STUDY ON DRUG UTILIZATION PATTERN OF CHRONIC RENAL FAILURE PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: Chronic Renal Failure is a worldwide public health problem with an increasing incidence and prevalence, poor outcomes and high cost of treatment due to co-morbidities and Polypharmacy. The aim of this study was to describe drug utilization pattern of patients with chronic renal failure in a tertiary care hospital.Methods: The study was conducted between July -2013 to December-2013. In total 150 patients were identified and 135 patients were recruited for further study. Study subject medical record and prescription was reviewed on their regular hospital visit. Those were missed the followup, their medical records and prescription were reviewed from the medical record departmentResults: In this study, male subjects (62.85 %) predominated; 37.05% of the patients were in the age group of 51 to 60 years. The mean age of subjects was 53.26 ±15.69 years. The average number of drugs prescribed per prescription was 5.26 ± 3.79.Conclusion: The prevalence of Polypharmacy was high in patients with CRF. Diuretics, anti hypertensive and anti diabetic drugs were used more frequently in chronic renal failure patients. Moreover time to time studies are required to improve management strategy and quality of life of patients.Â

The care of patients with Duchenne, Becker and other muscular dystrophies in the COVID-19 pandemic

The corona virus disease 2019 (COVID-19) pandemic has resulted in the reorganization of healthcare settings affecting clinical care delivery to patients with Duchenne and Becker muscular dystrophy (DBMD) as well as other inherited muscular dystrophies. The magnitude of the impact of this public health emergency on the care of patients with DBMD is unclear as they are suspected of having an increased risk for severe manifestations of COVID-19. In this paper, the authors discuss their consensus recommendations pertaining to care of these patients during the pandemic. We address issues surrounding corticosteroid and exon skipping treatments, cardiac medications, hydroxychloroquine use, emergency/respiratory care, rehabilitation management, and the conduct of clinical trials. We highlight the importance of collaborative treatment decisions between the patient, family, and health care provider, considering any geographic or institution-specific policies and precautions for COVID-19. We advocate for continuing multidisciplinary care for these patients using telehealth

Spinal muscular atrophy care in the COVID-19 pandemic era

peer reviewedThe Corona Virus Disease 2019 (COVID-19) pandemic has resulted in reorganization of healthcare settings affecting the delivery of clinical care to patients with spinal muscular atrophy (SMA). There is a concern that patients with SMA may be at increased risk of manifesting severe symptoms of COVID-19. Currently approved therapies for SMA improve survival and motor function, however, their delivery requires an increased exposure to the health system and a dedicated healthcare team. In this paper, we discuss consensus recommendations pertaining to care of SMA patients during the pandemic. We highlight that SMA treatments should not be perceived as elective. Decisions regarding the delay of treatments should be made with consideration of the potential risks of COVID-19 exposure and the risk of that delay. We emphasize the importance of collaborative treatment decisions between the patient, family, and health care provider, considering any geographic or institution-specific policies and precautions for COVID-19. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved

Ceramic processing and multiferroic properties of the perovskite YMnO3-BiFeO3 binary system

International audienceThe perovskite (1-x)YMnO3-xBiFeO(3) binary system is very promising because of its multiferroic end members. Nanocrystalline phases have been recently obtained by mechanosynthesis across the system, and the perovskite structural evolution has been described. Two continuous solid solutions with orthorhombic Pnma and rhombohedral R3c symmetries were found, which coexist within a broad compositional interval of 0.5 <= x <= 0.9. This might be a polar-nonpolar morphotropic phase boundary region, at which strong phase-change magnetoelectric responses can be expected. A major issue is phase decomposition at moderate temperatures that highly complicates ceramic processing. This is required for carrying out a sound electrical characterization and also for their use in devices. We present here the application of Spark Plasma Sintering to the ceramic processing of YMnO3-BiFeO3 phases. This advanced technique, when combined with nanocrystalline powders, allowed densifying phases at reduced processing temperatures and times, so that perovskite decomposition was avoided. Electrical measurements were accomplished, and the response was shown to be mostly dominated by conduction. Nonetheless, the intrinsic dielectric permittivity was obtained, and a distinctive enhancement in the phase coexistence region was revealed. Besides, Rayleigh-type behavior characteristic of ferroelectrics was also demonstrated for all rhombohedral phases. Magnetic characterization was performed in this region, and antiferromagnetism was shown

Epilepsy due to PNPO mutations: genotype, environment and treatment affect presentation and outcome

The first described patients with pyridox(am)ine 5'-phosphate oxidase deficiency all had neonatal onset seizures that did not respond to treatment with pyridoxine but responded to treatment with pyridoxal 5'-phosphate. Our data suggest, however, that the clinical spectrum of pyridox(am)ine 5'-phosphate oxidase deficiency is much broader than has been reported in the literature. Sequencing of the PNPO gene was undertaken for a cohort of 82 individuals who had shown a reduction in frequency and severity of seizures in response to pyridoxine or pyridoxal 5'-phosphate. Novel sequence changes were studied using a new cell-free expression system and a mass spectrometry-based assay for pyridoxamine phosphate oxidase. Three groups of patients with PNPO mutations that had reduced enzyme activity were identified: (i) patients with neonatal onset seizures responding to pyridoxal 5'-phosphate (n = 6); (ii) a patient with infantile spasms (onset 5 months) responsive to pyridoxal 5'-phosphate (n = 1); and (iii) patients with seizures starting under 3 months of age responding to pyridoxine (n = 8). Data suggest that certain genotypes (R225H/C and D33V) are more likely to result in seizures that to respond to treatment with pyridoxine. Other mutations seem to be associated with infertility, miscarriage and prematurity. However, the situation is clearly complex with the same combination of mutations being seen in patients who responded and did not respond to pyridoxine. It is possible that pyridoxine responsiveness in PNPO deficiency is affected by prematurity and age at the time of the therapeutic trial. Other additional factors that are likely to influence treatment response and outcome include riboflavin status and how well the foetus has been supplied with vitamin B6 by the mother. For some patients there was a worsening of symptoms on changing from pyridoxine to pyridoxal 5'-phosphate. Many of the mutations in PNPO affected residues involved in binding flavin mononucleotide or pyridoxal 5'-phosphate and many of them showed residual enzyme activity. One sequence change (R116Q), predicted to affect flavin mononucleotide binding and binding of the two PNPO dimers, and with high residual activity was found in Groups (ii) and (iii). This sequence change has been reported in the 1000 Genomes project suggesting it could be a polymorphism but alternatively it could be a common mutation, perhaps responsible for the susceptibility locus for genetic generalized epilepsy on 17q21.32 (close to rs72823592). We believe the reduction in PNPO activity and B6-responsive epilepsy in the patients reported here indicates that it contributes to the pathogenesis of epilepsy