bluuebunny/crossref_metadata_2025 huggingface dataset:
Noncanonical Contributions of MutLγ to VDE-Initiated Crossovers DuringSaccharomyces cerevisiaeMeiosis
Authors: Shodhan Anura , Medhi Darpan , Lichten Michael
Published: March 2019

In Saccharomyces cerevisiae, the meiosis-specific axis proteins Hop1 and Red1 are present nonuniformly across the genome. In a previous study, the meiosis-specific VMA1-derived endonuclease (VDE) was used to examine Spo11-independent recombination in a recombination reporter inserted in a Hop1/Red1-enriched region (HIS4) and in a Hop1/Red1-poor region (URA3). VDE-initiated crossovers at HIS4 were mostly dependent on Mlh3, a component of the MutLγ meiotic recombination intermediate resolvase, while VDE-initiated crossovers at URA3 were mostly Mlh3-independent. These differences were abolished in the absence of the chromosome axis remodeler Pch2, and crossovers at both loci became partly Mlh3-dependent. To test the generality of these observations, we examined inserts at six additional loci that differed in terms of Hop1/Red1 enrichment, chromosome size, and distance from centromeres and telomeres. All six loci behaved similarly to URA3: the vast majority of VDE-initiated crossovers were Mlh3-independent. This indicates that, counter to previous suggestions, levels of meiotic chromosome axis protein enrichment alone do not determine which recombination pathway gives rise to crossovers during VDE-initiated meiotic recombination. In pch2∆ mutants, the fraction of VDE-induced crossovers that were Mlh3-dependent increased to levels previously observed for Spo11-initiated crossovers in pch2∆, indicating that Pch2-dependent processes play an important role in controlling the balance between MutLγ-dependent and MutLγ-independent crossovers.
Genome-Wide Discovery of DEAD-Box RNA Helicase Targets Reveals RNA Structural Remodeling in Transcription Termination
Authors: Lai Yu-Hsuan , Choudhary Krishna , Cloutier Sara C , Xing Zheng , Aviran Sharon , Tran Elizabeth J
Published: March 2019

RNA helicases are a class of enzymes that unwind RNA duplexes in vitro but whose cellular functions are largely enigmatic. Here, we provide evidence that the DEAD-box protein Dbp2 remodels RNA-protein complex (RNP) structure to facilitate efficient termination of transcription in Saccharomyces cerevisiae via the Nrd1-Nab3-Sen1 (NNS) complex. First, we find that loss of DBP2 results in RNA polymerase II accumulation at the 3′ ends of small nucleolar RNAs and a subset of mRNAs. In addition, Dbp2 associates with RNA sequence motifs and regions bound by Nrd1 and can promote its recruitment to NNS-targeted regions. Using Structure-seq, we find altered RNA/RNP structures in dbp2∆ cells that correlate with inefficient termination. We also show a positive correlation between the stability of structures in the 3′ ends and a requirement for Dbp2 in termination. Taken together, these studies provide a role for RNA remodeling by Dbp2 and further suggests a mechanism whereby RNA structure is exploited for gene regulation.
Parental Perceptions, Beliefs and Attitudes towards Routine Childhood Vaccinations – United Arab Emirates Experience
Authors: H. Rabei, , H. Elamin, , D. AlSultani, , R. Albarghuthi, , H. AlTatari,
Published: March 2019

Background: Immunizations have been considered by many as one of the greatest inventions of the 20th century. Despite their success, there had been rising dispute in regards to vaccinations, which led to the emergence of skeptics all around the world who are questioning their efficacy and raising concerns about their safety.

While increasing data are published internationally about this topic, little do we know about the figures in the United Arab Emirates (UAE)

Objectives: This study aims to explore the attitudes, beliefs and perceptions of parents across different Emirates in UAE about the routine vaccinations. 

The results of the study will help health care providers have better understanding of the compliance to vaccinations in the area and therefore initiate targeted awareness campaigns to address main issues behind vaccine refusal and misconceptions around it.

Methods: An observational, cross-sectional study was approved by the institutional review board in accordance with the regulations of the Health Authority in Abu Dhabi (HAAD). Survey questionnaires consisting of 26 questions of qualitative and quantitative aspects were distributed to randomly selected parents across five different cities in United Arab Emirates.

Results: A total of 397 participants were included in our study. Parents have showed good perception of the effectiveness of vaccines as 90% agreed that vaccines are effective in preventing certain diseases. However, in regards to parents’ knowledge, 44% did not know that some vaccines prevent certain types of cancer. When looking at the rate of vaccination refusal in our study, we found that 10% of our population refuses to vaccinate their children. Three quarters of those did so because of either their belief that their child will develop his/her immunity naturally or that vaccinations are not safe. Also of note, one thirds of parents believed that vaccinations can cause serious side effects while 19% reported that they have not received sufficient information regarding vaccination from their child’s health care provider.

Conclusion: In our study, parents have demonstrated adequate knowledge and attitudes towards vaccinations. However, there still remains parents who refuse to vaccinate their children. Reasons behind the refusal can be tackled by the primary health care providers through adequate counseling and community based campaigns which aims to educate families about the safety and importance of vaccination.
Polynomial and Exponential Bounded Logic Programs with Function Symbols: Some New Decidable Classes
Authors: Asuncion Vernon , Zhang Yan , Zhang Heng , Li Ruixuan
Published: March 2019

A logic program with function symbols is called finitely ground if there is a finite propositional logic program whose stable models are exactly the same as the stable models of this program. Finite groundability is an important property for logic programs with function symbols because it makes feasible to compute such programs' stable models using traditional ASP solvers. In this paper, we introduce new decidable classes of finitely ground programs called poly-bounded and k-EXP-bounded programs, which, to the best of our knowledge, strictly contain all other decidable classes of finitely ground programs discovered so far in the literature. We also study the relevant complexity properties for these classes of programs. We prove that the membership complexities for poly-bounded and k-EXP-bounded programs are EXPTIME-complete and (k+1)-EXPTIME-complete, respectively.
Socio-educational factors associated to perception of research among stomatology students in a Cuban university
Authors:   Universidad de Ciencias Médicas de Granma. Clínica Estomatológica de Esps. ‘Manuel de Jesús Cedeño Infante’. Bayamo, Cuba., Corrales-Reyes Ibraín Enrique , Fornaris-Cedeño Yasmany ,   Universidad de Ciencias Médicas de La Habana. Facultad de Ciencias Médicas ‘Manuel Fajardo’, La Habana, Cuba., Valdés-Gamboa Leonardo ,   Universidad de Ciencias Médicas de Granma. Clínica Estomatológica de Esps. ‘Manuel de Jesús Cedeño Infante’. Bayamo, Cuba., Dorta-Contreras Alberto Juan ,   Universidad de Ciencias Médicas de La Habana. Facultad de Ciencias Médicas ‘Dr. Miguel Enríquez’. Central Laboratory of Cerebrospinal Fluid (LABCEL). La Habana, Cuba., Mejia Christian R. ,   Universidad Continental. Huancayo, Perú.
Published: March 2019

Introduction: Conducting research at the undergraduate level is essential to prepare future professionals for the process of properly channeling their scientific interest and provision of care. However, the factors influencing the degree of participation of students in research are unknown. Aim: To determine the socio-educational factors associated with the perception of research among stomatology students in a Cuban university. Materials and Methods: Cross-sectional analytical study conducted on 166 stomatology students. Participants received an anonymous, validated and self-administered questionnaire designed to collect information on the perception of scientific research within the educational spectrum, which included elements related to writing, participation, scientific publication and the interest of pursuing a career in research. Using associative statistics, those who had an overall positive perception of research were considered interested and were assessed according to socio-educational variables. Results: Students showed a positive perception of scientific research; however, when asked if they wanted to pursue a career in research, only 61.4% responded affirmatively. This positive perception increases with the progression of academic years (p<0.04), is higher in males (p=0.030) and in students who perform assistantships in core courses (p=0.001). Conclusions: There is a positive perception of scientific research, which tends to be intensified by academic progression and other factors. This must be considered by educational institutions in order to generate strategies as a response.
Prevalence of impacted mandibular third molars and its association with distal caries in mandibular second molars using cone beam computed tomography
Authors:   Oral Diagnosis Dept. College of Dentistry, University of Sulaimani, Madam Mitterrand Road, Sulaimani, Kurdistan Region, Iraq., Rashid Mardin Othman , Talabani Ranjdar Mahmood ,   Lecturer at Conservative Dept. College of Dentistry, University of Sulaimani Madam Mitterrand Road, Sulaimani, Kurdistan Region, Iraq., Baban Mohammed Taha ,   Dental Nursing Dept. Sulaimani Technical Institute Sulaimani Polytechnic University Chwarchra, Sulaimani, Iraq., Gul Sarhang Sarwat ,   Lecturer at Periodontic Dept. College of Dentistry, University of Sulaimani, Madam Mitterrand Road, Sulaimani, Iraq., Salih Rishwan Omar ,   Health Directory of Sulaimani Qrga, Sulaimani, Iraq., Abdulkareem Bamo Namiq ,   Lecturer at Oral Surgery Dept. College of Dentistry, University of Sulaimani, Madam Mitterrand Road, Sulaimani, Kurdistan Region, Iraq., Abdulalttef Darwn Saeed ,   Lecturer at Conservative Dept. College of Dentistry, University of Sulaima­ni, Madam Mitterrand Road, Sulaimani, Iraq.
Published: March 2019

This study evaluated the prevalence and eruption’s pattern of impacted mandibular third molars (IMTM) and the influence of their eruption status on the distal caries of mandibular second molars (MSM) using cone-beam computed tomography (CBCT). Material and methods: CBCT images taken for different purposes in private dental practices were analyzed retrospectively. Radiographic assessment included: prevalence of IMTM, degree of angulation, level of impaction and type of IMTM. Furthermore, the distance between the cement-enamel junctions (CEJ) of second and third molars and the occurrence of caries lesion on the distal surface of MSM was also evaluated. Data were analyzed by chi square test and logistic regression was used to find the association between distal caries of MSM and eruption status of IMTM. Results: Three hundred and eight CBCTs were screened, the prevalence of IMTM was 36.88% and their angulation degree were mostly less than 90º (mesioangular). Amongst those with impaction, 58 subjects (43%) had distal caries on MSM, 29.6% in females and 30.4% in the age group 19-27 years. Caries on the distal side of MSM were significantly associated with age, level and type of impaction, angulation degree and CEJ distances (p<0.05). Conclusions: The prevalence of IMTM is high (36.88%) and there are significant relationships between angulation degree, level and type of impaction, and CEJ distances with caries on the distal side of MSM.
Histological and biochemical effects of Cinnamomum cassia nanoparticles in kidneys of diabetic Sprague-Dawley rats
Authors: Kouame Koffi , Peter Aniekan Imo , Akang Edidiong Nnamso , Moodley Roshila , Naidu Edwin Coleridge , Azu Onyemaechi Okpara
Published: March 2019

This study investigated the antidiabetic activity of Cinnamomum cassia (C. cassia, Cc) silver nanoparticles (CcAgNPS) and effects of C. cassia on the kidneys of rats with induced type 2 diabetes. Twenty-four Sprague-Dawley rats weighing 250 ± 20 g were induced with diabetes by intraperitoneal injection of streptozotocin (STZ, 60 mg/kg). Animals were randomly assigned to one of four groups (n = 6) and treated for eight weeks with normal saline (control, group A), 5 mg/kg of CcAgNPs (group B), 10 mg/kg of CcAgNPs (group C), or 200 mg/kg of Cc (group D). Body weight and fasting blood glucose (FBG) was measured weekly and fortnightly, respectively. At the end of experiments, animals were euthanized, blood and kidney tissue samples were collected for biochemistry (oxidative stress markers and renal function parameters) and kidneys were harvested for histology (PAS and HE staining). Body weight was significantly higher in group B and C vs. control (p < 0.05), while no significant differences were observed in the kidney-to-body weight ratio between groups. FBG, glutathione, malondialdehyde, alanine aminotransferase, aspartate aminotransferase, serum urea and creatinine were significantly lower in group B, C and/or D vs. control (all p < 0.05). In group A, severe distortion of the glomerular network was observed, marked by the loss of capsular integrity, thickened basement membrane, tubular cells with pyknotic nuclei, vacuolization, and interstitial space with infiltrations. These adverse effects were mitigated by 5 mg/kg and 10 mg/kg of CcAgNPs. Our study confirms structural and functional damage to kidneys caused by diabetes. CcAgNPs have a regenerative potential in diabetes-induced kidney damage and may be used as an antidiabetic agent.
Contested Sovereignty and Conflict: Between Spain and Catalonia
Authors: Olomojobi Yinka , Omonye Omoigerale
Published: March 2019

This paper examines the Catalonia-Spain trajectory. Quite recently, the region of Catalonia became known for its sovereignty demand, which has strained relations with Spain its host state. Economic grievances, nationalism, and political disillusionment are some of the explanations given for the growing secessionist moves in the region. Apart from this, other reasons identified include strained historical ties, class struggle, the erosion of its autonomous region by General Francisco Franco and the subsequent demand for selfdetermination by separatists. An issue that runs through this work is the refusal of the Spanish government to concede to this separatist’s demand which has deteriorated any negotiations for dialogue. However, the Spanish government has announced that it is open to negotiate anything except a referendum. Furthermore, based on the reaction of the Spanish government, the 2014 referendum held by the Catalans seems to be nonconclusive. This study, therefore seeks to examine the contentious issues of “contested sovereignty” with relations to the Catalonia-Spain quagmire and its seemly subsisting impact in the pro-independence agitations in Europe and Africa.
Tax Compliance in the Russian Federation, the United Kingdom of Great Britain and Northern Ireland, and the United States of America: Forcing and Encouraging Lawful Conduct of Taxpayers
Authors: Ovcharova Elena , Tasalov Kirill , Osina Dina
Published: March 2019

The article is devoted to the consideration of the system for the tax authorities to assess tax risks and to prevent tax law violations. The work focuses on how the tax authorities affect the conduct of taxpayers through “soft law,” disclose information about their approach towards understanding tax risks and enforce a system of measures to ensure compliance. Tax compliance is analysed in the article as good-faith and lawful conduct of a taxpayer, which is formed under the influence of a system of, at the same time, preventive and incentive measures. This article considers tax compliance issues in Russia, the United Kingdom and the USA, not so much as a consequence of the voluntary actions of the taxpayer, but as a consequence of the conditions that are set for a taxpayer by the administrative action of tax authorities. To do this, the approaches of the tax authorities to defining the criteria for tax risks and the procedure for assessing them are analysed, as is the effect of these approaches on the subsequent implementation of tax control measures, while the system of enforcement measures and incentives for taxpayers to comply with tax legislation are examined. Tax compliance is the most desirable regime for the state, but in the entire history of taxation no jurisdiction has been able to achieve full tax collection solely based on a persuasive method. At the same time, owing to the limited resources of tax administrations, in practice there is no real opportunity to examine absolutely every taxpayer. For specifically this reason, a risk-based approach to carrying out tax control with a reasonable combination of both incentive measures and the enforcement of compliance with tax legislation is becoming increasingly relevant. The authors consider the implementation of a risk-based approach and its effect on tax compliance, on the choice of tax control measures, and on depth and scope in terms thereof, using the example of the experience of Russia, the United Kingdom and the USA. The article also pays special attention to an analysis of incentive measures and the enforcement of tax compliance in these jurisdictions.
The Pedagogical Education of Chemistry Teachers: a critical-reflexive analysis of teacher education
Authors: Tres Lairton , Del Pino José Claudio
Published: March 2019

This article discusses the pedagogical aspects of the chemistry teachers training course of a community university in the state of Rio Grande do Sul. The course got through several curricular reformulations, which enabled the implementation of chemical education subjects, responsible for the articulation of technical and pedagogical knowledge throughout the course. We did a structured interview with the course’s graduates and then made a critical-reflexive analysis of the developed work, trying to understand the former students’ perspectives about the parameters used as indicators for their education and the contributions of this process towards the construction of chemistry teachers. Among the main results, we highlight the importance of the actions in chemical education established to allow the insertion of the future teachers in the school context from the beginning of the course. This encouraged them to become researchers of a reflexive practice and to establish themselves as mediating educators in the teaching-learning process, creating the link between technical and pedagogical knowledge by teaching.
Digital Technologies in the Teaching and Learning of Human Anatomy: analysis of the perceptions of Higher Education academics
Authors: Bandeira Scheunemann Camila Maria , De Almeida Caroline Medeiros Martins , Campos Lopes Paulo Tadeu
Published: March 2019

The discipline of human anatomy in higher education has sought to restructure its approach and methodological strategies; in this context, digital technologies are presented as alternative means that can be incorporated in the study of this discipline. This exploratory qualitative research had as objective to analyze the perceptions of health academics about the use of digital technologies for the teaching and learning of human anatomy. The participants were 20 academics of the discipline of human anatomy of courses of the health area of a private university of the metropolitan region of Porto Alegre. The data were collected from a questionnaire, composed of questions related to the teaching and learning of human anatomy and the use of digital technologies for this component. The data were analyzed from the Content Analysis. Scholars have pointed out in their perceptions that digital resources contribute to the learning of anatomy; among the features most cited by them and indicated to be used are YouTube and social networks. The research pointed to contributions to present, from the perceptions of the students, the importance of considering the digital resources because they are incorporated in their daily life. We verified the need for further studies on perceptions, since they are indicative of the resources that can be used to learn anatomical concepts.
Differential Equations: Between the Theoretical Sublimation and the Practical Universalization
Authors: Nápoles Valdez Juan Eduardo
Published: March 2019

In this paper, we present, briefly, the bifront character of the ordinary differential equations (ODE): on the one hand the theoretical specialization in different areas and on the other, the multiplicity of applications of the same, as well as some reflections on the development of a course of ode in this context.
To compare the efficacy and safety of silodosin and dutasteride combination with alfuzosin and dutasteride combination in patients of benign prostatic hyperplasia: a randomized, open label study
Authors: Kahkashan Iram , Chawdhary Shabnam , Tandon Vishal R. , Gupta Rahul
Published: March 2019

Background: BPH is a major cause of bothersome lower urinary tract symptoms (LUTS) and affects quality of life (QoL) which deteriorates if not taken care with the passage of time. The aim and objective of the study was to compare the efficacy and safety of combination of silodosin and dutasteride with the combination of alfuzosin and dutasteride in patients of BPH.Methods: A randomized, open label, intention to treat study was carried out on newly diagnosed patients of BPH. Patients were randomly divided into two groups and followed up to 12 weeks. Group 1 of patients received a combination of silodosin 8 mg and dutasteride 0.5 mg (SD) (n=20) while the patients of group 2 received combination of alfuzosin 10 mg and dutasteride 0.5 mg (AD) (n=20). Primary endpoint was measured by changes in the mean baseline International prostate symptom score (I-PSS) and uroflowmetry and secondary outcome with changes observed on ultrasonography.Results: IPSS and IPSS-QOL significantly improved in both the treatment groups (p <0.001) along with mean maximum flow rate (Qmax) and mean average flow rate (Qavg). Prostate volume and residual urine volume showed a significant improvement in both the treatment groups at 12 weeks. However, the intergroup differences in IPSS, uroflowmetry and USG parameters were not significant. Both treatments were well tolerated.Conclusions: The current study established that both the drug combinations i.e. silodosin and dutasteride (SD) and alfuzosin and dutasteride (AD) largely have a comparable effect on both the dynamic and static components of BPH. Further, both drug combinations appear to have a comparable safety profile.
Comparative evaluation of levetiracetam and valproic acid as monotherapy on cognitive impairment in patients of epilepsy
Authors: Khanna Shreshth , Bala Suman , Singh Yashpal , Sharma Taruna , Kalra Juhi , Dhasmana D. C. , Kohli Saurabh
Published: March 2019

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.
An evaluation of pattern of adverse drug reactions reporting by undergraduate medical students in a tertiary care hospital
Authors: Bali Zorawar Singh , Bhat Mohammad Younis , Farhat Samina , Nabi Urfan
Published: March 2019

Background: Adverse drug reactions (ADRs) are an important cause of mortality and morbidity worldwide and reporting ADRs voluntarily is fundamental to medical drug safety surveillance but gross underreporting of ADRs is a cause for a concern. Being key health care professional, physicians, pharmacists and nurses have immense responsibility in reporting of ADRs. Therefore, the sensitization and involvement of undergraduate medical students can reduce underreporting. This study is aimed at evaluating knowledge, attitude and reporting of quality of ADRs by undergraduate medical students.Methods: The study was conducted after sensitizing the second professional year undergraduate students about Pharmacovigilance as part of their internal assessment and asked them to submit reports of ADR observed during their clinical posting.Results: A total of 82 ADR’s were reported after sensitization with majority of them i.e. 30 related to skin and appendages disorder followed by gastrointestinal tract with antibiotics i.e. 28 and analgesics being most common probable/possible culprits.Conclusions: The response percentage of reporting ADRs was 54.66%. Medical students being future healthcare professionals should be exposed to ADR reporting during their clinical teaching posting as a part of sensitization and make them actively involved in reporting to improve detection rate and make Pharmacovigilance a success.
Knowledge, awareness and attitude regarding WHO recommended ANC visits among pregnant women attending antenatal clinic at D.Y. Patil hospital, Kolhapur, Maharashtra, India
Authors: Dhavalshankh Archana G. , Dhavalshankh Ganesh P. , Dixit Abhishek
Published: March 2019

Background: ANC is the care woman receives throughout the pregnancy in order to ensure that both the mother and child remain healthy. Promotion of maternal and child health is the most important component of family welfare programme of Govt. of India. It is useful to promote, prevent and protect maternal and perinatal health for the sustainable growth and development of country. Unfortunately, many women in developing countries do not receive such care. This study is conducted to identify, address and to assess the awareness and knowledge about own health during pregnancy and to improve maternal health, to improve maternal health services and to limit barriers among health systems working at all levels.Methods: This study is done in D.Y. Patil Hospital, Kolhapur among pregnant women attending ANC from April to June 2017. A questionnaire was used to collect data and assessed in either positive or negative response. Statistical analysis was done in terms of percentage.Results: During the analysis 48.1% had knowledge about ANC check-ups and 26.7% admitted about the importance of ANC check-up and visits. Regarding awareness, 35.8% were aware about the importance of ANC card, 28.3% were aware about the parameters, check-ups and investigations. 23% agreed that each ANC visit can improve the health and baby’s growth, while evaluating Attitude 32.6% enquired about their improvement or complications they will have to face.Conclusions: Present study data is baseline but informative for further planning of health in intervention programme. It is also useful for enhancing awareness of antenatal care and for motivating the women to utilize maternal care services.
A cross sectional study to assess knowledge, attitude and practice of rational antibiotic prescription among resident doctors
Authors: Antony Anatte , Mohamedali Seema P. , M. Anuradha
Published: March 2019

Background: Irrational prescription is a major contributor to the antimicrobial resistance. Resident doctors are the major focus of interventional programs aimed at rational prescription of antibiotics. So, their knowledge, attitude and practice regarding rational antibiotic prescription need to be assessed to plan future strategies.Methods: A questionnaire based cross sectional study among interns and resident doctors of a Government Medical College was conducted. Questionnaire consisted of questions to assess knowledge, attitude and practice of resident doctors in rational antibiotic prescriptions and multiple-choice questions to assess practice of hospital antibiotic policy.Results: 80 participants were enrolled in the study. All participants responded to yes or no questions and 47 answered multiple choice questions. 40% were aware of the current hospital antibiotic policy and 29% knew the term antibiotic stewardship. Only 15% were confident in their knowledge on antimicrobial resistance. 87.5% think there is no use in prescribing an antibiotic in common cold. 36.3% overprescribes antibiotics in their daily practice. Only 32.5% practiced de-escalation. 90% were educating patients regarding correct use of antibiotics. 90% send samples for culture and sensitivity but only 22.2% waited for results to start antibiotics.Conclusions: There is a need for approaches that includes implementation of antibiotic policy and to plan for effective teaching programs regarding antibiotic resistance and importance of rational prescription of antibiotics which can improve the quality of antibiotic prescription and minimize antibiotic resistance.
Prevalence of insulin induced lipodystrophy in patients with diabetes mellitus in a tertiary care centre: a cross sectional study
Authors: Bezawada Shravani , V. Anuradha H. , Kalra Pramila
Published: March 2019

Background: Diabetes Mellitus is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycaemic drugs and insulin along with the dietary and lifestyle modifications. Lipodystrophy is the most neglected adverse drug effect caused by injecting insulin. The main objective of this study was to assess the prevalence of lipodystrophy at the insulin injection sites in patients suffering from diabetes mellitus (Type 1 and Type 2).Methods: A cross-sectional study was conducted in the Department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. The demographic features and anthropometric measurements were noted. Insulin injection sites were examined clinically by inspection and palpation for presence of swelling like lipodystrophy, injection marks and signs of allergy like erythema etc. Lipodystrophy was graded from 0-3 and denoted as lipohypertrophy or lipoatrophy. The results were tabulated and presented accordingly.Results: In this study, out of 250 patients 17 (6.8%) patients presented with insulin induced lipodystrophy. Lipohypertrophy was the most common presentation and only one case presented with lipoatrophy.Conclusions: It can be concluded from the present study that lipodystrophy which is an important adverse effect due to insulin injection needs to be monitored regularly in every patient taking insulin for better control of glucose levels.
A comparative evaluation of diclofenac and tramadol as post-operative analgesics along with causality and severity assessment of ADRs
Authors: Shaifali Iram , Prakash Suruchi , Chandra Shalini , Saran Jagdamba
Published: March 2019

Background: Diclofenac and Tramadol are well established analgesics for post-operative pain management, yet some adverse effects are associated with their use which govern their tolerability. The objective of the study was to evaluate the comparative efficacy of the two drugs and to assess the causality and severity of documented Adverse Drug Reactions (ADRs).Methods: An open labelled, prospective, interventional, simple randomized clinical study to compare efficacy and safety of diclofenac and tramadol was conducted by the Department of Pharmacology in collaboration with the Department of Surgery. Post-operative pain intensity was measured on Visual Analogue Scale (VAS). Causality and severity assessment of the recorded ADRs was done using WHO-UMC scale and modified Hartwig and Seigel Scale respectively.Results: A total of 211 patients underwent different surgeries. The most common surgery performed was mesh hernioplasty 78 (36.96%). VAS score was used as data to determine the analgesic efficacy of two drugs. Wilcoxon Signed Rank test showed significant reduction in pain on all days for each group individually while Mann Whitney U test compared both the groups and revealed that both the drugs i.e. diclofenac and tramadol were equally efficacious in reducing post-operative pain. Causality assessment showed that all the documented ADRs fall in POSSIBLE category while severity assessment revealed that all the ADRs were MILD in nature.Conclusions: Diclofenac and tramadol proved to be equi-effective in reducing post-operative pain . The study also emphasized that active surveillance of ADRs can lead to timely intervention and provide maximum benefit to the patient.
Preliminary phytochemical screening and GC-MS analysis of Cladophora glomerata: green marine algae
Authors: S. Usha N. , J. V. Sabari Anand , . Mangaiyarkarasi
Published: March 2019

Background: Seaweeds since ages are excellent source of biologically active ingredients. Several Asian countries have a strong tradition of using various seaweeds in herbal medicines preparations. These plants contain various phytochemical constituents having biological activities. Seaweeds are the source of phytochemicals namely agar-agar, carrageenan and algin, which are extensively used in various industries such as food, confectionary, textiles, pharmaceuticals, dairy and paper industries mostly as gelling, stabilizing and thickening agents. They are also used for human consumption, animal feed and as manure in several countries. Several Asian countries are using various seaweeds in traditional medicines.Methods: In the present study, the shade dried and methanolic extract of Cladophora glomerata, a marine green algae was subjected to preliminary phytochemical and gas chromatography-mass spectrometry analysis(GC-MS) to identify the various bioactive components.Results: The methanolic extract of Cladophora glomerata revealed the presence of alkaloids, glycosides, flavonoids, saponins, diterpenes and carbohydrates. The GC-MS analysis of the methanolic extract of Cladophora glomerata showed the presence of 42 different compounds. The major compounds were dibutyl phthalate (27.07%), hexadecanoic acid, methyl ester (9.58%), 1,2-benzene-di-carboxylic acid (8.11%), octatriacontyl trifluoroacetate (6.81%), cholesterol (6.66%).Conclusions: Thus, in the present study of Cladophora glomerata, phytochemical and GC-MS analysis provides an important novel information to support further ongoing studies to evaluate structure of bioactive compound and its pharmacological activities.
A meta-analysis of analgesic efficacy of opioids in the treatment of neuropathic pain
Authors: A. Preethi , M. Kulandaiammal
Published: March 2019

Background: Neuropathic pain is the most common form of chronic pain often associated with impaired quality of life due to its poor management. Tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors and calcium channel alpha 2 ligand agonist are preferred as first line therapy for neuropathic pain. Lignocaine patches and transdermal patches of capsaicin are used as second line agents. Moderate efficacy opioids like tramadol and strong opioids are recommended as second line and third line therapy for neuropathic pain respectively. Previous meta-analysis and systematic review shows inconsistent data and lacks reliability in getting conclusive results in opioids use in neuropathic pain. So, author conducted a meta-analysis to reanalyse the analgesic efficacy of opioid agonist for the treatment of neuropathic pain.Methods: Author searched Oxford pain relief data base, Google web, Embase, Medline and Cochrane library from February 2001 to November 2017 for articles related to analgesic efficacy of opioid agonist in neuropathic pain based on author’s selection criteria. Reference list of reviews were retrieved using Prisma Algorithm and analysed using REVIEW MANAGER 5 software.Results: Among 1108 publications searched, only 5 trials met the inclusion criteria. Primary outcome measure was proportion of participants reporting 50% of pain relief or better. In five trials, 305 patients treated with opioids and placebo/standard treatment for neuropathic pain, the number per treatment group ranges from 31 to 170 (median 50±5). The overall point estimate of risk difference was 0.17 (95% CI 0.02 to 0.33, P=0.026) translating to number needed to treat (Benefit) of 5.9 (3.0 to 50.0).Conclusions: In this meta-analysis, opioid agonist efficacy trials shown consistent analgesic efficacy and benefit over placebo/standard treatment in reducing neuropathic pain.
Antibiotic susceptibility pattern of bacteria isolated from patients of respiratory tract infection in a tertiary care hospital of Eastern India
Authors: Prasad Ashok , Mukherjee Shatavisa , Era Nikhil , Mukherjee Mala
Published: March 2019

Background: Respiratory tract infections have been one of the commonest types of infections affecting the Indian population. With antibiotic resistance being a global threat and challenge to healthcare, concerns over skilful and judicious use of existing antibiotics have been on rise. Update on region specific bacterial susceptibility pattern is thus a need. The present study was planned to identify the common pathogens responsible for the respiratory tract infection and their antibiotic susceptibility patterns.Methods: A prospective study was carried out, where subjects with lower respiratory tract (LRT) infection admitted in the Intensive Care Unit in the tertiary care centre in Eastern India during the one-year period were enrolled in the study. Samples such as sputum, suction tip, endotracheal aspirate, bronchial aspirate and pleural fluid were obtained under aseptic precautions and were processed. The bacterial isolates were subjected to susceptibility testing by standard Kirby Bauer disc diffusion methods. The susceptibility patterns of the bacterial pathogens were determined.Results: Out of 234 processed samples, klebsiella (33.44%) was found to be commonest pathogen isolated from all the sites followed by Pseudomonas, staphylococcus and others. Amongst the penicillin group of antibiotics, ampicillin showed highest activity against pseudomonas and E. coli respectively. Antibiotics like penicillin G, ampicillin/sulbactam and amoxicillin/clavulanic acid combination showed lower susceptibility towards most pathogens. Amongst broad spectrum antibiotics, amikacin showed high susceptibility towards pseudomonas species followed by chloramphenicol and tetracycline.Conclusions: With changing trends in microbiological patterns of responsible organisms, knowledge regarding antibiotic susceptibility pattern needs to be regularly revised, thus ensuring prompt initiation of adequate and appropriate antibiotic treatment with better patient outcomes.
Prescribing pattern and adverse drug reactions of cardiovascular drugs in out-patient department of a tertiary care hospital
Authors: R. Nalini , R. Mansoora Shahiba , J. Ezhil Ramya , M. Kannan S.
Published: March 2019

Background: The main objective of prescription pattern analysis is to assess the rationality of drug use. It has been found that cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. This study is to estimate the prescribing pattern and adverse drug reactions in patients with cardiovascular diseases.Methods: This prospective observational study was conducted for a period of 2 months in cardiology outpatient department.100 patients who fulfilled the study criteria were observed. The central drug standard control organisation (CDSCO) reporting forms were used for the collection of adverse drug reactions. Causality assessment was done by using the World Health Organization Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre (WHO-UMC) scoring system and severity assessment by modified Hartwig and Siegel scale.Results: The study group consists of 79% male and 21% females. Average number of drugs per prescription was 4.65. Most commonly prescribed drugs were antiplatelets (32%) followed by statins (18.27%) and the least common were calcium channel blockers (1.72%) and cardiac glycosides (0.86%). A total of 174 adverse drug reactions were reported out of which 24.7% were myalgia due to statins, 15.5% were cough due to angiotensin converting enzyme inhibitors and 14.3% were gastritis due to antiplatelets.Conclusions: Antiplatelets, statins and angiotensin converting enzyme inhibitors dominated the prescribing pattern. Myalgia, cough, gastritis, insomnia by atorvastatin, enalapril, aspirin, beta blockers respectively were found to be the most commonly reported ADRs among the cardiovascular drugs.
Dilated cardiomyopathy: a pharmacotherapeutic research
Authors: Mohiuddin Mohammad Younus
Published: March 2019

Background: AHA defines cardiomyopathies as a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to a variety of causes that frequently are genetic.Methods: This is a prospective observational study conducted in the year 2017 at an OPD of Cardiology of a private hospital located in Telangana state, India. Data has been collected after diagnosis is made and treatment regimen is given by an Interventional Cardiologist.Results: Data has been collected from 78 cardiac patients, out of which 17.9% patients had Dilated Cardiomyopathy (DCM) among them 57.14% were male. In the present study DCM was reported more in the age group of 61-70 years (42.85%). Treatment pattern in most of the prescriptions include Diuretics, Beta blockers, Angiotensin Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARBs), Cardiac Glycosides, Antiplatelet and Antihyperlipidaemics.Conclusions: To conclude, lack of awareness among people about this disease is leading it to progress to advanced stages and prognosis of which is poor. Conducting community awareness programs can play a key component in improving the prognosis of this disease.
Analysis of gastrointestinal drugs in patients admitted in CCU and ICCU of a tertiary care hospital in Goa, India
Authors: Kerkar Shantadurga S. , Bhandare Padma N.
Published: March 2019

Background: Gastrointestinal (GI) diseases are a common problem worldwide. They are frequently encountered in non-critical as well as in critically ill hospitalized patients.Methods: This was a prospective and observational study conducted on patients admitted in CCU and ICCU of Goa Medical College and Hospital. Data was collected from the patients’ case records and was analysed referring to WHO prescribing indicators. Data was represented as Mean±SD, number and frequency.Results: A total of 2250 drugs were prescribed, out of which 376 (16.71%) were gastrointestinal drugs. Most common route of administration was oral 323 (85.90%). Prescription patterns of GI drugs were:  275 (73.14%) from National List of Essential Medicines, 20 (5.31%) as fixed dose combinations and 4 (1.06%) by generic names. Pantoprazole 183 (48.67%) was the most frequently prescribed drug for peptic ulcer in present study.Conclusions: From the findings of this study we noted that among the GI drugs used, those for peptic ulcer were the most commonly prescribed. Also majority were from the essential drug list. But prescribing by generic names was low. Review of drug utilization trends is a necessary aid to formulate and modify existing protocols and guidelines to improve treatment outcomes in a given setting.
Comparative study of adverse drug reaction pattern of two anti-asthma groups of drugs in a tertiary care hospital
Authors: S. Narendra Babu , C. Vinoth Kumar , R. Nandini
Published: March 2019

Background: Bronchial Asthma is one of the worldwide health problems associated with increased morbidity and also mortality. Bronchial Asthma is a disease of airways that is characterized by increased responsiveness of the trachea-bronchial tree. Anti asthmatic drugs are associated with adverse effects which can affect the compliance and course of treatment. Monitoring adverse drug reactions in asthma will play a vital role in alerting physicians about the possibility and circumstances of such events, thereby protecting the user population from avoidable harm.Methods: The study was conducted in 500 bronchial asthma patients (250 patients in Beta 2 agonist group (Salbutamol) and 250 patients in Methylxanthine group (Deriphyllin) who fulfilled the study criteria and were observed for three months at Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. Their prescriptions were collected and analysed. Adverse drug reactions(ADRs) in each group were collected and evaluated. The causality assessment was done by WHO-UMC assessment scale and severity by using Modified Hartwig-Seigel severity assessment scale.Results: Total 38% of patients taking anti-asthma drugs were encountered adverse drug reactions and were more common in elderly females (61 to 70 years). Adverse Drug Reactions were more common in Methylxanthine group (48%) compared to Beta 2 agonist group (28%). Headache (38%) was the commonest ADR in Methylxanthine group and Tremors (31%) in Beta 2 agonist group. Most of ADRs were mild (95 %), manageable and comes under possible (60 %) category of WHO causality assessment scale.Conclusions: Treatment of Bronchial Asthma is mainly based on Beta 2 agonist and Methylxanthine group. So, occurrence of ADR is much common. Our study offers a representative idea of the ADR profile of anti asthmatic drugs. Constant vigil in detecting ADRs and subsequent dose adjustments can make therapy with anti asthmatic drugs safer and more effective. This, in turn, will improve compliance.