ACUTE AND SUB-ACUTE ORAL TOXICITY ASSESSMENT OF THE POLYHERBAL FORMULATION IN ALBINO WISTER RATS

Objective: Polyherbal formulation (PHF) is prepared from five herbs; these herbs are well-known and widely used in the traditional system of medicine for the treatment of diabetes and various diseases. Individually, each herb is completely safe, but the combined effects of these herbs are not known. Thus, the main objective of the present study was to assess the toxicological profile of PHF by acute and sub-acute oral toxicity in rats.Methods: The acute and sub-acute oral toxicity study was carried out as per OECD guidelines 423 and 407 respectively. In the acute toxicity study female albino Wistar rats administered single oral dose (2000 mg/kg) of PHF, while in sub-acute toxicity study male and female albino Wistar rats administered daily oral doses (100, 200 and 400 mg/kg) of PHF for 28 d. At the end of the study, the animals were humanely sacrificed and assessed for the effect of PHF on body weight and relative organ weights and hematological, biochemical and histopathological parameters.Results: In the acute toxicity study no mortality or behavioral changes were observed in rats treated with a single dose of PHF (2000 mg/kg) indicating that the LD50 is higher than 2000 mg/kg. In the sub-acute toxicity study, PHF was administered at three dose levels (100, 200 and 400 mg/kg), showed no significant changes in body weight and relative organ weights and hematological, biochemical and histopathological parameters.Conclusion: These results exhibit the absence of acute and sub-acute oral toxicity after treatment of PHF in rats. However, further studies in animals and in humans are needed in order to have sufficient safety evidence for its use in humans.Keywords: Polyherbal formulation, Acute and sub-acute toxicity, Hematology, Biochemistry, Histopatholog

Tracking collective emotions in sixteen countries during COVID-19: A novel methodology for identifying major emotional events using Twitter

Using messages posted on Twitter, this research developed a new methodology for estimating collective emotions (CEs) within countries. It applied time-series analytic methodology to develop and demonstrate a novel application of CEs to identify emotional events that are significant at the societal level. The study analyzed over 200 million words from over 10 million Twitter messages posted in sixteen countries during the first 120 days of the COVID-19 pandemic. Daily levels of collective anxiety and positive emotions were estimated using Linguistic Inquiry and Word Count’s (LIWC) psychologically validated lexicon. The resulting time series estimates of both collective emotions were analyzed for structural breaks which mark abrupt changes in a series due to external shocks. External shocks to collective emotions come from events that are of shared emotional relevance and the analysis of structural breaks showed that a reduction in collective anxiety and increase in collective positive emotions in most countries followed WHO’s declaration of the COVID-19 situation as a global pandemic. Announcements of economic support packages and social restrictions also had similar impacts in countries. This indicated that reduction of uncertainties around the rapidly evolving COVID-19 situation during the first 120 days of the pandemic had a positive emotional impact on people in all the countries in the study. The study contributes to the field of CEs and applied research on collective psychological phenomena

A cross sectional study of knowledge, attitude and practices related to fixed dose combinations use among clinicians and resident doctors at a tertiary care teaching hospital in India

Background: In the year 2016, Government of India had banned 350 fixed dose combinations (FDCs) for the safety and efficacy purpose. The present study was conducted to assess the knowledge, attitude and practices of the clinicians and residents about the use of FDCs at a tertiary care hospital.Methods: A questionnaire based study was conducted at a tertiary care hospital after getting approval from institutional ethics committee. A pre-validated questionnaire comprising of 30 items was distributed to 100 participants. The questionnaire focused on the prescribing behaviour, knowledge on therapeutic efficacy, advantages and limitations of FDC use, clinician perception regarding FDC use and the strategies to improve the awareness about the regulatory updates of the marketed drugs.Results: Total 52/100 clinicians responded. Out of these, 88% prescribed FDCs in their practice, 62% prescribed FDCs only after ensuring therapeutic efficacy and 50% prescribed WHO approved FDCs. 64% were aware of the recent ban on some FDCs by DCGI. Internet was the most common source of latest updates on the regulatory status of the drug, as stated by 55% clinicians. All clinicians agreed that efforts are needed to ensure that prescribers remain up to date about the post-marketing regulatory status of the drugs.Conclusions: Even though many clinicians prescribe FDCs regularly, they appreciated the step of banning some FDCs; however, the clinicians need to be trained to update themselves regularly. The source and relevance of these updates should be taught to the undergraduate students during their training period which can be reemphasized during post graduate training period

A prospective study on causality, severity and preventability assessment of adverse drug reactions in a tertiary care hospital in India

Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment

Evaluation of prescribing pattern of drugs use in patients of coronary artery disease at a tertiary care hospital

Background: Coronary artery disease (CAD) is a major cause responsible for mortality more in younger age group than in elderly. Studies have reported underuse of four evidence based medicines namely aspirin, β-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB), and statins in patients with CAD, particularly in developing countries. Therefore, this study was planned to analyse the prescriptions of patients with CAD to determine the appropriateness of the prescriptions.Methods: After obtaining the Institutional ethics committee permission, a cross sectional observational study was conducted at a tertiary care hospital. Total 150 patients were enrolled from the outpatient department, wards and intensive care unit of medicine department. Total 150 patients’ prescriptions presenting with varied category of CAD were screened and analysed.Results: The most common categories of CAD encountered was ST segment elevated myocardial infarction (N=50, 33%) followed by chronic stable angina (N=29, 20%). Among the drugs prescribed, antiplatelet drugs were prescribed to 135 (90%), hypolipidemics to 134 (89%), nitrates to 114 (76%), beta blockers to 97 (65%), ACE inhibitors to 94 (64%), anticoagulants to 60 (40%) and miscellaneous drugs to 52 (35%), patients. Of 68 (45%) patients with type 2 diabetes mellitus, 15 (22%) were prescribed only metoprolol and others were given ACE-I or ARBs.Conclusions: Among four evidence based drugs, use of 3 drugs, antiplatelets, beta blockers and hypolipidemics was apparent in 90% of prescriptions. Use of ACE inhibitors and ARBs was observed in type 2 diabetic patients with CAD, reflecting rational prescribing behavior of clinicians

Molybdenum oxide on Fe2O3 Core-Shell catalysts: Probing the nature of the structural motifs responsible for methanol oxidation catalysis

A series of MoOx-modified Fe2O3 catalysts have been prepared in an attempt to make core–shell oxidic materials of the type MoOx/Fe2O3. It is conclusively shown that for three monolayers of Mo dosed, the Mo stays in the surface region, even after annealing to high temperature. It is only when the material is annealed above 400 °C that it reacts with the iron oxide. We show by a combination of methods, and especially by XAFS, that at temperatures above 400 °C, most of the Mo converts to Fe2(MoO4)3, with Mo in a tetrahedral structure, whereas below that temperature, nanocrystalline MoO3 is present in the sample; however, the active catalysts have an octahedral MoOx layer at the surface even after calcination to 600 °C. This surface layer appears to be present at all temperatures between 300 and 600 °C, and it is the nanoparticles of MoO3 that are present at the lower temperature that react to form ferric molybdate, which underlies this surface layer. It is the MoOx layer on the Fe2(MoO4)3 underlayer that makes the surface active and selective for formaldehyde synthesis, whereas the iron oxide surface itself is a combustor. The material is both activated and improved in selectivity due to the dominance of the methoxy species on the Mo-doped material, as opposed to the much more stable formate, which is the main intermediate on Fe2O3

Synthesis and Visible-Light Photocatalytic Property of Bi2WO6Hierarchical Octahedron-Like Structures

A novel octahedron-like hierarchical structure of Bi2WO6has been fabricated by a facile hydrothermal method in high quantity. XRD, SEM, TEM, and HRTEM were used to characterize the product. The results indicated that this kind of Bi2WO6crystals had an average size of ~4 μm, constructed by quasi-square single-crystal nanosheets assembled in a special fashion. The formation of octahedron-like hierarchical structure of Bi2WO6depended crucially on the pH value of the precursor suspensions. The photocatalytic activity of the hierarchical Bi2WO6structures toward RhB degradation under visible light was investigated, and it was found to be significantly better than that of the sample fabricated by SSR. The better photocatalytic property should be strongly associated with the high specific surface area and the abundant pore structure of the hierarchical octahedron-like Bi2WO6

Relationship of Hearing Impairment in Patients with Lamivudine Therapy: A Systematic Review and Meta-analysis

Introduction: Lifelong Antiretroviral Therapy (ARVT) in patients with Human Immunodeficiency Virus (HIV) infection damages cochlea. Hearing Loss (HL) has been reported with lamivudine therapy in both HIV and/or Hepatitis B Virus (HBV) infections. Hence, the benefit of lamivudine therapy in individuals affected by these infections and risk of development of HL needs to be studied to make an adequate benefit-risk assessment. Aim: To evaluate the relationship of hearing impairment in patients treated with lamivudine and diagnosed with either HIV or HBV infection. Materials and Methods: The present study is a systematic review in which English-language publications that assessed HL in patients who are on lamivudine drug therapy were included. The types of studies included were: prospective studies, retrospective studies, case reports and case series. A comprehensive database search (PubMed, PubMed Central, Cochrane review, Google scholar and Embase) was conducted to identify the relevant literature published on HL and were searched for keywords related to lamivudine and HL- ‘lamivudine and hearing loss’, ‘lamivudine and deafness’, ‘lamivudine and hypoacusis’, ‘lamivudine and hearing impairment’ and ’lamivudine and ototoxicity’ for searching the data. The publications were independently reviewed and assessed for study quality and the data (title, author, year of publication, study design, study setting, population characteristics) extraction was done. Results: Out of 1,778 publications found at the initial stage, nine were included in the systematic review and quantitative meta-analysis. The majority (4/9) were cross-sectional studies. The prevalence of hearing impairment defined as per the protocol was 41% (total population 1,548). The I2 statistic was used to test statistical heterogeneity, with values of >50% representing important heterogeneity, then a random-effects model was used to perform the meta-analysis. A subgroup analysis was performed for the age group ≤18 years and >18 years. All analyses were conducted using the R software version 4.1.0. It was found that most of the studies (8/9) suffered moderate-serious overall risk across all the domains of ROBINS-1 tool. Conclusion: This study showed a positive association of HL with lamivudine in patients with HIV infection