A single compartment simulation model of pharmacokinetics

For better understanding about derivation of various parameters related to pharmacokinetics, this model is developed. Animals or human volunteers are not used in this model but the principles used in pharmacokinetic studies in volunteers are incorporated. There is detailed description about setting of the model and derivation of various parameters step by step. An example is followed to illustrate the calculations involved. Possibilities of further extension of model to derive additional parameters and variations are discussed. The experience indicates that the model serves as a good demonstration to undergraduate students and a meaningful experiment for PG-students for learning and as a practical-examination exercise. The purpose of the article is to widen the use of this simple teaching tool at various centers

Cross sectional observational study to assess the knowledge of drugs utilized in emergency medical conditions amongst medical interns and residents in tertiary care teaching hospital

Background: Medical interns and residents are future medical professionals and as first-line responders, they may confront any type of emergency. Knowledge of pharmacotherapeutics (PTs) is the backbone of emergency care. Therefore, this study is designed to assess PTs’ knowledge and identify the lacunae in handling various medical emergencies among medical interns and residents.Methods: This was a cross-sectional, observational, questionnaire-based study. A self-structured questionnaire containing 30 close-ended questions, assessing the knowledge of drugs utilized in various medical emergency conditions was prepared and circulated in the form of a Google form. A credit score of “1” was given for each correct response. Grading of knowledge was done as “poor” (≤50%), “average” (>50-70%), and “adequate” (>70%-100%) The student’s unpaired t-test was used to analyse the data.Results: A total of 282 candidates responded, with 148 (52.48 %) interns and 134 (47.52%) residents. Participants had the least knowledge of PTs for anaphylactic shock. Participants’ knowledge of PTs was found to be adequate regarding the central nervous system and electrolyte disorders while average regarding toxicology, immunization, and endocrine system. Results suggested that residents (mean score: 21.42±5.06) were significantly (p=0.0165) more knowledgeable than interns (mean score: 19.96±5.08). Among respondents, 17.6% of interns and 13.4% of residents had poor performance while 45.9% of interns and 53.7% of residents had adequate performance.Conclusions: The current study provides valuable information regarding the state of PTs’ knowledge in medical emergencies among interns and residents, which can be used to improve undergraduate as well as postgraduate training. 

Occurrence of depression, anxiety and stress among medical students working during COVID Pandemic

Background: Since the COVID-19 pandemic began, medical students have been allotted various duties like rapid antigen testing, Sanjivani corona ghar seva (service provided by the government for home quarantine people), RTPCR swab collection, and posting in wards and intensive care units (ICUs). While executing the COVID-19 duties, students had a significant degree of a significant degree of ambiguity and apprehension. The purpose of this study was to determine the psychological impact of COVID-19 on medical students performing COVID-19 duties.Methods: A questionnaire-based, cross-sectional observational study was conducted among undergraduate and postgraduate students of a tertiary care teaching hospital, who were deployed on COVID-19 duty during pandemic. A google form-based questionnaire was structured, encompassing demographic details, Depression, Anxiety and Stress Scale-21 (DASS-21) questionnaire and other (additional) COVID-19 duty related questions. The analysis of data was done by using unpaired t-test and chi-square test in Statistical package for social sciences (SPSS) version 20.0Results: In our research study, we found that occurrence of depression, anxiety, and stress was 40.46%, 48.37%, and 30.69% among the medical students during COVID -19 duty, respectively. Higher occurrence and more severity (p<0.01) of depression, anxiety and stress was seen in female medical students during COVID-19 duty in pandemic.Conclusions: We observed a higher occurrence of depression, anxiety, and stress among medical students while performing their COVID-19 duty in a pandemic. Medical students played a significant role in the COVID-19 pandemic. Therefore, measures should be taken to ensure the psychological wellbeing of medical students.

In vitro i in vivo protuupalna, antibakterijska i farmakokinetička svojstva baikaleina

Baicalein is a bioactive flavone originally isolated from the roots of Scutellaria baicalensis, Scutellariala teriflora and Oroxylum indicum. The in vitro and in vivo anti-inflammatory and antibacterial properties of baicalein and pharmacokinetics after its single intramuscular administration were studied in Wistar rats. The in vitro anti-inflammatory activity of baicalein (10, 50 and 100 µM) was tested for its ability to inhibit the COX-2 enzyme by measuring PGE2 levels and determination of nitric oxide (NO) production in lipopolysaccharide (LPS) treated RAW 264.7 macrophage cells, in which baicalein was found to have significant inhibition of NO and PGE2 production in RAW 264.7 macrophage cells as compared with the LPS control group. The in vivo anti-inflammatory activity of baicalein (200 mg/kg) was assessed using the carrageenan-induced rat paw oedema model, following intramuscular injection. A significant percentage of inhibition of oedema volume was observed when compared with the carrageenan control group. In vitro and in vivo antibacterial activities of baicalein were determined by the micro broth dilution technique and neutropenic rat thigh infection model, wherein baicalein did not show any antibacterial property. Concentrations of baicalein were determined in rat plasma by high performance liquid chromatography (HPLC) after a single intramuscular administration at a dose of 200 mg/kg body weight, in which the mean peak plasma drug concentration (Cmax) of 0.77 ± 0.02 μg/mL was achieved at 0.08 h. The mean elimination half-life (t½β), the apparent volume of distribution (Vd(area)), total body clearance (Cl(B)) and mean residence time (MRT) were observed as 0.63 ± 0.06 h, 601.03 ± 28.18 L/kg, 677.39 ± 35.36 L/h/kg and 0.76 ± 0.06 h, respectively. Conclusively, in the present study, baicalein did not show in vitro or in vivo antibacterial property, but proved to have good anti-inflammatory activity. The available anti-inflammatory drugs have proved to have side effects in veterinary and human therapeutics. In this situation, baicalein may become an effective alternative to non-steroidal anti-inflammatory drugs and should also be studied in target animal species. Further research should be carried out to improve the solubility and bioavailability of baicalein through injectable routes.Baikalein je bioaktivni flavon izvorno izoliran iz korijena biljaka Scutellaria baicalensis, Scutellariala teriflora i Oroxylum indicum. U ovom su radu istraživana in vitro i in vivo protuupalna i antibakterijska svojstva baikaleina te farmakokinetika nakon njegove pojedinačne intramuskularne primjene u wistar štakora. In vitro protuupalno djelovanje baikaleina (10, 50 i 100 µM) analizirano je s obzirom na sposobnost inhibicije enzima COX-2 mjerenjem razine PGE2 i određivanjem proizvodnje dušikova oksida (NO) u makrofagnim stanicama RAW 264,7 tretiranim lipopolisaharidom (LPS). Ustanovljeno je da baikalein znakovito inhibira proizvodnju NO i PGE2 u makrofagnim stanicama RAW 264,7 u usporedbi s LPS kontrolnom skupinom. In vivo protuupalno djelovanje baikaleina (200 mg/ kg) procijenjeno je pomoću modela za mjerenje edema šape nakon intramuskularne injekcije karagenana, te je uočena znakovita inhibicija volumena edema u usporedbi s kontrolnom skupinom. In vitro i in vivo antibakterijsko djelovanje baikaleina određeno je metodom razrjeđivanja mikrobujona te modelom infekcije bedra neutropeničnog štakora, pri čemu baikalein nije pokazao antibakterijska svojstva. Koncentracije baikaleina utvrđene su u plazmi štakora tekućinskom kromatografijom visoke djelotvornosti (HPLC) nakon pojedinačne intramuskularne primjene u dozi od 200 mg/kg tjelesne mase u kojoj je prosječna vršna koncentracija lijeka (Cmax) bila 0,77 ± 0,02 μg/mL, a postignuta je za 0,08 h. Prosječan poluživot eliminacije (t½β) bio je 0,63 ± 0,06 h, providni volumen distribucije (Vd(površina)) 601,03 ± 28,18 L/kg, ukupni tjelesni klirens (Cl(B)) 677.39 ± 35.36 L/h/kg, a prosječno vrijeme zadržavanja (MRT) 0,76 ± 0,06 h. Zaključeno je da u ovom istraživanju baikalein nije pokazao in vitro i in vivo antibakterijska svojstva, ali je pokazao dobro protuupalno djelovanje. S obzirom na to da dostupni protuupalni lijekovi imaju nuspojave u liječenju ljudi i životinja, baikalein bi mogao biti učinkovita alternativa nesteroidnim protuupalnim lijekovima te bi ga trebalo istražiti i kod ciljanih životinjskih vrsta. Potrebna su daljnja istraživanja kojima bi se poboljšala topljivost i bioraspoloživost baikaleina injekcijskom primjenom

Reduced suppressive effect of beta(2)-adrenoceptor agonist on fibrocyte function in severe asthma

Background Patients with severe asthma have increased airway remodelling and elevated numbers of circulating fibrocytes with enhanced myofibroblastic differentiation capacity, despite being treated with high doses of corticosteroids, and long acting β2-adrenergic receptor (AR) agonists (LABAs). We determined the effect of β2-AR agonists, alone or in combination with corticosteroids, on fibrocyte function. Methods Non-adherent non-T cells from peripheral blood mononuclear cells isolated from healthy subjects and patients with non-severe or severe asthma were treated with the β2-AR agonist, salmeterol, in the presence or absence of the corticosteroid dexamethasone. The number of fibrocytes (collagen I+/CD45+ cells) and differentiating fibrocytes (α-smooth muscle actin+ cells), and the expression of CC chemokine receptor 7 and of β2-AR were determined using flow cytometry. The role of cyclic adenosine monophosphate (cAMP) was elucidated using the cAMP analogue 8-bromoadenosine 3′,5′-cyclic monophosphate (8-Br-cAMP) and the phosphodiesterase type IV (PDE4) inhibitor, rolipram. Results Salmeterol reduced the proliferation, myofibroblastic differentiation and CCR7 expression of fibrocytes from healthy subjects and non-severe asthma patients. Fibrocytes from severe asthma patients had a lower baseline surface β2-AR expression and were relatively insensitive to salmeterol but not to 8-Br-cAMP or rolipram. Dexamethasone increased β2-AR expression and enhanced the inhibitory effect of salmeterol on severe asthma fibrocyte differentiation. Conclusions Fibrocytes from patients with severe asthma are relatively insensitive to the inhibitory effects of salmeterol, an effect which is reversed by combination with corticosteroids

Pattern of utilization of blood and blood components in obstetrics at tertiary care hospital

Background: Obstetric emergencies occur suddenly and unexpectedly. Blood transfusion becomes one of the live saving measures in such situations. Severe anaemia due to nutritional deficiency, obstetric haemorrhage either during pregnancy, labour or in postpartum period are the commonest indications for blood transfusion worldwide. Blood bank services play important role in saving lives in obstetric emergencies. Health institutions must carry out internal blood transfusion audits to reassure optimal and judicious use of blood and blood components.Methods: Analysis of 755 Obstetric patients requiring blood transfusion in eighteen months period was done to find out the incidence and indications for blood transfusion at tertiary care hospital.Results: Overall, 5.33% of obstetric admissions required transfusion of blood or its components. Severe anaemia (36.55%), accidental haemorrhage (20.92%), postpartum haemorrhage (8.34%), placenta praevia (5.03%) and caesarean section (10.33%) were the common indications for blood transfusion. In more than 65% cases, two or three unit of blood were transfused. In majority of cases (96%) components were used.Conclusions: Blood transfusion helped to save many lives in the present study. Severe anaemia and obstetric haemorrhage of varied aetiology were the common indications for blood transfusion. Component therapy helped to correct specific deficiency. Voluntary blood donation should be encouraged in the younger generation to keep adequate stock of blood in blood bank for emergency use. Preventive measures like improving dietary iron intake and prophylactic iron therapy will go a long way in reducing the need for blood transfusion in Obstetrics

Changing pattern of birth weight over a decade in rural India

Background: Birth weight is one of the important determinants of neonatal wellbeing. Birth weight has many determinants that mainly include maternal nutritional status and the term of gestation. Low birth weight is associated with high neonatal and childhood mortality and morbidity. Over the years the birth weight is showing the increasing trend in developing countries like India. The study aimed at finding out the changing pattern of birth weight over a decade in rural India.Methods: A retrospective analysis of over 45,000 births that took place in Tertiary care hospital from year 2008-2017was undertaken. The socio economic determinants of birth weight were studied.Results: The incidence of low birth weight declined from 47 percent to 35 percent over ten years. The mean rise in birth weight in ten years was observed in both male (176 grams) and female (151grams).The incidence of very low birth and extremely low birth was found declined. There was positive co relationship between improved birth weight and improved socio economic status, delay in age at marriage, higher maternal weight gain during pregnancy, improved pre pregnancy nutritional status of women.Conclusions: There is steady decline in incidence of low birth weight over last ten years in study area. Improved maternal health, better nutrition, improved quality of antenatal care and various efforts and actions from the government side have contributed in improving the birth weight

A Testable Solution of the Cosmological Constant and Coincidence Problems

We present a new solution to the cosmological constant (CC) and coincidence problems in which the observed value of the CC, $\Lambda$, is linked to other observable properties of the universe. This is achieved by promoting the CC from a parameter which must to specified, to a field which can take many possible values. The observed value of Lambda ~ 1/(9.3 Gyrs)^2$(approximately 10^(-120) in Planck units) is determined by a new constraint equation which follows from the application of a causally restricted variation principle. When applied to our visible universe, the model makes a testable prediction for the dimensionless spatial curvature of Omega_k0 = -0.0056 s_b/0.5; where s_b ~ 1/2 is a QCD parameter. Requiring that a classical history exist, our model determines the probability of observing a given Lambda. The observed CC value, which we successfully predict, is typical within our model even before the effects of anthropic selection are included. When anthropic selection effects are accounted for, we find that the observed coincidence between t_Lambda = Lambda^(-1/2) and the age of the universe, t_U, is a typical occurrence in our model. In contrast to multiverse explanations of the CC problems, our solution is independent of the choice of a prior weighting of different$\Lambda$-values and does not rely on anthropic selection effects. Our model includes no unnatural small parameters and does not require the introduction of new dynamical scalar fields or modifications to general relativity, and it can be tested by astronomical observations in the near future.Comment: 31 pages, 4 figures; v2: version accepted by Phys. Rev.

Tidal Turbine Benchmarking Exercise: Environmental Characterisation and Geometry Specification

Uncertainty in tidal turbine loading contributes significantly to conservatism in turbine design. This uncertainty originates not only from a lack of knowledge of the flow field at a particular site, but also from lack of understanding of the fundamental physics which govern the loading and performance of tidal turbines in unsteady and turbulent flow regimes. In order to reduce this conservatism and the costs associated, the mathematical and engineering models used in turbine design must be improved. To facilitate the development of these models requires scale experimental data for validation. However, few well-documented experimental data sets are available for tidal turbines, especially at scales large enough to achieve Reynolds number independence and comparability to full scale devices.This paper reports on the initial phases of a tidal turbine benchmarking project that will conduct a large laboratory scale experimental campaign on a highly instrumented 1.6m diameter tidal rotor. The turbine will be tested in well defined flow conditions, including unsteadiness created by free surface waves, as well as freestream turbulence, with instrumentation to determine edgewise and flapwise loading distributions along the blades as they rotate through the unsteady flows. As towing tanks by their nature have low levels of freestream turbulence, a carriage-mounted turbulence grid will be utilised to generate sufficient freestream turbulence in a well-defined manner.In this paper the turbine geometry and test conditions are specified, as well as providing details of the rotor’s hydrodynamic design process. Additionally, the results of a flow characterisation of the carriage-mounted turbulence grid via Acoustic Doppler Velocimetry are presented. The turbulence grid produced a mean turbulence intensity of 3:5% across the region in which the turbine will be tested, and a very uniform flow profile of 0:913 times the upstream velocity