Study on antibiotic use among geriatric patients based on anatomical therapeutic classification or defined daily dose methodology and world health organization-essential medicine list access, watch and reserve concept in tertiary care hospital of South India

Background: Geriatric patients are more vulnerable to infections and need special consideration on antibiotic use. Resistance to antibiotics among infectious bacteria has developed within a short span. There is a direct correlation between the consumption of antibiotics and the development of resistance. And surprisingly very few literatures were available on antibiotic consumption in geriatric population using defined daily dose (DDD) concept which paved the idea to conduct this study.Methods: A prospective observational study was carried out from November 2018 to April 2019. A total of 206 prescriptions of elderly patients were included in the study. The antibiotics were categorized by anatomical therapeutic classification (ATC) and DDD indicator/1000 inhabitants/day (DID) was used to figure out antibiotic consumption.Results: About 25.2% of patients were treated with antibiotics for respiratory tract infections. The patients received antibiotics empirically (53.8%) and without bacteriological investigation (58.73%). The overall consumption of antibiotics was 20.47 DID in which oral antibiotics was (8.5 DID) 42% and parenteral antibiotics (11.8 DID) 58%. Cephalosporins was observed to be the most consumed antibiotics (33.2%), specifically cefotaxime (14.6%) and ceftriaxone (12.6%). Moreover, 54.4% of antibiotics consumed from watch category of World Health Organisation (WHO) essential medicines list (EML) which was completely against WHO standard proportion.Conclusions: Higher consumption of cephalosporins, which falls into watch category was analysed in geriatric patients. These broad-spectrum antibiotics have high potential to develop antimicrobial resistance. A strict antibiotic policy is needed to be framed that enhance rational prescribing practices in geriatrics

Assessment of drug utilization among geriatric patients based on defined daily dose concept in a rural tertiary care teaching hospital

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines

ANTIMICROBIAL, WOUND HEALING AND ANTIOXIDANT ACTIVITIES OF ANTHOCEPHALUS CADAMBA

Anthocephalus cadamba (Roxb.) Miq. Syn A. chinensis (Lamk) A. Rich (Rubiaceae) is ethnomedicinally widely used in the form of paste by tribe in western Ghats for treating skin diseases. In this context, antimicrobial potential of A. cadamba against a wide range of microorganisms was studied. To validate the ethnotherapeutic claims of the plant in skin diseases, wound healing activity was studied, besides antioxidant activity to understand the mechanism of wound healing. The alchoholic and aqueous extract of this plant showed significant antibacterial and antifungal activity against almost all the organisms: Micrococcus luteus, Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and four fungi Candida albicans, Trichophyton rubrum—dermatophyte fungi, Aspergillus niger, Aspergillus flavus and Aspergillus nidulans—systemic fungi, with especially good activity against the dermatophyte (Trichophyton rubrum) and some infectious bacteria (Escherichia coli, Proteus mirabilis and Staphylococcus aureus) with an MIC of 2.5 µg/disc. The results show that A. cadamba extract has potent wound healing capacity as shown from the wound contraction and increased tensile strength. The results also indicated that A. cadamba extract possesses potent antioxidant activity by inhibiting lipid peroxidation and increase in the superoxide dismutase (SOD) and catalase activity

THIRTY FIVE YEARS OF OPERATIONAL RESEARCH PROJECT FOR DRYLAND AGRICULTURE : ACHIEVEMENTS AND IMPACTS (1976 to 2012)

Not AvailableAgriculture is the backbone of Indian economy and rainfed agro-ecosystem occupies an important place in Indian agriculture, covering 68 per cent of the cultivated area (96 m.ha) supporting 40 per cent human, 60 per cent livestock population and producing 44 per cent of the food requirements thus playing a pivotal role in India’s food security. Five out of ten Agro-Climatic Zones in Karnataka were classified as dry zones covering 63 per cent of the total geographical area and 71 per cent of the net sown area, with substantial contribution to agricultural production from dry lands. About 57 per cent of food grain production in Karnataka comes from rainfed areas while, 97 per cent of total pulses and 80 per cent oilseeds were produced in dry land areas. Research on dryland agriculture in the red soil regions of Karnataka was started in 1970 with the establishment of All India Coordinated Research Project for Dryland Agriculture (AICRPDA) at Gandhi Krishi Vignana Kendra (GKVK), Bangalore,Not Availabl

Patient-reported outcome results from the open-label, randomized phase III myeloma X trial evaluating salvage autologous stem-cell transplantation in relapsed multiple myeloma

Purpose: Salvage autologous stem-cell transplantation (sASCT) in patients with multiple myeloma (MM) relapsing after a prior autologous stem-cell transplantation leads to increased remission duration and overall survival. We report a comprehensive study on patient-reported outcomes, including quality of life (QoL) and pain in sASCT. Methods: Patients were randomly assigned to either sASCT or nontransplantation consolidation (NTC). Pain and QoL were assessed as secondary outcomes using validated QoL instruments (European Organisation for Research and Treatment of Cancer QLQ-C30 and myeloma-specific module, QLQ-MY20; the Brief Pain Inventory [Short Form]; and the Leeds Assessment of Neuropathic Symptoms and Signs [Self-Assessment] scale). Results: A total of 288 patients (> 96%) consented to the QoL substudy. The median follow-up was 52 months. The European Organisation for Research and Treatment of Cancer QLQ-C30 Global health status scores were higher (better) in the NTC group at 100 days after random assignment ( P = .0496), but not at later time points. Pain interference was higher (worse) in the sASCT group than in the NTC group at 6 months after random assignment ( P = .0267), with patients with sASCT reporting higher scores for Pain interference with daily living for up to 2 years after random assignment. Patients reporting lower concerns about adverse effects of treatment after sASCT had a time to progression advantage. Conclusion: Patients with sASCT with relapsed MM demonstrated a comparative reduction in QoL and greater impact of treatment adverse effects lasting for 6 months and up to 2 years for pain, after which patients who had received sASCT reported better outcomes. Patients who experienced lower adverse effects after sASCT had longer time to progression and overall survival, showing the need to improve symptom management peritransplantation. To our knowledge, this study provides the most comprehensive picture of QoL before and after sASCT in patients with relapsed MM

Development of reverse phase HPLC method for simultaneous estimation of quetiapine fumarate and curcumin in nano structured lipid carrier formulations

The present work was aimed with the objective of developing simple, precise and sensitive high performance liquid chromatographic method for simultaneous estimation of quetiapine fumarate and curcumin and to execute the developed method in the simultaneous estimation of both the drugs in nanostructured lipid carrier formulations. The method was carried out using various solvents, buffers, at different flow rates for the complete separation and estimation of both the drugs. Using ICH guidelines, the developed method was validated. After various trials the chromatographic conditions were optimized. The complete chromatographic separation and estimation of both drugs was possible using phenomenex kinetex XB-C18 100 A analytical column (3.5 μm, 4.6 mm × 150 mm) and methanol: water 70:30 v/v as a mobile phase, at the flow rate of 1.0 mL/min. Sample of 200 μL was injected and chromatogram was recorded at 290 nm in triplicates. The absorption maximum for quetiapine fumarate was found to be in 290 nm, whereas curcumin possess absorption maxima at 421 nm. The simultaneous estimation of both drugs is possible when estimated at particular single wave length. The peak response for quetiapine fumarate and curcumin was maximum at 290 nm which has been fixed for the analysis.&nbsp

Wound Healing Activity of Ethanolic Extract Of Hemidesmus Indicus (Linn) R.Br Leaves In Rats

ABSTRACT The study was carried out to evaluate the wound healing activity of ethanolic extract of Hemidesmus indicus leaves in rats. Twenty four healthy animals of Wister strain were assigned to four groups, containing six animals each. Group 1 (positive control) was provided with nitrofurantoin ointment, group 2 (solvent control) with 70% ethanol, group 3 (test dose I) with 5% w/w Hemidesmus indicus ointment and group 4 (test dose II) with 10% w/w Hemidesmus indicus ointment. The total exposure of the study was 16 days. The groups were compared for the percentage of wound healing. It was observed that the group treated with nitrofurantoin ointment showed an increase in the rate and percentage of wound contraction and period of epithelization compared to the ethanol treated group. The alcoholic extract of Hemidesmus indicus (5% and 10% ointment) increased rate of wound contraction and period of epithelization than solvent and control groups. Comparison between test dose I and test dose II showed that the percentage and rate of wound healing was increased at test dose I than test dose II. The study evaluated the wound healing activity of the alcoholic extract of Hemidesmus indicus and identified it to possess significant wound healing activity