Aluminium Salalens vs. Salans: "Initiator Design" for the Isoselective Polymerisation of rac-Lactide

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC05795K, Communication

Paul McKeown, Matthew G Davidson, Gabriele Kociok-Kohn, Matthew Jones
We report the rationallised design of aluminium initiators and their application for ROP of rac-lactide (rac-LA). Very minor change to the ligand backbone (imine reduction) to give secondary amines was...
The content of this RSS Feed (c) The Royal Society of Chemistry

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2aeprdC
via IFTTT

Hydrogen cleavage by solid-phase frustrated Lewis pairs

Chem. Commun., 2016, Advance Article
DOI: 10.1039/C6CC04937K, Communication

Jun-Yi Xing, Jean-Charles Buffet, Nicholas H. Rees, Peter Norby, Dermot O'Hare
We report the direct synthesis of a solid-phase frustrated Lewis pair (s-FLP), reaction with H₂ under mild conditions led to heterolytic H-H bond cleavage and the formation of [[triple bond, length as m-dash]SiOB(H)(C₆F₅)₂][^tBu₃PH].
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2aepztG
via IFTTT

The Thoracic Peri-Operative Integrative Surgical Care Evaluation (POISE) Trial- Stage I

Conditions:   Lung Neoplasms;   Esophageal Neoplasms;   Stomach Neoplasms
Intervention:   Other: Integrative Care
Sponsors:   The Canadian College of Naturopathic Medicine;   Ottawa Hospital Research Institute;   Lotte & John Hecht Memorial Foundation
Not yet recruiting - verified July 2016

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ah2B2B
via IFTTT

Regorafenib in Combination With Paclitaxel in Advanced Oesophagogastric Carcinoma

Conditions:   Esophageal Neoplasms;   Stomach Neoplasms;   Neoplasm Metastasis
Interventions:   Drug: Regorafenib;   Drug: Paclitaxel
Sponsor:   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Recruiting - verified July 2016

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2au228S
via IFTTT

Feasibility Study of Adjuvant Treatment With S-1 and Oxaliplatin in Patients With Resectable Esophageal Cancer

Condition:   Esophageal Cancer
Intervention:   Drug: S-1 and Oxaliplatin
Sponsors:   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA);   Celgene Corporation
Recruiting - verified July 2016

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ah2DHJ
via IFTTT

The Addition of Nab-paclitaxel (Abraxane) to First Line Treatment of Metastasized Oesophagogastric Carcinoma (ACTION)

Conditions:   Esophageal Cancer;   Toxicity
Intervention:   Drug: Nab-paclitaxel
Sponsors:   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA);   Celgene Corporation
Recruiting - verified July 2016

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2au2svV
via IFTTT

Feasibility Study of Chemoradiation, TRAstuzumab and Pertuzumab in Resectable HER2+ Esophageal Carcinoma

Condition:   Esophageal Carcinoma
Intervention:   Drug: Pertuzumab, trastuzumab
Sponsors:   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA);   Roche Pharma AG
Recruiting - verified July 2016

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ah2CDz
via IFTTT

Patient satisfaction in the management of mild-to-moderate ulcerative colitis: Results of a Delphi study among patients and physicians

To determine factors contributing to satisfaction with treatment in mild-to-moderate ulcerative colitis (UC) from both the patients and the physicians perspectives.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ZocRb
via IFTTT

Collagenous colitis and Crohn's disease: Guilty or innocent bystander?

The authors report a case of a 73-year-old male evaluated for profuse watery diarrhea and weight loss for 2 months, aggravated the week before. His past medical history was relevant for ileal Crohn's disease diagnosed at the age of 34 years, with two segmental enterectomies due to ileal stenosis and enterocutaneous fistula. The histopathological exam of the resected bowel showed transmural lymphoplasmocytic infiltrate with deep ulceration and non-caseating granulomas. Due to penetrating phenotype, immunomodulatory therapy was proposed but the patient refused.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2aJZiSC
via IFTTT

HCV novel therapeutic regimens in Wonderland: A budget impact analysis in the Lombardy Region

The advent of new HCV drugs has generated widespread economic concerns, particularly within the Italian setting, characterized by continuous linear cuts and spending review actions. The overall trade-off between investments and savings needs an in depth analysis.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29Zol74
via IFTTT

Effectiveness of Endoscopic Ultrasonography during Double Balloon Enteroscopy for characterization and management of small bowel submucosal tumours

Characterization of small bowel submucosal tumours is challenging, requiring additional investigations. Endoscopic Ultrasonography performed during Double Balloon Enteroscopy, appeared a promising technique although it has not been fully evaluated. The aim was to determine the effectiveness of this technique for characterization and management of sub mucosal tumours in a large cohort of patients.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2aJYI7l
via IFTTT

An increase in serum tumour necrosis factor-α during anti-tumour necrosis factor-α therapy for Crohn's disease – A paradox or a predictive index?

Soluble tumour necrosis factor-α (sTNF-α) has been reported to increase in the course of anti-TNF-α therapy for rheumatoid and skin diseases.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ZnQtH
via IFTTT

Früherkennung

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ad91C2
via IFTTT

RANZCR 2016 Case of the Day competition

Radiopaedia.org and the Royal Australian and New Zealand College of Radiologists (RANZCR) are collaborating to give everyone in the world an opportunity to a submit a radiology case for the RANZCR 2016 Case of the Day competition.

Each day during the RANZCR 2016 Annual Scientific Meeting (October 13 - 16) on the Gold Coast a series of cases will be featured in the Case of the Day area. The cases will also be shared across Radiopaedia's social media network and on the homepage so the whole world can join in the learning. 

The competition is open to anyone in the world, not just those living in Australia and New Zealand. This is our way of helping to make RANZCR 2016 a truly global education event.  

Prizes

All successful Case of the Day submission will receive 12 months online access to our Adult Brain MRI review course and Neuroradiology Update 2016 course, featuring Frank Gaillard, Andrew Dixon and Peter Mitchell. Prizes will also be available for delegates at the conference who complete the daily case of the day quiz. 

Dates

Submissions close on September 23rd 2016, and the winners will be chosen by Radiopaedia and RANZCR in the following couple of weeks. Winners will be contacted by email, so please make sure the email listed in your Radiopaedia.org profile is correct. 

Submitting a case

To have your case considered for the RANZCR 2016 Case of the Day, simply upload an awesome case to Radiopaedia and add the tag "RANZCR2016" in the right hand column of the case edit page. We're accepting great radiology cases from any subspecialty.

For those submitting a case to Radiopaedia for the very first time, you'll find that it is really easy.  The short video tutorial below will help you with most things you need to know. It may also be worth checking out our case publishing guidelines. 

Contact

If you have any questions, please write to general@radiopaedia.org.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a9oOkc
via IFTTT

Corrigendum to “Magnesium alloys as body implants: Fracture mechanism under dynamic and static loadings in a physiological environment” [Acta Biomater. 8 (2012) 916–923]

Publication date: Available online 26 July 2016
Source:Acta Biomaterialia
Author(s): Lokesh Choudhary, R.K. Singh Raman




from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2abbCPK
via IFTTT

Brain stiffness increases with myelin content

Publication date: Available online 27 July 2016
Source:Acta Biomaterialia
Author(s): J. Weickenmeier, R. De Rooij, S. Budday, P. Steinmann, T.C. Ovaert, E. Kuhl
Brain stiffness plays an important role in neuronal development and disease, but reported stiffness values vary significantly for different species, for different brains, and even for different regions within the same brain. Despite extensive research throughout the past decade, the mechanistic origin of these stiffness variations remains elusive. Here we show that brain tissue stiffness is correlated to the underlying tissue microstructure and directly proportional to the local myelin content. In 116 indentation tests of six freshly harvested bovine brains, we found that the cerebral stiffnesses of 1.33±0.63 kPa in white matter and 0.68±0.20 kPa in gray matter were significantly different (p<0.01). Strikingly, while the inter-specimen variation was rather moderate, the minimum and maximum cerebral white matter stiffnesses of 0.59±0.19 kPa and 2.36±0.64 kPa in each brain varied by a factor of four on average. To provide a mechanistic interpretation for this variation, we performed a histological characterization of the tested brain regions. We stained the samples with hematoxylin and eosin and luxol fast blue and quantified the local myelin content using image analysis. Interestingly, we found that the cerebral white matter stiffness increased with increasing myelin content, from 0.72kPa at a myelin content of 64% to 2.45kPa at a myelin content of 89%, with a Pearson correlation coefficient of ρ=0.91 (p<0.01). This direct correlation could have significant neurological implications. During development, our results could help explain why immature, incompletely myelinated brains are softer than mature, myelinated brains and more vulnerable to mechanical insult as evident, for example, in shaken baby syndrome. During demyelinating disease, our findings suggest to use stiffness alterations as clinical markers for demyelination to quantify the onset of disease progression, for example, in multiple sclerosis. Taken together, our study indicates that myelin might play a more important function than previously thought: It not only insulates signal propagation and improves electrical function of single axons, it also provides structural support and mechanical stiffness to the brain as a whole.

Graphical abstract

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apX8Zd
via IFTTT

Study of Antiobesity Effect through Inhibition of Pancreatic Lipase Activity of Diospyros kaki Fruit and Citrus unshiu Peel

Pancreatic lipase is the enzyme responsible for digestion and absorption of triglycerides, being its inhibition one of the widest studied methods used to determine the potential activity of natural products to inhibit dietary fat absorption. Decrease of energy intake from dietary fat through inhibition of this enzyme may be an excellent strategy to prevent and treat obesity. The inhibitory activity on pancreatic lipase enzyme of Diospyros kaki fruit and Citrus unshiu peel mixture extract (PCM) was evaluated in vitro and its antiobesity effects were studied based on the serum lipid parameters analysis from high-fat diet- (HFD-) fed mice in vivo. PCM was orally administered at a dose of 50 and 200 mg/kg body weight for 6 weeks. In addition, the activity of pancreatic lipase was assessed using orlistat (positive control). PCM exhibited inhibitory effect on lipase activity with IC50 value of 507.01 μg/mL. Moreover, serum triacylglycerol, total cholesterol levels, and visceral fat weight were significantly reduced compared to HFD control mice in PCM 200 mg/kg-treated mice (). These results suggest that PCM administration may be a novel potential antiobesity agent for reduction of fat absorption via inhibition of pancreatic lipase.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a9nHRt
via IFTTT

Traumatic Renal Artery Thrombosis in a Child A case Report

2016-07-27T05-45-28Z
Source: The Southeast Asian Journal of Case Report and Review
Charu Tiwari, Hemanshi Shah, Vikrant Kumbhar, Gursev Sandlas.
Introduction: Blunt abdominal injuries are common in children with liver, spleen and kidneys being more commonly injured. Of these, renal trauma account for 10% of these injuries. Case Report: We have presented a case of blunt abdominal trauma leading to renal artery thrombosis which was managed conservatively. Conclusion: Prompt diagnosis and conservative management usually leads to successful outcome and unnecessary laparotomies are thereby avoided.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a9o26V
via IFTTT

Incidental cervical metastases from thyroid carcinoma during neck dissection

Publication date: Available online 26 July 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): S. Périé, F. Torti, M. Lefevre, N. Chabbert-Buffet, A. Jafari, J. Lacau St Guily
ObjectivesTo quantify and discuss the prevalence of unsuspected thyroid lymph node metastases discovered in specimens from neck dissection for head and neck squamous cell carcinoma (HNSCC) and discuss the impact on patient management.Study designRetrospective study between May 2004 and January 2007.SettingUniversity hospital.MethodsPathological analysis of cervical lymph node dissection performed during surgery for HNSCC in a total of 349 neck dissections in 266 consecutive patients.ResultsTwenty-one patients showed metastatic lymph nodes from thyroid cancer (prevalence 7.9%): 13 cases were metastatic from a papillary thyroid carcinoma and 8 cases from a follicular carcinoma. In 5 of the 21 patients, classical dissection was associated to recurrent nerve dissection and unilateral lobectomy; no thyroid carcinoma was found. Thirteen patients received radiotherapy for HNSCC.Follow-up comprised annual ultrasonographic examination of the neck and thyroid in these 21 patients. Total thyroidectomy was decided on in 5, with discovery of 3 micro-papillary thyroid carcinomas, in a single patient (complementary ¹³¹I treatment). No thyroid carcinomas were found for the other 4 patients. No patients died from thyroid carcinoma during follow-up (mean: 41 months).ConclusionThe prevalence of lymph node metastasis from thyroid carcinoma in cervical lymph node dissection during treatment of HNSCC seems higher (7.9%) than rates reported in the literature (0.3 to 1.6%). This may be due to the histopathological methods employed. Management of patients should be discussed in the light of thyroid ultrasonography and prognosis of HNSCC.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a99l2D
via IFTTT

Deviations of different systems for guided implant surgery

Abstract

Objectives

To compare the deviation of different systems for Guided Implant Surgery (GIS) related to the specific tolerance between drills and sleeves.

Material and methods

Four different systems for GIS and their appropriate sleeves were used: Camlog Guide (CG), Straumann Guided Surgery (SG), SIC Guide (SIG), and NobelGuide (NG). System-appropriate metal sleeves were inserted into plexiglass boxes, and guided drilling procedure was performed (i) holding the drills in the most centric position of the sleeves and (ii) applying forces eccentrically. Digital microscope images of the plexiglass boxes were taken and axial deviations were calculated based on the Pythagorean Theorem, whereas coronal and apical deviations were measured with a corresponding software-device and calculated by subtracting the measured deviations from the original diameter of the drills. Statistically significant differences between centric and eccentric drilling were determined applying the t-test for independent data.

Results

The axial deviation ranged from 0° (SG) to 5.64° (CG). The apical deviations varied between 0.01 mm (SIG) and 3.2 mm (NG) and the coronal deviations ranged from 0.01 mm (SIG) to 1.60 mm (NG). In terms of angular deviation, there were statistically significant differences between centric and eccentric drilling for all four systems. Coronal and apical deviations, showed no statistical significance between centric and eccentric drilling for SIG and NG, in contrast to CG and SG.

Conclusions

The clinician may have considerable impact on the accuracy of GIS when applying eccentric forces.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apUrXL
via IFTTT

Quality control of house dust mite extracts by broad-spectrum profiling of allergen-related enzymatic activities

Abstract

Background

Diagnosis and immunotherapy of allergy against mites is based on complex extracts from large-scale cultures. However, the analysis of their composition using specific antibodies is limited. By taking advantage of the prevailing enzymatic nature of mite allergens, we have developed a broad-spectrum biochemical method for the standardisation of native mite products.

Methods

Microplate-based assays have been implemented for thirteen Dermatophagoides pteronyssinus enzymatic activities, associated to Der p 1, 3, 4, 6, 8, 9, 15 and 20 allergens. The dynamics of these activities along culture growth, and their profile in purified fractions (bodies and faeces) and international reference standards (WHO/IUIS, two CBER/FDA) have been characterised. The stability of enzymatic activities and major allergens under stress conditions (40°C) has been assessed in the presence/absence of specific protease inhibitors.

Results

The analysis of enzymatic activities revealed distinct profiles along culture growth and between fractions (bodies and faeces). Remarkable differences were found when comparing international reference standards, being consistent with their source material (purified bodies or whole cultures). After 72 hours at 40°C, only trypsin and alpha-amylase maintained high activity. Notably, the prominent role of trypsins in the hydrolytic degradation of major allergens is demonstrated by the use of inhibitors.

Conclusions

Our method offers a robust approach to assess the complexity of mite extracts and highlights the critical importance of source materials for the composition and stability of finished products. The implementation of this approach in industry-based quality control procedures would contribute to the standardisation of allergenic extracts used for diagnosis and immunotherapy.

This article is protected by copyright. All rights reserved.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2aelHJ4
via IFTTT

Toxins, Vol. 8, Pages 231: Susceptibility of Broiler Chickens to Coccidiosis When Fed Subclinical Doses of Deoxynivalenol and Fumonisins—Special Emphasis on the Immunological Response and the Mycotoxin Interaction

Deoxynivalenol (DON) and fumonisins (FB) are the most frequently encountered mycotoxins produced by Fusarium species in livestock diets. The effect of subclinical doses of mycotoxins in chickens is largely unknown, and in particular the susceptibility of birds to pathogenic challenge when fed these fungal metabolites. Therefore, the present study reports the effects of DON and FB on chickens challenged with Eimeria spp, responsible for coccidiosis. Broilers were fed diets from hatch to day 20, containing no mycotoxins, 1.5 mg DON/kg, 20 mg FB/kg, or both toxins (12 pens/diet; 7 birds/pen). At day 14, six pens of birds per diet (half of the birds) were challenged with a 25×-recommended dose of coccidial vaccine, and all birds (challenged and unchallenged) were sampled 6 days later. As expected, performance of birds was strongly affected by the coccidial challenge. Ingestion of mycotoxins did not further affect the growth but repartitioned the rate of reduction (between the fraction due to the change in maintenance and feed efficiency), and reduced apparent nitrogen digestibility. Intestinal lesions and number of oocysts in the jejunal mucosa and feces of challenged birds were more frequent and intense in the birds fed mycotoxins than in birds fed control feed. The upregulation of cytokines (interleukin (IL) IL-1β, IL-6, IL-8 and IL-10) following coccidial infection was higher in the jejunum of birds fed mycotoxins. Further, the higher intestinal immune response was associated with a higher percentage of T lymphocytes CD4+CD25+, also called Tregs, observed in the cecal tonsils of challenged birds fed mycotoxins. Interestingly, the increase in FB biomarker of exposure (sphinganine/sphingosine ratio in serum and liver) suggested a higher absorption and bioavailability of FB in challenged birds. The interaction of DON and FB was very dependent on the endpoint assessed, with three endpoints reporting antagonism, nine additivity, and two synergism. In conclusion, subclinical doses of DON and FB showed little effects in unchallenged chickens, but seem to result in metabolic and immunologic disturbances that amplify the severity of coccidiosis.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2awwhNw
via IFTTT

Comparative evaluation of different doses of ciprofloxacin alone and in combination with sulfasalazine in experimentally induced inflammatory bowel disease in rats

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Shivashankar Parashuram, Purushotham Krishna, Mangala Lahkar.
Background: Inflammatory bowel disease (IBD) is an idiopathic, chronic inflammatory condition, which affects the gastrointestinal tract and has no curative treatment. The present study aimed to investigate the effect of different doses of ciprofloxacin alone and in combination with sulfasalazine in AA (acetic acid)-induced inflammatory bowel disease (IBD) in rats. Methods: A total of 36 animals were included in the study. Animals were divided into five groups (n = 6): group I - control (normal saline), group II-AA+ normal saline, group III-sulfasalazine(360mg/kg) +AA, group IV A - ciprofloxacin (50 mg/kg), group IV B- ciprofloxacin 100 mg/kg + AA, group V - ciprofloxacin 100 mg/kg + sulfasalazine (360 mg/kg) +AA. Group IV was divided into two subgroups, namely IVA and IVB, on the basis of different doses of ciprofloxacin used. After completion of two weeks of treatment, rats were sacrificed under ether anaesthesia for assessment of intestinal inflammation using parameters namely colon weight change, macroscopic and histopathological evaluation. Results: There was a decrease in colonic weight, macroscopic scores and microscopic scores in groups treated with ciprofloxacin at a dose of 100 mg/kg i.e. high dose given alone and in combination with sulfasalazine. Combination treatment was more effective when compared to single drug treatment. Conclusions: The present study indicates the efficacy of ciprofloxacin in acetic acid-induced IBD. The effects are more pronounced at higher dose i.e., 100 mg/kg. Combination of ciprofloxacin and sulfasalazine has shown greater efficacy than single drug treatment.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apU6o2
via IFTTT

Innovative new method to test skill of bioassay in postgraduate students during doctor of medicine pharmacology examination using objective structured practical examination and animal experiment software

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Naresh D. Balani, Prabodh Anant Wankhade.
Background: Despite the guidelines for discontinuation of dissection and animal experimentation and introduction of use of alternatives to animal experimentation, Maharashtra University of Health Science, Nashik has not modified the exam pattern by shifting the emphasis on to use of animal experiment software. In one study on importance of bioassay in career, it has been reported that 96.6% did not use their knowledge of Bioassay during their 10 years of post MD career, whether in pharmaceutical industry or in academics. 16.6% feel that experiment on bioassay should be continued in the current state. 76.7% of them wish it to be modified to a dose response curve (DRC). Methods: We have designed an innovative technique by combination of OSPE, mounting skill testing using simulation and animal experiment software. This technique serves the purpose of testing the skill of bioassay methodology in four postgraduate students receiving training. The animal was not sacrificed and not dissected in this technique. Results: All the four test subjects could understand well about task to be done. The totals out of 140 were 87.5, 83, 70.5 and 55 respectively. The corrected marks out of 150 was calculated and shown in the table. 3 out of 4 passed in the examination as shown in observation table. Conclusions: This method is good alternative to the traditional method of bioassay, as there is no need of sacrificing and dissecting the animal for the sake of this less important experiment.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab8gfK
via IFTTT

Use of over the counter drugs in urban and rural populations of Mandya district: a cross-sectional study

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Nagarajaiah B. Hanumantharayappa, Shashikumar N. Siddaiah.
Background: Over-the-counter (OTC) drugs are medicines which are sold directly to a consumer without a prescription. There is a big potential for misuse and abuse of such products. Over the counter (OTC) drugs are meant for self-medication and are of proved efficacy and safety. Their improper use and unable to follow the precautions due to lack of knowledge of their side effects and interactions could lead to serious complications, especially in children and elderly. Methods: This cross-sectional study was conducted using a pre-tested & semi-structured questionnaire. A total of 400 urban and 400 rural persons were interviewed for this study. 100 persons were interviewed in Mandya city and 50 each from the city in each of the 6 taluks. Data was entered in Microsoft Excel software and was analysed using Statistical Package for Social Sciences (SPSS) software. Chi-square test was used to calculate the difference in use among the urban and rural OTC drug users. Results: A total of 800 persons were interviewed regarding their use of OTC drugs, among them 400 were urban residents and 400 were rural residents of Mandya district. Of the 400 urban persons and rural persons, 310 respondents (77.50%) and 273 respondents (68.25%) reported the use of OTC in the recall period of the last 6 months respectively. The difference in the usage of OTC by urban adults was significantly more than that of rural adults. Conclusions: The proportion of the respondents who had practiced self-medication with OTC drugs is very high. The prevalence of self-medication with OTC drugs in our study was found to be 72.87% and is nearly same in both rural and urban population. As this study was conducted in a limited population in Mandya district, generalization of the study to all the population cannot be done, and it requires large study in all districts of Karnataka with adequate sampling methods.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apTrCS
via IFTTT

Bacterial infections in cirrhosis - does standard empirical therapy need a rethink?

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Shiran Shetty, Venkatakrishnan Leelakrishnan, Krishnaveni Janarthanan.
Background: Patients with cirrhosis not only have a higher incidence and a greater severity of infections but infections increase the mortality and morbidity in cirrhosis. Third-generation cephalosporins and quinolones are currently the most commonly recommended first-line empirical therapy in most infections. This study was conducted to study the bacterial etiology, susceptibility of these organisms to these commonly used antibiotics. Methods: All patients of cirrhosis of liver admitted to a tertiary care centre underwent cultures from blood, urine and ascitic fluid and the incidence of infection was calculated. Sensitivity pattern of organisms to third generation cephalosporins and quinolones were studied. Results: A total of 150 patients were included in the study and 58 (37.8%) of them had one or more infections. Spontaneous bacterial peritonitis was the most common infection noted and gram-negative bacilli (E. coli) were the commonest organisms isolated. The overall response rate to quinolones and third generation cephalosporins was only 47%. Conclusions: Increasing use of antibiotics in empirical role has increased resistance to commonly used antibiotics. Empirical therapy should be decided based upon local epidemiological patterns and the same cannot be generalized.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab8mns
via IFTTT

Assessment of medication adherence among hypertensive patients: a cross-sectional study

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Anup Bhusal, Pradeep R. Jadhav, Yeshwant A. Deshmukh.
Background: Hypertension affects around one billion individuals worldwide and is expected to increase by 29% to reach 1.56 billion by 2025. It is usually asymptomatic, chronic disorder needing lifelong treatment. The objective of this study was to study the medication adherence among hypertensive patients using hill-bone compliance to high blood pressure therapy scale (HILL-BONE CHBPTS) and to compare medication adherence in hypertensive patients with controlled and uncontrolled blood pressure. Methods: A cross-sectional, observational study was conducted for a period of one year in the Outpatient department of Medicine in a tertiary care hospital, Navi Mumbai. A total of 129 hypertensive patients who were on at least six months on antihypertensive medications were enrolled. Blood pressure was measured and details of drug therapy were noted. Medication adherence was assessed using HILL-BONE CHBPTS and respective scores were calculated. Results: HILL-BONE CHBPTS scores were on the higher side signifying poor medication adherence among hypertensive patients. HILL-BONE CHBPTS score correlated significantly in a positive direction with diastolic blood pressure, duration of treatment and the number of medications, As per JNC 8 recommendations, 58.9% (76) hypertensive patients were having blood pressure under control, whereas 41.1% (53) were having uncontrolled blood pressure. HILL-BONE CHBPTS scores were significantly higher (reflecting lower adherence) in hypertensive patients with uncontrolled blood pressure than those having optimally controlled blood pressure. Conclusions: Overall the medication adherence was poor in hypertensive patients. Adherence to therapeutic regimens is an important factor in blood pressure control among hypertensive patients and needs priority. Health education related to medication adherence needs be improved in hypertensive patients.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apTq1M
via IFTTT

A comparative study of adverse reactions of taxol and non taxol based chemotherapy regimens in breast cancer

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Geetha Rani, Dulcie Celia, Ezhil Ramya, Meenakshi Balasubramanium.
Background: The incidence of breast cancer is increasing in India. A combination of medicines is typically used to treat breast cancer. All the medications used in treatment are associated with various side effects. So this study is done to estimate and compare the adverse reactions of taxol and non-taxol based chemotherapy regimens in breast cancer patients attending Tirunelveli Medical College Hospital. Methods: The study was conducted in the oncology ward at TVMCH for a period of 60 days from August 2nd October 2nd 2014. Patients with unilateral or bilateral carcinoma breast with or without metastasis, receiving chemotherapy were included. Medication details such as the type of regimen, dose, and duration of regimen and relevant data of lab investigations were collected. 30 patients who fulfilled study criteria were included, out of which 16 were assigned FAC (5flurouracil, adriamycin, cyclophosphamide) regimen and 14 were assigned PAC (paclitaxel, adriamycin, cyclophosphamide) regimen. Results: The incidence of adverse reactions like myelodepression resulting in Neutropenia (64.28%), Anaemia (57%) and Thrombocytopaenia (21%) was comparatively higher with PAC regimens than FAC regimen. Nausea (75%) and vomiting (43%) was found to be higher with FAC regimen despite anti-emetic use. No serious adverse reactions occurred in either regimens. Conclusions: The adverse reaction profile of FAC regimen was found to be favourable than PAC therapy though not statistically significant, with no references to efficacy and potency of these regimens in the treatment of breast cancer patients with or without metastasis.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab8fbG
via IFTTT

To study the pattern of suspected adverse drug reactions in patients coming to the department of dermatology in Gauhati Medical College and Hospital, Guwahati, Assam, India

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Ajoy Borah, Mangala Lahkar, Binita Singha, Ratan J. Lihite, Debeeka Hazarika.
Background: Cutaneous adverse drug reactions (ADRs) are the commonest ADRs (30-45%) and are responsible for about 2% of hospital admissions. This study was conducted to study the pattern of ADRs coming to the department of dermatology in a Tertiary Health Care Hospital. The objectives of the study were to assess the causality, severity, preventability, age distribution, sex distribution and the reactions occurring. Methods: Cross-sectional study. The suspected adverse drug reactions (ADRs) reported from the department of dermatology in the Spontaneous ADR reporting form was analysed in this study over a period of one year. Results: A total of 513 cases of reported ADRs were analysed. The highest number of ADRs was reported in the Age group 21-40 years with female preponderance. Erythematous maculopapular lesions were the most common ADR and maximum cases of ADRs were observed with steroids. Most cases were found to be probable (causality assessment), of mild severity and were probably preventable. Conclusions: The study showed that a number of drugs cause dermatological ADRs. These ADRs vary in their appearance, duration, causality, severity, and preventability.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apU67t
via IFTTT

Drug utilization study in patients with type 2 diabetes mellitus attending diabetes clinic of a tertiary care hospital in rural Bengal

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Sekhar Mandal, Tamoghna Maiti, Asoke Kr. Das, Abhijit Das, Ananya Mandal, Biswanath Sharma Sarkar, Soumitra Mandal.
Background: Diabetes mellitus (DM) is a common and important health problem affecting the citizens of developed as well as developing nations. Not only does it require long term therapy, it is also crippling in terms of cost of management. Drug utilization studies help to determine rational drug use especially in poorer and rural populations. The objective of this study was to evaluate drug utilization pattern in type-2 diabetes patients in a diabetic clinic of a tertiary care teaching hospital in rural Bengal. Methods: This was a prospective observational study including 181 patients for a period of 6 months in Bankura Sammilani Medical College. Patients diagnosed as type 2 diabetes mellitus were included in the study. The demographic data, disease data and utilization of different classes of oral hypoglycaemic agents and insulin as well as other individual drugs were analysed using the World Health Organization (WHO) indicators for drug utilization studies. Results: The study population was predominantly male (61.33%) and nearly a third (30.9%) belonged to the age group of 50-59 years. Co-morbid conditions were found in 74% patients, among which hypertension (51.1%) was the most common co-morbid condition. The average number of drugs per prescription was 4.22 and the average number of antidiabetic drugs per prescription was 2.18. Metformin was the most commonly prescribed drug (79.6%), followed by sulfonylurea class of drugs (66.9%). Nearly 17.7% patients were on insulin preparations. Glimepiride and metformin was the most common combinations used (45.5%). Antibiotics were included in 15.5% prescriptions and proton pump inhibitors were prescribed in 32% cases. All the medicines were prescribed as generics and injections were prescribed in 17.7% cases. Conclusions: This study gives a picture of the pattern of drug use among diabetes patients in our set up. While metformin was the commonest drug used, glimepiride and metformin combination was the commonest combination therapy.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab7Juq
via IFTTT

Comparative study to evaluate the anti-diabetic activity of commercially available extract of Tinospora cordifolia and Phyllanthus emblica in streptozocin induced diabetic rat

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Nishant Pathak, Arkapal Bandyopadhyay, Gyanendra Kumar, Rakesh Chandra Chaurasia, Kachnar Varma.
Background: Diabetes is a chronic metabolic disorder with significant socioeconomic impact on a developing country like India. Ayurvedic texts have mentioned Tinospora cordifolia (guduchi) and Phyllanthus emblica (amla) to possess antidiabetic properties. The study was conducted to evaluate the anti-diabetic activity of commercially available extract of these herbal plants in streptozocin induced diabetic rats and its comparison to standard antidiabetic drug glibenclamide. Methods: The study was carried out with albino rats of either sex weighing between 100-150 gm. All the rats were intraperitonially injected with 35 mg/kg of streptozocin in citrate buffer. Blood glucose was estimated after 1 week high fat diet and rats having blood glucose >200 mg/dl were considered diabetic and included in further study. They were divided into 6 groups of 6 rats each. Six groups were given different interventions as distilled water (which were control rats), Tinospora cordifolia extract low dose (200 mg/kg/day), Tinospora cordifolia extract high dose (400mg/kg/day), Phyllanthus emblica extract low dose (200 mg/kg/day), Phyllanthus emblica extract high dose (400 mg/kg/day) and standard drug glibenclamide (0.6 mg/kg/day). All the rats received allocated drugs for further 6 weeks. Blood glucose was measured every 2 weeks till the end of sixth weeks by glucose-oxidase method. Results: In both low as well as high dose groups, Tinospora cordifolia and Phyllanthus emblica showed significant reduction (P


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apUe6W
via IFTTT

Cost analysis of antiepileptic drugs available in India

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Ajay Kumar Shukla, Rekha Mehani.
Background: Epilepsy is one of the major causes of morbidity, mortality and needs long-term treatment. There is a wide range of variation in the prices of drugs marketed in India. Thus, a study was planned to analyse out cost variations of antiepileptic drugs available in Indian market. Methods: Minimum and maximum costs in rupees (INR) of antiepileptic agents manufactured by different companies, in the same strength and dosage forms were obtained from current index of medical specialties January ‑ April 2016. The cost ratio and percentage cost variation were calculated for each generic antiepileptic agent. Results: There is a wide variation in the prices of different brands of same antiepileptic agent in Indian market. The highest cost ratio and percent cost variation was found for divalproex 500 mg [(1:3.17) and 216.7], followed by lamotrigine 25 mg [(1:2.5) and 150], clobazam 10 mg [(1:2.47) and 147.3] and clonazepam 0.5 mg [(1:2.46) and 145.9]. Conclusions: The average percentage price variation of different brands of the same oral antiepileptic drugs in Indian market is very wide. Treatment of epilepsy has a long course with compliance being a key factor for successful treatment. Improved adherence to the treatment can be ensured by decreasing the cost of therapy, by changes in the government policies and regulations and creating awareness among treating physicians for switching to cost effective therapy.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab7Oyi
via IFTTT

Fluconazole induced multifocal bullous eruptions: a case report

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Subhankar Choudhury, Bhulan Prasad Loc, Rati Ranjan Debbarma, Arijit Das.
The term bullous drug eruption refers to adverse drug reactions that result in fluid filled blisters. Blistering can be due to various medications. A 22 year old primigravida developed bullous lesions on upper limbs, lower legs and face after taking six doses of lumether forte (artemether 80 mg + lumefantrine 480 mg themis medicare ltd) and difenac plus (diclofenac 50 mg + paracetamol 500 mg intermed), and single dose of flucan (fluconazole 150 mg Bombay tablet Mfg co) and mebex (mebendazole 100 mg Cipla Limited). She had a previous history of localized bullous eruption 2 years back after taking a single dose of forcan (fluconazole 150 mg Cipla Limited) for vaginal candidiasis. There are reported cases of bullous eruptions due to diclofenac, mebendazole and paracetamol. However in our case past history of localized bullous eruptions after taking fluconazole, made it superior to other offenders to be suspected as the probable culprit. Naranjo causality score was (+5).


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apUkvh
via IFTTT

Hand tremor possibly induced by interaction of risperidone and lithium in a case of bipolar disorder with schizophrenia: a case report

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Santanu Munshi, Ranjita Santra (Dhali), Indranil Saha.
Drug-induced movement disorders possess a varied presentation and pose a challenging task for the physicians to diagnose such cases. A middle-aged woman with bipolar disorder comorbid with schizophrenia was under treatment with lithium carbonate, risperidone, sodium valproate, trihexiphenidyl tablets on a daily basis for two years. She experienced bilateral tremors of the hands which were present at rest and exacerbated by mental activity, when under observation and during voluntarily initiated activity. There were no associated extrapyramidal or cerebellar signs. The tremors persisted after withdrawal of sodium valproate and trihexiphenidyl, but disappeared completely after risperidone was stopped but lithium carbonate intake continued in an uninterrupted manner. Investigations did not reveal any positive finding. Hence, drug interaction may possibly be the offender for tremors in this case.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab8kMm
via IFTTT

Phenylephrine induced fixed drug eruption: a rare case of cross sensitivity

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Mahesh Chander Gupta, Mamta Rani, Kamal Aggarwal.
Fixed drug eruption (FDE) is a type of dermatosis characterized by recurrent lesions at exactly the same sites with each administration of the causative agents. FDEs are common types of drug eruptions amongst all cutaneous drug-induced side effects, mostly by intermittent exposure. Multiple drugs with common chemical structure can cause same type of lesions at same site called as cross sensitivity. There are many causative agents and the incidence of FDEs for a particular drug depends on the frequency of its use. Though usually not severe or fatal, cosmetic embarrassment is main problem, especially when they recur on the previously affected sites leaving behind residual hyperpigmentation. Phenylephrine is a sympathomimetic agent, given orally for the symptomatic relief of nasal congestion. It is also commonly combined with other ingredients in preparations intended for the relief of cough and cold symptoms. Considering the frequent use of Phenylephrine, associated drug eruptions generally appear to be rare, cross sensitivity with pseudoephedrine is even rarer. In our case phenylepherine was self-administered to control cold induced congestion and patient developed FDE on vermillion of upper lip, which healed after 2 weeks leaving hyperpigmentation and reappear on same site after re-challenge also. She has history of FDEs due to pseudoephedrine on same site on lips. This is a rare case of sympathomimetics induced FDE with cross sensitivity between phenylepherine and pseudoephedrine; hence we are reporting it here.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apTQFv
via IFTTT

A rare case of imatinib mesylate induced acute kidney injury

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Ratna Agrawal, Kaustav Saha, Sabita Mohapatra.
Imatinib is a revolutionary targeted molecule strikingly successful in chronic phase of chronic myeloid leukemia and higher doses are beneficial in the accelerated phase of the disease. Its known adverse effects include abdominal pain, vomiting, fluid retention, periorbital edema, pleural effusion, myalgia, liver damage and congestive heart failure. Renal damage due to this drug has not been well reported. In this case, the patient developed acute kidney injury as evidenced by raised creatinine level after two months of administration of imatinib mesylate. At 4th visit, the levels of urea and creatinine were significantly above the upper normal limit. The patient was kept under supervision of his renal status and at the starting of 5th visit decision was made to change the drug from imatinib to nilotinib. Currently the patient is tolerating nilotinib well. Causality assessment using WHO scale revealed imatinib to have possibly caused this rare adverse reaction.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab7CyO
via IFTTT

Pharmacoeconomic analysis of drugs used for peptic ulcer in India

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Bhanu Prakash Kolasani, C. M. Divyashanthi.
Background: Acid peptic disorders are common medical problems in daily clinical practice leading to a significant economic burden on healthcare expenses. Due to lack of information on comparative drug prices and quality, it becomes difficult for physicians to prescribe the most economical treatment. So the present study was planned to analyse the price variations of various anti-ulcer drugs available in India. Methods: The cost of a particular anti-ulcer drug being manufactured by different companies, in the same dose and dosage forms, was obtained from latest issue of current index of medical specialties January to April, 2016. The difference between the maximum and minimum prices of same drug was analysed and percentage variation in the prices was calculated. Results: Overall, the prices of a total of 12 anti-ulcer drugs belonging to four different categories available in 38 different formulations were analysed. Among the proton pump inhibitors, pantoprazole (40 mg; EC tablet) showed the maximum price variation of 500.75%. With regard to H2 blockers, ranitidine (50 mg; injection) showed the maximum price variation of 989.92%. The maximum price variation among various formulations of ulcer protective was seen with sucralfate (1000 mg; tablet) of 166.00% while misoprostol (200µg; tablet) was the only drug present in prostaglandin analogues and it showed a price variability of 14.33%. Conclusions: The average percentage variations of different brands of the same anti-ulcer drugs in same dose and dosage form manufactured in India were very wide. The government and drug manufacturing companies must direct their efforts in reducing the cost of anti-ulcer drugs and thereby minimizing the economic burden on the patients.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apTzm1
via IFTTT

Studies on the antitumor potentials of betulinic acid against murine ascites Daltons lymphoma

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Anamika Bhaumik, Surya Bali Prasad.
Background: Betulinic acid, a naturally occurring pentacyclic triterpene, exhibits a variety of biological activities including anticancer properties. Despite the wide importance of ethnobotanical studies on the anticancer therapeutic uses of betulinic acid, its exact role has not been fully elucidated. Therefore, the present studies were undertaken to evaluate the antitumor effect of betulinic acid in a murine malignant tumor model along with various biochemical changes in the tumor cells of the host. Methods: Ascites Daltons lymphoma (DL) tumor-transplanted Swiss albino mice were treated with betulinic acid (i.p., 10 mg/kg body weight) and the pattern of hosts survival was analysed. The viability of DL cells was assessed using trypan blue exclusion test. The DL cells were also studied for the determination of apoptosis using fluorescence microscopy. Reduced glutathione and protein estimations were done in DL cells under different treatment conditions. Results: Betulinic acid treatment caused a significant increase in life span (ILS ~150%) of the tumor-bearing hosts, which may indicate tumor regression/antitumor activity. Following betulinic acid treatment, decrease in DL cells viability and damaging changes in the cell membranes and a decrease in reduced glutathione content in DL cells were observed. Conclusions: Present findings reveal the potent antitumor activity of betulinic acid against murine ascites Daltons lymphoma. The cytotoxicity of betulinic acid to build up antitumor effects may involve induction of apoptosis as well as a decrease in glutathione level in tumor cells.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab8hAh
via IFTTT

Assessment of inhalation technique and predictors of incorrect performance among patients of chronic obstructive pulmonary disease and asthma

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Tulika Jha, Ashok Kumar Sahai, Malay Sarkar, Purshottam Kumar Kaundal, Praveen Bhardwaj, Indrajeet Sharma.
Background: Poor inhalation technique is responsible for decreasing the efficacy of topical drug therapy in asthma and chronic obstructive pulmonary disease (COPD). Certain steps of the inhalation technique are erred most often and if ascertained, can be rectified leading to an overall improvement in the technique. The predictors for poor use can also be marked. Methods: Inhaler technique for pressurised metered dose inhalers (pMDI), pressurised metered dose inhaler with spacer and dry powder inhaler (DPI) was assessed in one hundred and five patients who fulfilled the inclusion and exclusion criteria and were enrolled in this study. Inhaler technique was assessed using an ERAS/ISAM Task force report based scores and the lung function using pulmonary function test (PFT).The technique was re-assessed and scored after a period of three months along with the assessment of the lung function by PFT. Results: The mean of ERS/ISAM task force report based score for evaluation of the techniques of inhalation increased from 5.79±2.58 to 8.23±2.41 (p


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apTONF
via IFTTT

Study of prescription pattern and adverse drug reactions in patients with cervical cancer in tertiary care teaching institute

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
Ankita Sunilrao Jire, Chaitali S. Bajait, Vijay K. Mahobia, Vijay M. Motghare.
Background: Cervical cancer is the second most common cancer in women especially in developing countries. In India, it is estimated that 1, 22, 644 new cases of cancer cervix occur every year. Incidence rate is 22 per lac population and mortality rate is 12.4 per lac population. The objective of this study was to study the prescription pattern and adverse drug reactions (ADRs) in patients with cervical cancer. Methods: Twenty five patients of cancer cervix Stage (IIa to IVb) receiving chemotherapy were enrolled in the study after written informed consent of patients. Approval was obtained from institutional ethics committee. It was cross sectional, observational study. Prescriptions were analysed for no. of drugs prescribed, time interval between two cycles, no. of cycles of chemotherapy. Any ADR observed by patient or treating physician was noted and causality was assessed by Naranjos algorithm. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale, modified Hartwig and Siegel scale respectively. Results: Twenty five patients were enrolled with mean age 52.24±8.66 years and mean weight 51.76±5.88 kg. 84% patients were on combination chemotherapy. Percentage of anticancer drugs prescribed were: cisplatin (72%); paclitaxel (40%); 5FU (36%); carboplatin (32%); gemcitabine (4%). Chemotherapeutic drugs were given at 3 weekly intervals for 6 cycles. ADR observed were nausea (76%), vomiting (40%), alopecia (32%), headache (12%), bodyache (12%), anorexia (12%), diarrhoea (8%) and malaise (4%). Causality assessment of ADR by Naranjos algorithm showed 89.8% probable and 10.2% possible reactions. According to modified Schumock and Thornton scale, 26.5% reactions are not preventable however 73.5% are definitely preventable. According to modified Hartwig and Siegel scale, 75.5% were mild level 1severity however 24.5% were moderate level 3 severity. Conclusions: Among patients with CA cervix, cisplatin was most commonly prescribed drug. Nausea was most common ADR which is of mild level 1 severity.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab89Ry
via IFTTT

Assessment of prescription writing skills among undergraduate medical students

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
M. J. Sudha, S. Viveka, S. Remya.
Background: The existing medical undergraduate curriculum includes training in prescription writing in second phase under pharmacology and Therapeutics. This study evaluates the prescription writing skills of undergraduate medical students and interns and need for emphasis on prescription writing during various phases of learning process in medical undergraduates. Methods: After obtaining institutional ethics committee approval, we recruited 4th to 8th semester medical undergraduate students and interns into the study, who gave written informed consent. They were given a pilot-tested, pre-evaluated questionnaire addressing the issues of prescription writing. They were asked to prescribe for a common clinical scenario. Their prescriptions were analysed for various parameters as indicated in WHO guidelines. Results: Of the 350 medical undergraduate students and interns invited, 281 of them participated in the study. 169 participants (60.1%) agree that they have not written a formal prescription to any patient when the questionnaire was administered. 134 participants (47.6 %) feel that undergraduate training has not prepared them for prescribing properly. 90% of participants said reinforcing classes during 3rd, 4th year and during Compulsory Routine Rotatory Internship will be beneficial. Though 220 participants have opined that generic name should be used while prescribing, only 124 have actually used generic names in their prescriptions. Fifteen participants have failed to write the symbol while prescribing. All 121 interns in the study have used brand names while prescribing. Conclusions: There are widespread lacunae in prescription writing by medical undergraduates. There is perceived need for reinforcement sessions at third and final phase of undergraduate education to address this gap. Most participants opine that clinicians do not discuss this issue during case discussion. There is knowledge and practice gap in using generic names while prescribing.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2apTYVB
via IFTTT

Drug utilization study of anti-hypertensive drugs in a tertiary care hospital

2016-07-27T05-12-55Z
Source: International Journal of Basic & Clinical Pharmacology
D. Bhavika, V. Prasanna, B. Swathi.
Background: Hypertension is a major non-communicable disease and a risk factor for cardiovascular diseases. The antihypertensive drugs used for its management constitute a significant portion of the medicines prescribed in a health care centre. The aim of our study was to analyse the utilization pattern of anti-hypertensive drugs at a tertiary care hospital in accordance with the WHO prescription indicators. Methods: A prospective cross sectional observational study was carried out in the outpatient of general medicine department of Osmania General Hospital. The prescriptions of the hypertensive patients visiting the outpatient were monitored. From the data collected, the prescription pattern of antihypertensive drugs, and WHO prescription indicators, were analysed. Results: Out of the 301study subjects, 134 (44.51%) were males and 167 (55.48%) were females, with the maximum number of patients (197) falling in the age group 51-70 years. Among the antihypertensive drugs prescribed, Amlodipine was most frequently prescribed (53.15%). The frequently used drugs for monotherapy - amlodipine (26.91%) and for two drug therapy - amlodipine+enalapril (17.27%), and for three drug therapy - atenolol+enalapril+nifedipine (2.32%). The WHO prescribing indicators as analyzed from the data collected are; Average number of drugs prescribed per encounter - 5.64/prescription, Percentage of medicines prescribed by generic name - 89.22%, Percentage of medicines prescribed from essential drug list -90.17% . Conclusions: The study provides an insight into antihypertensive drug usage pattern in tertiary care hospital and their rational use. The study emphasizes the need for preventive measures and effective educative measures in the population about hypertension.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2awySqV
via IFTTT

Evaluation of Voice Acoustics as Predictors of Clinical Depression Scores

The aim of the present study was to determine if acoustic measures of voice, characterizing specific spectral and timing properties, predict clinical ratings of depression severity measured in a sample of patients using the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI-II).

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2agUGSN
via IFTTT

Towards Objective Voice Assessment: The Diplophonia Diagram

Diplophonia is an often misinterpreted symptom of disordered voice, and needs objectification. An audio signal processing algorithm for the detection of diplophonia is proposed. Diplophonia is produced by two distinct oscillators, which yield a profound physiological interpretation. The algorithm's performance is compared with the clinical standard parameter degree of subharmonics (DSH).

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2atUa7k
via IFTTT

Erratum to: Clinical profile of tetanus patients attended at Felege Hiwot Referral Hospital, Northwest Ethiopia: a retrospective cross sectional study

No description available

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a9iitQ
via IFTTT

The relation of weight suppression and BMIz to bulimic symptoms in youth with bulimia nervosa

Background: Weight suppression (WS), which is the difference between a patient's highest and current weight, has been associated with bulimic symptom severity in adults with bulimia nervosa (BN). However, the impact of WS on eating disorder psychopathology in youth with BN is unknown. Methods: Participants included 85 youth with DSM-5 BN who presented for outpatient treatment. Current WS was calculated as the difference between highest and current body mass index z-score (BMIz), while greatest WS was the difference between highest and lowest BMIz, both assessed at participants' current height. Separate multivariable linear regressions were conducted to determine if current or greatest WS was significantly associated with frequency of binge eating, compensatory behaviors, or dietary restraint. A secondary analysis was conducted on youth ages 16 and older, given the limitation of assessing WS at current height in younger participants with greater height instability. Results: Youth with higher levels of greatest WS (but not current WS) were older, had a longer duration of illness, and reported greater weight and shape concern. When adjusting for BMIz, neither current nor greatest WS was significantly associated with bulimic behaviors or dietary restraint in the full sample. However, in the subset of youth ages 16 and older, current WS moderated the effect of BMIz on binge eating and compensatory behaviors. For youth with high WS, those with a high current BMIz engaged in more frequent binge eating than those with low current BMIz, and the negative impact of BMIz on compensatory behaviors became weaker. Conclusions: Our findings suggest that WS is clinically relevant in the presentation of youth with BN, and that it may need to be addressed as one important factor in BN psychopathology. Future studies using growth charts to determine historically highest and lowest BMIz may help to further elucidate the link (or lack thereof) between WS and BN psychopathology in youth.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2awwroe
via IFTTT

Fertility preservation in women with cervical, endometrial or ovarian cancers

Background: Although cancer in general affects an aged population, a significant number of women develop cancer at childbearing age. Long-term survival rates after gynecological cancer, especially in young patients are increasing and all quality-of-life aspects, including preservation of fertility have become of major relevance.OutcomesSurgical techniques aimed at sparing reproductive organs and preserving fertility have been developed for women presenting with gynecological cancer found at early stages. Indications for fertility-sparing surgery are in general restricted to women presenting with a well-differentiated low-grade tumor in its early stages or with low malignant potential. Up to now, use of fertility-sparing techniques in well-selected patients has not been shown to affect overall survival negatively and fertility outcomes reported have been favorable. Still larger amounts of data and longer follow-up periods are needed. Several current fertility-sparing cancer treatments may result in sub-fertility and in those cases assisted reproductive techniques are indicated. Overall quality of life has been satisfactory in cancer patients after fertility-sparing surgery. Conclusions: Fertility-sparing surgery is a viable tool to enable gynecological cancer patients of young age to fulfill their family building without impairment of oncological outcome. Cancer patients of reproductive age should undergo fertility counseling to analyze this sensitive subject. Further studies are needed to investigate the role of fertility-sparing treatment and combined adjuvant therapy in higher-grade cancers.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a9iedI
via IFTTT

GAGA factor, a positive regulator of global gene expression, modulates transcriptional pausing and organization of upstream nucleosomes

Background: Genome-wide studies in higher eukaryotes have revealed the presence of paused RNA polymerase II (RNA-Pol) at about 30–50 bp downstream of the transcription start site of genes involved in developmental control, cell proliferation and intercellular signaling. Promoter-proximal pausing is believed to represent a critical step in transcriptional regulation. GAGA sequence motifs have frequently been found in the upstream region of paused genes in Drosophila, implicating a prevalent binding factor, GAF, in transcriptional pausing. Results: Using newly isolated mutants that retain only ~3 % normal GAF level, we analyzed its impacts on transcriptional regulation in whole animals. We first examined the abundance of three major isoforms of RNA-Pol on Hsp70 during heat shock. By cytogenetic analyses on polytene chromosomes and chromatin immunoprecipitation (ChIP), we show that paused RNA-Pol of Hsp70 is substantially reduced in mutants. Conversely, a global increase in paused RNA-Pol is observed when GAF is over-expressed. Coupled analyses of transcriptome and GAF genomic distribution show that 269 genes enriched for upstream GAF binding are down-regulated in mutants. Interestingly, ~15 % of them encode transcriptional factors, which might control ~2000 additional genes down-regulated in mutants. Further examination of RNA-Pol distribution in GAF targets reveals that a positive correlation exists between promoter-proximal RNA-Pol density and GAF occupancy in WT, but not in mutants. Comparison of nucleosome profiles indicates that nucleosome occupancy is preferentially attenuated by GAF in the upstream region that strongly favors nucleosome assembly. Using a dominant eye phenotype caused by GAF over-expression, we detect significant genetic interactions between GAF and the nucleosome remodeler NURF, the pausing factor NELF, and BAB1 whose binding sites are enriched specifically in genes displaying GAF-dependent pausing. Conclusion: Our results provide direct evidence to support a critical role of GAF in global gene expression, transcriptional pausing and upstream nucleosome organization of a group of genes. By cooperating with factors acting at different levels, GAF orchestrates a series of events from local nucleosome displacement to paused transcription. The use of whole animals containing broad tissue types attests the physiological relevance of this regulatory network.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2awwEI0
via IFTTT

Cancers, Vol. 8, Pages 71: CD8 T Cell–Independent Antitumor Response and Its Potential for Treatment of Malignant Gliomas

Malignant brain tumors continue to represent a devastating diagnosis with no real chance for cure. Despite an increasing list of potential salvage therapies, standard-of-care for these patients has not changed in over a decade. Immunotherapy has been seen as an exciting option, with the potential to offer specific and long lasting tumor clearance. The "gold standard" in immunotherapy has been the development of a tumor-specific CD8 T cell response to potentiate tumor clearance and immunological memory. While many advances have been made in the field of immunotherapy, few therapies have seen true success. Many of the same principles used to develop immunotherapy in tumors of the peripheral organs have been applied to brain tumor immunotherapy. The immune-specialized nature of the brain should call into question whether this approach is appropriate. Recent results from our own experiments require a rethinking of current dogma. Perhaps a CD8 T cell response is not sufficient for an organ as immunologically unique as the brain. Examination of previously elucidated principles of the brain's immune-specialized status and known immunological preferences should generate discussion and experimentation to address the failure of current therapies.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ab38Zd
via IFTTT

Advantages, limitations, and diagnostic accuracy of photoscreeners in early detection of Amblyopia: a review

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2a91NNw
via IFTTT