Adverse drug reaction monitoring study in hospitalized patients: support for pharmacovigilance at a tertiary care hospital

Background: Adverse drug reaction (ADR) reporting is an integral component of pharmacovigilance. However, under-reporting of ADR is commonly observed. The present study has been planned with aim to assess the pattern of reported ADRs in terms of its frequency, causality and severity so as to reinforce pharmacovigilance activities.Methods: This prospective observational study was conducted with the aim to evaluate suspected ADRs in hospitalized patients in departments of Medicine, Surgery and Orthopaedics of a tertiary care hospital in North India for a period of 6 months. The ADRs were assessed in terms of the demographic parameters, organ system affected, drugs implicated, type of ADRs by Rawlin’s and Thompson classification, causality using WHO-UMC scale and severity of ADR by Modified Hartwig’s and Siegel scale.Results: A total of 111 ADRs were reported during the study period. There was male preponderance (54.96%) with majority of ADRs in age group of 18-60 years (79.28%). Gastrointestinal system was most commonly affected (36.36%). The most common drug implicated in causing ADRs was Ceftriaxone (11.71%). Majority of ADRs were Type A reactions (86.49%). Causality assessment using WHO-UMC scale depicted that 74.77% of ADRs were possible. Severity analysis showed that 82.88% of ADRs were mild as per Modified Hartwig’s and Siegel scale.Conclusions: ADR reporting should be encouraged among health-care professionals, para-medical staff and patients in general so that the ultimate goal of pharmacovigilance can be fulfilled

Computer assisted learning versus conventional teaching: a questionnaire based study

Background: Animal experiments have ethical concerns thus practical sessions mean demonstration classes. Incorporation of novel teaching methods in pharmacology is the need of the hour when there is extensive use of computers among students. The present study was conducted to analyse and compare the knowledge gained by students through traditional demonstration lectures versus Computer assisted learning (CAL) sessions.Methods: This study was done on 112 second professional MBBS students after taking informed consent. They were divided in 2 groups viz. CAL group and Traditional teaching group and were taught experimental pharmacology topics using different teaching methods. The performance of the students in the two groups was then compared based on questionnaire. Student’s perception on use of CAL was also assessed.Results: A statistically significant difference in performance was seen among the students in the traditional teaching group and CAL group. In CAL group, the average scores for the Rabbit’s eye, Dog’s blood pressure, Animals used in Experimental Pharmacology and Screening methods sessions were 9.07, 8.3 and 3.8 respectively while in traditional teaching group the scores were 8.4, 7.8 and 3.4 respectively. Similarly, in frog’s heart session, CAL group scored higher (7.14) than traditional group (6.79). 76.8% students strongly agreed that CAL sessions were useful and 100% students strongly agreed that traditional lectures are difficult to retain.Conclusions: The study concludes that CAL is a promising teaching option when compared to traditional demonstration lectures for undergraduate practical pharmacology classes

A study monitoring prescription pattern of antibiotics in a tertiary care hospital in North India

Background: Irrational prescribing of medicine results in serious morbidity and mortality as well as additional economic burden and also lead to reduction in the quality of treatment; thereby causing wastage of resources, increased treatment cost, increased risk for adverse drug reaction, and emergence of resistance. WHO has generated indicators in three main drug use areas; prescribing, patient care, and facility specific factors.Methods: This study was carried out with the aim of identifying prescription pattern of antibiotics and evaluates the rationality of prescriptions in accordance with WHO prescribing indicators. 300 prescriptions were examined from the inpatient department (IPD) of a tertiary care teaching hospital from the Department of Medicine, Surgery, and Orthopedics. The IPDs were visited twice a week. Each prescription was followed for the duration of 5 days. The prescribing and dispensing details from each prescription were recorded in a tabular form as mentioned in data acquisition form. The data were analyzed as per the WHO core drug use indicators.Results: This study clearly highlights the practice of polypharmacy, low uses of generic drugs, injudicious usage of antibiotic, and injection and low usage of the drug prescribed from essential drug list.Conclusions: Multi-faceted interventions are required at many levels for the benefits of the community in the form of continued medical educational programs, consumer awareness, formation of hospital formulary, and undergraduate clinical pharmacology and therapeutics teaching

Costochondral Grafts in the treatment of Temporomandibular joint ankylosis: a Clinical Study

Background: Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic block (arthroplasty) without interposing any material (gap arthroplasty) or interpositional arthroplasty using autogenous or alloplastic materials. The objective of this paper was to note the potential of the costochondral graft (CCGs) as an interpositional material and to see whether they induce normal growth potential in the reconstructed mandible. Materials and method: The ankylosed temporomandibular joint was reached by a preauricular incision with or without angulation and exposed. In the first 4 cases, arthroplasty was done using a bur. The bony mass was detached of its muscle attachments and removed. In the 5th case, condylectomy was performed. In all cases, this was followed by immediate costochondral grafting. Results: The maximal incisal opening in the pre-operative period ranged from 0- 2mm and in the immediate post- operative period from 15- 20mm. at the end of the follow up period it ranged from 20- 35 mm. The increase in SNB angle, SND angle, ramus length and mandibular body length all showed linear growth of mandible on the side where costochondral grafting was done. Conclusion: The articular reconstruction with costochondral grafts for the treatment of TMJ ankylosis is efficient in relation to post- operative maximal incisal opening, recurrence and articular function

Study of hematological profile of systemic lupus erythematosus

Background: Hematological abnormalities are prevalent in systemic lupus erythematosus (SLE), with approximately 72% of patients experiencing anemia, primarily in the form of autoimmune hemolytic anemia. Other manifestations include leukopenia (32%), lymphopenia (54%), and thrombocytopenia (23%). This study aimed to further investigate these hematological manifestations, which may serve as presentations of SLE and might be overlooked if suspicion levels are low. Methods: A descriptive observational study was conducted over 18 months at a Sir Ganga Ram hospital, a tertiary care centre. One hundred thirteen SLE cases, comprising newly diagnosed patients and previously diagnosed patients’ records, were reviewed, with 13 cases excluded based on exclusion criteria. One hundred patients with hematological abnormalities and fulfilling ≥4 SLICC criteria for SLE diagnosis were included in the study. Results: One hundred cases of SLE with hematological abnormalities (88 women, 12 men) were analyzed. At presentation, 83% (n=84) of patients displayed hematological manifestations. The most prevalent abnormality was anemia, present in 72% of the study group, with a mean hemoglobin level of 10.073 gm/dl. Additionally, leukopenia, lymphopenia, thrombocytopenia, and pancytopenia were observed in 32%, 54%, 23%, and 14% of cases, respectively. Neutropenia was detected in only 5% of cases. Conclusions: Hematological manifestations are the most common presenting signs of SLE in North India. Anemia, with a multifactorial basis, is the most frequent hematological abnormality throughout the disease course. A high index of suspicion is crucial when evaluating cases of anemia in daily clinical practice

Are We at Risk of Losing the Current Generation of Climate Researchers to Data Science?

Climate model output has progressively increased in size over the past decades and is expected to continue to rise in the future. Consequently, the research time expended by Early Career Researchers (ECRs) on data-intensive activities is displacing the time spent in fostering novel scientific ideas and expanding the frontiers of climate sciences. Here, we highlight an urgent need for a better balance between data-intensive and foundational climate science activities, more open-ended research opportunities that reinforce the scientific freedom of the ECRs, and strong coordinated action to provide infrastructure and resources to the ECRs working in under-resourced environments

Are We at Risk of Losing the Current Generation of Climate Researchers to Data Science?

Climate model output has progressively increased in size over the past decades and is expected to continue to rise in the future. Consequently, the research time expended by Early Career Researchers (ECRs) on data-intensive activities is displacing the time spent in fostering novel scientific ideas and expanding the frontiers of climate sciences. Here, we highlight an urgent need for a better balance between data-intensive and foundational climate science activities, more open-ended research opportunities that reinforce the scientific freedom of the ECRs, and strong coordinated action to provide infrastructure and resources to the ECRs working in under-resourced environments

Are We at Risk of Losing the Current Generation of Climate Researchers to Data Science?

Climate model output has progressively increased in size over the past decades and is expected to continue to rise in the future. Consequently, the research time expended by Early Career Researchers (ECRs) on data-intensive activities is displacing the time spent in fostering novel scientific ideas and expanding the frontiers of climate sciences. Here, we highlight an urgent need for a better balance between data-intensive and foundational climate science activities, more open-ended research opportunities that reinforce the scientific freedom of the ECRs, and strong coordinated action to provide infrastructure and resources to the ECRs working in under-resourced environments

Validation of a noninvasive aMMP-8 point-of-care diagnostic methodology in COVID-19 patients with periodontal disease

Objectives: The aim of this study was to validate an active matrix metalloproteinase (MMP-8) point-of-care diagnostic tool in COVID-19 patients with periodontal disease. Subjects, Materials, and Methods: Seventy-two COVID-19-positive and 30 COVID-19-negative subjects were enrolled in the study. Demographic data were recorded, periodontal examination carried out, and chairside tests run for evaluating the expression of active MMP-8 (aMMP-8) in the site with maximum periodontal breakdown via gingival crevicular fluid sampling as well as via a mouth rinse-based kit for general disease activity. In COVID-19-positive patients, the kits were run again once the patients turned COVID-19 negative. Results: The overall (n = 102) sensitivity/specificity of the mouthrinse-based kits to detect periodontal disease was 79.41%136.76% and that of site-specific kits was 64.71%/55.88% while adjusting for age, gender, and smoking status increased the sensitivity and specificity (82.35%/76.47% and 73.53%/88.24, respectively). Receiver operating characteristic (ROC) analysis for the adjusted model revealed very good area under the ROC curve 0.746-0.869 (p < .001) and 0.740-0.872 (p < .001) (the aMMP-8 mouth rinse and site-specific kits, respectively). No statistically significant difference was observed in the distribution of results of aMMP-8 mouth rinse test (p = .302) and aMMP-8 site-specific test (p = .189) once the subjects recovered from COVID-19. Conclusions: The findings of the present study support the aMMP-8 point-of-care testing (PoCT) kits as screening tools for periodontitis in COVID-19 patients. The overall screening accuracy can be further increased by utilizing adjunctively risk factors of periodontitis. The reported noninvasive, user-friendly, and objective PoCT diagnostic methodology may provide a way of stratifying risk groups, deciding upon referrals, and in the institution of diligent oral hygiene regimens.Peer reviewe