Analysis of prescription pattern of antihypertensives in various stages of chronic kidney disease

Background: Chronic kidney disease (CKD) is an emerging health problem and is one of the major causes of mortality. Hypertension is closely linked with CKD and both these conditions cause severe cardiovascular events. Hence blood pressure control is pertinent in all stages of CKD. This plays a major role in preventing its progression to end stage kidney disease and death. The objectives of the study were to analyse the class, dosing schedule of antihypertensive prescribed in Chronic Kidney Disease and the incidence of monotherapy and combination therapy.Methods: This study designed as a cross sectional study was conducted in Nephrology department of a tertiary care center and antihypertensive prescription pattern of 364 CKD patients was analyzed. Demographic details, the co-morbid factors and the details of drugs received by each patient were recorded from their outpatient/ inpatient charts. Data collected were entered in MS excel sheet and descriptive analysis done using SPSS software.Results: Calcium Channel Blocker (CCB) was the most commonly prescribed antihypertensive (70.6%) in all stages and the most common CCB was Cilnidipine (54%) with the dosing schedule of 20mg twice daily (56.4%). Incidence of combination therapy was 71.7% and CCB+AA (Alpha agonist) was the commonest combination prescribed in all stages except stage 1.Conclusions: CCBSs were widely prescribed as antihypertensive in CKD irrespective of the stages. Cilnidpine was the routinely prescribed CCB and seemed to be well tolerated by the patients. The protocol followed in this tertiary care center was in accordance with the standard guidelines by Kidney Disease Improving Global outcomes 2012

Bromelain Inhibits Allergic Sensitization and Murine Asthma via Modulation of Dendritic Cells

The incidence of atopic conditions has increased in industrialized countries. Persisting symptoms and concern for drug side-effects lead patients toward adjunctive treatments such as phytotherapy. Previously, we have shown that Bromelain (sBr), a mixture of cysteine proteases from pineapple, Ananas comosus, inhibits ovalbumin (OVA)-induced murine model of allergic airway disease (AAD). However, sBr’s effect on development of AAD when treatment is administered throughout OVA-alum sensitization was unknown and is the aim of the present study. C57BL/6J mice were sensitized with OVA/alum and challenged with 7 days OVA aerosol. sBr 6 mg/kg/0.5 ml or PBS vehicle were administered throughout sensitization. Lung, bronchoalveolar lavage (BAL), spleen, and lymph nodes were processed for flow cytometry and OVA-specific IgE was determined via ELISA. sBr treatment throughout OVA-alum sensitization significantly reduced the development of AAD (BAL eosinophils and lymphocytes). OVA-specific IgE and OVA TET+ cells were decreased. sBr reduced CD11c+ dendritic cell subsets, and in vitro treatment of DCs significantly reduced CD44, a key receptor in both cell trafficking and activation. sBr was shown to reduce allergic sensitization and the generation of AAD upon antigen challenge. These results provide additional insight into sBr's anti-inflammatory and antiallergic properties and rationale for translation into the clinical arena

A systems approach towards remote health-monitoring in older adults: Introducing a zero-interaction digital exhaust.

Using connected sensing devices to remotely monitor health is a promising way to help transition healthcare from a rather reactive to a more precision medicine oriented proactive approach, which could be particularly relevant in the face of rapid population ageing and the challenges it poses to healthcare systems. Sensor derived digital measures of health, such as digital biomarkers or digital clinical outcome assessments, may be used to monitor health status or the risk of adverse events like falls. Current research around such digital measures has largely focused on exploring the use of few individual measures obtained through mobile devices. However, especially for long-term applications in older adults, this choice of technology may not be ideal and could further add to the digital divide. Moreover, large-scale systems biology approaches, like genomics, have already proven beneficial in precision medicine, making it plausible that the same could also hold for remote-health monitoring. In this context, we introduce and describe a zero-interaction digital exhaust: a set of 1268 digital measures that cover large parts of a person's activity, behavior and physiology. Making this approach more inclusive of older adults, we base this set entirely on contactless, zero-interaction sensing technologies. Applying the resulting digital exhaust to real-world data, we then demonstrate the possibility to create multiple ageing relevant digital clinical outcome assessments. Paired with modern machine learning, we find these assessments to be surprisingly powerful and often on-par with mobile approaches. Lastly, we highlight the possibility to discover novel digital biomarkers based on this large-scale approach

Long-Term Home-Monitoring Sensor Technology in Patients with Parkinson's Disease-Acceptance and Adherence.

Parkinson's disease (PD) is characterized by a highly individual disease-profile as well as fluctuating symptoms. Consequently, 24-h home monitoring in a real-world environment would be an ideal solution for precise symptom diagnostics. In recent years, small lightweight sensors which have assisted in objective, reliable analysis of motor symptoms have attracted a lot of attention. While technical advances are important, patient acceptance of such new systems is just as crucial to increase long-term adherence. So far, there has been a lack of long-term evaluations of PD-patient sensor adherence and acceptance. In a pilot study of PD patients (N = 4), adherence (wearing time) and acceptance (questionnaires) of a multi-part sensor set was evaluated over a 4-week timespan. The evaluated sensor set consisted of 3 body-worn sensors and 7 at-home installed ambient sensors. After one month of continuous monitoring, the overall system usability scale (SUS)-questionnaire score was 71.5%, with an average acceptance score of 87% for the body-worn sensors and 100% for the ambient sensors. On average, sensors were worn 15 h and 4 min per day. All patients reported strong preferences of the sensor set over manual self-reporting methods. Our results coincide with measured high adherence and acceptance rate of similar short-term studies and extend them to long-term monitoring

Novel glitazones as PPARγ agonists: molecular design, synthesis, glucose uptake activity and 3D QSAR studies

Abstract Background An alarming requirement for finding newer antidiabetic glitazones as agonists to PPARγ are on its utmost need from past few years as the side effects associated with the available drug therapy is dreadful. In this context, herein, we have made an attempt to develop some novel glitazones as PPARγ agonists, by rational and computer aided drug design approach by implementing the principles of bioisosterism. The designed glitazones are scored for similarity with the developed 3D pharmacophore model and subjected for docking studies against PPARγ proteins. Synthesized by adopting appropriate synthetic methodology and evaluated for in vitro cytotoxicity and glucose uptake assay. Illustrations about the molecular design of glitazones, synthesis, analysis, glucose uptake activity and SAR via 3D QSAR studies are reported. Results The computationally designed and synthesized ligands such as 2-(4-((substituted phenylimino)methyl)phenoxy)acetic acid derivatives were analysed by IR, 1H-NMR, 13C-NMR and MS-spectral techniques. The synthesized compounds were evaluated for their in vitro cytotoxicity and glucose uptake assay on 3T3-L1 and L6 cells. Further the activity data was used to develop 3D QSAR model to establish structure activity relationships for glucose uptake activity via CoMSIA studies. Conclusion The results of pharmacophore, molecular docking study and in vitro evaluation of synthesized compounds were found to be in good correlation. Specifically, CPD03, 07, 08, 18, 19, 21 and 24 are the candidate glitazones exhibited significant glucose uptake activity. 3D-QSAR model revealed the scope for possible further modifications as part of optimisation to find potent anti-diabetic agents

Optical parameters induced by phase transformation in RF magnetron sputtered TiO2 nanostructured thin films

Pure TiO2 thin films were deposited onto quartz substrates using a ceramic TiO2 target at an elevated substrate temperature of 573 K by RF magnetron sputtering, and an analysis of structural, optical and photoluminescence characteristics of the films upon phase transformation is reported in this paper. Structural investigations using X-ray diffraction revealed that the as-deposited film was amorphous in nature. Thermal annealing for 2 h at 873 K in air resulted in the formation of anatase phase, and a phase transformation to rutile was observed at 1073 K. An increase in grain size and an improvement in crystallinity were also observed on annealing. Rod- like rutile crystallites were observed in the SEM images of the film annealed at 1273 K. As-deposited films and films annealed up to 1073 K were highly transparent in the visible region with a transparency >80%. Optical band gap of the films decreased upon thermal annealing which is attributed to phase transformation from amorphous to anatase and then to rutile. Optical parameters such as refractive index, optical conductivity and optical dielectric constant increased with increase in annealing temperature. Since rutile is the optically active phase, the superior refractive index of the film annealed at 1073 K along with its high transparency in visible region suggests the application of this film in antireflective coatings. Photoluminescence emission of maximum intensity was observed for the film annealed at 873 K, which exhibits anatase phase. Intense blue emission observed in this film makes it suitable for use in optoelectronic display devices

Effect of Yttrium doping on antibacterial and antioxidant property of LaTiO3

Abstract The advancement of multidrug-resistant bacterial strains and their adverse effects is one of the most significant global health issues. The perovskite nanomaterial with combined antioxidant and antibacterial activities in one molecule has the potential for improved therapeutic solutions. In this work, Yttrium-doped Lanthanum Titanate (LaTi1 −x Y x O3, where x = 0, 0.05, and 0.1) was synthesized using auto combustion technique. Excellent crystalline structure with a tetragonal system is revealed by X-ray diffraction analysis (XRD). UV–Visible diffuse reflectance spectroscopy (UV–Vis DRS), Fourier transform infrared (FTIR), and photoluminescence (PL) were used to study its optical characteristics. The field emission scanning electron microscope (FE-SEM) shows rod-like pellet-shaped Yttrium-doped nanostructures, and the elements present were confirmed with the Energy Dispersive X-Ray Analysis (EDAX). Various concentrations of the synthesized materials were tested for antibacterial activity against Gram-positive (Staphylococcus aureus 902) and Gram-negative (E. coli 443) strains using the agar-well diffusion method with gentamicin antibiotic as a positive control. High antibacterial activity of 87.1% and 83.3% was shown by 10% Yttrium-doped LaTiO3 (LY(0.1)TO) at 500 mg/mL against both positive and negative stains, respectively. Moreover, the antioxidant properties of synthesized materials were assessed with IC50 values of 352.33 µg/mL, 458.055 µg/mL, and 440.163 µg/mL for samples LaTi1 − x Y x O3, where x = 0, 0.05, and 0.1 respectively. The antibacterial and antioxidant capabilities of the proposed samples illustrate their applicability in various biomedical applications