Pharmacovigilance in patient safety: Challenges and perspectives

Pharmacovigilance is growing as an important discipline, which plays an important role in patient safety concerning with the drug side effects. It is basically to identify the adverse effects related to drugs. Pharmacovigilance is an ongoing activity. This article is an attempt to prioritize the importance of pharmacovigilance, its important facets, challenges, and perspectives and a thought of a pharmacovigilance (dummy-example) system to establish a wider coverage through enhanced networking and thereby a more sound reporting of the adverse effects.

External fixation in proximal Humerus Fracture in elderly and co- morbid patients

Fractures around proximal humerus are common injuries occurring in predominantly elderly female population associated with osteoporosis. Elderly age group associated with comorbidity gives good outcome with minimal intervention with external stabilization of the fracture avoiding major surgical procedure on proximal humerus. Objective:to study the outcomes of fixation of proximal humerus fracture by external stabilizing system in elderly, osteoporotic and comorbid patients. Methodology:we did study of 30 Neers type 3 and type 4 fracture patients in span of 12 months from fracture in which 17 were female and 13 were male patients. The age group was 50 to 75. The results external fixation of fracture was evaluated as per Neers criteria. Results:all 30 patients were followed till fracture got union. In Neers type 3 fracture 13 (81.25%) patients got good results while in type 4 fractures 09 (64.28%) patients got good results. Conclusion: external stabilization of Neers type 3 and 4 proximal humerus fracture patients who are elderly, osteoporotic and comorbid shows excellent outcome with this minimally invasive stabilizing system.

Comparative Evaluation of Methicillin Resistant and Methicillin Sensitive Staphylococcus aureus of Livestock Origin for Antibiotic Sensitivity, Biofilm Formation and Virulence in Galleria mellonella

The objectives of the study were to isolate and identify livestock associated methicillin resistant Staphylococcus aureus (LA-MRSA) and methicillin sensitive S. aureus (LA-MSSA) from clinical mastitis cases and to compare their antibiotic susceptibility, biofilm formation and in vivo pathogenicity in Galleria mellonella larva model. A total of 60 milk samples were collected from cows suffering from mastitis and processed for isolation and identification of S. aureus using standard conventional methods. All the recovered S. aureas isolates were subjected for detection of MRSA and/or MSSA employing phenotypic (Cefoxitin disc assay) and genotypic (the mecA gene PCR) assays. Antibiotic susceptibility pattern of LA-MRSA and LA-MSSA test isolates was determined using disc diffusion method, biofilm formation by 96 well microtiter plate assay and pathogenicity testing in G. mellonella larvae. On microbiological, biochemical and PCR analyses, 14 S. aureus isolates were confirmed. Of these, 4 were tested as LA-MRSA and the remaining 10 isolates were LA-MSSA. Comparative evaluation suggested that MRSA isolates were resistant to different classes of antibiotics and were equally lethal to G. mellonella larvae. However, bioflim forming ability was significantly higher (p < 0.001) in the MSSA test isolates. An association of biofilm formation and pahogenicity testing was not observed between LA-MRSA and LA-MSSA test isolates. Further, LA-MRSA were resistant to different classes of antibiotic and were more lethal to G. mellonella larvae. These preliminary observations are of great concern as the LA-MRSA infections in the community have been documented and warrant in depth research for such pathogens

Prevalence And Severity Of Hamstring Tightness Among College Student: A Cross Sectional Study

Introduction: The present study was aimed to study clinic-investigative profile of foot lesions in diabetics in patients presenting in Pravara Rural Hospital, Loni. Materials and Methods: This prospective cross sectional study was under-taken in 50 patients carried out over a period of 2 years. Patients, irrespective of their age and gender, admitted in the inpatient department of surgery with Diabetes mellitus having foot problem and consenting for taking part in the study were included. All patients were evaluated by taking detailed history, clinical examination and necessary inves-tigation done. Results: Most patients present with diabetic foot lesion were in 7th decade of life. females were more commonly affected with male to female ratio 1:1.5. Ulcer was the common lesion seen here which was present in 24(48%) patients while abscess seen in 3 (6%) patients, was the least common lesion. There were many anaemic pa-tients (74%) in current study. Staphylococcus aureus was the commonest grown organism form the pus sample of foot lesions. Of the 50 patients, only 24 (48%) were known diabetics. Also, 18 (36%) patients were known smokers, 12 (24%) were alcoholic. Most patients (35 i.e, 70%) walked bare foot while only 15(30%) patients were using foot-wear. Cardiovascular diseases were common (10 i.e, 20%) associated conditions. Peripheral neuropathy was present in 21 (42%) patients. On staging the patients according to Wagner staging, most of the patients belonged to stage III (23) and IV (14). Doppler study in select patients revealed that 8(16%) patients were detected as impaired blood flow in peripheral vessels, 3(6%) patients showed complete stenosis and 5(10%) patients showed partial stenosis. Conclu-sion: Diabetic foot lesions were common in elderly patients. The most common presentation of foot lesions was ul-cer. The foot lesions were associated with poor blood sugar control, peripheral neuropathy, cardiovascular diseases, anemia, smoking and alcohol addiction. Most patients belonged to Wagner stages III and IV. Staphylococcus aureuswas the commonest grown organism form the pus sample of foot lesions .

Oral contraceptives and oral health: an insight.

Oral contraceptive pills are a safe and effective means of avoiding pregnancy followed by women worldwide. These drugs were first introduced in 1960s and 70s and contained higher dose of estrogen and progesterone and were reported to cause unwanted side effects like gingival inflammation, localized osteitis, alterations in salivary flow rate, changes in salivary components and gingival melanosis in oral tissues. With the advent of new generation formulations of low dose oral contraceptive pills, the effects on oral health is minimized and presently users are not considered as risk group for developing gingival and periodontal disease. This review briefs the effects of oral contraceptive pills on general health and oral health in particular and controversies surrounding their use.

Prevalence of chronic facet arthropathy: a retrospective study.

Background: To assess prevalence facet-joint arthropathy in chronic low back pain using computed tomography. Methods: A retrospective study profiled and analysed objective data from patients CT scans and previous records. Results: Facetal arthropathy was graded by Pathria’s criteria.102 joints (33.12%) were grade 1, 113 (36.69%) grade 2, 63 (20.45%) grade 3, and 30 (9.74. %) grade 4. Final result showed that females were affected more than the male in Grade II, III and IV. Age group more affected was between 46-85 years. Conclusions: Our study on chronic low back pain revealed prevalence of facet-joint involvement 66.88% (206 patients) in rural population with age group involved more than 46 years.

Pattern of oral cancer registered at a tertiary care teaching hospital in rural Western Maharashtra.

Non-communicable diseases including cancer are emerging as major public health problems in India. Cancer usually means malignancy, has become one of the ten leading cause of death in India. The leading sites of cancer vary from country to country. Oral cancer ranks in the top three of all cancers in India, accounting for over 30% of all cancers reported in the country and its control is quickly becoming a global health priority. The present study was conducted to find out the contribution of different type of oral cancer in a tertiary care teaching hospital of western Maharashtra, India. A retrospective hospital record based study was carried out for the period of 2007-2011 in the department of Radiotherapy of Pravara Rural Hospital, Loni, Maharashtra, India. A total of 5879 patients who were diagnosed with cancer, of them 633 (10.76%) patients had oral cancer. Data was collected on the basis of the patient’s record in the hospital and analyzed in the form of percentage and proportions whenever appropriate. A total of 633 oral cancer patients were screened, of which 411 (64.93%) were males and 222 (35.07%) were females. Among oral cancer, buccal mucosa was highest (37.12%); followed by tongue (36.80%), oropharynx (4.74%) and lip and palate (3.15%). Oral cancer is one of the common malignancies in developing countries like India. It is common in males compared to females and is usually seen after middle age.

Work related musculoskeletal disorders among hospital nurses in rural Maharashtra, India: a multi centre survey.

Nurses have one of the highest rates of MSD of any occupation. Although en number of studies were done to find out prevalence of Work related musculoskeletal disorders (WMSDs) among nurses across the world, there is limited information on its prevalence in Rural Maharashtra. This study investigated prevalence of WMSDs, job risk factors and the coping strategies towards reducing the risk of development of WMSDs among nurses from selected hospitals in rural Maharashtra, India. Validated questionnaires were distributed to 250 nurses working rural hospitals across Maharashtra but only 228 questionnaires were returned and 212 complete questionnaires were included for study. On Analysis we found that 89.1% nurses had experienced work-related musculoskeletal pain or discomfort at sometime in their occupational lives. WMSDs was highest in the low back (48.2%), followed by the shoulder (34.6%), neck (33.1) and knee (29 %). Other regions with less prevalence were Thoracic (10.5%), Feet and ankle (7.6%), Elbow ( 1.88%) and Hip (1.6 %). Priority was given to getting help to handle heavy patients ( 57.1 %), nursing procedure modification in order to avoid stress injury ( 50.2 %) coping strategies. Our study Concluded that high prevalence of LBP, Shoulder, neck and Knee pain over a 12-month period among nurses working in Rural hospitals in Maharashtra state , and certain risk factors like working in same position for long time, bending, twisting, lifting and treating excessive number of patients were strongly associated with WMSDs.

Tissue engineering: Is it the future of endodontics.

Pulpal regeneration after tooth injury is not easy to accomplish, because of the infected pulp requires tooth extraction or root canal therapy. Current treatment modalities offer high levels of success for many conditions; an ideal form of therapy might consist of regenerative approaches in which diseased or necrotic pulp tissues are removed and replaced with healthy pulp tissue to revitalize teeth. This review describes the possible techniques that will allow regenerative endodontics to become a reality. These potential approaches include root canal revascularization, postnatal stem cell therapy, pulp implant, scaffolding implant, three dimensional cell printing, injectable scaffolds and gene therapy

Seeing The Unseen : Conebeam Volumetric Tomography And Endodontics: A Review Article.

Cone beam volumetric tomography (CBVT) or cone beam computed tomography (CBCT) is a diagnostic imaging technology that is changing the way dental practioners view the oral and maxillofacial complex as well as teeth and the surrounding tissues. CBVT has been specifically designed to produce undistorted three dimensional images similar to computed tomography (CT), but at a lower equipment cost, simpler image acquisition and lower patient radiation dose. This article highlights the CBVT application in endodontics and its treatment outcome.

Infant breastfeeding and HIV: a review article.

Human Immunodeficiency Virus (HIV) and infant feeding is a complex issue, and there are still significant knowledge gaps, including whether antiretroviral prophylaxis for an infant during breastfeeding, or antiretroviral treatment for breastfeeding mother, are safe and effective in reducing HIV transmission. Breastfeeding is the best way to feed an infant. A woman infected with HIV, however, can transmit the virus to her child during pregnancy, labour, delivery or through breast feeding. Children those born to HIV positive women carry high risk of HIV infection. The HIV and Infant Feeding Framework for Priority Action was developed and endorsed by nine UN agencies. The purpose is to recommend governments key priority actions, related to infant and young child feeding, that cover the special circumstances, appropriate feeding practices for all infants, while scaling up interventions to reduce HIV transmission. This review highlights the recent guidelines used in managing infants with HIV.

Papillary serous carcinoma of the broad ligament: a rare case report.

Primary broad ligament carcinomas unassociated with either uterine or ovarian disease are extremely rare. This case report deals with such a rare occurrence of primary broad ligament carcinoma of the serous papillary type with foci of transitional differentiation in a 40 yr old woman with a clinical diagnosis of multiple fibroids of uterus. The highlight of this case is that besides being a rare tumor occurring in an unusual site such as the broad ligament the papillary serous carcinoma reported here also has a unique feature of transitional cell differentiation.

Placental site trophoblastic tumour: a case report.

Placental site trophoblastic tumour (PSTT) is a rare form of trophoblastic disease accounting for < 2% of all gestational trophoblastic neoplasms. Most of the cases follow a normal pregnancy and a small number have a preceeding molar pregnancy or spontaneous abortion. It can occur as early as several weeks or as late as 15 years after normal delivery, molar pregnancy or abortion. Excessive intermediate trophoblastic activity is the most important diagnostic criterion of this tumour originating from non villous trophoblast. But the possibility of a PSTT should be considered when there is excessive intermediate trophoblastic activity despite the presence of chorionic villi as in the present case. This case report highlights the unusual features like rarity of the tumour (< 2%), occurrence following spontaneous abortion which happens only in a minority of cases, and presence of chorionic villi in the tumour despite the fact that the tumour is of non villous trophoblastic origin.

Carcinoma within a fibroadenoma: a case report.

Carcinoma within a fibroadenoma is an extremely rare occurrence with a reported incidence of 0.1% and is most often diagnosed incidentally on post-operative examination of excision biopsy specimens. One such case is reported here for its rarity and also for stressing upon the need for compulsory excision of all breast masses clinically diagnosed as fibroadenoma and for highlighting the importance of histopathological evaluation of all breast masses irrespective of their clinical diagnosis as benign.