Formulation Development and Evaluation of Osmotic Drug Delivery System

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Regulation of glucose-6-phosphate dehydrogenase under salt-stress condition in Aspergillus sydowii.

Physiological responses of organisms to particular stresses are well understood in only a few cases (Bachofen, R. 1986 Experientia 42:1179-1182

Topics concerning state variable feedback in automatic control systems. Part 1 - Specification. Part 2 - Sensitivity. Part 3 - Intentional nonlinearities. Part 4 - Unavailable states

Specifications, sensitivity, intentional nonlinearities, and unavailable states concerned with state variable feedback in automatic control system

A cross sectional observational study to evaluate utilization of antimicrobials in paediatric department of a tertiary care teaching hospital

Background: Antimicrobials play cardinal role in management of infectious disease. Paediatric age group forms significant part of developing countries and have high chances of acquiring infectious. Misuse and overuse of these antimicrobials are leading culprits in causing antimicrobials resistance. The purpose of this study was to analyse utilization of antimicrobials among paediatric department of a tertiary care teaching hospital. Methods: A cross sectional observation study was conducted for three months in paediatric department of a tertiary care teaching hospital. The demographics and antimicrobials use details were observed daily from patients admitted to paediatric outpatient department, wards and intensive care unit to assess according to The World Health Organization-International Network of Rational Use of Drugs drug prescribing indicators and WHO antibiotics AWaRe (Access, Watch, Reserve) classification. Results: In our study we found that mean antimicrobial use in OPD, wards and ICU was1.15±0.35, 1.12±0.33 and 2.25±1.01 respectively. Cephalosporins were most commonly prescribed in OPD (34.62%) and wards (65.26%) while piperacillin-tazobactam (29.93%) in ICU. Percent encounter with an antibiotic in OPD, Wards and ICU was 8.41%, 30.71% and 33.58% respectively. 56.69%, 81.35% and 55.80% antibiotics prescribed in OPD, Wards and ICU respectively were of Watch group. 5.66% Reserve group antibiotics were prescribed in the ICU. Conclusions: Prescribing trends of antimicrobials is near to WHO standard but according to AWaRe classification, watch group antibiotics were prescribed more than Access group

Evaluation of the England Community Pharmacy Quality Scheme (2018-2019 and 2019-2020) in reducing harm from NSAIDs in older patients

INTRODUCTION: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for their analgesic and anti-inflammatory action, but the gastrointestinal (GI) adverse effects are a known cause of preventable harm. A medication safety audit was incentivised for community pharmacies in England in 2 successive years as part of the Pharmacy Quality Scheme (PQS) to address GI safety of NSAIDs. AIMS: To evaluate community pharmacy's contributions to NSAID safety and determine any change between audit 1 (2018-2019) and audit 2 (2019-2020). METHOD: Patients aged 65 years or over prescribed an NSAID were included in both audits. The audit tool assessed compliance with national standards relating to co-prescribed gastroprotection, referrals to the prescriber and patient advice on long-term NSAID use and effects, with responses submitted via an online portal. Descriptive analyses were performed to explore differences between the years and tested for significance using Χ2 tests. Qualitative data were analysed using an inductive thematic approach. KEY FINDINGS: Data from 91 252 patients in audit 1 and 73 992 in audit 2 were analysed. More patients were prescribed gastroprotection in audit 2 (85.0%) than audit 1 (80.7%, p<0.001). More patients without gastroprotection in audit 2 had a current or recent referral (67.5%) than in audit 1 (58.8%, p<0.001). Verbal or other communications between pharmacists and patients about their NSAID medication were reported more frequently in audit 2 (76.0% vs 63.5%, p<0.001). CONCLUSION: During two audits, community pharmacists in England reported referring more than 15 000 patients at risk of preventable harm from NSAIDs to prescribers for review. The audits demonstrated significant potential for year-on-year improvement in GI safety for a large cohort of older patients prescribed NSAIDs. This evaluation provides evidence of how the PQS can effectively address a specific aspect of medicines safety and the place of community pharmacy more broadly in improving medicines safety

Effect of Office Bleaching Agents on the Shear Bond Strength of Metallic Brackets Bonded Using Self-Etching Primer System at Different Time Intervals – An In-Vitro Study

A common method of treating discoloured teeth is to bleach them using hydrogen peroxide. Many studies in the literature have concluded that bleaching reduces shear bond&nbsp; strength of composite resin significantly and thus, to achieve clinically adequate shear bond strength of composite for bonding brackets to bleached enamel, it is important to find out the various methods of reducing adverse effects of bleaching. It has been proposed by some authors that a delay in bonding effectively reverses the effects of&nbsp; bleaching on bond strength. OBJECTIVES- To test the null hypothesis that there is no statistical significance in (1) bond strength and (2) failure site location with bleached and unbleached enamel prepared with TransbondPlus Self-etching Primer between&nbsp; different time intervals. MATERIALS AND METHODS- Sixty freshly extracted human premolar teeth were randomly divided divided into three groups of 20 teeth each Bleaching treatment was performed at two different time intervals (bleaching immediately before bonding and bleaching 30 days before bonding). All brackets were bonded with a self-etching primer system. The shear bond strength of these brackets was measured and recorded in MPa. Adhesive remnant index (ARI) scores were determined after the brackets failed. RESULTS- The mean shear bond strength of Group A (control) is found to be 20.4315 MPa (SD&plusmn; 6.81041) which was reduced to 11.1955 MPa (SD &plusmn; 4.58041) when bonding was done immediately after bleaching (group B). The shear bond strength increased to 14.9910 MPa (SD &plusmn; 4.74545) when enamel was 14.9910 MPa (SD &plusmn; 4.74545) when enamel was Group C) Pair wise comparison of shear bond strength between the three groups&nbsp; using Post hoc Tukey test showed that there is a very high statistically significant difference between shear bond strength of all three groups. CONCLUSION This study shows that bonding immediately after bleaching significantly reduces the shear bond strength , it can be reversed by a delay in the bonding by 30 days which shear bond strength , it can be reversed by a delay in the bonding by 30 days which improves the shear bond strength as reflected&nbsp; in the results of the study ,So it is advisable to delay the orthodontic bonding procedure by an interval of 30 days to improve survival rates and prevent frequent breakages of brackets due to bond failure

Interventions for increasing acceptance of local anaesthetic in children and adolescents having dental treatment

BACKGROUND: Delivery of pain-free dentistry is crucial for reducing fear and anxiety, completion of treatment, and increasing acceptance of future dental treatment in children. Local anaesthetic (LA) facilitates this pain-free approach but it remains challenging. A number of interventions to help children cope with delivery of LA have been described, with no consensus on the best method to increase its acceptance. OBJECTIVES: To evaluate the effects of methods for acceptance of LA in children and adolescents during dental treatment. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the Cochrane Oral Health's Trials Register (to 24 May 2019); the Cochrane Central Register of Controlled Trials (CENTRAL; 2019 Issue 4) in the Cochrane Library (searched 24 May 2019); MEDLINE Ovid (1946 to 24 of May 2019); Embase Ovid (1980 to 24 May 2019); and Web of Science (1900 to 24 May 2019). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform were also searched to 24 May 2019. There were no restrictions on language or date of publications. SELECTION CRITERIA: Parallel randomised controlled trials (RCTs) of interventions used to increase acceptance of dental LA in children and adolescents under the age of 18 years. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We performed data extraction and assessment of risk of bias independently and in duplicate. We contacted authors for missing information. We assessed the certainty of the body of evidence using GRADE. MAIN RESULTS: We included 26 trials with 2435 randomised participants aged between 2 and 16 years. Studies were carried out between 2002 and 2019 in dental clinics in the UK, USA, the Netherlands, Iran, India, France, Egypt, Saudi Arabia, Syria, Mexico, and Korea. Studies included equipment interventions (using several LA delivery devices for injection or audiovisual aids used immediately prior to or during LA delivery or both) and dentist interventions (psychological behaviour interventions delivered in advance of LA (video modelling), or immediately prior to or during delivery of LA or both (hypnosis, counter-stimulation). We judged one study to be at low risk and the rest at high risk of bias. Clinical heterogeneity of the included studies rendered it impossible to pool data into meta-analyses. None of the studies reported on our primary outcome of acceptance of LA. No studies reported on the following secondary outcomes: completion of dental treatment, successful LA/painless treatment, patient satisfaction, parent satisfaction, and adverse events. Audiovisual distraction compared to conventional treatment: the evidence was uncertain for the outcome pain-related behaviour during delivery of LA with a reduction in negative behaviour when 3D video glasses where used in the audiovisual distraction group (risk ratio (RR) 0.13, 95% confidence interval (CI) 0.03 to 0.50; 1 trial, 60 participants; very low-certainty evidence). The wand versus conventional treatment: the evidence was uncertain regarding the effect of the wand on pain-related behaviour during delivery of LA. Four studies reported a benefit in using the wand while the remaining studies results suggested no difference between the two methods of delivering LA (six trials, 704 participants; very low-certainty evidence). Counter-stimulation/distraction versus conventional treatment: the evidence was uncertain for the outcome pain experience during delivery of LA with children experiencing less pain when counter-stimulation was used (RR 0.12, 95% CI 0.04 to 0.34; 1 trial, 134 participants; very low-certainty evidence). Hypnosis versus conventional treatment: the evidence was uncertain for the outcome pain experience during delivery of LA with participants in the hypnosis group experiencing less pain (mean difference (MD) -1.79, 95% CI -3.01 to -0.57; 1 trial, 29 participants; very low-certainty evidence). Other comparisons considered included pre-cooling of the injection site, the wand versus Sleeper One, the use of a camouflage syringe, use of an electrical counter-stimulation device, and video modelling acclimatisation, and had a single study each. The findings from these other comparisons were insufficient to draw any affirmative conclusions about their effectiveness, and were considered to be very low-certainty evidence. AUTHORS' CONCLUSIONS: We did not find sufficient evidence to draw firm conclusions as to the best interventions to increase acceptance of LA in children due to variation in methodology and nature/timing of outcome measures. We recommend further parallel RCTs, reported in line with the CONSORT Statement. Care should be taken when choosing outcome measures

SegViz: A federated-learning based framework for multi-organ segmentation on heterogeneous data sets with partial annotations

Segmentation is one of the most primary tasks in deep learning for medical imaging, owing to its multiple downstream clinical applications. However, generating manual annotations for medical images is time-consuming, requires high skill, and is an expensive effort, especially for 3D images. One potential solution is to aggregate knowledge from partially annotated datasets from multiple groups to collaboratively train global models using Federated Learning. To this end, we propose SegViz, a federated learning-based framework to train a segmentation model from distributed non-i.i.d datasets with partial annotations. The performance of SegViz was compared against training individual models separately on each dataset as well as centrally aggregating all the datasets in one place and training a single model. The SegViz framework using FedBN as the aggregation strategy demonstrated excellent performance on the external BTCV set with dice scores of 0.93, 0.83, 0.55, and 0.75 for segmentation of liver, spleen, pancreas, and kidneys, respectively, significantly ($p<0.05$) better (except spleen) than the dice scores of 0.87, 0.83, 0.42, and 0.48 for the baseline models. In contrast, the central aggregation model significantly ($p<0.05$) performed poorly on the test dataset with dice scores of 0.65, 0, 0.55, and 0.68. Our results demonstrate the potential of the SegViz framework to train multi-task models from distributed datasets with partial labels. All our implementations are open-source and available at https://anonymous.4open.science/r/SegViz-B74

The “Scope” of Post-ERCP Pancreatitis

AbstractPancreatitis is the most common adverse event of endoscopic retrograde cholangiopancreatography, with the potential for clinically significant morbidity and mortality. Several patient and procedural risk factors have been identified that increase the risk of post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Considerable research efforts have identified several pharmacologic and procedural interventions that can drastically affect the incidence of PEP. This review article addresses the underlying mechanisms at play for the development of PEP, identifying patient and procedural risk factors and meaningful use of risk-stratification information, and details current interventions aimed at reducing the risk of this complication