue mycosis of long duration mimicking soft tissue sarcoma--a case report

Soft tissue mycosis usually presents with a triad of tumefaction, suppuration and ulceration. We report an unusual case of soft tissue mycosis in a 42-year-old male teacher who presented with painless swelling over the anterolateral aspect of the right shin for 4 years duration.

In vivo effect of vitamin E on serum and tissue glycoprotein levels in perchloroethylene induced cytotoxicity

The antioxidant efficacy of vitamin E on Perchloroethylene (PER) induced cytotoxicity has been studied in rats. Feeding PER to rats for 42 days using sesame oil as vehicle alters total protein and protein bound carbohydrate components in liver and kidney of experimental animals. Supplementation of vitamin E prevented the changes observed in total protein and protein bound carbohydrate components of PER administered rats. Histopathological studies also show the effectiveness of vitamin E on PER administered rats in protecting the cellular architecture of liver and kidney from PER induced cytotoxicity.

The association of neurofibromatosis and hyperparathyroidism

Two patients with coexisting neurofibromatosis and hyperparathyroidism are described, bringing the total number of such cases in the world literature to seven. Other more classic examples of the association of tumorous conditions of neuroectodermal and entodermal origin are discussed to support the suggestion that the association of these two diseases may be another variant of multiple endocrine neoplasia type 2 (MEN2b). It may be clinically profitable to investigate all patients with either disease in order to uncover their coexistence.