DRUG UTILIZATION EVALUATION OF ANTIBIOTICS IN GENERAL MEDICINE DEPARTMENT OF A TERTIARY CARE HOSPITAL

Objective: Conventional need of broad spectrum antibiotics for multiple organ infections in hospital, ensue the problem of resistance. Most of the antibiotic utilization is empirical leading to their irrational prescriptions. Our present study aims in accessing the drug utilization evaluation of antibiotic usage in a tertiary care hospital which helps in accessing rationality that aid in monitoring the drug efficacy, cost constraints and other factors related to patient safety.Methods: A prospective study was conducted for a period of four months from September 2015 to December 2015 in the Medicine department of Viswabarathi Hospital, Kurnool and AP.Results: A total of 210 prescriptions were analyzed. Among the wide range of antibiotics, i.e., 479 antibiotics prescribed, beta-lactams were found in the maximum cases which accounts for more than half of the cases. Little more than half of the prescriptions i.e.51.90% was with two antibiotics, followed by three antibiotic prescriptions. 9.05% prescriptions were with 4-5 antibiotics.Conclusion: Judgmental use of antibiotics will reduce the burden of multi-drug resistance and thereby enabling better patient management and limiting the resultant morbidity and mortality.Keywords: Infections, Prescriptions, Rationality, Antibiotic

A Single Case Study on treatment of Ileocaecal Tuberculous Sinus with Kadali Kshara Varti

Abdominal tuberculosis (TB) is an uncommon affliction in adolescence. It is usually associated with pulmonary tuberculosis. The disease is caused by lymphohaematogenous spread after primary infection in the lung or ingestion of infected sputum and has a typically nonspecific presentation. The occurrence of ileocaecal TB is probably from the contiguous spread of an abdominal focus or mesenteric lymph node. Ileocaecal TB is a rare entity, with very few reported cases in the literature. We report here a case of abdominal TB that manifested in the infection of an abdominal wall resulting in sinus at inguinal region and there by highlighting the Ayurvedic management of abdominal sinus by the use of Kshara Varti. Kshara Varti is the chief modality in the treatment in the Ayurvedic science and has been explained in Nadivrana

Prevalence of sensory peripheral neuropathy in diabetic patients at diabetes care centre: a cross sectional study

Background: Diabetic neuropathy is a nerve damaging disorder associated with diabetes; result from micro vascular injury involving small blood vessels that supply to the nerve (vas nervorum) in addition to macro vascular condition that can culminate in diabetic neuropathy. By the year 2025 hundreds of people were estimated to become diabetic. The rates of prevalence of neuropathy increasing worldwide which is directly related to the nonmodifiable risks like age, duration of diabetes, obesity, alcoholism, gender.Methods: A cross sectional interventional study was conducted on diabetic patients. Questionnaire, instruments and demographic details were used to collect data from patients. The diabetic neuropathy is conformed in patients by using biothesiometric analysis, tuning fork, monofilament, NSS and NDS.Results: Total 331 subjects included in the study, 200 cases diagnosed with DPN according to biothesiometry and prevalence percentage was found to be 60.4% and incidence was found to be 8.76% respectively. A significant greater proportion of males reported neuropathy more than females. The association between the obesity and the DPN was (r2=0.7922) low positive correlation. High positive correlation was confirmed with NSS, NDS respectively.Conclusions: It was concluded that there is a higher prevalence (60.4%) and incidence (8.76%) of neuropathy among the diabetic subjects and it may go on increasing as the age progress

Sacrospinous colpopexy versus McCall’s culdoplasty during vaginal hysterectomy in stage 3 and 4 prolapse for prevention of vault prolapse

Background: Pelvic organ prolapse is a common condition seen in women due to weakening of support of pelvic organs. Different surgical procedures have been adopted for suspension of vaginal vault during vaginal hysterectomy to restore vault to near normal anatomic position as preventive measures for vault prolapse. The aim of study was to compare the efficacy of the McCall’s culdoplasty and sacrospinous ligament colpopexy in stage 3 and 4 prolapse (POP-Q).Methods: This prospective study comprised 100 women presenting with stage 3 and 4 prolapse (POP-Q). They were divided into two equal groups of 50 each. The patients were randomized to undergo McCall’s culdoplasty (Group A) or sacrospinous ligament fixation (Group B) with vaginal hysterectomy based on note contained in an envelope comparative analysis was done, and patients were evaluated for intra-operative difficulties and immediate (48 hours) post-operative complications using SPSS-version 23 for statistical analysis. The patients were followed up at one month and one year to evaluate symptomatically and objectively.Results: In group A, patients with 3-degree prolapse 1 woman had hemorrhage and 1 woman had bladder injury intraoperatively. Whereas in group B, 5 women had hemorrhage and 1 woman had rectal injury intraoperatively. All complications were dealt successfully. No other major intra- and post-operative complications occurred.Conclusions: Vaginal hysterectomy with sacrospinous colpopexy resulted in better outcomes after surgery. Hence, it was concluded that unilateral or bilateral SSLF may be added to vaginal hysterectomy in patients of stage 3 or 4 prolapse

Evaluation of Indole production and Tellurite reduction for speciation of Candida species and Trichosporon species

Background: Candidiasis is one of the commonest infections in man, along with Trichosporon infection. Conventional methods for identification are often delayed, which leads to delay in empirical therapy in these infections. Methods: We here describe two newer methods, i.e. Indole production and Tellurite reduction for identification of these two genera. Results: Both these tests, combined together, were equally good as compared to conventional identification techniques. Conclusion: Indole production and Tellurite reduction are useful tests to identify these common yeast pathogens in the laboratory

Enhancing the ultrafast third order nonlinear optical response by charge transfer in VSe2-reduced graphene oxide hybrid

Nonlinear optical phenomena play a critical role in understanding microscopic light-matter interactions and have far-reaching applications across various fields, such as biosensing, quantum information, optical switching, and all-optical data processing. Most of these applications require materials with high third-order absorptive and refractive optical nonlinearities. However, most materials show weak nonlinear optical responses due to their perturbative nature and often need to be improved for practical applications. Here, we demonstrate that the charge donor-acceptor hybrid of VSe2-reduced graphene oxide (rGO) hybrid exhibits enhanced ultrafast third-order absorptive and refractive nonlinearities compared to the pristine systems, at least by one order of magnitude. Through density functional theory and Bader charge analysis, we elucidate the strong electronic coupling in the VSe2-rGO hybrid, involving the transfer of electrons from VSe2 to rGO. Steady-state and time-resolved photoluminescence (PL) measurements confirm the electronic coupling and charge transfer. Furthermore, we fabricate an ultrafast optical limiter device with better performance parameters, such as an onset threshold of 2.5 mJ cm-2 and differential transmittance of 0.42

Housekeeping and other metabolic functions of the Plasmodium plastid

The malaria parasite carries a plastid called the apicoplast that has been the subject of intense study in the last 15 years. Having originated from red-algal plastids, the apicoplast has lost its ability to photosynthesize, but carries out other essential functions such as type-II fatty acid synthesis, biosynthesis of haem and isoprenoid synthesis; the DOXP pathway for isoprenoid synthesis has recently been demonstrated to be the only pathway critical for parasite survival in the erythrocytic stage. The apicoplast also has a functional Suf system for assembly of (Fe–S) complexes on target proteins. The organelle has a 35 kb, double-stranded DNA genome that encodes a set of RNAs and proteins, the latter being translated from organellar mRNA by an active translation machinery, a major component of which is encoded by the nucleus. This article reviews current knowledge of housekeeping functions of the Plasmodium apicoplast and its (Fe–S) assembly system and discusses these components as sites for drug intervention against malaria

In vitro cryopreservation of date palm caulogenic meristems

Cryopreservation is the technology of choice not only for plant genetic resource preservation but also for virus eradication and for the efficient management of large-scale micropropagation. In this chapter, we describe three cryopreservation protocols (standard vitrification, droplet vitrification, and encapsulation vitrification) for date palm highly proliferating meristems that are initiated from vitro-cultures using plant growth regulator-free MS medium. The positive impact of sucrose preculture and cold hardening treatments on survival rates is significant. Regeneration rates obtained with standard vitrification, encapsulation-vitrification, and droplet-vitrification protocols can reach 30, 40, and 70%, respectively. All regenerated plants from non-cryopreserved or cryopreserved explants don't show morphological variation by maintaining genetic integrity without adverse effect of cryogenic treatment. Cryopreservation of date palm vitro-cultures enables commercial tissue culture laboratories to move to large-scale propagation from cryopreserved cell lines producing true-to-type plants after clonal field-testing trials. When comparing the cost of cryostorage and in-field conservation of date palm cultivars, tissue cryopreservation is the most cost-effective. Moreover, many of the risks linked to field conservation like erosion due to climatic, edaphic, and phytopathologic constraints are circumvented. (Résumé d'auteur

Enhanced Efficacy of Aurora Kinase Inhibitors in G2/M Checkpoint Deficient TP53 Mutant Uterine Carcinomas Is Linked to the Summation of LKB1-AKT-p53 Interactions.

Uterine carcinoma (UC) is the most common gynecologic malignancy in the United States. TP53 mutant UCs cause a disproportionate number of deaths due to limited therapies for these tumors and the lack of mechanistic understanding of their fundamental vulnerabilities. Here we sought to understand the functional and therapeutic relevance of TP53 mutations in UC. We functionally profiled targetable TP53 dependent DNA damage repair and cell cycle control pathways in a panel of TP53 mutant UC cell lines and patient-derived organoids. There were no consistent defects in DNA damage repair pathways. Rather, most models demonstrated dependence on defective G2/M cell cycle checkpoints and subsequent upregulation of Aurora kinase-LKB1-p53-AKT signaling in the setting of baseline mitotic defects. This combination makes them sensitive to Aurora kinase inhibition. Resistant lines demonstrated an intact G2/M checkpoint, and combining Aurora kinase and WEE1 inhibitors, which then push these cells through mitosis with Aurora kinase inhibitor-induced spindle defects, led to apoptosis in these cases. Overall, this work presents Aurora kinase inhibitors alone or in combination with WEE1 inhibitors as relevant mechanism driven therapies for TP53 mutant UCs. Context specific functional assessment of the G2/M checkpoint may serve as a biomarker in identifying Aurora kinase inhibitor sensitive tumors