Prospective study of the prescribing pattern of antibiotics and their outcome in patients admitted to intensive care unit at tertiary center

Background: Antibiotics are currently the most commonly prescribed drugs in hospitals, worldwide. overuse of antibiotics has important economic implications. Periodic evaluation of drug utilization in the intensive care unit (ICU) is necessary for optimization of health care system, proper use of resources and making prescription policy because ICU is considered as the epi-center of antimicrobial resistance. The aim of this study is to evaluate antibiotic prescription and consumption patterns at admission into intensive care unit and to know the average costs of antibiotics.Methods: The prescription data on 250 consecutive patients at admission into the ICU was audited from January to March 2019. Total antibiotics, dose, route and cost of antibiotics were noted and the defined daily dose/100 bed days of most common antibiotics were calculated. Statistical analysis is done using SPSS software.Results: A total of 689 antibiotics were prescribed in the 250 patients studied that is, an average of 2.28 antibiotics/prescription. Empirical antibiotics were prescribed to all the patients admitted to ICU. Average cost of the antibiotics was rupees 163.89 per patients. The most commonly prescribed antibiotic at ICU admission was ceftriaxone (62%) of all prescription. Second most common is metronidazole (32%). In this study, 76 patients recovered while 174 patients expired.Conclusions: Our study reveals that antibiotics are widely prescribed in critically ill patients and form significant drug consumed in the ICU. At admission elderly patients are prescribed >2 antibiotics and prescribing antibiotics where the cost of antibiotic is high

Pseudo-Meigs syndrome: a rare presentation of pedunculated fibroid

Serosal fibroid of uterus are usually asymptomatic but rarely; it may present with atypical symptoms to simulate malignancy and needs extensive evaluation. Authors are reporting a case of 26 years old P1L1 female with history of asymptomatic multiple intramural fibroids since 6 years came with complained of progressively increasing abdominal distension and mild pain abdomen from 2-3 months. On evaluation, she had ascites, pleural effusion and raised Ca-125. MR imaging of pelvis revealed moderate ascites and pedunculated serosal fibroid in addition to intramural fibroids with normal bilateral ovaries. She was evaluated to rule out uterine sarcoma and tuberculosis but diagnosis of them could not be established. Finally, conclusion of Pseudo-Meigs syndrome was made. Myomectomy of single pedunculated fibroid relieved her symptoms. Though, subserosal fibroids are benign in pathology, timely surgery is must to avoid morbidity and mortality owing to massive ascites and pleural effusion

A NEW METHOD DEVELOPMENT AND VALIDATION FOR ESTIMATION OF PARACETAMOL IN PHARMACEUTICAL DOSAGE FORM BY REVERSE PHASE-HIGH PERFORMANCE LIQUID CHROMATOGRAPHY

Objective: An accurate, simple, reproducible and sensitive method for the determination of paracetamol in pharmaceutical dosage form was developed and validated using a reversed-phase C18 column (250 mm X 4.6 mm i. d, 5 µm particle size) with isocratic elution.Methods: A mixture of Acetonitrile: 10 mM potassium dihydrogen orthophosphate buffer (15:85 v/v), pH 2.5 was used as a mobile phase at the flow rate of 1.0 ml/min and detector wavelength at 210 nm. The retention time of paracetamol was found to be 5.7 minutes (min). The method was statistically validated for the linearity, accuracy, precision and robustness.Results: The linearity of paracetamol was in the range of 25.00 to 60.00µg/ml. This method showed an excellent linear response with the correlation coefficient (R2) value of 0.999 for the paracetamol. The recovery of the drug was ranged from 99.51 to 100.68%. An intra-day and inter-day precision study of the new method was less than the maximum allowable limit (% RSD<2.0).Conclusion: The proposed method was cost effective, which can be used for the estimation of paracetamol in bulk and in solid dosage forms.Â

A study on the symptoms, sleep quality and cognitive function of the women during menopause

Background: Menopause is the time that marks the end of your menstrual cycle. It is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. The primary objective of the study was to evaluate the pattern of symptoms among women during menopause. The secondary objective was to assess the sleep quality and cognitive function of the women during menopause and to create awareness and educate rural women regarding menopause. Methods: A cross-sectional observational study was carried out in and around B. G. Nagar, Nagamangala, Mandya for 6 months. Results: A total of 504 women were enrolled in the study. Out of 504, 224 (44.4%) participants come under perimenopause, 117 (23.31%) participants come under perimenopause and 163 (33.34%) participants comes under post menopause. After filling out the questionnaire it was observed that there was a decline in cognitive function of postmenopausal women along with poor sleep quality. When the age group of the participants was compared with the different symptoms of menopause a significant relation was found between the age category of the participants and the somatic symptoms. A significant relation was found between the sexual activity and with the somatic symptoms (p=0.00**), psychological symptoms (p=0.00**) and urogenital symptoms (p=0.00**) of the participants. Conclusions: As women passes from premenopausal to perimenopause to post menopause menopausal symptoms were increased. The menopausal transition and postmenopausal years are associated with significant symptoms

Genotypic Variability in Tomato for Total Carotenoids and Lycopene Content during Summer and Response to Post Harvest Temperature

Lycopene is the major carotenoid responsible for fruit colour in tomato (Lycopersicon esculentum Mill.). However, colour of the fruit is greatly affected by high temperature prevailing during fruit growth in the summer crop. To select a genotype suitable for summer conditions that can maintain colour better, a set of 52 tomato genotypes were evaluated for lycopene, total carotenoids and for TSS during summer in Bengaluru. Among the genotypes screened, IIHR 2892 recorded very high lycopene content (328.4mg/100g dry weight) and IIHR 2866 recorded very low lycopene content (25.2mg/100g dry weight). TSS values ranged from 2.6° Brix in cv. Vybhav to 7.0° Brix in IIHR 2866. In addition, study was carried out to determine the effect of postharvest temperature on biosynthesis of lycopene in five selected tomato cultivars (Arka Rakshak, Arka Samrat, Arka Ananya, Lakshmi and Abhinava). Tomatoes harvested at breaker stage were stored at 27° C, 35° C and 40° C for ripening. High temperature reduced lycopene content in tomato fruits. Lycopene synthesis in fruits was completely inhibited above 35°C. In this study, mean lycopene content in tomatoes stored at 27° C was 3-4 times higher than that in tomatoes stored at 40° C. This indicates that in tomatoes, temperature at which the fruits are stored after harvest, is a more important factor for colour development

Changes in Fruit Quality and Carotenoid Profile in Tomato (Solanum lycopersicon L.) Genotypes under Elevated Temperature

Tomato (Solanum lycopersicon L.) is a rich source of carotenoids, especially lycopene, and is affected severely by high temperatures under tropical conditions. To study the effect of elevated temperature on lycopene content and other quality parameters, five tomato genotypes, viz., RF4A, Abhinava, Arka Saurabh, IIHR 2195 and Arka Vikas, were grown in a temperature gradient tunnel (TGT) facility under 33.4 and 35.4°C temperature conditions. Fruits were analyzed for total carotenoids, total phenols, total flavonoids, total sugars, TSS, acidity, Vitamin C besides carotenoids profile (β-carotene, lycopene, phytoene and luteoxanthin content). Results revealed that all the quality parameters studied were superior at 33.4°C, compared to 35.4°C in all the genotypes. 'IIHR 2195' recorded highest total phenols (479.28mg/100g dw), total flavonoids (70.27mg/100g dw), ferric reducing antioxidant potential (FRAP) (310.53mg/100g dw), diphenyl picryl hydrazyl (DPPH) radical (487.89mg/100g dw), Vitamin C content (292.25mg/ 100g dw) and total sugars (606.88mg/g dw) at 33.4°C and at 35.4°C. 'RF4A' and 'Arka Vikas' were found to have better total carotenoids content and lycopene at higher temperature than other genotypes. 'Arka Vikas' recorded highest total soluble solids (TSS) (8.9°Brix) and acidity (0.80%) at 35.4°C. Higher TSS and acidity were recorded at 35.4°C than at 33.4°C in all the five genotypes. Genotypic variation was observed in the above stated biochemical parameters in response to elevated temperatures

The European Association for Haemophilia and Allied Disorders (EAHAD) Coagulation Factor Variant Databases: Important resources for haemostasis clinicians and researchers

Haemophilia published by John Wiley & Sons Ltd Introduction: Advances in genomic sequencing have facilitated the sequencing of genes associated with disorders of haemostasis. The identification of variants within genes and access to curated data incorporating structural, functional, evolutionary as well as phenotypic data has become increasingly important in order to ascribe pathogenicity. Aim: The European Association for Haemophilia and Allied Disorders (EAHAD) Coagulation Factor Variant Database Project aims to provide a single port of entry to a web-accessible resource for variants in genes involved in clinical bleeding disorders. Results: New databases have evolved from previously developed single gene variant coagulation database projects, incorporating new data, new analysis tools and a new common database architecture with new interfaces and filters. These new databases currently present information about the genotype, phenotype (laboratory and clinical) and structural and functional effects of variants described in the genes of factor (F) VII (F7), FVIII (F8), FIX (F9) and von Willebrand factor (VWF). Conclusion: The project has improved the quality and quantity of information available to the haemostasis research and clinical communities, thereby enabling accurate classification of disease severity in order to make assessments of likely pathogenicity

Case Report: It's not always about the veins; intervention of bilateral May–Thurner Syndrome secondary to iliac aneurysm

May–Thurner Syndrome (MTS) remains evasive because of the insidiousness and variable etiologies by which it can manifest. In this study, we examine a unique presentation of MTS resulting from compression of both common iliac veins by a right common iliac artery aneurysm that required complex endovascular venous and arterial intervention