A questionnaire-based study on the knowledge, attitude, and the practice of ecopharmacology among the healthcare professionals in Amaltas Medical College and Hospital, Dewas, Madhya Pradesh

Background: Ecopharmacology which deals with the health hazards posed by discarded or used medicinal products in the environment, is a globally emerging issue. There are guidelines for pharmaceutical waste management (like GMP and FDA guidelines) for the manufacturing units, pharmacists and consumers. However, it is uncertain whether consumers are aware of it. Before beginning the process of creating awareness, it is first necessary to assess the existing knowledge of the issue in the community. This study was planned to assess the knowledge, attitude and practice (KAP) of ecopharmacology in the medical personnel and students in our institute. Methods: It was a questionnaire based cross-sectional observational study. Study population included MBBS students, nursing students and resident doctors. Total 500 consenting participants were enrolled and subjected to a structured KAP questionnaire and data was expressed in percentage. Questionnaire consisted of 20 questions out of which 3 were open ended and remaining closed ended. Results: Present study result showed that 73% respondents had heard of term ecopharmacology and majority (98%) felt that it was their responsibility to protect environment from pharmaceutical waste. Responses from 83% of participants indicated that they were worried about the excess medicines at their homes. 87% of participants threw it in garbage bin, but (58%) were unsure whether their drug disposing method was safe and 25% knew it was unsafe. Most respondents (94%) felt that there should be guidelines for safe disposal of expired/unused drug and were enthusiastic about participating in campaign for this issue. Medical personnel also suggested some solutions to deal with this problem. Conclusions: Awareness and concern regarding the problem is high however in absence of knowledge of methods of safe disposal of unused drug, it is not transforming into safe disposal practices

Model Studies on Footing Beam Resting on Geogrid Reinforced Soil Bed

Geogrid reinforcement below foundation (resting on layered soil conditions having less bearing capacity) to support footing has considerable effect on shear, settlement and cost reducing alternative to conventional method of support. Therefore, in the present paper, a 2D finite element soil- foundation interaction modeling of a square footing has been carried out to investigate the effect of types of geogrid on sttlement, contact presseure and elastic strain.  Performance level of geogrids made from three different types of polymer polypropylene, polyester and non-polymer (PP, PET and NP) have been analysed. Foundation system consists of a square footing beam resting on layered soil conditions (upper compacted and lower loose). Geogrid reinforcement is provided between upper dense soil and lower loose soil and has been assumed to have finite bending stress and, therefore, idealized as a beam. Both soil layers are also assumed to have finite bending stresses. Analysis is carried out by using a computer software program ANSYS with a two dimensional linear 8-noded isoparametric element. The result of analysis is compared with both the systems (foundation system with geogrid reinforcement & without geogrid reinforcement) and optimum thickness and optimum depth of placement of geogrid reinforcement have been found. It is found that use of geogrid and the types of geogrid affect the behavior of the foundation system significantly. Keywords: Footing beam; Geogrids; Settlement; Contact Pressure

Utility of ST score on admission as a marker for outcome in acute myocardial infarction in a resource constrained setting

Introduction: An early and specific indicator is needed to prognosticate acute myocardial infarction (MI). This indicator should be simple, quick, reliable, non-invasive, inexpensive, and easily applicable to all the patients especially in a resource-constrained setting. The present study tried to evaluated efficacy of ST score on electrocardiography as a prognostic indicator in acute ST-elevated MI (STEMI). Materials and Methods: A prospective study was conducted on consecutive thrombolysed patients of STEMI admitted in teaching hospital. ST score defined as sum of ST-segment elevation in all leads related to infarct location was calculated in standard 12-lead electrocardiographic tracings immediately on admission and then serially postthrombolysis at 90 min, 6 h, 24 h, and day 3 and 5 of admission. Primary end-point was all-cause mortality at 30 days. Results: The mean ST score between survivor and nonsurvivor was 19.27 mm and 16.16 mm, respectively. The score on admission in patients who had poor outcome was significantly higher than those who had good outcome (poor = 20.27 mm vs. good outcome = 12.47 mm; P = 0.002). This difference persisted throughout but was maximum at 90-min postthrombolysis (13.82 mm vs. 7.39 mm; P = 0.0001). The optimal cutoff point maximizing sensitivity and specificity was found at 11 mm for both anterior- and inferior wall MI (IWMI) with a sensitivity of 73% and specificity of 58%. Conclusion: This study concludes that an increase of 1 mm in ST score increased the odds of complications by 1.06 (95% confidence interval [CI], 1.01–1.2) for anterior-wall MI and by 1.09 (95% CI, 0.96–1.2) for IWMI. In a resource-constrained health facility where electrocardiography may be the only available equipment, ST score can easily and effectively be used to stratify patients into high-risk and low-risk categories

Solubility Enhancement and Formulation of Mouth Dissolving Tablet of Clonazepam with Solid Dispersion Technology

Clonazepam (CLZ) is an anticonvulsant benzodiazepine widely used in the treatment of epilepsy. CLZ is a BCS Class II drug and its bioavailability is thus dissolution limited. The objective of the present study was to prepare solid dispersions (SDs) of CLZ by various techniques, using the amphiphilic carrier Gelucire 50/13 in various proportions, to increase its water solubility. Drug-polymer interactions were investigated by Fourier-transform infrared (FTIR) and UltraViolet (UV) spectroscopy. The SDs were characterized physically by differential scanning calorimetry (DSC) and X-ray diffraction (XRD). A phase solubility study was performed and the stability constant (Ks) was found to be 275.27, while the negative Gibbs free energy (ΔGo tr) indicated spontaneous solubilization of the drug. The dissolution study showed that the SDs considerably enhanced the dissolution rate of the drug. The FTIR and UV spectra revealed no chemical incompatibility between the drug and Gelucire 50/13. XRD patterns and the DSC profiles indicated the CLZ was in the amorphous form, which explains the improved dissolution rate of the drug from its SDs. Finally, mouth dissolving tablets (MDTs) were prepared from the optimized batches (kneading method) of solid dispersion, using crospovidone and Doshion P544 resin as superdisintegrants. The tablets were characterized by in-vitro disintegration and dissolution tests. The study of the MDTs showed disintegration times in the range 32.0±0.85 to 20.0±1.30 sec and dissolution was faster than for the commercial preparation. In conclusion, this investigation demonstrated the potential of solid dispersions of a drug with Gelucire 50/13 for promoting the dissolution of the drug and contributed to the understanding of the effect of a superdisintegrant on mouth dissolving tablets containing a solid dispersion of a hydrophobic drug

Optimal Pricing Policies with an Allowable Discount for Perishable Items under Time-Dependent Sales Price and Trade Credit

Trade credit is generally used by businesses to obtain external funds. This article demonstrates an inventory system from the retailer’s point of view in which (1) the influence of trade credit on expanding small businesses and their consumers is the focus of this research, and (2) the retailer’s on-hand inventory follows the non-instantaneous deterioration. (3) To maximize profit, the demand is disclosed, which is based on not just the sales price, but also on cumulative demand, which indicates saturation and diffusion. (4) The product’s initial price and the permitted discount rate at the time of deterioration are considered to be time-dependent functions of the sales price. In the absence of deterioration, the item is sold at a constant rate, and whenever deterioration occurs, the sales price is assumed to be an exponential function of the discount variable. The main aim is to optimize the total profit of the retailer in terms of cycle time and sales price. The traditional algorithm of optimization is used to address the optimization problem. Finally, the theoretical results are validated by solving three numerical illustrations and conducting a sensitivity analysis of the main factors resulting from the following managerial implications: (1) credit period provides the maximum profit margin of any financing method, and (2) an increase in the initial rate of demand raises sales price while increasing overall profit significantly

Deterioration Control Decision Support System for the Retailer during Availability of Trade Credit and Shortages

The deterioration rate is a significant aspect of perishable goods. Since perishable items will always deteriorate, there are effective methods for reducing the rate of deterioration. Furthermore, in the existing inventory control literature, the deterioration rate is often viewed as an exogenous component. Keeping this problem in mind, this article develops the perishable inventory control system from the retailer’s perspective in which: (i) the deterioration rate is a controllable factor and suggests a new fresh quality technology (FQT) indicator, (ii) demand is determined by the perishable product’s quality, that is controlled by its rate of deterioration, (iii) the credit duration is predefined, and (iv) shortages are expected. The key goal is to demonstrate that there is an ideal quantity of the order that minimizes the retailer’s overall cost in terms of cycle time and deterioration rate. Finally, theoretical results are validated by solving two numerical illustrations and conducting a sensitivity analysis of the main factors resulting from the following managerial implications: (i) if the range of deterioration is between zero and one then the retailer should invest in the preservation factor to preserve the perishable product and if greater than one the retailer should not invest in the preservation factor, (ii) credit period significantly reduces the total cost. Hence, this trade credit strategy is more beneficial to the model

Optimal Pricing Policies with an Allowable Discount for Perishable Items under Time-Dependent Sales Price and Trade Credit

Trade credit is generally used by businesses to obtain external funds. This article demonstrates an inventory system from the retailer’s point of view in which (1) the influence of trade credit on expanding small businesses and their consumers is the focus of this research, and (2) the retailer’s on-hand inventory follows the non-instantaneous deterioration. (3) To maximize profit, the demand is disclosed, which is based on not just the sales price, but also on cumulative demand, which indicates saturation and diffusion. (4) The product’s initial price and the permitted discount rate at the time of deterioration are considered to be time-dependent functions of the sales price. In the absence of deterioration, the item is sold at a constant rate, and whenever deterioration occurs, the sales price is assumed to be an exponential function of the discount variable. The main aim is to optimize the total profit of the retailer in terms of cycle time and sales price. The traditional algorithm of optimization is used to address the optimization problem. Finally, the theoretical results are validated by solving three numerical illustrations and conducting a sensitivity analysis of the main factors resulting from the following managerial implications: (1) credit period provides the maximum profit margin of any financing method, and (2) an increase in the initial rate of demand raises sales price while increasing overall profit significantly

Deterioration Control Decision Support System for the Retailer during Availability of Trade Credit and Shortages

The deterioration rate is a significant aspect of perishable goods. Since perishable items will always deteriorate, there are effective methods for reducing the rate of deterioration. Furthermore, in the existing inventory control literature, the deterioration rate is often viewed as an exogenous component. Keeping this problem in mind, this article develops the perishable inventory control system from the retailer’s perspective in which: (i) the deterioration rate is a controllable factor and suggests a new fresh quality technology (FQT) indicator, (ii) demand is determined by the perishable product’s quality, that is controlled by its rate of deterioration, (iii) the credit duration is predefined, and (iv) shortages are expected. The key goal is to demonstrate that there is an ideal quantity of the order that minimizes the retailer’s overall cost in terms of cycle time and deterioration rate. Finally, theoretical results are validated by solving two numerical illustrations and conducting a sensitivity analysis of the main factors resulting from the following managerial implications: (i) if the range of deterioration is between zero and one then the retailer should invest in the preservation factor to preserve the perishable product and if greater than one the retailer should not invest in the preservation factor, (ii) credit period significantly reduces the total cost. Hence, this trade credit strategy is more beneficial to the model