An observational study on the surgical antibiotic prophylaxis in the surgery ward of a tertiary care hospital

Background: Surgical site infection (SSI) is the most common postoperative complication and represents a significant burden in terms of patient morbidity, mortality and cost to health services around the world. Appropriate antibiotic prophylaxis helps in reducing the incidence of SSIs. Appropriate surgical prophylaxis is a multifactorial process that depends on proper case selection, antibiotic selection including dosing and route of administration and duration of therapy.Methods: A prospective observational study was conducted over 3 months on 200 operated patients in surgery ward of a tertiary hospital. Patient details like demography, type of surgery performed and antibiotics prescribed pre and post-surgical procedure was collected and analysed using Microsoft excel.Results: Out of 200 patients 32.5% (65) were females and 67.5% (135) were males. Total number of prophylactic antibiotics prescribed were 368. The most commonly prescribed group of antibiotics was cephalosporins (44.29%) followed by metronidazole (26.5%) and ofloxacin (9.48%). Among the cephalosporins the most commonly prescribed was cefuroxime in 82 patients (50.3%) and cefoperazone in 79 patients (48.46%). SSI developed in 3 out of 200 patients (1.5%).Conclusions: There is an urgent requirement to promote rational antibiotic prescribing among surgeons. The need of the hour is developing and implementing national guidelines for surgical prophylaxis by a multidisciplinary group of experts

Evaluation of prescribing patterns of medical practitioners in the state of Goa, India

Background: According to WHO, worldwide more than 50% of all medicines are prescribed, dispensed, or sold inappropriately, while 50% of patients fail to take them correctly. Evaluating the prescribing patterns of the medical practitioners will throw light on the common types of irrational practices such as inappropriate use of antimicrobials, polypharmacy, over-use of injections, failure to prescribe according to clinical guidelines.Methods: 600 prescriptions prescribed by medical practitioners from March to April 2016 were analyzed using WHO prescribing indicators.Results: Out of the 1900 drugs prescribed, average number of drugs per prescription was 3.17. Total number of drugs prescribed by generic name was 11 (0.58%). An antibiotic was prescribed in 119 patients (19.83%). An injection was prescribed in 23 patients (3.8%). 567 drugs prescribed were from the essential drug list of India (29.8%).Conclusions: Polypharmacy increases the risk of drug interactions, treatment cost, decreases the patient’s compliance. Prescribing medicines by generic name avoids the confusion. By adhering to the national essential list of medicine, drugs will be available to the patients at all times and be cheaper

STUDY ON IN VITRO CYTOTOXICITY OF PAPAIN AGAINST LIVER CANCER CELL LINE HEP G2

Objective: Cancer is a devastating public health problem all over the world. Herbal medicines have a vital role in the prevention and treatment of cancer. Papain is a proteolytic enzyme and a phyto therapeutic agent which highly appreciated in the medical field that prevents several chronic diseases such as cardiovascular disease, cancer and diabetes. The aim of the study describes about the cytotoxicity of papain against liver cancer cell line HepG2. Methods: In different concentrations of samples have been taken for cytotoxicity analysis using the MTT assay and calculate the percentage of cell viability. Results: The 50% inhibition concentration (IC50) of a sample was 125µg/ml and their cell viability percentage was 49.20. The 85% of cytotoxicity has been observed in 1000 µg/ml of papain against HepG2 cell line than other concentrations. Conclusion: 1000 µg/ml of papain has maximum (85%) cytotoxicity effect against liver cancer cell line hepG2

Anthropometric Characteristics of Underprivileged Adolescents : A Study from Urban Slums of India

Corrigendum: https://doi.org/10.1155/2017/8595129Peer reviewe

Correlation of peak expiratory flow rate and single breath count in normal adults

Background: Spirometry mandates the requirement of equipments and skilled technicians which may be difficult to acquire in resource limited situations. Thus simple alternative tests like Peak Expiratory Flow Rate (PEFR) and Single Breath Count (SBC) can be used to assess the pulmonary functioning of an individual.Methods: Hundred healthy participants of both genders between the age group of 18-50 years were recruited for this study. They were asked to perform PEFR using the Mini Wright Peak Flow Meter and SBC using a metronome. Three reading were noted and the best of three readings were used for analysis.Results: The mean age and BMI of the participants were 31.54±10.42 years and 23.88±5.14 kg/m2 respectively. The Spearman’s correlation coefficient of PEFR and SBC was 0.7048 with p<0.001 indicating a strong positive correlation.Conclusions: SBC can be used as a simple, convenient and cost-effective alternative to PEFR to assess pulmonary function in adults.

Knee osteoarthritis - a pathological basis for use of newer drug therapies

Knee osteoarthritis (OA) is a disease of the whole knee joint occurring due to an interaction between inflammatory, hypoxic, and mechanical pathways. Initial management includes monotherapy with analgesics or anti‑inflammatory agents, eventually switching over to combination therapy with steroids and/or newer drugs. Cardiovascular risks associated with non‑steroidal anti‑inflammatory drugs (NSAIDs) limit their long term use. Hence, novel target receptors or pathways, which remain unaffected by conventional therapy and modify disease are being increasingly looked for. Newer drugs such as glucosamine, chondroitin, methylsulfonylmethane, diacerein along with vitamins/minerals are commonly used as adjuncts to NSAIDs or as monotherapy. Because of their novel mechanisms of action and better safety profile they seem to be promising as disease modifying agents in the treatment of OA. Google, PubMed, Cochrane databases and Science Direct search was performed, and relevant articles were identified. This review focuses on the pathological targets which these drugs modify in order to bring about a symptom modifying effect

Mental Wellbeing and Self-reported Symptoms of Reproductive Tract Infections among Girls: Findings from a Cross-sectional Study in an Indian Slum

This study examined the self-reported mental wellbeing among slum-dwelling adolescents in Western India and asked whether adolescent postmenarcheal girls’ mental wellbeing and self-reported symptoms suggestive of reproductive tract infections (RTIs) were associated. A sub-section of a cross-sectional personal interview survey among unmarried 10–18-year-old adolescents (n= 85) in a slum in the city of Nashik was analyzed. Logistic regression models were used to assess the associations between sociodemographic variables, physical health indicators, and adolescent postmenarcheal girls’ mental wellbeing. Nearly every other postmenarcheal girl reported having experienced symptoms suggestive of RTIs during the last twelve months. Adolescent postmenarcheal girls’ mental health and some aspects of somatic health appear to be closely interrelated. Understanding the relationship between adolescent mental wellbeing and reproductive health in low-income countries requires further investigation. Health service development in growing informal urban agglomerations in India and beyond should provide combined mental and reproductive health services for adolescents. &nbsp

A retrospective comparative study of multiple choice questions versus short answer questions as assessment tool in evaluating the performance of the students in medical pharmacology

Background: The aim was to assess the effectiveness of multiple choice versus short answer questions (SAQs) as assessment tools for evaluating performance of 2nd MBBS students.Methods: The study was observational, retrospective study of written pen and paper type assessment that utilized a sample of 100 2nd year medical students. Study consisted of two parts; part I was multiple-choice questions (MCQs) based on endocrine system where four options were given for a question and the single best answer was to be ticked. MCQ was timed at 20 mins for 30 questions with 1 mark each. There was no negative marking. Part II was SAQ on same system where 16 SAQ were given. SAQ was timed at 60 mins for 30 marks questions. After the test students had to reply on a feedback form.Result: There was a strong correlation between the marks scored in two formats of test and there was no statistical difference between the two set of marks.Conclusion: SAQs are as effective as MCQs in assessing the performance of the students in medical pharmacology

Determining freshwater lake communities’ vulnerability to snowstorms in the northwest territories

As the exposure to extreme snowstorms continues to change in response to a warming climate, this can lead to higher infrastructure damages, financial instability, accessibility restrictions, as well as safety and health effects. However, it is challenging to quantify the impacts associated with the combination of the many biophysical and socio-economic factors for resiliency and adaptation assessments across many disciplines on multiple spatial and temporal scales. This study ap-plies a framework to quantitatively determine the multiple impacts of snowstorms by calculating the livelihood vulnerability index (LVI) for four exposed freshwater lake communities in Canada s Northwest Territories using three contributing factors (exposure, sensitivity, and adaptive capac-ity). Results indicate that Déline is the most vulnerable community (0.67), because it has the highest exposure and one of the highest sensitivity ranks, while its ability to adapt to exposure stressors is the lowest among the communities. In contrast, Fort Resolution exhibits the lowest LVI (0.26) and has one of the highest adaptive capacities. This study emphasizes that while these freshwater communities may be exposed to snowstorms, they have different levels of sensitivity and adaptive capacities in place that influences their vulnerability to changes in hazardous snowfall conditions. The information gained from this study can help guide future adaptation, mitigation, and resiliency practices for Arctic sustainability efforts. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This research was funded by the McGill Sustainability Systems Initiative (MSSI), grant number 246889” from Montreal, Canada

Heterogeneity in HIV and cellular transcription profiles in cell line models of latent and productive infection: implications for HIV latency.

BackgroundHIV-infected cell lines are widely used to study latent HIV infection, which is considered the main barrier to HIV cure. We hypothesized that these cell lines differ from each other and from cells from HIV-infected individuals in the mechanisms underlying latency.ResultsTo quantify the degree to which HIV expression is inhibited by blocks at different stages of HIV transcription, we employed a recently-described panel of RT-ddPCR assays to measure levels of 7 HIV transcripts ("read-through," initiated, 5' elongated, mid-transcribed/unspliced [Pol], distal-transcribed [Nef], polyadenylated, and multiply-sliced [Tat-Rev]) in bulk populations of latently-infected (U1, ACH-2, J-Lat) and productively-infected (8E5, activated J-Lat) cell lines. To assess single-cell variation and investigate cellular genes associated with HIV transcriptional blocks, we developed a novel multiplex qPCR panel and quantified single cell levels of 7 HIV targets and 89 cellular transcripts in latently- and productively-infected cell lines. The bulk cell HIV transcription profile differed dramatically between cell lines and cells from ART-suppressed individuals. Compared to cells from ART-suppressed individuals, latent cell lines showed lower levels of HIV transcriptional initiation and higher levels of polyadenylation and splicing. ACH-2 and J-Lat cells showed different forms of transcriptional interference, while U1 cells showed a block to elongation. Single-cell studies revealed marked variation between/within cell lines in expression of HIV transcripts, T cell phenotypic markers, antiviral factors, and genes implicated in latency. Expression of multiply-spliced HIV Tat-Rev was associated with expression of cellular genes involved in activation, tissue retention, T cell transcription, and apoptosis/survival.ConclusionsHIV-infected cell lines differ from each other and from cells from ART-treated individuals in the mechanisms governing latent HIV infection. These differences in viral and cellular gene expression must be considered when gauging the suitability of a given cell line for future research on HIV. At the same time, some features were shared across cell lines, such as low expression of antiviral defense genes and a relationship between productive infection and genes involved in survival. These features may contribute to HIV latency or persistence in vivo, and deserve further study using novel single cell assays such as those described in this manuscript