STUDY ON RISK FACTORS, CLINICAL AND THERAPEUTIC PROFILE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS IN GOVERNMENT GENERAL HOSPITAL

Objective: This study mainly aims to assess and evaluate risk factors, clinical and therapeutical profile in chronic obstructive pulmonary disease (COPD) patients and promote rational drug therapy; to identify the prevalence of COPD symptoms and to assess the drugs prescribed in treating COPD patients; and to evaluate patterns of diagnosing COPD in patients and determine the severity of COPD in patients using COPD assessment test (CAT). Methods: A prospective observational study conducted in government general hospital among 220 patients for 6 months. Data were collected from patients by CAT questionnaire through interviewing each subject. Results: The majority of the patients (36%) were in the age group of 71–80 years. Males are more prone to the COPD (91%). Most common initiation interdependence of these habits are 31–40 years and 61.8% are suffering with comorbidities. A total of 145 (65%) have social habits. About 68% of the patients are suffering from occupational exposure, 78% of the patients are suffering from old pulmonary problems. Conclusion: Clinical pharmacist main provision is providing care to individual patients by patient counseling, regarding the rational usage of drug and also providing proper education regarding the usage of nebulizers and creating awareness to the patients

PRESCRIPTION PATTERN OF ANTIBIOTICS AND THEIR APPROPRIATENESS IN PATIENTS WITH CHRONIC KIDNEY DISEASE-AN OBSERVATIONAL STUDY IN A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA

Objective: The primary objective of the study was to assess the prescribing pattern of antimicrobial agents in patients with chronic kidney disease. The secondary objectives of this study are to assess antibiotic appropriateness and dose optimization in patients with chronic kidney disease in relation to their comorbidities. Methods: A retrospective study was conducted, and medical records of all patients with CKD who were admitted in the nephrology department of Sri Venkateswara Institute of Medical Sciences, Tirupati, during Jan 2018-Dec 2018 were reviewed for antibiotic prescriptions. A total of 200 medical records were selected and assessed for antimicrobial prescriptions. A p-value <0.05 was considered significant throughout the statistical analysis. Results: Analysis showed that overall 163 drugs were prescribed to CKD patients, of which nearly 96 (58.9%) required dosage adjustment. Of those 163 drugs, the majority N= 25 (26%), were unadjusted, and the remaining N = 71 (74%) were properly adjusted. The length of hospitalization of CKD patients was below 7 was 13.5%, above 7 was 86.5%. Mean and SD was 10.27±7.18 d, (Range: 1–35 d). The Chi-square analysis confirmed that out of the seven studied variables, two i.e. Length of stay days; p<0.001. Conclusion: It is concluded that the occurrence of medication dosing errors was moderate in hospitalized chronic kidney disease patients in our study. Nearly 20% of patients who had prolonged stays were prescribed antibiotics for a prolonged period. The predictors of medication dosing errors in CKD patients were the severe-to-end stages of chronic kidney disease, the number of prescribed antibiotics, and the length of hospitalization

Industry 4.0 Benefits, Challenges, Critical Success Factors: Comparative analysis through the lens of Resource Dependence Theory across continents and economies

Purpose: As we enter a new era of digital transformation, Industry 4.0 promises to revolutionize the way we do business, providing unprecedented opportunities and challenges. This study aims to investigate empirically and comparatively analyse the benefits, challenges, and critical success factors of Industry 4.0 (I 4.0) across four continents and developing and developed economies. Methodology: This study employed an online survey to explore the benefits, challenges, and critical success factors of developed and developing economies. In order to ensure the validity of the survey, a pilot test was conducted with 10 respondents. A total of 149 participants with senior managerial, vice-presidential, and directorial positions from developed and developing economies spanning four continents were invited to take part in the survey. Findings: The study ranks benefits, challenges and CSFs across economies and continents. Further, the benefit of Industry 4.0 helping to achieve organizational efficiency and agility differed across the developing and developed economies. Further, the benefit improves customer satisfaction significantly differed across continents; in terms of challenges, Employee resistance to change had a higher proportion in developing economies. Future viability of Industry 4.0 also differed across the continents. Regarding CSFs, there was no difference across the developing and developed economies. Finally, change management and project management vary across the continents. Implications: This study contributes to a balanced understanding of Industry 4.0 by providing empirical evidence for a comparative analysis. Moreover, it extends the concept of Resource- Dependent Theory (RDT) to explain how organizations in developing economies and developed economies deploy resources to manage external condition uncertainties to implement Industry 4.0. Furthermore, this study provides a structural framework to understand the specific benefits, challenges, and critical success factors of implementing Industry 4.0, which can be utilized by policymakers to promote Industry 4.0 in their economies or continents. Originality of Value: As far as our knowledge goes, no studies have empirically demonstrated the comparative analysis of benefits, challenges and CSFs across economies and continents and distinguish an original contribution of our work

Diabetes and heart failure associations in women and men:Results from the MORGAM consortium

Background: Diabetes and its cardiovascular complications are a growing concern worldwide. Recently, some studies have demonstrated that relative risk of heart failure (HF) is higher in women with type 1 diabetes (T1DM) than in men. This study aims to validate these findings in cohorts representing five countries across Europe. Methods: This study includes 88,559 (51.8% women) participants, 3,281 (46.3% women) of whom had diabetes at baseline. Survival analysis was performed with the outcomes of interest being death and HF with a follow-up time of 12 years. Sub-group analysis according to sex and type of diabetes was also performed for the HF outcome. Results: 6,460 deaths were recorded, of which 567 were amongst those with diabetes. Additionally, HF was diagnosed in 2,772 individuals (446 with diabetes). A multivariable Cox proportional hazard analysis showed that there was an increased risk of death and HF (hazard ratio (HR) of 1.73 [1.58–1.89] and 2.12 [1.91–2.36], respectively) when comparing those with diabetes and those without. The HR for HF was 6.72 [2.75–16.41] for women with T1DM vs. 5.80 [2.72–12.37] for men with T1DM, but the interaction term for sex differences was insignificant (p for interaction 0.45). There was no significant difference in the relative risk of HF between men and women when both types of diabetes were combined (HR 2.22 [1.93–2.54] vs. 1.99 [1.67–2.38] respectively, p for interaction 0.80). Conclusion: Diabetes is associated with increased risks of death and heart failure, and there was no difference in relative risk according to sex

Diabetes and heart failure associations in women and men: Results from the MORGAM consortium

BackgroundDiabetes and its cardiovascular complications are a growing concern worldwide. Recently, some studies have demonstrated that relative risk of heart failure (HF) is higher in women with type 1 diabetes (T1DM) than in men. This study aims to validate these findings in cohorts representing five countries across Europe.MethodsThis study includes 88,559 (51.8% women) participants, 3,281 (46.3% women) of whom had diabetes at baseline. Survival analysis was performed with the outcomes of interest being death and HF with a follow-up time of 12 years. Sub-group analysis according to sex and type of diabetes was also performed for the HF outcome.Results6,460 deaths were recorded, of which 567 were amongst those with diabetes. Additionally, HF was diagnosed in 2,772 individuals (446 with diabetes). A multivariable Cox proportional hazard analysis showed that there was an increased risk of death and HF (hazard ratio (HR) of 1.73 [1.58–1.89] and 2.12 [1.91–2.36], respectively) when comparing those with diabetes and those without. The HR for HF was 6.72 [2.75–16.41] for women with T1DM vs. 5.80 [2.72–12.37] for men with T1DM, but the interaction term for sex differences was insignificant (p for interaction 0.45). There was no significant difference in the relative risk of HF between men and women when both types of diabetes were combined (HR 2.22 [1.93–2.54] vs. 1.99 [1.67–2.38] respectively, p for interaction 0.80).ConclusionDiabetes is associated with increased risks of death and heart failure, and there was no difference in relative risk according to sex

Transcriptome profiling reveals bisphenol A alternatives activate estrogen receptor alpha in human breast cancer cells

AbstractBackgroundPlasticizers with estrogenic activity, such as bisphenol A (BPA), have been reported to have potential adverse health effects in humans. Due to mounting evidence of these health effects and public pressure, BPA is being phased out by the plastics manufacturing industry and replaced by other bisphenol variants in “BPA-free” products.ObjectivesWe have compared estrogenic activity of BPA to 6 bisphenol analogues (bisphenol S, BPS; bisphenol F, BPF; bisphenol AP, BPAP; bisphenol AF, BPAF; bisphenol Z, BPZ; bisphenol B, BPB) in three human breast cancer cell lines.MethodsEstrogenicity was assessed by cell growth in an estrogen receptor (ER)-mediated cell proliferation assay, and by the induction of estrogen response element (ERE)-mediated transcription in a luciferase assay. Gene expression profiles were determined in MCF-7 human breast cancer cells by microarray analysis and confirmed by Illumina-based RNA sequencing.ResultsAll bisphenols showed estrogenic activity in promoting cell growth and inducing ERE-mediated transcription. BPAF was the most potent bisphenol, followed by BPB &gt; BPZ ~ BPA &gt; BPF ~ BPAP &gt; BPS. The addition of ICI 182,780 antagonized the activation of ERs by bisphenols. Data mining of ToxCast high-throughput screening assays confirms our results but also shows divergence in the sensitivities of the assays. The comparison of transcriptome profile alterations resulting from BPA alternatives with an ERα gene expression biomarker further indicates that all BPA alternatives act as ERα agonists in MCF-7 cells. These results were confirmed by RNA sequencing.ConclusionIn conclusion, BPA alternatives are not necessarily less estrogenic in a human breast cancer cell model. Three bisphenols (BPAF, BPB, and BPZ) were more estrogenic than BPA. The relevance of human exposure to BPA alternatives in hormone-dependent breast cancer risk should be investigated.</jats:sec

Evaluating the usefulness of 50 millesimal potencies in the treatment of chronic diseases - A retrospective study

Introduction: The 50 millesimal potency, is not fully utilized in our day to day practice. This retrospective study was done to reveal a new horizon for the physicians who use it occasionally and an eye opener for those who have never tried it. Aim: The aim was to evaluate the usefulness of 50 Millesimal potency of indicated medicine in the treatment of chronic diseases from a retrospective study. Materials and Methods: Cases treated with 50 Millesimal potency (LM) during January-May 2014, were screened and based on eligibility criteria, 50 cases were selected to study retrospectively. Treatment outcome was analyzed based on follow-up criteria. Data were statistically analyzed with Chi-square test in GNU PSPP Software. Results: 50 Millesimal potencies have the potential to give significant improvement (P = 0.01) in the treatment of chronic diseases. There were no cases reported with aggravation. The action of LM potency is not influenced (P = 0.97) by previously used Centesimal potency. Constitutional prescription has proved to have significant (P = 0.01) association with treatment outcome with LM potency, whereas Sector prescription (P = 0.12) does not. Irrespective of age, gender, and duration of illness, 50 Millesimal potencies act advantageously. Conclusion: The data suggest that 50 Millesimal potencies have significant beneficial effects in the treatment of chronic diseases

Development and validation of spectrophotometric method for estimation of anastrozole bulk and pharmaceutical dosage formulation

A simple, precise and accurate method was developed and validated by using a simple solvent system for anastrozole bulk and tablet dosage form. In the developed method, water and ethanol are used as solvents. The λmax was determined to be 221nm. The procedure was validated as per ICH rules for Accuracy, Precision, Detection limit, Linearity, Reproducibility and Quantitation limit. The linearity concentration range was 40-60μg/mL with the correlation coefficient of 0.9971. The percentage recovery for anastrozole was found to be 98.6 to 100.8%. Limit of detection and limit of quantitation values were found to be 1μg/mL and 3μg/mL. The method has been successfully used to analyze commercial solid dosage containing 1mg of anastrozole with good recoveries and proved to be robust.Keywords: Anastrozole, Spectrophotometer, Method development, Validatio

The Effectual Spectrum Defragmentation Algorithm with Holding Time Sensitivity in Elastic Optical Network (EON)

The elastic optical network (EON) fulfills the upcoming generation network requirements such as high-definition videos, high bandwidth demand services, and ultra-high-definition televisions. The key issues in EON are routing spectrum assignment and spectrum fragmentation for spectrum allocation. The spectrum fragmentation issues are resultant in poor consumption of spectrum resources and an increase in the new connection blocking. A flexible defragmentation algorithm must utilize more spectrum resources with a high transmission rate. This paper presents a new multiconstrained defragmentation algorithm (MCDFA) for elastic optical networks. The MCDFA addressed two key issues: spectrum allocation for new connections and then reconfiguring the existing connections in a nondisruptive manner. The first-last-exact fit spectrum allocation policy assigns the spectrum slots during the new connection request. It splits each light path request by disjoint/ nondisjoint and by efficiently handling the small fragmented slots in spectrum resources. The simulation results are evaluated using standard metrics such as bandwidth blocking probability, bandwidth fragmentation ratio, and spectrum utilization gain. The results also demonstrated that our proposed algorithm generates promised solution to EON’s routing, spectrum assessment, and fragmentation issues