A prospective pharmacovigilance study to evaluate adverse effect profile of first line anti-tubercular drugs in newly diagnosed sputum positive patients

Background: Tuberculosis (TB) continues to remain one of the most pressing health problems in India with highest TB burden country in the world. Anti-tubercular therapy (ATT) induced organ toxicities are potentially serious ADRs of first line ATT regimen. The underlying mechanism of ATT-induced ADRs especially hepatotoxicity and the factors predisposing to its incidence which is significantly high in Indians are not clearly understood. It's vital to emphasize on ATT induced ADRs as it has direct influence on therapeutic outcome; result in high dropout rate and potential to develop MDR/XDR cases. ADR monitoring help us to revise the treatment protocol thereby improve treatment adherence and therapeutic outcome. Objective of this study is therefore designed to explore and monitor ADRs of first line anti-TB drugs.Methods: In this prospective observational study 60 TB patients (18-70 yrs) of either sex, newly sputum positive with normal parameters were included. Patients were followed up for six months aiming primarily to assess rate of ADRs and to identify preventable and potentially serious ADRs of anti-TB drugs. The ADRs of ATT on various organ systems (heart, kidney and liver), biochemical and haematological parameters were assessed and compared after 2 and 6 months; gender and age specific adverse events were also studied. Data obtained was analysed using student’s t-test of OpenEpi statistical software.Results: Study clearly revealed that ATT exhibit significant increase in toxicity markers viz. liver enzymes (p<0.01), urea and creatinine (p<0.01), ESR (p<0.05) and PTINR (p<0.01), wherein decrease in Hb% (p<0.01) when compared to baseline.Conclusions: ATT related ADRs is the major cause of dropouts and development of MDR/XDR cases. It's crucial to develop strategies to ameliorate ADRs both to improve the quality of patient care and to control TB safely. The data obtained from present study may be helpful in developing these effective strategies

Role of Color Doppler in predicting perinatal outcome in preeclampsia

Background: Preeclampsia is one of the most common complications of pregnancy, which increases both fetal and maternal mortality and morbidity. Since preeclampsia is characterized by abnormal placenta formation leading to inadequate uteroplacental blood flow, Doppler ultrasonography can prove to be a useful tool to assess fetal outcome in PIH patients. Through this study, we sought to determine the perinatal outcome on the basis of Doppler changes seen in Umbilical and Middle Cerebral artery.Methods: This was a prospective study conducted from September 2014 to August 2017 in a tertiary care hospital where 150 singleton pregnant patients with preeclampsia were examined with Doppler ultrasound of the Umbilical artery and Middle cerebral Artery. Serial Doppler examination was performed and the results of the last Doppler examination within 10 days of delivery was considered. Perinatal outcome was studied in the form of perinatal death, mean APGAR at 1 and 5 minutes, birth weight and admission to Neonatal Intensive Care Unit (NICU).Results: Abnormal Doppler velocimetry of the umbilical artery (increased resistance, AEDV, REDV) were significantly associated with poor perinatal outcome in the form of low birth weight, APGAR of ≤7 at five minutes of birth and NICU admission. However, S/D ratio of the Middle cerebral artery could not positively predict poor perinatal outcome in this study.Conclusions: Doppler technology has provided the best opportunity for repetitive non-invasive hemodynamic monitoring in human pregnancy. Umbilical artery Doppler findings are slight better predictor of adverse perinatal outcome than an abnormal MCA

Entanglement transitions in random definite particle states

Entanglement within qubits are studied for the subspace of definite particle states or definite number of up spins. A transition from an algebraic decay of entanglement within two qubits with the total number $N$ of qubits, to an exponential one when the number of particles is increased from two to three is studied in detail. In particular the probability that the concurrence is non-zero is calculated using statistical methods and shown to agree with numerical simulations. Further entanglement within a block of $m$ qubits is studied using the log-negativity measure which indicates that a transition from algebraic to exponential decay occurs when the number of particles exceeds $m$. Several algebraic exponents for the decay of the log-negativity are analytically calculated. The transition is shown to be possibly connected with the changes in the density of states of the reduced density matrix, which has a divergence at the zero eigenvalue when the entanglement decays algebraically.Comment: Substantially added content (now 24 pages, 5 figures) with a discussion of the possible mechanism for the transition. One additional author in this version that is accepted for publication in Phys. Rev.

A rare case report of ovarian torsion with sigmoid volvulus

Ovarian torsion results from twisting of the ovary about the suspensory ligament, which contains the ovarian artery and vein, lymphatic’s, and nerves. Volvulus is a torsion of a segment of the alimentary tract, that often leads to intestinal obstruction. Ovarian torsion leading to sigmoid volvulus is the rarest complication which authors found in this case. Hence the case was presented. A 28-year-old women presented with acute pain in abdomen since 14 hours, followed by 2 episodes of vomiting, abdominal distension since 10 hours. Plain X-ray Abdomen erect was done which showed ‘Coffee bean’ sign with multiple air fluid levels suggestive of sigmoid volvulus. On laparotomy, after opening the peritoneum, large right ovarian cyst around 12×11×10 cm with solid and haemorrhagic content with long pedicle around 8 cm with 3 turns of torsion was noted. Abutting the ovarian mass, sigmoid colon was seen twisted around its mesentery including the twisted ovarian pedicle. Hence, the twisted component included the twisted ovarian pedicle and twisted sigmoid mesentery. Stepwise detorsion of ovarian pedicle followed by oophorectomy was done. For sigmoid volvulus, resection of vascular compromised sigmoid colon and descending colon stoma was done. Reanastomosis was done later after 3 months post operatively

Extractive Spectrophotometric Determination of Omeprazole in Pharmaceutical Preparations

Purpose: To develop a simple, rapid and selective method for the extractive spectrophotometric determination of omeprazole using acidic dyes. Methods: Extractive spectrophotometric determination of omeprazole was developed using acidic dyes - bromophenol blue and orange G - as ion-pairing agents in aqueous medium (pH 7.0 and 6.0, respectively). The ion pair chromogen formed, which was extracted with chloroform, was measured quantitatively at 408 nm and 508 nm, respectively. The developed method was used to analyse commercial omeprazole tablets.Results: Using bromophenol blue and orange G dyes, the ion-paired formed obeyed Beer’s law in the ranges 5 - 30 μg/ml and 50 - 250 μg/ml at 408nm and 503nm, respectively, with molar absorptivities of1.712 × 103 L mol-1 cm-1 and 2.095 × 103 L mol-1 cm-1, respectively, for omeprazole,. The purity of omeprazole obtained was 98.1±0.9 and 99.7±0.3, respectively. Standard deviation (S.D.), % relativestandard deviation (% R.S.D.) and standard error were 0.001 - 0.013, 0.94 - 1.07 % and 4 × 10-4, respectively. The complexes formed were stable for approx. 3 h. Conclusion: Recovery studies gave satisfactory results indicating that none of the major additives/excipients interferred with the assay method. Therefore, a simple, rapid and selective methodwas developed for extractive spectrophotometric determination of omeprazole. This method may be useful for routine laboratory analysis of omeprazole

Review of Supercapacitive Performance of Metal Oxide Thin Film Synthesized by Chemical Route

Objective of this paper is synthesis of metal-oxide supported on conducting substrate by electrochemical deposition. According to this study analysis of metal oxide thin film were done for physico-chemical properties like pH, current density, specific capacitance Vs voltage, surface area, cycle stability and coulombic efficiency. In order to get efficient metal-oxide thin film for various metal-oxide. Finally, higher energy density materials with better stability in an actual operating condition can be obtained by chemical route

Review of Metal Oxide Thin Film Based Supercapacitors

Metal oxide thin films based supercapacitors known for several decades and are those used as for storing the potential energy.Presently research had done on energy storage methods namely redox electrochemical capacitors, the electrochemical double layer capacitor,metal oxides and conducting polymers. Recently, many chemically deposited metal oxide thin film electrodes including MnO2, Co3O4, NiO, Fe3O4 etc. have been tested in supercapacitors. From this review data of metal oxide thin films proposed to play a major role in supercapacitor technolog

Plasmodium falciparum epigenome:A distinct dynamic epigenetic regulation of gene expression

Histone modification profiles are predictive of gene expression and most of the knowledge gained is acquired through studies done in higher eukaryotes. However, genome-wide studies involving Plasmodium falciparum, the causative agent of malaria, have been rather few, at lower resolution (mostly using ChIP-on-chip), and covering limited number of histone modifications. In our recent study [1], we have performed extensive genome-wide analyses of multiple histone modifications including the active (H3K4me2, H3K4me3, H3K9ac, H3K14ac, H3K27ac and H4ac), inactive (H3K9me3 and H3K27me3), elongation (H3K79me3) and regulatory element (H3K4me1) in a stage-specific manner. Furthermore, we used a ligation-based method suitable for sequencing homopolymeric stretches as seen in P. falciparum for next-generation sequencing library amplification [2], enabling highly quantitative analysis of the extremely AT-rich P. falciparum genome. Our recently published study suggests that transcription regulation by virtue of poised chromatin and differential histone modifications is unique to P. falciparum [1]. Here we describe the experiments, quality controls and chromatin immunoprecipitation-sequencing data analysis of our associated study published in Epigenetics and Chromatin [1]. Stage-specific ChIP-sequencing data for histone modifications is submitted to Gene Expression Omnibus (GEO) database under the accession number GSE63369.</p

An interesting case report of ruptured pyogenic liver abscess with 40 weeks gestation in labour

Pyogenic liver abscess during pregnancy is an extremely rare condition. Although rare, in situations of sepsis or septic shock in pregnancy, as well as the common sources of infection, a possibility of a liver abscess should be considered. We present a case report of 32-year-old primigravida 37.3 weeks by date, 37 weeks by scan with breech presentation with premature rupture of membranes and pain in abdomen since 12 hours with breathlessness, fever and diarrhoea since 2 days came in emergency to study hospital. General condition of the patient on arrival was pulse-140 beats per minute, blood pressure was 90/60 mmHg, respiratory rate was 40/min, on per abdominal examination, breech presentation with fetal heart rate of 150 beats per minute on doppler was noted. Per vaginal examination revealed cervical os 5 cm dilated, 40% effacement, breech presentation, absent membranes. With urgent report of complete hemogram and acid blood gas analysis, metabolic acidosis was noted which was corrected and patient was taken for emergency lower segment caesarean section. Intra-operative, 250 ml greenish pus flakes fluid was noted inside the abdominal cavity. Fluid was drained and sent for culture sensitivity with maximum aseptic precautions, uterus was opened, baby was delivered followed by uterus closure. Ruptured liver abscess 6×4×2 cm in 2nd and 3rd segment of liver was noted, abdominal wash with antibiotics and NS was given, drain was kept. Appropriate antibiotics were started and was discharged on day 14 after suture removal

Evaluation of Diuretic Activity of Aqueous and Methanol Extracts of Lepidium sativum Garden Cress (Cruciferae) in Rats

Purpose: The present study was undertaken to investigate diuretic effect of aqueous and methanol extracts of the dried seeds of Lepidium sativum in normal rats.Method: Aqueous and methanol extracts of L. sativum seeds were administered to experimental rats orally at doses of 50 and 100 mg/kg p.o. Hydrochlorothiazide (10 mg/kg) was used as positive control instudy. The diuretic effect of the extracts was evaluated by measuring urine volume, sodium and potassium content, conductivity and pH.Result: Urine volume was significantly increased by the two doses of aqueous and methanol extracts in comparison to control group. While the excretion of sodium was also increased by both extracts, potassium excretion was only increased by the aqueous extract at a dose of 100 mg/kg. There was no significant change in the conductivity and pH of urine after administration of the L. sativum extracts. The diuretic effect of the extracts was comparable to that of the reference standard (hydrochlorothiazide) and the methanol had the additional advantage of a potassium-conserving effect.Conclusion: We can conclude that aqueous and methanol extracts of L. sativum produced notable diuretic effect which appeared to be comparable to that produced by the reference diuretic HCTZ. The present study provides a quantitative basis for explaining the folkloric use of L. sativum as a diuretic agent in Moroccan population