Role of earth observations for sustainable development: emerging trends

Sustainable development aims at optimal use of natural resources, protection and conservation of ecological systems, and improving economic efficiency. It tries to provide food, fuel, fiber and shelter for the ever increasing world population on sustainable basis. Ecosystems like agro, coastal, forest, freshwater and grasslands, and natural disasters are some of the ideal facets for examining the magnitude of the problems and the plausible solutions that need to be generated. Decision-making for sustainable development is a complex process and involves studying trade-offs that need to be made among conflicting goals of different sectors. The present paper examines the scope for Earth Observation (EO) contributions towards the above, and tries to profile the EO capabilities vis-a-vis the systems' information needs. It further identifies the gaps, which EO needs to fulfill towards meeting either the imaging or processing needs of various applications. Considering these, in the next 6-7 years, a host of spacecraft systems carrying different sensors have been planned across the globe including India. Endeavours of NASA, ESA, India, JAXA etc. and complementary data sharing initiatives by International Charter on Space and Major Disasters and the UN agencies are expected to enlarge the scope for increased role of EO data towards the cause of sustainable development

A prospective study of efficacy and safety of olopatadine versus azelastine in allergic conjunctivitis at a tertiary care hospital

Background: Allergic conjunctivitis, an ocular surface inflammatory disease with significant social and economic impact affects approximately 25% of the general population. H1 receptor blockers, mast cell stabilizers and drugs that block cytokine and prostaglandin formation form the treatment armamentarium. Olopatadine hydrochloride and Azelastine hydrochloride are dual-acting selective H1 receptor antagonist with mast-cell stabilizing property. This study was undertaken to assess the efficacy and safety of olopatadine hydrochloride 0.1% and Azelastine hydrochloride 0.05% in allergic conjunctivitis amongst Indians.Methods: After obtaining Institutional Ethics Committee approval and written informed consent, 120 patients diagnosed with allergic conjunctivitis fulfilling the inclusion/exclusion criteria were enrolled in the study. Study was done from April 2014 to June 2015 at Minto eye hospital. Study subjects were treated with olopatadine hydrochloride 0.1% and Azelastine hydrochloride 0.05% eye drops BD for 15 days. Ocular symptoms, instead of and signs and adverse events, if any were recorded on the day 8 and day 15 follow up visits.Results: At the end of the study period, the reduction in the ocular itching score from baseline was higher in the olopatadine group compared to the azelastine group (p<0.002). Similarly, the scores of ocular congestion (p<0.008), foreign body sensation (p<0.009), tearing (p<0.001), erythema (p<0.002) and chemosis (p<0.015) also showed larger reduction in the olopatadine treated patients. The common adverse events encountered in both the groups were stinging after instillation, burning, bitter taste and headache.Conclusions: In allergic conjunctivitis, both olopatadine and azelastine were found to be effective in relieving ocular signs and symptoms, but olopatadine was found to be superior in terms of efficacy, safety and tolerability with minimal side effects

Knowledge, attitude and practice towards pharmacovigilance among postgraduate medical students at a tertiary care hospital: a cross sectional questionnaire based study

Background: Adverse drug reaction (ADR) is major global health problem affecting both children and adults. ADRs are among the leading cause of mortality and morbidity leading to prolonged hospitalization. Hence, spontaneous reporting of ADRs by healthcare professionals forms the backbone of pharmacovigilance. Therefore, there is an urgent need for sensitization about drug safety monitoring among healthcare professionals (HCPs).Methods: A cross sectional questionnaire based study was conducted among 200 postgraduate medical students between April 2016 and May 2016 using a pre-validated questionnaire. Descriptive statistics was used for analysis.Results: Among 200 questionnaires distributed, only 150 provided responses reflecting a response rate of 75%. The postgraduates who understood the definition of adverse drug reaction and pharmacovigilance were 90% and 64% respectively. The most encouraging finding was 97% of postgraduates thought that reporting an ADR was necessary which in turn increases the patient safety. 60% postgraduates were unaware that the nurses and pharmacists also had the responsibility of reporting ADR. The postgraduates who encountered ADRs during clinical practice were 79% whereas reporting was only 2%.Conclusions: This study suggests that even though majority of postgraduates have better knowledge and attitude towards pharmacovigilance and ADR, the practice of reporting ADRs is inadequate. Therefore, there is an urgent need for educational intervention in the form of training programmes and continued medical education (CME) periodically to encourage ADR reporting among the postgraduates

Reassessment of dispensing pharmacy and animal experiments in undergraduate practical pharmacology curriculum: feedback from students

Background: Dispensing pharmacy exercises and animal experiments are still being taught in medical colleges even though they are not relevant for clinical practice. One has to keep pace with ever changing needs of the students and changing trends. So this study is designed to know the perceptions and alternative suggestions of MBBS students regarding dispensing pharmacy and animal experiments and use them to improve teaching.Methods: 177 MBBS students studying at Bangalore medical college who have completed their university examination in pharmacology subject were included in this questionnaire based study. The data was analysed using descriptive statistics.Results: Majority of the students disfavoured dispensing pharmacy (82%) and animal experiments (73%) in undergraduate practical pharmacology. 78% of the students preferred computer assisted learning (CAL) as an alternative to animal experiments. Some of the clinical pharmacology exercises favoured by students,  as an alternative to dispensing pharmacy were, drug station (clinical station) with real cases in hospital (88%), module on various drug formulations (74%), module on pharmacovigilance (74%), problem based exercises (73%), drug administration procedures (68%), drug dosage calculations (68%), pharmacoeconomic exercises (66%), prescription writing and criticism of prescription (62%), short term research project (44%) and so on.Conclusions: Computer assisted learning seems to be a better alternative to animal experiments. In the changing scenario, teaching clinical pharmacology should be focused rather than teaching dispensing pharmacy, which is obsolete

Efficacy and safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in the treatment of primary open angle glaucoma: a comparative study at a tertiary care hospital

Background: Prostaglandin analogues (PGAs) reduce intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG); however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). Hence the above study was taken to evaluate the benefit of BAK-free formulations of travoprost. The objectives of the study were to compare the efficacy, safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in patients with primary open angle glaucoma.Methods: 40 patients with POAG who fulfilled the inclusion /exclusion criteria were randomised into two groups of 20 each to receive BAK-free travoprost 0.004% or BAK-preserved travoprost once daily in the evening. Efficacy was measured in terms of reduction in IOP monitored at 4, 8 and 12 weeks from baseline. Ocular surface disease index (OSDI) questionnaire was used to assess the ocular surface symptoms. Safety was assessed by monitoring treatment emergent adverse drug reactions (ADRs).Results: Both the study medications were effective in reducing IOP when compared to baseline. Mean IOP reduction from baseline to week 12 was 11±3mmHg (p <0.001), 10.78±3.01mmHg, (p<0.001) in BAK-free travoprost and BAK-preserved travoprost groups respectively. Both produced equivalent reductions in IOP at the end of 4 (7.89±1.82 vs 7.63±2.83, p=0.72), 8 (9.94±2.75 vs10.05±2.75, p=0.90), and 12 weeks (11±3 vs10.78±3.01, p=0.82). BAK-free travoprost demonstrated significantly lower OSDI scores (15.10±3.60) compared to BAK- preserved travoprost (23.47±7.10) at 12 weeks (p <0.0001). There was no significant difference in occurrence of conjunctival hyperaemia between the study drugs (c2 = 0, df = 1, p = 1) and BAK-free travoprost was well tolerated.Conclusions: BAK-free and BAK-preserved travoprost significantly reduced IOP at 12 weeks. But, BAK- free travoprost produced significantly less ocular surface symptoms as compared to BAK- preserved travoprost. Hence it could be a favourable option in POAG patients with ocular surface disease symptoms

Profile of serious adverse drug events in a tertiary care hospital of South India - a five years experience

Background: Adverse drug event (ADE) is said to be serious, when it is life-threatening, leads to hospitalization, disability, congenital anomaly, death or requires intervention to prevent permanent impairment or damage. The present study aimed to determine the pattern, causality, preventability of serious ADEs.Methods: This retrospective study was carried out to profile serious ADEs reported from Bangalore Medical College and Research Institute to Adverse Drug Reaction (ADR) Monitoring Centre, under Pharmacovigilance Programme of India from 2012 to 2016. Patient demographics, clinical and drug data, details of the ADE, onset time, causal drug details, outcome and severity were collected as per CDSCO form. Causality was assessed by WHO-ADR probability scale, preventability by modified Schumock and Thornton scale.Results: A total of 809 ADEs were reported, of which 50 (6.18%) were serious in nature. Male preponderance (74%) was observed, with 42% among patients aged 20-40 years. 56% of serious ADEs were reported from department of Dermatology. Steven Johnson Syndrome (SJS) (20%) contributed for most of the ADEs. Antiepileptics caused maximum number of serious ADEs (32%). 76% of the ADEs were found to be ‘probable’ and 4% were definitely preventable. 56% of them was life threatening and 86% required intensive interventions. 16% patients experienced serious ADEs during hospital stay.Conclusions: Serious ADEs constituted 6.18% of all ADEs reported. SJS was commonly seen with antimicrobials and hepatotoxicity with ATT. Antiepileptics and ATT contributed for majority of them. This study highlights the importance of monitoring and timely management of serious ADEs to commonly prescribed medications

A comparative study of probiotic, prokinetic based triple therapy with USFDA regimen in the eradication of Helicobacter pylori in a tertiary care hospital

Background: Helicobacter pylori infection has been associated with peptic ulcer disease, gastric carcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma. Its eradication is important and current regimens are associated with antibiotic resistance, side effects and poor patient compliance. Probiotics supplementation can overcome the above problem and additions of prokinetics improve dyspepsia symptoms and thereby improve patient compliance. So the aim of the study was to compare efficacy and safety of standard United States Food and Drug Administration (USFDA) regimen with probiotic, prokinetic based novel regimen.Methods: 100 patients diagnosed with H. pylori infection were randomly assigned into two eradication regimen groups viz., group A and group B. Group A received standard USFDA regimen, amoxicillin 1 gm, lansoprazole 30 mg and clarithromycin 500 mg twice a day for 2 weeks and group B received a probiotic and prokinetic itopride 50 mg thrice daily, pantoprazole 40 mg, amoxicillin 1 gm and clarithromycin 500 mg twice daily for 2 weeks. Patients with Rapid Urease Test (RUT) and histopathology reports negative for H. pylori were considered as eradicated and then the percentage of eradication rate in both groups was compared.Results: H. pylori eradication rates were more in group B compared to group A (84% vs 70%, p =0.096 at 95% CI). The occurrence of side effects was less in group B compared to group A (30% vs 46%, p= 0.099). Diarrhoea was statistically less in group B compared to group A (p< 0.05).Conclusions: Probiotics supplementation increases eradication rates of anti H. pylori therapy and improves tolerability by reducing side effects especially diarrhoea. Prokinetics and probiotic based novel regimen improved dyspepsia symptoms and patient compliance

A prospective cohort study to evaluate the correlates of polypharmacy and its association with depression among elderly patients

Background: Polypharmacy is a reliable indicator of irrational prescribing particularly among elderly. Polypharmacy increases the risk of adverse drug reactions (ADRs) exponentially imposing higher economic burden. Addressing and evaluating the prescribing practices in elderly will rationalize the drug utilization leading to improvement in quality of health care. The present study was taken to evaluate the determinants of polypharmacy and its association with depression, defined as a 15 item geriatric depression scale (GDS) >6, in elderly patients.Methods: This prospective cohort study was conducted at department of medicine, Victoria hospital, Bengaluru 100 patients aged 60 and above years was enrolled. Relevant data regarding patients’ demographic details, smoking and alcohol consumption, medical diagnosis and drug details were collected. Geriatric Depression Scale was used to diagnose depression.Results: Out of 100 patients screened, 36% were males and 64% were females. Polypharmacy was noted in 73% of the elderly, of which 43% had cumulative co morbidity (≥4 diagnoses).  68% were found to have a GDS score of ≥6, which corresponded to Depression. Patients with depression (GDS score ≥6) had 1.54 (OR-1.54, 95% CI-0.59-4.01) times more risk of encountering polypharmacy (≥4 drugs). Cumulative co-morbidity (OR-1.52, 95% CI-1.08–2.11, p <0.05) was identified as an independent correlate of polypharmacy.Conclusions: Increasing age, males, Cumulative comorbidity of ≥4 diagnoses and geriatric depression were found to be the positive correlates of polypharmacy in elderly. Though geriatric depression increases the odds of encountering polypharmacy, it does not affect drug consumption directly; rather it is an important index of cumulative co-morbidity which influences polypharmacy significantly

A comparative single dose study of oral acetaminophen 650 mg to its standard 500 mg dose in adult pyrexia patients in a tertiary care hospital

Background: Acetaminophen commonly called as paracetamol is the most used ‘over-the-counter’ analgesic for headache, musculoskeletal pain, dysmenorrhoea etc. It is the best drug to be used as antipyretic for fever due to any cause and safest to be prescribed in all age groups. Antipyretic dose of acetaminophen is 325 to 650 mg; 3 to 4 times a day and is available in the strength of 650 mg and 500 mg tablets. This study was conducted to analyse the antipyretic efficacy and safety profile of two different doses of acetaminophen in patients with low grade fever.Methods: 300 hospitalised patients aged more than 18 years, in department of General Medicine, having low grade fever (38º to 39º C) were randomly allocated into two groups of 150 each, group A received 500 mg and group B received 650 mg of single oral dose of acetaminophen tablets. Oral temperature was measured before dosing, 30 minutes after dosing, one hour, two hourlies thereafter for 6 hours after the dose. Safety was assessed by monitoring for adverse effects during the study and 24 hours after administration of the assigned drug.Results: There was a statistically significant decrease in temperature in group B patients from baseline 39.06±0.87º C to 37.02±0.89º C at the end of 6th hour as compared with 39.18±0.80º C to 38.03±0.77º C in Group A patients (p=0.031).Conclusions: Our study concluded that acetaminophen in a dose of 650 mg is highly efficacious antipyretic drug compared to acetaminophen 500 mg with no adverse effects

A Comparative study to assess the effectiveness and safety of cilnidipine versus amlodipine in patients with newly diagnosed essential hypertension: insights from a single centre prospective observational study

Background: Calcium channel blockers (CCBs) are proposed to play a pivotal role for the management and control of hypertension. Dihydropyridine-type calcium channel blockers (CCBs) like Amlodipine are frequently used because for their strong antihypertensive and minimal adverse side effects. However, it is commonly associated with the causation of pedal edema among the patients. Cilnidipine, which is a novel new generation calcium channel blocker, is presumed to cause lesser pedal edema with a satisfactory clinical control of hypertension along with negligible side effects. This study was carried out to compare clinical effectiveness and safety profile between Amlodipine and Cilnidipine.Methods: A prospective, randomized, open label study of 12 weeks’ duration was conducted amongst 60 patients with newly diagnosed essential hypertension. 30 patients of one group received Tab. Amlodipine 5 mg and 30 patients of same age groups received Tab. Cilnidipine 10mg.Results: There was a highly statistically significant decrease in the level of blood pressure in the Cilnidipine group compared to the Amlodipine group mainly at day 90 (P<0.001). Cilnidipine treated group had a fall in blood pressure of 23 ± 8 mmHg and the Amlodipine group had a decrease in the blood pressure of 12±7mmHg. Additionally, there was also significant reduction in pulse rate in the cilnidipine group. Only 4 patients in the Cilnidipine group developed ankle edema which completely disappeared at the end of 12 weeks of therapy compared to 9 patients in the Amlodipine group which persistently worsened at the completion of the study.Conclusions: Our study concluded that cilnidipine was a well-tolerated anti-hypertensive drug amongst patients with newly diagnosed essential hypertension and associated with minor adverse effects