Molecular dynamics simulation-based trinucleotide and tetranucleotide level structural and energy characterization of the functional units of genomic DNA.

Genomes of most organisms on earth are written in a universal language of life, made up of four units - adenine (A), thymine (T), guanine (G), and cytosine (C), and understanding the way they are put together has been a great challenge to date. Multiple efforts have been made to annotate this wonderfully engineered string of DNA using different methods but they lack a universal character. In this article, we have investigated the structural and energetic profiles of both prokaryotes and eukaryotes by considering two essential genomic sites, viz., the transcription start sites (TSS) and exon-intron boundaries. We have characterized these sites by mapping the structural and energy features of DNA obtained from molecular dynamics simulations, which considers all possible trinucleotide and tetranucleotide steps. For DNA, these physicochemical properties show distinct signatures at the TSS and intron-exon boundaries. Our results firmly convey the idea that DNA uses the same dialect for prokaryotes and eukaryotes and that it is worth going beyond sequence-level analyses to physicochemical space to determine the functional destiny of DNA sequences.

A 12-YEAR-OLD ASIAN INDIAN BOY WITH BILATERAL RAPIDLY PROGRESSIVE NECROTIZING MACULAR RETINITIS.

PURPOSE: To describe clinical and imaging findings in a young boy presenting with bilateral rapidly progressive necrotizing macular retinitis. METHODS: A 12-year-old Asian Indian boy developed bilateral progressive macular retinitis. He had generalized tonic-clonic seizures for the past 3 months and gave a history of poor scholastic performance with dementia of recent onset. Multimodal imaging comprising and detailed systemic and laboratory work-up was performed. RESULTS: Both eyes showed rapidly progressive full-thickness retinitis lesions observed as disruption of retinal architecture in both eyes. Left eye optical coherence tomography shows full-thickness retinal involvement with sparing of the internal limiting membrane. Electroencephalogram and magnetic resonance imaging (brain) were suggestive of subacute sclerosing panencephalitis and the diagnosis was confirmed by elevated cerebrospinal fluid and serum IgG measles. The patient did not survive despite treatment with systemic interferon therapy. CONCLUSION: It is important to look for the measles virus as a probable cause of necrotizing retinitis and neurologic symptoms in immunocompetent unvaccinated young patients. Early referral to a neurologist may assist in the early diagnosis of subacute sclerosing panencephalitis and targeted therapy.

Scrutinizing predator journals in pharmacology and calculating their predatory rate.

BACKGROUND: As the list of predatory journals is burgeoning, the researchers should have knowledge of calculating the predatory rate (PR) for the journals, in which they aim to publish their work and self-guard them from publishing in bogus journals. AIM AND OBJECTIVES: Our aim is to find out the predatory rate for various Pharmacology journals. MATERIALS AND METHODS: Here, we have examined the recently updated list (in 2017) of standalone predatory journals created and maintained by Beall, pertinent to all auspices of pharmacology including pharmacy, pharmaceutical, and pharmacognosy. The PR of various journals was calculated. RESULTS: Of 131 journals, pertinent to the pharmacology field, 45.03% of them had the PR between 0.72 and 0.84. 98.5% of journals were classified as predatory, whereas only 2 (1.53%) journals were classified in the category of predatory practice. CONCLUSION: It should be an eye-opener to the researchers, and they should deliberately select the journals to get real recognition of their work.

Concurrent prescribing: Evaluation of its knowledge among dentists.

INTRODUCTION: Considering the staggering number of drugs being prescribed to the patients for dental ailments, the ability of the dentists to recognize potential drug-drug interactions (DDIs) is essential to reduce their occurrence. This study aims to assess the dentist's ability to recognize the potentially clinically significant DDIs in clinical practice. SUBJECTS AND METHODS: This questionnaire-based study was carried out among the dentists working at private tertiary care teaching dental hospitals in Jaipur city. Eighty-five dentists working as faculty members in various departments and having postgraduate degree in their respective specialty were enrolled after taking their written informed consent. A prevalidated close-ended questionnaire was given to the respondents to check their knowledge about common DDI possible in clinical dentistry practice. STATISTICAL ANALYSIS USED: Statistical analysis was done using descriptive statistics. Data were collected in a predesigned Microsoft Excel 2010. Continuous variables were presented as mean values ± standard deviation, and categorical variables were presented as percentages. RESULTS: Among 85 dentists recruited for the study, no one had knowledge about all the common DDIs in dental practice. The participants could correctly identify only 47.86% of drug pairs. Drug information services available on the Internet were the most common source (32%) of knowledge of DDIs among them. Knowledge of the prescribed drug (40%) and complete drug history including over-the-counter and herbal products (35%) were the two important ways identified by them for avoiding unwanted drug interactions in clinics. CONCLUSION: The study revealed that the existing knowledge of the dentists was not adequate. Hence the knowledge of the dentists about DDIs pertinent to dentistry should be enriched and should be reinforced by arranging training sessions at constant intervals of time.

A Prospective Analysis of Drug Interactions in Patients of Intensive Cardiac Care Unit.

INTRODUCTION: Drug-Drug Interaction (DDI) is a serious concern in cardiac patients due to polypharmacy. AIM: The present study was aimed to identify the potential DDI among hospitalized cardiac patients and evaluate the mechanism and severity of such interactions. MATERIALS AND METHODS: A prospective observational study was conducted in intensive cardiac care unit of a tertiary care hospital for six months. Patients aged 18 years and above and taking two or more drugs were included in the study. Medscape drug interaction checker was used to identify and analyze the pattern of potential DDI. RESULTS: Out of 500 patients, most of the patients were male (78.4%) in the age group of 50-60 years (31%). The most common diagnosis was acute coronary syndrome (57.2%). Out of total 2849 DDI, 2194 (77.01%) were pharmacodynamic, 586 (20.57%) were pharmacokinetic in nature while 69 (2.42%) drug pairs interacted by unknown mechanism. Majority of drug interactions were significant {2031 (71.29%)} in nature followed by minor {725(25.45%)} while serious drug interactions were observed in only 93 (3.26%) drug pairs. A positive correlation was observed between patient's age and number of drugs prescribed (r=0.178, p<0.001), number of drugs prescribed and potential Drug-Drug Interaction (pDDI) (r= 0.788, p<0.001) and between patient's age and pDDI (r=0.338, p<0.001). CONCLUSION: The risk of pDDI was more commonly observed in elderly male patients particularly with antiplatelet drugs like low dose aspirin and clopidogrel.

Knowledge, attitude and perception of medical and dental undergraduates about antimicrobial stewardship.

OBJECTIVES: This study aimed to identify the current knowledge, attitude, and perception (KAP) of the future prescribers about antimicrobial (AM) education so that the identified lacunae in the training curriculum can be effectively addressed. MATERIALS AND METHODS: A questionnaire-based survey was carried out in the 2(nd) year students of medical and the dental undergraduate (UG) courses at a tertiary care teaching center in Jaipur. Each respondent completed the given questionnaire independently in the allocated time. A scoring system was used to rate the KAP of the respondents as poor, average, or good. RESULTS: Statistically significant differences were found in the KAP of the medical and dental future prescribers (P = 0.0086, 0.0002, and <0.0001 for the KAP, respectively). CONCLUSION: The attitude of the UG students towards AM education is good, but the deficiencies in the knowledge and perception need to be improved further. Suitable interventions to address these lacunae must be planned.

Maxillary posterior teeth removal without palatal injection -truth or myth: a dilemma for oral surgeons.

BACKGROUND: Pain control is one of the most important factors for successful treatment. Each new measure to control pain has been looked as miraculous act at the initial stages. The improvements in agents and techniques for local anaesthesia are probably the most important advances in dental science to have occurred in the past years. AIM: To evaluate 4% articaine hydrochloride against 2% lignocaine hydrochloride anaesthesia in providing adequate palatal anaesthesia in maxillary posterior regions, without the need for a palatal block. SETTINGS AND DESIGN: Healthy patients above 15 y of age and requiring bilateral extraction of their maxillary posterior teeth were included in this crossover study. The exclusion criteria included medical history of cardiovascular and kidney diseases, gastrointestinal bleeding or ulceration, allergic reactions to local anaesthetic, pregnancy or current lactation. MATERIALS AND METHODS: Eighty patients, requiring bilateral extraction of their teeth due to various reasons were enrolled for this study. Each patient received both lignocaine and articaine anaesthetic in equivalent dose at two different appointments. Maxillary infiltration technique was used for extraction of maxillary posterior teeth at both the appointments. A 170-mm Heft Parker visual analogue scale was used to assess the pain on the palatal mucosa after buccal infiltration of either anaesthetic agent. Blood pressure, Pulse rate and electrocardiographic monitoring were done during the procedure. Adverse effects during the study period were also monitored. STATISTICAL ANALYSIS: Data was analysed by Z-test and student's t-test. RESULTS: Pain scores on probing palatal mucosa after buccal infiltration of the anaesthetic were more for lignocaine as compare to articaine and it was statistically significant (p <.001). However, for hemodynamic parameters and electrocardiographic monitoring, there was no statistically significant difference in blood pressure, pulse rate and electrocardiograph before and after the completion of extraction (p > 0.05). CONCLUSION: Four percent articaine offers better clinical performance than 2% Lignocaine, particularly in terms of providing adequate palatal anaesthesia with only buccal infiltration.

Irrational fixed dose combinations & need for intervention: understanding of dental clinicians and residents.

CONTEXT: There is a growing concern about ever-burgeoning list of irrational fixed dose combinations (FDCs) which have flooded pharmaceutical market recently in India. Till date no structured study has evaluated the level of understanding among the dental clinicians and residents about these concepts. The present study is designed to fulfil that lacuna. OBJECTIVE: To evaluate the knowledge, attitude and practice, regarding the use of FDCs by the dental residents and dental clinicians in a tertiary care teaching dental hospital. MATERIALS AND METHODS: The present study was carried out among postgraduate students and dental clinicians working at Rajasthan Dental College, a tertiary care teaching dental hospital, in Jaipur, India. Sixty residents and 77 dental clinicians from the departments of Orthodontics, Prosthodontics, Oral Medicine, Periodontology, Conservative Dentistry & Endodontics, Oral & Maxillofacial Surgery, Pedodontics who gave their informed consent were enrolled. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of fixed dose combinations was filled up. Data was analysed with suitable statistical tests. RESULTS: Out of the 60 residents and 77 dental clinicians recruited for the study, none of them were aware about all of the advantages and disadvantages of FDCs. On an average, only 47% of residents and 61% dental clinicians were aware of FDC included in WHO Essential Medicines List (EML). Only 47% residents and 58% dental clinicians could recall a single banned FDC in India. Common sources of information about FDCs were Monthly Index of Medical Specialities (MIMS), medical representatives and internet. The most commonly prescribed irrational FDC was diclofenac + paracetamol combination, 42% residents and 41% dental clinicians and residents believed that regular Continuous Medical Education (CMEs) stressing upon rational use of medicine could reduce the magnitude of this problem. CONCLUSION: It is the need of the hour to reduce the magnitude of this problem by sensitizing dental residents and prescribers regarding the efficacy, safety, suitability, rationality and cost benefit of FDCs available for patient use.