A prospective observational study of adverse drug reactions to antiretroviral therapy: type and risk factors in a tertiary care teaching hospital

Background: To collect demographic details of patients receiving antiretroviral therapy (ART) and study type of adverse drug reactions (ADRs) and risk factors for ADRs to ART and to assess causality, severity, and preventability assessment of the reported ADRs.Methods: A prospective observational study was conducted for 6 months from January 2012 until June 2012 at ART Center, KR Hospital of Mysore Medical College & Research Institute, Mysore. Data were evaluated for patient demography, risk factors for ADRs, type of ADRs. ADRs were also assessed for their causality, severity, and preventability as per the standard algorithm, using SPSS for windows (version 16.0).Results: Out of 158 patients evaluated, majority were of age group of 21-40 years (66.5%). More number of illiterate patients (55.7%) showed ADRs to ART. Most patients were of CD4 count <250 cells/μl (65.82%). Most common regimen which caused ADRs was zidovudine + lamivudine + nevirapine. Most common type of ADRs was anemia (55.06%) and rash (25.31%). On evaluation of the causality of ADRs, majority were found to be possible (89.24%). The severity assessment showed that most of the patients ADRs were of level 3 (93.05%). The preventability assessment showed that 30.38% patients ADRs were preventable.Conclusion: Identifying risk factors are of crucial importance to optimize the initial choice of ARVs regimen before initiating therapy and to prevent severity and complications caused by ART, thereby improving the quality of care to patients on ART

Treatment of acute ischemic stroke with recombinant tissue plasminogen activator: practice pattern among neurologists and physicians

Background: Stroke is an abrupt onset of a neurologic deficit due to a focal vascular disease. Treatment guidelines for acute ischemic stroke (AIS) within 4.5 hours of onset are thrombolysis with recombinant tissue plasminogen activator (rtPA). To determine the practice pattern of rtPA in the treatment of acute ischemic stroke among consultants using a questionnaire.Methods: A questionnaire based study was carried out from May to September 2015. Neurologists and physicians from Kolar and Bengaluru were given a questionnaire comprising of 21 questions, regarding the treatment of AIS with rtPA. The data was analyzed using descriptive statistics.Results: A total of 76.9% responded to the questionnaire, of which 18 were neurologists and 82 were physicians. An average of 4-5 AIS patients per month were seen by the doctors. Majority (72%) did not use rtPA, due to delay in patient reaching hospital or non-affordability of the drug. The consultants (66%) opined that rtPA was the best if patient arrived within 4.5 hours of onset of AIS. Only 34% consultants knew the correct score of AIS for administration of rtPA. The usage of penumbral imaging before thrombolysis was agreed by neurologists (58%) and physicians (34%). The IV+IA rtPA thrombolytic therapy produced highest rate of recanalization as expressed by neurologists (84%) and physicians (56%). Majority (80%) felt that use of rtPA beyond 4-6 hours had no beneficial effect. The adverse effects encountered were hypotension and bleeding.Conclusions: Neurologists and physicians opined that treatment with rtPA was effective in patients of AIS within 4.5 hours of onset, but the limitations were late arrival of patient to hospital and drug cost

Machine Learning Algorithm to Identify Hesitancy Towards Covid-19 Vaccination Among the Rural Citizens Under E-Governance Initiatives

The Indian Government has taken massive initiatives to control the pandemic virus of COVID-19. Recently, the Government has decided to begin the process of a large-scale vaccination programme to create an end to the crisis due to COVID-19. However, vaccination is found to be the major solution as suggested by various health care experts to stop the widespread of this deadly virus, hesitancy towards getting vaccinated is found to be more in the rural villages of India. The process of getting vaccinated was not made compulsory by the government, but still there exists skepticism in minds of rural citizens towards COVID-19 vaccination. Text Analytics has been implemented to identify the exact emotions among rural citizens towards COVID Vaccinations. Hence the present research study has identified the major reasons for hesitancy towards getting vaccinated for COVID-19 using machine learning techniques. The researchers of the current study have also measured the emotions and signs of sentiments of the rural citizens on COVID-19 vaccination

A qualitative, grounded theory exploration of the determinants of self-care behavior among Indian patients with a lived experience of chronic heart failure

Prior reports have documented extremely poor adherence to evidence-based medications among South Asian patients with established chronic cardiovascular diseases. Treatment adherence is now considered a part of the ‘self-care’ process, the determinants of which have not been adequately explored or explained among South Asian patients with chronic heart failure (CHF). Our objective was to qualitatively ascertain the determinants of the selfcare process among Indian patients with a lived experience of heart failure

Meeting sustainable development goals via robotics and autonomous systems

Robotics and autonomous systems are reshaping the world, changing healthcare, food production and biodiversity management. While they will play a fundamental role in delivering the UN Sustainable Development Goals, associated opportunities and threats are yet to be considered systematically. We report on a horizon scan evaluating robotics and autonomous systems impact on all Sustainable Development Goals, involving 102 experts from around the world. Robotics and autonomous systems are likely to transform how the Sustainable Development Goals are achieved, through replacing and supporting human activities, fostering innovation, enhancing remote access and improving monitoring. Emerging threats relate to reinforcing inequalities, exacerbating environmental change, diverting resources from tried-and-tested solutions and reducing freedom and privacy through inadequate governance. Although predicting future impacts of robotics and autonomous systems on the Sustainable Development Goals is difficult, thoroughly examining technological developments early is essential to prevent unintended detrimental consequences. Additionally, robotics and autonomous systems should be considered explicitly when developing future iterations of the Sustainable Development Goals to avoid reversing progress or exacerbating inequalities

Treatment of acute ischemic stroke with recombinant tissue plasminogen activator: practice pattern among neurologists and physicians

Background: Stroke is an abrupt onset of a neurologic deficit due to a focal vascular disease. Treatment guidelines for acute ischemic stroke (AIS) within 4.5 hours of onset are thrombolysis with recombinant tissue plasminogen activator (rtPA). To determine the practice pattern of rtPA in the treatment of acute ischemic stroke among consultants using a questionnaire.Methods: A questionnaire based study was carried out from May to September 2015. Neurologists and physicians from Kolar and Bengaluru were given a questionnaire comprising of 21 questions, regarding the treatment of AIS with rtPA. The data was analyzed using descriptive statistics.Results: A total of 76.9% responded to the questionnaire, of which 18 were neurologists and 82 were physicians. An average of 4-5 AIS patients per month were seen by the doctors. Majority (72%) did not use rtPA, due to delay in patient reaching hospital or non-affordability of the drug. The consultants (66%) opined that rtPA was the best if patient arrived within 4.5 hours of onset of AIS. Only 34% consultants knew the correct score of AIS for administration of rtPA. The usage of penumbral imaging before thrombolysis was agreed by neurologists (58%) and physicians (34%). The IV+IA rtPA thrombolytic therapy produced highest rate of recanalization as expressed by neurologists (84%) and physicians (56%). Majority (80%) felt that use of rtPA beyond 4-6 hours had no beneficial effect. The adverse effects encountered were hypotension and bleeding.Conclusions: Neurologists and physicians opined that treatment with rtPA was effective in patients of AIS within 4.5 hours of onset, but the limitations were late arrival of patient to hospital and drug cost

Metallic conduction in NiS₂ nanocrystalline structures

Thermolysis of Ni butanethiolate in a sulfur atmosphere has been carried out at 300 and 600 &#176;C to produce NiS2 nanocrystalline films with mean crystallite sizes of 16 and 192 nm and resistivity values of &#8764;451 and 3540 &#956;&#8486;·m, respectively; the resistivity values are &#8764;2 orders of magnitude less compared to the bulk value (12000 &#956;&#8486;·m). This is a significant observation since NiS2 is an insulator in the bulk. Combining electrostatic force microscopy, transport, and surface degradation experiments, we establish conclusively that the surface layer of NiS2 is metallic. The density of the surface conduction states computed through the variable range hopping model is found to be comparable to the bulk density of states of good metals. The precursor is also amenable for patterning by electron beam and molding

Seroepidemological investigation of Toxoplasma gondii and Trichinella spp. in pigs reared by tribal communities and small-holder livestock farmers in Northeastern India.

Toxoplasma gondii and Trichinella spp. are critical tissue-dwelling foodborne zoonotic parasites associated with pork consumption and pig rearing. Despite being a major pig-rearing region in the country, Northeastern India has not undergone any investigation regarding the presence of T. gondii and Trichinella spp. in pigs. Therefore, this study aims to determine the seroprevalence of T. gondii and Trichinella spp. and identify associated risk factors in pigs reared by tribal communities and small-holder livestock farmers in the northeastern region of India. In a cross-sectional serological survey, 400 pigs from 400 households across five northeastern states of India underwent testing for the seroprevalence of porcine toxoplasmosis and trichinellosis. Serum samples (80 from each state) were analyzed using commercially available ELISA assays. Data on backyard farm characteristics and various management aspects were collected, and risk factors linked with prevalence were analyzed through univariate and multivariate logistic regression analysis. The findings revealed that the apparent and true prevalence of anti-T. gondii antibodies were 45% (40.12-49.88, 95% CI) and 45.7% (40.7-50.69, 95% CI), respectively. As for anti- Trichinella antibodies, both the apparent and true prevalence were 0.75% (-0.1-1.6, 95% CI). The univariate and multivariate analyses indicated that age above 24 months (OR 7.20, 95% CI 2.45-23.71), exposure to cats (OR = 5.87, 95% CI 2.55-14.05), and farms operating for breeding purposes (OR = 5.60, 95% CI 3.01-11.04) were significant risk factors associated with the seroprevalence of T. gondii. This study marks the initial documentation of the seroprevalence of T. gondii and Trichinella spp. in pigs reared by tribal communities in Northeastern India. The results emphasize the significance of these parasites as foodborne zoonotic threats in the region, potentially posing substantial public health risks, especially within tribal and rural communities. The insights derived from this research could be valuable in formulating targeted preventive and control strategies against T. gondii and Trichinella spp. in pigs, not only in this region but also in areas with similar rearing practices