Prescription pattern of antiepileptic drugs in a tertiary care hospital

Background: Epilepsy is a chronic neurological disorder which affects about 0.5% to 1% of the population. The older antiepileptic drugs like carbamazepine and phenytoin are the mainstay of treatment of epilepsy. With the development of newer drugs for various type of epilepsy, the prescribing pattern for epilepsy has changed over the last decade. The objective of this study was to evaluate the prescription pattern of antiepileptic drugs in outpatient department of a tertiary care health care centre in Kerala and to assess how adherent they are to the available treatment guidelines of epilepsy.Methods: Data was collected from patients attending the outpatient department of Neurology in Government Medical College, Kozhikode for 2 months from January 2018 to February 2018. A total of 442 patients were enrolled in the study and data regarding the type of epilepsy, the antiepileptic drug prescribed, and the demographic profile were recorded and analysed.Results: Among the study participants, 237 were males (53.6%) and 205 females (46.2%). The study showed that among the 442 participants enrolled, the most common type of epilepsy was focal seizures (64.5%) and the most commonly prescribed drug was carbamazepine (28%), followed by levetiracetam (22%) and valproate (20%). Majority of the patients were treated with a single drug (79.2%).Conclusions: Newer drugs have been increasingly added to the list of antiepileptic drugs, but most of them serve as adjuvant to older ones and the important drugs used as monotherapy are still the older ones

Pollard RHO algorithm implemented to Discrete Log with Lucas sequences

The Diffie - Hellman problem may be used securely over the multiplicative group F*p, (Z/nZ)* and the group of rational points on an elliptic curve over a finite field. These groups involve large key sizes or expensive arithmetic operations. In the paper [17] paper we considered the group of Lucas sequences and described the generalization of discrete log problem with the group of Lucas sequences and adapted the baby-step giant-step algorithm to the generalization and for the computations we gave an algorithm to fast computing methods for lucas sequences based on the idea proposed by P.J.Smith. In this paper we consider the group of Lucas sequences and implement the pollard rho algorithm to the generalization of discrete log problem to the group of Lucas sequences. For the computations we implement with fast computing algorithm

Improved Hybrid Algorithm Approach based Load Balancing Technique in Cloud Computing

The routine life of modern citizens is completely dominated by the computer aided services The computer aided services depends on information and communication technologies The success behind this cloud computing are data centers with virtualization technology equipped with fastest internet and the wide acceptance of the users due to its affordable price to the common people Effective services can be provided to the end user only when proper scheduling of tasks are done in peak hours when heterogeneous collection of requests are coming to the data cente

Comparison of combination metformin-vildagliptin versus metformin-glimepiride in patients of type 2 diabetes mellitus with inadequately controlled metformin monotherapy

Background: Metformin has been recommended as a first-line therapy for T2DM in many guidelines. Adding a sulfonylurea to metformin has been a conventional and gold standard for decades to achieve tight glycaemic control. dipeptidyl peptidase-4 (DPP-4) inhibitors, an incretin-based therapy has emerged as important adjunctive drugs in T2DM. Therefore, the present study was planned to evaluate and compare the efficacy and safety of combination metformin-vildagliptin and metformin-glimepiride in patients of T2DM inadequately controlled with metformin monotherapy.Methods: A total 45 patients were allocated to each metformin-vildagliptin group and metformin-glimepiride group. Fasting plasma glucose, post prandial plasma glucose, body weight, adverse events were recorded at 0 week, 6 weeks, and 12 weeks. Glycosylated haemoglobin was recorded at 0 week and 12 weeks.Results: There was no statistically significant difference between the two groups (p>0.05) at the end of 12 weeks in the mean percentage reduction in FPG, PPPG and HbA1c.There was statistically highly significant (p0.05).Conclusions: In patients of T2DM with inadequately controlled metformin monotherapy, combination metformin-vildagliptin provides comparable efficacy in terms of FPG, PPPG and HbA1c to that of combination metformin-glimepiride with no risk of weight gain reduction in risk of hypoglycemic events

Plant regeneration from leaf-derived callus in Plectranthus barbatus Andr. [Syn.: Coleus forskohlii (Wild.) Briq.]

A protocol was developed for Plectranthus barbatus for high frequency shoot organogenesis from leaf derived callus of aseptically grown plantlets derived from mature plant explants of high yielding clones (yield of forskolin 1.5 to 1.9%) on Gamborg medium (B5) medium supplemented with 2 mg/l 2,4- dichloro phenoxy acetic acid (2,4-D). Shoots were regenerated from the callus on MS medium supplemented with 6-benzyl amino purine (BAP) (2 mg/l) + naphthalene acetic acid (NAA) (1 mg/l). The highest rate of shoot multiplication was achieved at the 6th subculture and more than 2000 shoots were produced from callus clump. Roots were induced from shoots of in vitro grown plantlets on basal half strength MS medium and high rooting frequencies were obtained. Regenerated plants were easily acclimatized in greenhouse conditions and later transferred to soil with 100% survival. The procedure here allows the micropropagation of P. barbatus in five months of culture and proliferated cell masses which could be used for studies of organic compounds of pharmaceutical interest.Keywords: Callus culture, medicinal plant, root induction, shoot organogenesisAfrican Journal of Biotechnology Vol. 12(18), pp. 2441-244

Exclusion of Wormhole and Blackhole Attacks in Manets using Fuzzy Lamport Timestamp Algorithm

Security for any network is a primary concern as it is necessary to safeguard the resources that are being shared. A mobile ad-hoc network (MANET) enables the mobile devices to form a temporary network without any centralized infrastructure. MANET is vulnerable to several attacks, e.g. wormhole and blackhole attacks. Since there is increase in use of wireless communication, minimizing the intruders in wireless networks has been a high priority task. These attacks affect directly the performance of network. Eliminating such attacks in MANET is a challenging task. In this paper, a novel method that excludes the packets of wormhole and blackhole attacks in a MANET using fuzzy Lamport timestamp algorithm (FLTA) is proposed. The proposed FLTA is used to identify the order of event and to make synchronization of time clock in network device. The Lamport timestamp algorithm incorporates a fuzzy inference system to improve the performance of network. The simulated results of the proposed algorithm are compared with that of LTAWB [13] and SMTWB [12] for wormhole and blackhole attacks. It is observed that the proposed FLTA shows better performance as compared to LTAWB and SMTWB protocols in terms of throughput, end-to-end delay and packet delivery ratio

Detailed Visual Cortical Responses Generated by Retinal Sheet Transplants in Rats with Severe Retinal Degeneration.

To combat retinal degeneration, healthy fetal retinal sheets have been successfully transplanted into both rodent models and humans, with synaptic connectivity between transplant and degenerated host retina having been confirmed. In rodent studies, transplants have been shown to restore responses to flashes of light in a region of the superior colliculus corresponding to the location of the transplant in the host retina. To determine the quality and detail of visual information provided by the transplant, visual responsivity was studied here at the level of visual cortex where higher visual perception is processed. For our model, we used the transgenic Rho-S334ter line-3 rat (both sexes), which loses photoreceptors at an early age and is effectively blind at postnatal day 30. These rats received fetal retinal sheet transplants in one eye between 24 and 40 d of age. Three to 10 months following surgery, visually responsive neurons were found in regions of primary visual cortex matching the transplanted region of the retina that were as highly selective as normal rat to stimulus orientation, size, contrast, and spatial and temporal frequencies. Conversely, we found that selective response properties were largely absent in nontransplanted line-3 rats. Our data show that fetal retinal sheet transplants can result in remarkably normal visual function in visual cortex of rats with a degenerated host retina and represents a critical step toward developing an effective remedy for the visually impaired human population.SIGNIFICANCE STATEMENT Age-related macular degeneration and retinitis pigmentosa lead to profound vision loss in millions of people worldwide. Many patients lose both retinal pigment epithelium and photoreceptors. Hence, there is a great demand for the development of efficient techniques that allow for long-term vision restoration. In this study, we transplanted dissected fetal retinal sheets, which can differentiate into photoreceptors and integrate with the host retina of rats with severe retinal degeneration. Remarkably, we show that transplants generated visual responses in cortex similar in quality to normal rats. Furthermore, transplants preserved connectivity within visual cortex and the retinal relay from the lateral geniculate nucleus to visual cortex, supporting their potential application in curing vision loss associated with retinal degeneration

A study of feto-maternal outcome in cases of pre-labour rupture of membranes

Background: Prelabour rupture of membranes is a common obstetric problem and the assessment of women with possible membrane rupture is a management issue faced in every day practice. The diagnosis and treatment of Prelabour rupture of membranes depends upon the facilities available. Unrecognized and inadequately treated conditions can lead to various maternal and neonatal complications.Methods: The present prospective study was conducted on 200 pregnant women satisfying the inclusion criteria after getting consent for participation. Pregnant women between the gestational age of 28 – 40 weeks who presented with Prelabour rupture of membranes to casualty were enrolled into the study.Results: 76.5% of the study participants were between 37-40 weeks of gestation and the remaining 23.5% belonged to the preterm population. Maternal morbidity was found to be 68% among the study participants with latency period more than 24 hrs. 37.5% of the neonates developed morbidity and the neonatal mortality was 2%.Conclusions: Prelabour rupture of membranes contributes significantly to maternal morbidity, neonatal morbidity and perinatal mortality

Study on the effectiveness of orientation class about rational prescription on interns

Background: Prescribing is one aspect of patient care where it is possible to do considerable harm if not done judiciously. The first experience of unsupervised prescribing begins during the internship year. Junior doctors are the most frequent prescribers in the hospital setting and are reported to make most of the prescribing errors. The Objective of the study was to study on the effectiveness of orientation class about rational prescription on interns.Methods: Sample size was 100 students attending orientation course at the beginning of intern ship. This study was done in Government Medical College Kozhikode, after getting ethics Committee approval. Total of 100 interns were included in the study. Pre-test was conducted to assess the prescribing skills by giving one case scenario, followed by a class on rational prescription writing. 14 questionnaires are made and prescription quality is assessed. Post-test was given after 2 weeks where the same previous case scenario repeated.Results: This study shows that orientation class about rational prescription during the beginning of internship improves the quality of prescription writing. Among the 14 parameters made for assessment of quality of prescription thirteen shows significant P value. So it is very effective to take orientation class about rational prescription during the internship period.Conclusions: It is very effective to take orientation class about rational prescription and periodic updating during the internship period improves the quality of prescription. As they learn the basics of prescription writing during their third semester only. Thus we can reduce the prescribing errors