AN ASSESSMENT OF POTENTIAL DRUG-DRUG INTERACTIONS IN HYPERTENSIVE PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: To an assessment of potential drug-drug interactions in hypertensive patients in a tertiary care hospital. Methods: A prospective, observational study was conducted at a tertiary care hospital, Erode for a period of 8 mo. A sample of 480 patients was assessed for PDDIs using drug checker in Micromedex®-2.7. Results: A total of 430 patients were analyzed and it was found to be 396 (82.50%) hypertensive patients had PDDIs, and a sum total of 1160 PDDIs were observed. Potential drug-drug interactions (PDDIs) higher in female hypertensive patients [255 (64.39%)] compared to males. Incidences of PDDIs were found to be higher in the age group of 60-70 y were [177 (44.69%)] and incidences of interactions based on the duration of (4-6 d) hospital stays were 272 (68.68%). Moreover, 49.24% of patients were found to be prescribed with more than 7 drugs, with higher incidences of PDDIs. Some of the most common drug interacting pair was between aspirin and clopidogrel combination observed in 325 PDDIs in the major, with pharmacodynamics in nature. Conclusion: Clinical pharmacist ought to have the role of regular monitoring of drug therapy in identifying and preventing the medications that have the potential to cause drug-drug interactions, thereby minimizing the undesirable outcomes in drug medical care and improving the quality of care

PHARMACIST INTERVENTION ON IDENTIFICATION OF DRUG INTERACTIONS IN TERTIARY CARE HOSPITALS

Objective: The aim of this study was to assess the potential drug interactions (pDIs) among hospitalized patients in cardiac and neurology wards in 3 tertiary care hospitals.Methods: A prospective, observational study was carried out for a period of 12 mo. A sample of 1330 patients was assessed for pDDIs using Micromedex®-2.7and drugs.com and www.dugs.com.Results: A total of 1330 patients were analyzed and it was found that 685 were cardiac and 645 were neurology patients. The study identified 524 (76.49%) cardiac patients and 425 (65.89%) neurology patients, with potential drug-drug interactions (pDDIs) higher in male cardiac [298 (56.87%)] and male neurology [235 (55.29%)] patients, compared to females. Incidences of pDDIs were found to be higher in the age group of 60-70 y in cardiac [193 (36.83%)] and neurology [165 (38.84%)] patients and incidences of interactions based on duration of (4-6 d) hospital stays in cardiac were 380 (72.53%) and 275 (64.70%) in neurology patients respectively. Moreover, 51.90% cardiac patients and 57.41% neurology patients were found to be prescribed with more number of drugs in cardiac and neurology (7 drugs) patients, were found to have developed higher incidences of pDDIs. The most common drug interacting pair was between aspirin and clopidogrel combination, observed in 245 cardiac and 316 in neurology patients. Drug-food interactions (DFIs) were found with between atorvastatin-citrus fruits in cardiac and phenytoin-protein rich foods in neurology patients. The most common drug-disease interaction (D-DIs) was found to between isosorbide dinitrate–myocardial infarction in cardiac and carbamazepine-seizuresin neurology respectively.Conclusion: It is recommended that physicians should be aware of the interactions among those drugs while prescribing, and careful monitoring is also required

PROSPECTIVE OBSERVATIONAL STUDY ON MYOCARDIAL INFARCTION IN RELATIONSHIP WITH VARIOUS RISK FACTORS

ABSTRACTObjective: The aim of this study was to determine the prevalence of risk factors which influence the increased rate of myocardial infarction in atertiary care hospital.Methods: Data for this 6 months prospective observational study were collected from 227 patients admitted to a tertiary care hospital with acutemyocardial infarction, through patient interviews and case reports and were analyzed.Results: A total of 227 cases were taken for this study. Out of 227 patients, 168 (74.19%) were males and 59 (25.81%) were females. This studyreveals some major risk factors which contribute the increased rate of myocardial infarction and were smoking, chronic alcoholism, obesity, sedentarylifestyle, male sex, physical inactivity, comorbid diseases, sleep disorders as well as age group between 41 and 60 years. No association between oilconsumption coffee intake and a positive association between tea intake was observed. Out of 105 patients diagnosed with ST elevated MI, 55 (52.23%)were treated with fibrinolytic therapy and 50 (47.77%) were excluded from this therapy mainly due to delayed admission. All the patients were foundto be benefited by beta-blocker therapy.Conclusion: Results suggested that awareness regarding moderate physical activity, cessation of cigarette smoking, increased daily consumption offruits and vegetables may reduce the increased myocardial infarction risk.Keywords: Myocardial infarction, Risk factors, Fibrinolytic therapy, Beta blockers

ASSESSMENT OF POTENTIAL DRUG INTERACTIONS AMONG HOSPITALIZED PATIENTS IN NEUROLOGY DEPARTMENT IN TERTIARY CARE HOSPITALS

Objective: This research was instigated to determine and assess the prevalence, severity, type, and the total number of potential drug interactions in the neurology department of two hospitals in India. Methods: The data were collected from the prescriptions and by patient history interview on a daily basis. The drug-drug interactions (DDIs) were identified using Micromedex® database-2.7 and drugs.com. Results: The drug interactions were influenced by a plethora of risk factors: Gender, age, comorbidities, length of hospital stay, and the neurological condition. The study was comprised 320 patients, among 196 patients were identified with potential DDIs (PDDIs), and a total of 450 PDDIs were observed. The prevalence of PDDIs according to the severity was major (42.6%), moderate (45.11%), and minor (12.22%). Conclusion: To lessen PDDIs, the range of medications for the patients must be properly managed, and it is encouraged to remove all medicines without therapeutic advantage, intention, and an indication

Assessment and evaluation of drug information services provided by drug information centre at a multispecialty hospital in Erode, Tamil Nadu, India

Background: To evaluate the performance of Drug Information Centre (DIC) in providing quality drug information services to the health care professionals.Methods: It was a prospective study carried out for a period of six months (June-November 2017). The drug information services provided by the pharmacist at the DIC during ward rounds, direct access, telephone and mail were documented in the drug information request and documentation forms. The quality of drug information provided was assessed with the help of feedback questionnaire which was filled by receivers.Results: A total of 283 queries were received, with a maximum from ward rounds 140(49.47%). On evaluation, it was found that most of the queries were from physicians 207 (73.14%) followed by nurses 33(11.66%), pharmacists 26 (9.18%), patients 17 (6.07%). Among that 178 (62.89%) queries were received from department of general medicine. Most of the queries were intended to update knowledge 110 (38.86%) and for the purpose of better patient care 90 (31.81%). The time frame for an authentic reply ranged from minutes to 24 hours, where a maximum of 110 (38.86%) queries had sent a 24 hours deadline. The majority of the queries were for adverse drug reactions [ADR-60 (21.20%)] and most preferred resources were primary 188 (66.43%).Conclusions: The DIC has always presented and offered itself to be an impressive resource, which is used routinely as an information source by all levels of professionals involved in the health system, in addition to the patients themselves

Sirolimus attenuates disease progression in an orthologous mouse model of human autosomal dominant polycystic kidney disease

In autosomal dominant polycystic kidney disease (ADPKD), abnormal proliferation of tubular cells drives cyst development and growth. Sirolimus, an inhibitor of the protein kinase mammalian target of rapamycin (mTOR) and a potent anti-proliferative agent, decreases cyst growth in several genetically distinct rodent models of polycystic kidney disease (PKD). We determined here the effect of sirolimus on renal cyst growth in Pkd2WS25/− mice; an ortholog of human ADPKD involving mutation of the Pkd2 gene. In Pkd2WS25/− mice treated with sirolimus, both the two kidney/total body weight (2K/TBW) ratio and the cyst volume density (CVD) were significantly decreased by over half compared with untreated mice suffering with PKD. However, there was no effect on the increased blood urea nitrogen (BUN) levels as an index of kidney function. There are two distinct complexes containing mTOR depending on its binding partners: mTORC1 and mTORC2. Western blot analysis of whole kidney lysates and immunohistochemistry of the cysts found that phospho-S6 ribosomal protein, a marker of mTORC1 activity, was increased in Pkd2WS25/− mice and its phosphorylation was decreased by sirolimus treatment. Phospho-Akt at serine 473, a marker associated with mTORC2 activity, was not different between Pkd2WS25/− mice and normal littermate controls. Hence, our study found that inhibition of mTORC1 by sirolimus correlated with decreased renal cyst growth in this model of human ADPKD but had no effect on the decline in renal function

Surface and grain boundary scattering in nanometric Cu thin films: A quantitative analysis including twin boundaries

The relative contributions of various defects to the measured resistivity in nanocrystalline Cu were investigated, including a quantitative account of twin-boundary scattering. It has been difficult to quantitatively assess the impact twin boundary scattering has on the classical size effect of electrical resistivity, due to limitations in characterizing twin boundaries in nanocrystalline Cu. In this study, crystal orientation maps of nanocrystalline Cu films were obtained via precession-assisted electron diffraction in the transmission electron microscope. These orientation images were used to characterize grain boundaries and to measure the average grain size of a microstructure, with and without considering twin boundaries. The results of these studies indicate that the contribution from grain-boundary scattering is the dominant factor (as compared to surface scattering) leading to enhanced resistivity. The resistivity data can be well-described by the combined Fuchs-Sondheimer surface scattering model and Mayadas-Shatzkes grain-boundary scattering model using Matthiessen\u27s rule with a surface specularity coefficient of p = 0.48 and a grain-boundary reflection coefficient of R = 0.26

Dynamic recruitment of microRNAs to their mRNA targets in the regenerating liver.

BACKGROUND: Validation of physiologic miRNA targets has been met with significant challenges. We employed HITS-CLIP to identify which miRNAs participate in liver regeneration, and to identify their target mRNAs. RESULTS: miRNA recruitment to the RISC is highly dynamic, changing more than five-fold for several miRNAs. miRNA recruitment to the RISC did not correlate with changes in overall miRNA expression for these dynamically recruited miRNAs, emphasizing the necessity to determine miRNA recruitment to the RISC in order to fully assess the impact of miRNA regulation. We incorporated RNA-seq quantification of total mRNA to identify expression-weighted Ago footprints, and developed a microRNA regulatory element (MRE) prediction algorithm that represents a greater than 20-fold refinement over computational methods alone. These high confidence MREs were used to generate candidate \u27competing endogenous RNA\u27 (ceRNA) networks. CONCLUSION: HITS-CLIP analysis provide novel insights into global miRNA:mRNA relationships in the regenerating liver