Assessment of knowledge, attitude and practice of interns towards antibiotic resistance and its prescription in a teaching hospital: a cross sectional study

Background: Aim of the present study is to assess the knowledge, attitude and practices adopted by interns towards the antibacterial resistance and prescription.Methods: This is a cross sectional questionnaire based study conducted among the interns working in a teaching hospital. After obtaining the consent, the interns were asked to answer the preformed structured questionnaire to evaluate their knowledge, attitude and practice towards antibiotic resistance and prescription. Completed questionnaire were collected, compiled and data was analysed using descriptive statistics. Chi-square test was also used at appropriate places to determine the statistical significance.Results: A total of 80 participants completed the questionnaire. The response rate was 100%. Most of the interns had good knowledge of antibiotic resistance. 95% of the interns felt that the antibiotic resistance is an important and serious global health issue. Only 21.2% felt the need of antibiotic to treat common cold symptoms. Majority of the respondents agreed with the need of an antibiotic policy in the hospital to achieve rational antibiotic usage. With regard to having a course on rational use of antibiotics in the curriculum, 63.7% agreed and 31.2% strongly agreed.Conclusions: Our study has generated information about the knowledge, attitude and practice of interns towards antibiotic resistance and prescription which can help planning for an effective curriculum regarding antibiotic resistance and prescription

Pharmaceutical drug promotion: perception and attitude of medical interns towards drug company interactions in a tertiary care teaching hospital

Background: Interactions of pharmaceutical industry with the physicians which are usually mediated through pharmaceutical representatives have a significant impact on physician decision-making. This interaction can start as early as medical school during their training and this is said to influence their prescribing behavior when they become physicians. Aims and objectives of the study was to evaluate the attitude of interns towards pharmaceutical companies interactions including accepting gifts, ethical issues and influence on clinical decisions and also to study perception of medical interns towards the accuracy of information provided by the medical representatives.Methods: This was a cross sectional questionnaire based study that was conducted among the medical interns of the teaching hospital attached to Mandya Institute of Medical Sciences, Mandya. The study was carried out between July and August 2016. A preformed structured questionnaire was distributed to the interns consenting to participate in the study. Completed questionnaires were collected, compiled and data was analyzed.Results: A total of 93 questionnaires were distributed and 90 interns responded (response rate 96.7%). About 44.4% respondents felt that accepting gifts from Drug Company would influence their own decision making. Only 26.6% of them were of the opinion that it is ethical to accept pharmaceutical company gifts. Majority of them felt that Medical Representatives exaggerate the benefits of medicines and downplay the risks and contraindications of medicine. About 32.2% of them were of the opinion that they would prefer to prescribe the drug from the companies offering them with gifts over those without. Majority of the respondents felt that the doctors should be offered with gifts by drug companies whenever their drugs are prescribed.Conclusions: Attitude of Medical Interns towards Drug Company interactions as observed suggests for training the budding doctors on appropriate drug company interactions to prevent the risks associated with promotional efforts of pharmaceutical companies.

Study of drug utilization pattern in the department of radiotherapy in a tertiary care teaching hospital

Background: Drug utilization studies are an important tool in evaluating the rationality of therapeutic practice and also it is said to improvise the therapeutic use of drugs. The present study will be undertaken to evaluate the drug utilization pattern in the department of Radiotherapy.Methods: This was a prospective, observational study that was undertaken in the department of Radiotherapy in a tertiary care teaching hospital. The study was conducted for a period of 6 months after obtaining permission from Institutional Ethical Committee. The study was conducted among cancer patients undergoing radiotherapy. The data was collected from the patient case records and was analyzed as per the WHO prescribing indicators.Results: In the present study it was observed that the average number of drugs prescribed per encounter was 7.7. The drugs prescribed by generic name were 41.4%. Percentage of encounters with an antibiotic prescribed was 100. Percentage of encounters with an injection prescribed was 20.5%. Percentage of drugs prescribed from essential drugs list was 35.8%.Conclusions: Drug utilization studies helps in modifying the prescription pattern and helps in making the drug usage more rational

Comparative antioxidant and antimicrobial studies of cold and hot bark hydromethanolic extract of Couroupita guianensis Aubl

Couroupita guianensis, known by its common name as cannon ball tree, belongs to Lecythidaceae family, native of south and central America, India and Sri lanka. It’s been in use in traditional medicine and worshipped as sacred tree in india. With the importance of tree in various medicinal aspects as per the reports the present investigation was carried to access the phytochemical components, free radical scavenging and antimicrobial activity of cold and hot hydromethanolic extracts from the barks of medicinally important Couroupita guanensis. Phytochemical screening revealed the presence of total antioxidants, flavonoids, phenols and phytosterols in both cold and hot extracts. Quantitative estimations of the phytochemicals revealed the presence of high contents of total antioxidant activity (598.4 µg/ml), phenol content activity of (417.52 µg/ml) and phytosterols of (133.92 µg/ml) in cold hydromethanolic extracts compared to the hot hydromethanolic extract. The presence of high flavonoid content (417.52 µg/ml) was recorded in hot extract compared to the cold extract. Hot extract gave more scavenging activity with IC50 value (33.5 µg/ml). ABTS radical scavenging activity was found to be more in cold extract with IC50 values (24. µg/ml). Antimicrobial assay showed activity with B. cereus (13.00±0.00mm) and S.aureus (15.00±0.00mm) bacteria showed maximum zone of inhibition compared to the hot extract whereas C. albicans (13.00±O.00mm) showing maximum zone of inhibition compared to the cold extract and was not sensitive to any other fungal forms tested. This investigation pays way to consider Couroupita guianensis, with highly potential antioxidant and antimicrobial components, be used in pharmaceutical companies for the development of phytomedicine for the therapy and treatments

Structure of poly(propyl ether imine) (PETIM) dendrimer from fully atomistic molecular Dynamics Simulation and by Small Angle X-ray scattering

We study the structure of carboxylic acid terminated neutral poly (propyl ether imine) (PETIM) dendrimer from generation 1 through 6 (G1-G6) in a good solvent (water) by fully atomistic molecular dynamics (MD) simulations. We determine as a function of generation such structural properties as: radius of gyration, shape tensor, asphericity, fractal dimension, monomer density distribution, and end-group distribution functions. The sizes obtained from the MD simulations have been validated by Small Angle X-Ray Scattering (SAXS) experiment on dendrimer of generation 2 to 4 (G2-G4). A good agreement between the experimental and theoretical value of radius of gyration has been observed. We find a linear increase in radius of gyration with the generation. In contrast, Rg scales as ~ N^x with the number of monomers. We find two distinct exponents depending on the generations: x = 0.47 for G1-G3 and x = 0.28 for G3-G6 which reveals their non-space filling nature. In comparison with the amine terminated PAMAM dendrimer, we find Rg of G-th generation PETIM dendrimer is nearly equal to that of (G+1)-th generation of PAMAM dendrimer as observed by Maiti et. al. [Macromolecules,38, 979 2005]. We find substantial back folding of the outer sub generations into the interior of the dendrimer. Due to their highly flexible nature of the repeating branch units, the shape of the PETIM dendrimer deviates significantly from the spherical shape and the molecules become more and more spherical as the generation increases. The interior of the dendrimer is quite open with internal cavities available for accommodating guest molecules suggesting using PETIM dendrimer for guest-host applications. We also give a quantitative measure of the number of water molecules present inside the dendrimer.Comment: 33 page

ANALYSING CYBERCRIME UNDERGROUND ECONOMY USING DATA ANALYTICS

Given the rapid acceleration of digital hazards, little work has been carried out into the subject's institutions or procedures that could help to guide scientists and specialists in Information Systems that handle digital security. There is also no discussion of Crime as a Service that is a criminal action program which facilitates decentralized cyber-crime. The examination whole and useful cyber- crime issue that we see has persuaded us to research underground cybercrime economy by adopting information research strategy from a scientific point of view of the structure. To accomplish this objective, we will propose 1. a structure to information investigation to break down the underground cyber-crime, 2. CaaS and product definitions for wrong-doing and 3. a model for related order. Furthermore, 4. Create a software web-app to show how the proposed system and request structure can really be actualized. At that point, we will use web applications to explore the under-ground economy of cyber-crime by breaking down a huge data-set from the web-based network. In implementing the strategy- based structure science review, this review applies objects, institutions, and strategies to the project here. It also gives professional expertise to recommend rules on how governments and associations can plan underground cybercrime assaults in all businesses

Rationale and Design of a Comparative Effectiveness Trial to Prevent Type 2 Diabetes in Mothers and Children: The ENCOURAGE Healthy Families Study

The number of youth with type 2 diabetes (T2D) is expected to quadruple over 4 decades. Gestational diabetes mellitus (GDM) is also increasing and is linked with development of T2D in women, and greater risk for T2D in adolescents exposed to GDM. Despite the increasing prevalence of T2D, approaches to prevent diabetes in high-risk youth and families are rare. To address this, we are conducting the Encourage Health Families Study (ENCOURAGE). This is a randomized trial evaluating the comparative effectiveness and costs of an adaptation of the Diabetes Prevention Program (DPP) directed at mothers who had GDM or prediabetes and their children. The intervention is a group-based lifestyle program which we developed and implemented in partnership with the YMCA. We are comparing the ENCOURAGE intervention targeted to 1) mothers who have had GDM or prediabetes, and 2) mothers who have had GDM or prediabetes along with their school-aged children. This manuscript provides 1) the rationale for a targeted approach to preventing T2D and the interventions, 2) description of the translation of the DPP curriculum, and 3) the study design and methodology. The primary aims are to determine if participation leads to 1) weight loss in high-risk mothers, and 2) youth having healthier weights and lifestyle habits. We will also evaluate costs associated with each approach. These data are essential to build a translation model of T2D prevention that is both realistic and feasible to address this growing problem in both youth and adults

Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial

To determine if a widely available weight-management program (Weight Watchers) could achieve sufficient weight loss in persons with prediabetes compared with a Diabetes Prevention Program-based individual counseling program supported by National Diabetes Education Program materials. METHODS: We conducted an individual, randomized intervention trial in Indianapolis, Indiana, in 2013 to 2014, in 225 persons with prediabetes. We compared the Weight Watchers weight-management program (n = 112) with Your Game Plan to Prevent Type 2 Diabetes, a program developed by the National Diabetes Education Program. Outcomes were weight and metabolic markers measured at baseline, 6 months, and 12 months. RESULTS: Intervention participants lost significantly more weight than controls at 6 months (5.5% vs 0.8%) and 12 months (5.5% vs 0.2%; both P < .001). The intervention group also had significantly greater improvements in hemoglobin A1c and high-density lipoprotein cholesterol level than did controls. CONCLUSIONS: A large weight-management program is effective for achieving lifestyle changes associated with diabetes prevention. Such programs could significantly increase the availability of diabetes prevention programs worldwide making an immediate and significant public health impact

Metal-insulator Crossover Behavior at the Surface of NiS_2

We have performed a detailed high-resolution electron spectroscopic investigation of NiS$_2$ and related Se-substituted compounds NiS$_{2-x}$Se$_x$, which are known to be gapped insulators in the bulk at all temperatures. A large spectral weight at the Fermi energy of the room temperature spectrum, in conjunction with the extreme surface sensitivity of the experimental probe, however, suggests that the surface layer is metallic at 300 K. Interestingly, the evolution of the spectral function with decreasing temperature is characterized by a continuous depletion of the single-particle spectral weight at the Fermi energy and the development of a gap-like structure below a characteristic temperature, providing evidence for a metal-insulator crossover behavior at the surfaces of NiS$_2$ and of related compounds. These results provide a consistent description of the unusual transport properties observed in these systems.Comment: 12 pages, 3 figure