Background & Aims: Adverse Drug Reactions (ADRs) are common with drug treatment. They can be collected by active and passive methods. The aim of the study was to compare active and passive ADR ...monitoring methods in terms of yield and lag period in category I tuberculosis patients. Materials & Methods: A prospective observational analytical study was done in a directly observed therapy short-course (DOTS) center and pharmacovigilance center of SMS hospital, Jaipur, Rajasthan, India from 1.1.2019 to 31.12.2019. A total of 303 category I tubercular patients on DOTS were divided into groups A (150) and B (153). Group A (active) patients were interviewed personally or telephonically for ADRs on 0,3,7,15,30, 90,180 days of therapy as per pre-structured & pre-validated questionnaire. Group B (passive) patients were asked to report ADRs themselves to pharmacovigilance center directly or through a drop box. Collected ADRs were compared statistically using software Minitab 14, Pennsylvania, USA. Results: The yield of ADRs in active method was 4.5 times higher than the passive method. GIT related ADRs were similar in both groups, cutaneous were higher in active and CNS concerned were higher in passive method. However, consistency of ADR reporting was more in passive method. Mean lag period between onset and reporting of ADRs by active and passive methods were 5.72 and 22.4 days, respectively. Conclusion: Active method initially and numerically facilitates ADR reporting together with decreased lag period but passive method gives consistent yield in chronic diseases like TB, hence, an integrated approach to identify and manage ADRs will be most beneficial for patients.
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A novel, potent series of glucagon receptor antagonists (GRAs) was discovered. These indazole- and indole-based compounds were designed on an earlier pyrazole-based GRA lead MK-0893. ...Structure–activity relationship (SAR) studies were focused on the C3 and C6 positions of the indazole core, as well as the benzylic position on the N-1 of indazole. Multiple potent GRAs were identified with excellent in vitro profiles and good pharmacokinetics in rat. Among them, GRA 16d was found to be orally active in blunting glucagon induced glucose excursion in an acute glucagon challenge model in glucagon receptor humanized (hGCGR) mice at 1, 3 and 10mg/kg (mpk), and significantly lowered acute glucose levels in hGCGR ob/ob mice at 3mpk dose.
Connective tissue nevi of the skin are benign hamartomatous lesions consisting predominantly of one of the components of the extracellular matrix comprising of collagen, elastin or glycosaminoglycans ...type. Connective tissue nevi may be solitary or multiple, sporadic or inherited. Collagenomas are asymptomatic and usually occurs over upper trunk, arms, back, thighs and soles. We, hereby report a young boy with collagenoma over the scalp, a rare site.
There is paucity of scientific literature regarding the clinical outcome of long lasting basal insulin and rapid acting mealtime insulin regimes in surgical situations although employed in ...non-surgical situations. This study has evaluated the clinical outcome of two subcutaneous split-mixed Glargine+Lispro and Detemir+Aspart insulin regimes in type 2 diabetics undergoing surgery.
Pre-operative glucose control with subcutaneous insulin in non-urgent situations is logical and well accepted. But the best regimen amongst the many available ones of insulin administration during ...peroperative period during major surgery is uncertain. We compared three subcutaneous insulin regimens for pre-operative glucose control in type 2 diabetes mellitus (T2DM) patients. One hundred and seventy-two T2DM patients hospitalised for major surgeries were enrolled in the study. Pre-operative glycaemic control was achieved with one of the following regimens: (1) Premix 30/70 insulin (R/N-0-R/N). (2) R + NPH; basal-bolus regular and NPH insulin (R-R-R/N). (3) R + G; basal-bolus regular and glargine insulin (R-R-R-G) G: glargine insulin; N: neutral protamine hagedorn insulin; R: regular insulin. Insulin doses were adjusted to achieve fasting and postmeal glucose values respectively <120 and <180 mg/dl. Intra-operative management included glucose insulin potassium solution. Postoperatively, patients were switched back to the same insulin regimen that they received pre-operatively. These regimens were compared for following parameters. (1) Time to achieve glycaemic target. (2) Total daily insulin dose. (3) Incidence of hypo- and severe hyperglycaemia. (4) Complications like renal failure, infection, etc. (5) in hospital mortality. R + G regimen was associated with lesser dose of insulin (29.53 +/- 9.83 versus 35.67 +/- 12.19 and 37.42 +/- 13.5 unit respectively for regimen 2 and 1, p < 0.005), lesser time to achieve glycaemic target (6.75 +/- 3.25 versus 7.37 +/- 7.47 and 8.23 +/- 6.04 days, p > 0.05), lower incidence of hypoglycaemia (10.53 versus 14.81 and 30.00%, p < 0.02) and severe hyperglycaemia (5.26 versus 29.63 and 8.33%, p < 0.005). Incidence of infection (10.53 versus 18.52 and 15.00%, p > 0.05), renal complications (10.53 versus 11.11 and 15.00%, p > 0.05) and mortality (5.26 versus 14.81 and 15.00%, p > 0.05) were lower with this regimen, but the difference was not statistically significant. Premix 30/70 and R + NPH regimens were comparable for most parameters but hypoglycaemia and severe hyperglycaemia were more frequent respectively with premix 30/70 and R + NPH regimens. In contrast to the popular perception about the risk of hypoglycaemia with long acting insulins, insulin analogue glargine was found to be better than NPH insulin in basal bolus regimens in achieving better glycaemic control with fewer incidence of hypoglycaemia.
This paper reports the synthesis and SAR of LF inhibitors. Compound
40 is potent against LF (IC
50 54
nM) and efficacious in animals studies against anthrax spore challenges.
A potent and selective ...anthrax LF inhibitor
40, (2
R)-2-(4-fluoro-3-methylphenyl)sulfonylamino-
N-hydroxy-2-(tetrahydro-2
H-pyran-4-yl)acetamide, was identified through SAR study of a high throughput screen lead. It has an IC
50 of 54
nM in the enzyme assay and an IC
50 of 210
nM in the macrophage cytotoxicity assay. Compound
40 is also effective in vivo in several animal model studies.
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