Pharmacogenomics- The Promise of Personalized Medicine.

Introduction: Pharmacogenomics (PGx) is the study of the genetic basis of variability among individuals in response to drugs. It is the newest discipline of medicine and is becoming a very active area of research, with the pharmaceutical industry gaining experience applying it, integrating it into the drug development process, and also learning to better manage the expectations of the medical community. Methodology: A comprehensive review of the literature on the principles, applications, challenges and prospects of pharmacogenomics was performed. Results: Pharmacogenomics tailors therapies to the genetic makeup of an individual and can therefore offer treatments that are more efficacious and have fewer side effects. Despite these benefits, personalized medicine has not been embraced by large pharmaceutical companies. It is expected that the first wave of successful pharmacogenomics products will be used in acute treatments for which current therapies have and severe side effects. These products should also be good candidates for premium pricing. Personalized medicine (PM), based on the genetic makeup of a patient, may result in not only an improved therapeutic response but also a clinically important reduction in adverse drug reactions. The experience to date is mixed, with a few successes but many frustrations. Conclusion: However, for pharmacogenomics to be truly embraced, the benefits of this technology must become more widely accepted in terms of economic, public, regulatory and ethical issues.

Research involving Human Subjects - Ethical Perspective.

ABSTRACT: Research involving human subjects are important to develop new therapeutics for the betterment of the human race. To take part in such research as volunteers is moral duty of any human. But such experiments should be justifiable and minimal risky for the participants. History of unethical research involving humans led to the development of many guidelines to make such research ethical as well as to gain maximum possible output. Several guidelines have been formulated to ensure research with human participants ethical. All the guidelines emphasize on one thing in particular- informed consent of the human subjects. Other considerations include rational benefit-harm ration, beneficence, justice, adequate research design and approval from proper authorities. All these guidelines aim to prevent any unethical research involving humans against their will.

Scientific Freedom & Limits - Clinical Research Perspective.

ABSTRACT: Being a scientist, especially a clinical research one, is a noble but tough job. Scientific job is different from other jobs in terms of working hour and pressure; they need more freedom in their job & research that also put lots of responsibility on them. Research is funded by public money and it is the responsibility of scientists to gain maximum output from it. Clinical research is very complex and involves the use of animal, microbial as well as human samples and volunteers which make it more prone to ethical scrutiny. Minority of researchers who commit fraudulent use of public money & unethical clinical practice threaten public support for science. Now a day, there is growing concern of public and politicians on the freedom of scientists and unethical scientific practice in clinical trials. The most efficient measures to prevent scientific misconduct are awareness—notably, self-awareness— education and transparency. Most of the developed countries have formulated their own guidelines to ensure proper utilization and ethical clinical research and trials. Bangladesh is still lagging behind in terms of regulation and monitoring of clinical research and trials. This review aims to make related peoples to be aware of the necessity of its own guidelines for clinical research and trials.

Ethics in clinical research.

ABSTRACT: History of unethical clinical research practice date back to a very long time, though the most remarkable unethical clinical research was those by the Nazis during second world war, which eventually shaken the scientific community and gives birth to the first guideline of ethics in clinical research, the Nuremberg Code. Following Nuremberg code, a number of ethical guidelines has been formulated most important of which are the declaration of Helsinski. To make any research involving human subjects or samples ethically acceptable, a number of key features have to be considered by the scientists. These guidelines are internationally accepted and without following these guidelines, no clinical research is acceptable in the world. Though, there are many countries in the world like Bangladesh, which don’t have any ethical guidelines of their own and thus scientists in those countries do not adhere the any ethical guideline while conducting their research. Each country should have their own ethical guidelines and each clinical research institutes should have own ethical review committee to ensure ethical clinical research.

Ethics in stem cell research.

ABSTRACT: Stem cells have constituted a revolution in regenerative medicine and cancer therapies by providing the possibility of generating multiple therapeutically useful cell types that could be used for treating some of genetic and degenerative disorders. However, human embryonic stem cell research raises few ethical and political controversies because of its involvement in destruction of human embryos. The ethical issues in human embryonic stem cell research encompasses not only with question of the ethics of destroying human embryos, but also with questions about complicity of researchers in destruction of embryos, moral distinction between creating embryos for research purposes and creating them for reproductive ends and the permissibility of cloning human embryos to harvest stem cells. Bangladesh should formulate its own regulations justifying its stand regarding this matter.

Neonatal bacteremia in a neonatal intensive care unit: analysis of causative organisms and antimicrobial susceptibility.

Background: Bangladesh has a neonatal death rate that is substantially high and demands urgent attention. Objective: This retrospective study was performed to determine the incidence of bacterial neonatal sepsis condition in the Chittagong area of Bangladesh with focus on various demographic characteristics of neonates, causative organisms and their antibiotic susceptibility. Methodology: Blood culture was performed on all neonates with risk factors or signs of suggestive sepsis. Blood samples were cultured using tryptone soya broth (TSB- blood broth) according to standard method. Results: From the 1400 neonates 104 had positive blood culture for neonatal sepsis infection. Among the infected children 40 (38.46%) were born in the hospital and 64 (61.54%) were born at home. The EONS (Early Onset Neonatal Sepsis) accounted for 68 (65.38%) and LONS (Late Onset Neonatal Sepsis) accounted for 36 (34.62%). Among the isolated organism Klebsiella pneumoniae accounted for 79 (75.96%), Serratia marcescens 19 (18.27%), Pseudomonas aeruginosa 04 (3.85%) and Staphylococcus aureus accounted for 02 (1.92%). Among the isolated species 102 were attributed to G (-ve) bacteria and 02 were attributed to G (+ve) bacteria. Most of the G (-ve) bacteria showed resistance to commonly used antibiotics such as ampicillin, ceftriaxon and gentamicin. In this study all isolates showed sensitivity to the imipenem. Conclusion: Collection of up-to-date data is mandatory for appropriate use of antibiotics.