INCIDENCE AND MANAGEMENT OF TREATMENT-RELATED SIDE EFFECTS FOR PATIENTS RECEIVING PLATINUM THERAPY IN AN OUTPATIENT ONCOLOGY CLINIC

  Objective: Platinum agents (PAs) are the most commonly used chemotherapeutic agents, aiming to induce tumor cell death by cytotoxicity. This leads to have high potential for toxicity and adverse effects. The main objectives of this study were to describe the incidence of side effects caused by platinum therapy and to conclude the management of treatment-related side effects for patients receiving platinum therapy.Methods: A descriptive, retrospective study was carried out over a period of 9 months. Laboratory reports of 100 cancer patients were recorded. All statistical analyses were performed using SPSS 17.0 and GraphPad Prism. A p<0.05 (95% confidence interval) was considered significantly throughout the study.Results: Among 100 patients 55% were male and 45% were female. A total of 70% (n=70) patients who received platinum compounds as chemotherapy regimen, among them 97.14% (n=68) patients appears to have anemia. Among the occurrence of adverse drug reactions, the incidence of anemia was found to be significant (n=68, 97.14%). Statistically significant difference was found in the incidence of anemia between PAs and non- PAs treated group (p=0.0001).Conclusion: Among PAs cisplatin-induced anemia and nephrotoxicity appears to be high in this study. There is a need to improve the management of anemia induced by PAs. Since anemia is preventable, this study emphasizes the need to improve the management of anemia induced by PAs

A kinetic and mechanistic study on the silver (I)-catalyzed oxidation of l-alanine by cerium (IV) in sulfuric acid medium

AbstractThe kinetics and mechanism of Ag(I)-catalyzed oxidation of l-alanine by cerium (IV) in sulfuric acid media have been investigated by titrimetric technique of redox in the temperature range of 298–313K. It is found that the reaction is of first order with respect to Ce(IV) and l-alanine, and it is of a positive fractional order with respect to Ag(I). It is found that the pseudo first order ([l-alanine]≫[Ce(IV)]≫[Ag(I)]) rate constant k′ increases with the increase of[H+]. The major oxidation product of alanine has been identified as acetaldehyde by an 1H NMR and IR spectroscopy. Under the experimental conditions, the kinetically active species has been found to be Ce4+. Under nitrogen atmosphere, the reaction system can initiate the polymerization of acrylonitrile, indicating generation of free radicals. On the basis of the experimental results, a suitable mechanism has been proposed. The rate constants of the rate-determining step together with the activation parameters were evaluated

Bio-Analytical Method Development of Repaglinide Drug Delivery Systems

A sensitive, specific and rapid high-performance liquid chromatography-ultraviolet spectroscopy method was developed and successfully validated to estimate the repaglinide in rabbit plasma. The solvent extraction method was used for  repaglinide from serum by using ethyl acetate and 0.1N HCl. The mobile phase consists of acetonitrile: phosphate buffer pH 4.0 at 60:40 %v/v with 1% triethylamine at flow rate of 0.8ml/min and at fixed wavelength of 254nm. On ten minutes of run time, repaglinide was retention at 7.4min. The extraction efficiency 95% for repaglinide. The intra-day and inter-day precision was in the terms of %RSD less than 1.76%. The developed method was validated and proposed method is useful for pharmacokinetics studies.  Keywords: Anti-diabetics, HPLC,Methanol,Phosphate buffer, Repaglinid

Study on Bacteriological profile of Diabetic Foot Infection in a Tertiary Care Hospital.

INTRODUCTION : Diabetes mellitus is a health problem of first order as evidenced by the high prevalence and numerous consequences. Approximately 8.3% of the world population suffers from the disease with a similar proportion of undiagnosed patients. Further the incidence increases with age reaching to 11% in above- 65age group. It is the fourth common cause of death all over world as a direct cause not taking into account the cardiovascular mortality due to Diabetes. Diabetic foot infections are frequently occurring, complicated and costly problems in the lifetime of a diabetic. It ranks first among the most common diabetes related cause of lower limb amputation making upto 20% of all hospital admissions and prolonged hospital stay. Approximately 20% of the diabetic patients develop foot problems in the course of their lifetime and illness. To add further to the burden about 40% of them come back for readmission. Diabetic foot ulcers constitute the most common neurotraumatic cause of amputation as about 50% of the patients require a minor or major amputation. There is 15 to 40 fold increased risk of requiring amputation than non-diabetics. Diabetic foot infection increases the need for surgical management like amputation at various levels by 50% when compared to uninfected Diabetic foot ulcers. The mortality rate reported in developed countries in diabetic foot infections is one among six of the diagnosed patients within one year of diagnosis.8 The burden is obviously under-reported in developing countries due to practical, social and economical grounds. DFI has become one of the major medical, social and economical problem all over the world due to its implications on health and hence human resource. It becomes essential to have a detailed clinical study pertaining to the local burden and pattern of the disease. Enumeration of data from such studies in our locality will serve as pillars to support the implementation of modern multidisciplinary approach in management of DFI. AIMS AND OBJECTIVES : Emphasis the importance of integrated approach towards the diabetic foot management through study of microbiological data in tertiary care hospital. OBJECTIVES: To identify and isolate the common organisms causing infection in diabetic foot ulcers. • To study the Antimicrobial sensitivity pattern of the isolates. • To study the prevalence of Multidrug resistant organisms in the isolates. • To identify the occurrence of Polymicrobial infection in Diabetic foot infection. • To observe the risk factors for Polymicrobial infection in Diabetic foot infection. • To suggest an effective, economical Antimicrobial policy for treatment of Diabetic foot infection. MATERIALS AND METHODS : Observational study. Inclusion Criteria : Patients with H/O Type II Diabetes mellitus: 1. attending Diabetic clinic for DFI/DFU, 2 . admitted in Sugical wards for DFI/DFU. 3. attending surgery OP for DFI/DFU. The patients of all age groups belonging to both the sex with DFU/DFI with or without systemic signs and symptoms of infection were considered and included in the study. Exclusion Criteria: Those with Type I Diabetes mellitus and associated co-morbid conditions, immuno compromised patients, HIV Positive patients were excluded. RESULTS : During the study period from April 2011 to April 2012, a total number of 142 samples were collected from 142 patients with DFI/DFU attending Surgery and Diabetology Out Patient Department and those admitted at Thanjavur Medical College Hospital, Thanjavur. The total 142 samples were processed in the Microbiology laboratory of Thanjavur Medical College and Hospital. Among the total population, 85 males (59.85%) and 57 females (40.15%) were affected by Diabetic foot infection [Table 1]. The mean age of the subjects was out of the 142 specimens processed, 119 (84%) showed significant growth and 23 (16%) yielded no growth of organisms. The processed 119 samples yielded a total of 165 organisms, the polymicrobial isolation being the reason behind. 81(68%) samples yielded monomicrobial growth while 38 samples (32%) showed polymicrobial growth. The following organisms were isolated from the 142 samples subjected for study and the 119 positive cultures. Staphylococcus aureus - 31(26%), Pseudomonas spp. - 28(24%), Proteus spp. - 25(21%), Enterococci -15(13%) Enterobacter-14(12%), Klebsiella spp. - 13(11%), Escherichia coli - 10(8%), CONS - 10(8%), Corynebacterium spp.-8(7%), Nonhemolytic Streptococci-5(4%), Acinetobacter-3 (2.5%) and Citrobacter-3(2.5%). CONCLUSION : This study presents a comprehensive clinical and bacteriological survey of diabetic foot infection in our locality. The non-availability of local data regarding the profile of organisms and their antimicrobial sensitivity pattern is a stimulus for this study. Though earlier data suggest the Gram Positive aerobic bacteria as predominant isolates from infected diabetic foot ulcers, the aerobic Gram negative bacilli are the most frequently isolated. Hence the major etiological factors for DFI in our patients are different. Isolation of multidrug resistant Pseudomonas aeruginosa and increasing fraction of Enterobacter species raises a serious concern about the treatment modality. Higher prevalence of both MRSA isolates and ESBL producing Gram negative organisms confirms that MDRO infection is alarmingly higher in our patients on treatment for diabetic foot infection. The place of study being a referral centre with fluent usage of broad spectrum antibiotics and the non compliance of the patients to prolonged treatment may be the possibility behind

Formulation and Evaluation of Gastroretentive Floating Matrix Tablets of Perindopril Erbumine.

Drug delivery is the method or process of administering a pharmaceutical compound to achieve a therapeutic effect in humans or animals. Drug delivery technologies are the formulation technologies that modify drug release profile, absorption, distribution and elimination for the benefit of improving product efficacy and safety, as well as patient convenience and compliance. It was concluded that an inverse correlation existed between swelling index and the drug release i.e. the formulation having maximum swelling index showed better controlled release. The formulations containing HPMC K100M showed satisfactory results for floating and swelling behaviour as well as controlled release properties. In the best formulation (F1) swelling was strong enough to avoid premature disintegration as well as the burst effect and retarded drug release in a controlled manner for a longer period of time (11 hours) and 12 hour gastric residence was confirmed by invivo studies. Thus floating drug delivery system using high viscosity gel forming polymers would be a promising and feasible approach to achieve controlled release above the absorption zone especially for narrow absorption window drugs like Perindopril erbumine. It is the role of the future scientists to utilize the effectiveness of this delivery system clinically for hypertensive patients

Cluster Based Analysis and Consumption of Food Products in Targeted Public Distribution System

The Public Distribution System in India is 50 years old. At present it is being carried on as an anti-inflationary and antipoverty system. Tamil Nadu, the southernmost State in the country, is adopting the Universal Public Distribution System covering its entire population and supplying regularly rice, wheat, sugar, kerosene and other products like pulses, edible oil etc. The PDS is a centrally sponsored scheme that entitles beneficiaries to subsidized food grains every month. Several challenges have been identified in the implementation of PDS like (i) Targeting errors (ii) Large leakages or diversion (iii) The elimination of bogus cards and (iv) The problems in Fair Price Shops. This paper analyses and evaluates the problems and finds the possible solutions using the data mining techniques based on preprocessing and clustering. The K-means and K-harmonic means algorithms are combined to cluster the data based on the type of food commodities for rice and wheat

Evaluation of Chronic Kidney Disease by Using Visual Evoked Potential and Uremic Markers

BACK GROUND: Chronic Kidney Disease is often unrecognized health problem due to less awareness, less health care facilities. Due to its progressive and irreversible course it may presents with serious complications involving all systems including the central nervous system of our body. AIM AND OBJECTIVE: The aim of the present study was to “evaluate the involvement of central nervous system (CNS) in Chronic kidney disease (CKD) patients by doing Visual Evoked Potentials (VEP) and the estimation of blood levels of uremic markers (Uremic neurotoxins) like Blood Urea, Serum Creatinine. Serum Parathyroid hormone (PTH) in comparison with age matched controls”. The objectives of the study were to determine the subclinical involvement of central nervous system in CKD patients by doing Visual Evoked Potentials and compare it with controls, to assess the uremic neurotoxin’s role in uremic encephalopathy by measuring the blood levels of uremic markers (uremic neurotoxins) like Blood Urea, Serum Creatinine, Serum Parathyroid hormone in CKD patients and compare it with controls, to find out the most vulnerable group of CKD patients by comparing the VEP parameters and blood levels of uremic markers (uremic neurotoxins) among the two CKD groups (CKD3-5 on medical therapy, CKD5D on dialysis and to find the correlation between the Visual Evoked Potential (VEPs) parameters and blood level of uremic marker in Chronic Kidney Disease (CKD) patients. MATERIAL AND METHODOLOGY: 60 diagonsed as CKD (30-CKD3-5, 30-CKD5D) were recruited from Department of Nephrology ,Stanley medical college,Chennai.30 normal subjects were recruited from Master health checkup, Stanley Medical College, Chennai. Ethical committee approval was obtained .Informed and written consent was obtained. After explaining the procedure, VEP recording was done with the RMS Polyrite apparatus. The blood investigation done for the measurement of uremic markers. RESULTS: Means, standard deviations, chi square and 'p' values were calculated by One way ANOVA and ‘t’ test. Chi-square test was used to experiment the importance of disparity among the consolidated (quantitative) variables. Prolonged latencies with highly significant p-value (p<0.0001) of all VEP parameters and reduced amplitude with significant p-value (<0.05) was noticed. Elevated blood levels of all uremic markers was noticed. This altered variables was higher among CKD3-5 with significant p-value(p<0.05) in comparison with CKD 5D. Correlation was noticed but not significant between VEP parameters and blood levels of uremic markers. DISCUSSION: The altered parameters of VEP and Uremic markers may predict the subclinical involvement of central nervous system involvement in CKD patients. CONCLUSION: In order to reduce the morbidity and mortality in CKD patients, VEP recording and the estimation of blood levels of uremic markers may used as a screening tool to identify the subclinical involvement of central nervous system in future

Finite Element Analysis and Experimental Study on the Effect of Extrusion Ratio during Hot Extrusion Process of Aluminium Matrix Composites

The finite element (FE) analysis on the effect of extrusion process parameter namely, extrusion ratio at different billet temperatures on the plastic strain and strain rate of aluminium matrix composite during hot extrusion process has been dealt. The dynamic explicit FE code in ANSYS 15.0 workbench was used for simulation. The FE analysis was carried out on the SiC reinforced aluminium matrix composites for three extrusion ratios 4:1, 8:1 and 15:1, for the billet temperatures in the range 350 °C - 450 °C in steps of 50 °C. The plastic strain and strain rate were found to increase with increase in the extrusion ratio. A minimum strain and strain rate was found to occur at the billet temperature of 450 °C. The silicon carbide particles reinforced aluminium matrix composites were then extruded at the optimised temperature of 450 °C for various extrusion ratios as mentioned above. The effect of extrusion ratio on the microstructure and surface quality of extruded rod was studied

Surgical management of fingertip injuries

Background: Fingertip injuries are common due to industrial accidents, ranging from small laceration and nail bed injuries to traumatic amputation and severe crush. It is best retain as much native tissue when viable. Surgical options in treating the fingertip injuries are individualized to each patient considering the injury pattern, age, hand dominance and occupation.Methods: It is a retrospective study of 102 fingertip injuries in 95 patients, whose age ranges from 2 years to 60 years over a period of 3 years.Results: In 90% of patient’s primary wound healing was achieved in 2 weeks period. All were satisfied with the functional outcome and average period of returning to the work is 4 weeks. Conclusions: Fingertip injuries needs individualized management specialized to achieve optimum results, maximum patient satisfaction rates and early return to pre injury occupation level

Development and Validation of Glimepiride and Metformin in Human Plasma by HPLC: An application study

A simple and cost effective RP-HPLC method is developed for simultaneous estimation of glimepiride (GLIM) and metformin (MET) at tablet dosage form using C-18 column (4.6 x 250mm, 5?, 100 A?) with a mobile phase composed ofmethanol: water (90:10% v/v) buffered with ortho phosphoric acid at a flow rate of1.0 mL/min (UV detection at 231 nm). The retention time of both drugs (GLIM and MET) are observed as 4.286 and 2.262 respectively. Human plasma spiking studies of both the API and the formulation at the concentration of (0.2g/mL - 1g/mL) for glimepiride and metformin (1g/mL - 5g/mL) expresses the standard correlation coefficients of 0.9998 and 0.9999 respectively for API and 0.9917 and 0.99 respectively for the tablet dosage form. The mean (%) recoveries of glimepiride and metformin are 99.98 and 99.9% respectively. The % RSD below 0.5 shows the high precision of the proposed method. Assay studies revealed that 98.05% of purity is observed for glimepiride and 99.69 for metformin in a tablet dosage form. Human plasma spiking studies revealed that a minimal quantum of glimepiride had been bound with the plasma proteins compare to metformin in the tablet dosage form. The method was validated as per the ICH guidelines