A REVIEW ON PATIENT-CONTROLLED ANALGESIA INFUSION SYSTEM

PCA is a patient-controlled analgesia infusion pump, which is used to infuse the medicine into the patients after surgery. It contains a syringe with pain medicine to infuse that is prescribed by the physician. The drugs used for pain control are high-alert medicines, since overmedication may cause death to the patients. These types of unbearable events may happen due to medical errors, prescription errors, adverse events (AEs), etc. Hence, it requires a precautionary attention or continuous monitoring for PCA pump infusion patients. However, always physicians or nurses may not monitor a patient continuously. To provide safety to the patient, the PCA pump needs a smart care process to alert the physician. This study represents the survey on PCA pump errors, AEs, and solutions for it to avoid them. The solution will automatically alert the infusion-related situation of the patients, those are taking the intravenous drug infusion at different procedure rooms in the hospitals. Moreover, it increases the safety to infusion pump with advances of decision-making in health, patient monitoring, alert notification to nursing, and productivity. This quality care can be achieved by integrating the PCA pump with other intelligent systems. Â

Drug utilization study of atopic dermatitis in a tertiary care hospital

Background: Atopic dermatitis is a chronic relapsing hypersensitivity manifestation of the skin which has shown an increasing prevalence world over. It ranges from a mild atopic itch to an unrelenting chronic eczema. Its prevalence which is on the rise necessitates a rational approach to the diagnosis and treatment.Methods: A prospective study was conducted for a period of six months and 245 prescriptions were collected after obtaining requisite permission and a proper informed consent. The data was analysed by using WHO drug use indicators.Results: Of the 245 prescriptions analysed, there was a female predominance with a female to male ratio of 1.63:1. Age group presenting more with the symptoms of atopic dermatitis was 20 to 29 years. Antihistamines were the most commonly prescribed medication (221), Emollients were present in 193 prescriptions. Topical steroids were received by 150 patients of whom 51 were prescribed as an FDC. Tacrolimus was given to 17 patients.Conclusions: It is essential to rule out helminthic infestation, scabies and seborrhoea dermatitis to make a proper diagnosis of atopic dermatitis. More generic prescribing wherever possible might help to reduce the cost per patient

ANTIOXIDANT ACTIVITY OF RHIZOME EXTRACTS OF COLEUS FORSKOHLII BRIQ

Objective: The present study was on the analysis of the phytochemical constituents of Coleus forskohlii which was collected from five different areas in Tamil Nadu, where it is grown for commercial purposes.Methods: C. forskohlii tubers were collected from five areas (Thiruvannamalai, Kanchipuram, Kallakuruchi, Salem, and Vandalur) of Tamil Nadu. Dried tubers were extracted with different solvents such as aqueous, ethanol, and acetone (polar) and petroleum and chloroform (non-polar). Extracts were evaluated for total phenol and flavonoid content and antioxidant activity evaluation by 1,1-diphenyl-2-picrylhydrazyl (DPPH) reduction.Results: The highest DPPH radical scavenging activity (87.6%) was observed in ethanol extract of rhizome collected from Thiruvannamalai area. Total phenol and flavonoid contents were found to be, respectively, 38.82±0.22 mg gallic acid equivalents/g and 21.34±0.32 quercetin equivalent/g.Conclusion: The study clearly indicated the antioxidative potential of different extracts of C. forskohlii and this property may be useful in the preparation of drug formulations, health tonics, and cosmetics

APPLICATION OF MULTIFACTORIAL EXPERIMENTAL DESIGN FOR OPTIMIZATION OF PRODIGIOSIN PRODUCTION USING SERRATIA MARCESCENS MBB01, MBB02 AND MBB05

Objective: The present study was aimed at investigating the prodigiosin production under optimized conditions with different parameters such astemperature, incubation time, substrate concentration, and inoculum size.Methods: Response surface methodology was found to be useful in optimizing and determining interactions among process variables in prodigiosinproduction by applying Box–Behnken and face-centered central composite design.Results: Prodigiosin producing Serratia marcescens (SM) MBB01, MBB02, and MBB05 were isolated from soil (Western Ghats Ecosystem). Thesignificant R value was 0.9666, 0.9459, and 0.9433, and the maximum experimental response for prodigiosin production was 497, 690, and560 mg/mL, whereas the predicted value was 495.3, 706.6, and 574.8 mg/mL for SM MBB01, SM MBB02, and SM MBB05, respectively.2Conclusion: Statistically optimized conditions by Box–Behnken design found to be very significant in improved pigment production by SM MBB01,MBB02, and MBB05. The correlation between the predicted and observed values indicates the adequacy of the model.Keywords: Prodigiosin, Serratia marcescens, RSM

Oxygen delivery system in pre-hospital emergency care in india GVK EMRI 108: a review article

The goal of an effective emergency medical system should be to provide universal emergency care along with assured quality. Oxygen is often used drug in the pre hospital. Oxygen delivery can be monitored by pulse oximetry, typically with a goal of reversing hypoxemia. This paper describes the importance of oxygen in emergency care and its contribution to reducing avoidable death and disability. It also highlights the oxygen delivery systems and training processes /protocols in ambulance based pre-hospital care. In addition, it also shares the usage rates of oxygen and delivery methods in thermal and electrical burns in 108 GVK EMRI, India ambulances. A descriptive study methodology was adopted for explaining the training and pre-hospital care processes of oxygen delivery. Retrospective study method was adopted to measure the oxygen utilization rates in management of burns cases in 108 ambulances in the year 2015. EMTs consistently assessed vitals and provided oxygen to patients’. When EMTs found that patients’ had oxygen saturation less than 95%, they provided supplemental oxygen 95% of the times. EMTs though adhering to the routine use of oxygen in 9 out of 10 cases “where indicated, refresher training should focus on use of oxygen in special circumstances and the benefit to be closely monitored for favourable clinical outcomes”. There is a need to study such common and important essential pre-hospital interventions in all types of emergencies being served

The raising epidemic of COPD in women

Background: Chronic obstructive pulmonary disease (COPD) represents an important public health challenge that is both preventable and treatable. Although it is more frequently observed in males, the number of females with COPD is on the rise due to either active smoking or passive exposure and biomass fuel combustion.Methods: It is a cross sectional study comprising forty female patients with signs and symptoms of COPD and graded according to Global association for obstructive lung diseases (GOLD) spirometry strategy. For all the enrolled patients, clinical history was taken and investigations like chest X-ray, Spirometry, Six minute walk distance test (6MWD) and BODE index was assessed.Results: The majority of cases (72.5%) belong to fifth to sixth decade. Most of cases were from rural area. 85% of the COPD females were smokers. Among non smokers biomass fuel is major risk factor. COPD is common in patients with smoking history of more than 20 years. Duration of exposure to biomass fuel exceeded 45 years in the COPD subjects. The mean 6MWD was 311 meters suggesting low exercise capacity. Most of the patients with severe COPD have BODE score >7 with poor prognosis.Conclusions: This study recognizes the prevalence of reverse chutta smoking among the COPD females and the risk of biomass exposure in the development of COPD in women, especially from rural areas. Identification and control of the risk factors are important steps in prevention and treatment of COPD.

Did human DRD2 haplotypes originate in India? A survey of haplotype frequencies and linkage disequilibrium in the tribes of Eastern Ghats, South India

In recent years, a possible role of the dopamine D2 receptor (DRD2) locus has been reported in various fields like the etiology of alcoholism, neuropsychiatric disorders, etc. Therefore, it has been the focus of considerable attention. DNA analysis has made it easier to study haplotypes, arrays of alleles at closely linked loci along the chromosome. These regions are short enough to show little or no recombination, and behave as blocks that might have ancient origins. Scoring these markers as haplotypes, allows analysis both in terms of haplotype frequencies and identity in terms of linkage disequilibrium. The human dopaminergic system is an important focus of study in the fields of neuropsychiatry and pharmacology; it is also a promising nuclear DNA marker in studies of human genome diversity. Haplotype frequencies and linkage disequilibrium for the dopamine D2 receptor gene (DRD2) were determined in 197 unrelated individuals from four tribal populations of the Eastern Ghats, an important region of India. The three marker systems in this study are highly polymorphic in all the four tribal populations and the haplotype system showed high levels of heterozygosity than the Nilgiri Hill tribes and those in other parts of the world, except Africa. Out of the possible eight haplotypes, seven are commonly shared by all the populations. The ancestral allele B2D2Al accounts for 0.028 to 0.166, which was present in all the groups consistently. The linkage disequilibrium was statistically significant in all the populations. The results show a chance of Indian origin or back migration of human DRD2 haplotypes. Data obtained in this study on DRD2 represent one of the small, but growing number of datasets examining disequilibrium and haplotype frequencies in human populations and also indicate that the gene flows from the Eastern Ghats to the Western Ghats. These populations might be one of the oldest among other Indian populations

Genetic structure and affinities among tribal populations of southern India: a study of 24 autosomal DNA markers

We describe the genetic structure and affinities of five Dravidian-speaking tribal populations inhabiting the Nilgiri hills of Tamil Nadu, in south India, using 24 autosomal DNA markers. Our goals were: (i) to examine what evolutionary forces have most significantly impacted south Indian tribal genetic variation, and (ii) to test whether the phenotypic similarities of some south Indian tribal groups to Africans represent a signature of close relationship to Africans or are due to convergence. All loci were polymorphic and average heterozygosities were substantial (range: 0.347-0.423). Genetic differentiation was high (Gst= 6.7%) and genetic distances were not significantly correlated with geographic distances. Genetic drift therefore probably played a significant role in shaping the patterns of genetic variation observed in southern Indian tribal populations. Otherwise, analyses of population relationships showed that Indian populations are closely related to one another, regardless of phenotypic characteristics, and do not show particular affinities to Africans. We conclude that the phenotypic similarities of some Indian groups to Africans do not reflect a close relationship between these groups, but are better explained by convergence

ALKAPTONURIA SYNDROME-A REVIEW

Alkaptonuria, also called endogenous ochronosis, and also called as Black Urine Disease, is a rare metabolic autosomal recessive disorder. It occurs by complete inhibition of homogentisic acid oxidase enzyme having its deposition in various tissues. Alkaptonuria is caused due to deficiency of homogentisic acid oxidase involved in the metabolism of tyrosine. Dark discolouration of urine, ochronosis at cartilage and connective tissues, arthritis at the third of fourth decade of life, renal stone disease, spontaneous tendon rupture etc. May be seen in alkaptonuria. Disease severity varies among individual patients, even between siblings, and increase with age because of homogentisic acid accumulation. Usually, life span is not shortened in AKU, but the quality of life is severely effected. Several studies have suggested that Nitisinone may be effective in the treatment of alkaptonuria. Characteristically, the excess HGA means sufferers pass dark urine, which upon standing turns black. This is a feature present from birth. Over time patients develop other manifestations of AKU, due to the deposition of HGA in collagenous tissues, namely ochronosis and ochronotic osteoarthropathy. Although this condition does not reduce life expectancy, it significantly affects the quality of life. The natural history of this condition is becoming better understood, despite gaps in knowledge. Clinical assessment of the condition has also improved along with the development of potentially disease-modifying therapy. Furthermore, recent developments in AKU research have to lead to new understanding of the disease, and further study of the AKU arthropathy has the potential to influence therapy in the management of osteoarthritis

Predictors for Gingival Index in Middle-Aged Asian Indians with Type 2 Diabetes from South India: A Cross-Sectional Observational Study

Asian Indians develop type 2 diabetes mellitus (T2DM) much earlier as compared to White Caucasians, due to unique phenotypic and genetic architecture. Periodontitis in T2DM patients is often a neglected clinical feature. This study was conducted to derive predictor variables for gingival index in middle-aged Asian Indians with T2DM in a semiurban population of Dravidian ethnicity from Tamil Nadu, India. T2DM patients (n=232, mean age: 50.6±10.4 years) with periodontitis (n=123, mean age: 54.3±2.4 years) and without periodontitis (n=109, mean age: 55.2±3.1 years) were recruited between 2014 and 2016 by purposive sampling method. Dental examinations for pocket depth (PD) and clinical attachment level (CAL) were performed and gingival index was calculated. Fasting venous blood samples were analysed for measures of glycaemia and cholesterol. Significant positive correlation (p<0.01) was observed for gingival index with glycosylated haemoglobin (HbA1c), pocket depth, presence of T2DM, and clinical attachment level. Stepwise multiple linear regression analysis derived increased pocket depth (p<0.01), elevated HbA1c (p<0.01), clinical attachment level (p<0.01), and presence of diabetes (p<0.01) as significant predictors (r2 value = 0.67) for increased gingival index in middle aged patients with T2DM. These variables significantly (p<0.01) predispose middle-aged T2DM patients to increased gingival index, thus warranting appropriate intervention