Whole genomic sequencing of Staphylococcus aureus strain RMI-014804 isolated from pulmonary patient sputum via next-generation sequencing technology

Nosocomial infections, commonly referred to as healthcare-associated infections, are illnesses that patients get while hospitalized and are typically either not yet manifest or may develop. One of the most prevalent nosocomial diseases in hospitalized patients is pneumonia, among the leading causes of mortality and morbidity. Viral, bacterial, and fungal pathogens cause pneumonia. More severe introductions commonly included Staphylococcus aureus, which is at the top of bacterial infections, per World Health Organization reports. The staphylococci, S. aureus, strain RMI-014804, mesophile, on-sporulating, and non-motile bacterium, was isolated from the sputum of a pulmonary patient in Pakistan. Many characteristics of S. aureus strain RMI-014804 have been revealed in this paper, with complete genome sequence and annotation. Our findings indicate that the genome is a single circular 2.82 Mbp long genome with 1,962 protein-coding genes, 15 rRNA, 49 tRNA, 62 pseudogenes, and a GC content of 28.76%. As a result of this genome sequencing analysis, researchers will fully understand the genetic and molecular basis of the virulence of the S. aureus bacteria, which could help prevent the spread of nosocomial infections like pneumonia. Genome analysis of this strain was necessary to identify the specific genes and molecular mechanisms that contribute to its pathogenicity, antibiotic resistance, and genetic diversity, allowing for a more in-depth investigation of its pathogenesis to develop new treatments and preventive measures against infections caused by this bacterium.

An investigation of the efficacy of di fferent statistical mod els in malaria forecasting in the semi-arid regions of Gujarat, India

Background & objectives: Robust forecasting of malaria cases is desirable as we are approaching towards malaria elimination in India. Methods enabling robust forecasting and timely case detection in unstable transmission areas are the need of the hour. Methods: Forecasting efficacy of the eight most prominent statistical models that are based on three statistical methods: Generalized linear model (Model A and Model B), Smoothing method (Model C), and SARIMA (Model D to model H) were compared using last twelve years (2008–19) monthly malaria data of two districts (Kheda and Anand) of Gujarat state of India. Results: The SARIMA Model F was found the most appropriate when forecasted for 2017 and 2018 using modelbuilding data sets 1 and 2, respectively, for both the districts: Kheda and Anand. Model H followed by model C were the two models found appropriate in terms of point estimates for 2019. Still, we regretted these two because confidence intervals from these models are wider that they do not have any forecasting utility. Model F is the third one in terms of point prediction but gives a relatively better confidence interval. Therefore, model F was considered the most appropriate for the year 2019 for both districts. Interpretation & conclusion: Model F was found relatively more appropriate than others and can be used to forecast malaria cases in both districts.

Validation of micro-chip based PCR assays for diagnosis of both Plasmodium falciparum and Plasmodium vivax

Background & objectives: Microscopy is considered as the gold standard for malaria diagnosis, however sub-microscopic infections can only be detected by Polymerase chain reaction, which demands high cost and elaborate laboratory setup. The Micro-chip PCR based Truenat Malaria Pv-Pf and Pf assay is a portable solution for detection of sub-microscopic/asymptomatic cases of malaria in the field, three lots of which were evaluated for P. falciparum and P. vivax malaria. Methods: Three lots of Truenat® Malaria Pv-Pf and Pf assay (kits) were assessed using blood samples of P. vivax and P. falciparum as well as malaria negative blood samples. DNA was extracted from the blood samples using the Trueprep Auto v2 Universal Cartridge based sample prep device and real time qPCR was performed using Truelab DUO micro PCR Analyzer with three lots of Truenat® Malaria Pv-Pf and Pf Assays. Mean, Standard deviation and one-way analysis of variance (ANOVA) was used to assess the significance of inter-lot variability in Cycle threshold values. Results: The Truenat® Malaria Pv-Pf and Pf assays identified the malaria parasites with 100% accuracy. Based on the test for variance (ANOVA) the inter-lot variability in cycle threshold values were not significant, indicating a high degree of precision. Interpretation & conclusion: Based on high accuracy and precision between different lots, the Truenat® Malaria Pv-Pf and Pf assays were found to be suitable for the diagnosis of sub-microscopic infections in field conditions to provide support in elimination of malaria.

Synthesis of some new N-[alkyl/aralkyl]-N-[2,3-dihydro-1,4-benzodioxan-6-yl]-4-chlorobenzenesulfonamides as possible therapeutic agents for Alzheimer's disease and Type-2 Diabetes

In the current research work, a series of new N-[alkyl/aralkyl]-N-[2,3-dihydro-1,4-benzodioxan-6-yl]-4-chlorobenzenesulfonamides has been synthesized by reacting 1,4-benzozzdioxan-6-amine [1] with 4-chlorobenzenesulfonyl chloride [2] to yield N-[2,3-dihydro-1,4-benzodioxan-6-yl]-4-chlorobenzenesulfonamide [3] which was further reacted with different alkyl/aralkyl halides [4a-n] to afford the target compounds [5a-n]. Structures of the synthesized compounds were confirmed by IR, 1H-NMR, EI-MS spectral techniques and CHN analysis data. The results of enzyme inhibition showed that the molecules, N-2-phenethyl-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4- chlorobenzenesulfonamide [5j] and N-[1-butyl]-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4-chlorobenzenesulfonamide [5d], exhibited moderate inhibitory potential against acetylcholinesterase with IC50 values 26.25+/-0.11 ?M and 58.13+/-0.15 ?M respectively, whereas, compounds N-benzyl-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4-chlorobenzenesulfonamide [5i] and N-[pentane-2-yl]-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4-chlorobenzenesulfonamide [5f] showed moderate inhibition against ?-glucosidase enzyme as evident from IC50 values 74.52+/-0.07 and 83.52+/-0.08 µM respectively, relative to standards Eserine having IC50 value of 0.04+/-0.0001 µM for cholinesterases and Acarbose having IC50 value 38.25+/-0.12 µM for ?-glucosidase, respectively

Conventional versus microwave assisted synthesis, molecular docking and enzyme inhibitory activities of new 3,4,5-trisubstituted-1,2,4- triazole analogues

N-[Substituted]-5-[1-[4-methoxyphenylsulfonyl]piperidin-4-yl]-4H-1,2,4-triazol-3-ylthio] acetamide were synthesized by following conventional as well as microwave assisted protocol through five consecutive steps under theimpact of various reaction conditions to control the reaction time and the yield of product. Starting from 4- methoxybenzenesulfonyl chloride and ethyl isonipecotate, product 3 was obtained which was converted into product 4by treating with hydrazine hydrate. In step 3, the product 4 was refluxed with methyl isothiocyanate and KOH to yield compound 5 which was finally treated with variety of N-substituted acetamides to yield an array of different new compounds [8a-k]. These synthesized compounds were evaluated for their inhibition potential against bovine carbonic anhydrase [bCA-II], acetylcholinesterase [AChE] and butyrylcholinesterase [BChE] enzymes. Compound 8g demonstrated good activity against bCA-II, AChE and BChE with IC50 values of 8.69 +/- 0.38 MuM, 11.87+/-0.19 MuM and 26.01+/-0.55 MuM respectively. SAR studies assisted with molecular docking were carried out to explore the mode of binding of the compounds against the studied enzymes

Anti-diabetic activity of aqueous extract of Ipomoea batatas L. in alloxan induced diabetic Wistar rats and its effects on biochemical parameters in diabetic rats

Diabetes is a condition where the fasting blood glucose level elevated above the normal range [80-120mg/dL]. This increase in blood glucose level may be due to the insulin deficiency i.e. insulin dependent diabetes mellitus [IDDM or type I] or due to insulin resistance i.e. non-insulin dependent diabetes mellitus [NIDDM or type II]. Diabetes leads to severe complications in the body even life treating complications e.g. nephropathy, retinopathy, neuropathy increased vascular permeability and delayed wound healing if left untreated. Different drugs are used for the treatment of diabetes mellitus, but synthetic drugs are costly and possess severe side effects. So, more emphasis is being placed on the use of traditional medicines because these sources have fewer side effects than the synthetics drugs and are economical. So the white skinned sweet potato [Ipomoea batatas L.] peel-off was selected for its anti-diabetic effect as well as to see its effects on biochemical parameters. Both young [3-4 months] and old [up to 1 year] Wistar rats were selected for current study. It was found that the aqueous extract of WSSP peel-off had shown beneficial effects. In addition to the decrease in blood glucose level it also decreased protein glycation level total cholesterol, triglycerides, and LDL-cholesterol. Increase in HDL-cholesterol was also observed after treating the rats with aqueous extract of Ipomoea batatas. Additionally, WSSP peel-off had also shown positive results on total protein concentration, albumin, globulin, and plasma enzymes [SGOT and SGPT]. Further research would be needed in order to purify the anti-diabetic components and it should be available in compact dose form for all diabetic patients

Enhanced production of Lovastatin by filamentous fungi through solid state fermentation

Lovastatin is a natural competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme-A [HMG-CoA] reductase and inhibits specifically rate limiting step in cholesterol biosynthesis. Further, lovastatin in comparison with synthetic drugs has no well-reported side effects. Four pure isolated filamentous fungal strains including Aspergillus niger IBL, Aspergillus terreus FFCBP-1053, Aspergillus flavus PML and Aspergillus nidulans FFCBP-014 have been cultured by solid state fermentation [SSF] using rice straw as substrate for the synthesis of lovastatin. After selecting Aspergillus terreus FFCBP-1053 as the best producer of lovastatin, various selected physical parameters including pH, temperature, inoculums size and moisture content were optimized through response surface methodology [RSM] under center composite design [CCD] for lovastatin hyper production. Maximum lovastatin production of 2070+/-91.5 was predicted by the quadratic model in the medium having moisture content 70% and pH 4.5 at 35 degree C which was verified experimentally to be 2140+/-93.25Mug/g DW of FM [microgram/gram dry weight of fermentation medium], significantly [P<0.05] high as compared to un-optimized conditions while it was noted that lovastatin production is independent on inoculum size [P>0.05] measured by spectrophotometer at 245 nm against standard. It was determined that optimized conditions for the hyper-production of lovastatin from fungal sources have a significant effect

Synthesis, spectral analysis and antibacterial activity of some novel 5- substituted-2-[[6-bromo-3,4-methylenedioxybenzyl]thio]-1,3,4- oxadiazole derivatives

A number of novel 5-substituted-2-[[6-bromo-3,4-methylenedioxybenzyl]thio]-1,3,4-Oxadiazole derivatives [6a-l] have been synthesized to evaluate their antibacterial activity. Using aryl/aralkyl carboxylic acids [1a-l] as precursors, 5-substituted-1,3,4-Oxadiazol-2-thiols [4a-l] were yielded in good amounts.The derivatives, 4a-l, were subjected to electrophilic substitution reaction on stirring with 6-bromo-3,4-methylenedioxybenzyl chloride [5] in DMFto synthesize the required compounds. All the synthesized molecules were well characterized by IR, [1]H-NMR, [13]C-NMR and EIMS spectral data and evaluated for antibacterial activity against some bacterial strains of Gram-bacteria. The molecule, 6d, demonstrated the best activity among all the synthesized molecules exhibiting weak to moderate inhibition potential

Hepatoprotective and hepatocurative effects of Spilanthes acmella Murr against paracetamol induced hepatotoxicity

Hepatotoxicity is appreciably escalating health dilemma worldwide and the degree of the problem has encouraged importance in the exploration for hepatotherapeutic agents from plants. In the current research work, the hepatoprotective/hepatocurative activity of methanolic extract of Spilanthes acmella Murr aerial parts in paracetamol induced hepatotoxicity was investigated in rabbits by the analysis of different liver enzymes including ALT, AST, ALP along with histopathological investigations. In first phase of the study, paracetamol toxicated rabbits were treated with extract and standard drug jatepar TM. The hepatotoxicant [paracetamol] significantly increased the levels of aspartate transaminase, alanine transaminase, alkaline phosphatase compared to normal control. Spilanthes acmella Murr at [400 mg/kg] reversed the elevation in the level of ALP, AST and ALT caused by the hepatotoxicants and jetepar[R] TM [standard] also reversed the deleterious effects of the hepatotoxicants. In second phase of this study, extract of Spilanthes acmella Murr was given to rabbits for ten days then paracetamol was administered in one group and level of liver parameters was paralleled with regular control group and the group that was receiving the extract. It is concluded that methanolic extract of Spilanthes acmella Murr aerial parts possesses hepatocurative and hepatoprotective activity

Effects of methanolic and aqueous extracts of Ipomoea batatas L on mineral contents level [calcium and magnesium] in alloxan-induced diabetic rats

In diabetic patients, electrolyte disorders frequently occur with the characteristic changes in minerals like calcium and magnesium etc. Several medicines are used to manage diabetes mellitus but they exert adverse effects. Plants are a valuable alternative to synthetic medicines because they are easily available, economical and have fewer side effects. Ipomoea batatas L is a well-known antidiabetic plant [sweet potato] but its effects on calcium and magnesium concentration have not studied. The prime focus of this study is to estimate the potential of Ipomoea batatas L peel-off on magnesium and calcium level in Alloxan-induced diabetic rats. Alloxan monohydrate was mixed in 0.9% NaCl solution and administrated [150 mg/kg [S/C]] to male Wistar rats to induce diabetes. After three days blood samples were collected and blood glucose level was recorded. Wistar rats having a blood glucose level of 200 mg/dl and above were selected for the study. Methanol and water extract of Ipomoea batatas L peel–off was given orally with a dose rate of 4g/day. Calcium and magnesium estimation was done using an atomic absorption spectrophotometer. Our results revealed an increase in both the calcium and magnesium level in heart, brain, liver, hind limb, and forelimb after Ipomoea batatas extract treatment. In kidneys decreased calcium level was noted as they excrete calcium. Mineral [Calcium, magnesium] level was increased in all organs except kidney after both extracts treatment. Ipomoea batatas being anti-diabetic in nature also maintain the homeostasis of calcium and magnesium in diabetes. Therefore, we propose the long-term use of such agents might help in the prevention of diabetes-associated complications. However, the validation of these results to human population needs further extensive study

Synthesis of 2-Furyl [[4-aralkyl]-1-piperazinyl] methanone derivatives as suitable antibacterial agents with mild cytotoxicity

The aim of the present research work was synthesis of some 2-furyl [[4-aralkyl]-1-piperazinyl] methanone derivatives and to ascertain their antibacterial potential. The cytotoxicity of these molecules was also checked to find out their utility as possible therapeutic agents. The synthesis was initiated by reacting furyl[-1-piperazinyl] methanone [1] in N,N-dimethylformamide [DMF] and lithium hydride with different aralkyl halides [2a-j] to afford 2-furyl[[4-aralkyl]-1piperazinyl] methanone derivatives [3a-j]. The structural confirmation of all the synthesized compounds was done by IR, EI-MS, 1H-NMR and 13C-NMR spectral techniques and through elemental analysis. The results of in vitro antibacterial activity of all the synthesized compounds were screened against Gram-negative [S. typhi, E. coli, P. aeruginosa] and Gram-positive [B. subtilis, S. aureus] bacteria and were found to be decent inhibitors. Amongst the synthesized molecules, 3e showed lowest minimum inhibitory concentration MIC = 7.52 +/- 0.[micro]g/mL against S. Typhi, credibly due to the presence of 2-bromobenzyl group, relative to the reference standard, ciprofloxacin, having MIC = 7.45 +/- 0.58[micro]g/mL

evaluation of efficacy and safety of Cough [EMA] granules used for upper respiratory disorders

Ivy leaf is used for the treatment of respiratory diseases with the intensive mucus formation, respiratory infections, and irritating cough coming from the common cold. Conferring to clinical trials, the efficacy, and tolerability of ivy leaf is good. The main compounds accountable for biological activity are triterpene and saponins. Ivy leaves show convulsive/antispasmodic, anti-inflammatory, antimicrobial, analgesic, anthelmintic and anti-thrombin activity. Not only ivy but also marshmallow and mustard seeds are used for these indications. This study was conducted to evaluate the efficacy and safety of Cough [EMA; European Medicines Agency] granules used for upper respiratory disorders. This clinical trial was conducted on 150 patients, out of which 75 received the Cough [EMA] granules and 75 received the placebo. The age range of patients was 3 years to above 15 years. The sample paired t-test was applied to evaluate the significant level. Cough [EMA] granules were found effective in the treatment of cough, cold, and flu symptoms. The new treatment Cough [EMA] granules were safe and well tolerated in patient at given specific age group. The study recommends that Cough [EMA] granules can be used effectively in the treatment of upper respiratory tract infection

Synthesis, in vitro and in silico studies of S-alkylated 5-[4methoxyphenyl]-4-phenyl-4H-1, 2, 4-triazole-3-thiols as cholinesterase inhibitors

The research was aimed to unravel the enzymatic potential of sequentially transformed new triazoles by chemically converting 4-methoxybenzoic acid via Fischer's esterification to 4-methoxybenzoate which underwent hydrazinolysis and the corresponding hydrazide [1] was cyclized with phenyl isothiocyanate [2] via 2-[4methoxybenzoyl]-N-phenylhydrazinecarbothioamide [3]; an intermediate to 5-[4-methoxyphenyl]-4-phenyl-4H-1,2,4triazol-3-thiol [4]. The electrophiles; alkyl halides 5[a-g] were further reacted with nucleophilic S-atom to attain a series of S-alkylated 5-[4-methoxyphenyl]-4-phenyl-4H-1,2,4-triazole-3-thiols 6[a-g]. Characterization of synthesized compounds was accomplished by contemporary spectral techniques such as FT-IR, 1H-NMR, 13C-NMR and EI-MS. Excellent cholinesterase inhibitory potential was portrayed by 3-[n-heptylthio]-5-[4-methoxyphenyl]-4-phenyl-4H-1,2,4triazole; 6g against AChE [IC50; 38.35 +/- 0.62?M] and BChE [IC50; 147.75 +/- 0.67micro M] enzymes. Eserine [IC50; 0.04 +/- 0.01?M] was used as reference standard. Anti-proliferative activity results ascertained that derivative encompassing long straight chain substituted at S-atom of the moiety was the most potent with 4.96 % cell viability [6g] at 25 micro M and with 2.41% cell viability at 50?M among library of synthesized derivatives. In silico analysis also substantiated the bioactivity statistics

Phytochemical analysis and hepatoprotective effect of polyherbal formulation on CCl4 induced hepatotoxicity in mice

The potent phytotherapeutic modalities against the hepatotoxicity have motivated us to explore numerous plants and polyherbal preparations because conventional drug discovery is more expensive and tedious. So, this study was conducted to evaluate the hepatoprotective potential of a polyherbal formulation [PHF], comprising of Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifolium and Cichorium intybus against carbon tetrachloride [CCl4] induced hepatotoxicity in experimental rats. CCl4 intoxication induced vacuole formation and fast degeneration so selective liver enzymes including alanine aminotransferase [ALT] and aspartate aminotransferase [AST], alkaline phosphatase [ALP] and total bilirubin in rat's plasma, as well as liver histological architecture, were used to evaluate the effect of herbal treatments with different doses [ranging 100-500 mg/kg] for two weeks. Statistical analysis showed that PHF significantly [P<0.05] improved the level of liver enzymes as well as improved the liver architecture comparative to control groups. It could be concluded from current findings that PHF prepared from Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifiloium and Cichorium intybus have some hepatoprotective activities

Kawasaki disease experience at tertiary care hospital Rawalpindi, Pakistan

Objective: To study the clinical features, investigations, cardiac complications, effects of treatment and demographic profiles in patients with classical Kawasaki disease [KD]

Study Design: Descriptive study

Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan 2007 to Dec 2011

Patients and Methods: Twenty five children of either gender aged 2 months to 12 years diagnosed with KD based on the international diagnostic criteria were included in this study. Collected data included patient demographics, clinical features, investigations, echo-cardio graphic findings, treatment and follow-up

Results: A total of 25 patients were evaluated during the above mentioned duration. Mean age at diagnosis was 3.7 years [SD +/- 3.05]. Fever was present in 100 percent of the patients with the other major diagnostic features present in more than 90 percent of the patients. Seventeen [68 percent] patients presented after ten days of fever. Coronary aneurysms were seen in 40 percent of the patients. We administered intravenous immune-globulins [IVIG] in 100 percent of the patients. 12 percent of the patients still had coronary aneurysms after 1 year of diagnosis. There was no mortality

Conclusion: KD needs to be considered in the differential diagnosis of all children with persistent unexplained fever with rash. A great number of cases of KD are missed and treated as common cold or flu. Diagnostic criteria used for KD is helpful in diagnosis of KD and can help in early prompt treatment with IVIG to prevent the life threatening complication of coronary aneurysms

Myocardial Revascularization utilizing interanl mammary arteries

Objective: To study myocardial revascularization with arterial grafts utilizing internal mammary arteries, with special reference to its morbidity and mortality and the results of internal mammary artery grafting in various ages and genders

Study Design: Retrospective study

Place and Duration of Study: National Institute of Cardiovascular Diseases [NICVD], from Mar 2012 to Feb 2013

Material and Methods: Patients with concomitant valve replacement, ventricular aneurysmectomy redo coronary bypass or other cardiac or ascending aortic procedures were excluded from this analysis. No patient was excluded for any other reason. The age range was 35 to 80 years. The statistical analysis for comparison of different proportions were carried out with the help of chi-square statistics, when the test is valid

Results: A total of 150 patients were studied during the year 2012-2013, out of which 135 were males and 15 were females. The ages ranged between 35-80 years. Majority of the patients in both groups were in the age range between 45-60 years. Far less were females 10 percent-15 patients as compared to male patients [90 percent - 135]. Out of these 18 percent had unstable and 5 percent had atypical angina. After surgery most of the patients in both the study groups experienced an equal degree of angina relief. Exertional dyspnea was present in 20 percent and palpitation in 5 percent of our patients

Conclusion: In this study conclude that internal mammary grafting does not increase morbidity, has lower mortality. Possibly no absolute contra - indications to the use of single, internal mammary artery there may be some relative contra-indication

Enndobronchial Ultrasound-guided trans-Bronchial needle aspiration for the diagnosis of Granulomatous versus non Granulomatous lung diseases

Objective: To evaluate the diagnostic accuracy of Endo-bronchial ultrasound guided transbronchial needle Aspiration in patients with mediastinal lymphadenopathy and mass lesions especially in the context of granulomatous versus non granulomatous lung disorders

Study Design: Open label, unblended prospective observational cohort

Place and Duration of Study: Department of Pulmonology, Pak Emirates Military Hospital Rawalpindi, from July 2015 to Mar 2016

Patients and Methods: All patients presented during study periods with meditational lymphadenopathy or lesions in which the initial bronchoscopy did not reveal any diagnosis were included in the study. Endobronchial ultrasound-guided transbronchial needle aspiration was performed in the bronchoscopy suit under conscious sedation and local anesthesia. Rapid on site evaluation was available for most of the cases. The procedure was performed using an integrated fibreoptic bronchoscopy with 22G TBNA needle by an experienced Bronchoscopist. The data was analyzed by using SPSS version 21

Results: A total of 53 patients with mean age of 44 years underwent endobronchial ultrasound-guided transbronchial needle aspiration for evaluation of meditational or hilar lesions between Jul 2015 to Apr 2016. There were 43 [81.1percent] male and 10 [18.8percent] female patients. A total of 108 Lymph nodes were sampled in 53 patients, rapid on site evaluation was available in 41 [77.3percent] patients. Adequate representative sample could be obtained in 45 of 53 [84.9percent] patients. The overall diagnosis were chronic granulomatous lesion in 27 [50.9percent] patients, squamous cell carcinoma in 10 [18.8percent], lymphoproliferative disorder in 2 [3.7percent], thymoma in 1 [1.3percent] and reactive hyperplasia in 5 [9.4percent] of cases. No major complication of the procedure was observed

Conclusion: End bronchial ultrasound-guided transbronchial needle aspiration was found useful diagnostic modality for lymph nodes sampling in patients with lymphadenopathy and mass like lesions in mediastinum

Traumatic events for house officers and their coping strategies

Objective: To determine the major stresses of house officers, causes of these stress and the coping strategies

Study Design: Descriptive cross sectional study

Place and Duration of Study: Study was conducted in 13 different tertiary care hospitals of Karachi in both government and private sectors from Oct to Nov 2017

Material and Methods: A descriptive cross sectional study with multistage random sampling technique was done in which a self-designed and self-explanatory questionnaire was used. Results were analyzed using statistical package for social sciences [SPSS] version 20

Results: About 300 questionnaires were distributed to interns. From the total, 83.9 percent participants were female. The mean age of the participants was 24 years. Out of the total respondents, 9.4 percent participants stated no any significant medical mistake. Issues arising due to lack of knowledge or incompetency leading to mis diagnosis of patients were reported by 20.5 percent respondents. One of the common mistakes reported was wrong drug administration; either route, dosage or incorrect medicine, committed by about 25.3 percent of doctors participated. The most reported reason thought to be the underlying cause of mistakes was work overload that was about 36.3 percent

Conclusion: It can be concluded by the present study that house officers are susceptible to stress which affects their overall work performance and it leads to significant medical mistake due to which patient suffer and because of this pressure it's very hard both physically and mentally for a doctor to cope up

Effect of caffeine on anti-clotting activity of warfarin in healthy male albino rabbits

Drug-drug interactions are most commonly occurring phenomenon in clinical practice. Many physicians are afraid of being involved in an allegation of malpractices due to the occurrence of any severe interaction. These interactions not only occur between drugs but also between any kind of food, tobacco smoke, caffeine and alcohol etc. Therefore, the present study was directed to inspect the effect of caffeine on the anticoagulation activity of warfarin in healthy adult male albino rabbits. Blank blood samples were collected from each rabbit. Rabbits were given warfarin [0.5mg kg-1] orally via stomach tube and blood samples were collected in PT/INR vials at various intervals. After a washout period of 14 days, warfarin was orally administrated at same dose rate along with caffeine [5 mg kg-1 every twelve hours for three days] and same sampling schedule was repeated. Prothrombin time [PT] and the international normalized ratio [INR] of blood samples were determined to estimate changes in the anticoagulation activity of warfarin after its concurrent administration with caffeine. The PT data revealed that Rmax and AUC increased significantly [P