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

Antioxidant Activity of Indian Medicinal Rice (Oryza Sativa L.) cv. Njavara

A study was conducted to find out the antioxidant activity of medicinal rice (Oryza sativa L.) cv. Njavara. Two eco types of Njavara rice Njavara black (NB) and Njavara yellow (NY) were procured from RRS, Moncompu and one eco type of Hraswa was obtained from ARS, Mannuthy. Hraswa was treated as the control. Diphenyl picryl hydrazyl (DPPH) radical scavenging activity, hydroxyl radical scavenging activity, superoxide anion radical scavenging activity, reducing power assay, total antioxidant activity, total phenols, zinc and selenium (Se) were estimated. The results of the antioxidant properties revealed that for DPPH scavenging activity and hydroxyl radical activity NY had highest antioxidant activity. For superoxide radical scavenging activity, NB had the highest activity. Present investigation showed that as the concentration increased, the reducing power of all the rice varieties increased and the highest reducing power was shown by NB. NY had shown the highest total antioxidant activity. Present study revealed that among the three rice varieties NB had the highest total phenol content. Zn content was slightly higher in NY than NB. The present study revealed that control variety Hraswa had the highest Se content

Medicinal Properties of Njavara Rice (Oryza Sativa L.) cv.

A study was conducted to find out the therapeutic value of medicinal rice (Oryza sativa L.) cv. Njavara. Njavara rice for the study was procured from Rice Research Station, Moncompu. For assessing the efficacy of Njavara on the blood sugar levels, a feeding trial for 3 months was conducted among five subjects who were diabetic and willing to participate but not on medication. Blood sugar levels were monitored during 0, 45 and 90th day of supplementation. The results revealed that for all subjects\u27 blood sugar levels decreased after supplementation study. Diphenyl picryl hydrazyl (DPPH) radical scavenging activity, hydroxyl radical scavenging activity, superoxide anion radical scavenging activity and Vitamin E level were also ascertained. The findings revealed that after the supplementation of Njavara, the DPPH scavenging activity, hydroxyl radical activity, superoxide anion-radical scavenging activity and vitamin E level of the blood samples of all the five subjects under study have increased

COVID-19 symptoms-does pregnancy alter the course of the disease

Background: COVID-19 or corona virus 2 is a widespread pandemic taking a huge toll on the world population.it has a varied presentation in different age groups. Similarly, it has a poorer outcome in the elderly with various comorbidities and those who are immunocompromised. Though pregnancy is a relatively immunocompromised state studies have found that pregnant women have a less severe presentation. We have tried to assess this aspect of COVID-19 in pregnant women.Methods: We evaluated the records of 158 pregnant women who presented to our hospital from April 2020 till September 2020.Their symptoms at presentation were evaluated. we also noted the outcome of these pregnancies.Results: 16% of these were more than 34 weeks of period of gestation. 65.19% presented without any symptoms. 15.19% presented with fever. 10.75% presented with cough. 8.22% presented with headache. 5.69% presented with sore throat alone. 3.16% presented with breathlessness. 0.63% presented with anosmia alone, loss of taste, severe acute respiratory infection, vomiting, sore throat and breathlessness respectively. 54 patients delivered of which 7 delivered vaginally and there were 47 caesareans. Remaining patients after cure were discharged. There were 3 miscarriages. Two babies were found to be COVID-19 positive from nasopharyngeal swab taken on day 1, however this was a small number to indicate vertical transmission.Conclusion: Our study showed that a large proportion of pregnant patients presented without symptoms.it remains to be evaluated why this is so.it may provide us with clues on how to deal with disease in the general population

Covid 19, the Kerala experience: an observational, single centre retrospective study of outcome in covid positive pregnancies

Background: Covid 19 has spread across the world at an alarming rate. Approximately 4.05 million people have got infected worldwide resulting in around 279,000 deaths. Over 1 million people have recovered worldwide. Aim of this study was to determine whether course and severity of covid 19 is altered in pregnant women and whether covid 19 seemed to worsen the prognosis in pregnant women.Methods: Around 50 covid positive patients were admitted to this study hospital, a tertiary care referral hospital and medical college, between march and May 2020, 11 were pregnant. Authors collected their data retrospectively to understand the course of their disease till the period of recovery.Results: There were 6 patients above 31 weeks of whom one had elective repeat caesarean section, one had full term vaginal delivery, one is under follow up. Three patients had foetal distress necessitating emergency caesarean section. Of the remaining 5 patients with periods of gestation between 9-13 weeks, 1 of 24 weeks, 6 patients above 31 weeks, one had a miscarriage. Rest pregnancies are continuing and under follow up. 6 women had been symptomatic at admission, with mild symptoms of low-grade fever, sore throat and rhinitis. All were treated with hydroxychloroquine (HCQs). Those with respiratory symptoms like cough were also treated with oseltamivir. In view of high prevalence of H1N1 in the region. None of the women developed severe disease. The disease did not appear to worsen prognosis in pregnant women. The rate of recovery in pregnant women was similar to that seen in non-pregnant women and also men under the age of 40 years admitted in this study hospital.Conclusions: Covid 19 did not seem to worsen the prognosis in pregnant individuals when compared to rest of the population. The foetal outcomes also seemed favorable. However larger studies are required before concrete guidelines could be formulated for management of the disease in pregnancy

Morphophysiological characters of Dendrobium var. Yellow Splash as influenced by bioinoculants and different levels of benzyladenine

Dendrobium is the most commonly grown tropical orchid species in India and Kerala. They are highly specific about their nutrient requirement. The use of bio-inoculants in crop production of ornamentals has opened up a new possibility of using them for improving the growth and yield of orchids. Hence the objective of study was to evaluate the response of Dendrobium cv. Yellow Splash to different kinds of bio-inoculants viz., AMF, Azospirillum and a microbial consortia PGPR Mix – 1 developed from KAU, along with 50, 100 and 150 ppm of benzyladenine. The experiment consisted of ten different treatments involving bio-inoculants and benzyladenine. Plant height and number of leaves were maximum in the plants inoculated with AMF along with 100 ppm benzyladenine. Treatment comprising of Azospirillum and 100 ppm benzyladenine was superior in terms of other morphological parameters like leaf breadth, leaf area and plant spread. Maximum leaf length and highest number of shoots were observed in plants inoculated with Azospirillumand 150 ppm benzyladenine. Considering the floral parameters, both quantitative and qualitative attributes were found to be superior in the treatment consisting of AMF along with 150 ppm benzyladenine. Highest root length was observed under the treatment AMF along with 100 ppm benzyladenine while number of roots and root volume were maximum in the plants inoculated with Azospirillum and 150 ppm benzyladenine. Plants inoculated with AMF and 100 ppm benzyladenine had highest chlorophyll content while highest stomatal frequency was observed under the treatment Azospirillum and 100 ppm BA. From the study it could be concluded that inoculation of Dendrobium orchids with bio-inoculants like AMF and Azospirillum can significantly improve the morphological characters of the plants which in turn influence the production of quality spikes

HIV Infection and Host Genetic Mutation among Injecting Drug-users of Northeastern States of India

A community-based cross-sectional study was conducted among injecting drug-users (IDUs) of the northeastern states of India to understand the host genetic factors that confer resistance to HIV infection. The study aimed at assessing the existence and magnitude of genetic mutations of chemokine receptors, such as CCR2-64I, CCR-5 D-32, and SDF-1-3‘A, that are known to confer resistance to HIV infection and progression of disease in some set-ups. In total, 711 IDUs from Manipur, Mizoram, Nagaland, and Meghalaya were sampled for the study. The selected participants were interviewed to study their sociodemography, risk behaviours, and risk perceptions after obtaining their verbal informed consent. The interview was followed by collection of about 5 mL of blood samples by an unlinked anonymous method for studying genetic mutation and HIV infection. All the blood samples were transported to and processed at the clinical medicine laboratory of the National Institute of Cholera & Enteric Diseases, Kolkata, India. The genetic mutations were detected by polymerase chain reaction (PCR) and the restriction fragment length polymorphism (RFLP) assay techniques. The study revealed that 328 (46.1%) IDUs were aged 20–29 years, 305 (42.9%) were aged 30–39 years, and only two (0.3%) were aged above 49 years. The rate of HIV seropositivity varied widely among the IDUs living in different northeastern states that ranged from 4.5% to 61%. There was not a single IDU with CCR5 homozygous mutation. Mutated genes of CCR2-64I and SDF-1-3'A were detected in the frequencies of 49% and 23% respectively in them. The rate of HIV seropositivity in IDUs having CCR2 mutant gene was 27% (n=94) and without mutation was 27% (n=98). Similarly, HIV seropositivity in IDUs with and without SDF1 mutation was 28% (n=46) and 27% (n=146) respectively. Both the differences were not statistically significant. A CCR5 homozygous mutation is known to be the most prominent marker that confers resistance against HIV infection. The absence of CCR5 mutant gene in this population suggests that they do not have any additional protection against HIV infection. Analysis also revealed that, although mutation of CCR2 and SDF1 was present in this population, it did not confer any additional resistance against HIV. This indicates that the IDUs of northeastern India are not additionally protected against HIV infection through genetic mutation and are, therefore, vulnerable to acquire HIV infection due to high-risk behaviour and other related factors