Asian Journal of Pharmaceutical and Clinical Research

OXCARBAZEPINE-INDUCED HYPONATREMIA IN METABOLIC ENCEPHALOPATHY: A CASE REPORT

AMRITHA CHANDRASEKARAN SASHIKAR, ANGELIN GRACE T, ANN JENCY A, DHIVYAPRASATH P — Fri, 07 Feb 2025 00:00:00 +0530

The 81-year-old woman in this instance had a 3-day history of diminished sensorium and was suffering from significant left ventricular dysfunction, osteoporosis, uterine malignancy, and a history of nephrectomy, among other chronic illnesses. Medication for heart failure, neuropathic pain, anemia, and fluid retention were all part of her treatment plan. Along with careful monitoring of electrolytes and renal function, the patient was treated with a mixture of pregabalin, clonazepam, carvedilol, atorvastatin, spironolactone, and other supplements. The patient’s usage of oxcarbazepine, a medication known to create electrolyte imbalances and antidiuretic effects, is probably what caused her to develop hyponatremia. Using the Naranjo adverse drug response probability scale, a causality evaluation revealed a “probable” adverse drug response with a score of 7, indicating a probable connection between her electrolyte imbalance and oxcarbazepine.

BUCCAL FAT PAD AS A PEDICLED AUTOGRAFT FOR ROOT COVERAGE: A CASE REPORT

JATIN CHAUHAN, RAJESH KUMAR THAKUR, BIPIN KUMAR YADAV, DIKSHA GUPTA — Fri, 07 Feb 2025 00:00:00 +0530

The buccal fat represents a specialized and organized adipose tissue that maintains its volume and stability over long periods of time and serves as a well-vascularized, easily accessible local flap for reconstructive procedures such as the enhancement of root coverage in severe recession defects, thereby augmenting the dimensions of keratinized mucosa. Areas with Miller's Class III and IV gingival recessions are not considered amenable to intervention utilizing surgical root coverage methodologies because of the poor prognosis with existing techniques. In this case report, a pedicled buccal fat pad (PBFP) was used as a subepithelial grafting technique for root coverage in a maxillary posterior tooth exhibiting a Class III gingival recession defect coupled with a deficiency of keratinized gingiva. At a 3-month follow-up, this approach demonstrated effective root coverage, increased keratinized tissue, and improved patient comfort, as documented, with no notable complications.

NANOTECHNOLOGY-DRIVEN THERAPEUTICS FOR LIVER CANCER: CLINICAL APPLICATIONS AND PHARMACEUTICAL INSIGHTS

Fri, 07 Feb 2025 00:00:00 +0530

Hepatocellular carcinoma (HCC) represents a significant threat to global health and is responsible for significant mortality rates worldwide. Conventional treatment options such as surgery and chemotherapy have inherent limitations. In order to remedy these deficits, the development of novel therapeutic strategies is essential. Nanomedicines have shown promise in HCC treatment as they offer improved stability, controlled release, and increased drug loading capacity. This review explores the application of nanoconstructs in HCC treatment, including active and passive targeting strategies. In addition, liver cell targeting approaches, targeting moieties, and conjugation chemistry for surface functionalization are investigated. A compact overview of various therapeutic approaches to HCC treatment is also given.

FACULTY PERSPECTIVES ON THE IMPLEMENTATION OF COMPETENCY-BASED MEDICAL EDUCATION AT A TERTIARY CARE HOSPITAL IN INDIA

Fri, 07 Feb 2025 00:00:00 +0530

Objective: The objective of this study was to assess the perspectives of faculty members at Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Port Blair, on the implementation of CBME.

Methods: Forty-three faculty members had participated in a cross-sectional study at ANIIMS, Port Blair. A structured and validated questionnaire from previous CBME studies in India was utilized, featuring both closed-ended (five-point Likert scale) and open-ended questions. The questionnaire assessed faculty preparedness, perspectives, and challenges in implementing CBME, covering domains such as familiarity with CBME, training levels, resource constraints, and perceived bottlenecks. It was administered through Google forms, shared in person and through electronic media. Data were analyzed using SPSS version 27, with descriptive statistics for categorical variables and subgroup comparisons performed using the Chi-square test at a significance level of p<0.05.

Results: Most respondents were aware of the components of CBME (76.74%) and have participated in CBME-related training (69.77%). However, only 60.47% of respondents said that they were confident in their ability to teach in small groups, and only 51.16% said that they were familiar with assessment tools. Lack of administrative support (76.74%), time limits for defining specific learning objectives (76.74%), and a lack of faculty strength (88.37%) were the biggest obstacles. There were also logistical issues with interdepartmental cooperation (74.42%) and assessment (67.44%). Feedback systems were found to be in need of improvement, with 81.40% of respondents saying they needed more instruction on how to give constructive criticism.

Conclusion: Although ANIIMS faculty acknowledges CBME as a beneficial reform, they have major obstacles in the areas of personnel, training, and logistical assistance. To maximize CBME implementation and delivery, these weaknesses must be filled through focused faculty development initiatives, administrative actions, and resource distribution.

STUDY OF CYSTATIN-C AS A CARDIOVASCULAR RISK MARKER IN PATIENTS WITH CHRONIC KIDNEY DISEASE: CROSS-SECTIONAL ANALYTICAL STUDY

HARSHAL PACHPOR, ARUN TADAS, UMESH KAWALKAR, AVINASH NAMDEO JADHAO — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The objective of this study was to evaluate the relationship between Cystatin C, lipid profile, and cardiovascular risk in patients with chronic kidney disease (CKD), particularly in a rural Indian population. The study aimed to assess whether Cystatin C could serve as a reliable biomarker for predicting cardiovascular events in CKD patients.

Methods: This cross-sectional analytical study was conducted in a tertiary care hospital in central India from September 2015 to November 2018. A total of 100 participants were enrolled, including 50 CKD patients (with GFR <60 mL/min/1.73 m²) and 50 age- and sex-matched healthy controls. Fasting blood samples were collected to measure serum Cystatin C and lipid profile parameters (total cholesterol, triglycerides, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very low-density lipoprotein). CKD patients were followed for 6 months to monitor cardiovascular events. Statistical analyses included unpaired t-tests, Chi-squared tests, and correlation analysis.

Results: Serum Cystatin C levels were significantly higher in CKD patients (3.8±0.96 mg/L) compared to controls (0.76±0.11 mg/L, p<0.001). CKD patients exhibited dyslipidemia, characterized by elevated total cholesterol, LDL, and triglyceride levels, and reduced HDL levels. The LDL/HDL ratio was significantly higher in CKD patients (3.73±1.44) compared to controls (2.72±0.79, p<0.001). Among CKD patients, those who developed cardiovascular events during follow-up had significantly higher Cystatin C levels (4.9±0.91 mg/L) compared to those who did not experience cardiovascular events (3.6±0.24 mg/L, p<0.001).

Conclusion: Cystatin C is a reliable marker for renal dysfunction and an independent predictor of cardiovascular risk in CKD patients, particularly in rural populations. Elevated Cystatin C levels were closely associated with dyslipidemia and an increased risk of cardiovascular events. These findings suggest that Cystatin C could be a valuable tool for the early identification of CKD patients at high risk for cardiovascular complications. Incorporating Cystatin C into clinical practice could enhance risk stratification and improve management strategies for CKD patients.

SERIAL ASSESSMENT OF CARDIAC BIOMARKERS IN ACUTE MYOCARDIAL INFARCTION: A COMPREHENSIVE STUDY

HARSHAL PACHPOR, ARUN TADAS, SANDIP LAMBE, AVINASH NAMDEO JADHAO — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: To examine the correlation between the serial activity of cardiac troponin T (cTnT) and the enzymatic activities of creatine kinase MB (CPK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) in patients with acute myocardial infarction (AMI).

Methods: This hospital-based retrospective observational study involved 50 patients diagnosed with AMI, including those with non-segment elevation myocardial infarction, and 50 healthy age- and sex-matched controls. All participants underwent electrocardiographic evaluation and serial blood sample collection at 6, 24, and 48 h post-admission. cTnT levels were measured using electro-chemiluminescence immunoassay, while CPK-MB levels were assessed by immunoinhibition methodology. Serum levels of LDH and AST were determined using the UV kinetic method on a fully automated autoanalyzer.

Results: At 6, 24, and 48 h, cardiac biomarkers were significantly elevated in patients with AMI compared to healthy controls. cTnT levels were 1.13±1.24 ng/mL at 6 h, 3.64±0.34 ng/mL at 24 h, and 5.84±0.39 ng/mL at 48 h, while the control group showed a value of 0.09±0.18 ng/mL. Similarly, serum CPK-MB levels were 99.68±31.46 ng/mL at 6 h, 186.42±54.20 ng/mL at 24 h, and 124.28±46.53 ng/mL at 48 h. Serum AST (serum glutamic-oxaloacetic transaminase) levels were 78.34±26.25 IU/L at 6 h, 173.90±56.03 IU/L at 24 h, and 119.31±36.21 IU/L at 48 h. Finally, serum LDH levels progressively increased, reaching 521.53±118.36 IU/L at 6 h, 1025.36±101.85 IU/L at 24 h, and 1823.21±129.34 IU/L at 48 h. These findings demonstrate a time-dependent rise in biomarker levels following myocardial injury.

Conclusion: The biomarkers troponin T, CPK-MB, LDH, and AST provide valuable insights into the extent and severity of myocardial injury in patients with AMI. Monitoring their levels over time can aid in the diagnosis, risk stratification, and management of patients with AMI.

COMPARATIVE CROSS SECTIONAL STUDY OF EFFECT OF 0.5% HEAVY BUPIVACAINE VERSUS 0.5% HEAVY BUPIVACAINE + FENTANYL 25 MCG ON NEWBORN APGAR SCORE BORN TO TERM GESTATION MOTHER BY LOWER SEGMENT CESAREAN SECTION (LSCS) UNDER SUBARACHNOID BLOCK

REGALLA KINNERA, VENKATESWARARAO B, AAVULA MURALIDHAR, ABID ALI — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The scientific aim of anesthesiology is to temporarily eliminate pain. This goal was first established for surgical pain management, but it has since expanded to include post-operative pain management, chronic pain management, and cancer pain management.

Methods: Sixty patients from ASA I and II who were scheduled for elective cesarean sections participated in a comparative cross-sectional study. The patients were divided into two groups at random, Group F and Group B. Fentanyl 25 mcg and 0.5% hyperbaric buprevacaine 12.5 mg were administered intrathecally to parturients in Group F. Group B parturients got 12.5 mg of 0.5% hyperbaric buprevacaine intravenously.

Results: The two groups’ appearance, pulse, grimace, activity, and respiration (APGAR) scores were compared, and the neonatal APGAR score was unaffected by the intrathecal administration of fentanyl to buprevacaine. In both groups, the durations of sensory blockade onset, motor blockade onset, and resolution to bromage 0 were statistically insignificant. When compared to Group B, group F displayed longer durations for both two-segment regression and total sensory blocking. When compared to Group B, Group F had a lower frequency of side effects such as nausea, vomiting, and shivering.

Conclusions: We come to the conclusion that, in elective cesarean sections, 0.5% heavy Bupivacaine combined with 25 mcg of fentanyl is preferable to 0.5% heavy Bupivacaine alone.

THE ROLE OF IRON FOLIC ACID AND MULTIPLE MICRONUTRIENTS IN TYPE OF CHILDBIRTH DELIVERY: ECONOMIC AND HEALTH IMPLICATION

NAJMIATUL FITRIA, SARAH PUTI AMALIA, AFIFAH MACHLAURIN, HANSEN NASIF — Fri, 07 Feb 2025 00:00:00 +0530

Objective: Pregnancy is a critical period that can pose nutritional challenges, such as chronic energy deficiency and anemia, increasing maternal mortality risk. The World Health Organization recommends iron and folic acid supplements to mitigate these risks. This study compared labor types and associated costs between iron-folic acid (IFA) and multiple micronutrient (MMN) supplementations during pregnancy.

Methods: An economic evaluation was conducted retrospectively at Semen Padang Hospital, analyzing data from January to December 2021. A total of 201 pregnant women were included, with 128 undergoing cesarean delivery. Cost data were collected from the hospital’s perspective and analyzed to identify differences between supplementation groups.

Results: Total direct costs did not differ significantly between the IFA and MMN groups (p=0.82). However, medical costs varied substantially, with cesarean delivery costs being approximately 5 times higher than normal delivery costs.

Conclusion: This study emphasizes the economic burden of cesarean deliveries compared to normal births and highlights the need for further evaluation of micronutrient supplementation’s cost-effectiveness. Findings advocate for policies that optimize maternal health outcomes and reduce delivery-related costs, addressing the high incidence of elective cesarean sections.

Evaluation of Effects of Different Core & Veneer Thickness Combination on Translucency of Two All Ceramic System: An in Vitro Study"

BHUMIKA SANGTANI, KAVITA MARU, MANISH SANGTANI, ARCHITA GANGWAL — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The study aimed to evaluate the effect of change in thickness of core or veneer ceramic on translucency of two types of Lithium Di Silicate Glass Ceramic IPS e-max PRESS and IPS e-max CAD.

Methods: A total of 56 disks (IPS e.max PRESS, IPS e.max CAD; Ivoclar Vivadent), 15 mm in diameter with different thicknesses (0.80 mm, 1.00 mm), were fabricated as core materials with the lost wax and heat-press techniques, according to the manufacturer’s recommendations. They were divided into groups (n=7), the size of which was determined by power analysis (Δ=0.2; power=0.80; α=0.05). Each core material was veneered with its compatible veneer ceramic (IPS e.max PRESS, IPS e.max CAD. All surfaces were measured by profilometry to ensure consistency within the groups. A glass disk (1.5 mm) positive control (group P) and a metal core (1.5 mm) negative control (group N) were prepared. The translucency parameter (TP) values were calculated using spectrophotometry to calculate the color differences of the specimens over black and white backgrounds.

Results: IPS e.max PRESS and IPS e.max CAD depicted decreasing order or mean % transmittance as 0.15477 for IPS e.max PRESS (0.5+0.5), 0.14431 IPS e.max PRESS (0.8+0.2), 0.06671 IPS e.max CAD (0.5+0.5), 0.06297 IPS e.max CAD (0.8+0.2). The difference between these groups was found to be statistically significant (p<0.05). However, not significant difference found between Group 1 IPS e.max PRESS (0.8+02)-Group2 IPS e.max PRESS (0.5+0.5) and Group5 IPS e.max CAD (0.8+0.2)-Group6 IPS e.max CAD (0.5+0.5) pairs (p>0.05). One-way analysis of variance found significant differences among the TP values of the ceramic groups (p<0.05).

Conclusion: When overall thickness was increased to 1.5 mm, keeping similar veneer at 0.5 mm IPS e-max CAD exhibited better esthetic outcome than IPS e-max PRESS. Interaction of core and veneer are different with different ceramic systems at different thicknesses. Most appropriate ceramic material can be decided based only on specific clinical situation being faced.

STRUCTURE-BASED VIRTUAL SCREENING, MOLECULAR DOCKING, AND DYNAMICS SIMULATION APPROACHES FOR IDENTIFICATION OF INHIBITORS OF HELICOBACTER PYLORI MQNB

Fri, 07 Feb 2025 00:00:00 +0530

Objectives: Helicobacter pylori is the major cause of duodenal ulcers and gastric cancer. Menaquinone is essential for the respiration and survival of H. pylori. Identification of compounds that have good binding affinity at the active site of MqnB will be the promising approach against H. pylori. This study aims to identify the natural lead compounds against MqnB enzymes in H. pylori through in silico methods.

Methods: As the three-dimensional structure of H. pylori MqnB is not available, we have modeled the three-dimensional structure followed by identification of the active site. The binding of the compounds from the COlleCtion of Open NatUral prodUcTs database was screened against MqnB, and dynamics simulation studies were carried out for the top three lead compounds.

Results: The predicted model of MqnB was subjected to a molecular dynamics (MD) simulation study to obtain the dynamic behavior of MqnB. The best representative model was validated and further used for structure-based virtual screening. Based on the docking results, three lead compounds were chosen among the top hits and subjected to 200 ns MD simulation. The results highlight the dynamic nature of MqnB in complex with the lead compounds and favorable binding interactions are comparable with the substrate. All the compounds showed promising interactions with MqnB during MD simulations.

Conclusion: Identified lead compounds show good binding potential and also maintain interactions with amino acid residues at the active site of MqnB enzyme. These compounds could be further explored in the drug discovery process against H. pylori.

NEUROENDOCRINE AND INFLAMMATORY BIOMARKER IN IMMEDIATE POST-PARTUM STATE WITH STILL BIRTH AND ITS COMPARISON WITH LIVE BIRTH AS PREGNANCY OUTCOME

KAVYA SASANK, HARNAM KAUR, SHARMA SB, SHARMA JC — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: Stillbirth remains a significant contributor to global and perinatal mortality, with a rate of 13.9/1,000 total births worldwide and 11.79/1,000 in India. The contributing factors include hypertensive disorders, diabetes, infections, and congenital anomalies. The immediate postpartum period provides an opportunity to evaluate the maternal physiological and biochemical changes that may be linked to stillbirth. Neuroendocrine and inflammatory biomarkers, such as dehydroepiandrosterone sulfate (DHEA-S) and homocysteine (HCY), are essential in understanding the stress and inflammation associated with adverse pregnancy outcomes, including stillbirth. This study aimed to estimate and compare the levels of DHEA-S and HCY in women with stillbirth and live births to explore their potential association with adverse pregnancy outcomes.

Methods: A case-control study was conducted at a tertiary care center involving 60 women aged 20–35 years. The participants were divided into two groups: 30 women with stillbirth and 30 controls with live births. Detailed demographic, obstetric, and clinical data were collected and venous blood samples were analyzed for DHEA-S and HCY using the enzyme-linked immunosorbent assay and immunoturbidimetric methods, respectively. Data analysis was performed using the Statistical Packages for the Social Sciences v23.0, with statistical significance set at p<0.05.

Results: The mean gestational age was significantly lower in the stillbirth group (34.8±4.8 weeks) compared to the controls (38.7±1.0 weeks, p=0.01). The stillbirth cases exhibited significantly higher levels of DHEA-S (2.74±0.48 μg/mL) and HCY (12.25±5.27 μmoL/L) compared to the controls (0.98±0.45 μg/mL, p=0.01; 8.64±2.28 μmoL/L, p=0.01). Abnormal levels of DHEA-S were observed in all stillbirth cases, while only 50% of controls had abnormal levels (p=0.01). Obstetric complications in the stillbirth group included anemia (13.3%), hypothyroidism (6.7%), intrauterine growth restriction (3.3%), oligohydramnios (3.3%), preeclampsia (3.3%), type 2 diabetes with polyhydramnios (3.3%), and breech presentation (3.3%). Significant differences in physical characteristics such as height and body mass index were noted between the groups.

Conclusion: Elevated levels of DHEA-S and HCY in the stillbirth group suggest distinct pathophysiological responses in the postpartum period, which may indicate the adverse pregnancy outcomes. These biomarkers could potentially serve as useful tools for identifying and managing pregnancies at risk for stillbirth and related complications. Further studies are required to validate their role in predicting and improving the pregnancy outcomes.

A COMPARATIVE STUDY TO DETERMINE THE EFFECTIVENESS AND SAFETY OF PROBIOTICS AS AN ADJUNCT TO ANTIHISTAMINES COMPARED TO ANTIHISTAMINES ALONE IN PATIENTS WITH ALLERGIC RHINITIS

NAGUR SHARONE GRACE, MONICA N, MATTAM SARATH CHANDRA, VEENA B — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The objectives of the study are to evaluate the effectiveness and safety of probiotics as an adjunct therapy to antihistamines in comparison to antihistamines alone in individuals suffering from allergic rhinitis (AR).

Methods: A non-blinded, comparative study included 100 patients with AR selected from Government E.N.T Hospital’s allergy clinic, Koti, Hyderabad. The participants were categorized into two groups of 50 patients each and received tablet levocetirizine 5 mg in the first group and tablet levocetirizine 5 mg plus capsule Sporlac plus (2.5 billion cells) in second group, for 28 days. Total nasal symptom score (TNSS), complete blood count (CBC), and absolute eosinophil count (AEC) were done at start and at the end of 28 days. Participants were followed up at the end of 28 days.

Results: There were no remarkable variations observed statistically in TNSS scoring and CBC among both groups; however, clinical significance was noted within each group. Mean AEC at baseline and at the end of 28 days in group 1 was 515.8 ± 47.02 cells/μL and 325.5 ± 52.9 cells/μL and in group 2 was 504.5 ± 41.19 cells/μL and 188.3 ± 51.7 cells/μL, respectively. There was a significant variation in average AEC at the end of 28 days of treatment (p<0.05). Only mild adverse effects were observed across all groups.

Conclusion: Although both treatments were found to have equal efficacy in alleviating symptoms of AR with good safety profile, probiotics as an adjunct to antihistamine significantly reduced AEC count when compared to anti-histamine alone proven to have more clinical benefit.

COMPARATIVE INSIGHTS INTO ULTRAVIOLET-B RADIATION-INDUCED BIOCHEMICAL MODULATIONS IN SENNA AURICULATA: A GAS CHROMATOGRAPHY-MASS SPECTROMETRY PROFILING STUDY

Fri, 07 Feb 2025 00:00:00 +0530

Objectives: This study explores the transformative effects of ultraviolet B (UV-B) radiation on the phytochemical profile of Senna auriculata leaves, a plant known for its medicinally properties.

Methods: Utilizing gas chromatography-mass spectrometry, we systematically compared the phytochemical profiles of methanolic extracts from untreated leaves (SKC) and those exposed to UV-B radiation (SKT).

Results: The analysis revealed a total of 59 compounds in the untreated leaves (SKC) and 50 in the UV-B exposed leaves (SKT). Among these, 36 metabolites were common to both samples, while 23 were unique to SKC, and 14 were exclusive to SKT. Notable compounds induced by UV-B radiation included Cystamine, 2-Methyl-6-(5-methyl-2-thiazolin-2-ylamino) pyridine, and 1,2-Benzisothiazol-3-amine tbdms. These compounds exhibited significant bioactivities, demonstrating antioxidant, anticancer, and antibacterial properties.

Conclusion: The findings highlight the role of UV-B radiation as a modulator of secondary metabolism, reshaping the phytochemical profile of S. auriculata to enhance its adaptive resilience and therapeutic potential. This study sheds light on the complex interaction between environmental stressors and phytochemistry, providing valuable insights into how controlled UV-B exposure can optimize the medicinal properties of plants.

NOVEL ULTRA-PERFORMANCE LIQUID CHROMATOGRAPHY METHOD FOR CONCURRENT ESTIMATION AND PHARMACOKINETIC ANALYSIS OF FAVIPIRAVIR AND MOLNUPIRAVIR IN RAT PLASMA

GOPE EDWARD RAJU, SRIKANTH POTTENDLA, SUNEETHA YAPARTHI — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The objective of this study was to establish a rapid and sensitive ultra-performance liquid chromatography (UPLC) method for the simultaneous estimation of molnupiravir and favipiravir in rat plasma using nirmatrelvir as internal reference.

Methods: The separation was performed on Waters Acquity UPLC BEH C18 (100 mm × 2.1 mm, 1.7 μm) by isocratic elution with a buffer containing 1 mL of formic acid in 1 L of water and the mixer of two components such as buffer and acetonitrile in the ratio of 70:30 as mobile phase with flow rate was 0.3 mL/min at ambient temperature.

Results: Analysis was carried out within 3 min over a good linear concentration range from 100 ng/mL to 4000 ng/mL for both drugs of favipiravir (r2=0.9999±0.018) and molnupiravir (r2=0.9998±0.006). This method has been successfully applied, exploring favipiravir (3.33 mg/kg) and molnupiravir (3.33 mg/kg) with internal standard nirmatrelvir extracted from rat plasma using liquid–liquid extraction.

Conclusion: The drugs were stable throughout the stability studies according to US Food and Drug Administration guidelines, just because, the validated approach has successfully conducting to the pharmacokinetic studies of two drugs.

CLINICAL AND MICROBIOLOGICAL PROFILE OF SECONDARY BLOODSTREAM INFECTIONS RESULTING FROM URINARY TRACT INFECTION CAUSED BY ENTEROBACTERALES

NANDHINI S, ARUNAVA KALI, VALENTINA Y, PRAVIN CHARLES M.V, JOSHY M EASOW — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: Bloodstream infection (BSI) is a common sequelae of urinary tract infections (UTIs) and it requires early detection and appropriate antibiotic therapy. This study analyzed the clinical and microbiological profile of secondary BSI resulting from UTI caused by Enterobacterales.

Methods: In this retrospective study, National Healthcare Safety Network criteria were used to define the cases of UTI and secondary BSI attributed to UTI. Data from medical records and laboratory reports of patients from January to May 2024 were compiled and analyzed.

Results: Among 932 urine samples with significant growth of Enterobacterales, 48 were blood cultures positive. Out of them, 26 patients (11 males and 15 females) met the criteria of BSI secondary to UTI as the same isolates also grew in blood specimens which was taken within the secondary BSI attribution period. Nine patients had catheter-associated symptomatic UTI (CA-SUTI) while 14 were non-CA-SUTI and 3 had asymptomatic bacteriuria. In urine culture, Escherichia coli (n=22, 68.1% multi-drug resistant and 31.8% non-multi-drug resistant [MDR]), Klebsiella pneumoniae (n=3, all MDR), and Citrobacter koseri (n=1, non-MDR) strains were isolated. Diabetes, renal calculi, fever, Foley’s catheter, age >60 years, intensive care unit admission, and hospital stay >10 days were more among individuals with MDR infections. Cefoperazone-sulbactam, piperacillin/tazobactam, and nitrofurantoin had good outcomes.

Conclusion: Cefoperazone-sulbactam, piperacillin/tazobactam, and nitrofurantoin were effective for treating patients with BSI attributed to UTI in our hospital with good outcomes. Hence, these antibiotics might have a critical role as empirical therapy for such, particularly those with underlying health conditions and risk factors for MDR infections.

EPIDEMIOLOGY AND CLINICAL PROFILE OF DENGUE AND CHIKUNGUNYA INFECTION AND SEROTYPE DIVERSITY OF DENGUE VIRUS IN NORTHERN INDIA

Fri, 07 Feb 2025 00:00:00 +0530

Objectives: Dengue and chikungunya (CHIKV) are major public health problem and are notable arthropod viral infections due to their expanding geographical distribution. As there are multiple serotypes of dengue virus circulating concurrently with CHIKV virus, the present study was conducted to describe the seroprevalence, epidemiological characteristics, clinical profile, seasonal trends, coinfection, and prevalent circulating dengue virus serotypes (DENVs).

Methods: Serum samples from clinically suspected cases of dengue and CHIKV were subjected to serological testing by performing enzyme-linked immunosorbent assay. The particulars of the patient including case history, demographic characteristics, co-morbidities, clinical features, and evolution of symptoms were recorded. Further, samples which were positive for NS1 antigen were subjected to multiplex real-time reverse transcription polymerase chain reaction testing for typing of DENVs 1, 2, 3, and 4.

Results: Seroprevalence of dengue and CHIKV was reported to be 23.39% and 20.65%, respectively. Maximum number of cases were reported in the age group of 21–40 years. Common clinical presentations in dengue patients were fever, myalgia, headache, and nausea/vomiting whereas in CHIKV, the most common symptoms were fever, myalgia, and joint pains. On molecular surveillance, DENV-2 was detected in maximum cases (73.33%) followed by serotype 3 (11.66%).

Conclusion: Dengue and CHIKV infections continue to co-exist and there is substantial overlap in their clinical presentation. Simultaneous diagnosis of both viruses will help in evaluation, appropriate treatment, and prophylactic measures. Surveillance of DENVs needs to be closely monitored for the emergence of new serotypes.

SYNTHESIS, SPECTRAL CHARACTERIZATION, AND IN SILICO STUDIES OF N-MANNICH BASES OF NOVEL SUBSTITUTED BENZIMIDAZOLE DERIVATIVES AS ANALGESIC, ANTIFUNGAL, AND POTENT INHIBITORS FOR BREAST CANCER

BHAGYASHRI D JADHAV, SUSHIL P NARKHEDE — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The aim of the present study is to synthesize N-Mannich bases of novel series of substituted benzimidazole derivatives and their in silico simulation.

Methods: This study presents research on the synthesis of N-Mannich bases of novel series of substituted benzimidazole derivatives using substituted benzimidazoles as the starting compound. In silico simulation and absorption, distribution, metabolism, and excretion prediction of all the compounds are demonstrated by their computational studies.

Results: All synthesized compounds were analyzed using 1hydrogen nuclear magnetic resonance, Fourier transform infrared, and mass spectrometry to validate their structures. In silico simulation against the 1C14 as analgesic, 5fsa as antifungal, and 600 k as breast cancer protein database indicated that synthesized compounds have moderate-to-good-binding energy.

Conclusion: Overall, the computational analyses indicate that the derivatives synthesized show encouraging pharmacokinetic characteristics and affinity, positioning them as potential candidates for further advancement as therapeutic agents.

ASSESSMENT OF BRAIN PERFUSION WITH MAGNETIC RESONANCE IMAGING AND ITS APPLICATION IN ACUTE ISCHEMIC STROKE

Fri, 07 Feb 2025 00:00:00 +0530

Objective: The purpose of this study was to evaluate the role of magnetic resonance imaging (MRI), with a particular emphasis on various MRI sequences, in the identification and control of acute ischemic cerebral stroke.

Methods: A cross-sectional research design was employed on the patients who had been clinically diagnosed with acute stroke at Sardar Patel Medical College, Bikaner. The study included patients of all age groups and sexes. All patients with acute stroke were evaluated on the basis of history and clinical examinations. A 3 Tesla GE SIGNA Architect machine was used to do MRI scans, including diffusion-weighted imaging (DWI) and conventional sequences, to determine the presence of acute infarcts.

Results: The majority of patients were from rural areas, and there was a notable male predominance (male-to-female ratio of 8.06:1). DWI outperformed conventional MRI sequences in terms of sensitivity for detecting acute infarcts; DWI hyperintensity with corresponding apparent diffusion coefficient hypointensity was observed in all 31 cases of acute infarcts, while conventional sequences detected altered signal intensities in only 58.06% of cases.

Conclusion: MRI is a powerful way of assessing the macroscopic and microscopic aspects of brain vascularization. The combination of magnetic resonance angiography (MRA), DWI, and perfusion imaging is probably the best way to select patients for thrombolytic therapy. Further work is needed to improve the accuracy of cerebral blood flow (CBF) and cerebral blood volume measurements and to develop a multivariate model integrating MRA, DWI, perfusion imaging, and clinical data to enhance stroke therapy strategies.

ASSESSMENT OF THE EFFECTIVENESS OF TRIPLE-DRUG THERAPY OVER DUAL-DRUG THERAPY IN COPD PATIENTS – A RETROSPECTIVE COHORT STUDY

SUJALA AAKARAM, KRISHNA PRASAD D — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The current study aimed to determine the efficacy of triple-drug combination therapy over double-drug combination therapy.

Methods: A retrospective cohort observational study was conducted on a total number of 240 patients at Medicover Hospitals. The study encompassed 240 subjects suffering from chronic obstructive pulmonary disease (COPD), and parameters such as demographics, symptoms, comorbid conditions, and forced expiratory volume (FEV1)/forced vital capacity (FVC) ratio were assessed. The data were compiled and analyzed by applying unpaired t-tests and Chi-square tests using software.

Results: Male patients with 61–70 years of age were prone to suffer from COPD as compared to the other age groups. With regard to the symptoms associated with COPD, shortness of breath and cough were more remarkable in >100 and >90 patients, followed by fever symptoms. In the COPD patients with dual therapy, FEV1:FVC ratio of over 3 months, 30% (n=36) of patients had a FEV1:FVC ratio of <0.7, which increased to 90% (n=108) in the post-treatment, whereas those with a ratio >0.7 decreased from 70% (n=84) to 10% (n=12). 16.67% of patients had a FEV1:FVC ratio of <0.7, which was raised to 93.33% after treatment. This significant shift (**p<0.001) demonstrated a substantial improvement in lung function following triple-drug therapy.

Conclusion: The study demonstrated that triple-drug therapy was effective over dual-drug therapy in the management of COPD by marked improvement in lung function and, thereby reduction in exacerbation rates.

ASSESSMENT OF KNOWLEDGE TOWARD PREVENTION OF HEPATITIS B INFECTION AND VACCINATION STATUS AMONG HEALTH CARE WORKERS AT A TERTIARY CARE CENTRE IN EASTERN INDIA

SUBHA SANKHA KUNDU, MOUMITA KUNDU, MUKESH KUMAR, DHAVAL PAREKH, ANAND KISHORE — Fri, 07 Feb 2025 00:00:00 +0530

Objectives: The present study aims to assess the knowledge about Hepatitis B infection of healthcare workers (HCWs) and their vaccination status.

Methods: This was a cross-sectional descriptive study, carried out over a period of 4 months, at a tertiary care hospital in Eastern India. The study enrolled 151 HCWs, including nurses and paramedical staff employed on either a permanent or contractual basis. Participants were selected randomly, and data were obtained using a structured, pre-tested data collection tool. The questionnaire included sections to capture sociodemographic details, assess knowledge about Hepatitis B virus (HBV) infection, determine vaccination status, and identify reasons for partial or lack of vaccination.

Results: Among the 151 participants, 29.8% were nurses, and 70.2% were auxiliary health workers, including laboratory technicians, administrative staff, housekeeping staff, ward attendants, and ambulance drivers. While all nurses exhibited complete knowledge across all domains of HBV awareness, only 14% of auxiliary health workers knew the causative organism and 9% were aware of prevention strategies. Vaccination coverage was suboptimal, with 48.3% fully vaccinated, 30.5% partially vaccinated, and 21.2% unvaccinated. Unvaccinated participants cited a lack of awareness (62.5%) and perceived irrelevance (31.3%) as major barriers. Among partially vaccinated participants, 65.2% were unaware of their vaccination schedule.

Conclusion: Significant gaps in HBV-related knowledge and vaccination coverage persist among auxiliary health workers, highlighting the need for targeted educational programs and routine workplace vaccination initiatives. Enhancing awareness about vaccination schedules and ensuring easy access to vaccines are critical steps to mitigate HBV transmission risks in healthcare settings and protect HCWs.