CARDIOVASCULAR DISEASE PREVALENCE AND DRUG UTILIZATION PATTERNS AT A TERTIARY CARE HOSPITAL IN NORTHEASTERN INDIA

Objective: The objective of this study was to evaluate the disease prevalence and drug utilization pattern in the department of cardiology in a tertiary care hospital in northeastern India.Methods: Indoor case papers 112 of patients fulfilling inclusion criteria were included in this study. The study was performed in between December 2014 to February 2015. Case papers analyzed and documented for demographic variables, indication, disease prevalence, co-morbidities and prescribing pattern of the physician.Results: A total of 112 cases were evaluated. Patients of age group between 61-90 y were diagnosed 48.21% of cardiovascular diseases (CVDs). Male patients (67%) were diagnosed CVDs more than female patients (33%). Our findings indicated that hyperlipidemia (84.82%), hypertension (80.35%) and ischemic heart disease (66.96%) were most frequently diagnosed disease and most of the diseases were treated by the combination of two or three drugs. The use of statins, beta blockers, diuretics, calcium channel blockers and angiotensin-converting enzymes (ACE) inhibitors was very common. Diabetes, anemia and asthma were the comorbidities associated with CVDs.Conclusion: Hyperlipidemia, hypertension and ischemic heart disease were the prevalent diseases among CVDs. Statins and antihypertensive were most prescribed drugs. Combinations of drugs were prescribed to the patients for effective therapy. The present study will help the healthcare professionals to optimize the efficient and safe use of cardiovascular drugs.Keywords: Ischemic heart diseases, Hypertension, Rational, Health professional

Combinational effect of angiotensin receptor blocker and folic acid therapy on uric acid and creatinine level in hyperhomocysteinemia-associated hypertension

© 2019 International Union of Biochemistry and Molecular Biology, Inc. Homocysteine [HSCH2CH2CH(NH2)COOH] (Hcy) is a sulfur-containing amino acid of 135.18 Da of molecular weight, generated during conversion of methionine to cysteine. If there is a higher accumulation of Hcy in the blood, that is usually above 15 µmol/L, it leads to a condition referred to as hyperhomocysteinemia. A meta-analysis of observational study suggested an elevated concentration of Hcy in blood, which is termed as the risk factors leading to ischemic heart disease and stroke. Further experimental studies stated that Hcy can lead to an increase in the proliferation of vascular smooth muscle cells and functional impairment of endothelial cells. The analyses confirmed some of the predictors for Hcy presence, such as serum uric acid (UA), systolic blood pressure, and hematocrit. However, angiotensin-converting enzyme inhibitors angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) alone are inadequate for controlling UA and creatinine level, although the addition of folic acid may be beneficial in hypertensive patients who are known to have a high prevalence of elevated Hcy. We hypothesized that combination therapy with an ARB (olmesartan) and folic acid is a promising treatment for lowering the UA and creatinine level in hyperhomocysteinemia-associated hypertension

Role of Serine/Threonine Kinase 11 (STK11) or liver kinase B1 (LKB1) Gene in Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome (PJS) is a well-described inherited syndrome, characterized by the development of gastrointestinal polyps and characteristic mucocutaneous freckling. PJS is an autosomal prevailing disease, due to genetic mutation on chromosome 19p, manifested by restricted mucocutaneous melanosis in association with gastrointestinal (GI) polyposis. The gene for PJS has recently been shown to be a serine/threonine kinase, known as LKB1 or STK11, which maps to chromosome subband 19p13.3. This gene has a putative coding region of 1302 bp, divided into nine exons, and acts as a tumor suppressor in the hamartomatous polyps of PJS patients and in the other neoplasms that develop in PJS patients. It is probable that these neoplasms develop from hamartomas, but it remains possible that the LKB1 or STK11 locus plays a role in a different genetic pathway of tumor growth in the cancers of PJS patients. This article focuses on the role of LKB1 or STK11 gene expression in PJS and related cancers

Advances in pulmonary drug delivery targeting microbial biofilms in respiratory diseases

The increasing burden of respiratory diseases caused by microbial infections poses an immense threat to global health. This review focuses on the various types of biofilms that affect the respiratory system and cause pulmonary infections, specifically bacterial biofilms. The article also sheds light on the current strategies employed for the treatment of such pulmonary infection-causing biofilms. The potential of nanocarriers as an effective treatment modality for pulmonary infections is discussed, along with the challenges faced during treatment and the measures that may be implemented to overcome these. Understanding the primary approaches of treatment against biofilm infection and applications of drug-delivery systems that employ nanoparticle-based approaches in the disruption of biofilms are of utmost interest which may guide scientists to explore the vistas of biofilm research while determining suitable treatment modalities for pulmonary respiratory infections. </jats:p

Integration of embedded generation in local grid using STATCOM

The renewable sources of energy are being connected to the local distribution system/local grid leading to embedded generation. As these sources are intermittent in nature, they impose technical challenges in the power system operation which include power quality related problems of local grid. The performance of the system has to be evaluated while connecting these sources to the local distribution system/micro grid. In this paper, the application of STATCOM-based power quality conditioner for improving the performance of wind driven induction generator embedded to the local grid have been discussed. The modelling, control and analysis of the proposed STATCOM-based power quality conditioner have been given. The MATLAB Simulink-based system model has been used for the performance evaluation while connection of wind-driven induction generator to the local grid, its variable speed operation and unbalanced supply system. The STATCOM-based power quality conditioner has been found effective for the power quality improvement of the local grid.power quality conditioners; wind energy conversion systems; induction generators; voltage sag; voltage unbalance; voltage flicker; voltage harmonics; static synchronous compensator; STATCOM; wind power; simulation; modelling; performance evaluation; variable speed; unbalanced supply; power quality improvement; local grid.

Power quality evaluation in deregulated power system using matrix method

Power quality has emerged as a challenging area in the context of deregulation, wherein electricity distribution buyers and sellers carry out mutually agreed-upon exchanges. A market for active power and reactive power is installed in many places as a result of a deregulation process. However, the power-quality-related market is in the developing stage. For a given site, the power quality attributes have individual indices which have to be combined to give a suitability index so that the performance of the supply system may be evaluated at the point of common coupling. In this paper, a new technique based on the matrix method and permanents is proposed to quantify the power quality of a site. The proposed algorithm method is explained and illustrated with a sample problem on site evaluation and ranking.power quality; voltage sag; voltage swell; harmonics; flicker; unbalance; suitability index; permanent; matrix method; deregulated power systems; electricity distribution; deregulation.

Coagulase gene polymorphism, enterotoxigenecity, biofilm production, and antibiotic resistance in Staphylococcus aureus isolated from bovine raw milk in North West India

Abstract Background Staphylococcus aureus is the predominant bacterium responsible for various diseases in animals and humans. Preventive strategies could be better implemented by understanding the prevalence, genetic patterns, and the presence of enterotoxin and biofilm-producing genes along with the antibiotic susceptibility of this organism. This study was conducted in Rajasthan, the northwestern state of India, holding the largest population of cattle that makes it the second largest milk producer in India and no such prior information is available on these aspects. Methods A total of 368 individual quarter bovine raw milk samples were collected from 13 districts of Rajasthan, and screened for the presence of S. aureus. Microbiological and molecular approaches were followed for bacterial identification. Genetic diversity was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) of coagulase gene (coa), whereas enterotoxin and biofilm-producing genes were studied by PCR analysis. Antibiotic strips were employed to study the antibiotic resistance among strains. Results In all, 73 S. aureus strains were obtained from 368 bovine raw milk samples out of that only 30 showed the presence of coa. Nine types of coa patterns ranging from 730 to 1130 bp were observed among these isolates. PCR–RFLP of coa distinguished the isolates into 15 genotypic patterns, of which patterns I, IV, V, and VI were predominant. Of the isolates, 30% were positive for sec, 10% for sea, and 3.3% for seb; these genes are responsible for enterotoxin production, whereas all isolates were found positive for icaAD and eno. The prevalence rates of other biofilm-producing genes fnbA, clfB, ebpS, sasG, fnbB, sasC, cna, bap, fib and, bbp were 97, 93, 90, 80, 80, 77, 53, 27, 10, and 6.6%, respectively. Twenty-seven (90%) strains were multidrug resistant, of which 15 were methicillin resistant. Maximum sensitivity was reported for kanamycin and it could be considered as a drug of choice for controlling S. aureus mediated cattle infections in the studied regions. Conclusions Overall, these strains could cause several diseases to humans, insisting the need for developing a stricter hygiene program for improving milking practices and animal health