Evaluation of pharmacovigilance concepts among healthcare professionals in Davangere, Karnataka, India

Background: Adverse drug reactions are one of the leading causes of morbidity and mortality worldwide. Timely detection and reporting of adverse drug events through pharmacovigilance is the best tool we have to prevent adverse drug reaction. One of the major reasons for underutilization of pharmacovigilance in India is deficit in awareness, attitude and practice of pharmacovigilance. The objective of this study was to assess these parameters among healthcare professionals in our hospital.Methods: 200 health care professionals (post graduate students, undergraduate students, interns and nurses) took part in the study. A pre-designed questionnaire structured to obtain information on pharmacovigilance was used for evaluation. Questionnaire also enquired on factors that deter respondents from reporting.Results: Among undergraduates, the satisfactory responses for knowledge, awareness and practice of pharmacovigilance were 12%, 72% and 42% respectively and for postgraduates it was 52%, 48% and 26% respectively. For interns it was 4%, 38% and 8 % respectively and nurses 8%, 18% and 26% respectively. Only 1% of undergraduates and 14% of postgraduates showed satisfactory responses to all three categories evaluated. Undergraduate students had a significantly higher awareness scores among the categories (p<0.05). When it comes to knowledge and practice there was not much differences between groups. Lack of time to report was the most cited factor across all categories discouraging reporting.Conclusions: Results are encouraging among undergraduate students, but not significantly better than postgraduates. The poor performance among interns and nurses is due to lack of awareness. A strong basic foundation course regarding pharmacovigilance in academics will help in effective implementation of pharmacovigilance

The red rain phenomenon of Kerala and its possible extraterrestrial origin

A red rain phenomenon occurred in Kerala, India starting from 25th July 2001, in which the rainwater appeared coloured in various localized places that are spread over a few hundred kilometers in Kerala. Maximum cases were reported during the first 10 days and isolated cases were found to occur for about 2 months. The striking red colouration of the rainwater was found to be due to the suspension of microscopic red particles having the appearance of biological cells. These particles have no similarity with usual desert dust. An estimated minimum quantity of 50,000 kg of red particles has fallen from the sky through red rain. An analysis of this strange phenomenon further shows that the conventional atmospheric transport processes like dust storms etc. cannot explain this phenomenon. The electron microscopic study of the red particles shows fine cell structure indicating their biological cell like nature. EDAX analysis shows that the major elements present in these cell like particles are carbon and oxygen. Strangely, a test for DNA using Ethidium Bromide dye fluorescence technique indicates absence of DNA in these cells. In the context of a suspected link between a meteor airburst event and the red rain, the possibility for the extraterrestrial origin of these particles from cometary fragments is discussed.Comment: 18 pages, 15 figures, accepted for publication in Astrophysics and Space Scienc

The genus Eugenia L. (Myrtaceae) in India

This paper provides a comprehensive taxonomic account of the genus Eugenia L. occurring in India. A total of 25 species and two varieties have been enumerated, of which 21 taxa are endemic to the Western Ghats. Eugenia macrosepala, an endemic species of the Western Ghats is reinstated here. Each species is provided with a short description, well known synonyms, types, distribution and phenology. An identification key is also provided

Trace elements analysis of Biophytum sensitivum (L.) DC. by EDXRF spectroscopy and its therapeutic role to diabetes mellitus

Minerals and trace elements have very important functions as they serve as structural components of tissues and also functions in cellular and basal metabolism. An important Ayurvedic medicinal plant, Biophytum sensitivum (L.) DC. was subjected to the analysis of its elemental contents in leaf and root through the EDXRF facility of UGC-DAE CSR, Kolkata centre, India, to develop a stronger basis for appreciating its nutritional and curative effects. The study is a new contribution. Various elements of biological importance for human metabolism were found to be present in different concentrations. The elements Ca, K, Si, Cl, P, and S were found in the highest concentration in leaf, in the descending order, but in the root, K took the leading position. The results have been discussed with reference to the established role of elements in physiology and pathology of human life. Special attention was given in revealing its role in bone building, controlling the sugar level and good wound healing capacity of the patients with diabetes mellitus

A Prospective study of the value of Neurological and Radiological Examinations in Predicting Bladder Function in persons with Thoraco-Lumbar Fractures and Spinal Injury.

INTRODUCTION : Spinal Cord Injury (SCI) is a devastating medical condition which results in decreased sensation below the level of injury, decreased motor power and decreased bladder and bowel control. “An ailment not to be treated” is what is written in the Edwin Smith Surgical Papyrus,1 written in Egypt between 2500 and 3000 B.C regarding Spinal Cord Injury. Thanks to Dr. Mary Varghese who did pioneering work in India by establishing a department for Spinal cord injured patients and efforts of several other leaders in this speciality across the world, we are now able to treat persons with spinal cord injuries and improve their quality of life. Spinal Cord Injury (SCI) has long-term effects in many aspects of an individual’s life. Acute SCI patients commonly have two major questions for which they seek answers, one is if they can walk and the other is if they can have normal bowel and bladder sensation and control. Anxiety about one’s urinary continence is often one of the major preoccupations of a person with spinal cord injury. The degree of bladder dysfunction may be related to the injury itself, the level of the spinal cord affected by the injury, and the severity of neurological impairment. Investigation techniques used to help address the issue of predicting bladder outcome in persons with acute SCI include clinical examination, X-rays of the spine, CT scan, MRI and electrophysiological examinations. AIMS AND OBJECTIVES : The aim of the study was 1. To examine the value of Neurological and Radiological examinations in predicting bladder function in persons with Thoraco-Lumbar fractures and Spinal Injury. 2. To determine if ASIA incomplete spinal lesions on clinical examination will have a better prognosis for bladder function in the form of volitional voiding. 3. To determine the role of bulbocavernous reflex in predicting the type of bladder. 4. To determine if persons with a vertebral fracture at T12 or above will have a hyperreflexic bladder and those with of L-1 and below will have an areflexic bladder. 5. To determine if those with a mild narrowing of the vertebral canal have a better prognosis for volitional voiding. MATERIALS AND METHODS : Inclusion criteria Twenty consecutive patients with thoracolumbar fractures and spinal injury, admitted in the Department of Physical Medicine Rehabilitation, Christian Medical College, and Vellore within three weeks of injury, were recruited into the study. Exclusion criteria: 1. Patients with non-traumatic paraplegia were excluded. 2. Patients with pre-existing thoraco-lumbar scoliosis were also excluded as evaluating the x-rays for canal size would be difficult. METHODS: After data collection it was subjected to statistical analysis using SPSS Software Vs. 11.0. Data were expressed as number (%) and mean +/- standard deviation for categorical and continuous variables. Chi-square/Fisher’s exact tests were used for group comparisons. Independent t- test (for normal data) and Mann-Whitney test (for non-normal data) were performed to compare the mean scores. RESULTS: • There was a significant correlation found between ASIA impairment scale obtained during the first neurological examination and volitional voiding. • There was a significant correlation found between ASIA motor scores more than 50, ASIA sensory scores more than 90, joint position sense of the great toe preserved obtained during the first neurological examination and volitional voiding. • The use of Canal body ratio at the level of vertebral fracture on plain radiographs was not useful in prediction of volitional voiding. Therefore plain radiography was not found to be a good predictor of bladder function in persons with thoracolumbar fractures and with spinal cord injury. CONCLUSION : In this study a possible association between initial neurological evaluation and radiological findings and bladder function at discharge in SCI patients with thoracolumbar fractures was tested. Neurological examination included sensory evaluation, joint position sense in the great toe, motor examination, and voluntary contraction of the external anal sphincter and bulbocavernous reflex. Radiological examination was done using plain X- rays and the canal body ratio and sagittal transverse ratio were calculated. 20 patients with thoracolumbar fractures who fulfilled the inclusion criteria were admitted in the study and the following conclusions arrived at: 1. A significant correlation was found between ASIA impairment scale obtained during the first neurological examination and volitional voiding (Fisher’s exact test, P<0.05). 2. A significant correlation was found between ASIA motor scores more than 50 obtained during the first neurological examination and volitional voiding (Fisher’s exact test, P<0.05). 3. A significant correlation was found between ASIA sensory scores more than 90 obtained during the first neurological examination and volitional voiding (Fisher’s exact test, P<0.05). 4. A significant correlation was found between joint position sense of the great toe preserved during the first neurological examination and volitional voiding (Fisher’s exact test, P<0.05). 5. The presence of Bulbocavernous reflex did not predict the type of bladder dysfunction on Urodynamic evaluation (P> 0.05). However an absence of Bulbocavernous reflex predicted an areflexic bladder. 6. The level of fracture did not correspond to the type of bladder. 7. The use of Canal body ratio at the level of vertebral fracture on plain radiographs was not useful in prediction of volitional voiding. (P> 0.05) 8. Therefore plain radiography was not found to be a good predictor of bladder function in persons with thoracolumbar fractures and with spinal cord injury. 9. Therefore the parameters: initial ASIA Impairment Scale from B to D, ASIA motor score > 50, ASIA sensory score > 90 and preservation of joint position sense of the great toe may be used to predict volitional voiding in persons with thoracolumbar fractures and spinal cord injury

Trace elements analysis of Biophytum sensitivum (L.) DC. by EDXRF spectroscopy and its therapeutic role in diabetes mellitus

8-14Minerals and trace elements, as structural components of tissues, play vital role in cellular and basal metabolism. The Little Tree Plant, Biophytum sensitivum (L.) DC., locally called Lajalu, is a well-known medicinal herb, traditionally considered as one of the 10 flowers used since ancient time for healthy life. In Ayurveda, it is used to treat various ailments viz., asthma, insomnia, convulsions, cramps, stomach ache, chest complaints, inflammation, tumours and skin disorders. In this study, we analyzed the elemental contents of its leaves and roots using EDXRF spectroscopy, and tried to find possible correlation with its nutritional and curative effects. The elements Ca, K, Si, Cl, P, and S were found in the highest concentration in leaf, in the descending order, but in the root, K took the leading position. The results have been discussed with reference to the established role of these elements in physiology and pathology of human life with special focus on its role in bone building, controlling the sugar level and wound healing capacity of patients with diabetes mellitus

DEVELOPMENT OF ROPINIROLE (FREE BASE) TRANSDERMAL PATCH US ING BLENDS OF HYDROXYPROPYL METHYLCELLULOSE/EUDRAGITS AND IT’ S IN VITRO/ IN VIVO CHARACTERIZATION

The objective of this study was toprepare and evaluate a matrix type transdermal patch ofropinirole using blends ofhydroxypropylmethylcellulose (HPMC) and EudragitRL 100 and HPMC and Eudragit ERS100. Materialsand Methods: Ropinirole free based used as the drugentity was prepared from its hydrochloride salt.Suitability of the polymers in the form of drug-excipientcompatability was determined prior to formulationdevelopment using FTIR. Patches were developed usingsolvent evaporation technique. Limonene was used asa penetration enhancer. Moisture absorption,moisture content and mechanical properties, drugcontent, in vitro drug release, drug-excipient compatibility,in vitro skin permeation were the in vitro parametersmeasured. Short-term stability, skin irritation andin vivo drug release were measured with oneoptimized formulation. Results and discussion:Ropinirole free base was used successfully in thepreparation of the patches. FTIR studies indicated nointeraction between the drug and the polymers of thisstudy. Formulations developed were strong and notbrittle with uniform drug release. Patches containinghigher HPMC generally showed higher drug releaseand permeation. Drug release and permeation decreasedwith increase in the concentrations of Eudragits. Drugrelease studies indicated Higuchi model for all thepatches with a diffusion mechanism of non-fickian type.Short-term stability studies indicated that ropinirolewas stable in the patches. Patches did not cause any skinirritation. In vivo the optimized patch sustained drugrelease for 24 hours upon one time administration.Conclusion: Clinically viable ropinirole transdermalpatch can be successfully prepared from its base formusing HPMC/Eudragits

Vrana Shopha - An Ayurvedic Perspective

Father of Surgery, Acharya Sushruta had complete knowledge of Vrana (wound) and their management along with its untimely and untreated complication. The Vrana Shopha is described as earlier phase of Vrana. Sushruta has mentioned in detail about Vrana Shopha. Vrana Shopha has 3 progressive stages. These are Amawastha (just early stage of inflammatory process), Pachyamanawastha (true inflammatory stage) and Pakwawastha (suppurative stage) respectively. Based on the vitiation of Dosha, Sushruta has described Vrana Shopha into 6 types: Vatika, Paittika, Kaphaja, Shonita, Sannipattaja and Agantuja. Acharya has differentiated them based on their Laxanas, such as colour, pain etc. Shatkriyakala was explained for the first time in this context by Sushruta. Sixty procedures for management of Vrana Shopha and Vrana was told by Sushruta. Out of these Apatarpana to Virechana were mentioned for Vrana Shopha and rest for Vrana. Knowledge about Vrana Shopha can prevent from further damage to the body

Role of volar plating in unstable distal radial fractures in elderly patients in tertiary teaching hospital

Background: Aim of the study was to investigate the efficacy of volar locking plate fixation for unstable distal radical fractures DRFs in the elderly population (60 years old and older).Methods: An ethical committee approved the study protocol for research studies at NRI medical college. We included only unstable distal radial fractures in elderly patients between 60 to 70 years, and patients who consent to the study. We excluded patients with comorbid conditions and below 60 years and patients with vascular injuries. Results were evaluated by the DASH questionnaire and Gartland and Werley scores.Results: According to Gartland and Werley score, 30 patients (85.7%) had excellent and good results. According to the DASH score, 31 patients (88.5%) had excellent and good results, and four patients (11.4%) had fair results. The most commonly noted complications in our study were arthritis (2 cases 5.7%), extensor pollicis longus tendon irritation (1 case 2.9%), and Reflex sympathetic dystrophy (1 case 2.9 %).Conclusions: Locked compression plate in unstable distal radius fractures provides excellent results with an effective correction of distal radius anatomy. Early range of movements of joints leads to a good outcome and return to regular activity.

CFD Analysis of Natural Convection in Differentially Heated Enclosure

The thermal control in many systems is widely accomplished applying natural convection process due to its low cost, reliability and easy maintenance. Typical applications include the heat exchangers, cooling of electronic equipment and nuclear reactors, solar chimneys and Trombe walls in building industry, etc. Numerical and experimental studies of natural convective flows in two dimensional channels, opened to ambient conditions at both end sections, are extensively reported in the literature but most of them are treated severely idealized situations. CFD code of natural convection with variable properties and slip condition are presented in the present work. The 2D, laminar simulations are obtained by solving the governing equations using a Fluent 6.2.16. It is considered that the temperature variations are not so high and the Boussinesq approximation is applied. The latter leads to the simplification of the system of equations. The computed results for Nusselt number, velocity and temperature profiles and heat transfer rate are directly compared with those proposed in the bibliography letting therefore the validation of the employed numerical procedure