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Aim: Irrational use of medicines is a global problem. In India, one contributing factor is the availability of a large number of fixed-dose combinations (FDCs). To improve rational use and to strengthen policies, it is important to assess the usage patterns and rationality of FDCs. Methods: This study was conducted as part of a 1-year prospective cross-sectional analysis of prescriptions in the outpatient clinics of broad specialities from 13 tertiary care hospitals across India. Five most commonly prescribed FDCs in each center were analyzed. In addition, all the prescribed FDCs were classified as per the Kokate Committee classification and it was noted whether any of the FDCs were irrational or banned as per the reference lists released by regulatory authorities. Results: A total of 4,838 prescriptions were analyzed. Of these, 2,093 (43.3%) prescriptions had at least one FDC. These 2,093 prescriptions had 366 different FDCs. Of the 366 FDCs, 241 were rational; 10 were irrational; 14 required further data generation; and the remaining 96 FDCs could not be categorized into any of the above. Vitamins and minerals/supplements, antibacterial for systemic use, and drugs for gastroesophageal reflux disease (GERD) and peptic ulcer were the most used FDCs. Conclusion: Based on the finding that some prescriptions contained irrational FDCs, it is recommended that a rigorous, regular, and uniform method of evaluation be implemented to approve/ban FDCs and that prescribers be periodically notified about the status of the bans.
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Introduction: Substance abuse is now steadily increasing in the adolescent age group across the globe. Pressure to blend in with substance‑using peers is an important predictor of substance abuse among adolescents. Smoking and alcohol intake are the two most common forms of substance abuse. Hence, this study tried to explore the effect of peer pressure on both substance users and nonusers and tried to find the adjusted effect of that pressure on substance abuse focused on smoking and alcohol intake. Materials and Methods: Acase–control study was conducted on college‑going students from various colleges and institutions in Kolkata during September and October 2021. The sample size for this case–control study was calculated taking confidence level at 99% and power 90%. Case and control ratio was taken as 1:1. Age‑based matching was ensured. Further matching among the cases and controls was done based on gender. Data were collected by investigators using a pretested self‑administered questionnaire that particularly focused on peer pressure along with some demographic factors. The questionnaire was distributed via electronic media and was circulated on various social platforms. A modified Peer Pressure Inventory containing 8 factors was created to evaluate the effect of peer pressure, and the Likert scale was used to score the responses of the participants. The odds ratio for the effect of peer pressure on smoking and drinking was calculated with a 99% confidence interval separately. Risk calculation was performed by multiple logistic regression to describe predictability and adjusted odds ratio of peer pressure on initiation of substance abuse. Results: The odds of the effect of peer pressure on initiation of drinking are 24.008 times higher. We also found that 53.62% of the cases have been drinking alcohol for at least 12 months. The odds of peer influence on initiating smoking tobacco were calculated to be 31.320. We found that 84.38% of the smokers had been subjected to significant peer pressure while 85.29% of the control subjects had not been subjected to significant peer pressure. Conclusion: Odds of peer pressure on smoking and alcohol initiation is quite high. Staying alone for more time has a protective effect on initiation of substance abuse.
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Purpose of the study: Teaching the physiology of motor unit recruitment as a strategy for force generationand changes in the recruitment patterns as a consequence of fatigue.Methodology: A protocol was designed to study fatigue developed as a consequence of graded isometricexercise and the surface electromyographic (sEMG) features associated with development of fatigue.Main findings: Fatigue can be quantified by reduction in grip force in isometric hand grip. During maximalexercise, sEMG amplitude declined with time as a consequence of fatigue. The sEMG amplitude wasobserved to increase in the case of submaximal exercise representing recruitment of additional motor unitsto compensate for declining force production in fatigued motor units.Conclusion: The proposed practical exercise fulfils the teaching goal of acquainting the students with themotor unit recruitment patterns as reflected in sEMG associated with fatigue development.
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Background: Immunity status, individual response to disease and types of antibodies produced are well known to vary from person to person, place to place and probably from population to population. A broad spectrum of specific auto antibodies that have so far been associated with specific rheumatic diseases, as noted in Western literature, has been well taken as a reference standard all over the world. There is neither research work nor any data correlating the auto antibodies and their antinuclear antibody (ANA) patterns with the immunoprofile in the Indian population to date. Aims: To understand a definite association between ANA patterns and specific antibodies in the serum in the Indian study population and to document similarities / differences with the West. Settings and Design: This prospective and retrospective double blind study was undertaken on the South Indian population referred for ANA testing by Indirect Immunofluorescence method and by immunoline methods. Materials and Methods: Serum samples of patients from a random South Indian population who sought medical help for rheumatic disease were subjected for ANA testing by indirect immunofluorescence (IIF) method and line immunoassay during the study period of 27 months. Serum samples were processed in dilution of 1:100 using HEp - 2010 / liver biochip (Monkey) (EUROIMMUN AG). The serum samples which were further processed for line immunoassay were treated in 1:100 dilution on nylon strips coated with recombinant and purified antigens as discrete lines with plastic backing (EUROIMMUN AG) coated with antigens nRNP / Sm, Sm, SSA, Ro-52, SSB, Scl-70, PM-Scl, PCNA, Jo-1, CENP-B, dsDNA, nucleosomes, histones, ribosomal protein-P, anti-mitochondrial antibodies (AMA-M2) along with a control band. The analysis was done by comparing the intensity of the reaction with positive control line by image analysis. Results: The antinuclear antibody indirect immunofluorescence (ANA - IIF) patterns obtained were projectable to visualize a certain spectrum of specific antibodies such as homogenous (45.5%) with dsDNA, nucleosomes, histones, SSA / Ro-52, RIB and RNP / Sm, speckled pattern (35.6%) with Sm, RNP, SSA/Ro-52, SSB, Sm and RIB; nucleolar pattern with Scl-70, Sm, RNP and centromere pattern with CENP-B. The methodology indicated that, cytoplasmic pattern noted in ANA also needs to be correlated with primate liver in a biochip, which should prompt further decision for a request for line immunoassay and it is preferable for two pathologists to report independently and sign out a consensus ANA report for better predictive value. Conclusions: As a definite correlation between the ANA patterns and the group of antibodies was detected by line immunoassay, one could predict presence of certain specific auto antibodies for a particular ANA pattern identified. This may restrict one from requesting for line immunoassay, which is expensive and economizes on the cost of laboratory investigations in a developing country like India. Thus, screening of sera by ANA-IIF method alone may suffice and probably reduce the expense of detailed immunological work-up with minimal loss in diagnostic accuracy. This study, the first of its kind in India, provides database and reference for the Indian subpopulation.
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Genetic organization of a proximal region of the second chromosome in Drosophila melanogaster has been analysed by saturation mutagenesis. Seven alleles were uncovered in this region in addition to the one previously known. Besides this, quite a few mutations were isolated that non-complemented more than one group of lethals and looked very much like deletions of varying extent. Except one, all the lethals complemented M(2)z.