Assessment of Knowledge, Attitude and Practice of Pharmacovigilance and Adverse Drug Reaction Reporting among Nursing Staff

INTRODUCTION: WHO characterizes adverse drug reaction (ADR) as any reaction to a medication which is harmful and unintended, and which happens at measurements typically utilized as a part of man for prophylaxis, analysis or treatment of illness or for the alteration of physiological capacity. Antagonistic medication responses are negative outcomes of medication treatment. They are one of the main sources of grimness and mortality. It has been assessed that around 2.9-5.6% of all clinic affirmations are because of ADRs and upwards of 35% of hospitalized patients encounter an ADR amid their hospitalization. An unconstrained revealing of ADRs has remained the foundation of pharmacovigilance and is imperative in keeping up tolerant wellbeing. In India, all social insurance experts including specialists, medical caretakers, and drug specialists can report an ADR by filling an ADR type of the Central Drugs Standard Control Organization. The dynamic interest of social insurance experts in the pharmacovigilance program can enhance the ADR revealing. AIM OF THE STUDY: To assess the knowledge, attitude and practice of pharmacovigilance and adverse drug reaction reporting among nursing staffs. OBJECTIVES: 1. To assess the knowledge of pharmacovigilance towards adverse drug reaction reporting. 2. To assess the attitude and practice towards adverse drug reaction reporting. 3. To determine the factors that encourages the study subjects to report adverse drug reaction. 4. To evaluate the factors that discourages the study subjects not to report adverse drug reaction. NEED OF THE STUDY: The most serious ADRs lead to hospitalization, and hospital stays can lead to further ADRs. Hence, HCPs and hospitals can play a significant role in minimizing ADR-related morbidity and mortality. HCPs can play multiple roles by carefully reviewing the full patient history, particularly the drug allergy and drug-drug interaction history, to avoid any unwanted ADRs. In addition, reporting ADRs to the responsible office at their hospital or the regulatory authority is a pharmacovigilance approach that can be used to minimize ADRs because reporting ADRs can increase HCPs’ awareness of reactions, which could result in the avoidance of particular drugs, thus reducing the harm associated with reactions to particular drugs. Several drugs have been withdrawn from the market as a result of HCPs reporting ADRs. However, understanding the knowledge and practice of health care professionals regarding ADR reporting is very important for enhancing the reporting of ADRs. Therefore, the present study is undertaken to determine the current status of ADR reporting and also to investigate knowledge and attitude of particularly nursing staffs towards pharmacovigilance and ADR reporting. METHODOLOGY: The study was conducted in 3 different multi-speciality hospitals, at Chennai. Study design: Cross sectional, questionnaire based study Study setting: This study was conducted from December 2017 to August 2018 for a period of 10 months. Study sample: The study sample size was 300. Inclusion criteria: Nurses, Any age group. Exclusion criteria: Other health care professionals, Study participants with unwillingness are excluded. CONCLUSION: The study discloses that nursing staffs have poor knowledge and poor practice but good in attitude towards ADR reporting. Even though they have reported more number of severe ADRs, they didn’t perform any further interventions to prevent it. The major factor which discourages them from reporting ADR is a patient confidentiality issue and managing patient was more important. Seriousness of reaction, unusualness of reaction, involvement of new drug, confidence in diagnosis of ADR was the factors that encourage nursing staffs to report ADR. Based on the outcomes of the present study following recommendations are concluded. ADR reporting forms should be freely available in all hospitals as it can improve the reporting rates of ADR in the country. ADR reporting should be mandatory for all healthcare professionals. Each hospital should have a database on ADR which should be considered by healthcare professionals. The nursing syllabus curriculum needs to be revised to include ADR and pharmacovigilance. Continuous education programme and workshop want to be conducted regularly relate to how and where to report ADR

Profiling invasive Plasmodium falciparum merozoites using an integrated omics approach

The symptoms of malaria are brought about by blood-stage parasites, which are established when merozoites invade human erythrocytes. Our understanding of the molecular events that underpin erythrocyte invasion remains hampered by the short-period of time that merozoites are invasive. To address this challenge, a Plasmodium falciparum gamma-irradiated long-lived merozoite (LLM) line was developed and investigated. Purified LLMs invaded erythrocytes by an increase of 10–300 fold compared to wild-type (WT) merozoites. Using an integrated omics approach, we investigated the basis for the phenotypic difference. Only a few single nucleotide polymorphisms within the P. falciparum genome were identified and only marginal differences were observed in the merozoite transcriptomes. By contrast, using label-free quantitative mass-spectrometry, a significant change in protein abundance was noted, of which 200 were proteins of unknown function. We determined the relative molar abundance of over 1100 proteins in LLMs and further characterized the major merozoite surface protein complex. A unique processed MSP1 intermediate was identified in LLM but not observed in WT suggesting that delayed processing may be important for the observed phenotype. This integrated approach has demonstrated the significant role of the merozoite proteome during erythrocyte invasion, while identifying numerous unknown proteins likely to be involved in invasion

Parallel and Distributed Computing for High-Performance Applications

The study of parallel and distributed computing has become an important area in computer science because it makes it possible to create high-performance software that can effectively handle challenging computational tasks. In terms of their use in the world of high-performance applications, parallel and distributed computing techniques are given a thorough introduction in this study. The partitioning of computational processes into smaller subtasks that may be completed concurrently on numerous processors or computers is the core idea underpinning parallel and distributed computing. This strategy enables quicker execution times and enhanced performance in general. Parallel and distributed computing are essential for high-performance applications like scientific simulations, data analysis, and artificial intelligence since they frequently call for significant computational resources. High-performance apps are able to effectively handle computationally demanding tasks thanks in large part to parallel and distributed computing. This article offers a thorough review of the theories, methods, difficulties, and developments in parallel and distributed computing for high-performance applications. Researchers and practitioners may fully utilize the potential of parallel and distributed computing to open up new vistas in computational science and engineering by comprehending the underlying concepts and utilizing the most recent breakthroughs

A keratin scaffold regulates epidermal barrier formation, mitochondrial lipid composition, and activity.

Keratin intermediate filaments (KIFs) protect the epidermis against mechanical force, support strong adhesion, help barrier formation, and regulate growth. The mechanisms by which type I and II keratins contribute to these functions remain incompletely understood. Here, we report that mice lacking all type I or type II keratins display severe barrier defects and fragile skin, leading to perinatal mortality with full penetrance. Comparative proteomics of cornified envelopes (CEs) from prenatal KtyI(-/-) and KtyII(-/-)(K8) mice demonstrates that absence of KIF causes dysregulation of many CE constituents, including downregulation of desmoglein 1. Despite persistence of loricrin expression and upregulation of many Nrf2 targets, including CE components Sprr2d and Sprr2h, extensive barrier defects persist, identifying keratins as essential CE scaffolds. Furthermore, we show that KIFs control mitochondrial lipid composition and activity in a cell-intrinsic manner. Therefore, our study explains the complexity of keratinopathies accompanied by barrier disorders by linking keratin scaffolds to mitochondria, adhesion, and CE formation

Cultivating capacities in community-based researchers in low-resource settings: Lessons from a participatory study on violence and mental health in Sri Lanka

Participatory methods, which rely heavily on community-based data collectors, are growing in popularity to deliver much-needed evidence on violence and mental health in low- and middle-income countries. These settings, along with local researchers, encounter the highest burden of violence and mental ill-health, with the fewest resources to respond. Despite increased focus on wellbeing for research participants and, to a lesser degree, professional researchers in such studies, the role-specific needs of community-based researchers receive scant attention. This co-produced paper draws insights from one group’s experience to identify rewards, challenges, and recommendations for supporting wellbeing and development of community-based researchers in sensitive participatory projects in low-resource settings. Twenty-one community-based researchers supporting a mixed-methods study on youth, violence and mental health in Sri Lanka submitted 63 reflexive structured journal entries across three rounds of data collection. We applied Attride-Stirling’s method for thematic analysis to explore peer researchers’ learning about research, violence and mental health; personal-professional boundaries; challenges in sensitive research; and experiences of support from the core team. Sri Lanka’s first study capturing experiences of diverse community-based researchers aims to inform the growing number of global health and development actors relying on such talent to deliver sensitive and emotionally difficult work in resource-limited and potentially volatile settings. Viewing participatory research as an opportunity for mutual learning among both community-based and professional researchers, we identify practice gaps and opportunities to foster respectful team dynamics and create generative and safe co-production projects for all parties. Intentional choices around communication, training, human and consumable resources, project design, and navigating instable research conditions can strengthen numerous personal and professional capacities across teams. Such individual and collective growth holds potential to benefit short- and long-term quality of evidence and inform action on critical issues, including violence and mental health, facing high-burden, low-resource contexts

Processing of triplex-directed psoralen DNA interstrand crosslinks by recombination mechanisms

Gene targeting via homologous recombination (HR) is an important application in biotechnology and medicine. However, in mammalian cells HR is much less efficient than random integration. Triplex-forming oligonucleotides (TFOs) linked to DNA damaging agents (e.g. psoralen) can stimulate HR, providing the potential to improve gene therapy applications. To elucidate factors affecting TFO-directed psoralen interstrand crosslink (ICL)-induced recombination, we constructed a series of plasmids with duplicated supF reporter genes, each containing an inactivating deletion, to measure HR frequencies in mammalian cells. Our results indicated that TFO-directed ICL-induced recombination frequencies were higher in the plasmids with larger distances between duplicated supF genes than with a smaller separation distance. However, the position of the ICL relative to the reporter genes did not affect HR frequencies. Recombination spectra were altered by the distance between supF copies. Although single-strand annealing (SSA) recombinants were predominant in all plasmid substrates, the plasmid with the shortest interval (60 bp) revealed a significant proportion of gene conversions (GCs). GCs occurred exclusively in the gene containing the shortest deletion, regardless of the distance between supF genes, ICL position or deletion orientation. Our analyses indicated that SSA is the predominant mechanism of ICL processing of these substrates in mammalian cells

HSP70-binding protein HSPBP1 regulates chaperone expression at a posttranslational level and is essential for spermatogenesis

Molecular chaperones play key roles during growth, development, and stress survival. The ability to induce chaperone expression enables cells to cope with the accumulation of nonnative proteins under stress and complete developmental processes with an increased requirement for chaperone assistance. Here we generate and analyze transgenic mice that lack the cochaperone HSPBP1, a nucleotide-exchange factor of HSP70 proteins and inhibitor of chaperone-assisted protein degradation. Male HSPBP1(−/−) mice are sterile because of impaired meiosis and massive apoptosis of spermatocytes. HSPBP1 deficiency in testes strongly reduces the expression of the inducible, antiapoptotic HSP70 family members HSPA1L and HSPA2, the latter of which is essential for synaptonemal complex disassembly during meiosis. We demonstrate that HSPBP1 affects chaperone expression at a posttranslational level by inhibiting the ubiquitylation and proteasomal degradation of inducible HSP70 proteins. We further provide evidence that the cochaperone BAG2 contributes to HSP70 stabilization in tissues other than testes. Our findings reveal that chaperone expression is determined not only by regulated transcription, but also by controlled degradation, with degradation-inhibiting cochaperones exerting essential prosurvival functions

Comparative study of Clinico-Bacterio-Radiological Profile and Treatment Outcome of Smokers and Nonsmokers Suffering from Pulmonary Tuberculosis

INTRODUCTION: Tobacco smoking and tuberculosis are two major worldwide public health problems. Smoking increases the risk of contracting tuberculosis (TB), increases the risk of recurrent TB and impairs the response to treatment of the disease. This study is intended to explore the relationship in India. OBJECTIVES: To compare the clinical /bacteriological/radiological profile and treatment outcome between smoker and non-smoker suffering from pulmonary tuberculosis. METHODOLOGY: This is a Prospective /observational study was carried out in total of 100 patients attending the outpatient clinic or being admitted as inpatient of the Department of Respiratory Medicine, Tirunelveli Medical College Hospital, Tirunelveli. After collecting the smoking history, sputum AFB and clinical history and examination findings were noted. Patient were followed up for treatment outcomes and sputum conversion. RESULTS: Majority (46%) of the study population were belonging to 41-60 age category. Out of the study population, majority were males, 67 (67%) majority were Non-smoker (52). Among the smokers, 16 were Ex-smoker and 32 were Smokers. Of the smokers, 13 were smoking cigarettes and 35 were smoking beedi. The mean Smoking Index of the study population is 428.58 with the standard deviation of 215.35. All the 100 were presented with cough with expectoration, 78 with Breathlessness, 11 with chest pain, 12 with Haemoptysis, 93 with fever and 88 with loss of appetite. Majority (38) were having 1+ bacteriological grade in sputum AFB. 4 were having 1+ bacteriological grade in sputum AFB during their completion of intensive phase. All were 100% sensitive in CBNAAT test. In the study population, 73 were declared cure at the end of the treatment period, 24 of them fall under completed category, 3 become defaulter. When smoking status was compared with the clinical symptoms such as Cough with Expectoration, Chest pain, Haemoptysis, Fever and Loss of Appetite, there is no statistical significance. Breathlessness was significantly more in smokers with the p-value of 0.016. When Sputum, Cavity, Outcome and severity with Smoking status, there was no association between sputum grading and smoking status. The mean smoking index among completed group and cured group are not statistically significant with 464.1176 and 387.5714 respectively. CONCLUSION: Cavitation was more among smokers, More number of advanced severity cases were present in smokers and more number of defaulters and less number of cured in smokers were present with a statistically significant with p-value less than 0.05. Smoking cessation programmes need to be targeted at tuberculosis patients both by clinicians specializing in tuberculosis and by national tuberculosis control initiatives. The effectiveness of such programmes in reducing smoking among tuberculosis patients and improving tuberculosis treatment outcomes also need to be assessed