Ragi (Finger millet) improves the nutritional value of ice cream by enhancing the iron and fibre content. Caramel flavoured medium fat ice cream (6 % fat) was prepared by addition of gelatinized malted ragi flour roasted in butter (MRB) @ 8 %, 9 % and 10 % by weight of mix and compared with control (C) i.e. vanilla ice cream containing 10 % fat. The overall acceptability score of product prepared using 9 % MRB was statistically (P>0.05) at par with the C, hence, it was selected. In the next part of the study, ragi ice cream was prepared using 4 different flavours viz. vanilla, mango, chocolate and caramel. Chocolate flavoured ragi ice cream was adjudged as best, followed by mango, caramel and vanilla ice cream. The iron and fibre content of chocolate flavoured ragi ice cream was found to be 12.8 ppm and 1.36 % respectively. vs. 1.5 ppm and 0.18 % respectively in control (C). Heat shock treatment as well as storage up to 30 days had no adverse effect on the sensory quality of the chocolate flavored ragi ice cream. Incorporation of finger millet in ice cream resulted in reduction in the amount of stabilizer used and effectively functioned as fat replacer in ice cream.
Context Cases of heart failure with preserved ejection fraction (HFpEF) exacerbations continue to affect patients' quality of life and cause significant financial burden on our healthcare system. Objective To identify risk factors for readmission in patients discharged with a diagnosis of HFpEF. Methods Electronic health records of patients over 18 years of age with a primary diagnosis of HFpEF treated between August 1, 2017 and March 1, 2018 in a community hospital were retrospectively reviewed. The study population included patients with HFpEF greater than 40% who were screened but did not qualify for the ongoing CONNECT- HF trial being conducted by Duke Clinical Research. To be included, subjects had to fall into 1 of 2 classifications (NYHA Class II-IV or ACC/AHA Stage B-D) and have a life expectancy greater than 6 months. Patients were excluded if they had terminal illness other than HF, a prior heart transplant or were on a transplant list, a current or planned placement of a left ventricular assist device, chronic kidney disease requiring hemodialysis, inability to use mobile applications, or inability to participate in longitudinal follow up. Readmission rate was analyzed at 30 and 90 days along with patients’ demographics and associated comorbidities, including peripheral vascular disease, anemia, pulmonary hypertension, arrythmia, and valvular heart disease. Patients were risk stratified using the LACE index readmission score and the Charlson comorbidity index. Results Of the 492 cases of HFpEF identified during the 7-month study period, 212 patients were included. The majority of patients were women (126; 59.4%), had a median body mass index above 30 kg/m2 (123; 58%), and had pulmonary hypertension (94; 44.3%), anemia (146; 68.8%), and arrhythmia (101, 47.6%). Forty-five (21.2%) patients were readmitted for HFpEF within 90 days of initial discharge; 32 of those (71.1%) were readmitted within 30 days of initial discharge. Patients with higher LACE and Charlson comorbidity index scores were more likely to be readmitted within 90 days. Peripheral vascular disease (P=.002), tricuspid regurgitation (P=.001), pulmonary hypertension (P=.049), and anemia (P=.029) were risk factors associated with readmissions. Use of ACEi/ARBs (P=.017) was associated with fewer readmissions. Conclusion Anemia, peripheral vascular disease, pulmonary hypertension, and valvular heart disease are not only postulated mechanisms of HFpEF, but also important risk factors for readmission. These study findings affirm the need for continued research of the pathophysiology and associated comorbidities of the HFpEF population to improve quality of life and lower healthcare costs.
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