A prospective study on the pattern of antibiotic use in a tertiary care hospital

Background: Indiscriminate use of antimicrobials is rampant throughout India, and this is a matter of serious concern. There are several reports linking antibiotic usage to bacterial resistance. Towards addressing this problem, community wise surveillance needs to be undertaken to monitor antibiotic exposure including their misuse. This study was meant to assess the extent and pattern of antibiotic use in a tertiary care facility.Methods: Subjects for study were patients attending a suburban hospital in central Kerala. Case records of patients who were prescribed systemic antibiotics were perused for relevant data. Seriously ill patients were excluded from the study.Results: 610 encounters with antibiotics could be identified from a total of around 2000 patient records, indicating an encounter rate of 29%; which is quite acceptable as per the WHO standard of prescribing indicators. However, more than 70% of prescriptions carried only brand names of medications. Use of antibiotics was mostly on the basis of clinical symptoms (presumptive), and culture reports were not given due credence. Prescriptions were invariably therapeutic in nature, and the concepts of surgical prophylaxis conveniently given a go by. The most common infections were those of the Upper Respiratory Tract (URTI), followed by skin and soft tissue infections. Ampicillin, azithromycin and cefuroxime were the most frequently prescribed agents. More than one third of infections were treated with a combination of antimicrobials. A general temptation for using cephalosporin - betalactamase inhibitor combinations could be related to the aggressive promotional policies of the pharmaceutical industry.Conclusions: The overall antibiotic encounter rate is acceptable as per WHO standards. But the tendency for using injections as well as antibiotic combinations is very high. Prophylactic use of antibiotics in surgical procedures is not being followed at all. A serious attempt needs to be made to implement National Guidelines for use of antimicrobials

AMCIS 2022 Reflecting on Gordon Davis and the Future of the IS Discipline

This is a recording of the AMCIS 2022 Reflecting on Gordon Davis and the Future of the IS Discipline

Perceptions of the educational environment at entry and exit of medical students to clinical teaching in a rural medical college

Background: The foundation for good health care to patients is the competence of health care providers. Motivated learners in supportive environments have high levels of self-efficacy. DREEM is considered a valid and reliable tool, globally accepted for assessing the educational environment. The objectives of the study were to elicit the perceptions of first clinical year and final year medical students in a rural medical college using the Dundee ready education environment measure (DREEM) inventory and to find out if there is any difference in the perceptions at entry and exit to the clinical environment.Methods: This was a cross sectional study on 78 students each in first clinical year and final year of this rural medical college. The DREEM inventory was used by the investigator to record relevant data, which was then statistically analyzed using SPSS software. The student t-test was used to compare the total and sub-domain mean scores in the two groups.Results: There was significant difference in perception in the final year students compared to the first clinical year class.Conclusions: The students of both first clinical year and final year have a positive perception about their educational environment. However there is a significant difference in the total DREEM score as well as total sub-domain scores among first clinical year students and final year students. Student perceptions are a valuable resource for institutional curriculum planners to make appropriate changes to enhance student learning

EPR and Structural Characterization of Water-Soluble Mn2+-Doped Si Nanoparticles.

Water-soluble poly(allylamine) Mn2+-doped Si (SiMn) nanoparticles (NPs) were prepared and show promise for biologically related applications. The nanoparticles show both strong photoluminescence and good magnetic resonance contrast imaging. The morphology and average diameter were obtained through transmission electron microscopy (TEM) and high-resolution transmission electron microscopy (HRTEM); spherical crystalline Si NPs with an average diameter of 4.2 ± 0.7 nm were observed. The doping maximum obtained through this process was an average concentration of 0.4 ± 0.3% Mn per mole of Si. The water-soluble SiMn NPs showed a strong photoluminescence with a quantum yield up to 13%. The SiMn NPs had significant T1 contrast with an r1 relaxivity of 11.1 ± 1.5 mM-1 s-1 and r2 relaxivity of 32.7 ± 4.7 mM-1 s-1 where the concentration is in mM of Mn2+. Dextran-coated poly(allylamine) SiMn NPs produced NPs with T1 and T2 contrast with a r1 relaxivity of 27.1 ± 2.8 mM-1 s-1 and r2 relaxivity of 1078.5 ± 1.9 mM-1 s-1. X-band electron paramagnetic resonance spectra are fit with a two-site model demonstrating that there are two types of Mn2+ in these NP's. The fits yield hyperfine splittings (A) of 265 and 238 MHz with significant zero field splitting (D and E terms). This is consistent with Mn in sites of symmetry lower than tetrahedral due to the small size of the NP's

デヌダチンアルカロイドAcochlearineの合成研究

要約のみTohoku University徳山英利課

AMCIS 2022 Awards Luncheon

This is a video recording and PDF document with the AMCIS 2022 Awards Ceremony

A One Medicine Mission for an Effective Rabies Therapy

Despite the disease's long history, little progress has been made toward a treatment for rabies. The prognosis for patient recovery remains dire. For any prospect of survival, patients require aggressive critical care, which physicians in rabies endemic areas may be reluctant or unable to provide given the cost, clinical expertise required, and uncertain outcome. Systematic clinical research into combination therapies is further hampered by sporadic occurrence of cases. In this Perspective, we examine the case for a One Medicine approach to accelerate development of an effective therapy for rabies through the veterinary care and investigational treatment of naturally infected dogs in appropriate circumstances. We review the pathogenesis of rabies virus in humans and dogs, including recent advances in our understanding of the molecular basis for the severe neurological dysfunction. We propose that four categories of disease process need to be managed in patients: viral propagation, neuronal degeneration, inflammation and systemic compromise. Compassionate critical care and investigational treatment of naturally infected dogs receiving supportive therapy that mimics the human clinical scenario could increase opportunities to study combination therapies that address these processes, and to identify biomarkers for prognosis and therapeutic response. We discuss the safety and ethics of this approach, and introduce the Canine Rabies Treatment Initiative, a non-profit organization with the mission to apply a One Medicine approach to the investigation of diagnostic, prognostic, and therapeutic options for rabies in naturally infected dogs, to accelerate transformation of rabies into a treatable disease for all patients

Number crunching in the cancer stem cell market

Like their normal counterparts, many tumours are thought to have a hierarchical organization, albeit a disorganized one. Accordingly, the concept of cancer stem cells has emerged, and that these cells are responsible for perpetuating tumour existence. Operationally, cancer stem cells are regarded as prospectively purified cells that are the most effective at tumour initiation in an in vivo assay, usually after xenotransplantation to NOD/SCID mice. The conventional wisdom is that such tumour-initiating cells are rare based upon having to xenotransplant large numbers of human tumour cells into immunodeficient mice to propagate the tumour, but new evidence indicates that perhaps these cells are not so rare, at least in malignant melanoma, if a supportive soil is provided for the transplanted cells along with further restriction of the murine host's immune response

Rare familial 16q21 microdeletions under a linkage peak implicate cadherin 8 (CDH8) in susceptibility to autism and learning disability

Background: Autism spectrum disorder (ASD) is characterised by impairments in social communication and by a pattern of repetitive behaviours, with learning disability (LD) typically seen in up to 70% of cases. A recent study using the PPL statistical framework identified a novel region of genetic linkage on chromosome 16q21 that is limited to ASD families with LD. Methods: In this study, two families with autism and/or LD are described which harbour rare >1.6 Mb microdeletions located within this linkage region. The deletion breakpoints are mapped at base-pair resolution and segregation analysis is performed using a combination of 1M single nucleotide polymorphism (SNP) technology, array comparative genomic hybridisation (CGH), long-range PCR, and Sanger sequencing. The frequency of similar genomic variants in control subjects is determined through analysis of published SNP array data. Expression of CDH8, the only gene disrupted by these microdeletions, is assessed using reverse transcriptase PCR and in situ hybridisation analysis of 9 week human embryos. Results: The deletion of chr16: 60 025 584-61 667 839 was transmitted to three of three boys with autism and LD and none of four unaffected siblings, from their unaffected mother. In a second family, an overlapping deletion of chr16: 58 724 527-60 547 472 was transmitted to an individual with severe LD from his father with moderate LD. No copy number variations (CNVs) disrupting CDH8 were observed in 5023 controls. Expression analysis indicates that the two CDH8 isoforms are present in the developing human cortex. Conclusion: Rare familial 16q21 microdeletions and expression analysis implicate CDH8 in susceptibility to autism and LD