Evaluation the pattern of adverse drug reactions by non-steroidal anti-inflammatory drugs at the outpatient orthopedics department of a university teaching hospital in north India

Background: The study was conducted with an aim to evaluate the pattern of occurrence of adverse drug reactions (ADRs) of Non-steroidal anti-inflammatory drugs (NSAIDs) in orthopedic patients in a tertiary care teaching hospital of North India.Methods: An observational study was carried out in the orthopedic outpatient department at the tertiary care hospital for the period of six months. All patients diagnosed with acute pain and receiving NSAIDs were included. The documented ADRs were assessed for causality, severity and preventability using Naranjo’s algorithm and WHO-UMC scale, modified Hartwig and Seigel Scale and modified Schumock and Thornton scale, respectively.Results: A total of 84 ADRs were reported from 51 patients. The most common ADRs observed were from gastrointestinal (38%) followed by skin (18%) and autonomic nervous system (12%). Maximum number of ADRs were reported in patients on diclofenac (47%) followed by piroxicam (44%). Upon causality assessment, majority of the reactions were possible (61.5% with WHO-UMC scale, and 57.1% with Naranjo’s algorithm). The association of results between the two scales was statistically significant (p<0.001). Majority of ADRs (73.4%) were assessed as mild and 66.7% of the ADRs were probably preventable.Conclusions: Authors conclude that incidence of ADRs can be decreased and compliance can be improved by early detection and management

Evaluation of propranolol, flunarizine and divalproex sodium in prophylaxis of migraine

Background: Preventive treatment has an important role in the management of migraine. Propranolol and flunarizine have been used for more than two decades while, open-label, controlled studies suggest divalproex sodium may also be efficacious for migraine prevention. The objective of the study to compare efficacy and safety of propranolol, flunarizine and divalproex sodium in patients for migraine prophylaxis.Methods: Following approval from IEC a 12-week randomized, open, comparative study was carried out at the outpatient department of Medicine. Patients between 18 to 65 years, with history of 3 to 12 migraines a month (IHS) for six months were included. Patients were divided into three groups of 30 patients to receive - propranolol 20 to 160mg/day; flunarizine 5 to 10mg/day or divalproex sodium 250 to 750mg/day, for three months.Results: Total 90/116 patients completed the study. No significant differences were found between the groups with regards to mean age or other baseline migraine features. All the drugs significantly decreased the frequency, duration and severity of migraine (P<0.001). There is no statistically significant difference between propranolol, flunarizine and divalproex sodium for any of the efficacy parameters. All the three treatments were well-tolerated and safe.Conclusions: All the three study drugs were equally effective with an acceptable tolerability profile, Divalproex sodium group showed more side effects, none of which were serious. However, further studies with larger number of patients and longer duration of treatment are recommended

Effect of moisture content on engineering properties of oats (Avena sativa L.)

The present study was undertaken to investigate the effect of moisture content on engineering properties of OL-09 variety of oat grains. Different engineering properties such as length, width, thickness, geometric mean diameter, volume, surface area, sphericity, bulk density, true density, porosity, angle of repose and angle of internal and external friction were determined in a moisture range of 8%-14% (wet basis, w.b) using standard methods. The physical properties such as length, width, thickness, geometric mean diameter, volume, surface area and sphericity significantly (P &lt;0.05) increased from 15.01 to 16.19 mm, 3.06 to 3.60 mm, 2.78 to 3.11 mm, 5.03 to 5.65 mm, 37.00 to 52.98 mm3, 76.03 to 94.80 mm2 and 33.58% to 35.01%, respectively as the moisture content increased from 8% to 14%.In the same moisture range, bulk density decreased from 474.32 to 408.19 kg/m3, while true density, porosity and thousand grain weight increased from 1017.54 to 1132.90 kg/m3, 53.35% to 63.94% and 41.45 to 44.84 g, respectively. Frictional properties like angle of repose, coefficient of internal friction and coefficient of external friction for wooden surface and galvanized iron sheet increased from 21.26 to 25.46˚, 0.67 to 0.76, 0.55 to 0.70 and 0.49 to 0.63 with increase in moisture content in same range, respectively. The coefficient of determination, obtained R2 for the considered various engineering properties showed a close correlation with increase in moisture content

UNBOUND

Featured here, are the extraordinary works of our graduating Fanshawe Design class. This accomplishment is truly a celebration of the three years of passion, hard work, and dedication put forth by our students. It is our greatest hope that family, friends and the fashion industry will enjoy the creative endeavors of these emerging designers from the Fashion Design program at Fanshawe College in London, Ontario.https://first.fanshawec.ca/famd_design_fashiondesign_unbound/1001/thumbnail.jp

Genetic Removal of Matrix Metalloproteinase 9 Rescues the Symptoms of Fragile X Syndrome in a Mouse Model

Fragile X syndrome (FXS), the most common single gene cause of inherited intellectual disability, is caused by a trinucleotide CGG repeat expansion in the 5' untranslated region of the Fragile X Mental Retardation gene (FMR1), which results in promoter hypermethylation and gene silencing. This loss or reduction of the gene product expression, Fragile X Mental Retardation Protein (FMRP), results in the translational dysregulation of specific target mRNAs. Patients with FXS and Fragile X mental retardation gene knockout (ko) mice, an animal model for FXS, exhibit defects in dendritic spine maturation that may underlie cognitive and behavioral abnormalities in FXS, which tend to be at the extreme of the autistic spectrum. Dendritic spines are small protrusions on the surface of dendrites that receive the majority of excitatory synapses in the brain, and changes in their morphology affect synaptic strength. Previous studies have shown that minocycline promotes dendritic spine maturation in primary cultures of hippocampal neurons and in the developing hippocampus of Fmr1 ko mice, which is accompanied by improvements in behavioral performance. Here I confirm the phenotypes previously reported for the Fmr1 ko mouse and investigate a possible link between matrix metalloproteinase-9 (MMP-9) and FMRP by characterizing double Fmr1/Mmp9 ko mice. I show that the deletion of mmp-9 in Fmr1 ko mice rescues the spine development both in vitro and in vivo, and that this deletion also returns mGluR-dependent LTD to the normal levels in Fmr1 ko mice. LTP however remains affected. I also investigated if Fmr1 ko mice exhibit certain behavioral problems, and whether a deletion of mmp-9 can ameliorate these behavioral deficits. The Fmr1 ko mice exhibit increased anxiety and hyperactivity in the open field and defects in social novelty discrimination, most of which are also improved by the removal of mmp-9. Further, I also examined the role of MMP-9 activity in physical traits that are observed in FXS, such as macroorchidism and found that those physical traits are also ameliorated by the genetic removal of mmp-9. Additionally, previous studies have shown the rates of basal protein synthesis to be higher in Fmr1 ko mice. I confirm this and show that the deletion of mmp-9 reduces both the basal levels of protein synthesis and the levels of intracellular signaling as the levels of phosphorylation of Akt, mTOR and eIF4e are reduced to wild type (wt) levels. The levels of MMP-9 and MMP-2 are also upregulated in the hippocampi of the Fmr1 ko mice and since there no differences in the mRNA levels of these two transcripts between Fmr1 ko and wt animals, this upregulation must be due to a translational dysregulation following the loss of FMRP. The fact that most of the FXS phenotypes are reversed by the genetic removal of mmp-9, strongly suggests that increased MMP-9 protein levels underlie these phenotypes and validates the use of specific MMP-9 inhibitors as possible therapeutic avenues for FXS

Sexual abuse in the South Asian diaspora community of the Lower Mainland of British Columbia

The sexual abuse of women and girls is a major public health and human rights concern that affects women worldwide and cross-culturally. This research paper specifically examines sexual abuse and violence against women and girls within the South Asian community, focusing on the Lower Mainland of British Columbia, Canada. In my discussion of reflexivity, I specifically examine my social location and personal experiences in regards to sexual abuse in the South Asian community. This is followed by a discussion of the theoretical concepts that inform my analysis of the key issues explored in this paper. From there, I offer a reflection on the current debate over whether or not culture may indeed be said to inform sexual violence against women and girls within South Asian communities. Having analyzed how culture may be relevant to the treatment of women and girls, I then critically examine my own experiences of growing up within a number of South Asian communities throughout BC. I note that the lessons I learned from my own mother and other members of the South Asian community emphasized both the importance of keeping silent in the face of sexual abuse to protect the reputation of one’s family and the importance of being a “good girl”. This reflection leads into a discussion of the particular social and cultural concepts, such as shame and honour, which may inform understandings of sexual violence against women and girls in South Asian diaspora communities within Western countries. I then examine current research on South Asian women who resist problematic cultural discourses in an effort to resist abusive situations and the therapeutic challenges Western service providers may come up against when working with such women. Following, I examine research on the experiences of front line workers in the Province of British Columbia who have worked with South Asian male perpetrators of intimate partner violence, including sexual violence. I then outline the current frameworks for service delivery for South Asian victims of sexual abuse in the Lower Mainland of British Columbia. I offer a number of recommendations to help service providers in the Lower Mainland offer more appropriate support and services to South Asian survivors of sexual abuse. Finally, I discuss what the South Asian community itself can do to address sexual abuse and violence against women and girls.Social Work, School ofArts, Faculty ofUnreviewedGraduat

Current status of the New Antiepileptic drugs in chronic pain.

Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various Non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer’s Lyrica become the market leading brand by 2018. In this review we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder should be withdrawal from randomized placebo trials rather than open-label studies; otherwise this may lead to off-label uses of drug. The purpose of the present review is to relate the various mechanisms of action of new AEDs to pathophysiological mechanisms and clinical efficacy in neuropathic pain and migraine

Paediatric elbow fractures and public play spaces : adherence to standards for children’s playground equipment and surfacing

Supracondylar humerus fractures (SCHF) are the most common fractures sustained following a fall onto an outstretched hand among healthy children, and one of the leading causes of hospital admission and surgical intervention. The aim of this study was to examine SCHF occurring at public play spaces—particularly to determine whether or not the playground equipment implicated in injurious falls aligned with Canadian playground safety standards. T`he majority of SCHF cases occurred at playgrounds with insufficient surface depth and/or non- compliant equipment. Upper body equipment, track rides and rotating play structures were of particular concern, as the children fell from heights exceeding the recommended standard, likely reflecting the degradation and compaction of the surfacing material over time.Medicine, Faculty ofPediatrics, Department ofOrthopaedic Surgery, Department ofPopulation and Public Health (SPPH), School ofNon UBCReviewedFacultyResearche

Severe Hyperphosphatemia in a Patient with Mild Acute Kidney Injury

Hyperphosphatemia may arise from various conditions including exogenous ingestion, extracellular shifts due to cell death or alterations in acid-base status, increased bone resorption, hormonal dysregulations leading to reduced renal excretion, reduced kidney function, or faulty measurement techniques. We herein present a case of a young pregnant woman who presented with mild acute kidney injury (AKI), invasive mucormycosis receiving liposomal amphotericin, and hyperphosphatemia out of proportion to the degree of kidney injury. While the patient was given routine phosphate-binding agent by her primary care team for presumed AKI-associated hyperphosphatemia, a full investigation by the renal consulting team for contributing factors other than kidney injury revealed that she actually had pseudohyperphosphatemia associated with the use of liposomal amphotericin. Erroneous treatment of pseudohyperphosphatemia may have been detrimental to this pregnant patient. A literature review for conditions associated with pseudohyperphosphatemia other than the use of liposomal amphotericin will be discussed

Brain-wide functional architecture remodeling by alcohol dependence and abstinence

Alcohol abuse and alcohol dependence are key factors in the development of alcohol use disorder, which is a pervasive societal problem with substantial economic, medical, and psychiatric consequences. Although our understanding of the neurocircuitry that underlies alcohol use has improved, novel brain regions that are involved in alcohol use and novel biomarkers of alcohol use need to be identified. The present study used a single-cell whole-brain imaging approach to 1) assess whether abstinence from alcohol in an animal model of alcohol dependence alters the functional architecture of brain activity and modularity, 2) validate our current knowledge of the neurocircuitry of alcohol abstinence, and 3) discover brain regions that may be involved in alcohol use. Alcohol abstinence resulted in the whole-brain reorganization of functional architecture in mice and a pronounced decrease in modularity that was not observed in nondependent moderate drinkers. Structuring of the alcohol abstinence network revealed three major brain modules: 1) extended amygdala module, 2) midbrain striatal module, and 3) cortico-hippocampo-thalamic module, reminiscent of the three-stage theory. Many hub brain regions that control this network were identified, including several that have been previously overlooked in alcohol research. These results identify brain targets for future research and demonstrate that alcohol use and dependence remodel brain-wide functional architecture to decrease modularity. Further studies are needed to determine whether the changes in coactivation and modularity that are associated with alcohol abstinence are causal features of alcohol dependence or a consequence of excessive drinking and alcohol exposure