Perception of doctors towards Adverse Drug Reaction (ADR) reporting: a cross sectional survey using a validated questionnaire

Background: Several studies have shown lack of sufficient knowledge and awareness among doctors on ADR reporting. Knowledge and attitude of doctors about ADR greatly influences extent of reporting. Identifying factors affecting ADR-reporting is vital to enable Pharmacovigilance teams to implement interventions to enhance rate and quality of reporting of ADRs. Hence, this study is done to evaluate perceptions of doctors towards ADR-reporting and to determine barriers for reporting ADR.Methods: Cross sectional study conducted among doctors using a validated questionnaire to assess knowledge, attitude, practice and barriers for reporting ADRs. The questionnaire captured the demographic details, knowledge (14), attitudes (7) and practice pattern (4) towards pharmacovigilance. Descriptive statistics was used to assess the response among doctors.Results: Of 157 doctors who responded to questionnaire, 90% of doctors were aware of pharmacovigilance program mainly through PVG activities by AMC and pharmacology classes. Only 47% doctors reported ADRs. The composite score on knowledge of ADR reporting and on knowledge of ADR burden was found to be moderate. 90% doctors opined ADR monitoring in hospital should be mandatory. 83% doctors opined ADR reporting by one person can make significant difference to community. One-third doctors felt there should be financial reward for ADR-reporting. In suspected cases, 57% doctors include ADR as differential diagnosis. 61% doctors said they will document ADR in patient file and 78% reports to AMC. More than one-third doctors don’t know where and how to report ADR. One-third doctors felt management of patients was more important than reporting ADR. Nearly one-fourth didn’t report fearing legal liabilities, difficulty diagnosing ADR and negative impact on doctors.Conclusions: Knowledge about ADR-reporting and attitude towards it is adequate. But, because of many barriers, actual practice of ADR-reporting is unsatisfactory. Hence, Pharmacovigilance training is essential for doctors to promote and improve ADR-reporting

Perceptual Compressive Sensing

Compressive sensing (CS) works to acquire measurements at sub-Nyquist rate and recover the scene images. Existing CS methods always recover the scene images in pixel level. This causes the smoothness of recovered images and lack of structure information, especially at a low measurement rate. To overcome this drawback, in this paper, we propose perceptual CS to obtain high-level structured recovery. Our task no longer focuses on pixel level. Instead, we work to make a better visual effect. In detail, we employ perceptual loss, defined on feature level, to enhance the structure information of the recovered images. Experiments show that our method achieves better visual results with stronger structure information than existing CS methods at the same measurement rate.Comment: Accepted by The First Chinese Conference on Pattern Recognition and Computer Vision (PRCV 2018). This is a pre-print version (not final version

Bilateral absence of musculocutaneous nerve

Brachial plexus is an important group of spinal nerve plexus that supplies the muscles of the upper limb via the ventral rami of the Cervical 5 - Thoracic 1 fibers of the spinal nerves. It is not uncommon to notice the variations during cadaveric dissections in many regions of the body, at different levels, such as, roots, trunks, division, cords, communications, and branches as reported in the literature. Although the nerve supply of the body musculature takes place in the fetal life itself, its course, branching pattern, innervations, and communication can show variable patterns as the fetal development progresses. One such anomaly was noticed during our routine cadaveric dissection in the Department of Anatomy, Jawaharlal Nehru Medical College, Belgaum, showing bilateral absence of the musculocutaneous nerve, which obviously drew the attention of the students of medicine, physiotherapy, and learning clinicians as well

Etizolam: Use and safety profile in children and adolescent

Introduction: Etizolam is a benzodiazepine that has anxiolytic, anticonvulsant, hypnotic, sedative, amnesic, and muscle-relaxant properties. It is used in adults with anxiety, depressive, somatization symptoms, generalized anxiety disorder, and panic disorder. Aims: The aim of the study was to chart review the use and safety of Etizolam in children and adolescents. Settings and Design: This study was a retrospective chart review. Methods: Patients who are on Etizolam and had at least 2 weeks follow-up were included for the study. The indications, effectiveness, and adverse effects were noted. Statistical analysis used: Data was analysed using Epi Info 7. Descriptive statistics were used. Results: 57 (38.51%) patients had been treated with Etizolam. The mean age of children was 13.59 years (7-18 years). Amongst the patients prescribed Etizolam, 37 (64.91%) had a data of follow-up of at least 2 weeks. 25 (67.57%) patients had moderate to complete improvement, 5 (13.51%) had mild improvement and 7 (18.92%) had no improvement. The adverse events were noted only in 3 (8.11%) patients. Conclusions: Etizolam is effective in treating common psychiatric symptoms and disorders in children and adolescents and is well tolerated with minimal adverse effects

5803Contemporary Trends of Incidence, Management and Outcomes of Non-acute Coronary Syndrome Associated Cardiogenic Shock: data from 2003 to 2011

Introduction: Cardiogenic shock (CS) is a critical condition with high mortality and morbidity. Acute coronary syndrome (ACS) is the most common condition associated with cardiogenic shock and extensive literature exists with respect to ACS related cardiogenic shock (ACS-CS). However, very limited contemporary data exists related to non-ACS related cardiogenic shock (non-ACS-CS). Hence we analyzed nationwide inpatient sample databases to study the temporal changes in incidence, management and clinical outcomes of non-ACS-CS. Methods: We identified all CS patients with age ≥18 years from 2003 to 2011. Among these, patients with ACS diagnosis were classified as ACS-CS patients while those without a diagnosis of ACS were considered as non-ACS-CS patients. Primary outcome was trend in non-ACS-CS, and secondary outcomes included in-hospital mortality and use of intra-aortic balloon pump (IABP). Results:Of 642,290 cardiogenic shock patients, 39.7% (n=255,355) were non-ACS patients. Mean age was 66.2±15.8 years, 40.6% female and 76.8% whites. The three most common primary causes of hospitalization in non-ACS-CS patients were congestive heart failure, septicemia and acute respiratory failure. The most common preexisting clinical comorbidities were hypertension, diabetes, hyperlipidemia, chronic pulmonary disease and congestive heart failure, and their prevalence increased significantly from 2003 to 2011 (all p trend Conclusion: Hospitalizations of patients with non-ACS- CS have increased exponentially among US adults from 2003 to 2011. While the proportion of comorbid chronic diseases has increased, there has been an overall decline in hospital mortality. There is a wide scope for improvement of clinical outcomes in these critically ill patients, demanding better and clear management guidelines

Optimization of screening and emitter density for an array of carbon nanotube field emitters

583-586In order to exploit the high current carrying capacity of Carbon Nanotubes (CNTs), it is important to maximize current density J by controlling screening as well as the emitter density. A model is developed in MATLAB to calculate the current density from an array of nanotube bundlestaking into account both the effect of screening and the emitter density in the framework of standard Fowler-Nordheim (F-N) theory. <span style="mso-bidi-font-weight: bold">The results obtained indicate that field emission can be optimized when the inter bundle distance is comparable with the nanotube height. Field emission measurements carried out on vertically aligned CNT bundles grown on patterned substrates give a strong support to the results obtained by simulation. </span

In Situ Monitoring of Mechanochemical Synthesis of Calcium Urea Phosphate Fertilizer Cocrystal Reveals Water-Based Autocatalysis

Using the mechanosynthesis of the calcium phosphate and urea fertilizer cocrystal as a model, we provide the first in situ investigation of autocatalysis in a mechanochemical reaction. The application of in situ Raman spectroscopy and synchrotron X-ray diffraction provided the first direct evidence of a mechanochemical system in which a reaction product (water) mediates the rate of transformation and underpins positive feedback kinetics

In situ monitoring of mechanochemical synthesis of calcium urea phosphate fertilizer cocrystal reveals highly effective water-based autocatalysis

Using the mechanosynthesis of the calcium urea phosphate fertilizer cocrystal as a model, we provide a quantitative investigation of chemical autocatalysis in a mechanochemical reaction. The application of in situ Raman spectroscopy and synchrotron X-ray powder diffraction to monitor the reaction of urea phosphate and either calcium hydroxide or carbonate enabled the first quantitative and in situ study of a mechanochemical system in which one of the products of a chemical reaction (water) mediates the rate of transformation and underpins positive feedback kinetics. The herein observed autocatalysis by water generated in the reaction enables reaction acceleration at amounts that are up to 3 orders of magnitude smaller than in a typical liquid-assisted mechanochemical reaction

Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation.

Frailty is a powerful predictor of outcomes after transcatheter aortic valve implantation (TAVI). Sarcopenia as assessed by psoas muscle area (PMA) is a validated tool to assess frailty before surgical procedures. We evaluated PMA as a predictor of outcomes after TAVI in 152 consecutive patients who underwent this procedure at our institution from 2011 to 2014. Preoperative computed tomography scans were used to measure PMA, which then was indexed to body surface area. Outcomes evaluated included (1) early poor outcome (30 days mortality, stroke, dialysis, and prolonged ventilation), (2) 1-year mortality, and (3) high-resource utilization (length of stay \u3e7 days, discharge to rehabilitation, or readmission within 30 days). Indexed PMA (odds ratio [OR] 3.19, confidence interval [CI] 1.30 to 7.83; p = 0.012) and age (OR 1.92, CI 1.87 to 1.98; p = 0.012) predicted early poor outcome. Society of Thoracic Surgeons score predicted 1-year mortality (hazard ratio 3.07, CI 1.93 to 6.23; p = 0.011). High-resource utilization was observed more frequently in patients with PMA less than the median (73% vs 51%, OR 2.65, CI 1.32 to 5.36; p = 0.006). In conclusion, indexed PMA predicts early poor outcome and high-resource utilization after TAVI