A prospective study on prescribing pattern of drugs in geriatric patients in the department of medicine in a tertiary care center

Background: India stands at 3rd position with large elderly population in the world. Elderly population has special problems related to health, social support, and economic security. Comorbidities in elderly people are frequent, which require use of multiple medications which increases the number of inappropriate medications    noncompliance, economic burden, adverse drug reactions (ADRs), and drug interactions. The overall incidence of ADR is two to three times higher due to physiological and pharmacological variations. Currently used screening tools for inappropriate prescription in old age are: Beers criteria and inappropriate prescribing in the elderly tool (IPET).Methods: A prospective observational study of elderly patients of either sex admitted in the medicine ward, conducted from May 2019-November 2019. A total of 102 prescriptions were collected and analysed. Data was analysed using Microsoft excel.Results: In this study most of the patients (67 out of 102) were in the age group 65-70 years with male population (73%) dominance. Most of the patient were admitted due to cardiovascular (35.84%) and respiratory system (14.15%) disorder. Anti-diabetics (17.64%) followed by anti-microbials (14.24%) were the most commonly prescribed medicines in this study. Our study revealed poly pharmacy in geriatric patients with an average number of drugs per prescription being 6.07. According to BEER’s criteria 3.47% of total drugs prescribed were inappropriateConclusions:  In this study most of the patients had co morbid conditions, cardiovascular disease and diabetes being the common cause led to polypharmacy. A high number of potential prescription errors were found.

A prospective study to evaluate oral iron preparations in antenatal women at a tertiary care hospital

Background: Iron deficiency is the most common cause of anemia in pregnancy worldwide. It can be mild, moderate or severe. Severe anemia can have very serious consequences for mothers and babies. Pregnant women requiring medication represent a challenge to healthcare providers to avoid any teratogenic risk to foetus. The purpose of this study was to provide information about the most effective iron preparations prescribed to pregnant women and to evaluate the haemoglobin status before and after oral iron therapy.Methods: This was a Prospective observational study conducted in the Department of Obstetrics and Gynaecology, Rajarajeswari Medical College and Hospital, between October 2013 and March 2014.This study was conducted by reviewing the antenatal care Outpatient department case papers of 200 pregnant women who were anaemic.Results: Demographic profile, detailed medical history and drug intake in current pregnancy was noted. The prescription pattern was assessed. Of the three common iron preparations prescribed, Ferrous sulphate was the most common preparation. Findings of our study showed that all pregnant anaemic women included in the study were provided with iron and folic acid therapy and the most effective oral iron preparation was Ferrous sulphate.Conclusions: Present study shows that ferrous sulphate is the most common iron preparation prescribed. Ferrous sulphate and ferrous fumarate preparations showed better improvement in Hb levels. Anaemia is common among all pregnant women and therefore it raises the concern about high morbidity and mortality associated with pregnancy outcome. This can be minimized by educating pregnant women about importance of balanced diet and utilization of antenatal facilities even during early pregnancy.

Study of anti-inflammatory activity of Ficus racemosa linn stem bark extract in albino rats

Background: Inflammation is part of the complex biological response of vascular tissues to harmful stimuli. Though there are standard anti-inflammatory drugs like aspirin, diclofenac, etc., these are not free of side effects. This has led to an increase in demand for natural products with anti-inflammatory activity having less side effects. Hence the study was conducted to evaluate the anti-inflammatory activity of ethanolic extract of Ficus racemose (EEFR) in albino rats.Methods: Healthy albino rats of either sex were divided into 4 groups of 6 animals each. Group1-control, group 2-diclofenac sodium 2 mg/kg and group 3 and 4 EEFR (200 and 400 mg/kg respectively), anti-inflammatory activity was evaluated by Carrageenan induced paw oedema: formalin induced-peritonitis and cotton pellet induced granuloma model for in vivo activity and protein denaturation test for in vitro activity.Results: EEFR exhibited significant in vitro (p<0.001) anti-inflammatory effect at the dose of 200 and 400 mg/kg. EEFR produced 61.37% inhibition at the dose of 400 mg/kg and diclofenac (standard drug) produced 62.95% of inhibition after 3 hours of drug treatment in carrageenan induced paw oedema. The exudate volume was decreased in formalin induced peritonitis by EEFR and diclofenac significantly (p<0.001). In cotton pellet induced granuloma EEFR (400 mg/kg) and diclofenac showed decreased formation of granuloma by 28.36% and 28.00% (p<0.001) respectively.Conclusions: EEFR has significant anti-inflammatory activity in both acute and chronic model in a dose dependant manner in comparison with standard drug

Multifarious pigment producing fungi of Western Ghats and their potential

Concerns about the negative impacts of synthetic colorants on both consumers and the environment have sparked a surge of interest in natural colorants. This has boosted the global demand for natural colorants in the food, cosmetics and textile industries. Pigments and colorants derived from plants and microorganisms are currently the principal sources used by modern industry. When compared to the hazardous effects of synthetic dyes on human health, natural colors are quickly degradable and have no negative consequences. In fact, fungal pigments have multidimensional bioactivity spectra too. Western Ghats, a biodiversity hotspot has a lot of unique ecological niches known to harbor potential endophytic pigment-producing fungi having enumerable industrial and medical applications. Most of the fungi have coevolved with the plants in a geographical niche and hence the endophytic associations can be thought to bring about many mutually beneficial traits. The current review aims to highlight the potential of fungal pigments found in the Western ghats of India depicting various methods of isolation and screening, pigment extraction and uses. There is an urgent need for bioprospecting for the identification and characterization of extremophilic endophytic fungi to meet industry demands and attain sustainability and balance in nature, especially from geographic hotspots like the Western Ghats

Exploring the Potential of Bacillus velezensis, an Endophytic Bacteria Isolated from Alternanthera philoxeroides for Plant Growth Promotion and Bioremediation Properties

The current work was done to analyse the bioremediation and plant growth promotion (PGP) traits of endophytic bacteria isolated from Alternanthera philoxeroides from Bellandur Lake, Bangalore, India. Twenty-nine endophytic bacteria were isolated and tested for their PGP traits like indole acetic acid (IAA), ammonia, nitrogen fixation, 1-aminocyclopropane-1- carboxylate (ACC) deaminase production, phosphate solubilization etc. Endophytic bacterium, BEBAphL1 obtained from leaves of A. philoxeroides exhibited significant plant growth promotion properties and the isolate was identified as Bacillus velezensis OQ874364 using 16S rRNA sequencing. The bacterium showed potential IAA, ammonia production, nitrogen fixation, phosphate solubilization, and ACC deaminase production. The results indicate that this endophyte is promising as a growth-promoting inoculant, reducing the reliance on chemical inputs in conventional agricultural practices while enhancing nutrient uptake and stress resilience in plants. B. velezensis exhibited tolerance to high levels of chromium (500 mg/L) and NaCl (15%) and was also able to decolourize Congo red by 70% at 0.005% concentration of dye. Characterization of dye samples pre- and post-bacterial treatment was done using Fourier-transform infrared spectroscopy (FTIR) and Gas Chromatography-Mass Spectrometry (GC-MS) analysis. The findings of the study indicate that B. velezensis shows promise as a plant growth stimulator capable of withstanding heavy metal exposure and breaking down dyes

Citrus for wellness: Exploring the bioactive properties of Citrus medica fruit peel with emphasis on its anticancer, antioxidant, antimicrobial and anthelmintic properties

Citrus medica (Citron) is an underutilised plant consisting of various bioactive elements with numerous medicinal benefits. The present study aimed to evaluate the bioactive properties, including anthelmintic, antimicrobial, antioxidant and anticancer activities, of chloroform extract obtained from the of fruit peel of C. medica. The different types of phytochemicals present in the chloroform extract were analysed using GC-MS. The major components detected included n-hexadecanoic acid, octadecanoic acid, t-tetradecenal, 1-nonadecene etc. Anthelmintic study was conducted using Eisenia fetida as a test organism, revealing a significant anthelmintic effect in the C. medica fruit peel extract compared to the standard drug. Antimicrobial properties were assessed against five test bacterial and fungal strains. Antibacterial tests showed zones of inhibition ranging from 8 to 11 mm, while no prominent zones of inhibition were observed in antifungal tests. The DPPH assay demonstrated significant antioxidant properties of Citron fruit peel extract compared to the standard ascorbic acid. The Chloroform extract of citron fruit peel exhibited significant cytotoxic properties against FaDu (human hypopharyngeal tumour) cell line. The present study indicates the potential of the chloroform extract of C. medica fruit peel to be employed as an anthelmintic, antibacterial, antioxidant and anticancer agent. Hence, it emphasises the prominence that can be given to the dietary consumption of citrus fruit peel in various forms, such as dried peel, powder etc

Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Background Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings Globally, in 2019, among HIV-negative individuals, there were 1.18 million (95% uncertainty interval 1.08-1.29) deaths due to tuberculosis and 8.50 million (7.45-9.73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000-279 000) deaths due to tuberculosis and 1.15 million (1.01-1.32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000-425 000) more deaths and 1.01 million (0.82-1.23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820-11 400) more deaths and 81 100 (63 300-100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1.5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4.27 (3.69-5.02), 6.17 (5.48-7.02), and 1.17 (1.07-1.28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2.23 (2.03-2.44) times greater among males than females, whereas the fraction due to unsafe sex was 1.06 (1.05-1.08) times greater among females than males. Interpretation As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestone

Differential Laccase Production among Diverse Fungal Endophytes in Aquatic Plants of Hulimavu Lake in Bangalore, India

The ability of plants to acclimatise and thrive in stressed environments can be attributed, in part, to the reserve of endophytic fungi that they harbour, that help enhance physiological and immunological defence and tolerance to various biotic and abiotic stressors. The present work has focussed on screening laccase producing endophytic fungi residing in different aquatic plants isolated from Hulimavu Lake, Bengaluru. This lake is well known for its water pollution contributed by anthropogenic factors. Survival of plants in this lake can hence be associated with their rich repertoire of endophytic fungi that enhance host plant defence towards stressors. Upon isolation and culturing of endophytic fungi, qualitative laccase detection using laccase specific growth media and quantitative laccase estimation using ABTS (2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) substrate were performed. Differential production rates were observed for the laccase enzyme by different endophytic fungi; production rates also varied between fungi isolated from different parts like node, stem, root and leaf of the same plant species too. Phylogenetic analysis of fungal isolates with highest laccase production was performed and the species was found to be Cladosporium tenuissimum. Even the crude extract of this strain displayed laccase production of 42.16U/L, as revealed by ABTS assay. Hence this strain is a promising candidate for optimization studies for utilisation in the domain of bioremediation and industrial applications

Understanding the Role of Antimicrobial Peptides in Neutrophil Extracellular Traps Promoting Autoimmune Disorders

AMPs are small oligopeptides acting as integral elements of the innate immune system and are of tremendous potential in the medical field owing to their antimicrobial and immunomodulatory activities. They offer a multitude of immunomodulatory properties such as immune cell differentiation, inflammatory responses, cytokine production, and chemoattraction. Aberrancy in neutrophil or epithelial cell-producing AMPs leads to inflammation culminating in various autoimmune responses. In this review, we have tried to explore the role of prominent mammalian AMPs—defensins and cathelicidins, as immune regulators with special emphasis on their role in neutrophil extracellular traps which promotes autoimmune disorders. When complexed with self-DNA or self-RNA, AMPs act as autoantigens which activate plasmacytoid dendritic cells and myeloid dendritic cells leading to the production of interferons and cytokines. These trigger a series of self-directed inflammatory reactions, leading to the emergence of diverse autoimmune disorders. Since AMPs show both anti- and pro-inflammatory abilities in different ADs, there is a dire need for a complete understanding of their role before developing AMP-based therapy for autoimmune disorders