A cross sectional study to assess pharmacotherapeutic adherence among diabetes mellitus patients in tertiary care hospital

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that associated with abnormalities in carbohydrate, fat, and protein metabolism which results in chronic complications. Attainment of optimal blood sugar level is generally based on appropriate usage and proper adherence to prescribed medications. The study was, therefore, aimed to assess adherence to oral antidiabetic drugs among diabetic patients attending outpatient clinic of L. L. R. Hospital, G.S.V.M. Medical College, Kanpur, U.P.Methods: Hospital based cross-sectional study design was conducted from April 2017 to June 2018. The data was collected by interviewing T2DM patients receiving antidiabetic medications using Morisky’s four item adherence assessment questionnaire. The collected data was processed and analyzed with SPSS version 20.Results: From the 126 patients of diabetes, when asked about adherence to their medications as per the Morisky's four item method, 114 (90.47%) of them did not forget to take the drugs, 108 (85.71%) of patients reported that they had been being careful in taking their medications, 90 (71.42%) patients did not stop medications when they felt better and the other 108 (85.71%) patients reported that they did not stop medications when they felt worse while taking medications. This study shows that 54 (42.86%) respondents were adherent to their medications.Conclusions: This study revealed a moderate level of adherence among the participants and statistically significantly depended upon their socioeconomic status. Efforts are needed to increase the medication adherence of these patients’, so they can realize the full advantage of prescribed therapies

Augmenting Food Security Through Agricultural Input Subsidy: Anevaluation of National Agricultural Input Voucher Scheme (NAIVS) with impact on Female-headed Households in Tanzania

Agricultural input subsidies have often been promoted as the solution to target food insecurity. This paper aims to investigate the impact of the National Agricultural Input Subsidy (NAIVS) on small-scale farmers in Tanzania particularly, for household food security, while investigating if the programme had any differential impact on female-headed households. On examining the general impact of the NAIVS on small-scale farmers, it is clear that the programme did affect food-security at the household level. Literacy also had a significant impact on household food-security and in terms of production. In terms of the specific impact of the programme on female-headed households, beneficiary female-headed households preferred spending more on education, birth control and family planning.They were also more food-secure and consumed more meals on an average, while the non-beneficiary households preferred spending more on food -- suggesting a lack of food self-sufficiency. However this cannot be attributed the input subsidy alone and needs further research. This paper aims to inform policy-making around agricultural input subsidies and its impacts on female headed households

Intraperitoneal bupivacaine alone or with dexmedetomidine or tramadol for post-operative analgesia following laparoscopic cholecystectomy: A comparative evaluation

Background and Aims: Intraperitoneal instillation of local anaesthetics has been shown to minimise post-operative pain after laparoscopic surgeries. We compared the antinociceptive effects of intraperitoneal dexmedetomidine or tramadol combined with bupivacaine to intraperitoneal bupivacaine alone in patients undergoing laparoscopic cholecystectomy. Methods: A total of 120 patients were included in this prospective, double-blind, randomised study. Patients were randomly divided into three equal sized (n = 40) study groups. Patients received intraperitoneal bupivacaine 50 ml 0.25% +5 ml normal saline (NS) in Group B, bupivacaine 50 ml 0.25% + tramadol 1 mg/kg (diluted in 5 ml NS) in Group BT and bupivacaine 50 ml 0.25% + dexmedetomidine 1 μg/kg, (diluted in 5 ml NS) in Group BD before removal of trocar at the end of surgery. The quality of analgesia was assessed by visual analogue scale score (VAS). Time to the first request of analgesia, total dose of analgesic in the first 24 h and adverse effects were noted. Statistical analysis was performed using Microsoft (MS) Office Excel Software with the Student′s t-test and Chi-square test (level of significance P = 0.05). Results: VAS at different time intervals, overall VAS in 24 h was significantly lower (1.80 ± 0.36, 3.01 ± 0.48, 4.5 ± 0.92), time to first request of analgesia (min) was longest (128 ± 20, 118 ± 22, 55 ± 18) and total analgesic consumption (mg) was lowest (45 ± 15, 85 ± 35, 175 ± 75) in Group BD than Group BT and Group B. Conclusion: Intraperitoneal instillation of bupivacaine in combination with dexmedetomidine is superior to bupivacaine alone and may be better than bupivacaine with tramadol

<i>Plasmodium vivax</i> Tryptophan Rich Antigen PvTRAg36.6 Interacts with PvETRAMP and PvTRAg56.6 Interacts with PvMSP7 during Erythrocytic Stages of the Parasite

<div><p><i>Plasmodium vivax</i> is most wide spread and a neglected malaria parasite. There is a lack of information on parasite biology of this species. Genome of this parasite encodes for the largest number of tryptophan-rich proteins belonging to ‘Pv-fam-a’ family and some of them are potential drug/vaccine targets but their functional role(s) largely remains unexplored. Using bacterial and yeast two hybrid systems, we have identified the interacting partners for two of the <i>P</i>. <i>vivax</i> tryptophan-rich antigens called PvTRAg36.6 and PvTRAg56.2. The PvTRAg36.6 interacts with early transcribed membrane protein (ETRAMP) of <i>P</i>.<i>vivax</i>. It is apically localized in merozoites but in early stages it is seen in parasite periphery suggesting its likely involvement in parasitophorous vacuole membrane (PVM) development or maintenance. On the other hand, PvTRAg56.2 interacts with <i>P</i>.<i>vivax</i> merozoite surface protein7 (PvMSP7) and is localized on merozoite surface. Co-localization of PvTRAg56.2 with PvMSP1 and its molecular interaction with PvMSP7 probably suggest that, PvTRAg56.2 is part of MSP-complex, and might assist or stabilize the protein complex at the merozoite surface. In conclusion, the PvTRAg proteins have different sub cellular localizations and specific associated functions during intra-erythrocytic developmental cycle.</p></div

Sub cellular localization of PvTRAg36.6 in <i>P</i>.<i>falciparum</i> transgenic parasites expressing GFP fusion protein.

<p>GFP fluorescence images showing localization of PvTRAg36.6-GFP in trophozoite stages of transgenic parasite line 3D7_ PvTRAg36.6-GFP, B. Images of co-immunostaining between anti-GFP antibody (green) and anti-SBP1 antibody (red). Parasite nuclei were labeled with DAPI (blue). Overlay shows images merged with bright field.</p

Co-localization studies of PvTRAg36.6 in <i>P</i>.<i>vivax</i>.

<p>Co-localization images of PvTRAg36.6 with apicoplast, rhoptry and micronemal markers in <i>P</i>.<i>vivax</i> natural infections. <b>(A)</b> Fluorescence pattern observed after co-immuno staining of <i>P</i>.<i>vivax</i> parasite with anti-PvTRAg36.6 (green) and anti-PfClpP (red) recognizing apicoplast in schizont (<b>A</b>, upper panel) as well as in free merozites (<b>A</b>, lower panel). <b>(B)</b> Co-immunostaining of anti-PvTRAg36.6 (green) with anti-PvRII (red) recognizing microneme in a schizont, and <b>(C)</b> Co-immunostaining of anti-PvTRAg36.6 (green) with anti-PvAARP (red) recognizing rhoptry neck in a schizont. The parasite nuclei were stained with DAPI (blue). Overlay shows the images merged with bright field.</p

Putative interacting protein partners of PvTRAg36.6 and PvTRAg56.2 identified by bacterial two hybrid assay.

<p>Putative interacting protein partners of PvTRAg36.6 and PvTRAg56.2 identified by bacterial two hybrid assay.</p

Sub cellular localization of PvTRAg36.6 in <i>P</i>.<i>vivax</i> natural infections.

<p>Immunofluorescence images of <i>P</i>.<i>vivax</i> infected red cells. Parasites were labeled with anti- PvTRAg36.6 (green) antibody and DAPI for nuclear staining (blue). Fluorescence pattern observed in ring (<b>R</b>, double infection), trophozoite <b>(T),</b> Schizont <b>(S)</b> stages and in free merozoites <b>(M)</b> are shown. Overlay shows the images merged with bright field.</p

Expression of PvTRAg-GFP fusion proteins in transgenic <i>P</i>.<i>falciparum</i>.

<p>Parasite lysates from wild type 3D7, transgenics 3D7_PvTRAg36.6-GFP and 3D7_PvTRAg56.2-GFP were subjected to western blot analyses using monoclonal anti-GFP antibody (upper panels) and anti-Bip antibody as control (lower panels). A: lane 1; wild type 3D7; Lane 2; 3D7_PvTRAg36.6-GFP, B: lane 1; wild type 3D7; lane 2; 3D7_PvTRAg56.2-GFP, Molecular weights of GFP fusion protein and parasite Bip protein are indicated. M shows the protein marker.</p