ROLE OF CLINICAL PHARMACIST IN ASSESSMENT OF DRUG RELATED PROBLEMS OF CARDIOVASCULAR AGENTS IN DEPARTMENT OF CARDIOLOGY IN A TERTIARY CARE HOSPITAL – A PROSPECTIVE OBSERVATIONAL STUDY

In total of 173 prescriptions of the patient, the total number of 329 drug interactions (DIs) was found, in which the 240 interactions were found in male and 89 in the female bearing 72.90% and 27.10%, respectively. Patient was of various age groups, in which the maximum frequency was seen in the age group of 61–70 years having 105 interactions bearing the percentage of 31.9%. According to the participation of different age group of the male and female with their corresponding age. The participation of male is high having frequency of 240 (72.9%) than female participation of frequency 89 (27.1%). The participation of male in the age group of 61–70 years is 83 and the female is 40 in the age group of 51–60 years. Potential DIs (PDIs) were categorized based on the gender. In that compared to 13 (40.6) females, males 19 (59.4%) were found to have more PDIs. Our study is more PDIs in adult patients. Because in adults lacking of nutrition’s and in elderly patients multiple prescribers, multiple drugs and multiple diseases. The number of potential drug-DI (PDDI) increased with an increase in the number of drugs prescribed. The numbers of drug prescribed increase with age. This DI has a potential to increase or decrease the therapeutic effect or to increase the risk of adverse drug reaction. An increased awareness of PDDIs, rational coprescription of drugs, and a close monitoring of patients in whom these drugs are prescribed are recommended. The recommendation is based on the special monitoring and the perspiration of the clinical pharmacist. The DI observed in the geriatric patient is more severe and common in compared to the other groups of study. The geriatric patient is physiological disability in correspond with the first-pass metabolism and the presence of the other diseases which also enables the multiple prescriptions causing polypharmacy. The gender specification also the cause of the interaction, the female is more prone to the DI due to the hormonal distribution in the body and inability of the physiological function to absorb and the distribution. The special training should be provided to the pharmacist for looking forward of the geriatric patient and female patient. The training regarding the prescription their adherence, use, toxicity, and dosage regimen is being properly enabled in the training for the practical application. This study helps to know the different interaction related to the cardiovascular agent with own class of the drug and the other class of drugs used therapeutically to care the disease

AN EXTENSIVE REVIEW ON PRASUGREL

In an attempt prasugrel increase in the overall use of this medication comparing to the anti thembolytics like heparin and wararin, with less patients complaints includes side effects a significant portion of patients receiving the medication for off label indications. More importantly, this agent is used in a substantial number of patients with known contraindications. Prasugrel are more intense platelet inhibition confirmed by the observation of highest percentage of minor or moderate bleeding among patients taking prasugrel, although there was no significant increase in the rate of severe, major, or life-threatening bleeding. Keywords: prasugrel, thembolytics, wararin, hepari

A REVIEW ON MEDICAL ADVANTAGES AND CHEMICAL CONSTITUENTS OF CARICA PAPAYA LINN.

Papaya is an evergreen blossoming plant having rich characteristic thing; it is recognized to offer different therapeutic purposes of premium. The normal item is sound and delicious. The entire plant parts such as root, bark, peel, seeds, blooms, leaves, and squash are known to have helpful properties. It is utilized for the treatment of a various infections such as dengue fever, warts, corns, sinuses, skin inflammation, against diabetic, glandular tumors, blood pressure, digestive disorders, constipation, antibacterial, antifertility, anti-HIV, expel worms, invigorate regenerative organs and many, as needs be it can be seen as a nutraceutical. The present review focuses on salient features of nutritional composition, health benefits, medical advantages, and synthetic constituents of papaya

ACUTE TOXICITY STUDIES OF AQUEOUS SEED EXTRACT OF VIGNA UNGUICULATA IN ALBINO RATS

Objective: Increased usage of traditional folklore medicines by the public has led to scientific evaluation of safety of the herbs thereby providing the physicians the data required to employ them in the management of ailments. Seeds of Vigna unguiculata are commonly consumed as vegetables and as a culinary dish in most parts of Asian sub-continent. The present study was carried out to screen phytochemical constituents, evaluate acute toxic effects and determine LD50 of aqueous seed extract of Vigna unguiculata.Methods: Phytochemical screening was carried out as described by Kokate. Acute oral toxicity study was carried out based on OECD guideline 423 and a limit test at a dose of 2000 mg/kg body weight was carried out in female wistar rats. The extract was orally administered in animals at a single dose of 2000mg/kg body weight. Signs of toxicity and mortality were noted after 1, 4 and 24h of administration of the extract for 14 days.Results: Phytochemical screening of the extract revealed the presence of flavonoids, alkaloids and proteins. No mortality and no significant changes were observed in physical observations, behavioral observations, autonomic effects, sensory responses, reflexes, respiratory effects and somatomotor activity in animals which reveal the safety of the extract at dose of 2000 mg/kg body weight.Conclusion: Conclusively, the results suggest that the aqueous extract is not acutely toxic to the rats and LD50 was found to be higher than 2000 mg/kg

An Osteological Study of Atlanto-Occipital Fusion with Embryological Basis and Clinico-Anatomical Correlations

ABSTRACT The first cervical vertibra also known as the 'atlas' is devoid of the center and exhibits articular facets on the upper and the lower surfaces of the lateral mass. The superior articular facets of atlas articulate with the articular facets of the occipital condyles to form the atlanto-occipital joint. There are various anatomical abnormalities and variants in the region of the atlanto-occipital junction. The atlanto-occipital fusion reduces the foramen magnum dimensions leading to the neurological complications due to compression of spinal cord, nerves, vessels or instability and mechanical immobility. A total of 150 human adult skulls were examined which were collected from Department of Anatomy, Sri Siddhartha Medical College, Tumkur, India. Each of the skulls was examined in detail. The variations which were present in the atlas vertebra and occipital bone of the skull were noted. Out of 150 dried human skulls studied, we observed atlanto-occipital fusion in one skull. The incidence of atlanto-occipital fusion was 0.67%. The sagittal and transverse diameters of the foramen magnum (36 mm X 34 mm) were within the normal range. Total or partial fusion of the atlas may be noted, the latter being the most common. Most of the time, it exists without any typical symptoms, but sometime may cause orthopedic problems or neurological effects. The serious consequences of upper cervical spinal manipulation with this type of anomaly may occur which may be fatal. Therefore the knowledge of such anomaly is essential for orthopedicians, anaesthetists, and clinicians

Mechanical Activation of Al-Oxyhydroxide Minerals – Physicochemical Changes, Reactivity and Relevance to Bayer Process

Overview of our research on ‘structure and reactivity’ of gibbsite and boehmite under varied conditions of mechanical activation, e.g. milling energy and presence of a second phase is presented. Bulk and surface changes induced in the solids by milling are characterized in terms of morphology, particle size distribution, specific surface area and nature of porosity, crystallite size and zeta potential. Results on enhanced amorphisation of gibbsite in presence of a second phase (quartz, hematite etc), changes in zeta potential of gibbsite due to loss of texture during milling and anomalous decrease in surface area of boehmite during milling are reported. Reactivity of the activated solids in sodium hydroxide and variation in thermal transformation temperatures is correlated with physicochemical characteristics of the samples and plausible explanation for the observed correlations presented. Significance of the results with specific reference to bauxite and alumina processing in Bayer process is highlighted

The Extracytoplasmic Domain of the Mycobacterium tuberculosis Ser/Thr Kinase PknB Binds Specific Muropeptides and Is Required for PknB Localization

The Mycobacterium tuberculosis Ser/Thr kinase PknB has been implicated in the regulation of cell growth and morphology in this organism. The extracytoplasmic domain of this membrane protein comprises four penicillin binding protein and Ser/Thr kinase associated (PASTA) domains, which are predicted to bind stem peptides of peptidoglycan. Using a comprehensive library of synthetic muropeptides, we demonstrate that the extracytoplasmic domain of PknB binds muropeptides in a manner dependent on the presence of specific amino acids at the second and third positions of the stem peptide, and on the presence of the sugar moiety N-acetylmuramic acid linked to the peptide. We further show that PknB localizes strongly to the mid-cell and also to the cell poles, and that the extracytoplasmic domain is required for PknB localization. In contrast to strong growth stimulation by conditioned medium, we observe no growth stimulation of M. tuberculosis by a synthetic muropeptide with high affinity for the PknB PASTAs. We do find a moderate effect of a high affinity peptide on resuscitation of dormant cells. While the PASTA domains of PknB may play a role in stimulating growth by binding exogenous peptidoglycan fragments, our data indicate that a major function of these domains is for proper PknB localization, likely through binding of peptidoglycan fragments produced locally at the mid-cell and the cell poles. These data suggest a model in which PknB is targeted to the sites of peptidoglycan turnover to regulate cell growth and cell division

Adherence to secondary prophylaxis and disease recurrence in 536 Brazilian children with rheumatic fever

<p>Abstract</p> <p>Background</p> <p>More than 15 million people worldwide have rheumatic fever (RF) and rheumatic heart disease due to RF. Secondary prophylaxis is a critical cost-effective intervention for preventing morbidity and mortality related to RF. Ensuring adequate adherence to secondary prophylaxis for RF is a challenging task. This study aimed to describe the rates of recurrent episodes of RF, quantify adherence to secondary prophylaxis, and examine the effects of medication adherence to the rates of RF in a cohort of Brazilian children and adolescents with RF.</p> <p>Methods</p> <p>This retrospective study took place in the Pediatric Rheumatology outpatient clinic at a tertiary care hospital (Instituto de Puericultura e Pediatria Martagão Gesteira) in Rio de Janeiro, Brazil, and included patients with a diagnosis of RF from 1985 to 2005.</p> <p>Results</p> <p>536 patients with RF comprised the study sample. Recurrent episodes of RF occurred in 88 of 536 patients (16.5%). Patients with a recurrent episode of RF were younger (p < 0.0001), more frequently males (p = 0.003), and less adherent (p < 0.0001) to secondary prophylaxis than patients without RF recurrence. Non-adherence to medication at any time during follow-up was detected in 35% of patients. Rates of non-adherence were higher in the group of patients that were lost to follow-up (42%) than in the group of patients still in follow-up (32%) (p = 0.027). Appointment frequency was inadequate in 10% of patients. Higher rates of inadequate appointment frequency were observed among patients who were eventually lost to follow-up (14.5%) than in patients who were successfully followed-up (8%) (p = 0.022). 180 patients (33.5%) were lost to follow up at some point in time.</p> <p>Conclusions</p> <p>We recommend implementation of a registry, and a system of active search of missing patients in every service responsible for the follow-up of RF patients. Measures to increase adherence to secondary prophylaxis need to be implemented formally, once non-adherence to secondary prophylaxis is the main cause of RF recurrence. Detection of irregularity in secondary prophylaxis or in appointments should be an alert about the possibility of loss of follow-up and closer observation should be instituted.</p

Metabolism of 2-Chloro-4-Nitrophenol in a Gram Negative Bacterium, Burkholderia sp. RKJ 800

A 2-Chloro-4-nitrophenol (2C4NP) degrading bacterial strain designated as RKJ 800 was isolated from a pesticide contaminated site of India by enrichment method and utilized 2C4NP as sole source of carbon and energy. The stoichiometric amounts of nitrite and chloride ions were detected during the degradation of 2C4NP. On the basis of thin layer chromatography, high performance liquid chromatography and gas chromatography-mass spectrometry, chlorohydroquinone (CHQ) and hydroquinone (HQ) were identified as major metabolites of the degradation pathway of 2C4NP. Manganese dependent HQ dioxygenase activity was observed in the crude extract of 2C4NP induced cells of the strain RKJ 800 that suggested the cleavage of the HQ to γ-hydroxymuconic semialdehyde. On the basis of the 16S rRNA gene sequencing, strain RKJ 800 was identified as a member of genus Burkholderia. Our studies clearly showed that Burkholderia sp. RKJ 800 degraded 2-chloro-4-nitrophenol via hydroquinone pathway. The pathway identified in a gram negative bacterium, Burkholderia sp. strain RKJ 800 was differed from previously reported 2C4NP degradation pathway in another gram-negative Burkholderia sp. SJ98. This is the first report of the formation of CHQ and HQ in the degradation of 2C4NP by any gram-negative bacteria. Laboratory-scale soil microcosm studies showed that strain RKJ 800 is a suitable candidate for bioremediation of 2C4NP contaminated sites

Probing Colored Particles with Photons, Leptons, and Jets

If pairs of new colored particles are produced at the Large Hadron Collider, determining their quantum numbers, and even discovering them, can be non-trivial. We suggest that valuable information can be obtained by measuring the resonant signals of their near-threshold QCD bound states. If the particles are charged, the resulting signatures include photons and leptons and are sufficiently rich for unambiguously determining their various quantum numbers, including the charge, color representation and spin, and obtaining a precise mass measurement. These signals provide well-motivated benchmark models for resonance searches in the dijet, photon+jet, diphoton and dilepton channels. While these measurements require that the lifetime of the new particles be not too short, the resulting limits, unlike those from direct searches for pair production above threshold, do not depend on the particles' decay modes. These limits may be competitive with more direct searches if the particles decay in an obscure way.Comment: 39 pages, 9 figures; v2: more recent searches include