A prospective study on prescribing pattern of drugs in geriatric patients in the department of medicine in a tertiary care center

Background: India stands at 3rd position with large elderly population in the world. Elderly population has special problems related to health, social support, and economic security. Comorbidities in elderly people are frequent, which require use of multiple medications which increases the number of inappropriate medications    noncompliance, economic burden, adverse drug reactions (ADRs), and drug interactions. The overall incidence of ADR is two to three times higher due to physiological and pharmacological variations. Currently used screening tools for inappropriate prescription in old age are: Beers criteria and inappropriate prescribing in the elderly tool (IPET).Methods: A prospective observational study of elderly patients of either sex admitted in the medicine ward, conducted from May 2019-November 2019. A total of 102 prescriptions were collected and analysed. Data was analysed using Microsoft excel.Results: In this study most of the patients (67 out of 102) were in the age group 65-70 years with male population (73%) dominance. Most of the patient were admitted due to cardiovascular (35.84%) and respiratory system (14.15%) disorder. Anti-diabetics (17.64%) followed by anti-microbials (14.24%) were the most commonly prescribed medicines in this study. Our study revealed poly pharmacy in geriatric patients with an average number of drugs per prescription being 6.07. According to BEER’s criteria 3.47% of total drugs prescribed were inappropriateConclusions:  In this study most of the patients had co morbid conditions, cardiovascular disease and diabetes being the common cause led to polypharmacy. A high number of potential prescription errors were found.

Study of anti-inflammatory activity of Ficus racemosa linn stem bark extract in albino rats

Background: Inflammation is part of the complex biological response of vascular tissues to harmful stimuli. Though there are standard anti-inflammatory drugs like aspirin, diclofenac, etc., these are not free of side effects. This has led to an increase in demand for natural products with anti-inflammatory activity having less side effects. Hence the study was conducted to evaluate the anti-inflammatory activity of ethanolic extract of Ficus racemose (EEFR) in albino rats.Methods: Healthy albino rats of either sex were divided into 4 groups of 6 animals each. Group1-control, group 2-diclofenac sodium 2 mg/kg and group 3 and 4 EEFR (200 and 400 mg/kg respectively), anti-inflammatory activity was evaluated by Carrageenan induced paw oedema: formalin induced-peritonitis and cotton pellet induced granuloma model for in vivo activity and protein denaturation test for in vitro activity.Results: EEFR exhibited significant in vitro (p<0.001) anti-inflammatory effect at the dose of 200 and 400 mg/kg. EEFR produced 61.37% inhibition at the dose of 400 mg/kg and diclofenac (standard drug) produced 62.95% of inhibition after 3 hours of drug treatment in carrageenan induced paw oedema. The exudate volume was decreased in formalin induced peritonitis by EEFR and diclofenac significantly (p<0.001). In cotton pellet induced granuloma EEFR (400 mg/kg) and diclofenac showed decreased formation of granuloma by 28.36% and 28.00% (p<0.001) respectively.Conclusions: EEFR has significant anti-inflammatory activity in both acute and chronic model in a dose dependant manner in comparison with standard drug

Adaptive Fuzzy PI Current Control of Grid Interact PV Inverter

Now a day‟s, Photo Voltaic (PV) power generation rapidly increasing. This power generation highly depending on the temperature and irradiation. When this power interface with grid through the voltage source inverter with PI controller. Its gains should be updated due to the parametric changes for the better performance. In This Work Fuzzy Controller updates the gains of the proportional integral (PI)s Controller under variable parametric conditions. the gaines of the PI Controller are updated based on the error current and change in error current through the fuzzy controller. The error current in direct and quadrature frame are the Inputs to the PI controller. The PI Controller generates the reference voltage to the pulse width modulation technique. Here reference voltage is compared with the carrier signal to generate the pulses to the 3-Ph Inverter connected to the grid. This controller has given well dynamic response with less steady state error and also given The less THD of the grid current compared to the PI and Fuzzy controller.It Is implemented and verified in MATLAB Simulink

Promoter-Specific Expression and Genomic Structure of IgLON Family Genes in Mouse

IgLON family is composed of five genes: Lsamp, Ntm, Opcml, Negr1, and Iglon5; encoding for five highly homologous neural adhesion proteins that regulate neurite outgrowth and synapse formation. In the current study we performed in silico analysis revealing that Ntm and Opcml display similar genomic structure as previously reported for Lsamp, characterized by two alternative promotors 1a and 1b. Negr1 and Iglon5 transcripts have uniform 5' region, suggesting single promoter. Iglon5, the recently characterized family member, shares high level of conservation and structural qualities characteristic to IgLON family such as N-terminal signal peptide, three Ig domains, and GPI anchor binding site. By using custom 5'-isoform-specific TaqMan gene-expression assay, we demonstrated heterogeneous expression of IgLON transcripts in different areas of mouse brain and several-fold lower expression in selected tissues outside central nervous system. As an example, the expression of IgLON transcripts in urogenital and reproductive system is in line with repeated reports of urogenital tumors accompanied by mutations in IgLON genes. Considering the high levels of intra-family homology shared by IgLONs, we investigated potential compensatory effects at the level of IgLON isoforms in the brains of mice deficient of one or two family members. We found that the lack of IgLONs is not compensated by a systematic quantitative increase of the other family members. On the contrary, the expression of Ntm 1a transcript and NEGR1 protein was significantly reduced in the frontal cortex of Lsamp-deficient mice suggesting that the expression patterns within IgLON family are balanced coherently. The actions of individual IgLONs, however, can be antagonistic as demonstrated by differential expression of Syp in deletion mutants of IgLONs. In conclusion, we show that the genomic twin-promoter structure has impact on both anatomical distribution and intra-family interactions of IgLON family members. Remarkable variety in the activity levels of 1a and 1b promoters both in the brain and in other tissues, suggests complex functional regulation of IgLONs by alternative signal peptides driven by 1a and 1b promoters.Peer reviewe

GMRT Observations of Interstellar Clouds in the 21cm line of Atomic Hydrogen

Nearby interstellar clouds with high (|v| >/= 10 km/s) random velocities although easily detected in NaI and CaII lines have hitherto not been detected (in emission or absorption) in the HI 21cm line. We describe here deep Giant Metrewave Radio Telescope (GMRT) HI absorption observations toward radio sources with small angular separation from bright O and B stars whose spectra reveal the presence of intervening high random velocity CaII absorbing clouds. In 5 out of the 14 directions searched we detect HI 21cm absorption features from these clouds. The mean optical depth of these detections is ~ 0.09 and FWHM is ~ 10 km/s, consistent with absorption arising from CNM clouds.Comment: 16 pages, 6 figures (included), Accepted for publication in Journal of Astrophysics & Astronomy, uses jaa.st

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio