Malabaricone-A Induces A Redox Imbalance That Mediates Apoptosis in U937 Cell Line

BACKGROUND: The 'two-faced' character of reactive oxygen species (ROS) plays an important role in cancer biology by acting both as secondary messengers in intracellular signaling cascades and sustaining the oncogenic phenotype of cancer cells, while on the other hand, it triggers an oxidative assault that causes a redox imbalance translating into an apoptotic cell death. PRINCIPAL FINDINGS: Using a tetrazolium [{3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl}-2H-tetrazolium] based cell viability assay, we evaluated the cytotoxicity of a plant derived diarylnonanoid, malabaricone-A on leukemic cell lines U937 and MOLT-3. This cytotoxicity hinged on its ability to cause a redox imbalance via its ability to increase ROS, measured by flow cytometry using 5-(and-6)-chloromethyl-2',7'-dichlorodihydrofluorescein diacetate and by decreasing glutathione peroxidase activity. This redox imbalance mediated apoptosis was evident by an increase in cytosolic [Ca(2+)], externalization of phosphatidyl serine as also depolarization of the mitochondrial membrane potential as measured by flow cytometry. There was concomitant peroxidation of cardiolipin, release of free cytochrome c to cytosol along with activation of caspases 9, 8 and 3. This led to cleavage of the DNA repair enzyme, poly (ADP-ribose) polymerase that caused DNA damage as proved by labeling with 4',6-diamidino-2-phenylindole (DAPI); furthermore, terminal deoxy ribonucleotide transferase catalysed incorporation of deoxy uridine triphosphate confirmed DNA nicking and was accompanied by arrest of cell cycle progression. CONCLUSIONS: Taken together, compounds like MAL-A having pro-oxidant activity mediate their cytotoxicity in leukemic cells via induction of oxidative stress triggering a caspase dependent apoptosis

ASSESSMENT OF PATIENTS’ KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Objectives: Proper assessment and understanding of knowledge, attitude and practice among diabetic population towards this disease is important as diabetes needs lifelong adoption of healthy lifestyles for prevention and control. This study aimed to assess diabetic patients’ knowledge, attitude and practice regarding diabetes mellitus in a tertiary care hospital. Methods: This cross sectional, observational and questionnaire based study was conducted over a period of two months on diabetic patients attending diabetic clinic. A pretested structured questionnaire consisting of 24 items was administered through face-to-face interview. Results: Responses from 129 subjects were analyzed. Most of the subjects could not define diabetes (60.45%), identified the symptoms of diabetes (polyurea 62.79% and polyphagia 55.81%), and knew that lifestyle modification was necessary to control diabetes (exercise 66.66%, dietary modification 62.79%). However they had notion that bitter substances could cure diabetes (51.93%) and insulin should be avoided (28.68%). Majority of the subjects did not monitor blood glucose at home (81.4%) and did not take care of their feet (59.69%). Patients’ knowledge was positively associated with family history, duration of diabetes and level of education. Duration of diabetes and educational level were positively associated with practice of the patients.   Conclusion: Present study reflects that diabetic patients require support and guidance for practicing better disease management. Role of a clinical pharmacist and clinical activities like patient counselling and pharmaceutical care program may help in improving patients’ knowledge, attitude and practice for managing diabetes

FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT BABY: A CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL

Objectives: Low birth weight is a challenging multifaceted public health problem due to its association with increased risk of morbidity and mortality of infants. Both community and institution based studies are needed to find out the lacunae regarding occurrence of low birth weight babies, so that effective strategies which are relevant to the local conditions can be adopted for its prevention. We conducted this study to estimate the prevalence and determine the factors associated with low birth weight in the live born infants delivered in a tertiary care hospital. Methods: This was an observational, cross-sectional questionnaire-based study done in the Department of Pharmacology and Department of Gynaecology and Obstetrics in this tertiary care hospital. Mothers who gave birth to their baby in the Obstetrics Ward were included. The subjects underwent a face-to-face interview using a suitably designed and validated questionnaire and the data were collected. Results: A total of 360 subjects were interviewed. 34.7% of mothers were below 20 yrs of age. Majority of the mother had education up to secondary level (58.33%) and were housewife (82.22%). 58.2% of mothers belonged to family size of 5-10 members. Among the 104 low birth weight infants, 63.46% were small for date and 36.54% were preterm. The mean weight of the newborn was 2.54 kg. Maternal age, number of family members, number of anti natal care visits, anemia maternal weight gain during pregnancy were associated with low birth weight (p<0.05). No significant differences were found among the newborns with and without low birth weight regarding the variables like religion, family type, maternal addiction, pervious abortion and tetanus toxoid taken by the mother. Conclusion: As low birth weight is the major cause of perinatal morbidity and mortality, every step should be taken for its prevention. In this regard, proper maternal education for antenatal care and regular visit to antenatal care clinic should be done. Field workers may help to impart correct knowledge of diet through proper health education besides providing other advices like delaying the age of first child, birth spacing, and family planning services utilization.     &nbsp

PRESCRIPTION AUDIT FROM THE OUT-PATIENT DEPARTMENT OF A RURAL HOSPITAL IN WEST BENGAL, INDIA: A CROSS SECTIONAL STUDY

Objectives: Standards of the medical treatment at different levels of the healthcare delivery system influence the quality of life. A prescription audit is a kind of vigilant activity that can oversees the observance of these standards. We conducted a prescription audit study to evaluate the prescribing pattern in the out-patient department in a rural hospital in West Bengal. Methods: The study was a cross-sectional study spanning for a period of 1 month from 1st September 2021 to 30th September 2021. It was conducted at the general out-patient department (OPD) of a Rural Hospital in West Bengal. 490 First encounter prescriptions were collected from the out-patient department and was reviewed for analysis. Results: Out of 490 OPD all of them contained the name, age and gender of the patient but body weights of the patients were documented only in 12.4% of cases. Only 43.7% of prescriptions contained a proper diagnosis and the route of administration was mentioned in only 58.4% of cases. Generic name was written among 78.2% prescriptions and 2.9% contained an injection. Antibiotic was prescribed in 19.4% of total prescriptions collected and 32.3% of drugs were from the essential drug list. Correct duration of treatment was given in 32.7% of drugs. 26.4% of prescriptions followed the standard treatment guidelines.  Conclusion: Our study showed encouraging trends regarding generic drug prescribing and limitation of antibiotic usage yet there are deficits in mentioning the diagnosis and vital drug related information like route of administration and duration of therapy

A study of knowledge, attitude and practice regarding administration of pediatric dosage forms and allied health literacy of caregivers for children

Context: Caregivers of sick children have to be careful with medicine dosing and giving medicines to a reluctant child can be challenging. Aim: To assess the knowledge, attitude, and practices of caregivers regarding pediatric medicine administration and health literacy allied to this task. Settings and Design: This cross-sectional study was carried out on outpatient and inpatient basis in the pediatrics department of a teaching hospital over 6 months. Subjects and Methods: Data regarding sociodemographic profile of patient and caregiver, idea regarding pediatric dosage forms, dosing of medicines, and medication errors during administration were recorded from 377 caregivers. Reconstitution of dry powder and measurement of 5 mL liquid medicine using measuring cup of the medicine phial was demonstrated by the caregivers. Statistical Analysis: Association assessed by point biserial correlation and Spearman's rank correlation. Results: Majority of the primary caregivers surveyed were young, educated, homemaker mothers. Liquid medicines were used maximally (88.9%). Majority (87.3%) of the caregivers used standardized dosing instruments to measure liquids and reconstitution (85.9%), and teaspoon measurement task (91%) was performed satisfactorily by most. Some potentially wrong practices (e.g., adding medicine to milk, redilution of reconstituted medicine, and storing beyond the recommended period) were recorded. Medication errors were reported by 44.5% caregivers, significantly more in the outpatient setting. Although the statistical correlation was weak, the chance of medication error was less, and the precision of measurement was better with increasing education of the caregiver. Conclusions: Physicians need to be aware of the limitations of knowledge and the possibility of wrong administration practices among caregivers of children. Remedial measures in this regard can reduce the risk of medication errors

A study on the evaluation of bite force, prosthetic and nutritional status in adult cleft patients in Kolkata

Context: Altered orofacial morphology and poor dental status affects the dietary intake of cleft patient, making susceptible to nutritional imbalance. Oral health care planning for this population is impossible without the evaluation of stomatognathic functional status as well as prosthetic and nutritional status and need. Aims: The aim of this study was to evaluate prosthetic status and prosthetic treatment need, bite force and nutritional status, in adult cleft patients and to compare them with the adult noncleft population of similar definition. Settings and Design: Cleft (n = 250) and noncleft (n = 250) individuals of either sex, aged 18 years or above, excluding severe medically compromised and differently abled, were examined and individual biteforce was measured after obtaining written consent and ethical clearance from the two institutions in Kolkata. Subjects and Methods: A “raw data sheet” was prepared according to the parameters of the “Oral Health Surveys: Basic methods,” World Health Organization (1997) for evaluation of prosthetic status and need, dentition status and Mini-Nutritional Assessment, Nestlé (1994) for the evaluation nutritional status. A Gnathodynamometer was used to record bite force. Statistical Analysis Used: Statistical analysis was performed using SPSS 20.0.1, Graph Pad Prism version 5, Student's t-test, and Chi-square test. Results: The mean bite force of frontal area in cleft group (3.4356 ± 0.9457 kgf) was found to be significantly lower (P < 0.0001) than in noncleft (22.8749 ± 5.3644 kgf) group. The difference of mean bite force in the right side (2.4576 ± 0.6131 kgf) and left side (1.2708 ± 0.1036 kgf) in cleft group was found to be statistically significant (P < 0.0001). Prosthetic need in maxillary arch was found to be significantly (χ2: 490.0000; P < 0.0001) higher in cleft than in noncleft group. Nutritional status was observed to be significantly (χ2: 179.4049; P < 0.0001) higher “at risk” in cleft than in noncleft group. Conclusions: Lack of adequate Government concern leading to significantly higher prosthetic need and lower prosthetic status, hence lower bite force resulting lower nutritional status in adult cleft patients in Kolkata

Myeloid derived suppressor cells (MDSCs) can induce the generation of Th17 response from naïve CD4+ T cells

IL-17 producing CD4+ T cells (Th17) are identified as a subset of proinflammatory T cells present at the tumor site of various murine and human cancer cases and plays a crucial role in shaping the neoplastic process through fostering tumor angiogenesis and metastasis. However, the development of Th17 response in the tumor microenvironment has not yet been fully elucidated. Herein, we make an attempt to disclose the involvement of tumor infiltrating antigen presenting cells (APCs), especially tumor associated macrophages (TAMs) and myeloid derived suppressor cells (MDSCs) to polarize naïve CD4+ T cells toward IL-17+ T cells. We have found that MDSCs either isolated from the tumor site or generated in vitro are superior over TAMs to induce IL-17 production by naïve CD4+ T cells. Furthermore, we have shown that MDSCs mediated induction of IL-17+ T cell response is independent of MDSCs-T cell contact but crucially depends on the cytokines secreted by MDSCs. Our study will help to develop potential therapeutic strategies by harnessing the ability of MDSCs to induce IL-17 production by CD4+ T cells and thus restrict the generation of inflammatory Th17 population at the disease site

PERCEPTION OF QUALIFIED MEDICAL PRACTITIONERS TOWARD PRESCRIBING IN INTERNATIONAL NON-PROPRIETARY (GENERIC) NAMES – AN OBSERVATIONAL, CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL IN INDIA

Objectives: The study was conducted to assess the perception and practice of medical practitioners, working in tertiary care, and teaching institutions in Eastern India, regarding the use of generic (non-proprietary) names while prescribing. The study tried to assess their perception toward using drugs from the National List of Essential Medicine (NLEM), as well. Methods: An observational, cross-sectional study was conducted. Medical practitioners attached to the institution were considered for the study and those who gave voluntarily consent were included. Hundred participants were interviewed based on convenient random sampling. They were provided with the study questionnaire and the responses were analyzed using Microsoft Excel 2007 using charts and tables. Results: Majority (43/100) did not feel that generic medicines are as effective as reputed brands, while 32 felt they are of equally effective. About 45% (45/99) felt generics to be equally safe as and 24% (24/99) did not feel so. About 86% considered generics to be cheaper. About 56% did not prefer to substitute with generics in all conditions. About 73% had doubts regarding the quality of production of generics. The decision to use generics was mostly influenced by the lower cost (73%) and by administrative pressure (53%). About 58% felt that the NLEM does not contain all the medicines they would require in practice. About 94% agreed to prescribe more in generics if the quality may be ensured. Conclusion: Awareness of the NLEM and about generics needs to be improved. Authorities need to ensure the quality of generics and assure the prescribers about it

SARS-CoV-2 infection and human semen: possible modes of contamination and transmission

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has turned into a global pandemic with multitudinous health impacts. Main body: In light of the higher vulnerability of men to COVID-19 than women, there is rising concerns on the impact of SARS-CoV-2 infection on male fertility and possibilities of seminal contamination and transmission. The pandemic has attributed to the brief suspension of many fertility clinics and pathology laboratories, though many remained functional. Few reports reflect that SARS-CoV-2 can contaminate the semen of COVID-19 patients as well as that of recovering patients. The viral invasion into the testis may be due to the disrupted anatomical barriers of the testis by the inflammatory responses, and the persistence of the virus in the semen may be facilitated by the testicular immune privilege. Since SARS-CoV-2 is an enveloped RNA virus, it is also theoretically possible that this virus can remain viable in the semen samples even after cryopreservation with liquid nitrogen. Conclusion: The present review emphasizes the possibilities of seminal dissemination of SARS-CoV-2 and thereby the chances of its sexual transmission. These perceptions and predictions are to facilitate immediate necessary actions to improvise the standard precautionary procedures for laboratory practices, including semen analysis or processing the semen sample for fertility treatments