Student’s perception about teaching methodologies used in pharmacology: a questionnaire based cross sectional study

Background: Pharmacology is one of the most clinically applied subjects which are highly volatile. Hence new methodologies have to be introduced in medical curriculum which must be in line with the students’ preferences. The study aimed to determine the opinion of students regarding the teaching of pharmacology, the best way of knowing and retaining the subject and application of the subject in future practice.Methods: The study will be conducted at private Medical college in Mangalore. It is an observational, KAP cross-sectional questionnaire-based study. Convenient sampling method is used in which 140 Second year MBBS students were enrolled. SPSS version 21 was used to generate tables and graphs. Results of the study are based on descriptive statistics.Results: Questions which were not answered were taken as invalid response. Results show that majority preferred newer learning methodology, case-based learning, integrated teaching were more appealing, and peer associated teaching like group discussion was better for applied topics. Attitude of students in learning has shifted from traditional text book to the recent concept of knowledge sharing.Conclusions: In general students’ perceptions regarding learning pharmacology was observed to be positive. The study highlights the need for interactive teaching. Practical sessions can be used to teach basic concepts and rational use of drugs. Knowledge seeking behaviour needs improvisation by teacher

Knowledge, attitude and practice of medical professionals towards adverse drug reaction reporting and pharmacovigilance in a tertiary care hospital: a cross sectional study

Background: The present study was planned to assess the knowledge, attitude and practice of healthcare providers regarding adverse drug reaction reporting and pharmacovigilance in a tertiary care hospital.Methods: The study was conducted in a tertiary care teaching hospital, it’s a observational, KAP cross-sectional questionnaire-based study. The KAP questionnaires was developed toward pharmacovigilance and ADRs and were used to assess the medical professionals.Results: Only 64% of doctors, 52% PG’s and 40% of nurses knew the correct knowledge regarding Pharmacovigilance (PhV). Regarding the attitude, all the respondents think reporting of ADR is a very necessary. 98% of doctors,80% of postgraduates and 96% of nurses have experienced ADR in the patient in their professional practice but reporting of same is very less. The factors discouraging them from reporting ADR’s was also assessed. 34% said difficult to decide whether ADR has occurred or not, 34% said lack of time, 17%- no remuneration and 15% said a single unreported case may not affect ADR database.Conclusions: This study demonstrated that knowledge and attitude towards pharmacovigilance is gradually improving among medical professionals, but unfortunately the actual practice of ADR reporting is still deficient among them

Periodic evaluation of drug utilization in intensive coronary care unit patients in a tertiary care hospital

Background: A wide and gradual variation exists periodically in the patterns of pharmacotherapy among patients admitted with CVDs in CCU. Periodic evaluation of drug utilization in the CCU is necessary for optimization of health care system, proper use of resources and making prescription policy.Methods: It was retrospective and prospective study. Study was carried out at Tertiary care hospital in Mangalore. Retrospective study period was from 1/07/2010 till 31/12/2010 and Prospective study duration was from 1/01/2016 till 30/06/2016. Patients from CCU were participants of this study.Results: Data of total 278 patients were taken, out of which 138 patients from 2010 and 140 patients in 2016 were analyzed respectively and were compared among drug therapy for IHD - Nitrates, dual antiplatelet therapy (aspirin and clopidogrel), dyslipidemic drugs and beta blockers remain drug of choice in both retrospective and prospective study. But, anticoagulant (heparin/ LMWH) use increased in prospective studies. In Heart failure - nitrates, antiplatelet, dyslipidemic drugs followed by inotropes and diuretics was used in both study. Cardiomyopathy was managed with diuretics, ACEIs, and nitrates in both retrospective and prospective study.Conclusions: In conclusion, predominance of male gender and poly-pharmacy were observed. However, it has identified areas to further rationalize and optimize patterns of polypharmacy and evidence based use of medications like beta blockers, anticoagulants/antiplatelet agents and antiarrythmisc. The results on the major determinants of cardiovascular drug use in CCU matched with the existing indications and cautions for use with each drug class

A study on management of oral cancer in a tertiary care hospital

Background: Oral cancers form nearly 30% of the cancers. The most effective way of combating oral cancer is by early diagnosis followed by concurrent chemo-radiotherapy which is the most popular approach in current practice. The adverse effects seen in oral cancer patient’s due to their treatment are nausea & vomiting, mucositis, constipation, diarrhoea, fatigue & radiation dermatitis. Polypharmacy is due to variety of treatment options in oral cancer patients, which needs to be addressed.Methods: Over a period of 18 months, the in-patient records of 79 patients with oral cancers, admitted to oncology ward of Justice K. S. Hegde Charitable Hospital, Mangalore, were scrutinized and the data collected in a specially designed proforma. Descriptive analysis of the data was done.Results: Required data was collected from 79 patients, out of which 55.7% of the patients underwent surgery and later received chemotherapy and radiotherapy. Most commonly seen adverse effects due to treatment were weight loss (75.9%), reduced appetite (67.1%), fatigue (75.9%), pain (79.7%) and skin discoloration (50.6%), etc. Various classes of adjuvant drugs were used for complications caused due to the treatment of oral cancers. Drugs like topical applicant /mouth washes constituted the bulk of the prescriptions (22%) followed by nutritional supplements (15.34%), NSAID/opioids (12.76%) hematinic (12.59 %) and other groups of drugs were also used.Conclusions: Present study helped us to plan evidence based strategies to reduce or prevent post treatment complications. Most of the adverse effects were treated accordingly to keep the patient comfortable

The internal structure of gadolinium and perfluorocarbon-loaded polymer nanoparticles affects ¹⁹F MRI relaxation times

19F magnetic resonance imaging (19F MRI) is an emerging technique for quantitative imaging in novel therapies, such as cellular therapies and theranostic nanocarriers. Nanocarriers loaded with liquid perfluorocarbon (PFC) typically have a (single) core-shell structure with PFC in the core due to the poor miscibility of PFC with organic and inorganic solvents. Paramagnetic relaxation enhancement acts only at a distance of a few angstroms. Thus, efficient modulation of the 19F signal is possible only with fluorophilic PFC-soluble chelates. However, these chelates cannot interact with the surrounding environment and they might result in image artifacts. Conversely, chelates bound to the nanoparticle shell typically have a minimal effect on the 19F signal and a strong impact on the aqueous environment. We show that the confinement of PFC in biodegradable polymeric nanoparticles (NPs) with a multicore structure enables the modulation of longitudinal (T1) and transverse (T2) 19F relaxation, as well as proton (1H) signals, using non-fluorophilic paramagnetic chelates. We compared multicore NPs versus a conventional single core structure, where the PFC is encapsulated in the core(s) and the chelate in the surrounding polymeric matrix. This modulated relaxation also makes multicore NPs sensitive to various acidic pH environments, while preserving their stability. This effect was not observed with single core nanocapsules (NCs). Importantly, paramagnetic chelates affected both T1 and T219F relaxation in multicore NPs, but not in single core NCs. Both relaxation times of the 19F nucleus were enhanced with an increasing concentration of the paramagnetic chelate. Moreover, as the polymeric matrix remained water permeable, proton enhancement additionally was observed in MRI.</p

Multicore liquid perfluorocarbon-loaded multimodal nanoparticles for stable ultrasound and ¹⁹ F MRI applied to in vivo cell tracking

Ultrasound is the most commonly used clinical imaging modality. However, in applications requiring cell-labeling, the large size and short active lifetime of ultrasound contrast agents limit their longitudinal use. Here, 100 nm radius, clinically applicable, polymeric nanoparticles containing a liquid perfluorocarbon, which enhance ultrasound contrast during repeated ultrasound imaging over the course of at least 48 h, are described. The perfluorocarbon enables monitoring the nanoparticles with quantitative 19 F magnetic resonance imaging, making these particles effective multimodal imaging agents. Unlike typical core–shell perfluorocarbon-based ultrasound contrast agents, these nanoparticles have an atypical fractal internal structure. The nonvaporizing highly hydrophobic perfluorocarbon forms multiple cores within the polymeric matrix and is, surprisingly, hydrated with water, as determined from small-angle neutron scattering and nuclear magnetic resonance spectroscopy. Finally, the nanoparticles are used to image therapeutic dendritic cells with ultrasound in vivo, as well as with 19 F MRI and fluorescence imaging, demonstrating their potential for long-term in vivo multimodal imaging. </p

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p&lt;0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p&lt;0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p&lt;0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Data from a survey on the impact of the pandemic on early-stage academics

We would like to share data from a survey run by the Young Academy of Europe (YAE) from June to October 2020, with questions aiming to unravel the situation of early-career researchers (including early stage group leaders) working in Europe, during the COVID-19 pandemic. We were particularly interested in the impact of care activities (related to young children or other family members), and the impact of gender. We include the online survey and collected data, without identifying information. The survey is published in Nature Career Column (July, 2021) ( https://www.nature.com/articles/d41586-021-01952-6)

Knowledge, attitude and practice of medical professionals towards adverse drug reaction reporting and pharmacovigilance in a tertiary care hospital: a cross sectional study

Background: The present study was planned to assess the knowledge, attitude and practice of healthcare providers regarding adverse drug reaction reporting and pharmacovigilance in a tertiary care hospital.Methods: The study was conducted in a tertiary care teaching hospital, it’s a observational, KAP cross-sectional questionnaire-based study. The KAP questionnaires was developed toward pharmacovigilance and ADRs and were used to assess the medical professionals.Results: Only 64% of doctors, 52% PG’s and 40% of nurses knew the correct knowledge regarding Pharmacovigilance (PhV). Regarding the attitude, all the respondents think reporting of ADR is a very necessary. 98% of doctors,80% of postgraduates and 96% of nurses have experienced ADR in the patient in their professional practice but reporting of same is very less. The factors discouraging them from reporting ADR’s was also assessed. 34% said difficult to decide whether ADR has occurred or not, 34% said lack of time, 17%- no remuneration and 15% said a single unreported case may not affect ADR database.Conclusions: This study demonstrated that knowledge and attitude towards pharmacovigilance is gradually improving among medical professionals, but unfortunately the actual practice of ADR reporting is still deficient among them