Analysis of gastrointestinal drugs in patients admitted in CCU and ICCU of a tertiary care hospital in Goa, India

Background: Gastrointestinal (GI) diseases are a common problem worldwide. They are frequently encountered in non-critical as well as in critically ill hospitalized patients.Methods: This was a prospective and observational study conducted on patients admitted in CCU and ICCU of Goa Medical College and Hospital. Data was collected from the patients’ case records and was analysed referring to WHO prescribing indicators. Data was represented as Mean±SD, number and frequency.Results: A total of 2250 drugs were prescribed, out of which 376 (16.71%) were gastrointestinal drugs. Most common route of administration was oral 323 (85.90%). Prescription patterns of GI drugs were:  275 (73.14%) from National List of Essential Medicines, 20 (5.31%) as fixed dose combinations and 4 (1.06%) by generic names. Pantoprazole 183 (48.67%) was the most frequently prescribed drug for peptic ulcer in present study.Conclusions: From the findings of this study we noted that among the GI drugs used, those for peptic ulcer were the most commonly prescribed. Also majority were from the essential drug list. But prescribing by generic names was low. Review of drug utilization trends is a necessary aid to formulate and modify existing protocols and guidelines to improve treatment outcomes in a given setting

Critical analysis of drug promotional literature available to the medical practitioners

Background: To ascertain whether the pharmaceutical companies are following the WHO criteria for “Ethical medicinal drug promotion 1988” and “OPPI Code of pharmaceutical marketing practices, 2012” and to what extent. Also, to evaluate the therapeutic claims made by them in their drug promotional literature and other aspects.Methods: Drug Promotional Literature (DPL) from different pharmaceutical companies was collected from various Medical practitioners and analysed to see if they achieved objectives. Therapeutic claims made by them were classified as authentic, exaggerated, controversial, false, and misinterpreted.Results: Total 250 DPLs were collected and critically analysed for information content. Out of the 11 WHO criteria for ethical medicinal drug promotion (1988), Majority (30%)  followed only 54.54% of the criteria while only 4% followed 100% of the criteria. The total number of claims in the 250 DPL were 354 of which 52.8% were authentic and 47.2% were misleading. From the misleading claims: 28.7% were exaggerated, 34.7% were controversial, 22.8% were false, 23% were ambiguous.Conclusions: This study enabled us to find out to what extent the pharmaceutical industries follow the standard criteria for DPL and evaluate the claims made by them. DPL is one of the important sources of drug information. Some of the pharmaceutical companies failed to follow the WHO criteria while advertising their products in order to make them look more lucrative having an underlying commercial motive. As they influence prescribing patterns of the clinicians, misleading promotional literature would result in irrational prescribing of drugs. To avoid this, DPL has to be critically evaluated

Perception and practice of self-medication amongst second year medical students in a tertiary care teaching hospital

Background: Management of medical ailments requires sound knowledge of diseases and drugs. Medical students are more likely to practice self-medication due to easy access to information. Inappropriate and inadequate treatment can lead to morbidity and mortality. Thus, the current study was carried out to understand the perception and practice of self-medication in medical students so that habit of ethical practice can be inculcated in them.Methods: A self-developed and prevalidated questionnaire was distributed amongst 145 students of second MBBS after approval from Institutional ethics Committee. Data was collected; analysed using MS Excel and the results were expressed as counts and percentages.Results: In this study authors noted 136 (93.79%) out of the 145 students practised self-medication. The commonest reason being effectiveness of medications for similar conditions in the past 92 (69.17%). 111 (81.61%) students reported fever as the most common indication. Analgesics/anti-pyretics 117 (86.02%) were the most frequently used drug groups. Majority 87 (63.97%) obtained information from friends and relatives. Adverse effects of self-medication were noted in 20 (14.70%).Conclusions: This study indicates higher prevalence of self-medication in medical students of Goa. Students can be sensitised and made aware about possible adverse effects and drug interactions with self-medication and how simple looking illness may take an ugly turn. Students being future doctors will continue this chain of spread of awareness of self-medication. Easy access to healthcare can also solve these problems

Design, Facile Synthesis and Characterization of Dichloro Substituted Chalcones and Dihydropyrazole Derivatives for Their Antifungal, Antitubercular and Antiproliferative Activities

Infectious diseases caused by fungi and mycobacteria pose an important problem for humankind. Similarly, cancer is one of the leading causes of death globally. Therefore, there is an urgent need for the development of novel agents to combat the deadly problems of cancer, tuberculosis, and also fungal infections. Hence, in the present study, we designed, synthesized, and characterized 30 compounds including 15 chalcones (2–16) and 15 dihydropyrazoles (17–31) containing dichlorophenyl moiety and also screened these compounds for their antifungal, antitubercular, and antiproliferative activities. Among these compounds, the dihydropyrazoles showed excellent antifungal and antitubercular activities whereas the chalcones exhibited promising antiproliferative activity. Among the dihydropyrazoles, compound 31 containing 2-thienyl moiety showed promising antifungal activity (MIC 5.35 µM), whereas compounds 22 and 24 containing 2,4-difluorophenyl and 4-trifluoromethyl scaffolds revealed significant antitubercular activity with the MICs of 3.96 and 3.67 µM, respectively. Compound 16 containing 2-thienyl moiety in the chalcone series showed the highest anti-proliferative activity with an IC₅₀ value of 17 ± 1 µM. The most active compounds identified through this study could be considered as starting points in the development of drugs with potential antifungal, antitubercular, and antiproliferative activities

Sensorineural hearing loss after concurrent chemoradiotherapy in nasopharyngeal cancer patients

<p>Abstract</p> <p>Background</p> <p>Sensorineural hearing loss (SNHL) is one of the major long term side effects from radiation therapy (RT) in nasopharyngeal cancer (NPC) patients. This study aims to review the incidences of SNHL when treating with different radiation techniques. The additional objective is to determine the relationship of the SNHL with the radiation doses delivered to the inner ear.</p> <p>Methods</p> <p>A retrospective cohort study of 134 individual ears from 68 NPC patients, treated with conventional RT and IMRT in combination with chemotherapy from 2004-2008 was performed. Dosimetric data of the cochlea were analyzed. Significant SNHL was defined as > 15 dB increase in bone conduction threshold at 4 kHz and PTA (pure tone average of 0.5, 1, 2 kHz). Relative risk (RR) was used to determine the associated factors with the hearing threshold changes at 4 kHz and PTA.</p> <p>Results</p> <p>Median audiological follow up time was 14 months. The incidence of high frequency (4 kHz) SNHL was 44% for the whole group (48.75% in the conventional RT, 37% with IMRT). Internal auditory canal mean dose of > 50 Gy had shown a trend to increase the risk of high frequency SNHL (RR 2.02 with 95% CI 1.01-4.03, p = 0.047).</p> <p>Conclusion</p> <p>IMRT and radiation dose limitation to the inner ear appeared to decrease SNHL.</p

All-sky search for short gravitational-wave bursts in the second Advanced LIGO and Advanced Virgo run

We present the results of a search for short-duration gravitational-wave transients in the data from the second observing run of Advanced LIGO and Advanced Virgo. We search for gravitational-wave transients with a duration of milliseconds to approximately one second in the 32-4096 Hz frequency band with minimal assumptions about the signal properties, thus targeting a wide variety of sources. We also perform a matched-filter search for gravitational-wave transients from cosmic string cusps for which the waveform is well modeled. The unmodeled search detected gravitational waves from several binary black hole mergers which have been identified by previous analyses. No other significant events have been found by either the unmodeled search or the cosmic string search. We thus present the search sensitivities for a variety of signal waveforms and report upper limits on the source rate density as a function of the characteristic frequency of the signal. These upper limits are a factor of 3 lower than the first observing run, with a 50% detection probability for gravitational-wave emissions with energies of ∼10-9 Mc2 at 153 Hz. For the search dedicated to cosmic string cusps we consider several loop distribution models, and present updated constraints from the same search done in the first observing run

Search for Eccentric Binary Black Hole Mergers with Advanced LIGO and Advanced Virgo during Their First and Second Observing Runs

When formed through dynamical interactions, stellar-mass binary black holes (BBHs) may retain eccentric orbits (e &gt; 0.1 at 10 Hz) detectable by ground-based gravitational-wave detectors. Eccentricity can therefore be used to differentiate dynamically formed binaries from isolated BBH mergers. Current template-based gravitational-wave searches do not use waveform models associated with eccentric orbits, rendering the search less efficient for eccentric binary systems. Here we present the results of a search for BBH mergers that inspiral in eccentric orbits using data from the first and second observing runs (O1 and O2) of Advanced LIGO and Advanced Virgo. We carried out the search with the coherent WaveBurst algorithm, which uses minimal assumptions on the signal morphology and does not rely on binary waveform templates. We show that it is sensitive to binary mergers with a detection range that is weakly dependent on eccentricity for all bound systems. Our search did not identify any new binary merger candidates. We interpret these results in light of eccentric binary formation models. We rule out formation channels with rates ⪆100 Gpc-3 yr-1 for e &gt; 0.1, assuming a black hole mass spectrum with a power-law index ≲2

Search for intermediate mass black hole binaries in the first and second observing runs of the Advanced LIGO and Virgo network

Gravitational-wave astronomy has been firmly established with the detection of gravitational waves from the merger of ten stellar-mass binary black holes and a neutron star binary. This paper reports on the all-sky search for gravitational waves from intermediate mass black hole binaries in the first and second observing runs of the Advanced LIGO and Virgo network. The search uses three independent algorithms: two based on matched filtering of the data with waveform templates of gravitational-wave signals from compact binaries, and a third, model-independent algorithm that employs no signal model for the incoming signal. No intermediate mass black hole binary event is detected in this search. Consequently, we place upper limits on the merger rate density for a family of intermediate mass black hole binaries. In particular, we choose sources with total masses M=m1+m2ϵ[120,800] M and mass ratios q=m2/m1ϵ[0.1,1.0]. For the first time, this calculation is done using numerical relativity waveforms (which include higher modes) as models of the real emitted signal. We place a most stringent upper limit of 0.20 Gpc-3 yr-1 (in comoving units at the 90% confidence level) for equal-mass binaries with individual masses m1,2=100 M and dimensionless spins χ1,2=0.8 aligned with the orbital angular momentum of the binary. This improves by a factor of ∼5 that reported after Advanced LIGO's first observing run