Miracle-dz/UniFAR-FTUs huggingface dataset:
An evaluation of knowledge, attitude and practice of Indian pharmacists towards adverse drug reaction reporting: A pilot study

Background: Pharmacovigilance is a useful to assure the safety of medicines and protect consumers from their harmful effects. Healthcare professionals should consider Adverse Drug Reaction (ADR) reporting as part of their professional obligation and participate in the existent pharmacovigilance programs in their countries. In India, the National PV Program was re-launched in July 2010. Objectives: This survey was conducted in order to assess the knowledge, attitude and practice of Indian pharmacists with the aim of exploring the pharmacists’ participation in ADR reporting system, identifying the reasons of under reporting and determining the steps that could be adopted to increase reporting rates. Materials and Methods: A cross-sectional survey was carried out among the pharmacists in India using a pretested questionnaire with 33 questions (10 questions on knowledge, 6 on attitude, 7 on practice, 7 on future of ADR reporting in India and 3 on benefits of reporting ADRs.). The study was conducted, over a period of 3 months from May 2012 to July 2012. Results: Out of the 600 participants to whom the survey was administered, a total of 400 were filled. The response rate of the survey was 67%. 95% responders were knowledgeable about ADRs. 90% participants had a positive attitude towards making ADRs reporting mandatory for practicing pharmacists. 87.5% participants were interested in participating in the National Pharmacovigilance program, in India. 47.5% respondents had observed ADRs in their practice, and 37% had reported it to the national pharmacovigilance center. 92% pharmacists believed reporting ADRs immensely helped in providing quality care to patients. Conclusion: The Indian pharmacists have poor knowledge, attitude, and practice (KAP) towards ADR reporting and pharmacovigilance. Pharmacists with higher qualifications such as the pharmacists with a PharmD have better KAP. With additional training on Pharmacovigilance, the Indian Pharmacists working in different sectors can become part of ADR reporting system.
Organizational Work Factors among Workers and Supervisors in Export Processing Zones which Support Global Markets

This is an investigation of the interaction between organizational and management factors at work for both workers and supervisors in the manufacturing sector. Survey was done in a sample consisted of 23 establishments, 630 workers, and 47 supervisors, meanwhile 10 focus group discussions (FGDs) for workers, and 5 FGDs for supervisors. Workers and supervisors alike reported illnesses and job dissatisfaction. Survey showed that the most prevalent issues among workers were: the need to upgrade skills (76.3%), pressured in doing work (60.5%), fast paced work (60.5%), repetitive work (63%), and that work is both physically and mentally tiring (59.7%). On the other hand, supervisors described their work as challenging and stimulating (66%), needed regular upgrading of skills (46.8%), and needed literacy on information technology (31.9%). Focus group discussions showed that workers and supervisors were confronted with stress, fast-paced work, the need to upgrade skills due to accommodation of information technology into the work production, fatigue, re-engineering and downsizing by management, low job control and difficult worker-supervisor relationship. This study was able to show that health of workers and supervisors were affected by both organizational and management factors at work.
Occupational Stress in Military Health Settings: A Questionnaire-based Survey

Background and Objectives: Military hospitals play a crucial role in delivery of healthcare services to patients during emergencies. Despite that, limited studies have attempted to characterize factors affecting quality of work life in employees of military health settings. To contribute in filling this gap, this study explored employee occupational stress in a military hospital, situated in the western region of Iran. Methods: A descriptive-analytical study of cross-sectional design was conducted in 2011. All employees working in the 597 Army Hospital (n = 76) were surveyed. Data was collected using questionnaire. Reliability of the scale was ensured by Cronbach’s alpha of 0.94. Descriptive statistics was employed for data summarization. T test and ANOVA were used to compare mean scores of occupational stress between demographic and professional groups. Findings: Occupational stress among employees averaged 46% ranging from 26% to 91%. While 25% of subjects reported low occupational stress, 58% showed moderate stress levels, and 17% expressed high stress levels. Clinicians showed significantly higher occupational stress as compared with administrative staff (P = 0.029). No significant effect was identified for other demographic and professional characteristics including age, sex, marital status, educational level, and work experience either between entire employees, or between clinicians. Conclusions: By finding considerable or high stress among three forth of the employees, our study support the notion that employees of military hospitals are more prone to occupational stress as compared with the personnel of civilian health settings. In addition, expression of higher stress levels by healthcare employees compared to their administrative counterparts shows that working conditions in military health settings are even more stressful for clinical staff. These findings add weight to the urgency of devising coping strategies to alleviate occupational stress in clinicians of military hospitals.
A questionnaire study on the knowledge, attitude, and the practice of pharmacovigilance among the healthcare professionals in a teaching hospital in South India

Objective: The primary objective of this study was to evaluate the knowledge, attitude, and practices (KAP) of the healthcare professionals about pharmacovigilance in Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH), Perambalur (Tamil Nadu), a tertiary care teaching hospital. The second primary objective was to assess the causation of underreporting of adverse drug reactions (ADRs) as it needs to be well-assessed in India. The secondary objective was to compare the findings of this study with the results of the published studies from India on evaluation of the KAP of pharmacovigilance among healthcare professional. Materials and Methods: A cross-sectional study was carried out using a pretested questionnaire. The questionnaire was designed to assess the KAP regarding pharmacovigilance. The healthcare professionals (doctors, nurses, and pharmacists) working in the DSMCH, Perambalur (Tamil Nadu) during the study period were included. Only those who gave their consent to participate were included in the study. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) statistical software, version 16. Results: One hundred and fifty pretested questionnaires were distributed among the healthcare professionals and 101 responded. 62.4% healthcare workers gave correct response regarding the definition of pharmacovigilance. 75.2% of healthcare workers were aware regarding the existence of a National Pharmacovigilance Program of India. 69.3% healthcare professional agreed that ADR reporting is a professional obligation for them. Among the participants, 64.4% have experienced ADRs in patients, but only 22.8% have ever reported ADR to pharmacovigilance center. Unfortunately only 53.5% healthcare workers have been trained for reporting adverse reactions. But, 97% healthcare professionals agreed that reporting of ADR is necessary and 92.1% were of the view that pharmacovigilance should be taught in detail to healthcare professional. Conclusion: This study demonstrated that knowledge and attitude towards pharmacovigilance is gradually improving among healthcare professionals, but unfortunately the actual practice of ADR reporting is still deficient among them.
Comparative evaluation of honey, chlorhexidine gluconate (0.2%) and combination of xylitol and chlorhexidine mouthwash (0.2%) on the clinical level of dental plaque: A 30 days randomized control trial

Aim: To compare the effect of honey, chlorhexidine mouthwash and combination of xylitol chewing gum and chlorhexidine mouthwash on the dental plaque level. Materials and Methods: Ninety healthy dental students, both male and female, aged between 21 to 25 years participated in the study. The subjects were randomly divided into three groups, i.e. the honey group, the chlorhexidine gluconate mouthwash group and the combination of xylitol chewing gum and chlorhexidine (CHX) mouthwash group. The data was collected at the baseline, 15 th day and 30 th day; the plaque was disclosed using disclosing solution and their scores were recorded at six sites per tooth using the Quigley and Hein plaque index modified by Turesky-Gilmore-Glickman. Statistical analysis was carried out later to compare the effect of all the three groups. P ≤ 0.05 was considered as statistically significant. Results: Our result showed that all the three groups were effective in reducing the plaque but post-hoc LSD (Least Significant Difference) showed that honey group and chlorhexidine + xylitol group were more effective than chlorhexidine group alone. The results demonstrated a significant reduction of plaque indices in honey group and chlorhexidine + xylitol group over a period of 15 and 30 days as compared to chlorhexidine.
The ultrasonographic detection of follicular rupture at the time of intrauterine insemination: is it really decisive?

Abstract Our aim is to assess the impact of the ultrasonographic detection of follicular rupture on the intrauterine insemination success. A total of 313 women undergoing ovarian stimulation for intrauterine insemination were enrolled. Transvaginal ultrasonography was performed to check whether the dominant follicle had ruptured and according to that the patients were divided into two groups. The ultrasound detection of follicular rupture was observed in 156 patients (54%). The independent variables favoring follicular rupture were: Age (t: 7.646, p < 0.0005), FSH value (t: −5.637, p < 0.0005), duration of infertility (t: −4.265, p < 0.0005), menstrual cycle length (t: −4.927, p < 0.0005). Moreover, the logistic regression analysis demonstrated that the predictive variables for follicular rupture were: FSH value (OR 1.7, CI 95% 1.3–2.3, p < 0.0005), duration of infertility (OR 2.6, CI 95% 1.6–4.2, p < 0.0005) and menstrual cycle length (OR 2.4, CI 95% 1.7–3.4, p < 0.0005). Pregnancy occurred in 23 patients of the group A (14.7%) and in 22 patients of the group B (16.5%) without a significant difference (p = 0.6). The logistic regression analysis confirmed that neither the evidence of follicular rupture nor any other variables influenced the pregnancy rate.
Oropharyngeal Decontamination Decreases Incidence of Ventilator-Associated Pneumonia: A Randomized, Placebo-Controlled, Double-blind Clinical Trial

Secondary pneumonia in patients requiring mechanical ventilation has a high morbidity and mortality. Diagnosis is difficult and treatment failure common; therefore, preventive measures are important. In a double-blind, placebo-controlled trial, we evaluated selective decontamination of the oropharynx with polymyxin B sulfate, neomycin sulfate, and vancomycin hydrochloride (PNV) in 52 patients requiring mechanical ventilation during a 3- to 34-day period (mean, 10 days). Either PNV or placebo was administered six times daily in the oropharynx. During the first 12 days of intubation, tracheobronchial colonization by gramnegative bacteria and Staphylococcus aureus , as well as pneumonia, occurred less frequently in the PNV than in the placebo group (16% vs 78%; P ( JAMA . 1991;265:2704-2710)
Advances in cell encapsulation technology and its application in drug delivery

Introduction: Cell encapsulation technology has improved enormously since it was proposed 50 years ago. The advantages offered over other alternative systems, such as the prevention of repetitive drug administration, have triggered the use of this technology in multiple therapeutic applications. Areas covered: In this article, improvements in cell encapsulation technology and strategies to overcome the drawbacks that prevent its use in the clinic have been summarized and discussed. Different studies and clinical trials that have been performed in several therapeutic applications have also been described. Expert opinion: The authors believe that the future translation of this technology from bench to bedside requires the optimization of diverse aspects: i) biosafety, controlling and monitoring cell viability; ii) biocompatibility, reducing pericapsular fibrotic growth and hypoxia suffered by the graft; iii) control over drug delivery; iv) and the final scale up. On the other hand, an area that deserves more attention is the cryopreservation of encapsulated cells as this will facilitate the arrival of these biosystems to the clinic.
A Prospective Study Demonstrating an Association between Plasma IgG2 Concentrations and Susceptibility to Otitis Media in Children

Plasma IgG subclass levels of 20 children, 12 and 32 months of age, who were susceptible to acute purulent otitis media, were compared with those of 20 age-matched control children. The IgG2 levels were significantly lower in the otitis-prone group, with a mean of 0.58 +/- 0.30 g/l at 12 months of age (controls 0.85 +/- 0.39) and 0.82 +/- 0.30 at 32 months of age (controls 1.38 +/- 0.49). Otitis-prone children with IgG2 levels less than or equal to 0.58 g/l (at 12 months of age) were found to suffer from Haemophilus influenzae infections 2.6 times as often as those with IgG2 levels greater than 0.58 g/l. On the other hand pneumococci were found 1.9 times as often in the group with IgG2 level greater than 0.58 g/l, as in the group with IgG2 level less than or equal to 0.58 g/l. Otitis proneness seems partly to be due to an immunological incompetence of IgG2, which also influences the bacterial spectrum of the infections.
Elementary school children's perceptions of traditional Korean foods, based on the health belief model*

This study investigated the eating habits of elementary school children and their perceptions related to traditional Ko- rean foods, based on the health belief model. The subjects were fifth grade elementary school children (274 boys and 274 girls) in eight Korean cities. The results were as follows: The children ate almost three meals per day and were grateful for their meals. However, they irregularly consumed meals and snacks. They tended to eat heartily and did not eat foods that they had not yet eaten. Their meals were based on rice and they have eaten kimchi and vegetables at almost every meal. However, they had undesirable habits in eating other foods, such as fruits, fish, soybeans, and sweet foods. They did not sensitively or seriously perceive their eating habits in relation to their health. They perceived that it was very good for their nutrition, health, and tastes to eat traditional Korean foods, and they had pride in traditional Korean foods and eating style. Although they expressed some difficulty regarding availability and preparation of traditional Korean foods, they hardly felt difficulty in eating them. They had high dietary self-efficacy with regard to eating these foods, ex - cept for two items of self-regulation. Their eating habits showed positive correlation with dietary self-efficacy, perceived susceptibility, and perceived benefit. In conclusion, eating habits of elementary school children in relation to traditional Korean foods are not desirable, but not serious. They did not sensitively or seriously perceive their eating habits in rela- tion to their health. However, they perceived that it was very good for their nutrition and health to eat traditional Korean foods, did not have a high level of difficulty in eating them, and had high dietary self-efficacy with regard to eating them. Therefore, we suggest that children should be exposed to various traditional Korean foods, along with education about them, in order to enhance their concern and motivation to eat them. (Korean J Nutr 2013; 46(1): 86 ~ 97)
Obesity prevention: feasible or futile?

Childhood obesity is associated with serious health complications that can begin in childhood. Within the last 20 years, the prevalence increased in most countries throughout the world, prompting some to identify the problem as a global epidemic. Work towards solutions to the crisis is beginning and generally involves not only treatment of those affected but individual and population-based prevention approaches. The current evidence on obesity prevention interventions for children is weak and serious limitations exist. The time has come to change the paradigm from interventions that emphasize individual behavior changes to political, policy, social and economic strategies that involve broad changes at the population level. A society-wide cultural transformation, similar to what took place with tobacco control, is proposed.
The evidence base for individual patient and client assessment by community nurses

There is wide recognition that patient and client assessment by community nurses is central to the provision of high quality care. It is also acknowledged that assessment in the home setting is a complex process requiring a wide range of knowledge and skills. This article identifies two distinct approaches to assessment that have emerged in different contexts around the world. These approaches comprise the formal, structured questionnaire-based assessment that has been developed particularly in response to the requirement to determine service eligibility and the informal, conversation-based assessment that draws on nursing concepts and theories. The article briefly traces the professional and policy influences that have shaped the development of these two approaches before turning to a critical analysis of selected empirical work that has examined their effectiveness. Research undertaken on the structured form of assessment has focused largely on issues of reliability. While the majority of studies indicate that this form of assessment is reliable in identifying patient need, some research highlights its failure to take account of patient and client perspectives. This raises questions about the appropriateness of the nursing interventions that are planned in response to a structured assessment. Less research attention has been devoted to exploring the conversation-based approach to assessment, but this body of work has drawn attention to the potential for practitioners to adopt a controlling influence over the assessment process. Reference is made to research in which the author has collaborated that illuminates the way in which two styles of conversation-based assessment impact differently on patients and clients. The article concludes by identifying the need for further research and argues that a key focus should be the ways in which assessment contributes to care planning and patient outcomes.
Nucleic acid vaccination strategies against infectious diseases

Introduction: Gene vaccines are an interesting and emerging alternative for the prevention of infectious diseases, as well as in the treatment of other pathologies including cancer, allergies, autoimmune diseases, or even drug dependencies. When applied to the target organism, these vaccines induce the expression of encoded antigens and elicit the corresponding immune response, with the potential ability of being able to induce antibody-, helper T cell-, and cytotoxic T cell-mediated immune responses. Areas covered: Special attention is paid to the variety of adjuvants that may be co-administered to enhance and/or to modulate immune responses, and to the methods of delivery. Finally, this article reviews the efficacy data of gene vaccines against infectious diseases released from current clinical trials. Expert opinion: Taken together, this approach will have a major impact on future strategies for the prevention of infectious diseases. Better-designed nucleic acid constructs, novel delivery technologies, as well as the clarification of the mechanisms for antigen presentation will improve the potential applications of this vaccination strategy against microbial pathogens.
Management of Chemotherapy Induced Nausea and Vomiting

Chemotherapy induced nausea and vomiting (CINV) is typically biphasic. The acute phase usually peaks in 5-6 hours after the administration of chemotherapeutic agents and the delayed phase can occur subsequently over 24hours after chemotherapy. Antiemetic therapy is crucial to prevent this unwanted side effect effectively, and NK1 antagonist, 5-HT3 antagonist, corticosteroid are the main player. The combination and dosing is determined by the emetogenicity of the chemotherapeutic agents to be administrated. (Korean J Med 2012;82:532-536)
CD4+CD25+ Regulatory T Cells Cure Murine Colitis: The Role of IL-10, TGF-β, and CTLA41

Regulatory T cells are critical in regulating the immune response, and therefore play an important role in the defense against infection and control of autoimmune diseases. However, a therapeutic role of regulatory T cells in an established disease has not been fully established. In this study, we provide direct evidence that CD4+CD25+ regulatory T cells can cure an established, severe, and progressive colitis. SCID mice developed severe colitis when adoptively transferred with naive CD4+CD25− T cells and infected with the protozoan parasite Leishmania major. The disease development can be completely halted and symptoms reversed, with a healthy outcome, by transferring freshly isolated or activated CD4+CD25+ T cells from syngeneic donors. The therapeutic effect of the regulatory T cells was completely blocked by treatment of the recipients with anti-IL-10R, anti-CTLA4, or anti-TGF-β Ab. However, the resurgence of colitis under these treatments was not accompanied by the reactivation of Th1 or Th2 response nor was it correlated to the parasite load. These results therefore demonstrate that CD4+CD25+ T cells are therapeutic and that the effect is mediated by both IL-10/TGF-β-dependent and independent mechanisms. Furthermore, colitis can manifest independent of Th1 and Th2 responses.
Study of thrombocytopenia in patients of malaria

Background: Malaria is a Protozoal disease caused by infection with parasites of the genus Plasmodium and transmitted to man by certain species of infected female Anopheline mosquito. In 2008 there were 1.52 million cases of malaria in India, out of which 0.76 million case of Plasmodium falciparum, comprising 50% of total malaria cases. There were 924 deaths from malaria. Hematological abnormalities have been observed in patients with malaria, with anemia, and thrombocytopenia being the most common. Materials and Methods: We conducted this study to find out the frequency and the degree of thrombocytopenia in patients with malaria. In our study, 230 patients with malaria positive were investigated with platelet count. Results: In the study group of 230 patients: 130 (56.51%) were positive for Plasmodium vivax, 90 (39.13%) were positive for P. falciparum and 10 (4.34%) had mixed infection with both P. vivax and P. falciparum. Out of 130 cases detected with vivax malaria, 100 cases had thrombocytopenia. Out of 90 cases detected with falciparum malaria, 70 cases had thrombocytopenia. Among 10 cases of mixed infection, 9 cases had thrombocytopenia. Conclusions: Presence of thrombocytopenia in a patient with acute febrile illness in the tropics increases the possibility of malaria. The above finding can have therapeutic implications in context of avoiding unnecessary platelet infusion in malaria patients.