Evaluation of indoor prescriptions of depression in psychiatry department of a tertiary care hospital in North India

Background: Depression is one of most common psychiatric illnesses affecting the human population and poses significant economic burden to society. Prescription for depression usually involves multiple medications sometime irrationally prescribed.Methods: Present study involved evaluation of 65 indoor prescriptions of patients diagnosed with depression from Psychiatry Department in a tertiary care hospital. The prescriptions were evaluated on basis of WHO Core Indicators for writing a good prescription. The demographic characteristics of the patient population were studied. Number of drugs prescribed per prescription and the average number per prescription were calculated to assess polypharmacy. The cost involved in treatment using latest market data from drug information source and the rationality of prescriptions were also evaluated.Results: 80% of the prescriptions were not in accordance with the WHO Core Indicators. An average of 2.415±1.102 medications were prescribed per prescription indicating polypharmacy. Insignificant difference was observed in cost per prescription per month of medicines when compared with lowest priced products available in market.Conclusions: Polypharmacy was found in most prescriptions and monotherapy was instituted in five prescriptions only, with clonazepam as the most prescribed antidepressant drug. Majority of prescriptions did not conform to WHO core indicators for prescription writing

THYMOL TEMPERS As (III) AND Hg (II) CAUSED HYPERCONTRACTILITY BY SIMILAR PATHWAYS IN ISOLATED AORTIC AND TRACHEAL RINGS

Objective: Thymol is known to cause smooth muscle relaxation, possibly by inhibition of Ca2+influx, release or loss of its sensitivity. It is, however, also reported to be a strong antioxidant in several other systems. In this study, we investigate other possible pathways of thymol caused relaxation of aortic and tracheal segments by using specific blockers, and explore it as potential ameliorator of arsenic and mercury caused hyper contraction.Methods: Male Wistar rats were used in all experiments. Aorta/trachea was carefully removed, cleaned, and cut into 2-mm thick rings. Isometric contractions were measured using organ bath system. One-way analysis of variance (ANOVA) and Student's t-test were used for statistical analyses. P<0.05 was considered significant.Results: In pollutant unexposed aortic and tracheal segments, thymol is found to inhibit contractions through quenching of reactive oxygen species (ROS) in addition to its previously reported effects on Ca2+movements. Equal effectiveness in absence and presence of NG-nitro-L-arginine methyl ester (L-NAME) indicates that nitric oxide (NO) has no significant role in the thymol caused relaxation.Conclusion: In both muscle types, thymol is found to be an effective ameliorator of As (III) and Hg (II) caused hyper contraction, at low concentrations; it acts by inhibiting the Ca2+influx whereas at high concentration, it acts by blocking Ca2+influx and neutralizing ROS.Â

Tenovin-1, a selective SIRT1/2 inhibitor, attenuates high-fat diet-induced hepatic fibrosis via Inhibition of HSC activation in ZDF rats

Type 2 diabetes mellitus (T2DM) increases the risk of non-alcoholic fatty liver disease (NAFLD) progression to advanced stages, especially upon high-fat diet (HFD). HFD-induced hepatic fibrosis can be marked by oxidative stress, inflammation, and activation of hepatic stellate cells. Sirtuin 1/2 (SIRT1/2), NAD-dependent class III histone deacetylases, are involved in attenuation of fibrosis. In our conducted research, TGF-β1-activated LX-2 cells, free fatty acid (FFA)-treated simultaneous co-culture (SCC) cells, and HFD-induced hepatic fibrosis in Zucker diabetic fatty (ZDF) rats, a widely used animal model in the study of metabolic syndromes, were used to evaluate the protective effect of Tenovin-1, a SIRT1/2 inhibitor. ZDF rats were divided into chow diet, HFD, and HFD + Tenovin-1 groups. Tenovin-1 reduced hepatic damage, inhibited inflammatory cell infiltration, micro/ macro-vesicular steatosis and prevented collagen deposition HFD-fed rats. Tenovin-1 reduced serum biochemical parameters, triglyceride (TG) and malondialdehyde (MDA) levels but increased glutathione, catalase, and superoxide dismutase levels. Tenovin-1 mitigated proinflammatory cytokines IL-6, IL-1β, TNFα and fibrosis biomarkers in HFD rats, TGF-β1-activated LX-2 and FFA treated SCC cells. Additionally, Tenovin-1 suppressed SIRT1/2 expression and inhibited JNK-1 and STAT3 phosphorylation in HFD rats and FFA-treated SCC cells. In conclusion, Tenovin-1 attenuates hepatic fibrosis by stimulating antioxidants and inhibiting inflammatory cytokines under HFD conditions in diabetic rats

Eff ect of participatory women’s groups facilitated by Accredited Social Health Activists on birth outcomes in rural eastern India: a cluster-randomised controlled trial

Background A quarter of the world’s neonatal deaths and 15% of maternal deaths happen in India. Few community-based strategies to improve maternal and newborn health have been tested through the country’s government-approved Accredited Social Health Activists (ASHAs). We aimed to test the eff ect of participatory women’s groups facilitated by ASHAs on birth outcomes, including neonatal mortality. Methods In this cluster-randomised controlled trial of a community intervention to improve maternal and newborn health, we randomly assigned (1:1) geographical clusters in rural Jharkhand and Odisha, eastern India to intervention (participatory women’s groups) or control (no women’s groups). Study participants were women of reproductive age (15–49 years) who gave birth between Sept 1, 2009, and Dec 31, 2012. In the intervention group, ASHAs supported women’s groups through a participatory learning and action meeting cycle. Groups discussed and prioritised maternal and newborn health problems, identifi ed strategies to address them, implemented the strategies, and assessed their progress. We identifi ed births, stillbirths, and neonatal deaths, and interviewed mothers 6 weeks after delivery. The primary outcome was neonatal mortality over a 2 year follow up. Analyses were by intention to treat. This trial is registered with ISRCTN, number ISRCTN31567106. Findings Between September, 2009, and December, 2012, we randomly assigned 30 clusters (estimated population 156 519) to intervention (15 clusters, estimated population n=82 702) or control (15 clusters, n=73 817). During the follow-up period (Jan 1, 2011, to Dec 31, 2012), we identifi ed 3700 births in the intervention group and 3519 in the control group. One intervention cluster was lost to follow up. The neonatal mortality rate during this period was 30 per 1000 livebirths in the intervention group and 44 per 1000 livebirths in the control group (odds ratio [OR] 0.69, 95% CI 0·53–0·89). Interpretation ASHAs can successfully reduce neonatal mortality through participatory meetings with women’s groups. This is a scalable community-based approach to improving neonatal survival in rural, underserved areas of India

Effect of participatory women's groups facilitated by Accredited Social Health Activists on birth outcomes in rural eastern India: A cluster-randomised controlled trial

Background: A quarter of the world's neonatal deaths and 15% of maternal deaths happen in India. Few community-based strategies to improve maternal and newborn health have been tested through the country's government-approved Accredited Social Health Activists (ASHAs). We aimed to test the effect of participatory women's groups facilitated by ASHAs on birth outcomes, including neonatal mortality. Methods: In this cluster-randomised controlled trial of a community interve

Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

Background: Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting.The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa.Methods/design: The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional endpoints include home care practices and health care-seeking in the antenatal, delivery and postnatal period. The impact of the intervention will be measured through a prospective surveillance system implemented by the project team, through which mothers will be interviewed around six weeks after delivery. Cost data and qualitative data are collected for cost-effectiveness and process evaluations

Analysis of Spectral differences between Printers to detect the Counterfeit Medicine Packaging

International audienc

Study on Color Gamut to Authenticate the Gravure Printers Output

International audienc

Authentication of a Gravure Printer from Color Values using an Artificial Neural Network

International audienceCounterfeited packaging products (Pharmaceuticals) can create severe health hazard. While counterfeiting the pharmaceutical product, printing and packaging takes very crucial role as the customer buy the product by the attraction and information provided by the package. So the counterfeiters emphasize more on packages and associated printing. This work is focused on pharmaceutical package printing not only for its social implication but also for its technological variation. Since most of the medicines are packed in metal foil, the printing technology associated is gravure printing. Little work has been done on this technology and its security aspects. The common ways to counterfeit the packages are to copy the text and images of the package and to reproduce it. However, the variation of color while reprinting it may be assessed to check whether the printing is done by the original manufacturer or their authenticated printer house. Scanning or taking photographs of the package and re-printing is one of the methods to counterfeit the original package sample. Different digital camera, mobile camera, scanner etc have been used to scanned the original sample and then to reprint it. When the image of the original print is taken through different mobiles, camera or scanners, the color values are not the same as the original print even if it is printed on the same printer. However, when the scanned samples are reprinted with different printers, the differences are much higher in comparison to the original print. In this study, blister foil has been taken as substrate and a reference color chart (IT8.7/3) printed with 4-color gravure printing machine. The reference image has been printed with three different gravure printers (P1, P2 ,P3). Then the images of print samples are taken by different input devices. The images are then printed in those three printers again. Study the difference in Lightness and color differences are analyzed to assess the difference of print and reprint samples among different gravure printing press. Artificial Neural Network (ANN) model is used to predict the CIELAB color values of a print sample printed from a printer. In this study, 70% of color patches (total 928) have been used to train the network, 15% of the data used as cross-validation and 15% of the data is used to verify the accuracy of the network. Then the predicted color values of one printer are compared with other print and scanned reprint sample to assess the differences. It has been observed that the difference of predicted color values with the print samples are much less. The difference becomes much higher for scanned reprint samples. Hence it will be possible to identify the fake sample (if someone tries to reprint it after scanning or taking images of original multicolor artwork and reprints it). Hence the predicted difference could be used to protect medicine packaging from counterfeiting

Anaesthetic concerns in post-COVID mucormycosis at a tertiary care hospital in India: An observational study

Administration of anaesthesia in post-COVID mucormycosis patients is a real challenge due to complications such as dyselectrolytemia, renal failure, multi-organ failure, and sepsis. The aim of this study was to evaluate the challenges and perioperative complications of administration of anaesthesia in terms of morbidity and mortality in patients undergoing surgical resection of post-COVID rhino-orbito-cerebral mucormycosis (ROCM). The present study was a case series, which was carried out on 30 post-COVID, biopsy-proven mucormycosis patients enrolled for ROCM resection under general anaesthesia, and all data were collected retrospectively for this series. The post-COVID mucormycosis patients had diabetes mellitus as the most common comorbidity (96.6%), and difficult airway was a common feature (60%) among them. Anaesthetic management of post-COVID mucormycosis patients is a real challenge due to associated comorbidities