A Prospective Analysis of Adverse Drug Reactions in a South Indian Hospital

Adverse drug reactions are a great cause of concern to the medical profession, the patients and the pharmaceutical industry. However ADR reporting and monitoring is yet to catch up in India. Hence we undertook a study to record and analyze adverse reactions among all patients admitted to the medical wards of a tertiary care. Centre patients admitted to all medical wards over one year were assessed for ADRs throughout their admission. Suspected ADRs were recorded and analyzed for i) the type of reaction ii) severity iii) Consequence on treatment that is if the drug was continued, or stopped, or needed to be treated with other drugs, iv) Physiological system involved and the v) group of the drugs associated with ADRs. Among 1250 patients admitted during the study period, 250 adverse events were observed. Majority (76.8%) were of mild type, 66% were severe requiring intensive care and 3 patients died. Antimicrobials were responsible for maximum (42.4%) ADRs followed by drugs acting on CNS (20%). When we analyzed the systems affected, CNS side effects were more common in our study. While in many other studies Cardiovascular and gastrointestinal side effects were the most common. Combination of drugs was responsible for a large percentage of ADRs. Inadvertent use of antipsychotics with sedatives led to respiratory failure in 4 patients of which 1 died. Contaminated IV fluids are suspected to be the cause of death in another fatal ADR. In conclusion there is a need for vigilant ADR monitoring to be done by all doctors to prevent morbidity and mortality from ADRs

Magnetism in Transition metal doped Cubic SiC

We report here our study on SiC doped with transition metals using first principle density functional theory calculations. We have considered cubic SiC with 3d transition metals as substitutional impurities for Si and C site separately. Cubic SiC doped with Cr, Mn, show ferromagnetism whereas with Sc, Ti, V and Co show site dependency of magnetic properties. Rests of the impurities are found to be non-magnetic.Comment: Presented in the 55th DAE-Solid State Physics Symposium, 26th to 30th December, 2010, Manipal University, Manipal, India; AIP Conf. Proc. 1349, 1087-1088 (2011

Microwave-Assisted Alkali Delignification Coupled with Non-Ionic Surfactant Effect on the Fermentable Sugar Yield from Agricultural Residues of Cassava

Cassava stem, leaves and peel are agricultural residues generated as waste biomass during the cultivation and processing of cassava. The potential of these biomasses as feedstock for ethanol production depends on the effective deconstruction via pretreatment and saccharification. The effect of alkaline hydrogen peroxide (AHP) treatment on microwave (MW)-irradiated or steam-exposed aqueous slurry was compared with MW-irradiation (300 W) of alkali slurry in delignifying the biomass and degrading the polysaccharides. Cellulose was degraded to a higher extent than hemicellulose in the AHP treatments. The steam-exposed and AHP pretreated residues on saccharification with Cellic (Cellulase complex) alone or Cellic along with Tween 20 resulted in high conversion of carbohydrate to reducing sugars (RS) in leaves (64-70%) and peel (74- 78%), with slightly lower conversion in stem. MW-irradiation of alkali slurry (5 min.) followed by Tween 20 supplemented saccharification was a better strategy degrading cellulose and hemicellulose to very high extent. Tween 20 supplementation was beneficial in enhancing the RS release from the biomasses even when Cellic dosage was halved. Ultrastructural studies indicated the disappearance of starch granules from stem and peel samples after MW-irradiation and saccharification, while fragmented cellulose fibers were visible in leaf samples. The study showed that MW-assisted alkali pretreatment followed by saccharification with Cellic in presence of Tween 20 was very effective in releasing maximum sugars from these biomasses

Structure and sequence analyses of Bacteroides proteins BVU_4064 and BF1687 reveal presence of two novel predominantly-beta domains, predicted to be involved in lipid and cell surface interactions.

BackgroundN-terminal domains of BVU_4064 and BF1687 proteins from Bacteroides vulgatus and Bacteroides fragilis respectively are members of the Pfam family PF12985 (DUF3869). Proteins containing a domain from this family can be found in most Bacteroides species and, in large numbers, in all human gut microbiome samples. Both BVU_4064 and BF1687 proteins have a consensus lipobox motif implying they are anchored to the membrane, but their functions are otherwise unknown. The C-terminal half of BVU_4064 is assigned to protein family PF12986 (DUF3870); the equivalent part of BF1687 was unclassified.ResultsCrystal structures of both BVU_4064 and BF1687 proteins, solved at the JCSG center, show strikingly similar three-dimensional structures. The main difference between the two is that the two domains in the BVU_4064 protein are connected by a short linker, as opposed to a longer insertion made of 4 helices placed linearly along with a strand that is added to the C-terminal domain in the BF1687 protein. The N-terminal domain in both proteins, corresponding to the PF12985 (DUF3869) domain is a β-sandwich with pre-albumin-like fold, found in many proteins belonging to the Transthyretin clan of Pfam. The structures of C-terminal domains of both proteins, corresponding to the PF12986 (DUF3870) domain in BVU_4064 protein and an unclassified domain in the BF1687 protein, show significant structural similarity to bacterial pore-forming toxins. A helix in this domain is in an analogous position to a loop connecting the second and third strands in the toxin structures, where this loop is implicated to play a role in the toxin insertion into the host cell membrane. The same helix also points to the groove between the N- and C-terminal domains that are loosely held together by hydrophobic and hydrogen bond interactions. The presence of several conserved residues in this region together with these structural determinants could make it a functionally important region in these proteins.ConclusionsStructural analysis of BVU_4064 and BF1687 points to possible roles in mediating multiple interactions on the cell-surface/extracellular matrix. In particular the N-terminal domain could be involved in adhesive interactions, the C-terminal domain and the inter-domain groove in lipid or carbohydrate interactions

SERUM FERRITIN AND HbA1c LEVELS IN TYPE 2 DIABETES MELLITUS

Introduction: Complications due to diabetes are a major cause of disability, reduced quality of life and death. Recent studies have emphasized the role of serum ferritin in insulin resistance and the incidence of diabetes mellitus. However, the role of ferritin as a marker of iron overload in pancreatic damage and peripheral insulin resistance or its role as an inflammatory marker is not clear. The aim of this study is to establish a correlation between serum ferritin, FBS and HbA1c in type 2 diabetes mellitus and to evaluate the role of serum ferritin on the glycemic status in type 2 diabetes mellitus. Methods: This was a cross- sectional study of 100 cases, visiting medical outpatient department of a tertiary care teaching hospital. Diabetic patients were compared with age and sex matched normal healthy controls. Effect of serum ferritin on glycemic status, gender and age was noted. Results: Statistically significant increase of FPG, HbA1C and serum ferritin levels were observed in type 2 diabetes mellitus group than controls in both females and males while there was no statistically significant difference of hemoglobin between diabetic group and controls in females and males. There was a high (r= 0.62, r= 0.66) positive correlation between SF and HbA1c of females and males respectively in diabetic group P-value=< 0.01. Conclusion: Higher positive correlation of serum ferritin with HbA1c shows that hyperglycemia affects ferritin levels possibly due to inflammation or oxidative stress or a combination of the two. KEYWORDS: Type 2 diabetes mellitus; Glycosylated haemoglobin; Ferritin

SERUM FERRITIN AND HbA1c LEVELS IN TYPE 2 DIABETES MELLITUS

Introduction: Complications due to diabetes are a major cause of disability, reduced quality of life and death. Recent studies have emphasized the role of serum ferritin in insulin resistance and the incidence of diabetes mellitus. However, the role of ferritin as a marker of iron overload in pancreatic damage and peripheral insulin resistance or its role as an inflammatory marker is not clear. The aim of this study is to establish a correlation between serum ferritin, FBS and HbA1c in type 2 diabetes mellitus and to evaluate the role of serum ferritin on the glycemic status in type 2 diabetes mellitus. Methods: This was a cross- sectional study of 100 cases, visiting medical outpatient department of a tertiary care teaching hospital. Diabetic patients were compared with age and sex matched normal healthy controls. Effect of serum ferritin on glycemic status, gender and age was noted. Results: Statistically significant increase of FPG, HbA1C and serum ferritin levels were observed in type 2 diabetes mellitus group than controls in both females and males while there was no statistically significant difference of hemoglobin between diabetic group and controls in females and males. There was a high (r= 0.62, r= 0.66) positive correlation between SF and HbA1c of females and males respectively in diabetic group P-value=< 0.01. Conclusion: Higher positive correlation of serum ferritin with HbA1c shows that hyperglycemia affects ferritin levels possibly due to inflammation or oxidative stress or a combination of the two. KEYWORDS: Type 2 diabetes mellitus; Glycosylated haemoglobin; Ferritin

Lime Pretreatment Associated Compositional and Ultrastructural Changes in Selected Root and Vegetable Processing Residues

The study aimed at exploring the suitability of processing residues from selected root and vegetables for bioethanol production, which are otherwise environmental pollutants. The effect of lime pretreatment at high (HT), low (LT) or room (RT) temperatures on compositional and ultrastructural changes in peels of root crops (sweet potato, elephant foot yam and tannia) and vegetable processing residues (peels from ash gourd and mixed vegetable waste) was studied. Pretreatment resulted in the removal of very little polysaccharides, including starch from these biomasses. Hemicellulose was removed to a higher extent in 24 h RT pretreatment (11.6-12.3%) compared to 7.3-8.5% removal in HT pretreatment. Maximum lignin removal (ca. 33-38%) occurred in RT pretreated (24 h) samples. Approximately 22-25.7% lignin was removed during HT pretreatment (121 °C) for 30 min. which increased to 28-31% when prolonged to 60 min. Pretreatment Efficiency (PE) was low (4.2-14.7%) in HT pretreatment, while 5.7-13.5% and 5.2-14.2% PE was observed in LT and RT pretreatments respectively. Scanning electron micrographs of lime pretreated biomass indicated that starch being a major ingredient of the biomass under study, preferential saccharification of starch by amylases might be necessary to expose the cellulose and hemicellulose for their subsequent saccharification to release fermentable sugars

Comparative Alterations in the Compositional Profile of Selected Root and Vegetable Peels Subjected to Three Pretreatments for Enhanced Saccharification

Lignocellulosic feedstocks have gained worldwide interest as alternative biofuel source in the context of squeezing petroleum resources, enhanced environmental pollution from greenhouse gases and resulting climate change. The potential of agricultural processing residues such as root and vegetable peels (beet root, greater yam, pumpkin and vegetable banana) for bioethanol production was investigated through an understanding of their compositional profile and efficacy of three pretreatments in altering their composition and reducing biomass recalcitrance. Starch was the major polysaccharide in the residues (range: 25-37%), followed by cellulose (18-22%) and hemicellulose (15-20%). While dilute sulfuric acid (DSA; 121°C ; 0.102 MPa) hydrolyzed starch and hemicellulose to a high extent, steam pretreatment of moist residues (40 % and 50 % MC) at 100 °C also facilitated hemicellulose and starch solubilization. On the contrary, lime pretreatment retained most of the cellulose, hemicellulose and starch in the pretreated residues. Delignification was the highest (28- 37%) in steam pretreated residues, with minimal effect in DSA and lime pretreatments, necessitating lignin binding surfactants during saccharification in the latter. Reducing sugar content in pretreated liquors and Pretreatment Efficiency (%) were the highest (40-45 g L-1 and 57-64% respectively) in the DSA pretreatment. The study showed that as the pretreated liquor DSA and steam pretreatment was rich in fermentable sugars, whole slurry saccharification would be beneficial for maximizing the bioethanol yield

STABILITY-INDICATING REVERSED-PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY METHOD FOR SIMULTANEOUS ESTIMATION OF METHYLCOBALAMIN, ALPHA-LIPOIC ACID, PYRIDOXINE HCL, AND FOLIC ACID IN BULK AND COMBINED DOSAGE FORM

Objectives: The purpose of the research is to develop a simple, precise, economical, accurate, reproducible, and sensitive method for the estimation of methylcobalamin, alpha-lipoic acid, pyridoxine hydrochloride, and folic acid drug product by reversed-phase high-performance liquid chromatography (RP-HPLC) method.Methods: New analytical method was developed for the estimation of methylcobalamin, alpha-lipoic acid, pyridoxine hydrochloride, and folic acid in drug product by RP-HPLC. The chromatographic separation was achieved on the Inertsil C18, 250 mm × 4.6 mm, 5 μm at ambient temperature. The separation achieved employing a mobile phase consists of buffer (added 5.05 g hexane-1-sulfonic acid is dissolved into 1000 mL of distilled water):acetonitrile in the ratio of 10:90% v/v. The flow rate was 1 mL/min and UV-visible spectrophotometer at 285 nm. The average retention time for methylcobalamin, alpha-lipoic acid, pyridoxine hydrochloride, and folic acid was found to be 3.5, 6.7, 8.5, and 9.3, respectively.Results: The developed method was validated as per ICH guidelines. All validation parameters were within the acceptable ranges. The assay methods were found to be linear from 0 to 2130 μg/mL for methylcobalamin, 0 to 142.5 μg/mL for alpha-lipoic acid, 0–4.54 μg/mL for pyridoxine hydrochloride, and 0–2 μg/mL for folic acid. The correlation coefficient was 0.999 for all drugs, respectively. The mean percentage values for the developed method were found to be within the range of 98–100.6%. The developed method was also found to be robust.Conclusion: It is concluded that developed method was accurate, precise, linear, reproducible, robust, and sensitive

Mechanism of resistance and genetic relatedness among fluoroquinolone resistant Escherichia coli causing urinary tract infections.

INTRODUCTION : Resistance to antimicrobials among bacterial pathogens is a rapidly emerging global problem. Antimicrobial resistance (AMR) is not just a problem in the hospital setting but has already spread to the community. Multidrug resistance has become a reality in the management of many important infections. This limits the choice of therapy, increases mortality, morbidity and the cost. Although the exact magnitude of economic burden and social issues related to AMR are not known, especially from developing countries, it is also likely to be significant. Hence it becomes important to understand the issues related to emergence and spread of AMR in bacteria. Therefore it was considered important to understand the mechanisms of fluoroquinolone resistance and its association with resistance to other antimicrobials in current use. A study was therefore undertaken for this purpose and also to understand the clonal spread of fluoroquinolone resistant (FQR) E.coli in our hospital and in the community. AIMS AND OBJECTIVES: Aim: To describe possible mechanisms for fluoroquinolone résistance (FQR), to document The susceptibility patterns of FQR E.coli causing Urinary tract infections (UTI) and to Ascertain whether these organisms belong to a single clone. Objectives: 1) To determine the prevalence of efflux pump mediated FQR among E.coli causing UTI. 2) To determine the prevalence of high-level resistance to nalidixic acid among FQR E.coli as a phenotypic marker of gyr A mutations. 3) To type FQR E.coli using Random Amplified Polymorphic DNA pattern. 4) To determine the prevalence of resistance to other antimicrobials like aminoglycosides and cephalosporins among the FQR E.coli. 5) To determine the prevalence of extended spectrum beta lactamase (ESBL) production Among FQR E.coli. MATERIALS AND METHODS : E.coli isolated from routine urine cultures were further evaluated to understand more details about Fluoroquinolone resistance (FQR), like its association with other antimicrobial resistance (AMR) and the possible mechanisms involved in causing FQR. The clonal relatedness of the isolates were also studied. A sample size of 120 strains was chosen for RAPD typing, which included a minimum sample size of 30 strains in each category. A sample size of 30 would give us enough information to conclude whether the strains belonged to single or multiple clones. It would also enable us to obtain information on the predominant genotypes in the hospital setting and in the community. This method of an acceptable sample size in each category was followed since there was no data on the clonal characteristics of FQR E.coli from India. RESULTS : Three hundred and forty three strains of E.coli resistant to norfloxacin isolated from urine samples were used for the study. All the strains were resistant to nalidixic acid and all except two were resistant to ciprofloxacin. CONCLUSION : The study was done to determine the mechanisms of fluoroquinolone resistance (FQR) among the E.coli causing urinary tract infections (UTI), its association with other antimicrobial resistance and genetic relatedness among them. The summary of the findings are as follows, 1) Antimicrobial resistance was significantly more among FQR E.coli when compared to fluoroquinolone susceptible E.coli. 2) A significantly high number of FQR E.coli produced ESBL when compared to fluoroquinolone susceptible isolates. 3) Multidrug resistance i.e. resistance to three or more groups of antimicrobials was significantly high among FQR E.coli. This might limit the choice of therapy and lead to therapeutic failures in the management of important infections. Further studies are required to understand why FQR, which is chromosomally mediated is significantly associated with plasmid mediated resistance like ESBL production. 4) All the FQR E.coli had the phenotypic evidence of mutations in the genes encoding for the target enzymes like gyrA. Similar evidence was also found among 90% of fluoroquinolone susceptible E.coli, which were resistant to nalidixic acid. Limiting the use of fluoroquinolones in the treatment of infections caused by nalidixic resistant E.coli is necessary to prevent further evolution of resistant strains. 5) In addition to target alterations 40% of FQR E.coli had up-regulated efflux pumps contributing to resistance. 6) A significant number of the efflux positive isolates were multidrug resistant compared to efflux negative isolates. However 71% of efflux negative strains also exhibited MDR suggesting that factors other than efflux play a role in MDR. 7) Up regulated efflux was significantly associated with nitrofurantoin resistance and also with cephalosporin resistance when compared to efflux negative FQR E.coli