ADVERSE DRUG REACTIONS AMONG DRUG-RESISTANT TUBERCULOSIS TREATMENT: AN OBSERVATIONAL COHORT STUDY

Objective: Adverse drug reaction (ADR) is regarded as one of the major challenges in the treatment of drug-resistant tuberculosis (DR-TB). It can lead to non-compliance or interrupting treatment completion, which can contribute to avoidable morbidity, drug resistance, treatment failure, reduced quality of life, or mortality. Methods: A retrospective cohort study was conducted in the Ernakulam district of Kerala from 2016 to 2019. All DR-TB patients registered under the DR-TB center were enrolled in the study. Due to privacy and confidentiality HIV infected patients and patients below 12 y of age were excluded in this study and only the data with ADR reported by patients is collected from medical records. Results: Out of the total 146 patients, about 75 % of patients experienced at least one ADR during treatment, and a total of 208 ADRs were reported. Among all the ADRs, the most common ADR was gastritis (12.98%) followed by ototoxicity (10%) and vomiting (5.76%), etc. It was found that males (78.76%) within the age group 46-65 y exhibited more ADR than females. Some of the ADR requires drug withdrawal and replacement with other drugs and most of the patients also needed symptomatic treatment without modifying the treatment regimen. All ADR reported were collected and causality assessment was done via WHO and Naranjo scale. The majority of ADR belongs to the “probable” category in the WHO scale and Naranjo scale. The evaluation of the severity of ADR by using the Modified Hartwig and Siegel scale indicated that most of the ADR was of moderate level showing a 4b reaction. The study also assessed the preventability of ADR using the Schumock and Thornton preventability scale. Conclusion: Many of the ADRs were unidentified or not reported due to several reasons like milder ADR, patient lack of knowledge, Negligence of symptoms, unawareness of health providers, etc. Whereas the long-term treatment and diversities in age, gender, etc. were found as major contributors to ADR along with comorbidities. New drugs in combination with existing drugs created the potential for previously unnotified reactions. Pharmacovigilance should address the safety of therapy and identify ADRs, especially the serious ones with routine monitoring to prevent mortality, morbidity, and other negative outcomes

A Novel Hybrid Based Method in Covid 19 Health System for Data Extraction with Blockchain Technology

Millions of people have been afflicted by the COVID-19 epidemic, which has resulted in hundreds of thousands of fatalities throughout the world. Extracting correct data on patients and facilities with and without COVID-19 with high confidence for medical specialists or the government is extremely difficult. As a result, utilizing blockchain technology, a reliable data extraction methodology for the COVID-19 database is constructed. In this accurate data extraction model development and validation study in blockchain technology for COVID analysis, here a novel Hybrid Deep Belief Lionized Optimization (HDBLO) approach is proposed. The weights of the deep model are optimized by the fitness of lion optimization. The implementation of this work is executed using MATLAB software. The simulation outcomes shows the effective performance of proposed model in blockchain technology in COVID paradigm in terms of Mean Absolute Error (MAE), Root Mean Square Error (RMSE), accuracy, F-measure, Processing time, precision and error. Consequently, the proposed approach is compared with the conventional strategies for significant validation

Does the revised cardiac risk index predict cardiac complications following elective lung resection?

Background: Revised Cardiac Risk Index (RCRI) score and Thoracic Revised Cardiac Risk Index (ThRCRI) score were developed to predict the risks of postoperative major cardiac complications in generic surgical population and thoracic surgery respectively. This study aims to determine the accuracy of these scores in predicting the risk of developing cardiac complications including atrial arrhythmias after lung resection surgery in adults. Methods: We studied 703 patients undergoing lung resection surgery in a tertiary thoracic surgery centre. Observed outcome measures of postoperative cardiac morbidity and mortality were compared against those predicted by risk. Results: Postoperative major cardiac complications and supraventricular arrhythmias occurred in 4.8% of patients. Both index scores had poor discriminative ability for predicting postoperative cardiac complications with an area under receiver operating characteristic (ROC) curve of 0.59 (95% CI 0.51-0.67) for the RCRI score and 0.57 (95% CI 0.49-0.66) for the ThRCRI score. Conclusions: In our cohort, RCRI and ThRCRI scores failed to accurately predict the risk of cardiac complications in patients undergoing elective resection of lung cancer. The British Thoracic Society (BTS) recommendation to seek a cardiology referral for all asymptomatic pre-operative lung resection patients with > 3 RCRI risk factors is thus unlikely to be of clinical benefit

Nearshore sediment dynamics of Kavaratti Island, Lakshadweep archipelago using integrated modelling system

845-857The Kavaratti Island of Lakshadweep archipelago exhibits high coastal erosion and shoreline changes due to the anthropogenic stresses on the island morphology. This study focuses on the shoreline analysis using Digital Shoreline Analysis System model and nearshore sediment dynamics using an integrated modeling system with high resolution bathymetry of ~15 m. The sediment load and bed level change were estimated using the sediment transport model through the feedback mechanism of flow and wave forces. The model simulations were performed during winter, pre-monsoon, monsoon and post-monsoon seasons for the year 2015 and calibrated using the field observation datasets. Shoreline change studies indicate the coastal erosion of about 83.43 % and accretion of about 16.55 % along the island coast. The study signifies the erosion around the fishing jetty and accretion at the western (Katchery) jetty due to wave induced currents and tidal influx. The scouring effect due to the presence of tetrapods along the island coast is observed between 0.02 and 0.18 m

Detection of the delayed condensation effect and determination of its impact on the accuracy of gas adsorption pore size distributions

Macroscopic, highly disordered, mesoporous materials present a continuing challenge for accurate pore structure characterization. The typical macroscopic variation in local average pore space descriptors means that methods capable of delivering statistically representative characterizations are required. Gas adsorption is a representative but indirect method, normally requiring assumptions about the correct model for data analysis. In this work we present a novel method to both expand the range, and obtain greater accuracy, for the information obtained from the main boundary adsorption isotherms by using a combination of data obtained for two adsorptives, namely nitrogen and argon, both before and after mercury porosimetry. The method makes use of the fact that nitrogen and argon apparently ‘see’ a different pore geometry following mercury entrapment, with argon, relatively, ‘ignoring’ new metal surfaces produced by mercury porosimetry. The new method permits the study of network and pore–pore co-operative effects during adsorption that substantially affect the accuracy of the characteristic parameters, such as modal pore size, obtained for disordered materials. These effects have been explicitly quantified, for a typical sol-gel silica catalyst support material as a case study. The technique allowed the large discrepancies between modal pore sizes obtained from standard gas adsorption and mercury thermoporometry methods to be attributed to the network-based delayed condensation effect, rather than spinodal adsorption. Once the network-based delayed condensation effect had been accounted for, the simple cylindrical pore model and macroscopic thermodynamic Kelvin-Cohan equation were then found sufficient to accurately describe adsorption in the material studied, rather than needing a more complex microscopic theory. Hence, for disordered mesoporous solids, a proper account of inter-pore interactions is more important than that of intra-pore adsorbate density distribution, to obtain accurate pore size distributions

Using chromosome introgression lines to map quantitative trait loci for photosynthesis parameters in rice (Oryza sativa L.) leaves under drought and well-watered field conditions

Photosynthesis is fundamental to biomass production, but sensitive to drought. To understand the genetics of leaf photosynthesis, especially under drought, upland rice cv. Haogelao, lowland rice cv. Shennong265, and 94 of their introgression lines (ILs) were studied at flowering and grain filling under drought and well-watered field conditions. Gas exchange and chlorophyll fluorescence measurements were conducted to evaluate eight photosynthetic traits. Since these traits are very sensitive to fluctuations in microclimate during measurements under field conditions, observations were adjusted for microclimatic differences through both a statistical covariant model and a physiological approach. Both approaches identified leaf-to-air vapour pressure difference as the variable influencing the traits most. Using the simple sequence repeat (SSR) linkage map for the IL population, 1–3 quantitative trait loci (QTLs) were detected per trait–stage–treatment combination, which explained between 7.0% and 30.4% of the phenotypic variance of each trait. The clustered QTLs near marker RM410 (the interval from 57.3 cM to 68.4 cM on chromosome 9) were consistent over both development stages and both drought and well-watered conditions. This QTL consistency was verified by a greenhouse experiment under a controlled environment. The alleles from the upland rice at this interval had positive effects on net photosynthetic rate, stomatal conductance, transpiration rate, quantum yield of photosystem II (PSII), and the maximum efficiency of light-adapted open PSII. However, the allele of another main QTL from upland rice was associated with increased drought sensitivity of photosynthesis. These results could potentially be used in breeding programmes through marker-assisted selection to improve drought tolerance and photosynthesis simultaneously