Spectrum of adverse drug reactions and implicated drugs in a tertiary care centre: a prospective study

Background: Adverse Drug Reaction(ADR) is the major limitation in providing health care to patients at a global level. It affects patient’s recovery and is an important cause of mortality and morbidity in both hospitalized and ambulatory patients. ADR can occur with any class of drugs. Early detection and evaluation of ADR is essential to reduce harm to the patients. Thus, the present study was aimed to estimate the number of ADR’s reported, analyze its spectrum and the drugs attributed to it.Methods: This was a prospective study conducted in a tertiary care teaching hospital for a period of 3 months from March 2016 to May 2016 in SRM Medical College and Hospital, Potheri. Adverse drug reactions were collected by spontaneous reporting by active and passive methods. The causality assessment of the reported ADR’s was done using Naranjo causality assessment scale.Results: A total of 38 ADR’s were reported during the study period with male predominance (58%). Most of the ADR’s (42%) were common in patients in the age group 19-39 years. More number of ADR’s were from Medicine (29%) followed by Surgery (16%) and OG (16%) departments. Most commonly affected organ systems were skin (45%) followed by GIT (24%). The drugs mostly accounted were antibiotics (55%) especially Cephalosporins (33%). Most of the reactions were type A (68%) rather than type B (32%) and thus predictable. According to Naranjo’s causality assessment, 63% of reactions were probable, 26% were possible and 11% were definite. No reactions were unlikely. Severity assessment by Modified Hartwig and Seigel scale revealed 45% ADRs to be moderate, 42% were mild and 13% were severe and life threatening.Conclusions: The study concluded that Adverse Drug Reactions are common and some of them resulted in increased healthcare cost due to need of some interventions and increased length of hospital stay. As majority of ADR is predictable (Type A), so preventable. The health system should promote the spontaneous reporting of Adverse Drug Reactions (May be done mandatory). The proper documentation and periodic reporting to regional pharmacovigilance centres to ensure drug safety

Dissecting mechanisms of brain aging by studying the intrinsic excitability of neurons

Several studies using vertebrate and invertebrate animal models have shown aging associated changes in brain function. Importantly, changes in soma size, loss or regression of dendrites and dendritic spines and alterations in the expression of neurotransmitter receptors in specific neurons were described. Despite this understanding, how aging impacts intrinsic properties of individual neurons or circuits that govern a defined behavior is yet to be determined. Here we discuss current understanding of specific electrophysiological changes in individual neurons and circuits during aging

Water Sustainability: Current and Future Challenges at SRM Institute of Science and Technology, Chennai, India

SRMIST has healthy approach to sustainability, incorporating social economic and environmental principles that have been in place for nearly a decade implementing short and long-term sustainable objectives. SRMIST developed, maintained the estate, and the surrounding landscape, with due environmental impact and social values and implemented effective, efficient utility management measures, policies and procedures. The 2018/2019 UI Green Metric ranked SRMIST as 9 th in India and 392nd in Global Ranking overall and 264th rank globally and 9th rank in India for water parameter and 3rd in the Nation and 243rd globally and 2nd rank nationally and 42nd rank globally for water. SRM IST improved implementation of the water conservation and recycling program from 75% in 2018 to 95 % in 2019. Water efficient appliances increased > 70% and has a long-term commitment for conservation of water by regularly monitoring the use of water with regular meters. SRMIST has 20 RO plants running 24x7 collecting 31,000L per day for all and installing Ultra Filtration unit. SRMIST’s goal is to reduce per capita water consumption varies from 3.7m3 to 3.3m. Among the 4600 M3 waste water generated an average 4140 M3 wastewater is treated and recycled. Rainwater harvesting pits have been constructed in 65% college buildings and hostels is used for the water recharge in the campus and the rainwater stored in the roof tanks are used for toilet flushing

Analysis of adverse drug reactions encountered in a tertiary care hospital: a cross sectional study

Background: Adverse drug reactions are due to hazards of drug therapy and can occur with any class of drugs. The aim of this study was to evaluate and record adverse drug reactions reported from various departments of a tertiary care hospital.Methods: A Cross Sectional study conducted in a tertiary care hospital for a period of 4 months from March to June 2017 after Institutional Ethics Committee approval. ADRs reports collected and analyzed for causality, severity and preventability by international standardized scales.Results: A total of 38 ADR’s were reported during the study period with male predominance (58%). Most of the ADR’s (42%) were common in patients in the age group 19-39 years. More number of ADR’s were from Medicine (29%). Most commonly affected organ systems were skin (45%). The drugs mostly accounted were antibiotics (55%) especially Cephalosporins (33%). According to Naranjo’s causality assessment scale 74% of reactions were probable, 26% were possible, Modified Hartwig and Seigel severity assessment scale revealed 45% ADRs to be moderate, 42% were mild and 13% were severe, Modified Schumock and Thorton Preventability assessment scale which revealed 61% ADRs were not preventable, 32% were probably preventable,7% were definitively preventable.Conclusions: Adverse Drug Reactions are common and some of them resulted in increased healthcare cost due to need of some interventions and increased length of hospital stay. The health system should promote the spontaneous reporting of ADR’s. The proper documentation and periodic reporting to Pharmacovigilance Centres is required to ensure drug safety

A comparative study between 0.5% centbucridine and 2% lignocaine with adrenaline (1:200,000) for bilateral extraction of mandibular premolar using nerve block anesthesia: a double blind randomized controlled clinical study

Background: The purpose of the study was to compare the efficacy of 0.5% centbucridine and 2% lignocaine with adrenaline (1:200,000).Methods: A clinical prospective, controlled, randomized, double blind group study was conducted on 22 patients referred for extraction of mandibular premolars, who were randomly assigned to 2 groups by the split mouth method. Before extraction of mandibular premolar, either 0.5% centbucridine or 2% lignocaine with 1:200,000 adrenaline were used for anesthesia. All the patients were given inferior alveolar, lingual, and long buccal nerve blocks. Pain on injection, onset of anesthesia, duration of anesthesia and changes in blood pressure and pulse rate were monitored and recorded.Results: In our study, statistically significant difference was found between the efficacy of agents as for time for onset of anesthesia, duration of action, and changes in blood pressure and pulse rate, but no statistically significant difference was found for pain on injection between two groups.Conclusions: The efficacy of centbucridine was found to be more as compared to lignocaine with adrenaline, in rapid onset of anesthesia, longer duration of action, and cardiovascular stability. There was no significant difference in the pain on injection for both centbucridine and lignocaine with adrenaline. Centbucridine can be used in medically compromised condition where adrenaline is contraindicated

Huntingtin Is Critical Both Pre- and Postsynaptically for Long-Term Learning-Related Synaptic Plasticity in Aplysia

Patients with Huntington’s disease exhibit memory and cognitive deficits many years before manifesting motor disturbances. Similarly, several studies have shown that deficits in long-term synaptic plasticity, a cellular basis of memory formation and storage, occur well before motor disturbances in the hippocampus of the transgenic mouse models of Huntington’s disease. The autosomal dominant inheritance pattern of Huntington’s disease suggests the importance of the mutant protein, huntingtin, in pathogenesis of Huntington’s disease, but wild type huntingtin also has been shown to be important for neuronal functions such as axonal transport. Yet, the role of wild type huntingtin in long-term synaptic plasticity has not been investigated in detail. We identified a huntingtin homolog in the marine snail Aplysia, and find that similar to the expression pattern in mammalian brain, huntingtin is widely expressed in neurons and glial cells. Importantly the expression of mRNAs of huntingtin is upregulated by repeated applications of serotonin, a modulatory transmitter released during learning in Aplysia. Furthermore, we find that huntingtin expression levels are critical, not only in presynaptic sensory neurons, but also in the postsynaptic motor neurons for serotonin-induced long-term facilitation at the sensory-to-motor neuron synapse of the Aplysia gill-withdrawal reflex. These results suggest a key role for huntingtin in long-term memory storage

Pyrene binary probes for unambiguous detection of mRNA using time-resolved fluorescence spectroscopy

We report here the design, synthesis and application of pyrene binary oligonucleotide probes for selective detection of cellular mRNA. The detection strategy is based on the formation of a fluorescent excimer when two pyrene groups are brought into close proximity upon hybridization of the probes with the target mRNA. The pyrene excimer has a long fluorescence lifetime (>40 ns) compared with that of cellular extracts (∼7 ns), allowing selective detection of the excimer using time-resolved emission spectra (TRES). Optimized probes were used to target a specific region of sensorin mRNA yielding a strong excimer emission peak at 485 nm in the presence of the target and no excimer emission in the absence of the target in buffer solution. While direct fluorescence measurement of neuronal extracts showed a strong fluorescent background, obscuring the detection of the excimer signal, time-resolved emission measurements indicated that the emission decay of the cellular extracts is ∼8 times faster than that of the pyrene excimer probes. Thus, using TRES of the pyrene probes, we are able to selectively detect mRNA in the presence of cellular extracts, demonstrating the potential for application of pyrene excimer probes for imaging mRNAs in cellular environments that have background fluorescence

Observing superluminous supernovae and long gamma ray bursts as potential birthplaces of repeating fast radio bursts

Superluminous supernovae (SLSNe) and long gamma ray bursts (LGRBs) have been proposed as progenitors of repeating Fast Radio Bursts (FRBs). In this scenario, bursts originate from the interaction between a young magnetar and its surrounding supernova remnant (SNR). Such a model could explain the repeating, apparently non-Poissonian nature of FRB121102, which appears to display quiescent and active phases. This bursting behaviour is better explained with a Weibull distribution, which includes parametrisation for clustering. We observed 10 SLSNe/LGRBs for 63 hours, looking for repeating FRBs with the Effelsberg-100 m radio telescope, but have not detected any bursts. We scale the burst rate of FRB121102 to an FRB121102-like source inhabiting each of our observed targets, and compare this rate to our upper burst rate limit on a source by source basis. By adopting a fiducial beaming fraction of 0.6, we obtain 99.99\% and 83.4\% probabilities that at least one, and at least half of our observed sources are beamed towards us respectively. One of our SLSN targets, PTF10hgi, is coincident with a persistent radio source, making it a possible analogue to FRB121102. We performed further observations on this source using the Effelsberg-100~m and Parkes-64~m radio telescopes. Assuming that PTF10hgi contains an FRB121102-like source, the probabilities of not detecting any bursts from a Weibull distribution during our observations are 14\% and 16\% for Effelsberg and Parkes respectively. We conclude by showing that a survey of many short observations increases burst detection probability for a source with Weibull distributed bursting activity.Comment: 11 pages, 5 figure

Polymorphous adenocarcinoma of the salivary glands : reappraisal and update

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.Peer reviewe