To Identify Drug-Drug Interaction in Cardiac Patients in Tertiary Care Hospitals

The potential for drug-drug interactions (pDDIs) is higher with cardiac medications, and reports of pDDIs in cardiovascular patients are more common. Multimorbidity, a greater number of drugs prescribed, longer hospital stays, complexity of disease, physiological changes with advancing age or conditions like renal failure, shock, hepatic disease like cirrhosis or acute viral hepatitis, stages of disease, and the influence of heart disease on drug metabolism make patients with CVD especially susceptible to DDIs. Our research found that pDDIs occurred at a much higher rate than expected in the Cardiology Division. Incidence of pDDIs was observed to rise with age, polypharmacy, and duration of hospital stay; pDDIs were also more common in males than females. Most of the interactions were of a pharmacodynamic character and were considered to be quite serious. Most pDDIs involved aspirin and clopidogrel, then aspirin and enalapril, and finally enalapril and enalapril. The surveillance of pDDIs in cardiac inpatients may benefit from the creation of such a database in hospitals

A PROSPECTIVE OBSERVATIONAL STUDY ON EFFECTS OF HEPATOPROTECTIVE AGENTS IN ALCOHOLIC LIVER DISEASE AT A TERTIARY CARE HOSPITAL

Drug utilization evaluation of hepatoprotective drugs is important in view of the spectrum of effect and associated risks with their therapy. The study was designed to evaluate the effects and adverse effects of hepatoprotective agents. A prospective, observational study was carried out for a period of 6 months at Osmania General Hospital (a tertiary care hospital). 120 patients were evaluated receiving corticosteroids, pentoxifylline, ursodeoxycholic acid for observing a trend in hepatic parameters and its outcomes. Ursodeoxycholic acid (81.66%) was the most commonly prescribed drug in almost all cases of alcoholic liver diseases followed by pentoxifylline (10%) in hepatorenal syndrome and then prednisolone (8.33%) in fatty liver. 67 cases were reported to have the significant drop in liver transaminases and bilirubin levels. Ursodeoxycholic acid resulted in a drop of 25% serum bilirubin and 35% drop in serum ALT (alanine transaminase) and 33% drop in serum AST (aspartate transaminase) in patients in a time gap of 1 week. Among 120 cases 94 were males (78.05%) and 26 females (21.04%) and maximum patients with alcoholic liver disease belonged to age group of 30-40 years (27.6%). Ursodeoxycholic acid (300 mg once daily) is used as an off-label drug for all types of alcoholic liver disease and also for viral hepatitis. Though Ursodeoxycholic acid showed a significant drop in liver transaminases and serum bilirubin levels in cirrhotic patients a better alternative lie in liver transplantation as long as they remain abstinent from alcohol. Keywords: Alcoholic liver diseases, Hepatoprotective agents, Liver transaminases, Bilirubin, Paired t-test

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Implantable Drug Delivery System: An Innovative Approach

The conventional routes of drug administration has limited control over drug release and maintaining constant plasma therapeutic drug concentrations for longer periods of time. To avoid these problems associated with utilization of traditional dosage forms, there was essential need for development of new dosage forms which would discharge drugs at controlled rate for local activity. This led to improvement of Novel Drug Delivery Systems (NDDS) that offers optimisation of therapeutic properties of drugs and makes them safer, productive and dependable over traditional ways of administration. Implantable drug delivery system (IDDS) forms a part of novel drug delivery system. This route of administering medications allows targeted distribution, location specificity, constant release rate, low amount of drug requirements, and minimisation of adverse effects with improved efficacy.  It provides possibility of administering drugs once weekly to yearly which otherwise previously require frequent daily dosing. Different implantable technologies are currently in use for many therapeutic applications such as in dentistry, ophthalmology, contraception and oncology. However, the expensiveness of this newly improved drug delivery system is quite high which hinders its large scale use.  Moreover, the recently developed devices require further enhancement and hence thorough scientific trials are needed before wide implementation in populations. Keywords: Implantable drug delivery, implants, drug delivery system, implantable pump, modulated drug delivery, novel drug delivery syste

Attitudes towards Medication Intake in Patients with Mental Illness are influenced by Their Own and Relatives’ Beliefs about Medication

Aim: In patients with psychiatric illness, beliefs and attitudes towards psychotropic medications influence their treatment adherence, in turn on treatment outcomes. Purpose: We examined the components of a relative’s beliefs about medication influencing the components of the patient’s beliefs about medication that in turn influences drug taking attitudes. Subjects and Methods: Patients and their relatives attending Psychiatry department who consented were both administered BMQ (Beliefs about Medication questionnaire). For patients, Drug attitude Inventory (DAI) was administered. Medication adherence was ascertained. Pearson’s correlation on the Patient’s BMQ sub-scales, relatives BMQ sub-scales and DAI was done. Multiple linear Regression analysis with Relatives and Patient BMQ sub scale on DAI was done. A mediation analysis to assess strengths of Direct and Indirect effects on the dependent variable as DAI was done. Results: 79 subjects participated in the study. Mediation analysis showed that DAI is directly negatively influenced by the Patient’s BMQ specific concern, coefficient (- 0.99), 95 % CI (-1.44, -0.55) and positively by patient’s BMQ specific necessity coefficient (0.55), 95 % CI (0.22, 0.88). Total indirect effect of Pt. Specific concerns through pt. specific necessity on DAI was coefficient (0.24), 95 % CI (0.05, 0.53). Patient specific concerns are in turn influenced by relatives specific concern, coefficient (0.43), 95 % CI (0.202, 0.507) and relative’s specific necessity, coefficient (0.295, 05 % CI [0.117, 0.387). Conclusion: Patient’s with high concerns about medication have more negative attitude towards medication intake which are in turn influenced by relative’s concerns and need for medication intake. Identification of such targets could help in counseling about medication use

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical science. © The Author(s) 2019. Published by Oxford University Press