Monitoring adverse drug reactions in patients on TDF+3TC+EFV in a tertiary care hospital in Eastern India: a prospective observational study

Background: Recently, the National Aids Control Organisation (NACO) in India advocated and recommended the use of tenofovir, lamivudine and efavirenz as a fixed-dose combination in initiating ART in all future treatment-naïve patients. The present study was thus undertaken to assess the nature and extent of safety concerns with this regime.Methods: A prospective observational study was carried out in the outpatient setting of nodal ART centre of Eastern India. A total of 242 patients on various ART regimens were studied for suspected ADRs over one year. Adverse event history, medication history and other relevant details were captured. Causality and severity of each reported ADR were duly assessed.Results: Out of 242 PLHIV put on this regimen, 75 patients did not encounter any adverse reactions during the entire study period. Out of remaining 167 patients who presented with a total of 451 ADRs, maximum ADRs were attributed to various psychiatric disorders which included insomnia, dizziness, drowsiness etc, which were followed by gastrointestinal disorders including anorexia, flatulence, nausea, vomiting etc. Dermatological complications included rashes, itching, SJS, pigmentation of nails, skin hyper pigmentation respectively.Conclusions: The study enables to obtain information on the pattern of adverse drug reactions associated with treatment naïve PLHIV put on first line antiretroviral regimen comprising of once daily dosing of tenofovir, lamivudine, efavirenz. Need of intensive monitoring for ADRs in ARTs followed with proper patient counselling regarding its nature can lead to better compliance to the therapy

Effect of Carbon Impurity on Molybdenum Nanostructure Evolution under Helium Ion Irradiation in Extreme Conditions

The performance of plasma facing components (PFC) is of great important for the realization of prototype nuclear fusion. Tungsten has been considered as the leading high-Z PFC material for these reactors and tokamaks due to its superior thermophysical properties, high melting point, low sputtering yield, and low tritium inventory. However, its surface deteriorates significantly under helium ion irradiation in extreme (fusion) conditions and forms nanoscopic fiber like structures (fuzz) Recent studies show that the formation of fuzz nanostructure on tungsten can be suppressed by the presence of plasma impurities such as carbon and beryllium. In the present study, the effects of carbon impurity on molybdenum nanostructure evolution under extreme condition helium ion irradiation have been investigated. For mixing the carbon impurity on molybdenum surface, a mixture of helium and methane (CH4) gas has been used. Separate experiments with 100% pure helium and with mixture gas have been performed. Ion energy (100eV), ion-flux (7.2 1020 ions m-2 s-1), ion-fluence (2.6 1024 ions m-2) and target temperatures (923K) were chosen from our previous studies and fixed constant during the whole study, for all the samples. The surface modification and compositional analysis, due to 100% pure helium ion and “helium+ carbon” ion irradiations, will be studied using scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), respectively. In addition, optical-reflectivity measurements will also be performed for monitoring the surface deterioration due to energetic pure helium ion and mixture “helium+carbon” ion irradiations. Our results indicate that 0.5 % carbon impurity (a mixture of 97.5 % helium and 2.5% methane gas) may prevent almost all the molybdenum fuzz formation and deposit a thin carbon layer on molybdenum surface

Monitoring cutaneous adverse drug reactions in patients on TDF+3TC+EFV: a single centre experience

Background: HIV-infected patients initiating antiretroviral therapy may manifest a wide variety of ADRs ranging from trivial manifestation, such as rashes, pigmentation, to severe life‑threatening reactions, such as Steven–Johnson syndrome, toxic epidermal necrolysis. The present study thus monitored cutaneous adverse drug reactions in patients on first line antiretroviral regimen comprising of tenofovir disoproxil fumerate, lamivudine and efavirenz as a three drug-combination.Methods: A prospective observational clinical study was carried out for a period of one year among PLHIV receiving TDF+3TC+EFV as first line regimen in the outpatient setting of a nodal ART centre of eastern India.Results: The major regimen induced dermatological complications presenting in our study set up included rashes, itching, SJS, pigmentation of nails, skin Hyperpigmentation. The morbilliform eruption, often referred to as a maculopapular rash, is the most common type of reaction occurring after treatment initiation.Conclusions: Adverse drug reactions are one of the most common public health concerns, which influence patients' treatment options along with health care costs

Assessment of drug use practices among dermatology out-patients using WHO core drug use indicators

Background: Considering the economic burden the skin diseases cause owing to its high prevalence, it is of interest to periodically monitor the drug use pattern so as to increase the therapeutic efficacy, decrease adverse effects and provide feedback to prescribers. The present study thus assessed the drug use practices among dermatology outpatients in a tertiary care teaching unit in Eastern India.Methods: The study assessed drug use practices for all prescriptions of patients attending the concerned OPD using WHO core drug use indicators which consist of mainly three domains, prescribing indicators, patient care indicators and healthcare indicators.Results: Total number of drugs in 471 prescriptions was found to be 1050. Number of drugs per prescription varied from 1 to 6 with average of 2.22. The most commonly prescribed drugs were antibiotics, followed by steroids and steroidal combinations. Prescribing indicators revealed that 2.09% drugs were generic prescribing, with about 18.78% of the drugs being prescribed from the WHO essential drug list. The proportion of encounters with at least one antibiotic prescribed was 34.82%. 13.9% drugs actually dispensed from hospital supply, of which all were adequately labelled.Conclusions: Increasing dermatological prescribing has necessitated assessment of their rational usage. Promoting rational drug use policy is recommended for effective healthcare management

Effect of low temperature stress on betel vine (Piper betle L.) types, Bangia and Desavari

The effect of low temperature stress was studied in two types (Bangia and Desavari) of betel vine (Piper betle). Among the two types, Desavari showed better performance under cold stress and had significantly higher leaf thickness, levels of total thiols and peroxidase activity and lower lipid peroxidation. &nbsp

Effect of low temperature stress on betel vine (Piper betle L.) types, Bangia and Desavari

The effect of low temperature stress was studied in two types (Bangia and Desavari) of betel vine (Piper betle). Among the two types, Desavari showed better performance under cold stress and had significantly higher leaf thickness, levels of total thiols and peroxidase activity and lower lipid peroxidation. &nbsp