Drug utilization study and prescribing patterns in psychiatry patients at a tertiary care hospital

Background: The Drug utilization research (DUR) compares drug use between different countries and regions and is used to assess the rationality of prescribing pattern of the drug therapy. With this background we decided to evaluate antipsychotic drugs prescribing pattern in the psychiatric patients in a tertiary care hospital.Methods: The study was carried out at Department of Psychiatry, DSMCH. It was open label, cross - sectional, prescribed Documents based study. Duration of the study was one month (May-2017). Out-Patient number, age, sex, diagnosis, prescribed generic name, brand name, dose, route of administration, duration of therapy obtained from the Prescription register of Out - Patient Department of the Psychiatry.Results: The clinical experiences of the Psychiatrist I, II and III were 17 years, 35 years and 10 years respectively. The Psychiatrist I, II and III prescribed treatment for 36 (31.9%), 61 (54%) and 16 (14.2%) patients respectively. Among overall (n=113) patients (average age 38.9 years), male n=56 (49.6%) and female=57 (50.4%) were treated by all the three psychiatrists. The percentage of prescription of various drugs used were: Escitalopram (15.7%), Clonazepam (14.6%), Sertraline (8.7%), Risperidone (7.5%), Propranolol (6.7%), Olanzapine (6.3%), Quetiapine (5.9%), Trihexyphenidyl (5.5%), Amitriptyline (5.1%) and Other prescribed drugs, were between (0.4 to 2.8%).Conclusions: From this study, it can conclude that rational usage of drugs were followed in this study. All three prescribers (Psychiatrist I, II, and III) prescriptions were found to be rationale

Are web corpora inferior? The Case of Czech and Slovak

Our paper describes an experiment aimed to assessment of lexical coverage in web corpora in comparison with the traditional ones for two closely related Slavic languages from the lexicographers’ perspective. The preliminary results show that web corpora should not be considered ― inferior, but rather ― different

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

<p>Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.</p> <p>Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate <60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.</p> <p>Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.</p&gt

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Partial purification and characterization of polygalacturonase-inhibitor proteins from pearl millet

Polygalacturonase-inhibitor proteins (PGIPs) are plant cell wall glycoproteins, involved in the inhibition of microbial endo-polygalacturonases (EPGs). The present study involved activity guided partial purification of pearl millet [Pennisetum glaucum (L.) R.Br.] protein extract by cation exchange chromatography, which resulted in two pooled protein peaks -Peak-A and Peak-B, both of which showed inhibitory activity against the Aspergillus niger EPG. Protein separation of the two peaks by gel electrophoresis showed prominent bands between 29 and 43 kDa, consistent with the molecular weights of the known plant PGIPs. The two PGIP peaks were further studied for their inhibitory activities with respect to three parameters viz., inhibitor concentration, pH and temperature effects. Enzyme inhibition was partial and increased with inhibitor concentration. The Peak-B was found to be the more active inhibitor of the two. The results indicate the presence of at least two isoforms of PGIP in pearl millet. This is the first such study to be undertaken in understanding the presence of the PGIPs in millets

Microprocessor based direct read out system for Aanderaa currentmeter

43-45Before deployment and subsequent retrieval of currentmeters, it is essential to check all the sensor parameters getting recorded on the magnetic spool. This paper outlines a scheme, developed at NIO, for online reading of the sensor parameters separately on the LED. The binary coded electrical signal available at the top end plate of the currentmeter is tapped and after suitable inversion, is fed to the system designed around a commercially available microprocessor board. The system sequentially displays N-value of the 6 sensor parameters including the reference number of the currentmeter during the measuring cycle. This system is routinely used for checking and calibrating the currentmeters in NIO and onboard vessels. In conjunction with hydrophone transducer, it can be used for real time monitoring of data recorded in the moored currentmeter

Generation of composite Persea americana (Mill.) (avocado) plants: A proof-of-concept-study.

Avocado (Persea americana (Mill.)), an important commercial fruit, is severely affected by Phytophthora Root Rot in areas where the pathogen is prevalent. However, advances in molecular research are hindered by the lack of a high-throughput transient transformation system in this non-model plant. In this study, a proof-of-concept is demonstrated by the successful application of Agrobacterium rhizogenes-mediated plant transformation to produce composite avocado plants. Two ex vitro strategies were assessed on two avocado genotypes (Itzamna and A0.74): In the first approach, 8-week-old etiolated seedlings were scarred with a sterile hacksaw blade at the base of the shoot, and in the second, inch-long incisions were made at the base of the shoot (20-week-old non-etiolated plants) with a sterile blade to remove the cortical tissue. The scarred/wounded shoot surfaces were treated with A. rhizogenes strains (K599 or ARqua1) transformed with or without binary plant transformation vectors pRedRootII (DsRed1 marker), pBYR2e1-GFP (GFP- green fluorescence protein marker) or pBINUbiGUSint (GUS- beta-glucuronidase marker) with and without rooting hormone (Dip 'N' Grow) application. The treated shoot regions were air-layered with sterile moist cocopeat to induce root formation. Results showed that hormone application significantly increased root induction, while Agrobacterium-only treatments resulted in very few roots. Combination treatments of hormone+Agrobacterium (-/+ plasmids) showed no significant difference. Only the ARqua1(+plasmid):A0.74 combination resulted in root transformants, with hormone+ARqua1(+pBINUbiGUSint) being the most effective treatment with ~17 and 25% composite plants resulting from strategy-1 and strategy-2, respectively. GUS- and GFP-expressing roots accounted for less than 4 and ~11%, respectively, of the total roots/treatment/avocado genotype. The average number of transgenic roots on the composite plants was less than one per plant in all treatments. PCR and Southern analysis further confirmed the transgenic nature of the roots expressing the screenable marker genes. Transgenic roots showed hyper-branching compared to the wild-type roots but this had no impact on Phytophthora cinnamomi infection. There was no difference in pathogen load 7-days-post inoculation between transformed and control roots. Strategy-2 involving A0.74:ARqua1 combination was the best ex vitro approach in producing composite avocado plants. The approach followed in this proof-of-concept study needs further optimisation involving multiple avocado genotypes and A. rhizogenes strains to achieve enhanced root transformation efficiencies, which would then serve as an effective high-throughput tool in the functional screening of host and pathogen genes to improve our understanding of the avocado-P. cinnamomi interaction

Polygalacturonase-inhibitor proteins in pearl millet: possible involvement in resistance against downy mildew

Polygalacturonase-inhibitor protein (PGIP) is a defense protein found in plant cell walls. It prevents the degradation of pectin by modulating the endo-polygalacturonase activity. The present study has used heterologous anti-bean PGIP probes to investigate the role of PGIP in pearl millet Pennisetum glaucum (L) R. Br. resistance against downy mildew caused by oomycete pathogen Sclerospora graminicola (Sacc.) Schroet. Northern blot analysis using bean pgip2 DNA fragment as probe showed an early and marked induction of transcripts (∼1.2 kb) upon pathogen-inoculation in pearl millet cultivar resistant to downy mildew, with the maximum level observed at 24 and 48 h post-inoculation (h.p.i.). Western blot analysis of pearl millet total cell wall proteins using antibodies against bean PGIP showed the presence of a major band of ∼43 kDa, and several minor ones. The protein accumulation was higher in resistant seedlings than in susceptible seedlings with a differential expression observed only in the case of incompatible interaction. Immunocytochemical localization in epidermal peelings of coleoptiles and tissue-printing showed a similar trend in the PGIP accumulation. PGIP was found to localize in the epidermal as well as in the vascular regions of tissues. Higher accumulation was observed in the stomatal guard cells of resistant cultivar inoculated with the pathogen. PGIP activity of pearl millet total protein extracts when assayed against Aspergillus niger PG displayed differential PG inhibitory activities between the resistant and suceptible cultivars with resistant sample showing the highest inhibition of 16\\%, post-pathogen treatment. Thus, PGIP appeared to be an important player in pearl millet–S. graminicola interaction leading to host resistance