“Without antibiotics, I cannot treat”: A qualitative study of antibiotic use in Paschim Bardhaman district of West Bengal, India

BACKGROUND:Misuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal and informal healthcare providers as well as patients accessing care at primary health centers across Paschim Bardhaman district in West Bengal. MATERIALS AND METHODS:We conducted 28 semi-structured, in-depth interviews with four groups of healthcare providers (allopathic doctors, informal health providers, nurses, and pharmacy shopkeepers) as well as patients accessing care at primary health centers and hospitals across Paschim Bardhaman district. Qualitative data was analyzed using the framework method in an inductive and deductive manner. RESULTS:Our results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal health providers and formal healthcare providers alike, and regularly visit providers even in remote areas to market newer antibiotics. Allopathic doctors and informal health providers frequently blame the other party for being responsible for antibiotic resistance, and yet both display interdependence in referring patients to one another. CONCLUSIONS:A holistic approach to curbing antibiotic resistance in West Bengal and other parts of India should focus on strengthening the capacity of the existing public health system to deliver on its promises, improving patient education and counseling, and including informal providers and pharmaceutical company representatives in community-level antibiotic stewardship efforts

TeV Scale Implications of Non Commutative Space time in Laboratory Frame with Polarized Beams

We analyze $e^{+}e^{-}\rightarrow \gamma\gamma$, $e^{-}\gamma \rightarrow e^{-}\gamma$ and $\gamma\gamma \rightarrow e^{+}e^{-}$ processes within the Seiberg-Witten expanded noncommutative scenario using polarized beams. With unpolarized beams the leading order effects of non commutativity starts from second order in non commutative(NC) parameter i.e. $O(\Theta^2)$, while with polarized beams these corrections appear at first order ($O(\Theta)$) in cross section. The corrections in Compton case can probe the magnetic component($\vec{\Theta}_B$) while in Pair production and Pair annihilation probe the electric component($\vec{\Theta}_E$) of NC parameter. We include the effects of earth rotation in our analysis. This study is done by investigating the effects of non commutativity on different time averaged cross section observables. The results which also depends on the position of the collider, can provide clear and distinct signatures of the model testable at the International Linear Collider(ILC).Comment: 22 pages, 19 figures, new comments and references added, few typos corrected, Published in JHE

Centrality evolution of the charged-particle pseudorapidity density over a broad pseudorapidity range in Pb-Pb collisions at root s(NN)=2.76TeV

Peer reviewe

Knowledge and attitude of indian population toward “self-perceived halitosis”

Aims: The aim of this study was to assess the level of knowledge and attitude of Indian population toward self-perceived halitosis, about its possible causes, available treatments, its influence on social relations and level of confidence. Materials and Methods: The questionnaire was distributed among 200 people in the outpatient department of Dental Hospital. It had four sections that included sociodemographic data, presence or absence of medical conditions and habits, knowledge about causes and treatment of malodor, oral hygiene practices, whether the subject had halitosis and measures employed to manage the condition, its influence on social relations, and level of confidence. Statistical Analysis Used: Chi-square test. Results: A total of 200 subjects were participated in the study. The prevalence of self-perceived halitosis was 52.5%. There was a significant association between knowledge about causes such as certain foods (P = 0.0004) and tongue coating (P = 0.002) with self-perceived malodor. There were significant associations between self-perceived halitosis and hesitation to talk to other people (P = 0.002) and uneasy feeling when someone was nearby (P = 0.010). Most of the respondents (61.25%) were not willing to visit a dentist or a physician for the condition. Conclusions: The Indian population lacked the knowledge regarding self-perceived halitosis. They had a negative attitude toward it as well

Ferrous iron-dependent delivery of therapeutic agents to the malaria parasite

BACKGROUND: The malaria parasites Plasmodium falciparum and Plasmodium vivax generate significant concentrations of free unbound ferrous iron heme as a side product of hemoglobin degradation. The presence of these chemically reactive forms of iron, rare in healthy cells, presents an opportunity for parasite-selective drug delivery. Accordingly, our group is developing technologies for the targeted delivery of therapeutics to the intra-erythrocytic malaria parasite. These so-called ‘fragmenting hybrids’ employ a 1,2,4-trioxolane ring system as an iron(II)-sensing ‘trigger’ moiety and a ‘traceless’ retro-Michael linker to which a variety of partner drug species may be attached. After ferrous iron-promoted activation in the parasite, the partner drug is released via a β-elimination reaction. METHODS: In this report, we describe three orthogonal experimental approaches that were explored in order to generate in vitro proof-of-concept for ferrous iron-dependent drug delivery from a prototypical fragmenting hybrid. CONCLUSION: Studies of two fragmenting hybrids by orthogonal approaches confirm that a partner drug species can be delivered to live P. falciparum parasites. A key advantage of this approach is the potential to mask a partner drug’s intrinsic bioactivity prior to release in the parasite

Evaluation of specifically designed implants placed in the low-density jaw bones: A clinico-radiographical study

Aim: In the less dense bone, it is difficult to obtain implant anchorage. The present study was undertaken to determine the survival rate of Maestro TM implants placed in d3 and d4 bones. Materials and Methods: Fourteen patients (10 males and 4 females) were selected for the study and implants were evaluated for posttreatment changes in at 3, 6, 9 and 12 months from implant placement. The implant probing depth and mobility were recorded 3 and 6 months after prosthesis placement. Also, peri-implant bone level was assessed at the baseline and 12 months postoperatively, followed by a statistical analysis. Results: The mean plaque and gingival indices showed a reduction at repeated intervals. The mean sulcular bleeding showed a slight reduction which was statistically significant. An overall mean bone loss was observed after 12 months follow-up, which was statistically not significant. The overall survival rate of implants was reported as 92.3%. Conclusion: The specific implant used in the study is advantageous in the soft bone condition. Clinical Significance: Although, there is a great evidence of implant failure in compromised jaw quality, the newer designs and approaches suggest that the poor quality is not a contraindication