A cross-sectional study to assess the adverse effect profile of second generation antipsychotics: risperidone, olanzapine and quetiapine

Background: Pharmacovigilance is the scientific approach to a drug related problem.  Psychotropic drugs are known to cause several adverse drug reactions (ADRs).  This study aimed to assess the adverse effect profile of 3 second generation antipsychotics-risperidone, olanzapine and quetiapine in patients on monotherapy of any of these second generation antipsychotics.Methods: This was a hospital based cross-sectional study conducted in psychiatric outpatient department of Psychiatry in Father Muller Mental Health Centre, Mangalore. The study sample consisted of patients suffering from schizophrenia and other psychotic disorders according to ICD 10 criteria (F20- F29) and who were maintaining remission  on any one of the second generation antipsychotics viz risperidone, olanzapine or quetiapine.Results: Out of 154 subjects, 68 were on risperidone, 74 were on olanzapine, and 12 were on quetiapine. Most common ADRs reported were increased appetite (26%), weight gain (15%), tremors (14%), fatigue (14%), constipation (14%), dyspepsia (10%), somnolence (12%), decreased appetite (10%). Among these ADRs none of them were preventable and belonged to mild to moderate severity. Causality of adverse events was assessed by Naranjo algorithm; a probability scale for ADR. Severity was assessed by modified Hartwig and Seigel scale. Preventability was assessed using Schumock and Thronton criteria.Conclusions: The most common ADRSs reported with SGAs were increased appetite and weight gain and the frequency of ADRs were higher with subjects receiving risperidone

Processing of Lead Zirconate Titanate-graphite 3-3 Piezocomposites

The lead zirconate titanate (PZT)-graphite piezocomposites have potential for higherpiezoelectric sensitivity, lower acoustic impedance, higher piezoelectric voltage constants, higherelectromechanical coupling coefficient, and higher hydrostatic coefficients as compared to densePZT materials. In addition, the properties of piezocomposites can be tailored for various weightpercentage of graphite powder. To study the phenomena, PZT-graphite 3-3 composites wereprepared by mixing calcined PZT and commercially available graphite powder. The mixed powderwas compacted, sintered, and poled by corona poling technique. Scanning electron microstructureswere recorded to study the effect of graphite on processing of 3-3 piezocomposites. The polarisingbehaviour, piezoelectric and dielectric properties of PZT-graphite composites were studied

Evaluation of functional outcome of displaced fracture neck of femur in elderly treated with cemented bipolar prosthesis by modified Harris hip score

Background: The current research was conducted to determine the functional outcome of the displaced fracture neck of femur in elderly patients treated with cemented bipolar hip prosthesis.Methods: The present research was a prospective study of 44 cases of displaced fracture neck of femur admitted to our institute between October 2017 and October 2019. Cases were chosen on the basis of inclusion and exclusion criteria. Cases were surgically treated with cemented bipolar hip hemiarthroplasty and functional findings were recorded with modified Harris hip score.Results: In our series of 44 cases there were 30 females and 14 males, with a maximum age of 92 years, minimum age of 65 years, and the average age was 72.72 years. At one-year follow-up, the average modified Harris hip score was 86.75% (maximum score of 95 and a minimum score of 66), overall, 20 patients (45.46%) achieved excellent, 16 patients (36.36%) achieved good, 5 patients (11.36%) achieved fair and 3 patients (6.82%) achieved poor results. 81.82% of the patients returned to the pre-fracture level of activity and independent ambulation. Patients had few complications like limb length discrepancy, 36.3% of patients had limb lengthening between 1 to 1.5 cm.Conclusions:  In elderly patients with displaced neck femur fractures, cemented bipolar hip prosthesis provides good functional outcome. However further study for a longer period in a larger sample with a direct comparison between the cemented versus uncemented groups is required

Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario

Background: Patients; sixty-five years of age and above, are a special risk group as far as drug prescribing is concerned. Prescription irregularities in such patients may be hazardous. STOPP/START criteria are considered as the most up to-date set of explicit criteria for evaluating geriatric prescriptions. To analyse geriatric prescriptions in a tertiary care centre with respect to STOPP/START criteria and WHO core drug prescribing indicators so as to get an idea of pattern of drug prescription in geriatric patients as well as frequency of potentially inappropriate prescriptions. Descriptive cross-sectional study in a tertiary care hospital.Methods: All inpatients aged 65 years and above who were prescribed at least one allopathic medication and consented to participate in the study were included and patients admitted for medical emergencies were excluded. Demographic data and details of drugs prescribed were collected from prescription chits and indoor case papers.Results: There was a high frequency of polypharmacy, prescription of antimicrobials and injections. Proportion of patients receiving at least one potentially inappropriate medication (PIM) as per STOPP criteria was 21.01%. Proportion of patients subjected to at least one potential prescribing omission (PPO) as per START criteria was 33.33%. Proportion of patients exposed to potentially inappropriate drug prescriptions as a whole (PIPs=PIMs+PPOs) was 46.37%. Statistical analysis used as descriptive statistics like numbers and percentages were used for data analysis.Conclusions: With regards to geriatric prescribing, adherence to WHO core prescribing indicators, prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement

Design and construction of a novel simple and low-cost test bench point-absorber wave energy converter emulator system

This paper proposed a test bench device to emulate or simulate the electrical impulses of a wave energy converter (WEC). The objective of the study is to reconstruct under laboratory conditions the dynamics of a WEC in the form of an emulator to assess the performance, which, in this case, is the output power. The designed emulator device is programmable, which makes it possible to create under laboratory conditions the operating mode of the wave generator, identical to how the wave generator would work under real sea conditions. Any control algorithm can be executed in the designed emulator. In order to test the performance of the constructed WEC emulator, an experiment was conducted to test its power output against that of a real point-absorber WEC. The results indicate that, although the power output for that of the real WEC was higher than the WEC emulator, the emulator performed perfectly well. The relatively low power output of the emulator was because of the type of algorithm that was written for the emulator, therefore increasing the speed of the motor in the algorithm (code) would result in higher output for the proposed WEC emulator. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Comparison of cardiovascular safety of escitalopram and sertraline based on electrocardiographic alterations: a pharmacovigilance study

Background: Escitalopram and sertraline are the most commonly prescribed antidepressant drugs, belongs to SSRI class. Both the drugs are long been considered as free from cardiovascular adverse effects. Recently number of studies reported potential association between these drugs and pronounced cardiovascular adverse effects. ECG changes like prolongation of QT interval are frequently used as markers for the increased risk of a fatal cardiac arrhythmia. The potential cardiovascular adverse reaction profile of both these drugs is little studied in Indian rural population.Methods: This was a 6 weeks prospective open label observational study carried out in a drug naive 209 patients receiving either escitalopram (n=106) or sertraline (n=103). ECG parameters like heart rate, RR interval, PQ/PR interval, QRS duration and QTc interval, were obtained directly from the digital machine recordings, additionally the QT interval was measured manually with the help of caliper. Statistical analysis was done by using Statistical software SPSS 17.0.Results: Out of 209 drugs naive patients, 12 from escitalopram group and 10 patients from Sertraline were lost to follow-up. Hence ECG recordings of the remaining 94 patients under escitalopram group, 93 patients under sertraline group were used for study analysis. The ECG alterations caused by the escitalopram were compared with that caused by sertraline. It was observed that the differences between the ECG alterations caused by either of escitalopram or sertraline were statistically non-significant.Conclusions: It was concluded, at therapeutic doses neither of the drugs have the potential risk of drug induced arrhythmias, throughout the study. 

A study of adverse drug reactions in patients receiving treatment for multi-drug resistant tuberculosis

Background: A high frequency of adverse drug reactions (ADRs) is one of the major challenges in the treatment of Multi-drug resistant tuberculosis (MDR-TB). Patients may refuse to continue treatment if ADRs are not properly addressed, drugs may be stopped unnecessarily and treatment may be terminated prematurely by inexperienced health workers, resulting in a high proportion of failure.Methods: Patients diagnosed for MDR-TB and registered in Drug Resistant TB centre (DR-TB) of tertiary care hospital during period of July 2014 to June 2015 were enrolled in the study. Data of patients hospitalized for the complaints of ADR in DR-TB centre during study period was collected.Results: Out of 468 patients, 60 (12.82%) patients developed at least one adverse reaction and were hospitalised for the same. Among 109 reported ADRs, Gastrointestinal upset was the most common ADR reported (5.98%) followed by psychosis (4.91%) and ototoxicity (2.99%).Conclusions: The health providers, the patients and their relatives should be sensitised about these ADRs for early detection and treatment. It can also be suggested that the setup of DR-TB centre should be integrated with psychiatry and ENT specialities, with all the provisions of early detection of ADR and treatment

Serum lipid profile in non-polycystic ovary syndrome and polycystic ovary syndrome women: a comparative and correlational study

Background: Polycystic ovary syndrome (PCOS), in addition to impaired ovulation, also affects metabolic pathways. Dyslipidemia, occurring in PCOS women leads to cardiovascular diseases in them. The purpose of the present study was to compare lipid profile and its correlation with biochemical and hormonal parameters in PCOS and non PCOS women, to analyse the correlation of lipid profile with hirsutism and body mass index (BMI) in PCOS women.Methods: The present study includes 68 women divided into non PCOS groups (n=30) and PCOS (n=38) as defined by Rotterdam criteria. PCOS group further divided into overweight / obese (n=23) and normal weight subgroups (n=15). Lipid profile, fasting blood glucose and hormonal profile were done in all the groups.Results: TG and TC/HDL ratio were significantly high in PCOS group. Hirsute patients had raised LDL levels as compared to non-hirsute. LDL showed positive significant correlation with insulin, HOMA, testosterone in PCOS group. TC was significantly positively correlated with insulin and HOMA in PCOS group. In both normal weight and overweight / obese PCOS subgroups, LDL had positive and significant correlation with testosterone. TC showed positive and significant correlation with HOMA in overweight/obese subgroup. HDL showed positive and highly significant correlation with FSH in normal weight PCOS.Conclusions: Hyperandrogenism in PCOS may be additionally marked by raised LDL. Overweight/obese PCOS subgroup may be prone to dyslipidemia as well as deranged glucose homeostasis, thereby making it an important therapeutic target

High sensitivity C - reactive protein (hs-CRP) and clinical characteristics, endocrine, metabolic profile in Indian women with PCOS: a correlation

Background: Role of hs-CRP was studied in PCOS women.Methods: Correlation between serum hs-CRP and endocrine, metabolic profile was studied in 30 healthy women and 88 PCOS women. In PCOS women correlation between hs-CRP and clinical characteristics viz obesity, infertility, acne, hirsutism, acanthosis nigricans (AN) was also studied. Serum levels of hs-CRP, Luteinizing hormone (LH), Follicle stimulating hormone (FSH), LH:FSH ratio, Testosterone (Testo), fasting insulin, fasting blood glucose (FBG), total cholesterol (TC), triglyceride (Tg), low density lipoprotein (LDL), high density lipoprotein (HDL) and Homeostasis Model Assessment (HOMA) were estimated.Results: Mean serum hs-CRP in PCOS women was higher than that in control women (6.9 ± SE 0.84 v/s 2.0 ± SE 0.19mg/L, P=0.005).  In PCOS group overweight/obese had higher hs-CRP as compared to normal weight women (P=0.0051). In control group hs-CRP was positively correlated with age (r=0.385 p=0.035) and LDL (r=0.38 P=0.036). PCOS women showed positive correlation between hs-CRP and cholesterol, LDL, fasting insulin, HOMA. PCOS women showed a significant negative correlation between hs-CRP and LH. AN positive PCOS women showed higher serum hs-CRP levels as compared to AN negative PCOS women (11 ± SE 0.7 v/s 5.5 ± SE 2.3, P=0.0439).Conclusions: Serum hs-CRP is raised in Indian PCOS women reflecting association of low grade chronic inflammation. A positive correlation is present between hs-CRP and AN, insulin in PCOS women and obesity may aggravate this association. A positive correlation between hs-CRP and TC, LDL in the background of normal lipid profile is suggestive of precedence of chronic inflammation over dyslipidemia in PCOS