Perception of doctors towards Adverse Drug Reaction (ADR) reporting: a cross sectional survey using a validated questionnaire

Background: Several studies have shown lack of sufficient knowledge and awareness among doctors on ADR reporting. Knowledge and attitude of doctors about ADR greatly influences extent of reporting. Identifying factors affecting ADR-reporting is vital to enable Pharmacovigilance teams to implement interventions to enhance rate and quality of reporting of ADRs. Hence, this study is done to evaluate perceptions of doctors towards ADR-reporting and to determine barriers for reporting ADR.Methods: Cross sectional study conducted among doctors using a validated questionnaire to assess knowledge, attitude, practice and barriers for reporting ADRs. The questionnaire captured the demographic details, knowledge (14), attitudes (7) and practice pattern (4) towards pharmacovigilance. Descriptive statistics was used to assess the response among doctors.Results: Of 157 doctors who responded to questionnaire, 90% of doctors were aware of pharmacovigilance program mainly through PVG activities by AMC and pharmacology classes. Only 47% doctors reported ADRs. The composite score on knowledge of ADR reporting and on knowledge of ADR burden was found to be moderate. 90% doctors opined ADR monitoring in hospital should be mandatory. 83% doctors opined ADR reporting by one person can make significant difference to community. One-third doctors felt there should be financial reward for ADR-reporting. In suspected cases, 57% doctors include ADR as differential diagnosis. 61% doctors said they will document ADR in patient file and 78% reports to AMC. More than one-third doctors don’t know where and how to report ADR. One-third doctors felt management of patients was more important than reporting ADR. Nearly one-fourth didn’t report fearing legal liabilities, difficulty diagnosing ADR and negative impact on doctors.Conclusions: Knowledge about ADR-reporting and attitude towards it is adequate. But, because of many barriers, actual practice of ADR-reporting is unsatisfactory. Hence, Pharmacovigilance training is essential for doctors to promote and improve ADR-reporting

A prospective observational study to compare efficacy and safety of methyldopa and nifedipine in management of moderate gestation hypertension

Background: Hypertensive disorder in pregnancy is one of the most common complications of pregnancy worldwide. It is associated with maternal mortality and morbidity as well as perinatal mortality. Antihypertensive drugs are often used to lower blood pressure with the aim of preventing its progression to adverse outcomes for the mother and the fetus. The risk of developing severe hypertension is reduced to half by using antihypertensive medications. Studies have been done using various antihypertensive in hypertensive disorders of pregnancy. But there are very few studied comparing nifedipine and methyldopa in hypertensive disorders of pregnancy where majority of the studies are evaluated for short duration. Hence we have undertaken this study to compare the efficacy and safety of methyldopa and nifedipine in patient with moderate gestational hypertension.Methods: This is a prospective observational study where pregnant patients with moderate gestational hypertension either on oral nifedipine 10 mg t.i.d. or on methyl-dopa 250 mg t.i.d. were enrolled during 6 month period. Data at week one and week four were observed along with side effects. Reduction in systolic and diastolic blood pressure from baseline and occurrence of side effects were studied. The statistical significance was at P < 0.05.Results: The mean reduction of systolic/diastolic BP with methyldopa in four weeks was 17/13 mmHg as compared to nifedipine being 18.5/14.5 in four week. There was significant reduction in systolic blood pressure in nifedipine group compared to methyldopa group at four weeks (p-0.04). Both treatments were well tolerated with minimal side effects.Conclusions: Methyldopa and Nifedipine are equally effective in controlling blood pressure in moderate gestational hypertension with minimal side effects. However, nifedipine can be preferred over methyldopa as it showed significant reduction in systolic blood pressure at four weeks

Characteristics, determinants and cost implications of severe adverse drug reactions in the intensive coronary care unit of a hospital

Background: The objective of the study was to determine the predictors, frequency, characteristics and incremental costs of severe Adverse Drug Reactions in the Intensive Coronary Care Unit (ICCU) of a hospital.Methods: Two trained physicians prospectively reviewed case records of all in-patients admitted to ICCU over one year (July 2015 to June 2016) and identified ADRs. Each ADR was assessed for causality, severity, predictability and preventability. Determinants of severe ADRs were identified using multiple binary logistic regression analysis. Cost of severe ADR was estimated based on the corrected duration of excess hospital stay after adjusting for age, gender, co-morbid conditions and number of drugs.Results: Of 573 cases admitted during one year, 47 (8%) patients had 56 severe ADRs. Streptokinase (16.1%) was the commonest drug associated with severe ADRs. Arrhythmias (30.4%) were the commonest severe ADR. Presence of arrhythmias (OR 4.54, 95% CI 2.25–9.14), renal dysfunction (OR 2.27, 95% CI 1.01–5.11) and poly-pharmacy (>10 drugs) (OR 1.13, 95% CI 1.007- 1.254) were found to be the predictors for occurrence of severe ADRs. Majority of severe ADRs were found to be probable 30 (53.6%). 46 (82%) were predictable and 25 (44.6%) probably preventable severe ADRs. Patients with severe ADRs had a longer duration of ICCU (0.8 extra day) and hospital stay (1.5 extra days) (adjusted analysis). The mean incremental cost incurred by patients in the severe ADR group was $ 32 (INR 2170/-) per patient based on the corrected duration of hospital stay.Conclusions: Severe ADRs in ICCU add considerably to treatment costs. Cardiac arrhythmias, renal dysfunction, and polypharmacy are important predictors of severe ADRs

MEDICINAL SIGNIFICANCE OF NOVEL COUMARINS: A REVIEW

Coumarone is a chemical compound found in many plants. Coumarone having diverse pharmacological properties popularly known as an antimicrobial, Analgesic anti-inflammatory, Anticancer, Antiviral, anticoagulant, antihypertensive, anticonvulsant, antihyperglycemic, antioxidant, activities. Coumarone was also observed in all green color veggies, and also in fruits and their seeds, dark coffee, tea leafs, further it is used for herbal remedies due to having less toxicity, very cheaper. The most useful method for the synthesis of Coumarone is from phenol and ethyl acetate and also by using catalyst. In this paper we tried to update the observations of authors towards the biological and medicinal significance of novel the natural and synthetic coumarone derivatives

Platelet indices and their correlation with HbA1c and association with microvascular complications in type-2 diabetes mellitus

Background: Depending on the aetiology of the DM, factors contributing to hyperglycaemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production. Mean platelet volume (MPV) and platelet distribution width (PDW) are important, simple, effortless, and cost-effective tools measured by hematology analyser which assess the volume and function of platelets. Analysing the platelet parameters can act as an alarm for progression of complications of DM. Hence, we studied the platelet parameters in diabetic patients with good and poor glycaemic control and their association in microvascular complications. Methods: This study was conducted on 100 patients having diabetes mellitus. All the patients were subjected to detailed history regarding age, sex, occupation, socioeconomic status, GPE and systemic examination. Results: Out of 100 cases, 29 patients had a good glycemic control (HbA1c&lt;7%) and 71 had poor glycemic control (HbA1c&gt;7%). Mean FBS was 118.59±19.36 mg/dl in good control group and 158.79±29.21 mg/dl in poor control (p&lt;0.001). Mean PPBS was 159.86±37.78 mg/dl in good control group and 235.80±53.28 mg/dl in poor control group (p&lt;0.001). Good glycemic control group had mean MPV of 7.89±0.63 fl and poor glycemic control group had mean MPV 10.06 fl (p&lt;0.001). Mean PDW was 12.32±1.94 in good control group and 13.81±2.25 in poor control group. Conclusions: Our study indicates that MPV and PDW are increased in diabetic patients, more so in patients with microvascular complications than in those without complications. Hence, they can be used as markers in predicting the microvascular complications in diabetes mellitus.

Characterization and evaluation of morphological and yield traits of tamarind genotypes

The evaluation of morphological and yield traits of tamarind genotypes was carried out during 2017-18 at Forest Research Station, Govinkovi, Honnali taluk, Davangere district. The experiment was laid out in randomized complete block design with 16 genotypes and three replications. Trees were 14-years-old and of grafted origin. All the morphological and yield traits showed significant difference among the selected genotypes indicating the presence of adequate variations. The genotypes recorded morphological variation in terms of tree shape (semi-circle to irregular shape), foliage arrangement (dense to sparse), flowering time (early, mid and late), stem colour (dark brown, brown and light brown), bud colour (greenish white, pink, dark pink), petal colour (yellow and pale yellow), pod colour (greyish brown, brown, light brown and dark brown), pulp colour (light brown, brown and reddish brown), pod shape (straight, slightly curved, curved and deeply curved) and pod size (very big, big, medium and small). The analysis of variance revealed significant difference with respect to tree height, stem girth, pod traits, pod yield per tree (K-9 : 12.80 kg), number of pods per tree (NTI-52 : 989.07) and pulp per cent (K-9 : 48.87). Among the 16 genotypes, the genotype K-9 was found superior with respect to pod size, pod weight, pulp weight and pod yield per tree. Genotype K-9 was found promising and due to perennial in nature further evaluation is required for stability

Fall armyworm, Spodoptera frugiperda (J E Smith): incidence, host range and its management

The invasive fall armyworm (FAW) Spodoptera frugiperda (J.E. Smith) was reported for the first time on maize causing severe damage in Karnataka, India during May 2018. Thereafter, the pest has spread to most states of India and now reported from many south Asian countries. The biology under laboratory condition showed that the fecundity was 1064 eggs. Incubation, total larval and pupal period were observed from 2-3, 14-19 and 9- 12 days, respectively. The larval population varied during different growth stages of the crop on maize in Shivamogga and Davanagere districts during Kharif and Rabi seasons. Heavy population buildup of S. frugiperda in Karnataka on sorghum was recorded in Kalaburgi, Raichur, Koppal and Shivamogga districts in November and December months. The damage on maize during July 2018 to February 2019 varied between 20.0 to 80.0 per cent. The management practices like installation of pheromone traps, removal of eggs and use of two rounds of insecticides (Chlorantraniliprole, spinetoram and emamectin benzoate) were found to be effective in reducing the larval population and recorded higher yield. Efficacy of various aspects on S. frugiperda is discussed in this paper

Sequencing Analysis of Genetic Loci for Resistance for Late Leaf Spot and Rust in Peanut (Arachis hypogaea L.)

The aim of this study was to identify candidate resistance genes for late leaf spot (LLS) and rust diseases in peanut (Arachis hypogaea L.). We used a double-digest restriction-site associated DNA sequencing (ddRAD-Seq) technique based on next-generation sequencing (NGS) for genotyping analysis across the recombinant inbred lines (RILs) derived from a cross between a susceptible line, TAG 24, and a resistant line, GPBD 4. A total of 171 SNPs from the ddRAD-Seq together with 282 markers published in the previous studies were mapped on a genetic map covering 1510.1 cM. Subsequent quantitative trait locus (QTL) analysis revealed major genetic loci for LLS and rust resistance on chromosomes A02 and A03, respectively. Heterogeneous inbred family-derived near isogenic lines and the pedigree of the resistant gene donor, A. cardenasii Krapov. &amp; W.C. Greg., including the resistant derivatives of ICGV 86855 and VG 9514 as well as GPBD 4, were employed for whole-genome resequencing analysis. The results indicated the QTL candidates for LLS and rust resistance were located in 1.4- and 2.7-Mb genome regions on A02 and A03, respectively. In these regions, four and six resistance-related genes with deleterious mutations were selected as candidates for LLS and rust resistance, respectively. These delimited genomic regions may be beneficial in breeding programs aimed at improving disease resistance and enhancing peanut productivity

Experimental investigation of moonpool shapes on a ship with forward speed

A moonpool is a feature of marine drilling platforms, drillships and diving support vessels, some marine research and underwater exploration or research vessels, and underwater habitats, in which it is also known as a wet porch. A floating platform with a moonpool is subjected to different forces due to sloshing and movement of the entrapped fluid in it, while the body is subjected to environmental loads like waves, winds, currents etc.,. Inside a moonpool considerable relative motions may occur, depending on shape and depth of the moonpool and the frequency range of the waves to which it is exposed. The vessel responses are entirely different in zero and non-zero Froude numbers. Later situation is paid attention in this study. There will be different water column elevations in the moonpool depending on the shapes. Two modes of responses are possible based on the shape of the moonpool viz., piston mode for square and sloshing mode for rectangular shape. An aspect ratio of 1:1 for square, 1:1.5 and 1:2 in case of rectangular shapes is considered during experimentation. Circular shaped moonpool is also tested for finding the response. The vessel is initially tested in a towing tank with different drafts and speeds based on Froude scaling. The different modes of oscillations of water column are measured using wave gauge and the vessel resistance is also studied, with and without moonpool. The water column elevation in moonpool may provide better insight to the designer to consider operational and safety parameters

Analysis of folk medicinal plant using atomic absorption spectrometer

613-615Myrtaceae family&rsquo;s folk medicinal plants are very essential for human health care in India and other countries of the world. The common people of Hyderabad -Karnataka region, viz., Bidar, Gulbarga and Yadgir districts, have been traditionally using medicinal plants for treatment of different types of disease. The collected medicinal plants have been dried in clean room without any ventilation and which is free from dust. Usual processes have been adopted to get a fine powder and ash sample, finally prepare 100 mL solution for analysis. A single beam iCE 3000 series atomic absorption spectrometer has been used for elemental analysis. The whole system is controlled via a data station running thermo scientific iCE SOLAAR software which runs under a windows operating system and changing different hollow cathode lamp sources and flames. The instrument was calibrated using different standards for analysis of trace/minor/major elements. In the present study, authors have analysed the 12 useful nutrient elements namely Mg, Al, Si, S, Cl, K, Ca, Cr, Mn, Fe, Cu and Zn in Eucalyptus Oblique and Gava medicinal plants. All estimated elemental concentrations have been found in acceptable quantity in studied medicinal plants (0.01-20.48 mg/L) and the variation of elemental concentration with respect to geographical changes of the regions and found their concentration within the permissible limits of WHO