A study of assessing knowledge, attitude and practice of pharmacovigilance among medical students of a South Indian teaching hospital

Background: Pharmacovigilance is the science relating to detection, assessment, understanding and prevention of adverse drug reaction. The purpose is to improve patient safety in relation to use of medicines. It is estimated that only 6-10% of adverse drug reactions (ADRs) are reported worldwide. The underreporting of ADR is due to lack of adequate knowledge, attitude and practice among healthcare professionals towards ADR reporting. Health care professional like physicians, pharmacist and nurses have immense responsibility in reporting ADR. Therefore, the objective of this study was to evaluate the knowledge, attitude and practices (KAP) of undergraduate medical students towards pharmacovigilance.Methods: A cross-sectional KAP based questionnaires study was carried out in 100 undergraduate students of Konaseema Institute of Medical Sciences, Amalapuram. The response of KAP questionnaires were analyzed in percentage and tabular form.Results: Nearly 87% participants heard about pharmacovigilance, but only 65% know its need or purpose. 88% people feel that ADR reporting may improve patient safety. Less than half of the students know about Institutional ADR centre. 81% students have seen ADR but only 31% knew about ADR reporting form and surprisingly only 20% have reported ADR. More than 80% feels reporting ADR will increase patient safety.Conclusions: Participants have good knowledge about Pharmacovigilance but lacks in attitude and practice towards reporting ADR. Greater awareness of pharmacovigilance and incorporation of it in medical curriculum will further strengthen pharmacovigilance activity

Electrochemical deposition of green rust on zero-valent iron

Perchloroethylene (PCE) is a toxic contaminant that has been introduced into the environment over many years through industrial and agricultural wastes. Research has been done in the past to investigate PCE degradation by zero-valent iron (ZVI), green rust (GR) and a mixture of both. The combination of ZVI and green rust has been reported to be more effective for degrading PCE than either of them alone. Forming green rust electrochemically has the potential for depositing GR more effectively on the surface of ZVI where it will be able to more easily transfer electrons from ZVI to contaminants such as PCE. Therefore, the goal of this research was to determine the feasibility of electrochemically depositing green rust on zero-valent iron and to characterize it in terms of its composition, crystal properties and amount produced. XRD analysis was conducted to determine composition and crystal properties and a procedure was developed to measure the amount produced. Equipment was constructed to deposit green rust electrochemically onto ZVI. A chain of experiments with varying voltage, pH, time and amounts of ZVI were conducted to determine feasible experimental conditions for GR formation. Then, a method was developed to accurately measure the amount of surface oxides of iron deposited on the zero-valent iron substrate. This method was tested and found useful for measuring iron in: i) standard solutions of soluble iron with different concentrations of reagents; ii) suspensions with solid iron hydroxides by themselves; and iii) suspensions with solid iron hydroxides and ZVI. Electrochemical experiments were conducted and the amounts of iron hydroxides deposited on the ZVI surface were measured. XRD analysis of the deposits on the surface was conducted and the patterns of XRD-peaks were compared to that of type 2 Â sulfate green rust

SciFix: Outperforming GPT3 on Scientific Factual Error Correction

Due to the prohibitively high cost of creating error correction datasets, most Factual Claim Correction methods rely on a powerful verification model to guide the correction process. This leads to a significant drop in performance in domains like scientific claims, where good verification models do not always exist. In this work, we introduce SciFix, a scientific claim correction system that does not require a verifier but can outperform existing methods by a considerable margin -- achieving correction accuracy of 84% on the SciFact dataset, 77% on SciFact-Open and 72% on the CovidFact dataset, compared to next best accuracies of 7%, 5%, and 15% on the same datasets respectively. Our method leverages the power of prompting with LLMs during training to create a richly annotated dataset that can be used for fully supervised training and regularization. We additionally use a claim-aware decoding procedure to improve the quality of corrected claims. Our method outperforms the very LLM that was used to generate the annotated dataset -- with Few-Shot Prompting on GPT3.5 achieving 58%, 61%, and 64% on the respective datasets, a consistently lower correction accuracy, despite using nearly 800 times as many parameters as our model.Comment: To appear in proceedings of EMNLP2023 (findings

IN VITRO STUDY OF AN AQUEOUS EXTRACT OF ECLIPTA ALBA HASSK. FOR HEPG2 CELL LINE

It is the need of the day to identify the new anticancer herbal drug, which not only in possession of good anticancer effects but also cost effective. Here we are presenting such an anticancer Ayurvedic herb which is used since the centuries for the treatment of different diseases of diverse origin. Eclipta alba Hassk., also called as Bhringraj is very important medicinal herb in many medicinal formulations. Though it is commonly used for hair growth, many evidences found its hepatoprotective activity. Here we are presenting all aspects about Bhringraj in terms of qualitative and quantitative values and we have also tried to prove the anticancer activity of it for hepatic cancer. We have used the aqueous extract of Eclipta alba Hassk. for phytochemical analysis, TLC, HPLC analysis to test active chemical components in it. Extract showed presence of many active chemical components which were responsible for its anticancer activity. In vitro study we used the aqueous extract of Eclipta alba Hassk. for the evaluation of its effects on HepG2 (Human liver cancer cell line). The SRB assay results were used to evaluate the anti-cancer activity of the extract. The effects of whole plant extract on cancer cell line were studied. Percentage of cell growth and cell viability were calculated from tabulated result values of srb assay. The experiment revealed that the average percentage of growth inhibition was 68.74%. Cell viability SRB assay also showed significant growth inhibition, at the same time statistical analysis of SRB assay also proved significant results. The research performed here is very useful for set up of different extract studies of Bhringraj for its anticancer activity

Drug utilization 90%: an innovative method in assessing quality of drug prescription with specific reference to non-steroidal anti-inflammatory drugs prescription

Background: DU90% is useful tool for assessing drug prescribing pattern. In this, drugs constituting 90% of the prescription volume are identified. Size of the DU90% segment helps us to assess rational prescribing. Large number of drugs in the DU90% segment indicates less rational prescribing, whereas small number suggests more rational prescribing.Methods: Study was carried out in orthopaedic out-patient department (OPD) for a period of three months. Only OPD based NSAID containing prescriptions were included. Data was analyzed based on demographic parameters, prescription indices, fixed dose combinations (FDC) and co-prescription of gastro-protective agents (GPA). DU90% was calculated based on defined daily dose (DDD) with their respective value in Anatomical Therapeutic Chemical (ATC) classification code. Defined daily dose is calculated as DDD/1000/day.Results: Diclofenac (38%) was the commonest NSAID prescribed. Diclofenac +chymotrypsin (25%) was the commonest FDC prescribed. Piroxicam (19%) was the commonest NSAID prescribed in monotherapy form.  Co-prescription of GPA was high (96%). 5 of the 7 prescribed NSAIDs constitute to DU90% segment.Conclusions: Preferential cyclooxygenase-2 (COX-2) inhibitor NSAIDs were more preferred. Number of prescribed NSAIDs constituting to DU90% is more, thus prescription pattern needs further rationalization. Further large scale study is required to bring out more details about NSAID prescription pattern and its rational use

Male breast cancer: is the scenario changing

<p>Abstract</p> <p>Background</p> <p>The overall incidence of male breast cancer is around 1% of all breast cancers and is on the rise. In this review we aim to present various aspects of male breast cancer with particular emphasis on incidence, risk factors, patho-physiology, treatment, prognostic factors, and outcome.</p> <p>Methods</p> <p>Information on all aspects of male breast cancer was gathered from available relevant literature on male breast cancer from the MEDLINE database over the past 32 years from 1975 to 2007. Various reported studies were scrutinized for emerging evidence. Incidence data were also obtained from the IARC, Cancer Mondial database.</p> <p>Conclusion</p> <p>There is a scenario of rising incidence, particularly in urban US, Canada and UK. Even though more data on risk factors is emerging about this disease, more multi-institutional efforts to pool data with large randomized trials to show treatment and survival benefits are needed to support the existing vast emerging knowledge about the disease.</p

Clinico-social parameters of diabetes among patientsutilizing emergency medical services

Background: Diabetes mellitus (DM) is increasing in its potential in developing countries. Rise in diabetic patients calling emergency medical services (EMS) is expected. It calls for thorough assessment of patients with DM utilizing EMS. In the present study, was to assess magnitude of DM among patients utilizing EMS and its clinico-social parameters.Methods: It was hospital record based observational study of patients calling EMS delivered by a tertiary care hospital in Pune, Maharashtra, India during 1st January 2013 to 31st December 2014. Patients with incomplete records were excluded. A person with medical background was trained to extract required information from hospital records. Patients with previously diagnosed DM were considered those who were on diet, oral hypoglycemic agents or taking insulin therapy and newly diagnosed patients with DM were considered those with the value of glycemia on admission >200 mg/dl in first 24 hours. Data analysis was done using SPSS 15.0 software.Results: 45.8% (894/1951) were Patients with DM out of that 78.19% (699/894) were known to have DM while 28.81% (195/1951) were new cases of DM. 5.1% (100/1951) patients had uncontrolled DM. DM was significantly more in >60 years age group and in urban residents (p<0.001). Patients with DM were significantly more to have breathlessness, altered sensorium and dyspnoea as major purpose to call EMS (p<0.001, <0.001 and 0.045 respectively). Other co-morbidities in the form of Hypertension, other cardiovascular abnormalities, COPD, CKD and history of CVA were significantly more among Patients with DM (p<0.001, except for COPD, p=0.027).Conclusions: There was a high burden of patients with DM on EMS. EMS teams should be well trained to diagnose and manage such emergencies. Mass awareness of screening for DM and its proper management will help to decrease such burden

The C-Terminal Domain of the MutL Homolog from Neisseria gonorrhoeae Forms an Inverted Homodimer

The mismatch repair (MMR) pathway serves to maintain the integrity of the genome by removing mispaired bases from the newly synthesized strand. In E. coli, MutS, MutL and MutH coordinate to discriminate the daughter strand through a mechanism involving lack of methylation on the new strand. This facilitates the creation of a nick by MutH in the daughter strand to initiate mismatch repair. Many bacteria and eukaryotes, including humans, do not possess a homolog of MutH. Although the exact strategy for strand discrimination in these organisms is yet to be ascertained, the required nicking endonuclease activity is resident in the C-terminal domain of MutL. This activity is dependent on the integrity of a conserved metal binding motif. Unlike their eukaryotic counterparts, MutL in bacteria like Neisseria exist in the form of a homodimer. Even though this homodimer would possess two active sites, it still acts a nicking endonuclease. Here, we present the crystal structure of the C-terminal domain (CTD) of the MutL homolog of Neisseria gonorrhoeae (NgoL) determined to a resolution of 2.4 Å. The structure shows that the metal binding motif exists in a helical configuration and that four of the six conserved motifs in the MutL family, including the metal binding site, localize together to form a composite active site. NgoL-CTD exists in the form of an elongated inverted homodimer stabilized by a hydrophobic interface rich in leucines. The inverted arrangement places the two composite active sites in each subunit on opposite lateral sides of the homodimer. Such an arrangement raises the possibility that one of the active sites is occluded due to interaction of NgoL with other protein factors involved in MMR. The presentation of only one active site to substrate DNA will ensure that nicking of only one strand occurs to prevent inadvertent and deleterious double stranded cleavage

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients