Brask Malone (airyarn5)
Implementing the clinical practice guidelines has reduced the gap between the clinical and the academic scenarios, where collaborative and inter-institutional work is enhanced to obtain better patient outcomes, based on the available evidence. OBJECTIVE To establish the evolution of the care process after the implementation of the Best Practices Guideline «Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour». METHOD A descriptive longitudinal study was carried out at the Mental Health Hospitalization Unit in Hospital Universitario Virgen de las Nieves, Granada. All patients admitted to the Unit between 2016 and 2018, 1471 in total, were included. Compliance of care process indicators and suicidal risk were evaluated; in addition, suicide rates per 100,000 inhabitants were obtained. Absolute and relative frequencies of the indicators were calculated, as well as the change during the study period by the chi-square Pearson test, for P less then .05. RESULTS We observed a statistically significant increase in the entire care process. The percentage of patients with suicidal risk assessment improved from 16% in 2016 to 45.25% in 2018. The application of safety measures grew reaching 100% in 2018, and community services referral went from 70.31% to 90.50%. The percentage of patients at risk of suicidal ideation remains stable. Suicide rates per 100,000 inhabitants in Granada decreased by 24.50%. CONCLUSIONS Improvement in the care process and the decrease in the suicide rate in Granada since the implementation of the guideline are consistent with the results of other research and offer a hopeful vision. Comprehensive strategies for suicide prevention must be promoted, and the evaluation of initiatives undertaken must continue. Compound 9 Diabetic kidney disease (DKD) is common complication of type 1 and type 2 diabetes and may lead to progressive kidney dysfunction culminating in end-stage kidney disease. Kidney function is evaluated less frequently than other care procedures in patients with diabetes, even though the opportunity to identify DKD early and slow or even halt renal damage early in the disease progression represents a potentially important clinical opportunity for early intervention. The following review provides an overview of the under-recognised importance of kidney function in T2D and current best-practice to support the identification of DKD as part of primary care T2D management. BACKGROUND Withania somnifera (L.) (family-Solanaceae), known as 'Indian ginseng' or 'Ashwagandha' is acclaimed as an effective adaptogen, immunomodulator, aphrodisiac and sedative. Ashwagandhaghrita is a recognized ghee based Ayurvedic formulation. Few ancient texts suggest murcchana process for preparation of Ashwagandha ghrita. OBJECTIVE The study was undertaken to evaluate probable effects of murcchana process on ghrita preparation with reference to time and storage conditions. MATERIALS AND METHODS Ashwagandha ghrita samples were prepared separately using plain ghee (Indian cow's ghee) and murcchana ghee. These formulations were stored separately in different glass bottles at room temperature and 400C/75%RH. Organoleptic characters (colour, odour, taste, texture and touch) and physicochemical parameters (acid value, peroxide value, iodine value, saponification value, unsaponifiable matter, refractive index and specific gravity) were determined after 3, 6, 9 and 12 months. Plain ghee and prepared ghrita were subjected for antioxidant evaluation by various in vitro methods. RESULTS Changes were observed in organoleptic characters and physicochemical parameters of plain ghee and Ashwagandha ghrita formulations. Alterations in these parameters were more pronounced at high temperature and on long storage. Ashwagandha ghrita prepared with murcchana process exhibited better antioxidant potential in all in vitro methods. CONCLUSION The murcchana process was found to be beneficial towards quality of ghrita. Hence, As
