Analysis of Cutaneous Adverse Drug Reactions at a Tertiary Care Hospital – a Prospective Study

Purpose: To analyze the clinical, pharmacological and economical aspects of the cutaneous adverse drug reactions (ADRs) reported at Civil Hospital, Ahmedabad, India.Methods: A prospective observational study over a period of one and half years (November 2006 to April 2008) was undertaken. Semi-spontaneous reporting along with a review of case record forms were used. The reports were analyzed for clinical pattern, causal drug groups, causality (WHO-UMC criteria), severity (Hartwig and Siegel scale) and preventability (modified Schumock and Thornton criteria). The cost of ADRs was calculated on the basis of hospital expenditure per patient and the amount spent by patients themselves.Results: Out of 143 reports, chemotherapeutic agents (39 %) were the most commonly suspected drugs followed by unknown medicines (29 %). Most of the ADRs were designated as possible or probable (69 %) and moderately severe (96.5 %) in nature. However, 14 – 16 % were definitely preventable. Cost incurred by the hospital was Indian national rupees (INR) 374,255, i.e.,USD 8241. While average cost incurred by outpatients was INR 99 (USD 2.18) and that of hospitalized patients was INR 264 (USD 5.81).Conclusion: A large number of cutaneous ADRs are due to unknown medicines. This calls for strict drug control mechanisms, patient education regarding self-medication and maintenance of prescription records. The cost associated with ADRs is high. ADR monitoring is essential to reduce patient suffering as well as to achieve the substantial savings in health care cost.Keywords: Cutaneous adverse drug reactions, Cost of ADRs, Preventability, Patient educatio

Case report: Thoracoscopic repair of renal ectopia associated with congenital diaphragmatic hernia: Report of two cases

Renal ectopia is a rare anomaly which may occur due to an abnormal ascent of the kidney. It is usually  asymptomatic and does not require treatment. Intrathoracic renal ectopia with concomitant congenital diaphragmatic hernia (CDH) is extremely rare. All symptomatic CDH cases must be treated with open or thoracoscopic repair. During plication of the diaphragm, care must be taken to avoid renal injury. Following, we present two rare variants of CDH with concomitant renal ectopia managed thoracoscopically.  Postoperative recovery was uneventful. Doppler ultrasound study performed one month after surgery confirmed normal vascularity of the kidneys and the absence of urinary outflow obstruction.KEYWORDS: Congenital diaphragmatic hernia; Renal ectopia; Thoracoscopic repai

Sustainable food security in India—Domestic production and macronutrient availability

<div><p>India has been perceived as a development enigma: Recent rates of economic growth have not been matched by similar rates in health and nutritional improvements. To meet the second Sustainable Development Goal (SDG2) of achieving zero hunger by 2030, India faces a substantial challenge in meeting basic nutritional needs in addition to addressing population, environmental and dietary pressures. Here we have mapped—for the first time—the Indian food system from crop production to household-level availability across three key macronutrients categories of ‘calories’, ‘digestible protein’ and ‘fat’. To better understand the potential of reduced food chain losses and improved crop yields to close future food deficits, scenario analysis was conducted to 2030 and 2050. Under India’s current self-sufficiency model, our analysis indicates severe shortfalls in availability of all macronutrients across a large proportion (>60%) of the Indian population. The extent of projected shortfalls continues to grow such that, even in ambitious waste reduction and yield scenarios, enhanced domestic production alone will be inadequate in closing the nutrition supply gap. We suggest that to meet SDG2 India will need to take a combined approach of optimising domestic production and increasing its participation in global trade.</p></div

The proportion of cancer-related entries in PubMed has increased considerably; is cancer truly "The Emperor of All Maladies"?

In this work, the public database of biomedical literature PubMed was mined using queries with combinations of keywords and year restrictions. It was found that the proportion of Cancer-related entries per year in PubMed has risen from around 6% in 1950 to more than 16% in 2016. This increase is not shared by other conditions such as AIDS, Malaria, Tuberculosis, Diabetes, Cardiovascular, Stroke and Infection some of which have, on the contrary, decreased as a proportion of the total entries per year. Organ-related queries were performed to analyse the variation of some specific cancers. A series of queries related to incidence, funding, and relationship with DNA, Computing and Mathematics, were performed to test correlation between the keywords, with the hope of elucidating the cause behind the rise of Cancer in PubMed. Interestingly, the proportion of Cancer-related entries that contain "DNA", "Computational" or "Mathematical" have increased, which suggests that the impact of these scientific advances on Cancer has been stronger than in other conditions. It is important to highlight that the results obtained with the data mining approach here presented are limited to the presence or absence of the keywords on a single, yet extensive, database. Therefore, results should be observed with caution. All the data used for this work is publicly available through PubMed and the UK's Office for National Statistics. All queries and figures were generated with the software platform Matlab and the files are available as supplementary material

Screening of bacterial biosorbents for removal of atrazine

Atrazine is one of the most heavily used herbicide worldwide. Atrazine has been detected in ground and surface waters in many countries beyond permissible limits due to its low vapor pressure, long persistence, and low biodegradability. This study aims to develop a bacterial biomass which can be used as biosorbent to remove the atrazine from waters easily and cost-effectively. Here, fourteen bacterial strains were isolated from soil having the history of atrazine contamination and batch experiments were carried with biosorbents prepared from various bacterial isolates. The biosorbent BS-1 developed from strain C-1 was found be the best for the removal of atrazine

Analysis of Cutaneous Adverse Drug Reactions at a Tertiary Care Hospital – a Prospective Study

Purpose: To analyze the clinical, pharmacological and economical aspects of the cutaneous adverse drug reactions (ADRs) reported at Civil Hospital, Ahmedabad, India. Methods: A prospective observational study over a period of one and half years (November 2006 to April 2008) was undertaken. Semi-spontaneous reporting along with a review of case record forms were used. The reports were analyzed for clinical pattern, causal drug groups, causality (WHO-UMC criteria), severity (Hartwig and Siegel scale) and preventability (modified Schumock and Thornton criteria). The cost of ADRs was calculated on the basis of hospital expenditure per patient and the amount spent by patients themselves. Results: Out of 143 reports, chemotherapeutic agents (39 %) were the most commonly suspected drugs followed by unknown medicines (29 %). Most of the ADRs were designated as possible or probable (69 %) and moderately severe (96.5 %) in nature. However, 14 – 16 % were definitely preventable. Cost incurred by the hospital was Indian national rupees (INR) 374,255, i.e.,USD 8241. While average cost incurred by outpatients was INR 99 (USD 2.18) and that of hospitalized patients was INR 264 (USD 5.81). Conclusion: A large number of cutaneous ADRs are due to unknown medicines. This calls for strict drug control mechanisms, patient education regarding self-medication and maintenance of prescription records. The cost associated with ADRs is high. ADR monitoring is essential to reduce patient suffering as well as to achieve the substantial savings in health care cost