Prescription Analysis And Prevalence Of Potentially Inappropriate Medication Use In Older Adults; An Observational Study

Objective: The objectives of the present study were to determine the prevalence of Potentially Inappropriate Medications and Adverse Drug Reactions in older adults and to collect doctors’ responses regarding the PIM list or any other criteria to treat older adults in India. Methods: This was an observational study conducted in different tertiary care hospitals of two districts, Erode and Salem after obtaining approval of the Institutional Ethics Committee. A sample of 250 older adults (60 y and above) and 97 doctors were included during the study period of 6 mo from February 2019 to July 2019. Inappropriate medications were identified by using 2019 updated Beer’s criteria. The causality of the adverse events was assessed by Naranjo Adverse Drug Reaction Probability Scale. Results: Out of the 250 prescriptions, only 86(34.4%) of the prescriptions were appropriate and 164(65.6%) were inappropriate. The most commonly inappropriate prescribed medications were diuretics, ranitidine, and tramadol. A total of 74 ADRs was observed in 74 patients. Of these, 57(22.8%) ADRs were due to inappropriate medications listed in Beers criteria. There was a significant association between the occurrence of ADRs and the use of PIMs listed in 2019 updated Beer’s criteria [χ2 = 6.08, P = 0.013 (df = 1)]. Conclusion: The study shows that there is a high prevalence of inappropriate medications and adverse drug reactions in hospitalized older adults. Beer’s criteria can be used as a guideline by the physicians while prescribing the drugs to the geriatric population.

Estimação de valores genéticos para codornas europeias em função dos níveis da relação treonina: lisina da dieta: do nascimento aos 21 dias de idade / Estimation of breeding values for European quails in function of threonine: lysine ratios of diet: from birth to 21 days of age

O presente trabalho foi realizado com o objetivo de avaliar a sensibilidade dos valores genéticos dos pesos corporais e as características de carcaças de codornas europeias às mudanças do gradiente ambiental (níveis da relação treonina com a lisina das dietas), do nascimento aos 21 dias de idade, por meio de modelos de regressão aleatória com diferentes classes de variância residual. Os dados utilizados neste estudo são provenientes de 915 codornas de corte da linhagem LF1 e 839 da linhagem LF2, pertencentes ao Programa de Melhoramento Genético da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Foram avaliados os pesos corporais e os rendimentos da carcaça das aves. As sensibilidades dos valores genéticos às mudanças nos níveis da relação treonina:lisina (interação genótipo x ambiente) foram obtidas por modelos de regressão aleatória (utilizando normas de reação) por meio do programa Wombat, que utiliza o princípio da máxima verossimilhança restrita (REML). O modelo de regressão aleatória que considerou duas classes de variância residual foi o mais indicado para a maioria das análises realizadas. Verificaram-se alterações na classificação dos valores genéticos para as duas linhagens de codornas de corte estudadas. Esse comportamento indica sensibilidade de valores genéticos aditivos às mudanças nutricionais, o que caracteriza a existência de interação genótipo x ambiente. A predição dos valores genéticos deve ser feita com o mesmo nível da relação treonina:lisina da dieta com a qual as codornas serão alimentadas no sistema de produção.(AU)

This research was carried out to evaluate the sensitivity of breeding values of body weight and carcass traits in two lines of European quails (LF1 and LF2) to changes in the environment gradient (levels of threonine: lysine ratio of diets) from hatch to 21 days of age in two lines LF1 and LF2 using Random Regression Models with different classes of residual variance. Records are from 915 quails of line LF1 and 839 of line LF2 belonging to the Breeding Improvement Program of Universidade Federal dos Vales do Jequitinhonha e Mucuri. Live body weight and weights and yields of carcass, breast, and thigh and drumstick were measured. The sensitivities of breeding values to changes in threonine: lysine ratios (genotype x environment interaction) of diets were obtained by random regression models (reaction model) using the WOMBAT program using the Restricted Maximum Likelihood principle. Model considering two classes of residual variance showed the best goodness of fit. The Reaction Norms analyses indicated changes in the ranking of breeding values for both lines suggesting quails selected in one level of threonine: lysine ratio will not express all their genetic potential if fed different threonine: lysine ratio diets. This behavior indicates sensitivity of breeding values to changes in the nutrition characterizing the genotype by environment interaction. The prediction of breeding values must be performed using the same level of threonine: lysine ratio in diet the quails will be fed in the production system.(AU)

Uropathogenic Analysis and Commonly Used Drug Sensitivity Patterns of the Pathogens in Dhaka City, Bangladesh.

Aims: Human urinary tract infections (UTI) are very common in Bangladesh. The objectives of the current study are to identify the uropathogenic agents infecting males and females of different age groups, and commonly used drugs sensitivity profiles. Study Design: A total of 980 urine samples from both sex and different age groups, were collected for the study. Chemical analyses of the samples were done by Dipstick method. Cultural, microscopic and biochemical analyses were done to identify the isolates. Finally antibiotic sensitivity was tested against conventionally used antibiotics. Place and Duration of Study: All the samples were collected from patients of both indoor patient department (IPD) and outdoor patient department (OPD) in the Laboratory Medicine Department, United Hospital, Dhaka, Bangladesh between January 2012 and May 2012 following published procedures. Results: Only 29.6% of the urine samples yielded positive culture. UTI showed more prevalence among female than male. Female belonging to the age group of 41-50 years were detected as high risk groups for UTI. Most common Gram negative isolates were Escherichia coli, Klebsiella sp., Candida sp., Pseudomonas sp., Proteus sp., and Acinetobacter baumannii. Gram positive bacteria comprised Enterococcus sp. and non-hemolytic Streptococci. Like most of the previous reports, E. coli was predominant, which is also corroborated in this study. However, the sensitivity pattern of the organisms differed from the previous studies. Conclusion: The isolates were found resistant to most common oral antibiotics used, such as cotrimoxazole, nitrofurantoin, and nalidixic acid. This finding, however, need further work to validate reliability.

Profil épidémiologique des patientes suivies dans un protocole de prévention de la transmission mère-enfant du VIH-1 au CHU Sylvanus Olympio

But : Les objectifs de notre étude étaient de décrire les caractéristiques sociodémographiques et obstétricales des patientes d'un protocole de prévention de la transmission mère-enfant du VIH1 au Togo.Patients et méthodes : Nous avons réalisé une étude prospective transversale de type suivi de cohorte dans le site PTME du CHU Sylvanus Olympio. Elle s'était étendue du 27 juin 2011 au 27 juin 2015.Résultats : Au total 255 femmes ont été incluses. L'âge moyen de nos patientes était de 30 ans. Les revendeuses étaient de 38,8% et les femmes au foyer représentaient 17,6%. 48,2% de nos patients avaient un niveau scolaire secondaire. Les célibataires ont représenté 36,1% et 54,5% étaient mariées monogames. 64% des patientes ont été dépistées positives au VIH au cours de leur grossesse et 80,7% étaient au stade clinique I de l'OMS. Quarante-quatre virgule cinq pour cent (44,5%) des patientes ont consulté pour la première fois au 1er trimestre de grossesse.Conclusion : Les résultats de cette étude révèlent que la majorité de nos patientes était jeune, asymptomatique et a majoritairement été dépistée dans notre maternité

Pattern of Anti-Microbial Sensitivity and Resistance against Salmonella Species in a Tertiary Hospital in Dhaka.

Background: Drug resistant Salmonella spp. continues to remain a health problem as last two decades have witnessed the emergence and spread of multidrug resistance against conventional anti-typhoid drugs. Multidrug resistant (MDR) typhoid is now a serious problem in many developing countries including Bangladesh. Objectives: To find out antimicrobial sensitivity and resistance patterns of different types of Salmonella spp. in patients with enteric fever and to find out the epidemiological strains (e.g. resistant strain, epidemic strain, MDR strain) in patients with enteric fever. Materials and Methods: This cross-sectional study was done during October 2009–November 2010 and January–December 2012 at United Hospital Limited, Dhaka. Laboratory reports of blood culture were collected from those patients who were investigated as suspected cases of enteric fever. Both the indoor and outdoor patients were enrolled in the study. Salmonella species resistant to one or more of the first line drugs were divided into resistant strain, epidemic strain and multi-drug resistant strain. Results: During the period October 2009–November 2010, total 210 subjects were enrolled. Among the participants, 122 were male and 88 were female. S. typhi were found in 133 samples whereas 76 were S. paratyphi A and only 1 S. paratyphi B. Sensitivity was found 77% for ampicillin, 91.4% for cotrimoxazole, 78.6% for chloramphenicol, 87.6% for ciprofloxacin, 96.6% for cefixime, 98% for ceftriaxone and only 22.1% for azithromycin (77.9% resistant). Total 91 (43.3%) cases were found having resistant strain, 6 (2.8%) epidemic strain and 8 (3.8%) MDR strain Salmonella spp. The sensitivity of azithromycin was analyzed among different categories of strains and revealed that 52.7% showed resistance in resistant strain, 100% in epidemic strain and 87.5% in MDR strain. During the period between January–December 2012, total 139 subjects were enrolled. Among the participants 68 were male and 71 were female with a ratio of 1:1.04. S. typhi were found in 84 cases whereas 55 were S. paratyphi A and no S. paratyphi B. Sensitivity was found 62.7% for ampicillin, 82% for cotrimoxazole, 83% for chloramphenicol, 45.2% for azithromycin, 95% for ciprofloxacin, 99.3% for cefixime and 100% for ceftriaxone. Total 55 (39.6%) cases were found having resistant strain, 3 (2.1%) epidemic strain and 17 (12.2%) MDR strain Salmonella spp. Against azithromycin 67.3% showed resistance in resistant strain, 33.3% in epidemic strain and 29.4% in MDR strain. Conclusion: The policy of empirical treatment of enteric fever needs to be rationalized and newer generation antibiotics should be restricted only for multi-resistant cases of enteric fever.

Triagem fitoquímica e avaliação da atividade antibacteriana de extratos das flores de Sambucus nigra L. (Caprifoliaceae) / Phytochemical screening and evaluation of the antibacterial activity of Sambucus nigra L. flower extracts (Caprifoliaceae)

RESUMO O presente trabalho teve como objetivo realizar a triagem fitoquímica e avaliar a atividade antibacteriana de extratos das flores de Sambucus nigraL. Os extratos; aquoso (10 %), etanólico (5 %) e Acetato de etila (5 %) foram submetidos a testes colorimétricos para triagem fitoquímica e a avaliação da atividade antibacteriana foi realizada pelo método de disco-difusão em ágar. Os resultados mostraram que nas concentrações de 6 e 12 mg o extrato aquoso apresentou halos significativos de inibição para Staphylococcus aureus, Pseudomonas aeruginosa e Streptococcus pyogenes, porém, quando comparado aos medicamentos usados como referência a atividade não foi satisfatória, e, ainda, evidenciou a ausência de inibição para todas as cepas testadas com o aumento da concentração para 18 e 24 mg. A análise da triagem fitoquímica evidenciou a presença de flavonoides com intensa reação de cor no extrato aquoso e etanólico, e de fraca intensidade no extrato acetato de etila. Nos mesmos extratos, pelos testes realizados, não foram detectados taninos, saponinas, antraquinonas e alcaloides. Concluiu-se que o extrato aquoso apresentou melhor efeito inibitório para Staphylococcus aureus, Pseudomonas aeruginosa e Streptococcus pyogenes, porém insuficiente para promover a inativação eficiente quando comparado aos controles.

ABSTRACT This study aimed to perform a phytochemical screening and to evaluate the antibacterial activity of the extracts of Sambucusnigra L. flowers. The aqueous (10%), ethanolic (5%) and ethyl acetate (5%) extracts were subjected to colorimetric tests for phytochemical screening and the antibacterial activity evaluation was performed by the disk-diffusion method in agar. The results showed that in the 6 and 12 mg concentrations the aqueous extract presented significant inhibition halos for Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pyogenes, but when compared with the medicines used as a reference, the activity was not satisfactory and, besides, it indicated the absence of inhibition for all the tested strains with the concentration increase of 18 and 24mg. The phytochemical screening analysis showed the presence of flavonoids with intense color reaction in the aqueous and ethanol extracts, and of low intensity in the ethyl acetate sample. In the same extracts, the tests did not detect tannins, saponins, alkaloids and anthraquinones. It was concluded that the aqueous extract showed better inhibitory effect on the Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pyogenes, but not enough to promote an effective inactivation when compared with the medicine tests.

A study of low power laser on the regenerative process of Girardia tigrina (Girard, 1850) (Turbellaria; Tricladida; Dugesiidae) / Um estudo de laser de baixa potência no processo regenerativo de Girardia tigrina (Girard, 1850) (Turbellaria; Tricladida; Dugesiidae)

The mechanism of regeneration does not start to restore the wound until its corresponding epimorphic phase. A bioestimulation of tissues and cells by laser radiation depends on the wavelength, on the dose, and on the intensity of the light. The goal of this work was to verify the effect of the low power laser at 660 nm on the regenerative process of Girardia tigrina. The specimens were maintained in the laboratory under a temperature ranging from 19° up to 24 °C for 21 days. The planarians were anesthetized by placing them on ice and then cut them with a scalpel. The three treatments were as following: animals individually irradiated with 14 sessions with 1 minute duration (treatment 1), 14 sessions with 3 minutes duration (treatment 2), and without irradiation (control). The planarians were amputated and divided in three study treatments: a control group (without radiation), and two other treatments: irradiated for 1 minute, and irradiated for 3 minutes. The animals were irradiated with diode laser (660 nm) with 3.3 ± 0.3 mW of power, using 0.94 mW.mm-2 power density for each irradiation procedure. During the experiment, 14 irradiation sessions were undertaken. The specimens were fixed in Bouin, and stained with hematoxyline and eosin. From observation and histological analysis, it was possible to assess the effects of interaction between laser and tissue. The head fragment after 1 minute of irradiation presented a better organized tissue scheme, when compared with the other treatments. Aspects of the body fragments submitted to 3 minutes of light treatment were very similar to fragments that had not been injured. It can be concluded that there are changes in the quality of regeneration when treated with low power laser under the conditions mentioned above.

O mecanismo de regeneração não restaura a ferida até sua fase epimórfica correspondente. A bioestimulação de tecidos e células por radiação laser depende do comprimento de onda, da dose e intensidade de luz. O objetivo deste trabalho foi verificar o efeito do laser de baixa potência (660 nm) no processo regenerativo de Girardia tigrina. Estes vermes têm uma elevada capacidade de regeneração. Os espécimes foram mantidos em laboratório sob uma temperatura de 19° a 24 °C por 21 dias. As planárias foram anestesiadas com gelo e amputadas com bisturi. Os 3 tratamentos foram compostos de: animais individualmente irradiados com 14 sessões de 1 minuto de duração (tratamento 1), com 14 sessões de três minutos de duração (tratamento 2) e não irradiados (controle). Elas foram irradiadas com laser diodo (660 nm) 3,3 ± 0,3 mW potência, usando 0.94 mW.mm-2 de densidade de potência para cada irradiação. Durante o experimento foram realizadas 14 sessões. Os espécimes foram fixados em Bouin e corados com hematoxilina e eosina. Com base nas observações e análise histológica, foi possível avaliar os efeitos da interação entre laser e tecido. O fragmento cabeça após 1 minuto de irradiação mostrou um tecido melhor organizado quando comparado com outros tratamentos. Os aspectos dos fragmentos corpo após 3 minutos de irradiação foram muito similares para os fragmentos que não sofreram injúria. Existem mudanças na qualidade de regeneração quando tratadas com laser nas condições acima mencionadas.

Morphometry of the eyes in regenerant of genus Dugesia (Platyhelminthes, Turbellaria, Dugesiidae)

A técnica de fotodocumentação foi utilizada para observar semanalmente os olhos de regenerantes de três espécies de Dugesia até o final do processo regenerativo. Os dados morfométricos analisados foram baseados na mensuração de 96 exemplares das espécies: Dugesia tigrina, D. schubarti e D. anderlani. Uma análise comparativa foi realizada por meio de representação gráfica de parâmetros estatísticos dos seguintes caracteres morfométricos: comprimento dos eixos transversal e longitudinal da mácula alba, cálice do pigmento e abertura ocular. D. schubarti apresenta um aspecto interessante: a média da abertura ocular na fase do processo regenerativo é maior do que nos exemplares originais.