Why Gujarat Needs Much Better Higher Education & Research to Succeed in Knowledge Economy & What We Can Do About It?

This white paper distills the deliberations on the role of higher education and research as a key enabler of a Knowledge based Society. In particular it discusses (a) the importance of higher quality PhDs for building a knowledge society, (b) the initiatives and progress in competing economies in higher education and research, (c) where Gujarat stands in comparison, and (d) some recommendations on what Gujarat can do to enable timely progress towards building a knowledge based society and economy. These deliberations were conducted in conjunction with the International Conference on \u27Reconnecting Gujarati Diaspora with its Homeland: Contribution to its Development with focus on Building a Knowledge Society

Survey of use of over the counter drug and other than over the counter drugs among medical students, nursing and technician staff of a tertiary care teaching hospital

Background: To find out pattern and extent of use of OTC and other than OTC drugs among medical students, nursing and technician staff.Methods: Study began after taking permission and approval from Institutional Review Board (IRB). Medical student, nursing and technician staff of tertiary care teaching hospital was enrolled after written informed consent. Pre validated questionnaire regarding use of such use was administered to each participant.Results: A total of 200 participants responded to questionnaire, M:F ratio was 1:1.7. Majority of the participants had taken OTC drugs for cough/cold (72.6%) followed by headache/ body ache (71.1%). Paracetamol (81%) followed by Diclofenac (42.5%), ibuprofen (37.8%) were the most common drugs taken. About 85% participants had taken antimicrobial considering it as an OTC product. Most commonly used antimicrobials were metronidazole (19.4%) followed by levofloxacin (17.9%).Most common reason for self medication was the perception that the disease wasn’t serious (44.8%), favourable prior advertisement (34.3%). About 52% requested for drug by mentioning name of drug. Most (50.7%) felt that OTC drug improved their illness. 45.9% stopped when symptoms disappeared. Majority of the participants (57.2%) believed use of OTC drug is a good practice. Most of the participants (56.7%) believed they can treat symptoms with OTC drugs.64.7% participants believed use of OTC drug is beneficial for them. Most of the participants lack the knowledge for dose (73.6%) and frequency (68.2%) of drug. A substantial number of participants (58.61%) were taking drugs outside OTC list.Conclusions: Awareness and dangers of misuse of OTC medications among all the participants was less. Therefore it is suggested that proper education should be imparted regarding illness where self-administration of OTC drugs to be employed

A study of morbidity and drug utilization pattern in indoor patients of high risk pregnancy at tertiary care hospital

Background: Pregnancy represents a special physiological state during which the use of drug is of growing concern due to risk of teratogenicity. High risk pregnancy is common threat to mother and foetus. Therefore, our aim was to study the drug utilization and morbidity pattern in high risk pregnancy in hospitalized pregnant women. Methods:An observational, prospective study was carried out in 250 patients for 6 months in the tertiary care hospital. Protocol was approved by the Institutional Review Board (IRB). The data were collected in a pre-designed proforma. Data were analysed by using SPSS version 20.0 Software. Results: Among 250 patients, 19 (7.6%), 218 (87.2%) and 13 (5.2%) were of less than 20, 20 to 30 and more than 30 years of age respectively. About 68.8% women had complained of abdominal pain and 67.6% had weakness followed by headache / body ache (47.2%), oedema (26.4%) and vomiting (18.8%). Iron (91.2%) and calcium (84.5%) were the commonest drugs prescribed followed by folic acid (59.6%), protein powder (54.8%), vitamin C (46.8%) and isoxsuprine (26.6%). As per FDA Drug Risk Category, Category-A (82.21%) was most frequently prescribed followed by Category-B (15.64%) and Category-C (2.15%). Percentage of drugs prescribed by generic name and from essential drug list was 62.80% and 80.79%. Conclusion: Iron, Calcium and Folic acid were most commonly prescribed drugs. There is lesser number of drugs prescribed by generic name suggesting need for sincere efforts to improve situation

Newer approaches in the treatment of asthma

Asthma is a worldwide public health problem. The most effective anti-asthmatic drugs - inhaled β2-agonists and glucocorticoids controls asthma in about 90-95% of patients. However, severe glucocorticoid-dependent and resistant asthma presents a great clinical burden. Therefore, reducing glucocorticoids - related adverse effects using novel steroid-sparing agents is needed. Furthermore, the mechanisms involved in the persistence of inflammation are poorly understood and the reasons why some patients have severe life threatening asthma and others have very mild disease are still unknown. Although glucocorticoids effectively control the inflammatory process in asthma, they have little effect on the lower airway remodeling processes that appear to play a role in the pathophysiology of asthma. Several new drugs developed to target specific components of the inflammatory process in asthma [e.g. anti-IgE antibodies (omalizumab), cytokines and/or chemokines antagonists, immunomodulators, antagonists of adhesion molecules)], have not yet been proven to be particularly effective. Hence, considering the central role of T lymphocytes in the pathogenesis of asthma, drugs targeting disease-inducing Th2 cells are promising future therapeutic strategies. Some of these new anti-asthmatic treatment approaches may in the future not only control symptoms and modify the natural course of asthma, but also potentially prevent or cure the disease. Hence, the development of novel drugs may allow resolution of these changes

Knowledge and attitude towards antimicrobial self medication usage: a cross sectional study among medical and nursing students

Background: Antimicrobial drug resistance is a fast mounting universal crisis. Many factors like self medication, inappropriate use and unregulated sale of medicines and self medication have been attributed to this problem. The objective was to determine extend and causes of antimicrobial self medication and to compare the knowledge attitude of senior and junior medical/nursing students. Methods: We conducted a cross-sectional study on randomly selected 410 students from Baba Farid University of Health Sciences Faridkot, Punjab. A total sample of 220 medical students were enrolled from GGS Medical College, Faridkot (1st year students 50 and 170 above 1st year senior medical students ) and 190 nursing students were enrolled from University College of Nursing, Faridkot. Results: prevalence of antimicrobial self medication came out to be around 74%. The most common cause for seeking antimicrobial (self therapy) was upper respiratory tract infection. A statistical significant knowledge/attitude gap was found between senior and fresher medical/nursing students. Conclusions: High prevalence of antimicrobial self medication among medical/nursing students is a matter of concern and it should be discouraged at appropriate level to safeguard students from preventable adversary exposure.

The epidemiology of Leishmania donovani infection in high transmission foci in India.

OBJECTIVE: Visceral Leishmaniasis (VL) is highly prevalent in Bihar, India. India and its neighbours aim at eliminating VL, but several knowledge gaps in the epidemiology of VL may hamper that effort. The prevalence of asymptomatic infections with Leishmania donovani and their role in transmission dynamics are not well understood. We report data from a sero-survey in Bihar. METHODS: Demographic and immunological surveys were carried out in July and November 2006, respectively in 16 highly VL endemic foci in Muzaffarpur district in Bihar. Household and individual information was gathered and capillary blood samples were collected on filter papers. Direct agglutination test (DAT) was used to determine infected individuals (cut-off titre 1:1600). DAT results were tabulated against individual and household variables. A multivariate generalized estimating equation (GEE) model was used to study the prevalence of serologically positive individuals taking into account the clustering at household and cluster levels. RESULTS: Of study subjects 18% were DAT positive, and this proportion increased with age. Women had a significantly lower prevalence than men >14 years old. Owning domestic animals (cows, buffaloes or goats) was associated with a higher risk of being DAT positive [OR 1.16 (95% CI 1.01-1.32)], but socio-economic status was not. CONCLUSIONS: Prevalence of leishmanial antibodies was high in these communities, but variable. Demographic factors (i.e. marriage) may explain the lower DAT positivity in women >14 years of age. Within these homogeneously poor communities, socio-economic status was not linked to L. donovani infection risk at the individual level, but ownership of domestic animals was

Suspected immune mediated response to COVID-19 vaccine: two individual case reports

SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), has spread rapidly around the world. Researchers have been working round the clock to develop effective vaccines, which people started receiving in December 2020. Therefore, careful follow-up and surveillance studies for continued vaccine safety monitoring will be needed to ascertain the potential risks of such adverse events or disease. Here, we present two individual cases of pancreatitis and typhilitis following COVID 19 vaccination. In the first case of a 38 years old male patient developed pancreatitis after 4 days of COVID 19 vaccination and in second case, of a 60 years old female patient developing typhilitis after just one day after vaccination. All possible causes of this occurrence were ruled out. Two main factors suggest a possible link to the vaccine, the chronology of the events and the incongruent immune response to the vaccine component. It is not possible to establish a direct causal relation between vaccination and adverse event following immunization; however, this report can be used to alert practitioners to this possibility of adverse event following immunization after COVID-19 vaccine

Iatrogenic phenytoin toxicity: a case report of medication error

Medication errors may produce severe toxicity resulting in hospitalization. This can be compounded if the physician obtains the wrong concentration from a reference manual and a pharmacy miscalculates the conversion. We present a case report of phenytoin toxicity related to overdose in 19 year girl which is related to prescribing error and dose related error. A 19 years old girl came to emergency department with convulsions, gum hypertrophy and ataxia. Patient had history of convulsion before 2 months at that time she was given Tab. Phenytoin (100mg) (Eptoin) 2 times a day prescribed for generalized tonic clonic seizures (GTCS). Then before seven days she presented with convulsion so physician increased the dose of drug from 2 times a day to 3 times a day. Then patient developed gum hyperplasia and ataxia after 7 days and she presented with convulsion. Serum Phenytoin level was >40mcg/ml. Phenytoin was withdrawn. Then patient then recovered eventually. Medication errors may produce severe toxicity resulting in hospitalization. It also increases morbidity and mortality. A prescribing fault is a failure in the prescribing process. It leads to, or has the potential to lead to, harm to the patient. Phenytoin metabolism is dose dependent. So very small increments in dosage may result in adverse effects. In our case sudden increase in the dose by 100mg led to blood level double than therapeutic blood level. So, medication error occurred at the prescription level and because of that patient developed toxicity and she needed to hospitalization. In this case instead of suddenly increasing the dose of phenytoin one should change the drug or add another drug to prevent toxicity or side effect

Emotion Transfer for Hand Animation

We propose a new data-driven framework for synthesizing hand motion at different emotion levels. Specifically, we first capture high-quality hand motion using VR gloves. The hand motion data is then annotated with the emotion type and a latent space is constructed from the motions to facilitate the motion synthesis process. By interpolating the latent representation of the hand motion, new hand animation with different levels of emotion strength can be generated. Experimental results show that our framework can produce smooth and consistent hand motions at an interactive rate

Pattern of antidiabetic drugs use in type-2 diabetic patients in a medicine outpatient clinic of a tertiary care teaching hospital

Background: Diabetes mellitus (DM) is an important public health problem in developing countries. Drug utilisation study of antidiabetic agents is of paramount importance to promote rational drug use in diabetics and make available valuable information for the healthcare team. The aim of study was to investigate the drug utilization pattern in type-2 diabetic patients.Methods: A prospective, cross-sectional study was carried out in medicine outpatient clinic of tertiary care hospital, Ahmedabad for eight weeks. Patients with type-2 diabetes and on drug therapy for at least one month were included. Patients’ socio-demographic and clinical data were noted in a pre-designed proforma. Data was analysed by using SPSS version 20 and Excel 2007.Results: Total 114 patients were enrolled with mean (± standard deviation) age and duration of diabetes of 56.8 ± 10.5 and 8.3 ± 9.4 years respectively. Male: Female ratio was 0.72:1. Mean fasting and postprandial blood glucose levels were 147.5 ± 73.1 and 215.6 ± 97.3 mg/dl respectively. Most common symptom was weakness/fatigue (77.2%). Hypertension (70.2%) was most common co-morbid illness. Mean number of drugs prescribed were 7.8 ± 2.5. Total numbers of patients receiving more than five drugs were 89.5%. Most commonly used drug group was biguanides (87.7%) followed by sulphonylureas (68.4%).Conclusion: Metformin (biguanide) was the most utilized (87.7%) antidiabetic drug for type-2 diabetes. This study revealed that the pattern of antidiabetic prescription was rational and largely compliant with NICE (National Institute for Health and Clinical Excellence) guidelines