Prescribing pattern of anti diabetic drugs in patients suffering from type 2 diabetes mellitus with co-existing hypertension in a tertiary care teaching hospital

Background: Diabetes mellitus and hypertension frequently co-exist in a patient. In such patients, the risk of complications, morbidity and mortality increases. One should be careful in management and choosing drugs. Authors undertook this study to understand the prescribing pattern of the physicians in diabetic hypertensive patients.Methods: This cross sectional, observational study was conducted in type 2 diabetic outdoor patients with co-existing hypertension, for duration of one year. We used descriptive statistics to analyze data of 615 patients to determine prescribing pattern of drugs.Results: 93.17% of patients were more than 40 years of age. Ratio of female to male patients was 1.30. Mean duration of diabetes was 5.81 years. Multi drug anti diabetic regimes (54.47%) were common than monotherapy (43.90%). Commonly prescribed anti diabetic drug groups were biguanides (89.27%), Sulfonylureas (43.90%) and insulin (15.28%). Metformin (89.27%), glibenclamide (29.11%) and insulin (15.28%) were commonly prescribed anti diabetic drugs. Metformin was the most common monotherapy drug and biguanide + sulfonylurea was the most common two drug combination. Commonly prescribed drugs for co-morbid conditions were enalapril (83.41%), aspirin (30.41%), amlodipine (29.76%) atorvastatin (27.32%) and famotidine (26.34%). Average number of drugs prescribed in a prescription was 4.65. Prescriptions with injections were 15.93% and with brand names were 13.15%.Conclusions: Prescribing pattern of drugs was as per current practices and recommendations of guidelines. Still, there is room for improvement in choice of drug, prescribing drug with generic name and choosing drug from essential medicine list

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

Background: Infection with human immunodeficiency virus (HIV) and subsequent acquired immunodeficiency syndrome (AIDS) continues to be a major public health problem. Treatment and therapeutic guidelines have evolved over a period of time. Drug utilization study helps to evaluate changing pattern of drug use, compliance with national guidelines and rational use of drugs.Methods: Authors conducted observational, non interventional, descriptive study in outdoor HIV positive patients for one year. We have analysed collected data using descriptive statistics to determine drug use indicators and utilization pattern of drugs.Results: Study showed that average number of drugs per encounter was 3.96. The most commonly prescribed antiretroviral therapy (ART) regime was combination of zidovudine, lamivudine with nevirapine (51.92%). Among antiretroviral drugs prescribed, nucleoside reverse transcriptase inhibitors (49.45%) were the most common drug subclass and lamivudine (33.33%) was the most common antiretroviral drug. Second most common medication class was antibacterial agents (18.77%) and co-trimoxazole (10.11%) was the most common antibacterial agent. The third most commonly prescribed drug class was vitamins namely folic acid and multivitamins (2.63 %). Percentage of encounters with an antibiotic prescribed was 41.46%. Tuberculosis was the most common opportunistic infection. In 90.05% of encounters with ART prescriptions, adherence was more than 95%.Conclusions: Overall the results suggest that the prescribing pattern to be in accordance with national guidelines and reflect changing patterns of drug usage in HIV positive patients in World. Drug use indicators reflect rational approach to prescribing pattern

An anthropometric study of intercondylar femur notch with MRI analysis

Background: Anterior cruciate ligament is the most common ligament injury of knee. The bony anatomy of femur and tibia is responsible for normal knee kinematics and static stability. Intercondylar notch dimensions is considered as a significant predictive risk factor for ACL tear. Narrow femoral intercondylar notch width in either sex were major correlating factors. Aim was to evaluate the intercondylar femur notch dimensions in patients of knee injury using magnetic resonance imaging at RD Gardi Medical College, Ujjain, Madhya Pradesh. Methods: This is a prospective study consist of 400 patients carried out from October 2020 to August 2022 in the Department of Orthopaedics, RDGMC Ujjain. All the patients of knee injury including ACL tear and age 18 years to 60 years are included in the study. Patient less than 18 years and more than 60 years were excluded from the study. Dicom radiant software is used as statistical tool to analyse the data. Various intercondylar notch dimensions in different sections are measured using MRI in the dicom software. Results: The cut off values of axial NWI, NSI, NDI as 0.238, 0.662, 0.472 respectively. Conclusions: We conclude that narrow femoral intercondylar notch, lower notch width index increases the risk of an ACL tear in the given population. This would help in identification of people at risk for ACL injuries. Our study provides a comprehensive analysis on the risk factor of ACL tear, which would help in betterment of the patients at danger for anterior cruciate ligament injury. People with decreased notch dimensions should be educated on the high risk of ACL tear and be given proper prophylactic precautions

A study of prescribing pattern of antihypertensive drugs in hypertensive patients with co morbid diabetes in a tertiary care teaching hospital

Background: Hypertension and diabetes mellitus are among the commonest non-communicable diseases. Co-existence of hypertension and diabetes increases morbidity and mortality. So co-existence of these diseases requires attention and rational management. Studying current prescribing pattern of drugs provide data for recommendations and decisions regarding rational practice. We undertook this study to study prescribing pattern.Methods: It was cross sectional, observational, descriptive study in outdoor patients suffering from hypertension and type 2 diabetes mellitus for duration of one year. Data of 601 patients were analyzed using descriptive statistics to determine prescribing pattern of drugs.Results: In this study, 71.55% patients were above 50 years age. Female patients were 56.57%. Average duration of hypertension was 4.08 years. Commonly prescribed antihypertensive drug groups were angiotensin converting enzyme (ACE) inhibitors (85.36%) followed by β receptor blockers (33.44%) and calcium channel blockers (29.95%). Enalapril (85.36%) followed by amlodipine (29.95%) and atenolol (21.46%) were commonly prescribed antihypertensive drugs. Single antihypertensive drug was prescribed in 292 (48.59%) prescriptions. The most common monotherapy drug was enalapril (82.19%). Two antihypertensive drugs were prescribed in 231 (38.43%) prescriptions. The most common two drug combination was ACE inhibitors + β receptor blockers (40.69%). Four antihypertensive drugs were prescribed in only 1.50% prescriptions.Conclusions: From this study, the results suggest that the prescribing pattern of antihypertensive drugs reflects recommendations of current guidelines and practices. However, β receptor blockers were prescribed more commonly. There is room for improvement in choice of drugs

RoboAgent: Generalization and Efficiency in Robot Manipulation via Semantic Augmentations and Action Chunking

The grand aim of having a single robot that can manipulate arbitrary objects in diverse settings is at odds with the paucity of robotics datasets. Acquiring and growing such datasets is strenuous due to manual efforts, operational costs, and safety challenges. A path toward such an universal agent would require a structured framework capable of wide generalization but trained within a reasonable data budget. In this paper, we develop an efficient system (RoboAgent) for training universal agents capable of multi-task manipulation skills using (a) semantic augmentations that can rapidly multiply existing datasets and (b) action representations that can extract performant policies with small yet diverse multi-modal datasets without overfitting. In addition, reliable task conditioning and an expressive policy architecture enable our agent to exhibit a diverse repertoire of skills in novel situations specified using language commands. Using merely 7500 demonstrations, we are able to train a single agent capable of 12 unique skills, and demonstrate its generalization over 38 tasks spread across common daily activities in diverse kitchen scenes. On average, RoboAgent outperforms prior methods by over 40% in unseen situations while being more sample efficient and being amenable to capability improvements and extensions through fine-tuning. Videos at https://robopen.github.io

Effect of the Histone Methyltransferase Specific Probe BRD4770 on Metabolic Profiling of the Endophytic Fungus Diaporthe longicolla

The endophytic fungus Diaporthe longicolla was isolated from the stem of Saraca asoca (Roxb.) Willd., commonly known as Ashok plant in India and Sri Lanka. Since no reports are available regarding epigenetic modulations by BRD4770 in microbial entities, D. longicolla was treated with different concentrations of BRD4770 for this purpose and evaluated for its antioxidant and antibacterial potential against five human pathogenic bacteria, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Shigella boydii, Klebsiella pneumoniae, and Escherichia coli. The crude extract obtained from cultures treated with 100 nM concentration of BRD4770 showed increased antioxidant activity and inhibition zone against S. aureus and MRSA, compared to the non-treated control. The composition of the non-treated and treated crude extract was analyzed, and induced compounds were identified with the help of Gas chromatography–mass spectrometry (GC-MS) and LC-ESI-MS/MS. LC-ESI-MS/MS analysis showed that berberine (antibacterial)-, caffeine-, and theobromine (antioxidant)-like compounds were induced in the BRD4770-treated crude extract. The presence of particular absorbance at a wavelength of 346.5 nm for berberine, 259.4 nm for caffeine, and 278.4 nm for theobromine in the reverse-phase high-performance liquid chromatography (HPLC) analysis of both BRD4770-treated crude metabolites and standard solution of the above compounds strongly supported the increased antibacterial and antioxidant activities that may be due to inducing the alterations in bioactivities of the BRD4770-treated culture

RF Based Remote Control for Electrical Appliances

This work presented here is to control electrical appliances through RF based remote system. From anywhere without any line of sight, RF based wireless remote control system can change the state of the electrical appliances either in off state or in on state. The controlling circuit is built around RF transmitter and RF Receiver modules which are operating at certain frequency along with a encoder and a decoder with few passive components. The four different channels at the encoder IC are used as input switches and the four channels at the decoder output are connected to the electrical devices through a relay. Here the transmission technique is amplitude shift keying (ASK) and the circuit is powered with 9 Volt. The main objective of this work is to control electrical appliances without line of sight requirement using the RF technology. It has many applications like we can control any independent electrical appliance such as T.V, room light, fan just from a remote. Operating them manually is a tedious job and become hectic sometimes. If one can control devices like fan, TV, lights and music system with a remote from a distance place just by pressing the button, life will become simpler. This will make our life more comfortable and easier

Conformational transitions of the sodium-dependent sugar transporter, vSGLT.

Sodium-dependent transporters couple the flow of Na+ ions down their electrochemical potential gradient to the uphill transport of various ligands. Many of these transporters share a common core structure composed of a five-helix inverted repeat and deliver their cargo utilizing an alternating-access mechanism. A detailed characterization of inward-facing conformations of the Na+-dependent sugar transporter from Vibrio parahaemolyticus (vSGLT) has previously been reported, but structural details on additional conformations and on how Na+ and ligand influence the equilibrium between other states remains unknown. Here, double electron-electron resonance spectroscopy, structural modeling, and molecular dynamics are utilized to deduce ligand-dependent equilibria shifts of vSGLT in micelles. In the absence and presence of saturating amounts of Na+, vSGLT favors an inward-facing conformation. Upon binding both Na+ and sugar, the equilibrium shifts toward either an outward-facing or occluded conformation. While Na+ alone does not stabilize the outward-facing state, gating charge calculations together with a kinetic model of transport suggest that the resting negative membrane potential of the cell, absent in detergent-solubilized samples, may stabilize vSGLT in an outward-open conformation where it is poised for binding external sugars. In total, these findings provide insights into ligand-induced conformational selection and delineate the transport cycle of vSGLT