Study on drug use pattern in the management of the cardiovascular diseases and with comorbidities

Background: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs

Study on drug related problems in tuberculosis patients undergoing treatment

Background: Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. It is one of the leading causes of mortality and morbidity around the world. The aim of this study to identify and document the drug related problems in tuberculosis patients under anti-tubercular treatment (ATT) in an attempt to promote adherence, reduce the drug related problems and improve success rate in TB treatment. The main objective of the study to identify the drug related problems in tuberculosis patients on ATT and second objective measure the medication adherence and counsel patients to improve medication adherence.Methods: A prospective observational study was conducted in Raja Muthiah Medical College Hospital for 6 months from November 2018 to April 2019. The study was approved by Institutional Human Ethics Committee (IHEC).Results: Total 101 drug related problems have been identified in 70 patients using pharmaceutical care network of Europe classification. Drug interactions 41.58% was the most common drug related problems found, which was clinically significant in tuberculosis patients with co- morbidities. Insufficient awareness of health and disease 21.75% was the second most common drug related problems found, 16.83% drug choice problems found. Nearly 64% of the enrolled patients were found to be non-adherence during pre-patient counselling. After the patient counselling the adherent rate was improved 74%.Conclusions: The study concludes that pharmacist provided patient counselling found to have significant influence on improvement in the patient’s knowledge towards their disease and medication, and adherence to prescribed therapy which helps to improve the clinical outcome of TB patients

IDENTIFICATION AND ASSESSMENT OF PREDIABETES-A RURAL INDIAN STUDY (A CORRELATIVE STUDY BETWEEN QUESTIONNAIRE AND BIOCHEMICAL ANALYSIS)

Objective: To identify and prevent the vulnerable prediabetic population becoming diabetic patients in the future using the Indian Diabetic Risk Score (IDRS) and to evaluate the performance of the IDRS questionnaire for detecting prediabetes and predicting the risk of Type 2 Diabetes Mellitus in Chidambaram rural Indian population. Methods: A cross-sectional descriptive study was carried out among patients attending a master health check-up of RMMCH hospital located at Chidambaram. The IDRS was calculated by using four simple measures of age, family history of diabetes, physical activity, and waist measurement. The relevant blood test, like Fasting plasma glucose (FBS), Glycated hemoglobin (HbA1C) test, were observed for identifying prediabetes. Subjects were classified as Normoglycemic, prediabetics, and diabetics based on the questionnaire and diagnostic criteria of the Indian Council of Medical Research (ICMR) guidelines. Results: In the study, sensitivity and specificity of IDRS score were found to be 84.21% and 63.4% respectively for detecting prediabetes in community with the positive predictive value of 51.6% and negative predictive value of 89.6% and prevalence of prediabetes in the Chidambaram rural population is 31.6% among the 60 participants. Conclusion: The Indian diabetic risk score questionnaire designed by Ma­dras diabetic research federation is a useful screening tool to identify unknown type 2 diabetes mellitus. The question­naire is a reliable, valuable, and easy to use screening tool which can be used in a primary care setup.&nbsp

Impact of Lysinibacillus macroides, a potential plant growth promoting rhizobacteria on growth, yield and nutritional value of tomato Plant (Solanum lycopersicum L. f1 hybrid Sachriya)

Plant growth promoting bacteria enhance the growth in plants by solubilizing insoluble minerals, producing phytohormones and by secreting enzymes that resist pathogen attack. The present study was aimed at identifying the potential of Lysinibacillus macroides isolated from pea plant possessing rich microbial rhizobiome diversity in promoting the growth of tomato plant (Solanum lycopersicum L). Potential of L. macroides in the promotion of S. lycopersicum L. growth by increased shoot length, terminal leaf length and breadth was assessed. Anatomical sectioning of stem and root revealed no varied cellular pattern indicating that the supplemented bioculture is not toxic to S. lycopersicum. Plantlets treated with L. macroides along with organic compost showed an increased total phenol content (17.58±0.4 mg/g) compared to control samples (12.44±0.41 mg/g). Carbohydrate content was noticed to be around 1.3 folds higher in the L. macroides plus compost mixture supplemented slots compared to control sample. Significant increase in shoot length was evident in the L. macroides plus compost supplied slots (23.4±2.7 cm). Plant growth promoting properties might be due to the nitrogen fixing activity of the bacteria which enrich the soil composition along with the nutrients supplied by the organic compost. Rich microbial rhizobiome diversity in pea plant and the usage of L. macroides from a non-conventional source improves the diversity of the available PGPR for agricultural practices. Further research is needed to detect the mechanism of growth promotion and to explore the plant microbe interaction pathway

SOD2 Deficiency in Cardiomyocytes Defines Defective Mitochondrial Bioenergetics as a Cause of Lethal Dilated Cardiomyopathy

Electrophilic aldehyde (4-hydroxynonenal; 4-HNE), formed after lipid peroxidation, is a mediator of mitochondrial dysfunction and implicated in both the pathogenesis and the progression of cardiovascular disease. Manganese superoxide dismutase (MnSOD), a nuclear-encoded antioxidant enzyme, catalyzes the dismutation of superoxide radicals (O2•-) in mitochondria. To study the role of MnSOD in the myocardium, we generated a cardiomyocyte-specific SOD2 (SOD2Δ) deficient mouse strain. Unlike global SOD2 knockout mice, SOD2Δ mice reached adolescence; however, they die at ~4 months of age due to heart failure. Ultrastructural analysis of SOD2Δ hearts revealed altered mitochondrial architecture, with prominent disruption of the cristae and vacuole formation. Noninvasive echocardiographic measurements in SOD2Δ mice showed dilated cardiomyopathic features such as decreased ejection fraction and fractional shortening along with increased left ventricular internal diameter. An increased incidence of ventricular tachycardia was observed during electrophysiological studies of the heart in SOD2Δ mice. Oxidative phosphorylation (OXPHOS) measurement using a Seahorse XF analyzer in SOD2Δ neonatal cardiomyocytes and adult cardiac mitochondria displayed reduced O2 consumption, particularly during basal conditions and after the addition of FCCP (H+ ionophore/uncoupler), compared to that in SOD2fl hearts. Measurement of extracellular acidification (ECAR) to examine glycolysis in these cells showed a pattern precisely opposite that of the oxygen consumption rate (OCR) among SOD2Δ mice compared to their SOD2fl littermates. Analysis of the activity of the electron transport chain complex identified a reduction in Complex I and Complex V activity in SOD2Δ compared to SOD2fl mice. We demonstrated that a deficiency of SOD2 increases reactive oxygen species (ROS), leading to subsequent overproduction of 4-HNE inside mitochondria. Mechanistically, proteins in the mitochondrial respiratory chain complex and TCA cycle (NDUFS2, SDHA, ATP5B, and DLD) were the target of 4-HNE adduction in SOD2Δ hearts. Our findings suggest that the SOD2 mediated 4-HNE signaling nexus may play an important role in cardiomyopathy

A review: Anti diabetic medicinal plants used for diabetes mellitus

Aim of the present study is evaluated various medicinal plants used for antidiabetic activity. Diabetes mellitus is one of the most common non-communicable diseases globally. It is the fourth leading causes of death in the most developed countries and there in substantial evendiced that it in epidemic in many developing and newly industrialized nations. This posing a serious threat to be met within 21st century. Since ancient time plants have been exemplary source of medicine. Ayurveda and other Indian literature mentioned the used of plants in treatment of various ailments. Out of an estimated 250 000 higher plants, less than 1% have been screened pharmacologically and very few in regard to diabetes mellitus. Systematic studies on the folklore medicinal plants that combat diabetes mellitus are scanty

Improved Resistance to Vibrio parahaemolyticus in Black Tiger Shrimp Penaeus monodon Treated with Streptococcus phocae PI80 and Bacillus subtilis

The aim of the study was to establish the immune response induced by Streptococcus phocae PI80, Bacillus subtilis, and commercial probiotics (Uni-Ecosense, EcoForce, Uni-Hatch) in the shrimp, Penaeus monodon. Total hemocyte count, phenoloxidase activity, nitroblue tetrazolium (NBT) reductase assay, phagocytic activity, and disease resistance was evaluated for 30 days. Total hemocyte count, phenoloxidase activity, NBT reductase assay, and phagocytic activity significantly increased in juveniles and adults treated with S. phocae PI80, a mixture of S. phocae PI80 and B. subtilis, or a commercial probiotic, but there were no significant differences in live weight of shrimps treated with probiotics or the control. Treatment with S. phocae PI80 plus B. subtilis enhanced survival of shrimps challenged with Vibrio parahaemolyticus. Our study demonstrates that administration of S. phocae PI80+B. subtilis at 4.6 х 108 CFU/ml water induced immune modulation, enhanced immune ability, and increased resistance to V. parahaemolyticus in juvenile and adult black tiger shrimp

Neurogranin regulates calcium-dependent cardiac hypertrophy

Intracellular Ca-calmodulin (CaM) signaling plays an important role in Ca-CaM-dependent kinase (CaMKII) and calcineurin (CaN)-mediated cardiac biology. While neurogranin (Ng) is known as a major Ca-CaM modulator in the brain, its pathophysiological role in cardiac hypertrophy has never been studied before. In the present study, we report that Ng is expressed in the heart and depletion of Ng dysregulates Ca homeostasis and promotes cardiac failure in mice. 10-month-old Ng null mice demonstrate significantly increased heart-to-body weight ratios compared to wild-type. Using histological approaches, we identified that depletion of Ng increases cardiac hypertrophy, fibrosis, and collagen deposition near perivascular areas in the heart tissue of Ng null mice. Ca spark experiments revealed that cardiac myocytes isolated from Ng null mice have decreased spark frequency and width, while the duration of sparks is significantly increased. We also identified that a lack of Ng increases CaMKII signaling and periostin protein expression in these mouse hearts. Overall, we are the first study to explore how Ng expression in the heart plays an important role in Ca homeostasis in cardiac myocytes as well as the pathophysiology of cardiac hypertrophy and fibrosis