STUDY ON DRUG UTILIZATION PATTERN OF CHRONIC RENAL FAILURE PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: Chronic Renal Failure is a worldwide public health problem with an increasing incidence and prevalence, poor outcomes and high cost of treatment due to co-morbidities and Polypharmacy. The aim of this study was to describe drug utilization pattern of patients with chronic renal failure in a tertiary care hospital.Methods: The study was conducted between July -2013 to December-2013. In total 150 patients were identified and 135 patients were recruited for further study. Study subject medical record and prescription was reviewed on their regular hospital visit. Those were missed the followup, their medical records and prescription were reviewed from the medical record departmentResults: In this study, male subjects (62.85 %) predominated; 37.05% of the patients were in the age group of 51 to 60 years. The mean age of subjects was 53.26 ±15.69 years. The average number of drugs prescribed per prescription was 5.26 ± 3.79.Conclusion: The prevalence of Polypharmacy was high in patients with CRF. Diuretics, anti hypertensive and anti diabetic drugs were used more frequently in chronic renal failure patients. Moreover time to time studies are required to improve management strategy and quality of life of patients.Â

Two patients with an anti-N-methyl-D-aspartate receptor antibody syndrome-like presentation and negative results of testing for autoantibodies. Pediatr Neurol

abstract We describe two boys whose distinct and remarkable clinical pictures suggested the possibility of anti-Nmethyl-D-aspartate receptor antibody encephalitis. Both patients responded to immunotherapy, but neither manifested that antibody. Patient 1 exhibited florid encephalopathy with psychotic manifestations including inappropriate affect, intermittent delirium, visual hallucinations, severe anorexia, agitation, paranoid ideation, and abnormal electroencephalogram results. He responded to intravenous immunoglobulin, with steady improvement over 3 months to almost complete remission for 1 year, followed by a relapse that again responded, more quickly, to intravenous immunoglobulin. A second relapse occurred 1 month later, and again responded to intravenous immunoglobulin. Patient 2 exhibited progressive, severely debilitating limb dystonia that worsened over 1.5 years, with milder psychiatric symptoms including mood instability, aggressiveness, impulsivity, and depression. When he developed thymic hyperplasia 1.5 years into his illness, he underwent a thymectomy, and improved significantly on a regimen of plasmapheresis and intravenous immunoglobulin. Patients presenting with symptoms suggestive of autoimmune encephalitis, but without antibodies, may still respond to immunotherapy

Altered Development of the Dorsolateral Prefrontal Cortex in Chromosome 22q11.2 Deletion Syndrome: An In Vivo Proton Spectroscopy Study

Chromosome 22q11.2 deletion syndrome (22q11DS), the most common microdeletion in humans, is associated with multiple medical features, almost universal cognitive deficits, and a high-risk of schizophrenia. The metabolic basis of the psychological/psychiatric features is not well understood. Volumetric brain imaging studies have shown that gray matter abnormalities in the dorsolateral prefrontal cortex (DLPFC), an area that is believed to be integral for higher neurocognition, as well as being involved in schizophrenia, are associated with the psychological manifestations. However, studies have not characterized any possible metabolite alterations within the DLPFC of children with 22q11DS and their correlations with the psychological findings

The care of patients with Duchenne, Becker and other muscular dystrophies in the COVID-19 pandemic

The corona virus disease 2019 (COVID-19) pandemic has resulted in the reorganization of healthcare settings affecting clinical care delivery to patients with Duchenne and Becker muscular dystrophy (DBMD) as well as other inherited muscular dystrophies. The magnitude of the impact of this public health emergency on the care of patients with DBMD is unclear as they are suspected of having an increased risk for severe manifestations of COVID-19. In this paper, the authors discuss their consensus recommendations pertaining to care of these patients during the pandemic. We address issues surrounding corticosteroid and exon skipping treatments, cardiac medications, hydroxychloroquine use, emergency/respiratory care, rehabilitation management, and the conduct of clinical trials. We highlight the importance of collaborative treatment decisions between the patient, family, and health care provider, considering any geographic or institution-specific policies and precautions for COVID-19. We advocate for continuing multidisciplinary care for these patients using telehealth

Spinal muscular atrophy care in the COVID-19 pandemic era

peer reviewedThe Corona Virus Disease 2019 (COVID-19) pandemic has resulted in reorganization of healthcare settings affecting the delivery of clinical care to patients with spinal muscular atrophy (SMA). There is a concern that patients with SMA may be at increased risk of manifesting severe symptoms of COVID-19. Currently approved therapies for SMA improve survival and motor function, however, their delivery requires an increased exposure to the health system and a dedicated healthcare team. In this paper, we discuss consensus recommendations pertaining to care of SMA patients during the pandemic. We highlight that SMA treatments should not be perceived as elective. Decisions regarding the delay of treatments should be made with consideration of the potential risks of COVID-19 exposure and the risk of that delay. We emphasize the importance of collaborative treatment decisions between the patient, family, and health care provider, considering any geographic or institution-specific policies and precautions for COVID-19. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved

Molecular Dysregulation in Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) comprises a heterogeneous group of neurodevelopmental disorders with a strong heritable genetic component. At present, ASD is diagnosed solely by behavioral criteria. Advances in genomic analysis have contributed to numerous candidate genes for the risk of ASD, where rare mutations and s common variants contribute to its susceptibility. Moreover, studies show rare de novo variants, copy number variation and single nucleotide polymorphisms (SNPs) also impact neurodevelopment signaling. Exploration of rare and common variants involved in common dysregulated pathways can provide new diagnostic and therapeutic strategies for ASD. Contributions of current innovative molecular strategies to understand etiology of ASD will be explored which are focused on whole exome sequencing (WES), whole genome sequencing (WGS), microRNA, long non-coding RNAs and CRISPR/Cas9 models. Some promising areas of pharmacogenomic and endophenotype directed therapies as novel personalized treatment and prevention will be discussed

Ceramic processing and multiferroic properties of the perovskite YMnO3-BiFeO3 binary system

International audienceThe perovskite (1-x)YMnO3-xBiFeO(3) binary system is very promising because of its multiferroic end members. Nanocrystalline phases have been recently obtained by mechanosynthesis across the system, and the perovskite structural evolution has been described. Two continuous solid solutions with orthorhombic Pnma and rhombohedral R3c symmetries were found, which coexist within a broad compositional interval of 0.5 <= x <= 0.9. This might be a polar-nonpolar morphotropic phase boundary region, at which strong phase-change magnetoelectric responses can be expected. A major issue is phase decomposition at moderate temperatures that highly complicates ceramic processing. This is required for carrying out a sound electrical characterization and also for their use in devices. We present here the application of Spark Plasma Sintering to the ceramic processing of YMnO3-BiFeO3 phases. This advanced technique, when combined with nanocrystalline powders, allowed densifying phases at reduced processing temperatures and times, so that perovskite decomposition was avoided. Electrical measurements were accomplished, and the response was shown to be mostly dominated by conduction. Nonetheless, the intrinsic dielectric permittivity was obtained, and a distinctive enhancement in the phase coexistence region was revealed. Besides, Rayleigh-type behavior characteristic of ferroelectrics was also demonstrated for all rhombohedral phases. Magnetic characterization was performed in this region, and antiferromagnetism was shown

A Case of Brown-Vialetto-Van Laere Syndrome Due To a Novel Mutation in Gene

Brown-Vialetto-Van Laere syndrome is a rare disorder characterized by motor, sensory, and cranial neuronopathies, associated with mutations in SLC52A2 and SLC52A3 genes that code for human riboflavin transporters RFVT2 and RFVT3, respectively. The authors describe the clinical course of a 6-year-old girl with Brown-Vialetto-Van Laere syndrome and a novel homozygous mutation c.1156T>C in the SLC52A3 gene, who presented at the age of 2.5 years with progressive brain stem dysfunction including ptosis, facial weakness, hearing loss, dysphagia, anarthria with bilateral vocal cord paralysis, and ataxic gait. She subsequently developed respiratory failure requiring tracheostomy and worsening dysphagia necessitating a gastrostomy. Following riboflavin supplementation, resolution of facial diplegia and ataxia, improvements in ptosis, and bulbar function including vocalization and respiration were noted. However, her sensorineural hearing loss remained unchanged. Similar to other cases of Brown-Vialetto-Van Laere syndrome, our patient responded favorably to early riboflavin supplementation with significant but not complete neurologic recovery