Monthly Publishing Peer Reviewed Journal

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1. In Vitro Antibiofilm, Antiquroum Sensing Activity of Gamma Tolerant Streptomyces Against Gram Negative Pathogens
Lokegaonkar S P, Nabar B M
Objective: The objective of this research was to study of antibiofilm, antibacterial, antiquroum sensing activity of gamma tolerant actinomycete isolated from soil. Methods: Secondary metabolites from Streptomyces albogriseolus GIS39Ama (genbank Accession number: KX694268) was obtained. The metabolites were tested for antiquroum sensing activity by performing violacein inhibition assay. The minimum biofilm inhibitory concentrations (MBIC) of metabolite against Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Vibrio cholerae were estimated. The effect of MBIC was further tested for reduction in exopolysaccharide content, viability of bacterial cells of biofilm, bacterial density of biofilm, extracellular DNA. Results The MBIC of Streptomyces albogriseolus GIS39Ama metabolite extract was found to be 625ppm against K. pneumoniae, V. cholerae, 1250ppm against P. aeruginosa and 312 ppm against E. coli.  Upto 95% reduction was achieved in exopolysaccharide content, 82% reduction in Viability, 89% reduction in bacterial density of biofilm was obtained. Inhibition of extracellular DNA was observed. The secondary metabolite extract exhibited antifungal activity. Conclusion: The actinomycete isolated from soil was found to exhibit antibiofilm, antiquroum sensing and antifungal properties.

2. The pharmacists’ responses and the collaboration between pharmacists and prescribers towards hospital medication errors, Saudi study
Ahmed S Eldalo, Mahmoud S Alhaddad
Background: medication errors result with many morbidities and mortalities that cost the country billions of dollars. Aim: this study aims to assess hospital pharmacists’ responses towards medication errors and to determine the collaboration between healthcare providers in solving problems related to medication errors in major hospitals of the Western Region, Saudi Arabia. Methods: a cross sections study was adopted in this research. A total of 270 questionnaires were randomly distributed to hospital pharmacists through face to face interviews in 8 major hospitals in the Western Region in Saudi Arabia. Data was analyzed using IBM SPSS, version 22, Armonk, NY: IBM Corp. Associations between variables were tested by Chi-square and Fisher’s exact tests. The level P ≤ 0.05 was considered as a cut-off point for significance. Results: A total of 190 pharmacists successfully completed the questionnaire from targeted hospitals. Only less than 40% of respondents check patients’ medications history and any potential allergy and drug-drug interactions. About 50% of pharmacists correct medication errors without referring to physician. Whereas, about one-quarter of physicians always accept pharmacists’ suggestions and write new prescriptions based on pharmacist recommendations. Forty nine percent of pharmacists perceived physicians inaccessible persons and about 70% of them feel frustrating when they call physicians without getting any response from them. Conclusion: pharmacists and physicians roles should be perceived as complementary role rather than competitive role. More collaboration need to be enforced the two professions through shared activities, events and workshops to reduce the gap of misunderstanding of their complementary role.

3. Interferon Induced Ulcerative Colitis in Chronic HCV Patients: Management and Review of Literature
Kamal A El-Atrebi, Hala T El-Bassyouni, Azza Hegazi
Background: Interferon induces ulcerative colitis in chronic HCV patients treated with PegIFN and ribavirin therapy. The aim of the work is to assess the role of interferon in inducing ulcerative colitis in chronic HCV patients treated with PegIFN and ribavirin therapy as well as discussing the management for both ulcerative colitis and HCV. Materials and Methods: The study included four chronic HCV patients, their age ranged from 28-61 years, they were subjected to combination therapy (Peg IFN and ribavirin). All cases developed early gastrointestinal symptoms (4-20 weeks during treatment) comprising loose motions and bloody diarrhea. The diagnosis was established on clinical, laboratory, endoscopy and histology findings. Determination of anti-Saccharomyces cervisae antibodies (ASCA) and perinuclear anti-neutrophil cytoplasmic (p-ANCA) antibodies was performed using indirect immunofluorescence technique and ELISA, respectively. The calprotectin (FC) in stool was estimated. Results: Chronic HCV patients treated with interferon developed ulcerative colitis that was diagnosed by calprotectin in stool and proctosigmoidoscopy or colonoscopy. Colonoscopy showed a picture suggestive of the mild form of ulcerative colitis. The examined biopsies showed the active form of ulcerative colitis. Serologically P-ANCA was positive in two cases and negative in two cases. While ASCA was negative in all patients. Moreover, the calprotectin in stool was positive in all cases. All four cases were treated with mesalazine (5-ASA) 3 g/day in divided doses for the ulcerative colitis for 6 months while they were on Peg IFN and ribavirin for HCV therapy. The bleeding stopped, re-endoscopy and biopsy revealed complete resolution and the patients showed sustained virological response (SVR). Conclusion: Interferon used in treating chronic HCV patients can be considered an initiating factor of ulcerative colitis that can be diagnosed by estimating calprotectin in stool, proctosigmoidoscopy or colonoscopy, and ASCA and P-ANCA. Our study suggests the treatment of ulcerative colitis with 5-ASA in HCV patients treated with combination therapy (IFN and ribavirin) for 6 months after completing HCV treatment.

4. Knowledge, Attitude and Practice Towards Pharmacovigilance and Adverse Drug Reaction Reporting Among Nurses in A Tertiary Care Hospital, Tirupati
R Rajalakshmi, B Vasundara Devi,  T S Durga Prasad, S Swetha, B Dharini
Adverse drug reactions (ADRs) are adverse consequences of drug therapy and are ranked as some of the major causes of patient morbidity and mortality. ADRs are representing a major concern of health systems in terms of early recognition, proper management and prevention. Under reporting of ADRs is a common problem in Pharmacovigilance program and spontaneous reporting is important in improving patient safety. This study was done to evaluate the knowledge, attitude and practice of nurses towards pharmacovigilance and adverse drug reaction reporting. It was a cross-sectional questionnaire based study among the nurses of a tertiary care hospital. A predesigned self-assessed questionnaire evaluating knowledge, attitude and practice was distributed among nursing staff and filled questionnaire were collected and analysed. A total of 101 (73.7%) nurses completed the questionnaire. ADR reporting was considered important by most of the nurses and majority of the nurses had knowledge about serious ADRs (50%). Nurses had very significant and positive attitude towards pharmacovigilance but there is a need for enrichment in knowledge and practice of ADR reporting.

5. Assess the Prevalence of Osteoporosis Among Middle Aged Women in Mamandur
Abirami.P, M. Nithya, K. Priyanka, G. Hemalatha 
Objective: The aim of this study was to determine the prevalence of Osteoporosis among Middle Aged Women and to associate the prevalence of Osteoporosis among Middle Aged Women with their demographic and Clinical variables.Methods: Quantitative approach and non-experimental descriptive research design was used. The data collection included two parts. Part A: Demographic variables, Part B:Clinical Variables, Part C: Standardized rating scale to assess the bone mineral density.A total of 130 middle aged women who fulfilled the inclusion criteria were chosen as samples by using non-probability purposive sampling technique. The study was conducted at Mamandur,Kancheepuram dt. Results: The data were analyzed and interpreted based on the objectives using descriptive and inferential statistics. Among 130 clients , 28 (22%) have normal T- score (< – 1.0); 66(51%) have osteopenia ( – 1.0 to – 2.5 ) ; 36 ( 28%) have osteoporosis ( – 2.6 to – 4.0 ) and there is a statistical significant association on prevalence of osteoporosis among middle aged women with their demographic variables like age and type of family with T – score levels at 95% (P < 0.05). Conclusion: Osteoporosis is an important public health problem leading to an increased risk of developing spontaneous and traumatic fractures. Because of the morbid consequences of osteoporosis, the prevention of this disease and its associated fractures is considered essential to the maintenance of health, quality of life, and independence in the elderly population.