A possible case of etoricoxib induced fixed drug eruption

Fixed drug eruption (FDE) is a most commonly with adverse drug reaction seen with use of Non-steroidalanti-inflammatory drugs (NSAIDs) in particular nimesulide followed by antibiotics and anticonvulsants. Etoricoxib is a selective cyclo-oxygenase isoenzyme-2 inhibitor which is superior to conventional NSAIDs and causes less side effects. Authors present a case of fixed drug eruption due to etoricoxib in a male patient. A 50-year-old patient presented to Outpatient Department (OPD) of Dermatology of a Tertiary Care Hospital with complains of skin rashes over lips, oral cavity, trunk, both the upper and lower limbs, palm, soles, scrotum and glans penis since a week. The detailed history of the patient revealed the use of etoricoxib a week back, prescribed for low back pain. It was suspected that the cutaneous drug reaction was due to the use of etoricoxib. The suspected drug etoricoxib was stopped, patient was admitted and managed symptomatically. The above reaction was assessed to be “possible” as per WHO-UMC and Naranjo causality scale, “moderate” on Hartwig’s scale and “Probably preventable” according to Schumock and Thornton criteria. This case reporting was done to sensitize the prescribers regarding rare side effects of the above drug and the need to confirm past history of drug reaction before prescription

Efficacy and safety of thrombolytic therapy in prosthetic valve thrombosis

Background: There is limited data available about the effectiveness of thrombolysis in prosthetic valve thrombosis (PVT). Therefore, this study aimed to evaluate the efficacy and safety of thrombolytic treatment in PVT patients.Methods: This was an observational study conducted at a tertiary-care centre in India between March 2013 and April 2014. Total of 56 patients with either recurrent PVT or with confirmed left-sided PVT was included in the study. Thrombolytic therapy was administered as an intravenous infusion of streptokinase or urokinase, initially at a loading dose of 2.5L IU/hour over 30 minutes, followed by 1L IU/hour for 48–78 hours depending upon the clinical and 2D-Echo observation. Primary endpoint was considered as the occurrence of a complete clinical response. Secondary endpoint was considered as a composite of death, major bleeding or embolic stroke.Results: Mean age of the patients was 37±13 years. Most of the patients presented with NYHA-II (51.7%), III (39.2%), and IV (8.9%) symptoms. Mitral and aortic valve thrombosis were observed in 40(71.4%) and 11(28.6%) patients. Forty-nine (73.3%) patients were treated with streptokinase. Whereas, rethrombosis patients were treated with urokinase [6(16%)] and tenecteplase [1(1.3%)]. Two (3.6%) patients died, 1(1.8%), 1(1.8%), 2(3.6%), and 1(1.8%) patient had peripheral embolism, central nervous system bleeding, stroke, and embolic complications.Conclusions: Thrombolytic therapy can be used as the first-line treatment for thrombolysis in PVT patients. All PVT patients can be treated with streptokinase unless specific contraindications exist. Urokinase or tenecteplase is an alternative thrombolytic agent in rethrombosis patients

Variations in the esterase activity during the germination period of Jatropha curcas seeds

Germination brings out the synthesis or activation of enzymes responsible for the degradation of seeds reserves. Among these enzymes, esterases are involved in the metabolic processes of germination and maturation of plants. They are constitutively expressed in seeds during germination to release the reserve materials for the growing embryo. In the present study, total protein content and esterase activity was monitored in germinating Jatropha curcas seeds. The esterase activity and specific activity observed were 9.07 µmoles/min/gm and 0.09258 IU/mg, respectively. Electophoretic analysis for esterase activity showed thirteen bands of esterases, among these 8 esterolytic bands were major and remaining were minor bands. The protein content and esterase activity decreased on 2nd, 4th, 5th and 8th day of seed germination and activity increased on 3rd, 6th, 7th day of germination. Similarly esterase activity increased on 7th day and decreased on 8, 9 and 10th day in the shoot tissue. ÂÂ

Antibiogram resistance pattern of extended-spectrum beta-lactamase-positive bacterial isolates

Objectives: To identify the antibiogram resistance pattern of extended-spectrum beta-lactamase (ESBL)-positive bacterial isolates. Materials and Methods: This prospective, observational study was conducted in Rajarajeswari Medical College and Hospital, Bangalore, over a period of 12 months. The clinical samples were inoculated on the standard recommended media. Inoculated plates were incubated aerobically at 37°C for 24 h, and organisms were identified by culture and appropriate biochemical reactions. Antimicrobial sensitivity was performed by Kirby-Bauer disk diffusion method on Mueller-Hinton agar using commercially available antibiotic discs as per the Clinical and Laboratory Standards Institute Guidelines-2014. Results: Escherichia coli were the most common ESBL-producing organisms isolated from the study population accounting to 45% of the total cases. The next most common organisms were Klebsiella species and Pseudomonas. Ceftriaxone was the most commonly used empirical antibiotic (33.3% cases). Piperacillin and meropenem were used in combination with tazobactam or sulbactam, respectively, as per the culture and sensitivity reports. Conclusion: The association of change in antibiotic to mortality was found to have significance. The change in antibiotic in deterioration of the illness showed decrease in mortality

A prospective, open label, randomized-controlled study to evaluate the efficacy and safety of MyVir tablets in mildly symptomatic COVID-19 patients

Background: Coronavirus can cause pneumonia, respiratory failure and death. The emergence of novel coronavirus has posed a challenging situation that warrants urgent global attention. Currently there was no effective therapy available for COVID-19 and hence antiviral and immune modulators are most sought after medicines to manage complications of COVID-19.Methods: In this study involving mild COVID-19 we randomized 42 patients to receive a MyVir tablets twice daily along with standard of care (SOC) or SOC alone in 1:1 ratio for 14 days. We evaluated the benefits of MyVir tablets by assessing clinical outcomes and improvement in immune markers (LDH, CRP, D-dimer, TLC).Results: At the end of the study the immune markers in MyVir group improved significantly compared to control group. In patients who received MyVir, CRP decreased from 3.3 mg/l to 1.7 mg/l (p=0.0171). D-dimer decreased from 0.589 on day 0 to 0.368 on day 14 (p=0.03) and LDH decreased from 224 U/l on day 0 to 158 U/l on day 14 in test group (p=0.05). TLC showed favorable improvement in study group compared to control group. Early recovery from COVID-19 symptoms was observed in patients on MyVir treated group. Patients treated with MyVir tablets reduced the duration of hospitalization when given along with standard of care.Conclusions: MyVir accelerated recovery of COVID-19 patients by early improvement in clinical symptoms and immune markers in this study and results clearly indicates that MyVir tablets has antiviral, immune booster activity. Hence this study provides evidence that MyVir has definitive role in the management of mild COVID-19 patients along with standard of care (funded by Mi Lab Life Sciences(P) Ltd. CTRI no. CTRI/2020/05/024967)

Biosubstitutes for dural closure: Unveiling research, application, and future prospects of dura mater alternatives

The dura mater, as the crucial outermost protective layer of the meninges, plays a vital role in safeguarding the underlying brain tissue. Neurosurgeons face significant challenges in dealing with trauma or large defects in the dura mater, as they must address the potential complications, such as wound infections, pseudomeningocele formation, cerebrospinal fluid leakage, and cerebral herniation. Therefore, the development of dural substitutes for repairing or reconstructing the damaged dura mater holds clinical significance. In this review we highlight the progress in the development of dural substitutes, encompassing autologous, allogeneic, and xenogeneic replacements, as well as the polymeric-based dural substitutes fabricated through various scaffolding techniques. In particular, we explore the development of composite materials that exhibit improved physical and biological properties for advanced dural substitutes. Furthermore, we address the challenges and prospects associated with developing clinically relevant alternatives to the dura mater

Whole-Genome Sequence of Sungri/96 Vaccine Strain of Peste des Petits Ruminants Virus

We report the complete genome sequence of the Sungri/96 vaccine strain of peste des petits ruminants virus (PPRV). The whole-genome nucleotide sequence has 89 to 99% identity with the available PPRV genome sequences in the NCBI database. This study helps to understand the epidemiological and molecular characteristics of the Sungri/96 strain