A retrospective study to evaluate the pattern of spontaneously reported antiretroviral induced adverse drug reactions in a tertiary care hospital

Background: To evaluate the adverse effect profile of spontaneously reported cases of adverse drug reactions due to antiretroviral (ART) drugs in a tertiary care teaching hospital.Methods: A descriptive retrospective study of pattern of ART induced adverse drug reactions (ADRs) spontaneously reported to the Pharmacology department at a tertiary care hospital from January 2011 to December 2016. The details of suspected ADRs including drugs involved, treatment given for ADRs, and the outcome were also documented. These ADRs were analyzed for causality (WHO scale), severity (Hartwig et al. scale), seriousness (ICH E 2A guidelines), preventability (Schumock and Thornton scale) and type based on Edwards and Aronson classification system.Results: Of the 75 cases of ART induced ADRs, reactions were slightly more common in males (52%) and had median age and duration of ART as 36 years and 109 days respectively. Drug induced anemia was the most common presentation followed by cutaneous ADR and zidovudine being the commonest offender. Severity was moderate in 85.3% and causality was probable in 16% and possible in 84% cases. The type reaction was augmented type in 41.3% and not preventable in 76%.Conclusions: Zidovudine is the commonest drug implicated in causing anemia amongst the antiretrovirals. Spontaneous reporting method for antiretroviral pharmacovigilance is insufficient. Targeted spontaneous reporting or cohort event monitoring need to be studied for antiretroviral pharmacovigilance

Comparison of efficacy of levofloxacin-metronidazole combination versus ceftriaxone in cases of moderate diabetic foot infection

Background: Foot ulcers are a significant complication of diabetes and are the most common cause of non-traumatic lower extremity amputations in the industrialized world. Diabetic foot infections can be treated effectively with cephalosporins and fluoroquinolnes. The purpose of this study was to compare the efficacy, safety and microbiological outcomes of ceftriaxone and combination of levofloxacin and metronidazole.Methods: This was a prospective, open labelled, randomized controlled trial study. Patients diagnosed of having diabetic foot infection were recruited for the study from the OPD and IPD of the surgery department of Govt. Medical College and Hospital, Miraj and PVP Govt. Hospital, Sangli from June 2007 to December 2007. Signed informed consents were obtained from the patients. The study complied with declaration of Helsinki. Enrolled patients were randomized in 2 groups. Group 1: ceftriaxone group: patients were hospitalized and received ceftriaxone1 gm intravenously for 14 days. Group 2: levofloxacin and metronidazole group: patients were treated as out-patients and received Levofloxacin 500 mg orally once daily with metronidazole 400 mg orally thrice daily for 14 days. Detailed history and complete physical examination was done for all patients. Sequential measurement of the lesion was done, to assess the change in size. Bacteriological evaluation was done. Clinical and microbiological outcome and safety parameters were assessed after treatment.Results: The baseline characteristics in both the groups were comparable and were not significant with each other (p >0.05). In both the groups the most commonly isolated aerobe was staphylococci species followed by different species of enterobacteriacae and pseudomonas. Most commonly isolated anaerobe was bacteroides fragilis. Microbiological and clinical outcomes were assessed and the total no of patients recovered in both groups were almost similar. The percentage of wound healing in both the treatment groups was equal. None of the patients in both the groups had shown complete wound healing. The number of adverse effects associated with the therapies was also similar. The cost of therapies in both the groups were assessed and found the difference was highly significant.Conclusions: Even though combination of levofloxacin-metronidazole and ceftriaxone alone had similar outcomes in terms of efficacy, on contrary in comparison of cost and convenience, levofloxacin - metronidazole therapy was proved better than ceftriaxone in treatment of diabetic foot ulcers

Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques

Background: Diabetic foot ulcers (DFU) are the complications of diabetes mellitus. The diabetic foot ulcer infections are polymicrobial in nature. If they are not recognized and controlled it leads to many devastating consequences like limb amputation, sepsis, and even mortality. Hence, the present study was undertaken to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques and the antimicrobial sensitivity pattern of the isolates.Methods: A total number of 103 patients with a foot ulcer of Wagner’s grade II or more and evidence of purulent exudates or edema were included in the study. Swab samples were obtained from the base of ulcers and were sent for bacteriological study. The specimen was processed in the microbiology laboratory for Gram stain, aerobic culture, and anaerobic culture. The organisms isolated were identified by standard procedures and antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method.Results: A total no of 253 organisms were isolated from 103 patients. Out of these, 217 aerobes were isolated, and the most common organism isolated from gram positive bacteria was Staphylococcus aureus, 53 (24.42 %). Pseudomonas aeruginosa, 42 (19.35 %) was the predominant organism isolated from gram negative bacteria. Among the total 36 anaerobes, Bacteroides fragilis group, 17 (47.22 %) was the most common organism isolated. All the gram positive aerobic organisms were found to be sensitive for vancomycin. Among the gram negative organisms, E. coli, Proteus mirabilis, Proteus vulgaris, showed more sensitivity to cefotaxime (90.62%, 91.66%, 75%) respectively. Metronidazole was the drug of choice in case of anaerobes followed by imipenem.Conclusions: It is necessary to identify the etiological factors and susceptible microorganisms responsible for causation of DFU. So that prompt management of diabetic foot ulcers is possible for successful outcome. Appreciation of the causative organisms in diabetic foot and their antibiotic sensitivity is essential for institution of appropriate antibiotic therapy

Study of website Promotion Techniques and Role of SEO in search engine results

The explosion in the designing of websites to reach maximum people by business sectors has been tremendously increased in last few years. Obviously website is of no use if it not visited. There are number of ways to promote the website and reach to maximum users. To promote website through search engine results is most effective way. Promoting website in search engine result has been completed with Search Engine Optimization (SEO) techniques. It is possible to move a web page to the top list results of a search engine by using only some necessary optimization rules. SEO is helping a web site to appear in first result page of a search engine. SEO is least costly and most effective way to reach many people. In the present paper we explained different website promotion techniques, explores the different search engine optimization techniques with on-page and off-page optimization. This paper reviews the work done by different researcher which identify on-page optimization techniques used in web pages using different methods and among them find out important on-page optimization techniques to help website to rank high in search engine results

Early Breast Cancer Prediction using Machine Learning and Deep Learning Techniques

Breast Cancer (BC) is a considered as one of the utmost lethal diseases across the globe that has a very high morbidity and mortality rate. Accurate and early prediction along with diagnosis is one of the most crucial characteristics for the treatment of Breast Cancer. Doctors can have an edge over Breast cancer if they are able to predict it in its early stages using deep learning and machine learning techniques. This paper proposed consists of comparison between the and accuracy of various machine learning models like Support vector machine (SVM), K-Nearest Neighbours (KNN), Naïve Bayes (NB), Logistic Regression (LR), Random Forest (RF), Decision Tree (DT), XGB Classifier and deep learning model of Artificial neural networks (ANN) for the precise detection of breast cancer. The most crucial properties from the database have been chosen using one feature-selection technique. Correlation is also used to choose the most correlated features from the data. Implementing the ANN model consists of one input layer, two hidden layers, and one output layer. All Machine Learning models and ANN model are then applied to selected features. The results demonstrated that the SVM classifier achieved the highest performance with an accuracy of ~98.24%

A Survey on Cyber Security for Smart Grid Networks

Smart grid is a electrical grid in which power generation units, transmission units, distribution units and electricity consumers are connected using advanced communication and information technologies. It is a new form of next generation power grid. Most of the countries across the globe are transforming their existing electrical grids to smart grid and hence smart grid technology is progressing worldwide. Smart grid provides a bi-directional flow of electricity and information from generation to transmission to distribution and hence more exposed to attacks. Many advanced communication technologies have been identified for smart grid usages. A secure communication infrastructure is a critical component of smart grid systems. Success of smart grids highly depends on secure communication network. Thus cyber security of smart grid networks is very important. In this paper, we summarize the cyber security threats, possible vulnerabilities and existing standards and solutions available for cyber security in smart grids networks based on the available reference material. DOI: 10.17762/ijritcc2321-8169.15050

EVALUATION AND QUALITY CONTROL OF NASAL SPRAY

Nasal drug delivery has now been recognized as a very promising route for delivery of therapeutic compounds including biopharmaceuticals. This route is also advisable for drugs undergoing extensive first pass effect. The present article highlights the evaluation parameters of nasal spray, suspension, and solutions. While formulating the nasal drug delivery formulations various parameters are to be consider such as Appearance, Color, and Clarity, Identification, Drug content (Assay), Impurities and Degradation Products, Preservative(s) and Stabilizing Excipient(s) Assay, Pump Delivery, Spray content uniformity, Spray Content Uniformity (SCU) through Container Life, Spray Pattern and Plume Geometry, Droplet Size Distribution, Particle size distribution (suspension),  Microscopic Evaluation (Suspensions), Foreign Particulates,  Microbial limit,  Preservative Effectiveness, Net Content and Weight Loss (Stability), Leachables (Stability), PH, Osmolality.   Key words: Nasal spray, Evaluation, Quality control, Drug delivery system

Facile green synthesis and characterization of Terminalia arjuna bark phenolic–selenium nanogel: a biocompatible and green nano-biomaterial for multifaceted biological applications

Biogenic nanoparticle production is in demand as it is secure, has great promise, and is environmental friendly. This study aimed at green synthesis, characterization, and evaluation of Terminalia arjuna selenium nanoparticles (TA-SeNPs) for their antioxidant, antibacterial, anticancer activities, and their incorporation in gel for biomedical applications. The bio-reduction attributes of the T. arjuna (TA) bark extract were utilized to fabricate selenium nanoparticles. The TA bark extract is abundant in phenolics (193.63 ± 1.61 mg gallic acid equivalents/g), flavonoids (88.23 ± 0.39 mg quercetin equivalents/g), and tannins (109.46 ± 1.16 mg catechin equivalents/g), which perform as effective capping and stabilizing agents, thus enabling the fabrication of stable SeNPs. The fabrication of TA-SeNPs was corroborated by UV–visible spectra, which exhibited surface plasmon resonance at 291 nm. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) demonstrated nano-sized spherical TA-SeNPs with an average diameter ranging from 100 to 150 nm. Zeta potential analysis revealed that TA-SeNPs were negatively charged (−26.1 mV). X-ray diffraction presented amorphous TA-SeNPs with a quantification of 82.36 ± 10.2 μg/mL resulting from ICP-AES. The IC50 45.18 ± 0.11 μg/mL for the DPPH assay and 66.51% reducing power capacity values indicated that the TA-SeNPs possessed excellent radical scavenging efficacy. Moreover, the TA-SeNPs exhibited a broad spectrum of antimicrobial activity against potential pathogens. Additionally, the TA-SeNPs exhibited a dose-dependent cytotoxic effect on the MCF-7 breast cancer cell line, with an IC50 of 23.41 μg/mL. Furthermore, the TA-SeNP-incorporated gel showed excellent spreadability, extrudability, and consistency with retention of antimicrobial properties and hydrophilic contact angle. As an outcome, TA-SeNPs offer the possibility of the formulation and growth of sustainably designed green SeNPs that can be produced, conserved, and marketed securely across the globe

Phytochemical studies and HPTLC fingerprint profiling of different extracts of Portulaca Quadrifida L.

The present study was designed to detect the class of compound by phytochemical evaluation and perform the high performance thin layer chromatography (HPTLC) fingerprint analysis of hexane extract of P. quadrifida (HEPQ), chloroform extract of P. quadrifida (CEPQ), ethyl acetate extract of P. quadrifida (EAEPQ) and ethanol extract of P. quadrifida (EEPQ). The successive extraction based on eluotropic solvent system was utilised for extraction. The preliminary phytochemical screening was carried out for all the extract. For the HPTLC fingerprint profiling the precoated Merck silica plates were used as stationary phase while, mobile phase utilised was Toluene: Chloroform: Ethanol (5:4:1 v/v/v). The scanning was done at White light, 254 nm and 366 nm. The presence of steroids, coumarins, flavonoids, glycosides, saponins, coumarins was found in all 4 extracts, except the terpenoids which were present in HEPQ and EAEPQ. The fingerprinting profile was successfully obtained for all four extracts of P. quadrifida. This profiling data can thus be utilized for quality control of the P. quadrifida both on qualitative and quantitative basis

A retrospective study to evaluate the pattern of spontaneously reported antiretroviral induced adverse drug reactions in a tertiary care hospital

Background: To evaluate the adverse effect profile of spontaneously reported cases of adverse drug reactions due to antiretroviral (ART) drugs in a tertiary care teaching hospital.Methods: A descriptive retrospective study of pattern of ART induced adverse drug reactions (ADRs) spontaneously reported to the Pharmacology department at a tertiary care hospital from January 2011 to December 2016. The details of suspected ADRs including drugs involved, treatment given for ADRs, and the outcome were also documented. These ADRs were analyzed for causality (WHO scale), severity (Hartwig et al. scale), seriousness (ICH E 2A guidelines), preventability (Schumock and Thornton scale) and type based on Edwards and Aronson classification system.Results: Of the 75 cases of ART induced ADRs, reactions were slightly more common in males (52%) and had median age and duration of ART as 36 years and 109 days respectively. Drug induced anemia was the most common presentation followed by cutaneous ADR and zidovudine being the commonest offender. Severity was moderate in 85.3% and causality was probable in 16% and possible in 84% cases. The type reaction was augmented type in 41.3% and not preventable in 76%.Conclusions: Zidovudine is the commonest drug implicated in causing anemia amongst the antiretrovirals. Spontaneous reporting method for antiretroviral pharmacovigilance is insufficient. Targeted spontaneous reporting or cohort event monitoring need to be studied for antiretroviral pharmacovigilance