Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
Inulin as a heterogeneous blend of fructose polymers is diversely found in nature primarily as storage carbohydrates in plants. Besides, inulin is believed to induce certain techno-functional and associated properties in food systems. Inulin owing to its foam forming ability has been successfully used as fat replacer in quite a wide range of products as dairy and baked products. Furthermore, it is known to impart certain nutritional and therapeutic benefits that extend apart to improve health and reduce the risk of many lifestyle related diseases. Additionally, as a functional ingredient, Inulin has been adopted in various efficacy studies involving animal and human studies to function as a prebiotic, in promoting good digestive health, influencing lipid metabolism and has some beneficial roles in ensuring optimum levels of glucose and insulin. This review article is an attempt to present a comprehensive overview on both techno-functional and therapeutic potential of inulin.
For millennia, spices have been an integral part of human diets and commerce. Recently, the widespread recognition of diet-health linkages bolsters their dietary importance. The bioactive components present in them are of considerable significance owing to their therapeutic potential against various ailments. They provide physiological benefits or prevent chronic ailment in addition to the fundamental nutrition and often included in the category of functional foods. Black pepper (Piper Nigrum L.) is an important healthy food owing to its antioxidant, antimicrobial potential and gastro-protective modules. Black pepper, with piperine as an active ingredient, holds rich phytochemistry that also includes volatile oil, oleoresins, and alkaloids. More recently, cell-culture studies and animal modeling predicted the role of black pepper against number of maladies. The free-radical scavenging activity of black pepper and its active ingredients might be helpful in chemoprevention and controlling progression of tumor growth. Additionally, the key alkaloid components of Piper Nigrum, that is, piperine assist in cognitive brain functioning, boost nutrient's absorption and improve gastrointestinal functionality. In this comprehensive treatise, efforts are made to elucidate the antioxidant, antimicrobial, anti-inflammatory, gastro-protective, and antidepressant activities of black pepper. Moreover, the synergistic interaction of black pepper with different drugs and nutrients is the limelight of the manuscript. However, the aforementioned health-promoting benefits associated with black pepper are proven in animal modeling. Thus, there is a need to conduct controlled randomized trials in human subjects, cohort studies, and meta-analyses. Such future studies would be helpful in recommending its application in diet-based regimens to prevent various ailments.
Summary Instant study was an attempt to elucidate the suitability of wheat bran for extrusion cooking and to check the effect of different extrusion parameters on the dietary fibre profile as well as on water solubility index. Response surface methodology was used to optimise the extrusion parameters. From results, it was concluded that extrusion cooking had a positive effect on total and soluble dietary fibre. Whilst the insoluble dietary fibre decreased appreciably with the varying processing parameters, the decrease in insoluble fibre and increase in soluble fibre were probably due to disruption of covalent and noncovalent bonds in the carbohydrate and protein moieties leading to smaller and more soluble molecular fragments. Additionally, water solubility index was greatly enhanced by varying extrusion temperature and screw speed. Conclusively, the findings suggest the usefulness of extrusion cooking to beneficially modify the wheat bran for value addition.
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