STUDY OF FIXED DOSE COMBINATIONS IN A TERTIARY CARE HOSPITAL

ABSTRACTObjective: To study and analyze the pattern of fixed dose combinations (FDCs) in medicine outpatient clinic.Methods: The study is prospective cross-sectional study was conducted for 2 months in medicine outpatient clinic in tertiary care hospital. Aftertaking approval from Institutional Ethics Committee, the data were collected on every working day of the hospital. Prescriptions from the patientscoming to medicine outpatient clinic outpatient department were taken and required information is filled in data record form.Results: A total of 83 prescriptions were included in the study. Out of 287 drugs, 111, i.e., 39.92% were fixed dose formulations. As per drug categoryanalysis, nutritional supplements were used (47.74%). While 27.02% and 9.03% of FDCs were given for cardiovascular complains and respiratorycomplains, respectively. FDCs used for other conditions were 16.21%. About 29.72% of total FDCs are included in approved list of FDCs by DrugsController General of India (DCGI), November 2014.Conclusion: 39.92% drugs are FDCs out of total prescribed drugs. Nutritional supplements are prescribed in higher concentrations. Out of total FDCsonly 29.72% were included in DCGI approved list of FDCs and only four FDCs are found in the WHO list of essential drugs.Keywords: Fixed dose combinations, Prescriptions, Approved, Drugs Controller General of India

A study of prescribing pattern of drugs in patients of cardiovascular emergencies at a tertiary care hospital of Western Maharashtra

Background: The main objective of drug utilization research is to assess the rationality of drug use. Recently it has been found that cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. The objective of present study was to focus on the trends in prescribing patterns of most frequently treated cardiovascular emergencies.Methods: A retrospective descriptive study was carried out in cardiovascular emergency patients. From the medical records the following data was collected:  Distribution of cardiovascular emergencies (age and sex wise), most common cardiovascular emergencies treated, outcome of each patient, average duration of stay in the hospital and drugs prescribed per patient,  correlation of clinical outcome with treatment if possible, drug utilization trend in cardiovascular emergencies. From the data, master chart was prepared for data analysis.Results: Total 82 patients case records were studied. Myocardial infarction (50%) was the most common cardiovascular emergency treated during study period followed by unstable angina (36.58%).  Male to female ratio was 1.83. Average hospital stay was found 5.75 days. The average number of drugs per patient was 8.4.  Hypertension (42.24%) and diabetes mellitus (19.51%) were the most common comorbidities found associated with cardiovascular emergencies. Aspirin clopidogrel combination (80.49%), enoxaparin (75.61%), atorvastatin (73.17%), glyceryl trinitrate (73.17%) were the most commonly prescribed drugs. The utilization rate of ACE inhibitors and ARBs (56.10%) was found higher than that of beta blockers (28.05%). Stool softeners (52.46%) and anxiolytics (28.58%) were the most commonly used non-cardiovascular drugs. Improvement was seen in 82.93% patients.Conclusions: Protocol of management strategy of cardiovascular emergencies in our tertiary care hospital was found near to standard recommended guidelines. Keywords:

A positron annihilation spectroscopic investigation of europium-doped cerium oxide nanoparticles

Doping in ceria (CeO2) nanoparticles with europium (Eu) of varying concentrations (0, 0.1, 0.5, …, 50 atom%) is studied using complementary experimental techniques and novel observations were made during the investigation. The immediate observable effect was a distinct reduction in particle sizes with increasing Eu concentration attributed to the relaxation of strain introduced due to the replacement of Ce4+ ions by Eu3+ ions of larger radius. However, this general trend was reversed in the doping concentration range of 0.1–1 atom% due to the reduction of Ce4+ to Ce3+ and the formation of anion vacancies. Quantum confinement effects became evident with the increase of band gap energy when the particle sizes reduced below 7–8 nm. Positron annihilation studies indicated the presence of vacancy type defects in the form of vacancy clusters within the nanoparticles. Some positron annihilation was also seen on the surface of crystallites as a result of diffusion of thermalized positrons before annihilation. Coincidence Doppler broadening measurements indicated the annihilation of positrons with electrons of different species of atoms and the characteristic S–W plot showed a kink-like feature at the particle sizes where quantum confinement effects began

Surface enhanced Raman scattering substrate based on gold-coated anodic porous alumina template

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ANTIMICROBIAL UTILIZATION PATTERN OF URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL

Objective: To study and analyze the pattern of antimicrobial utilization in urinary tract infection (UTI).Methods: A descriptive retrospective study was conducted in tertiary care hospital for 6 months including both male and female patients of all agegroups. Case sheets diagnosed with UTI based on ICD-10 disease coding were collected from medical records department. The demographic dataand prescription pattern of each case sheet were evaluated in detail. Drug utilization pattern was compared among different age groups of patients.Results: A total of 108 patients were included in the study, out of which 44.4% were males, and 55.6% were females. Most of the patients were in40-60 years age group (40.7%). UTI confirmed by culture in 59.26% patients; in which Escherichia coli was isolated in 35.9% patients followedby Klebsiella species (14.06%) and Pseudomonas aeruginosa (7.8%). Cephalosporins (70.37%) were most commonly used antibiotic followed byfluoroquinolones (38.89%), penicillins (29.63%), azithromycin (17.59%), and aminoglycosides (15.74%). Among the cephalosporins, third generationparenteral was most commonly used. In penicillins, amoxicillin + clavulanic acid combination was used in 9 patients. Amikacin was most commonlyused aminoglycoside followed by gentamicin. Mean duration of treatment was 6.28±3.02 days.Conclusion: Third generation cephalosporins (ceftriaxone and cefixime) were used as first line drug in most of the cases irrespective of the causativeorganism. This group should be reserved for complicated UTIs.Keywords: Urinary tract infections, Escherichia coli, Cephalosporins, Fluoroquinolones

Differential gene expression profiling of esophageal adenocarcinoma

BackgroundDifferential gene expression offers an attractive means by which to study genes that may be involved in disease development and/or progression. We performed quantitative gene expression in various stages of esophageal adenocarcinoma, treated exclusively by surgery with complete 2-field lymphadenectomy, in an attempt to discern genes involved in disease progression as well as genes that may predict survival.MethodsGene expression profiling was accomplished by cDNA-mediated annealing, selection, extension, and ligation (DASL) assay. RNA was extracted from 89 archived formalin-fixed, paraffin-embedded esophageal adenocarcinoma tissues. DASL assay was performed with the Sentrix Universal Array (Illumina Corp, San Diego, Calif) of 502 known cancer-related genes. Bioinformatics tools were used to determine significant differential gene expression in T1-2 versus T3-4 tumors and tumors without lymph node involvement (N0) versus tumors with lymph node involvement (N+). Gene expression was also correlated with overall survival.ResultsTwenty-one genes were overexpressed in T1-2 compared with T3-4 tumors (false discovery rate of 0). Underexpression of 1 gene was seen in N+ compared with N0 tumors (false discovery rate of 0). For overall survival, underexpression of 9 genes correlated with long survival.ConclusionsUsing differential gene expression of 502 known cancer genes, we identified genes that may be involved at various stages in the progression of esophageal adenocarcinoma. We also identified genes that may correlate with prolonged survival and, thus, may serve as prognostic markers. These findings may provide further insight into the mechanisms of development and/or progression of esophageal adenocarcinoma. Prospective studies are needed to verify the prognostic value of these genes

Emblica Officinalis: A Novel Therapy for Acute Pancreatitis — An Experimental Study

Acute necrotising pancreatitis is associated with an unacceptably high mortality for which no satisfactory remedy exists. Emblica officinalis (E.o.) is a plant prescribed in Ayurveda, the Indian traditional system of medicine, for pancreas-related disorders. This study was carried out to evaluate the protective effect of E.o. against acute necrotising pancreatitis in dogs. Pancreatitis was induced by injecting a mixture of trypsin, bile and blood into the duodenal opening of the pancreatic duct. Twenty eight dogs were divided into 4 groups (n = 6-8 each): GpI–control, GpII–acute pancreatitis, GpIII–sham-operated, GpIV–pretreatment with 28 mg E.o./kg/day for 15 days before inducing pancreatitis. Serum amylase increased from 541.99 ± 129.13 IU/ml to 1592.63 ± 327.83 IU (p<0.02) 2 hrs after the induction of pancreatitis in GpII. The rise in serum amylase in both GpIII and GpIV was not significant. On light microscopic examination, acinar cell damage was less and the total inflammatory score was significantly lower in the E.o. treated group as compared to GpII. Electron microscopy confirmed this and showed an increased amount of smooth, endoplasmic reticulum and small, condensed granules embedded in a vacuole. More studies are needed to explore the clinical potential of E.o. and its mechanism of action

Smart hybrid nanostructures for cancer treatment

The project leading to this work has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 751903

Physically stimulated nanotheranostics for next generation cancer therapy: Focus on magnetic and light stimulations

Physically or externally stimulated nanostructures often employ multimodality and show encouraging results at preclinical stage in cancer therapy. Specially designed smart nanostructures such as hybrid nanostructures are responsive to external physical stimuli such as light, magnetic field, electric, ultrasound, radio frequency, X-ray, etc. These physically responsive nanostructures have been widely explored as nonconventional innovative “nanotheranostics” in cancer therapies. Physically stimulated (particularly magnetic and light) nanotheranostics provide a unique combination of important properties to address key challenges in modern cancer therapy: (i) an active tumor targeting mechanism of therapeutic drugs driven by a physical force rather than passive antibody matching, (ii) an externally/remotely controlled drugs on-demand release mechanism, and (iii) a capability for advanced image guided tumor therapy and therapy monitoring. Although primarily addressed to the scientific community, this review offers valuable and accessible information for a wide range of readers interested in the current technological progress with direct relevance to the physics, chemistry, biomedical field, and theranostics. We herein cover magnetic and light-triggered modalities currently being developed for nonconventional cancer treatments. The physical basis of each modality is explained; so readers with a physics or, materials science background can easily grasp new developments in this field