A study of drug prescription patterns, disease-therapy awareness and of quality of life among patients with migraine visiting a tertiary care hospital in Mumbai, India

Background: Migraine is one of the leading causes of disability globally. There is scarcity of data on disease -therapy awareness and its correlation with demographic factors. Hence its was of interest to assess those along with quality of life in these patients. Methods: A Cross-sectional observational study was conducted in108 patients attending the Neurology and headache OPD at a tertiary care hospital between March 2017 and August 2018. Disease and therapy awareness among patients were evaluated using validated questionnaires and correlation was done with demographic factors. The severity of the disease and its impact on the patients' quality of life were assessed using the migraine disability assessment scale. Results: The mean disease and therapy awareness scores were 9 and 7 respectively. Both had a positive correlation with education and socioeconomic factors. The quality of life was affected moderately in 48.1% of the patients followed by severely 32.4% of the patients. The average number of drugs prescribed per encounter was 3.05. NSAIDS were used more commonly as compared to Triptans for acute attacks. Conclusions: The disease and therapy awareness were fair and positively correlated with education/ socioeconomic status. However, a significant disability was found among patients even with treatment. This highlights the need for educating these patients for effectively controlling the disability

Childhood Absence Epilepsy with Tonic-Clonic Seizures and Electroencephalogram 3–4-Hz Spike and Multispike–Slow Wave Complexes: Linkage to Chromosome 8q24

SummaryChildhood absence epilepsy (CAE), a common form of idiopathic generalized epilepsy, accounts for 5%–15% of childhood epilepsies. To map the chromosomal locus of persisting CAE, we studied the clinical and electroencephalographic traits of 78 members of a five-generation family from Bombay, India. The model-free affected–pedigree member method was used during initial screening with chromosome 6p, 8q, and 1p microsatellites, and only individuals with absence seizures and/or electroencephalogram 3–4-Hz spike– and multispike–slow wave complexes were considered to be affected. Significant P values of .00000–.02 for several markers on 8q were obtained. Two-point linkage analysis, assuming autosomal dominant inheritance with 50% penetrance, yielded a maximum LOD score (Zmax) of 3.6 for D8S502. No other locus in the genome achieved a significant Zmax. For five smaller multiplex families, summed Zmax was 2.4 for D8S537 and 1.7 for D8S1761. Haplotypes composed of the same 8q24 microsatellites segregated with affected members of the large family from India and with all five smaller families. Recombinations positioned the CAE gene in a 3.2-cM interval

Image_1_A comparative study of localized phosphorus application and broadcasting method on biomass production and their use efficiency on Chilli (Capsicum annuum) under alkaline soil.jpeg

Rhizospheric based phosphorus (P) fertilizer management is necessary for crop production due to environmental concerns caused by the overuse of the broadcasting method and limited P reserves. This study proposes a comparison of P management that enhances P nutrition in Chilli (variety: Arka Khyati) through seedling root-dipping (SRD) in P-enriched slurry (SSP-amended; pH of 8.1), micro-dose placement (MDP; drill and place closer to plant root), and full dose (187.6 mg kg-1) placement by broadcasting (FD). In SRD, seedlings were dipped in five different P concentrations (50, 100, 200, 300, and 400 mg P2O5 kg-1) for varying durations (0, ½, 1, 2, 3, and 4 hours) and transplanted into pots (dipping in 0 mg P2O5 kg-1 consider as control), along with the MDP and FD treatments (total 33 treatments with 5 replications). [Seedlings dipped in 200, 300, and 400 mg P2O5 kg-1 died within a week after transplanting, thus were excluded from further analysis]. The amount of P received in MDP and FD were 21-90 times higher than P adhesion to seedling roots in SRD treatments. Root volume was in order SRD>MDP>FD. Seedlings dipped in 100 mg P2O5 kg-1 for 2 hours in SRD exhibited the highest biomass production, P-use and -recovery efficiency; and showed an increase of 52%, 178%, and 293% in FD, MDP, and SRD compared to the control respectively. It is recommended to use the SRD method with other P sources in reduced amount to maintain the native P pool in soil, and further multilocational trials are needed to validate.</p

Ofatumumab versus Teriflunomide in Multiple Sclerosis

BACKGROUND: Ofatumumab, a subcutaneous anti-CD20 monoclonal antibody, selectively depletes B cells. Teriflunomide, an oral inhibitor of pyrimidine synthesis, reduces T-cell and B-cell activation. The relative effects of these two drugs in patients with multiple sclerosis are not known. METHODS: In two double-blind, double-dummy, phase 3 trials, we randomly assigned patients with relapsing multiple sclerosis to receive subcutaneous ofatumumab (20 mg every 4 weeks after 20-mg loading doses at days 1, 7, and 14) or oral teriflunomide (14 mg daily) for up to 30 months. The primary end point was the annualized relapse rate. Secondary end points included disability worsening confirmed at 3 months or 6 months, disability improvement confirmed at 6 months, the number of gadolinium-enhancing lesions per T1-weighted magnetic resonance imaging (MRI) scan, the annualized rate of new or enlarging lesions on T2-weighted MRI, serum neurofilament light chain levels at month 3, and change in brain volume. RESULTS: Overall, 946 patients were assigned to receive ofatumumab and 936 to receive teriflunomide; the median follow-up was 1.6 years. The annualized relapse rates in the ofatumumab and teriflunomide groups were 0.11 and 0.22, respectively, in trial 1 (difference, -0.11; 95% confidence interval [CI], -0.16 to -0.06; P<0.001) and 0.10 and 0.25 in trial 2 (difference, -0.15; 95% CI, -0.20 to -0.09; P<0.001). In the pooled trials, the percentage of patients with disability worsening confirmed at 3 months was 10.9% with ofatumumab and 15.0% with teriflunomide (hazard ratio, 0.66; P = 0.002); the percentage with disability worsening confirmed at 6 months was 8.1% and 12.0%, respectively (hazard ratio, 0.68; P = 0.01); and the percentage with disability improvement confirmed at 6 months was 11.0% and 8.1% (hazard ratio, 1.35; P = 0.09). The number of gadolinium-enhancing lesions per T1-weighted MRI scan, the annualized rate of lesions on T2-weighted MRI, and serum neurofilament light chain levels, but not the change in brain volume, were in the same direction as the primary end point. Injection-related reactions occurred in 20.2% in the ofatumumab group and in 15.0% in the teriflunomide group (placebo injections). Serious infections occurred in 2.5% and 1.8% of the patients in the respective groups. CONCLUSIONS: Among patients with multiple sclerosis, ofatumumab was associated with lower annualized relapse rates than teriflunomide. (Funded by Novartis; ASCLEPIOS I and II ClinicalTrials.gov numbers, NCT02792218 and NCT02792231.)