An epidemiological study on the prevalence of self-medication practises: a serious threat for the population in the Muvattupuzha region in Kerala, India

This study is an investigation on Self medication, defined as the ‘use of a product without medical prescription or consultation in order to prevent or treat a disease or a symptom or to promote health'. The main issues in self-medication are improper usage of resources, OTC abuse, pathogen resistance and potential side effects with prolonged suffering in many of the cases. A prospective, cross -sectional questionnaire based study was carried out among 450 people selected by random sampling in the Muvattupuzha, Kerala, region. The main objectives of this study were to find out the reason and type of illness for which people self-medicate, prevalence of self-medication during pregnancy, self-medication with antibiotics and pharmacist’s approach while dispensing the OTC drugs. In the study, it was clear that a majority of the population self-medicate which includes the prescription drugs and even antibiotics. Self-medication is a serious public health concern; the remedy is to provide health education and which is the responsibility of all the pharmacists

Microwave-free wide-field magnetometry using nitrogen-vacancy centers

A wide-field magnetometer utilizing nitrogen-vacancy (NV) centers in diamond that does not require microwaves is demonstrated. It is designed for applications where microwaves need to be avoided, such as magnetic imaging of biological or conductive samples. The system exploits a magnetically sensitive feature of NV centers near the ground state level anticrossing (GSLAC). An applied test field from a wire was mapped over an imaging area of $\approx 500 \times 470\,{\mu}\text{m}^2$. Analysis of the GSLAC lineshape allows to extract vector information of the applied field. The device allows micrometer-scale magnetic imaging at a spatial resolution dominated by the thickness of the NV layer (here $50\,{\mu}\text{m}$). For a pixel size of $4\,{\mu}\text{m} \times 3.8\,{\mu}\text{m}$ the estimated sensitivity is $4.8\,{\mu}\text{T}/\sqrt{\text{Hz}}$. Two modalities for visualizing the magnetic fields, static and temporal, are presented along with a discussion of technical limitations and future extensions of the method.Comment: 8 pages,6 figure

Growth promoting activities of antagonistic bacterial endophytes from Hevea brasiliensis (Willd. ex A.Juss.) Müll.Arg.

Rubber plantations are known to udergo various biotic and abiotic stresses. However, the symbiotic bacterial endophytes that inhabit them provide protection. Here, we isolated bacterial endophytes from the rubber tree, Hevea brasiliensis (Willd. ex A.Juss.) Müll.Arg. and studied their antagonistic activity against major pathogens such as Phytophthora meadii, Corynespora cassiicola and Corticium salmonicolar. The antifungal metabolites such as HCN, siderophores and salicylic acid were produced by the antagonistic endophytes under in vitro conditions. Bioassay showed the growth promotion by a consortium of selected antagonistic endophytes in H. brasiliensis seedlings. The photosynthetic efficiency of seedlings increased after endophyte inoculation. Endophyte-treated plants showed accumulation of starch granules in root tissues. The selected antagonistic isolates belong to Bacillus sp. and Pseudomonas sp. The study revealed the biocontrol and growth promoting potential of bacterial endophytes from H. brasiliensi

Growth promoting activities of antagonistic bacterial endophytes from Hevea brasiliensis (Willd. ex A.Juss.) Müll.Arg.

827-833Rubber plantations are known to udergo various biotic and abiotic stresses. However, the symbiotic bacterial endophytes that inhabit them provide protection. Here, we isolated bacterial endophytes from the rubber tree, Hevea brasiliensis (Willd. ex A.Juss.) Müll.Arg. and studied their antagonistic activity against major pathogens such as Phytophthora meadii, Corynespora cassiicola and Corticium salmonicolar. The antifungal metabolites such as HCN, siderophores and salicylic acid were produced by the antagonistic endophytes under in vitro conditions. Bioassay showed the growth promotion by a consortium of selected antagonistic endophytes in H. brasiliensis seedlings. The photosynthetic efficiency of seedlings increased after endophyte inoculation. Endophyte-treated plants showed accumulation of starch granules in root tissues. The selected antagonistic isolates belong to Bacillus sp. and Pseudomonas sp. The study revealed the biocontrol and growth promoting potential of bacterial endophytes from H. brasiliensis

Post-Transplant Outcomes in High-Risk Compared with Non-High-Risk Multiple Myeloma: A CIBMTR Analysis.

Conventional cytogenetics and interphase fluorescence in situ hybridization (FISH) identify high-risk multiple myeloma (HRM) populations characterized by poor outcomes. We analyzed these differences among HRM versus non-HRM populations after upfront autologous hematopoietic cell transplantation (autoHCT). Between 2008 and 2012, 715 patients with multiple myeloma identified by FISH and/or cytogenetic data with upfront autoHCT were identified in the Center for International Blood and Marrow Transplant Research database. HRM was defined as del17p, t(4;14), t(14;16), hypodiploidy (-Y) or chromosome 1 p and 1q abnormalities; all others were non-HRM. Among 125 HRM patients (17.5%), induction with bortezomib and immunomodulatory agents (imids) was higher compared with non-HRM (56% versus 43%, P \u3c .001) with similar pretransplant complete response (CR) rates (14% versus 16%, P .1). At day 100 post-transplant, at least a very good partial response was 59% in HRM and 61% in non-HRM (P = .6). More HRM patients received post-transplant therapy with bortezomib and imids (26% versus 12%, P = .004). Three-year post-transplant progression-free (PFS) and overall survival (OS) rates in HRM versus non-HRM were 37% versus 49% (P \u3c .001) and 72% versus 85% (P \u3c .001), respectively. At 3 years, PFS for HRM patients with and without post-transplant therapy was 46% (95% confidence interval [CI], 33 to 59) versus 14% (95% CI, 4 to 29) and in non-HRM patients with and without post-transplant therapy 55% (95% CI, 49 to 62) versus 39% (95% CI, 32 to 47); rates of OS for HRM patients with and without post-transplant therapy were 81% (95% CI, 70 to 90) versus 48% (95% CI, 30 to 65) compared with 88% (95% CI, 84 to 92) and 79% (95% CI, 73 to 85) in non-HRM patients with and without post-transplant therapy, respectively. Among patients receiving post-transplant therapy, there was no difference in OS between HRM and non-HRM (P = .08). In addition to HRM, higher stage, less than a CR pretransplant, lack of post-transplant therapy, and African American race were associated with worse OS. In conclusion, we show HRM patients achieve similar day 100 post-transplant responses compared with non-HRM patients, but these responses are not sustained. Post-transplant therapy appeared to improve the poor outcomes of HRM

Ageing and dementia in low and middle income countries - Using research to engage with public and policy makers

Abstract While two thirds of the 24 million people with dementia worldwide live in low and middle income countries, very little research has been conducted to support policy making in these regions. Among the non-communicable diseases, dementia (in common with other chronic NCDs linked more to long-term disability than to mortality) has been relatively under-prioritized. International agreements, plans and policy guidelines have called for an end to ageist discrimination and a focus upon reducing disadvantage arising from poverty and the consequences of ill health. Social protection, access to good quality age-appropriate healthcare and addressing the problem of disability are all key issues. However, as yet, little progress has been made in addressing these concerns. In this review we outline the current international policy agenda for older individuals, and its specific relevance to those with dementia and other disabling non-communicable diseases. We consider the potential for epidemiological research to raise awareness, refine the policy agenda, and promote action, using the example of the dissemination strategy developed by the 10/66 Dementia Research Group

Equity in the delivery of community healthcare to older people: findings from 10/66 Dementia Research Group cross-sectional surveys in Latin America, China, India and Nigeria

<p>Abstract</p> <p>Background</p> <p>To describe patterns of recent health service utilisation, and consequent out-of-pocket expenses among older people in countries with low and middle incomes, and to assess the equity with which services are accessed and delivered.</p> <p>Methods</p> <p>17,944 people aged 65 years and over were assessed in one-phase population-based cross-sectional surveys in geographically-defined catchment areas in nine countries - urban and rural sites in China, India, Mexico and Peru, urban sites in Cuba, Dominican Republic, Puerto Rico and Venezuela, and a rural site in Nigeria. The main outcome was use of community health care services in the past 3 months. Independent associations were estimated with indicators of need (dementia, depression, physical impairments), predisposing factors (age, sex, and education), and enabling factors (household assets, pension receipt and health insurance) using Poisson regression to generate prevalence ratios and fixed effects meta-analysis to combine them.</p> <p>Results</p> <p>The proportion using healthcare services varied from 6% to 82% among sites. Number of physical impairments (pooled prevalence ratio 1.37, 95% CI 1.26-1.49) and ICD-10 depressive episode (pooled PR 1.21, 95% CI 1.07-1.38) were associated with service use, but dementia was inversely associated (pooled PR 0.93, 95% CI 0.90-0.97). Other correlates were female sex, higher education, more household assets, receiving a pension, and health insurance. Standardisation for age, sex, physical impairments, depression and dementia did not explain variation in service use. There was a strong borderline significant ecological correlation between the proportion of consultations requiring out-of-pocket costs and the prevalence of health service use (r = -0.50, p = 0.09).</p> <p>Conclusions</p> <p>While there was little evidence of ageism, inequity was apparent in the independent enabling effects of education and health insurance cover, the latter particularly in sites where out-of-pocket expenses were common, and private health insurance an important component of healthcare financing. Variation in service use among sites was most plausibly accounted for by stark differences in the extent of out-of-pocket expenses, and the ability of older people and their families to afford them. Health systems that finance medical services through out-of-pocket payments risk excluding the poorest older people, those without a secure regular income, and the uninsured.</p

Activity of pomalidomide in patients with immunoglobulin light-chain amyloidosis

Immunoglobulin light-chain (AL) amyloidosis is a rare, incurable plasma cell disorder. Its therapy has benefited immensely from the expanding drug armamentarium available for multiple myeloma. Pomalidomide in combination with weekly dexamethasone (Pom/dex) is active among patients with relapsed myeloma. In the present study, we explored the Pom/dex combination in patients with previously treated AL. Patients were eligible for this prospective phase 2 trial if they had had at least one prior regimen and if they had reasonably preserved organ function. Patients were treated with oral Pom/dex. Thirty-three patients were enrolled. The median age was 66 years. Median time from diagnosis to on-study was 37 months. Eighty-two percent had cardiac involvement. The confirmed hematologic response rate was 48%, with a median time to response of 1.9 months. Organ improvement was documented in 5 patients. The median overall and progression-free survival rates were 28 and 14 months, respectively; the 1-year overall and progression-free survival rates were 76% and 59%, respectively. There was a discordance between the hematologic response and the N-terminal probrain natriuretic peptide response. The most common grade 3-5 adverse events, regardless of attribution, were neutropenia and fatigue. We conclude that pomalidomide appears to be a valuable drug covering an unmet clinical need in patients with previously treated AL. The trial is registered at www.clinicaltrials.gov as NCT00558896. (Blood. 2012;119(23): 5397-5404

Correction. "The 5th edition of The World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms" Leukemia. 2022 Jul;36(7):1720-1748

We herein present an overview of the upcoming 5th edition of the World Health Organization Classification of Haematolymphoid Tumours focussing on lymphoid neoplasms. Myeloid and histiocytic neoplasms will be presented in a separate accompanying article. Besides listing the entities of the classification, we highlight and explain changes from the revised 4th edition. These include reorganization of entities by a hierarchical system as is adopted throughout the 5th edition of the WHO classification of tumours of all organ systems, modification of nomenclature for some entities, revision of diagnostic criteria or subtypes, deletion of certain entities, and introduction of new entities, as well as inclusion of tumour-like lesions, mesenchymal lesions specific to lymph node and spleen, and germline predisposition syndromes associated with the lymphoid neoplasms