Adverse drug reaction profiles of commonly used platinum compounds in cancer chemotherapy

Background: The aim of the present study was to monitor and analyze the pattern of occurrence of adverse drug reactions (ADRs) to commonly used platinum compounds in MNJ Cancer Hospital, Hyderabad.Methods: Cancer patients, who received platinum compounds as chemotherapy regimen, were monitored for adverse reactions. Cancer patients belonging to either gender and of all ages, who were receiving platinum compounds under any standard regimen, were included for the study. Cases that were unlikely, conditional or unaccessible under World Health Organization (WHO)-Uppsala Monitoring Centre causality criteria were excluded from the study. The ADRs were recorded in Central Drugs Standard Control Organization forms. Causality was assessed by the WHO Causality Assessment Scale and Naranjo’s Algorithm. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale, modified Hartwig and Siegel scale, respectively.Results: Among 100 patients, 78 developed ADRs to platinum compounds. The reactions observed were vomiting, diarrhea, abnormal renal function tests, myelosuppression, anemia, thrombocytopenia, alopecia, and constipation. The WHO Causality Assessment Scale indicated 64.6% “possible” and 35.4% “probably,” but no “certain” reactions. Naranjo’s Algorithm showed 59.4% “possible” 40.6% “probable” reactions. 48% reactions were “definitely preventable” 16% were “probably preventable” and 36% were “not preventable.” Modified Hartwig and Siegel Scale of severity assessment showed that 12% reactions were “mild” 69% were “moderate” and 19% were severe.Conclusion: Platinum compounds have high potential for adverse effects. There is a need to improve the management of adverse effects. This study also emphasizes the need to improve pharmacovigilance awareness among physicians in order to improve the pharmacovigilance in India

Prescription pattern of antimicrobials in pregnant women attending antenatal clinic in a tertiary care hospital in Telangana, India

Background: Pregnancy is a physiological condition during which immune system is weakened. Therefore, most women are prone to develop infections during this period for which antimicrobials are prescribed. Drugs used during pregnancy may lead to teratogenicity. Therefore, this study was done with the following objectives: 1.to determine the type of infections encountered, 2.to assess the prescription profile of antimicrobials and 3.to assess FDA categories of antimicrobials used in pregnant women in a tertiary care center in Telangana, India.Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS) from 1st January 2018 to 30th June 2018.Results: Out of a total of 165 cases enrolled, 57 (34.5%) cases were prescribed antimicrobials and 108 (65.5%) were treated symptomatically. The mean (SD) age of women who were prescribed antimicrobials was 22.9 (2.97) years. Of the conditions encountered, respiratory tract infections (RTIs) accounted for 31%, followed by urinary tract infections (UTIs) 26% and gastroenteritis 25%. Most prevalent infections which required antimicrobials prescription were UTIs (36.84%), followed by Gastroenteritis (17.54%). Majority of the antimicrobials prescribed were from Betalactams (40.34%), followed by Nitrofuranes (29.82%), Nitroimidazoles (17.54%) and Antifungals (8.77%). Antimicrobials prescription was more in the 3rd trimester (63.1%), followed by 2nd trimester (31.6%) and 1st trimester (5.3%). Majority of the antimicrobials were administered orally (75.44%), followed by injections (15.79%) and per vaginal route (8.77%). Antimicrobials were mostly prescribed from FDA Category B (96%).Conclusions: RTIs were the most common among the conditions encountered. However, UTIs were the leading cause for antimicrobial prescriptions. Antimicrobials prescription was more during 3rd trimester. Most antimicrobials prescribed were safe as they were from FDA Category B

Efficacy of oral L-arginine on amniotic fluid index in pregnant women with oligohydramnios attending antenatal clinic in a tertiary care hospital in Telangana, India

Background: Oligohydramnios leads to feto-maternal morbidity and mortality. Though there is no specific treatment for oligohydramnios, use of L-arginine seems to be promising. As a nitric oxide donor, it causes vasodilatation, increases placental perfusion and finally increases amniotic fluid. However, data on the use of L-arginine for oligohydramnios is scarce. Hence, this study was aimed to evaluate the efficacy of oral L-arginine on Amniotic Fluid Index (AFI) and to document the pregnancy outcomes in women with oligohydramnios.Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS), Ghanpur, Telangana, India from 1st January 2018 to 30th June 2018.Results: A total of 50 participants were enrolled and 4 participants among them were lost to follow- up. Mean age (SD) of the women enrolled was 23.3 (3.49) years. Mean gestational age (SD) at the time of diagnosis was 34.61 (1.53) weeks. Mean AFI (SD) at the time of diagnosis and after treatment with L-arginine were 6.8 (1.3) cm and 9.4 (2.82) cm respectively. After a mean treatment duration (SD) of 3.23 (1.38) weeks, a mean (SD) increase of AFI by 2.6 (1.57) cm (P <0.0001) was observed. An increase of AFI was noted in 84.78% of cases (P <0.0001). Mean (SD) Gestational age at the time of delivery was 38.25 (1.48) weeks. Only 37% of participants required operational deliveries. Mean (SD) birth weight of the new borns was 2.54 (0.47) kg. Neonatal Intensive Care Unit (NICU) admissions were required in 32.6% of new borns.Conclusions: L-arginine is efficacious in improving AFI in oligohydramnios. AFI improvement could possibly lead to better neonatal outcomes by reducing preterm deliveries and operative interventions

Thoracoscopic Repair of Congenital Diaphragmatic Hernia in Neonates: Lessons Learned

Abstract Purpose: We sought to characterize our recent experience with thoracoscopic congenital diaphragmatic hernia (CDH) repair and identify patient selection factors. Methods: We reviewed the medical records of full-term neonatal (<1 month of age) patients who underwent thoracoscopic CDH repair between 2004 and 2008 (n=15). We obtained data on prenatal diagnosis, characteristics of the CDH and repair, complications, and outcome. Results: All patients were stabilized preoperatively and underwent repair at an average of 5.7+/-1.3 days. Six patients were prenatally diagnosed, including the 5 inborn. Thirteen defects were left-sided. All were intubated shortly after birth and 2 required extracorporeal membrane oxygenation (ECMO). Twelve of 15 (80%) patients underwent successful thoracoscopic primary repair, including 1 of the patients who required ECMO prior to repair. Conversion to open repair occurred in 3 of 15 (20%) patients because of the need for patch closure or intraoperative instability. Among those converted to open, all had left-sided CDH defects and 3 had stomach herniation (of 5 such patients). Patients spent an average of 6.9+/-1.0 days on the ventilator following repair. The average time until full-enteral feeding was 16.7+/-2.25 days, and average length of hospital stay was 23.8+/-2.73 days. All patients survived to discharge, and average length of follow-up was 15.3+/-3.6 months. Conclusions: Thoracoscopic repair of CDH is a safe, effective strategy in patients who have undergone prior stabilization. Stomach herniation is associated with, but does not categorically predict, conversion to open repair. ECMO use prior to repair should not be an absolute contraindication to thoracoscopic repair.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78119/1/lap.2009.0129.pd

Instruments of RT-2 Experiment onboard CORONAS-PHOTON and their test and evaluation V: Onboard software, Data Structure, Telemetry and Telecommand

The onboard software and data communication in the RT-2 Experiment onboard the Coronas-Photon satellite is organized in a hierarchical way to effectively handle and communicate asynchronous data generated by the X-ray detectors. A flexible data handling system is organized in the X-ray detector packages themselves and the processing electronic device, namely RT-2/E, has the necessary intelligence to communicate with the 3 scientific payloads by issuing commands and receiving data. It has direct interfacing with the Satellite systems and issues commands to the detectors and processes the detector data before sending to the satellite systems. The onboard software is configured with several novel features like a) device independent communication scheme, b) loss-less data compression and c) Digital Signal Processor. Functionality of the onboard software along with the data structure, command structure, complex processing scheme etc. are discussed in this paper.Comment: 24 pages, 2 figures, Accepted for publication in Experimental Astronomy (in press

Binary Galaxies in the Local Supercluster and Its Neighborhood

We report a catalog of 509 pairs identified among 10403 nearby galaxies with line-of-sight velocities V_LG < 3500 km/s.We selected binary systems in accordance with two criteria (bounding and temporal), which require the physical pair of galaxies to have negative total energy and its components to be located inside the zero-velocity surface. We assume that individual galaxy masses are proportional to their total K-band luminosities, M = L_K x 6M/L. The catalog gives the magnitudes and morphological types of galaxies and also the projected (orbital) masses and pair isolation indices. The component line-of-sight velocity differences and projected distances of the binary systems considered have power-law distributions with the median values of 35 km/s and 123 kpc, respectively. The median mass-to-K-band luminosity ratio is equal to 11 M/L, and its uncertainty is mostly due to the errors of measured velocities. Our sample of binary systems has a typical density contrast of d ro/ro_c ~ 500 and a median crossing time of about 3.5 Gyr. We point out the substantial fraction of binary systems consisting of late-type dwarf galaxies, where the luminosities of both components are lower than that of the Small Magellanic Cloud. The median projected distance for 41 such pairs is only 30 kpc, and the median difference of their line-of-sight velocities is equal to 14 km/s which is smaller than the typical error for radial-velocity (30 km/s). This specific population of gas-rich dwarf binary galaxies such as I Zw 18 may be at the stage immediately before merging of its components. Such objects, which are usually lost in flux-limited (and not distance-limited) samples deserve a thorough study in the HI radio line with high spatial and velocity resolution.Comment: published in Astrophysical Bulletin, 2008, Vol. 63, No. 4, pp. 299-34

A Region of Violent Star Formation in the Irr Galaxy IC 10: Structure and Kinematics of Ionized and Neutral Gas

We have used observations of the galaxy IC 10 at the 6-m telescope of the Special Astrophysical Observatory with the SCORPIO focal reducer in the Fabry-Perot interferometer mode and with the MPFS spectrograph to study the structure and kinematics of ionized gas in the central region of current intense star formation. Archive VLA 21-cm observations are used to analyze the structure and kinematics of neutral gas in this region. High-velocity wings of the H-alpha and [SII] emission lines were revealed in the inner cavity of the nebula HL 111 and in other parts of the complex of violent star formation. We have discovered local expanding neutral-gas shells around the nebulae HL 111 and HL 106.Comment: 22 pages, 10 figures; accepted in Astronomy Report

RT-2 Detection of Quasi-Periodic Pulsations in the 2009 July 5 Solar Hard X-ray Flare

We present the results of an analysis of hard X-ray observations of the C2.7 solar flare detected by the RT-2 Experiment onboard the Coronas - Photon satellite. We detect hard X-ray pulsations at periods of ~12 s and ~15 s. We find a marginal evidence for a decrease in period with time. We have augmented these results using the publicly available data from the RHESSI satellite. We present a spectral analysis and measure the spectral parameters.Comment: 12 pages, 8 figures and 3 tables, accepted for publication in The Astrophysical Journa

Discovery of an Unusual Dwarf Galaxy in the Outskirts of the Milky Way

In this Letter, we announce the discovery of a new dwarf galaxy, Leo T, in the Local Group. It was found as a stellar overdensity in the Sloan Digital Sky Survey Data Release 5 (SDSS DR5). The color-magnitude diagram of Leo T shows two well-defined features, which we interpret as a red giant branch and a sequence of young, massive stars. As judged from fits to the color-magnitude diagram, it lies at a distance of about 420 kpc and has an intermediate-age stellar population with a metallicity of [Fe/H]= -1.6, together with a young population of blue stars of age of 200 Myr. There is a compact cloud of neutral hydrogen with mass roughly 10^5 solar masses and radial velocity 35 km/s coincident with the object visible in the HIPASS channel maps. Leo T is the smallest, lowest luminosity galaxy found to date with recent star-formation. It appears to be a transition object similar to, but much lower luminosity than, the Phoenix dwarf.Comment: Ap J (Letters) in press, the subject of an SDSS press release toda