Study of prescription pattern and adverse drug reactions in patients with cervical cancer in tertiary care teaching institute

Background: Cervical cancer is the second most common cancer in women especially in developing countries. In India, it is estimated that 1, 22, 644 new cases of cancer cervix occur every year. Incidence rate is 22 per lac population and mortality rate is 12.4 per lac population. The objective of this study was to study the prescription pattern and adverse drug reactions (ADRs) in patients with cervical cancer.Methods: Twenty five patients of cancer cervix Stage (IIa to IVb) receiving chemotherapy were enrolled in the study after written informed consent of patients. Approval was obtained from institutional ethics committee. It was cross sectional, observational study. Prescriptions were analysed for no. of drugs prescribed, time interval between two cycles, no. of cycles of chemotherapy. Any ADR observed by patient or treating physician was noted and causality was assessed by Naranjo’s algorithm. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale, modified Hartwig and Siegel scale respectively.Results: Twenty five patients were enrolled with mean age 52.24±8.66 years and mean weight 51.76±5.88 kg. 84% patients were on combination chemotherapy. Percentage of anticancer drugs prescribed were: cisplatin (72%); paclitaxel (40%); 5FU (36%); carboplatin (32%); gemcitabine (4%). Chemotherapeutic drugs were given at 3 weekly intervals for 6 cycles. ADR observed were nausea (76%), vomiting (40%), alopecia (32%), headache (12%), bodyache (12%), anorexia (12%), diarrhoea (8%) and malaise (4%). Causality assessment of ADR by Naranjo’s algorithm showed 89.8% probable and 10.2% possible reactions. According to modified Schumock and Thornton scale, 26.5% reactions are ‘not preventable’ however 73.5% are ‘definitely preventable’. According to modified Hartwig and Siegel scale, 75.5% were ‘mild level 1’severity however 24.5% were ‘moderate level 3’ severity.Conclusions: Among patients with CA cervix, cisplatin was most commonly prescribed drug. Nausea was most common ADR which is of ‘mild level 1’ severity

Osmotic controlled drug delivery system (OSMO technology) and its impact on diabetes care

Recently, focus on the development of controlled release drug delivery system has increased, as existing drugs exhibit certain pharmacokinetic limitations. The major goal of designing sustained release formulations is to improve the drug performance by prolonged duration of drug action, decreased frequency of dosing and reduced side effects by using smallest quantity of drug administered by the most suitable route. Osmotic-controlled release oral delivery system (OSMO technology) is the most promising strategy based system for sustained delivery of drug. Drug can be delivered in a controlled manner over a long period of time by the process of osmosis. Osmotic drug delivery system appears to be a promising solution for the limitations of conventional extended release formulations by virtue of their distinguished technological features. The present review describes briefly about various controlled drug delivery systems with special focus on advantages of osmotic-controlled release oral delivery system related to diabetes therapy and improved compliance

The Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, India

OBJECTIVES: To develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. METHODOLOGY AND PRINCIPAL FINDINGS: This was a randomised controlled trial in which the person with dementia-caregiver dyad was randomly allocated either to receive the intervention immediately or to a waiting list group which received the intervention after 6 months. It was carried out in communities based in two talukas (administrative blocks) in Goa, India. Mild to moderate cases with dementia (diagnosed using the DSM IV criteria and graded using the Clinical Dementia Rating scale) and their caregivers were included in the trial. Community based intervention provided by a team consisting of Home Care Advisors who were supervised by a counselor and a psychiatrist, focusing on supporting the caregiver through information on dementia, guidance on behaviour management, a single psychiatric assessment and psychotropic medication if needed. We measured caregiver mental health (General Health Questionnaire), caregiver burden (Zarit Burden Score), distress due to behavioural disturbances (NPI-D), behavioural problems in the subject (NPI-S) and activities of daily living in the elder with dementia (EASI). Outcome evaluations were masked to the allocation status. We analysed each outcome with a mixed effects model. 81 families enrolled in the trial; 41 were randomly allocated to the intervention. 59 completed the trial and 18 died during the trial. The intervention led to a significant reduction of GHQ (-1.12, 95% CI -2.07 to -0.17) and NPI-D scores (-1.96, 95%CI -3.51 to -0.41) and non-significant reductions in the ZBS, EASI and NPI-S scores. We also observed a non-significant reduction in the total number of deaths in people with dementia in the intervention arm (OR 0.34, 95% CI 0.01 to 1.03). CONCLUSION: Home based support for caregivers of persons with dementia, which emphasizes the use of locally available, low-cost human resources, is feasible, acceptable and leads to significant improvements in caregiver mental health and burden of caring. ClinicalTrials.gov NCT00479271

Undergraduate dental students' perceptions regarding educational environment in a private dental institute in India

Introduction: Developing countries with improper dentist population ratio like India cannot lose health-care students during their undergraduate training period. Educational environment indirectly influences academic outcome of students needed to be assessed quantitatively so that perceptions of students can be acknowledged. The present study is influenced by this concern to understand views of students about the climate of their institute. Aim: The aim of this study is to gauge students' perceptions about their educational climate in a dental college in India and to evaluate the differences if any, related to gender and year of training with regard to perceptions toward educational environment. Subjects and Methods: A cross-sectional study was carried out using the Dundee Ready Educational Environment Measure (DREEM) questionnaire as the survey instrument. Questionnaire was distributed to undergraduate dental students (n = 326) within study duration of 6 months by primary investigator. Data analysis was done using SPSS version 21. Descriptive statistics were computed. t- test and one-way analysis of variance were used with level of statistical significance was set at P ≤ 0.05. Results: Overall DREEM score of institute was 126.46 indicating positive perceptions among students for their educational environment. Statistically significant difference was obtained for gender and year of study (P ≤ 0.05). A total of nine problem areas (individual mean score <2) were identified in the present academic environment. Conclusions: Undergraduate dental students have positive perceptions regarding their educational environment with some problematic areas needing proper action and intervention

Sociodemographic profile and future expectations of newly entered students in a dental institute in Greater Noida, India

Introduction: Dentistry is one of the most reputed professions all over the world and is becoming a fastest growing career choice for students. Thus, it is necessary to know reasons for choosing dentistry as a career and their future expectations. Aim: The aim was to obtain information about sociodemographic profile, influencing and motivating factors for a career choice and to know future expectations of 1 st year students enrolled in a private dental institute in India. Materials and Methods: A cross-sectional study was conducted by distributing pretested structured questionnaire to 100 1 st year students enrolled in the Institute. The overall response rate was 93%. Statistical analysis was performed using SPSS 20.0 and Chi-square test was applied. Results: Parents were most influencing factors for both male and female students to choose dentistry and students rated reputation and lifestyle (96.7%) as most motivating factor. About 80% of students wanted to pursue specialization after B.D.S where maximum preference was given to oral surgery (29%), endodontics (12%), and orthodontics (9%). Statistically significant association was found between gender and interest to do specialization in dentistry (P = 0.004). Conclusion: Dentistry upholds a reputable position among the students, and most students′ want to pursue specialization after completion, of course; however, it′s disheartening that very few students are inclined toward nonclinical branches

Prevalence of anatomical variations in maxillary sinus using cone beam computed tomography

Introduction: The maxillary sinuses (MS) are of particular importance to dentist because of their close proximity to the teeth and their associated structures, so increased risk of maxillary sinusitis has been reported with periapical abscess, periodontal diseases, dental trauma, tooth extraction, and implant placement. Complications of MS are related to its anatomic and pathologic variations. Thus, study was conducted to assess the prevalence of anatomic variations in MS by using cone-beam computerized tomography (CBCT). Aims and Objectives: To determine different anatomical variations in MS by using CBCT. Materials and Methods: CBCT scans of 150 subjects were collected between the age group of 18 years to 70 years and were analyzed for MS anatomical variation. Statistical Analysis: The distribution of age, sex, reasons for CBCT, and dimensions of sinus calculated using descriptive statistics and distribution of other anatomic findings using Chi-square test. Results: Prevalence of obstructed ostium is 23.3% and septa is 66.7%. Average height, width, and antero-posterior (A-P) dimensions for right MS are 34.13 mm, 26.09 mm, 37.39 mm and that of left MS are 33.24 mm, 26.11 mm, 37.72 mm respectively. Average distance between lower border of ostium to sinus floor in right MS is 32.17 mm and that of left is 32.69 mm. Average diameter of ostium in right MS is 1.88 mm and that of left is 1.67 mm. Conclusion: Study highlights the importance of accurate assessment of MS and its variations in order to properly differentiate the pathologic lesions from anatomic variations avoiding unnecessary surgical explorations

Evaluation of SLE Susceptibility Genes in Malaysians

Systemic Lupus Erythematosus (SLE) is a clinically heterogeneous autoimmune disease with strong genetic and environmental components. Our objective was to replicate 25 recently identified SLE susceptibility genes in two distinct populations (Chinese (CH) and Malays (MA)) from Malaysia. We genotyped 347 SLE cases and 356 controls (CH and MA) using the ImmunoChip array and performed an admixture corrected case-control association analysis. Associated genes were grouped into five immune-related pathways. While CH were largely homogenous, MA had three ancestry components (average 82.3% Asian, 14.5% European, and 3.2% African). Ancestry proportions were significantly different between cases and controls in MA. We identified 22 genes with at least one associated SNP (P<0.05). The strongest signal was at HLA-DRA (PMeta=9.96×10-9; PCH=6.57×10-8, PMA=6.73×10-3); the strongest non-HLA signal occurred at STAT4 (PMeta=1.67×10-7; PCH=2.88×10-6, PMA=2.99×10-3). Most of these genes were associated with B- and T-cell function and signaling pathways. Our exploratory study using high-density fine-mapping suggests that most of the established SLE genes are also associated in the major ethnicities of Malaysia. However, these novel SNPs showed stronger association in these Asian populations than with the SNPs reported in previous studies

Coal and Biomass based Fuels in Rural India : Emissions and Possibility of their Control

Papers reported in the 7th International Symposium on \u22Novel Carbon Resource Sciences\u22 Jun. 23-24, 2011Emissions from solid fuels used in the rural areas have been recognized as a major environmental and health hazard in India and many other developing countries. Use of these fuels is expected to continue in near future, and it is necessary to find techno-economically feasible solutions for emission control. Monitoring of CO and PM emissions as well as temperature measurements for rural cook-stoves have been done at actual emission sources, for some common solid fuels used in India. Based on these data, a catalytic approach for emission control from rural cook-stove has been explored by study of catalytic materials for CO oxidation

Coal and Biomass based Fuels in Rural India : Emissions and Possibility of their Control

Emissions from solid fuels used in the rural areas have been recognized as a major environmental and health hazard in India and many other developing countries. Use of these fuels is expected to continue in near future, and it is necessary to find techno-economically feasible solutions for emission control. Monitoring of CO and PM emissions as well as temperature measurements for rural cook-stoves have been done at actual emission sources, for some common solid fuels used in India. Based on these data, a catalytic approach for emission control from rural cook-stove has been explored by study of catalytic materials for CO oxidation.Papers reported in the 7th International Symposium on "Novel Carbon Resource Sciences" Jun. 23-24, 201