Analysis of drugs prescribed in emergency medicine department in a tertiary care teaching hospital in southern Rajasthan

Background: Emergency medicine department of a tertiary care hospital is one of the busiest department and most challenging one for the attending physician. Patients here are in critical condition and treating doctors have to take fast decisions and actions so there are always chances of error in prescribing drugs. Therefore this study was planned with an intention to analyse drug utilization in patients admitted in emergency medicine department using WHO core prescribing indicators.Methods: A prospective observational study on drugs prescribed in emergency medicine department in a tertiary care hospital was conducted for a period of three months. Data was extracted from 450 patients’ case records in a preformed performa after taking approval from institutional ethics committee. Data was analysed by using Microsoft excel. 2010.Results: 1080 drugs were prescribed in the 450 prescriptions analysed, average being 2.40 drugs per prescription. Analgesics, proton pump inhibitors and antibiotics were the highly prescribed drugs and commonest routes of administration used were intravenous and intramuscular. Approximately 93% drugs belonged to either or both the WHO and National essential drug lists.Conclusions: The results of the study disclosed both rational and irrational drug utilization. No polypharmacy was observed but 80% drugs were prescribed by brand name. Utilization of drugs belonging to essential drug lists indicates judicious use of drugs by our clinicians. Smaller sample size and lack of estimation of cost of treatment are the limitations of this study. Hence more data must be generated for accurate analysis

Detection of Antibiotic Resistance Genes in Source and Drinking Water Samples from a First Nations Community in Canada

Access to safe drinking water is now recognized as a human right by the United Nations. In developed countries like Canada, access to clean water is generally not a matter of concern. However, one in every five First Nations reserves is under a drinking water advisory, often due to unacceptable microbiological quality. In this study, we analyzed source and potable water from a First Nations community for the presence of coliform bacteria as well as various antibiotic resistance genes. Samples, including those from drinking water sources, were found to be positive for various antibiotic resistance genes, namely, ampC, tet(A), mecA, -lactamase genes (SHV-type, TEM-type, CTX-M-type, OXA-1, and CMY-2-type), and carbapenemase genes (KPC, IMP, VIM, NDM, GES, and OXA-48 genes). Not surprisingly, substantial numbers of total coliforms, including Escherichia coli, were recovered from these samples, and this result was also confirmed using Illumina sequencing of the 16S rRNA gene. These findings deserve further attention, as the presence of coliforms and antibiotic resistance genes potentially puts the health of the community members at risk.This work was supported by Discovery (A.K., W.G.D.F.) and CreateH2O (A.F.) grants funded by the Natural Science and Engineering Research Council of Canada as well as a University of Manitoba Start-up grant (E.K.). D.M.F. was funded by a Canada Research Chair grant to Peter Loewen, Department of Microbiology, University of Manitoba. R.P. is funded by a postdoctoral fellowship from the Government of Madhya Pradesh, India

BIODEGRADATION OF LOWDENSITY POLYETHYLENE (LDPE) BY PSEUDOMONAS AERUGINOSA STRAIN P9 ISOLATED FROM POULTRY DROPPINGS

This study aimed to isolate bacteria from poultry droppings for the degradation of lowdensity polyethylene (LDPE). Poultry droppings were collected from the Instructional Livestock Farm Complex (ILFC), Veterinary College, Mhow, Madhya Pradesh, India. LDPE films were treated with UV rays for 48 hours and used for the study. Four isolates were identified by Gram's staining. In M9, K9, P9, and E9; one was identified as Gram-positive, and 3 were found as Gram-negative bacteria. Screening of bacteria for LDPE biodegradation was done by clear zone formation. Out of 4 isolates, P9 was identified as LDPE degrading bacteria. LDPE degradation was analyzed by gravimetric analysis using the weight loss method, the functional group was analyzed by Fourier transform infrared spectroscopy, and the surface was analyzed by scanning electron microscopy. LDPE films with isolate P9 showed significant weight loss (16.98%±0.47) after 60 days. FT-IR analysis showed a decrease (58.8%) in carbonyl index and changes in functional group vibrations indicating LDPE degradation. SEM image examination revealed bacterial colonization, biofilm formation, surface erosions, cracks, and pit formation on the surface of LDPE which was indicative of the degradation of LDPE film. Further, the identification of isolate P9 was done by BD Phoenix M50 automated identification system and 16S rRNA sequencing. Sequencing and phylogenetic analysis of the P9 isolate showed 99.76% similarity with Pseudomonas aeruginosa (OR921266.1). Our findings underscore the potential of strain P9 from poultry droppings to efficiently utilize LDPE as a sole carbon source, thereby contributing to its degradation. This is the first report of isolating LDPE-degrading bacteria from poultry droppings. It is crucial to analyze the poultry gut microbiota for plastic degradation since this discovery highlights the need for further investigation

Analysis of drugs prescribed in emergency medicine department in a tertiary care teaching hospital in southern Rajasthan

Background: Emergency medicine department of a tertiary care hospital is one of the busiest department and most challenging one for the attending physician. Patients here are in critical condition and treating doctors have to take fast decisions and actions so there are always chances of error in prescribing drugs. Therefore this study was planned with an intention to analyse drug utilization in patients admitted in emergency medicine department using WHO core prescribing indicators.Methods: A prospective observational study on drugs prescribed in emergency medicine department in a tertiary care hospital was conducted for a period of three months. Data was extracted from 450 patients’ case records in a preformed performa after taking approval from institutional ethics committee. Data was analysed by using Microsoft excel. 2010.Results: 1080 drugs were prescribed in the 450 prescriptions analysed, average being 2.40 drugs per prescription. Analgesics, proton pump inhibitors and antibiotics were the highly prescribed drugs and commonest routes of administration used were intravenous and intramuscular. Approximately 93% drugs belonged to either or both the WHO and National essential drug lists.Conclusions: The results of the study disclosed both rational and irrational drug utilization. No polypharmacy was observed but 80% drugs were prescribed by brand name. Utilization of drugs belonging to essential drug lists indicates judicious use of drugs by our clinicians. Smaller sample size and lack of estimation of cost of treatment are the limitations of this study. Hence more data must be generated for accurate analysis

A mathematical model formulation to design a traditional Indian agri-fresh food supply chain: a case study problem

PurposeThe purpose of this paper is to study and develop supply chain structure of traditional Indian agri-fresh food supply chain (AFSC). This paper proposes a mathematical model to design a traditional Indian AFSC to minimize total distribution cost and post-harvest losses in the chain.Design/methodology/approachThis paper formulates two mathematical models to structure and represent the flow of products in the existing chain. First, a three-echelon, multi-period, multi-product, mixed-integer linear programming (MILP) model is formulated to minimize the total distribution cost incurred in the chain. Further, the developed formulation is extended by considering the perishability of products in the second model.FindingsA real case study problem of Mandsaur district (India) is solved in LINGO 17.0 package to check the validity of the formulated models. The perishable (second) model of AFSC reports better results in terms of costs and post-harvest losses minimization. The results revealed that 92% of the total distribution cost incurred in the transportation of products from farmers to the hubs.Research limitations/implicationsThis paper includes implications for redesigning an existing supply chain network by incorporating an appropriate transportation strategy from farmers to hubs to minimize transportation inefficiency and enhance the profitability of farmers.Practical implicationsThe formulated AFSC model would help managers and policymakers to identify optimal locations for hubs where required infrastructure would be developed.Originality/valueAccording to the author's best knowledge, this paper is the first to design traditional Indian AFSC by considering the perishability of products.</jats:sec