USE OF SIMULATION IN PHARMACY PRACTICE AND IMPLEMENTATION IN UNDERGRADUATE PHARMACY CURRICULUM IN INDIA

The use of simulation and related technology in healthcare education will continue to increase in the coming years and there is a collective role for this technique within pharmacy curricula. It is anticipated that increasing the amount of simulation in pharmacy curricula will have a positive impact on education and training of pharmacy students, and ultimately produce positive benefits for patients and the healthcare team. The apparent objective of introducing simulation techniques into the training program for pharmacy students is to advance the education and training of pharmacists with the ultimate objective of improving patient care and safety. Simulation experiences could never substitute experiences in real clinical settings, but has a great potential to complement clinical education as well as to use as a provision to develop skills required for a competent pharmacist. In addition to the development of technical skills such as procedural and clinical skills, simulation techniques have been used in pharmacy education in addressing general cognitive and social skills, notably in communication, decision-making, ethical issues, prioritization and teamwork. Pharmacy programs which aim to provide an opportunity for theoretical knowledge to be applied to a real clinical setting, simulated learning environments could enable a more systematic approach to both the training of clinical skills. Simulation provides a consistent, predictable experience to basic sciences, dispensing and medication supply. Ideally, it was recognized that simulation training should be integrated across all levels of pharmacy education and training.Keywords: Simulated Learning Program, Experiential education, Pharmacy practice, Indi

Quantitative genetic manipulation for nauplii size reduction of Artemia franciscana Kellogg, 1906 from Indian salinas and correlated changes in the polyunsaturated fatty acids (PUFA) profile

Thirteen generations of mass selection was carried out in a strain of Artemia franciscana collected from an Indian salina. The primary trait under selection was nauplii length, and the criteria of selection was small size. While 12.4% reduction (from 517.0±59.8 μm to 452.2±25.0 μm) was realised in the trait under selection from 13 generations, substantial increase in the polyunsaturated fatty acids (PUFA) content was realised as correlated response. The polyunsaturated fatty acid (PUFA) content showed a steady increase during the selection. The PUFA percentage in G2, G4, G6, G9, G11 and G13 generations were 21.43, 27.96, 27.19, 33.27, 36.98 and 37.25 respectively compared to 18.04 in the base generation. The content of essential polyunsaturated fatty acids such as 20:5n-3 and 22:6n-3 were also high in the selected generations, compared to the base generation indicating their nutritional superiority. The smaller nauplii with an enhanced level of PUFA, especially the essential polyunsaturated fatty acids, developed through selective breeding in the present work make it a promising strain as live feed for larviculture of marine species

Using artificial intelligence methods for systematic review in health sciences : A systematic review

The authors thank Mr. Josh Higashi for aiding in the post-hoc full-text screening.Peer reviewedPostprin

Spermidine/Spermine N1-Acetyltransferase 1 (SAT1)—A Potential Gene Target for Selective Sensitization of Glioblastoma Cells Using an Ionizable Lipid Nanoparticle to Deliver siRNA

Spermidine/spermine N1-acetyltransferase 1 (SAT1) responsible for cell polyamine catabolism is overexpressed in glioblastoma multiforme (GB). Its role in tumor survival and promoting resistance towards radiation therapy has made it an interesting target for therapy. In this study, we prepared a lipid nanoparticle-based siRNA delivery system (LNP-siSAT1) to selectively knockdown (KD) SAT1 enzyme in a human glioblastoma cell line. The LNP-siSAT1 containing ionizable DODAP lipid was prepared following a microfluidics mixing method and the resulting nanoparticles had a hydrodynamic size of around 80 nm and a neutral surface charge. The LNP-siSAT1 effectively knocked down the SAT1 expression in U251, LN229, and 42MGBA GB cells, and other brain-relevant endothelial (hCMEC/D3), astrocyte (HA) and macrophage (ANA-1) cells at the mRNA and protein levels. SAT1 KD in U251 cells resulted in a 40% loss in cell viability. Furthermore, SAT1 KD in U251, LN229 and 42MGBA cells sensitized them towards radiation and chemotherapy treatments. In contrast, despite similar SAT1 KD in other brain-relevant cells no significant effect on cytotoxic response, either alone or in combination, was observed. A major roadblock for brain therapeutics is their ability to cross the highly restrictive blood–brain barrier (BBB) presented by the brain microcapillary endothelial cells. Here, we used the BBB circumventing approach to enhance the delivery of LNP-siSAT1 across a BBB cell culture model. A cadherin binding peptide (ADTC5) was used to transiently open the BBB tight junctions to promote paracellular diffusion of LNP-siSAT1. These results suggest LNP-siSAT1 may provide a safe and effective method for reducing SAT1 and sensitizing GB cells to radiation and chemotherapeutic agents

Methodological approaches for assessing certainty of the evidence in umbrella reviews: A scoping review

INTRODUCTION: The number of umbrella reviews (URs) that compiled systematic reviews and meta-analysis (SR-MAs) has increased dramatically over recent years. No formal guidance for assessing the certainty of evidence in URs of meta-analyses exists nowadays. URs of non-interventional studies help establish evidence linking exposure to certain health outcomes in a population. This study aims to identify and describe the methodological approaches for assessing the certainty of the evidence in published URs of non-interventions. METHODS: We searched from 3 databases including PubMed, Embase, and The Cochrane Library from May 2010 to September 2021. We included URs that included SR-MAs of studies with non-interventions. Two independent reviewers screened and extracted data. We compared URs characteristics stratified by publication year, journal ranking, journal impact factor using Chi-square test. RESULTS: Ninety-nine URs have been included. Most were SR-MAs of observational studies evaluating association of non-modifiable risk factors with some outcomes. Only half (56.6%) of the included URs assessed the certainty of the evidence. The most frequently used criteria is credibility assessment (80.4%), followed by GRADE approach (14.3%). URs published in journals with higher journal impact factor assessed certainty of evidence than URs published in lower impact group (77.1 versus 37.2% respectively, p < 0.05). However, criteria for credibility assessment used in four of the seven URs that were published in top ranking journals were slightly varied. CONCLUSIONS: Half of URs of MAs of non-interventional studies have assessed the certainty of the evidence, in which criteria for credibility assessment was the commonly used method. Guidance and standards are required to ensure the methodological rigor and consistency of certainty of evidence assessment for URs

Lack of detection of SARS-CoV-2 in wildlife from Kerala, India in 2020–21

Spillover of SARS-CoV-2 into a variety of wild and domestic animals has been an ongoing feature of the human pandemic. The establishment of a new reservoir in white-tailed deer in North America and increasing divergence of the viruses circulating in them from those circulating in the human population has highlighted the ongoing risk this poses for global health. Some parts of the world have seen more intensive monitoring of wildlife species for SARS-CoV-2 and related coronaviruses but there are still very large gaps in geographical and species-specific information. This paper reports negative results for SARS-CoV-2 PCR based testing using a pan coronavirus end point RDRP PCR and a Sarbecovirus specific E gene qPCR on lung and or gut tissue from wildlife from the Indian State of Kerala. These animals included: 121 Rhinolophus rouxii (Rufous Horsehoe Bat), six Rhinolophus bedommei (Lesser Woolly Horseshoe Bat), 15 Rossettus leschenaultii (Fulvous Fruit Bat), 47 Macaca radiata (Bonnet macaques), 35 Paradoxurus hermaphroditus (Common Palm Civet), five Viverricula indica (Small Indian Civet), four Herpestes edwardsii (Common Mongoose), ten Panthera tigris (Bengal Tiger), eight Panthera pardus fusca (Indian Leopard), four Prionailurus bengalensis (Leopard cats), two Felis chaus (Jungle cats), two Cuon alpinus (Wild dogs) and one Melursus ursinus (sloth bear)

Unraveling the effects of live microalgal enrichment on Artemia nauplii

Artemia nauplii, though deficient in many essential nutrients, are used extensively in fish/shellfish larviculture. Enrichment using various diets can enhance their nutrient profile to the required level. The present study examines the effects of enrichment of Artemia nauplii with live microalgae viz., Pavlova viridis, Isochrysis galbana, Nannochloropsis oculata and Dicrateria inornata. Total length and width, survival percentage and the fatty acid profile of the microalgae enriched and unenriched nuaplii were estimated at 0, 1, 3, 5, 7 and 9 h time intervals. No significant increase in total length and width was observed between the enriched and unenriched Artemia nauplii during the study, indicating the absence of any enrichment diet induced growth rate of the nauplii. Salinity stress study revealed that the microalgae enriched nauplii can live long in low saline conditions than the unenriched nauplii. The total PUFA content of the live microalgae enriched nauplii reached maximum at 7 h post-enrichment followed by a significant drop after 9 h. The results of the study indicated that live microalgae can be used as excellent enrichment dietary sources for Artemia nauplii, which in turn can provide many of the vital nutrients essential for fish larviculture

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature.</p> <p>Case presentation</p> <p>We report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma.</p> <p>Conclusion</p> <p>It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.</p

Efficacy and safety of celecoxib on the incidence of recurrent colorectal adenomas: a systematic review and meta-analysis

Background: Celecoxib has previously been shown to be effective in reducing recurrent colorectal adenomas, but its long-term effects are unknown. In addition, safety issues are of major concern. Therefore, we examined the efficacy and safety of celecoxib as a chemopreventive agent along with its posttreatment effect. Methods: We performed a meta-analysis based on a systematic review of randomized controlled trials (RCTs) comparing celecoxib at various doses (400 mg once daily, 200 mg twice daily, and 400 mg twice daily) vs placebo in persons with history of colorectal adenomas. Several databases were searched from inception up to April 2018. Long-term follow-ups of RCTs were also included to evaluate posttreatment effect. Primary outcome was the incidence of recurrent colorectal adenomas. Various safety outcomes were evaluated, especially cardiovascular (CV) events. Risk-benefit integrated analyses were also performed. Results: A total of three RCTs (4,420 patients) and three post-trial studies (2,159 patients) were included in the analysis. Use of celecoxib at any dose for 1-3 years significantly reduced the incidence of recurrent advanced adenomas (risk ratio, 0.42 [95% CI, 0.34-0.53]) and any adenomas (0.67 [95% CI, 0.62-0.72]) compared with placebo. Subgroup analysis on different dosing suggested a greater effect with 400 mg twice daily. However, celecoxib 400 mg twice daily significantly increased the risk of serious adverse (1.2 [95% CI, 1.0-1.5]) and CV events (3.42 [95% CI, 1.56-7.46]), while celecoxib at 400 mg/day, especially with once daily dosing, did not increase CV risk (1.01 [95% CI, 0.70-1.46]). Analysis of post-trial studies indicated that the treatment effect disappeared (1.15 [95% CI, 0.88-1.49]) after discontinuing celecoxib for >2 years. Conclusion: Celecoxib 400 mg once daily dosing could potentially be considered as a viable chemopreventive option in patients with high risk of adenomas but with low CV risk. Long-term trials on celecoxib at a dose of ≤400 mg either once or twice daily are warranted