Prescription audit of online booked outpatients for department of medicine and dermatology in a tertiary care hospital: a comparative observational study

Background: A regular and effective prescription audit is a key tool to ensure rational use of drugs and to assess drug utilization in the health care system. This study is first of its kind, in Rajendra Institute of Medical Sciences (RIMS), Ranchi, highlighting comparative assessment of prescriptions of online booked appointments in department of medicine and dermatology via online registration system (ORS) using WHO prescribing indicators. This ORS is an integral part under Digital India Initiative.Methods: This was a comparative, observational study conducted in Department of Pharmacology of RIMS, Ranchi. The study period was 6 months from 1 March 2019 to 31 August 2019. Prescriptions details of outpatient department (OPD) patients were collected from the government authorized pharmacy facility “Dawai Dost “at RIMS. 75 prescriptions from each of the departments were analyzed.Results: 75 prescriptions from patients who attended medicine and dermatology outpatient department (OPD) during the study period, after registering appointment via ORS, was collected and comparative assessment was done. This audit highlights important correctable parameters although legibility was not the major concern. Adherence to National List of Essential Medicines (NLEM) was 45% and 49% for department of medicine and dermatology respectively.Conclusions: The prescription audit process should be done regularly to assess ORS prescription to ensure high quality rational prescribing and support Digital India initiative. Adherence to NLEM of India should be 100%. The latest NLEM of India should be provided to the concerned departments and feedback should be provided to the physicians.

Impact Of Music Therapy On Stress Management

Music, as an art form holds a special place in human culture. It encompasses a wide range of sounds and melodies that evoke emotions, thoughts, and memories. Traditional philosophies define music as tones ordered horizontally (as melodies) and vertically (as harmonies). Music theory, within this realm, is studied with the presupposition that music is orderly and often pleasant to hear. Music Therapy is the clinical & evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Studies suggest that those undergoing music therapy experience reduced anxiety immediately after the session, which indicates that music therapy could be a convenient way to reduce symptoms quickly. Studies also suggest that music therapy can improve symptoms of depression, with those undergoing music therapy along with standard treatments for depression such as talking therapy improving more than people who only received standard therapy. Chen, X., Wei, Q., Jing, R., & Fan, Y. (2021) conducted a study on cancer patients to investigate the effects of music therapy on stress and quality of life. The results indicated that music therapy interventions significantly reduced stress levels and enhanced the overall quality of life for cancer patients1. In a study conducted by Shirsat, A., Jha, R. K., & Verma, P. (2023), researchers explored the impact of music therapy on individuals with Alzheimer's disease. They found that music therapy could be a powerful treatment strategy, improving cognitive function and emotional well-being in Alzheimer's patients2. The importance of consulting qualified music therapists when implementing music therapy as a stress management tool will be emphasized. The findings and insights from this study, underlining the significance of music therapy in stress management for man and women are significant. The role of music therapy in fostering social connections and providing support will be explored, emphasizing its significance in stress management

Impact Of Music Therapy On Stress Management

Music, as an art form holds a special place in human culture. It encompasses a wide range of sounds and melodies that evoke emotions, thoughts, and memories. Traditional philosophies define music as tones ordered horizontally (as melodies) and vertically (as harmonies). Music theory, within this realm, is studied with the presupposition that music is orderly and often pleasant to hear. Music Therapy is the clinical & evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Studies suggest that those undergoing music therapy experience reduced anxiety immediately after the session, which indicates that music therapy could be a convenient way to reduce symptoms quickly. Studies also suggest that music therapy can improve symptoms of depression, with those undergoing music therapy along with standard treatments for depression such as talking therapy improving more than people who only received standard therapy. Chen, X., Wei, Q., Jing, R., & Fan, Y. (2021) conducted a study on cancer patients to investigate the effects of music therapy on stress and quality of life. The results indicated that music therapy interventions significantly reduced stress levels and enhanced the overall quality of life for cancer patients1. In a study conducted by Shirsat, A., Jha, R. K., & Verma, P. (2023), researchers explored the impact of music therapy on individuals with Alzheimer's disease. They found that music therapy could be a powerful treatment strategy, improving cognitive function and emotional well-being in Alzheimer's patients2. The importance of consulting qualified music therapists when implementing music therapy as a stress management tool will be emphasized. The findings and insights from this study, underlining the significance of music therapy in stress management for man and women are significant. The role of music therapy in fostering social connections and providing support will be explored, emphasizing its significance in stress management

Nimesulide induced toxic epidermal necrolysis: a rare case report

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Nimesulide, a selective cyclo-oxygenase (COX-2) inhibitor was first launched in Italy in 1985 and subsequently marketed in more than 50 countries including India. Due to its better and faster antipyretic action, it has gained popularity among physicians and paediatricians. Here, we report a case of 60 years old male patient who developed toxic epidermal necrolysis (TEN) following ingestion of tablet nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, anti-fungal and supportive care. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN. Nimesulide has never been approved in countries like USA, Canada, Britain, New Zealand, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and medical practitioners should report all the adverse drug reactions to such drugs.

Immunoinformatics and reverse vaccinology approach in designing a novel highly immunogenic multivalent peptide-based vaccine against the human monkeypox virus

Background: Monkeypox is a highly infectious zoonotic disease, often resulting in complications ranging from respiratory illnesses to vision loss. The escalating global incidence of its cases demands prompt attention, as the absence of a proven post-exposure treatment underscores the criticality of developing an effective vaccine.Methods: Interactions of the viral proteins with TLR2 and TLR4 were investigated to assess their immunogenic potentials. Highly immunogenic proteins were selected and subjected to epitope mapping for identifying B-cell and MHC class I and II epitopes. Epitopes with high antigenicity were chosen, considering global population coverage. A multi-target, multi-epitope vaccine peptide was designed, incorporating a beta-defensin 2 adjuvant, B-cell epitopes, and MHC class I and II epitopes.Results: The coordinate structure of the engineered vaccine was modeled and validated. In addition, its physicochemical properties, antigenicity, allergenicity, and virulence traits were evaluated. Molecular docking studies indicated strong interactions between the vaccine peptide and the TLR2 receptor. Furthermore, molecular dynamics simulations and immune simulation studies reflected its potent cytosolic stability and robust immune response dynamics induced by the vaccine.Conclusion: This study explored an innovative structure-guided approach in the use of immunoinformatics and reverse vaccinology in pursuit of a novel multi-epitope vaccine against the highly immunogenic monkeypox viral proteins. The simulation studies indicated the engineered vaccine candidate to be promising in providing prophylaxis to the monkeypox virus; nevertheless, further in vitro and in vivo investigations are required to prove its efficacy

Assessment of ecosystem services of rice farms in eastern India

Authors acknowledge the financial help provided by Ministry of Earth Sciences, Govt. of India and also thank Director General, Indian Council of Agricultural Research (ICAR) and Director, ICAR-National Rice Research Institute (NRRI) for giving all the necessary help in executing the work. The help provided by Odisha state officials in carrying out the survey work is gratefully acknowledged. This study is a part of the project entitled “Delivering food security on limited land (DEVIL; Belmont Forum / FACCE-JPI via NERC: NE/M021327/1).Peer reviewedPublisher PD

Fc-Optimized Anti-CD25 Depletes Tumor-Infiltrating Regulatory T Cells and Synergizes with PD-1 Blockade to Eradicate Established Tumors

CD25 is expressed at high levels on regulatory T (Treg) cells and was initially proposed as a target for cancer immunotherapy. However, anti-CD25 antibodies have displayed limited activity against established tumors. We demonstrated that CD25 expression is largely restricted to tumor-infiltrating Treg cells in mice and humans. While existing anti-CD25 antibodies were observed to deplete Treg cells in the periphery, upregulation of the inhibitory Fc gamma receptor (FcγR) IIb at the tumor site prevented intra-tumoral Treg cell depletion, which may underlie the lack of anti-tumor activity previously observed in pre-clinical models. Use of an anti-CD25 antibody with enhanced binding to activating FcγRs led to effective depletion of tumor-infiltrating Treg cells, increased effector to Treg cell ratios, and improved control of established tumors. Combination with anti-programmed cell death protein-1 antibodies promoted complete tumor rejection, demonstrating the relevance of CD25 as a therapeutic target and promising substrate for future combination approaches in immune-oncology