A questionnaire based study on the knowledge, attitude, and the practice of ecopharmacology among the healthcare professionals in a teaching hospital in India

Background: Ecopharmacology which deals with the health hazards posed by discarded or used medicinal products in the environment, is a globally emerging issue. There are guidelines for pharmaceutical waste management (Like GMP and FDA guidelines) for the manufacturing units, pharmacists and consumers. However, it is uncertain whether consumers are aware of it. Before beginning the process of creating awareness, it is first necessary to assess the existing knowledge of the issue in the community. This study was planned to assess the knowledge, attitude and practice (KAP) of ecopharmacology in the medical personnel and students in our institute.Methods: It was a questionnaire based cross-sectional observational study. Study population included MBBS students, nursing students and resident doctors. Total 500 consenting participants were enrolled and subjected to a structured KAP questionnaire and data was expressed in percentage. Questionnaire consisted of 20 questions out of which 3 were open ended and remaining closed ended.Results: Present study result showed that 73% respondents had heard of term ecopharmacology and majority (98%) felt that it was their responsibility to protect environment from pharmaceutical waste. Responses from 83% of participants indicated that they were worried about the excess medicines at their homes. 87% of participants threw it in garbage bin, but (58%) were unsure whether their drug disposing method was safe and 25 % knew it was unsafe. Most respondents (94%) felt that there should be guidelines for safe disposal of expired/unused drug and were enthusiastic about participating in campaign for this issue. Medical personnel also suggested some solutions to deal with this problem.Conclusions: Awareness and concern regarding the problem is high however in absence of knowledge of methods of safe disposal of unused drug, it is not transforming into safe disposal practices

Physical activity assessments in obese and non-obese adolescents using the Bouchard diary

Background Obesity is now a global epidemic problem. Increased prevalence of obesity is associated with increased sedentary behavior and low physical activity.\ud \ud Objective To assess the physical activity patterns of adolescents aged 10-15 years and to compare mean energy output, intensity of physical activity, duration of moderate-vigorously intensity of physical activity, and length of screen time in obese and non-obese adolescents.\ud \ud Methods This cross-sectional study was conducted on 7th and 8th grade students aged 12-15 years at 216 junior high schools in West Jakarta. Physical activity was assessed using the Bouchard diary for 2 school days and 1 holiday.\ud \ud Results There was no significant difference in mean energy output between the obese and non-obese adolescents. The median intensity of physical activity of obese adolescents was lower than that of non-obese adolescents [1.5 (range 0.8 to 1.8) vs. 2 (range 1.6 to 2.8) METs, respectively; P <0.001]. The mean duration of moderate-vigorous intensity of physical activity in obese adolescents was shorter than that of non-obese adolescents [19.3 (SD 6.9) vs. 26.4 (SD 3.4) minutes, respectively; P=0.000]. Median length of screen time was longer for obese adolescents than for non-obese adolescents [2.8 (range 1 to 6.6) vs. 1.8 (range 0.3 to 6.1) hours, respectively; P <0.001]. There was no adolescent who met the recommended physical activity intensity and duration criteria.\ud \ud Conclusion Physical activity varies among adolescents aged 10-15 years. Obese adolescents have significantly less physical activity duration and intensity than non-obese adolescents, but significantly longer screen time. All adolescents’ physical activity is less than the recommended intensity and duration

Altered Ca(2+ )homeostasis in polymorphonuclear leukocytes from chronic myeloid leukaemia patients

BACKGROUND: In polymorphonuclear leukocytes (PMNL), mobilization of calcium ions is one of the early events triggered by binding of chemoattractant to its receptors. Besides chemotaxis, a variety of other functional responses are dependent on calcium ion mobilization. PMNL from chronic myeloid leukaemia (CML) patients that were morphologically indistinguishable from normal PMNL were found to be defective in various functions stimulated by a chemoattractant – fMLP. To study the mechanism underlying defective functions in CML PMNL, we studied calcium mobilization in CML PMNL in response to two different classical chemoattractants, fMLP and C5a. RESULTS: Release of calcium estimated by flow cytometry and spectrofluorimetry using fluo-3 as an indicator showed that the [Ca(2+)](i )levels were lower in CML PMNL as compared to those in normal PMNL. But, both normal and CML PMNL showed maximum [Ca(2+)](i )in response to fMLP and C5a at 10 sec and 30 sec, respectively. Spectrofluorimetric analysis of the total calcium release in chemoattractant treated PMNL indicated more and faster efflux of [Ca(2+)](i )in CML PMNL as compared to normal PMNL. CONCLUSION: Fine-tuning of Ca(2+ )homeostasis was altered in CML PMNL. The altered Ca(2+ )homeostasis may contribute to the defective functions of CML PMNL

Prescription pattern of antimicrobial agents by dental practitioners: a questionnaire based study

Background: The aim of this study was to know the pattern & rationality of antimicrobial prescription by dental practitioners.Methods: It was questionnaire based cross sectional study. A total of 175 questionnaires were distributed to dental practitioners working in a tertiary care Dental College & Hospital and private practitioners in Jaipur (Rajasthan). The questionnaire contained questions about years of practice, diagnosis for which antimicrobial were prescribed, dosage and duration of antimicrobial drugs for prophylaxis, acute and chronic conditions, patient compliance & adverse effects. Data was expressed as counts and percentages.Results: Out of 175 questionnaires distributed, 150 were included in the study. 78% dentists had practices less than 5 years duration. Most common indications for which antimicrobials were prescribed were abscess, cellulitis, irreversible pulpitis, and acute gingivitis. Most common antimicrobials used for prophylaxis were Amoxycillin and Metronidazole. For the treatment of acute and chronic conditions, Amoxycillin, Metronidazole, Ofloxacin and Ornidazole alone or in combination were used. Only 20% dentist advised culture & sensitivity tests. 74% patients completed the recommended course of antimicrobials. 56% patients reported adverse drug reactions (ADRs) with the most common being nausea and vomiting, but only 13% dentists reported them to proper authorities.Conclusions: In this study, Amoxycillin and Metronidazole were the most common drugs used for the management of oral diseases, but were prescribed without culture & sensitivity in most cases. 56% patients reported ADRs, but only 13% dentists reported them to proper authorities. Appropriate measures need to be taken to promote rational prescribing and ADR reporting

Preliminary lessons from COVID-19 disruptions of small-scale fishery supply chains

The ongoing COVID-19 pandemic and associated mitigation measures have disrupted global systems that support the health, food and nutrition security, and livelihoods of billions of people. These disruptions have likewise affected the small-scale fishery (SSF) sector, disrupting SSF supply chains and exposing weaknesses in the global seafood distribution system. To inform future development of adaptive capacity and resilience in the sector, it is important to understand how supply chain actors are responding in the face of a macroeconomic shock. Comparing across seven SSF case studies in four countries, we explore how actors are responding to COVID-19 disruptions, identify constraints to adaptive responses, and describe patterns of disruption and response across cases. In all cases examined, actors shifted focus to local and regional distribution channels and particularly drew on flexibility, organization, and learning to re-purpose pre-existing networks and use technology to their advantage. Key constraints to reaching domestic consumers included domestic restrictions on movement and labor, reduced spending power amongst domestic consumers, and lack of existing distribution channels. In addition, the lack of recognition of SSFs as essential food-producers and inequities in access to technology hampered efforts to continue local seafood supply. We suggest that the initial impacts from COVID-19 highlight the risks in of over-reliance on global trade networks. The SSFs that were able to change strategies most successfully had local organizations and connections in place that they leveraged in innovative ways. As such, supporting local and domestic networks and flexible organizations within the supply chain may help build resilience in the face of future macroeconomic shocks. Importantly, bolstering financial wellbeing and security within the domestic market both before and during such large-scale disruptions is crucial for supporting ongoing supply chain operations and continued food provision during macroeconomic crises

Anti-tubulin drugs conjugated to anti-ErbB antibodies selectively radiosensitize.

Tumour resistance to radiotherapy remains a barrier to improving cancer patient outcomes. To overcome radioresistance, certain drugs have been found to sensitize cells to ionizing radiation (IR). In theory, more potent radiosensitizing drugs should increase tumour kill and improve patient outcomes. In practice, clinical utility of potent radiosensitizing drugs is curtailed by off-target side effects. Here we report potent anti-tubulin drugs conjugated to anti-ErbB antibodies selectively radiosensitize to tumours based on surface receptor expression. While two classes of potent anti-tubulins, auristatins and maytansinoids, indiscriminately radiosensitize tumour cells, conjugating these potent anti-tubulins to anti-ErbB antibodies restrict their radiosensitizing capacity. Of translational significance, we report that a clinically used maytansinoid ADC, ado-trastuzumab emtansine (T-DM1), with IR prolongs tumour control in target expressing HER2+ tumours but not target negative tumours. In contrast to ErbB signal inhibition, our findings establish an alternative therapeutic paradigm for ErbB-based radiosensitization using antibodies to restrict radiosensitizer delivery