Knowledge, attitudes, and practices among healthcare providers on cervical cancer, human papilloma virus and it’s vaccine at ESI PGIMSR, MGM Hospital Parel Mumbai, India

Background: Cervical cancer is the second most common cause of cancer in females Worldwide and nearly 85% of the cervical cancer cases are diagnosed in developing countries. The health care providers can play an important role in promoting cervical cancer screening and knowledge about HPV vaccination. So this study was conducted to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination and to analyze the factors influencing the knowledge about HPV vaccination, among nursing staff.Methods: A cross-sectional study was conducted among 143 nurses and 75nursing students (total 218) at ESIPGIMSR MGM Hospital, Parel Mumbai. Data was collected using Questionnaire, designed based on the study objectives.Results: 73 (33.49%) of the nurses did received education on cervical cancer and HPV in the past. Most of the nurses, 184 (84.4%) considered that they were at no risk of cervical cancer. 143 (65.60%) nurses knew that Pap smear can be done to screen patients. Out of 141 married nurses, only 39 (27.28%) regularly had a gynaecological examination and 105 (74.47%) had never done Pap smear. In addition, 119 (54.59%) participants did not know at what age Pap smear should commence. Only 73 (33.49%) nurses knew about the route of transmission of HPV and 57 (26.15%) knew about HPV vaccine. 215 (98.62%) nurses did not receive an HPV vaccine.Conclusions: The nurses and nursing students did not have prior adequate education on cervical cancer, HPV, and vaccine and the desired level of knowledge on risk factors and signs of cervical cancer and prevention of the disease

Nevirapine induced Stevens-Johnson syndrome: a case report

Stevens-Johnson syndrome (SJS) is a severe mucocutaneous skin reaction with extensive necrosis and detachment of the epidermis. Nevirapine is one of the high risk agents implicated in development of SJS. Here, we present a case of 27 years old male with HIV infection who was diagnosed to have SJS following administration of nevirapine

ROLE OF NANOEMULSION FOR SAFE AND COST-EFFECTIVE DELIVERY OF AMPHOTERICIN B

Amphotericin B is a highly effective antifungal agent and its use has been surged drastically due to its effectiveness against a wide range of fungal infections. It is effective against both topical and systemic infections and even this is the only drug having high efficacy against Leishmania, Candida, Aspergillus and many more. Owing to this, the demand of Amphotericin B is gaining momentum. However, this drug possesses numerous drawbacks like toxicity, poor solubility to name a few, due to which its current use is dwindling. So far the numbers of formulations have been marketed in order to triumph over its toxicity and solubility related issues. Unfortunately, no single study conducted hitherto gain success in overcoming its lethal ramifications. Among all formulations, nanoemulsions are at the top to combat all issues related to this drug. Nanoemulsion has shown enhanced stability, reduced cost and toxicity. This review will assimilate complete information on the use of nanoemulsion based formulations of Amphotericin B, its developed formulations and also will enunciate the important considerations and future perspectives. The complete data have been composed from Google Scholar, ScienceDirect and PubMed using the following keywords

Evaluating the Effect of Non-cellular Bioactive Glass-Containing Scaffolds on Osteogenesis and Angiogenesis in in vivo Animal Bone Defect Models

The use of bone scaffolds to replace injured or diseased bone has many advantages over the currently used autologous and allogeneic options in clinical practice. This systematic review evaluates the current evidence for non-cellular scaffolds containing bioactive glass on osteogenesis and angiogenesis in animal bone defect models. Studies that reported results of osteogenesis via micro-CT and results of angiogenesis via Microfil perfusion or immunohistochemistry were included in the review. A literature search of PubMed, EMBASE and Scopus was carried out in November 2019 from which nine studies met the inclusion and exclusion criteria. Despite the significant heterogeneity in the composition of the scaffolds used in each study, it could be concluded that scaffolds containing bioactive glass improve bone regeneration in these models, both by osteogenic and angiogenic measures. Incorporation of additional elements into the glass network, using additives, and using biochemical factors generally had a beneficial effect. Comparing the different compositions of non-cellular bioactive glass containing scaffolds is however difficult due to the heterogeneity in bioactive glass compositions, fabrication methods and biochemical additives used

Atg12 Maintains Skeletal Integrity by Modulating Pro-Osteoclastogenic Signals and Chondrocyte Differentiation

Weightlessness and radiation, two unique elements of space, profoundly decreases bone mass. We aimed to elucidate the role of autophagy in maintaining structural integrity of the skeleton. We hypothesize that loss of autophagy in bone leads to an imbalance in pro-osteoclastogenic and pro-osteogenic signals, resulting in net bone loss. To test our hypothesis, we performed global postnatal deletion of Atg12 using tamoxifen-inducible Cre. Compared to Vehicle (Control) groups, Tamoxifen (Atg12 iKO) groups showed decreased LC3B-I to II conversion and increased p62 protein levels, consistent with loss of autophagy. qPCR revealed increased expression of pro-osteoclastogenic cytokines in bone and marrow respectively in male iKOs compared to controls. Microcomputed tomography revealed decreased cortical bone volume, cortical thickness and periosteal perimeter consistent with bone loss; and a longer primary spongiosa in male Atg12 iKOs display compared to male controls. Histology showed that compared to male controls, male iKOs had a profound increase in chondrocyte column length of the growth plate with hyper-expansion of both proliferating and hypertrophic zones. Taken together, these findings indicate that autophagy plays an important role in the maintenance of bone structural integrity by mediating the production of pro-osteoclastogenic signals and regulating chondrocyte proliferation and differentiation

KIT pathway upregulation predicts dasatinib efficacy in acute myeloid leukemia

Peer reviewe

Knowledge, attitudes, and practices toward coronavirus and associated anxiety symptoms among university students : a cross-sectional study during the early stages of the COVID-19 pandemic in Bangladesh

Background: University students’ knowledge, attitude, and practice (KAP) toward COVID-19 are vital to prevent the spread of the virus, especially in the context of developing countries. Consequently, the present study aimed to determine the KAP levels of university students and associated anxiety during the earlier stage of the pandemic in Bangladesh. Methods: A cross-sectional, online study with 544 university students was conducted during April 17–May 1, 2020. The questionnaire incorporated several KAP-related test items aligned with the World Health Organization (WHO) guidelines. Anxiety was measured with the 2-item Generalized Anxiety Disorder scale (GAD-2). Multivariable logistic regression analysis was performed to determine the association between KAP levels and anxiety adjusting for sociodemographic variables. Subgroup analyses included rerunning models stratified by gender and quarantine status. Results: Approximately 50% of students showed high levels of knowledge about COVID-19 guidelines, 59% reported behavioral practices that aligned with COVID-19 guidelines, and 39% had negative attitudes toward COVID-19 guidelines. Attitudes differed by anxiety (χ2 = 23.55, p < 0.001); specifically, negative attitudes were associated with higher anxiety (OR: 2.40, 95% CI = 1.66–3.46, p < 0.001). Associations were significant for male (OR = 2.36; 95% CI = 1.45–3.84, p < 0.001) and female (OR = 2.45; 95% CI = 1.3–4.34; p < 0.001) students. Stratified analyses found non-quarantined students with negative attitudes had three times the chance of experiencing anxiety (OR = 3.14, 95% CI: 1.98–4.98, p < 0.001). Non-quarantined students with low levels of knowledge had half the chance of developing anxiety (OR = 0.49, 95% CI: 0.31–0.78, p < 0.01). Conclusion: Based on these findings, it is recommended that university authorities continue to prioritize proactive and effective measures to develop higher levels of knowledge, more positive attitudes and better behavioral practices regarding COVID-19 for the mental health of their students

Intrinsic resistance to PIM kinase inhibition in AML through p38α-mediated feedback activation of mTOR signaling

Although conventional therapies for acute myeloid leukemia (AML) and diffuse large B-cell lymphoma (DLBCL) are effective in inducing remission, many patients relapse upon treatment. Hence, there is an urgent need for novel therapies. PIM kinases are often overexpressed in AML and DLBCL and are therefore an attractive therapeutic target. However, in vitro experiments have demonstrated that intrinsic resistance to PIM inhibition is common. It is therefore likely that only a minority of patients will benefit from single agent PIM inhibitor treatment. In this study, we performed an shRNA-based genetic screen to identify kinases whose suppression is synergistic with PIM inhibition. Here, we report that suppression of p38α (MAPK14) is synthetic lethal with the PIM kinase inhibitor AZD1208. PIM inhibition elevates reactive oxygen species (ROS) levels, which subsequently activates p38α and downstream AKT/mTOR signaling. We found that p38α inhibitors sensitize hematological tumor cell lines to AZD1208 treatment in vitro and in vivo. These results were validated in ex vivo patient-derived AML cells. Our findings provide mechanistic and translational evidence supporting the rationale to test a combination of p38α and PIM inhibitors in clinical trials for AML and DLBCL

Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: A case study in Zambia

Abstract Background Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4) should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. Methods A 'fishbone' (Ishikawa) diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. Results The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. Conclusions The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical practice. A better understanding of the supply system and of the pattern of demand for MgSO4 in Zambia should enable policy makers and stakeholders to develop and implement appropriate interventions to improve the availability and use of MgSO4