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BACKGROUND: Warfarin, anticoagulant is used for thromboembolic disorders. Inter-individual variation in clinical response to warfarin is due to various factors, including polymorphism of Vitamin K epoxide reductase complex 1 (VKORC1)-1639G>A. The aim of our study was to evaluate the effect of VKORC1 polymorphism on the maintenance dose of warfarin. MATERIALS AND METHODS: Cross-sectional study conducted by the departments of Pharmacology, Cell Biology and Molecular Genetics on patients attending cardiology clinic, receiving warfarin for at least 2 months. Genomic deoxyribonucleic acid was extracted and genotyping was done by Polymerase Chain Reaction - Restriction Fragment Length Polymorphism. The correlation between VKORC1 gene polymorphism and warfarin maintenance dose was analyzed. RESULTS: A total of 102 patients with a mean age of 47.72 ± 10.31 years, of which 58 (56.86%) were male. The frequency of VKORC1 G>A for GG, GA, and AA genotypes was 74.51%, 19.61%, and 5.88%, respectively. Variant allele AA was less frequent than the wild type. Mean weekly warfarin dose was 23.12 ± 8.08, 22.93 ± 8.21, and 15.6 ± 5.35 mg in patients with GG, GA, and AA genotypes, respectively. Patients with GG genotype required therapeutic dose compared to variant type (P = 0.001). Multiple stepwise regression model showed 26.3% variability in warfarin dose was due to VKORC1 genotype (R = 0.513, R2 = 0.263, adjusted R2 = 0.256, P = 0.0001). CONCLUSION: VKORC1 polymorphism alone influence 26.3% variability in warfarin dose and AA genotype patients required lower dose.
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Molecules and combinations of molecules are the natural communication currency of microbes; microbes have evolved and been engineered to sense a variety of compounds, often with exquisite sensitivity. The availability of microbial biosensors, combined with the ability to genetically engineer biological circuits to process information, make microbes attractive bionanomachines for propagating information through molecular communication (MC) networks. However, MC networks built entirely of biological components suffer a number of limitations. They are extremely slow due to processing and propagation delays and must employ simple algorithms due to the still limited computational capabilities of biological circuits. In this work, we propose a hybrid bio-electronic framework which utilizes biological components for sensing but offloads processing and computation to traditional electronic systems and communication infrastructure. This is achieved by using tools from the burgeoning field of optogenetics to trigger biosensing through an optoelectronic interface, alleviating the need for computation and communication in the biological domain.
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Gynecomastia is benign enlargement of male breast, drug-induced gynecomastia accounts for about 25%. We are reporting a case of spironolactone-induced unilateral gynecomastia. A 52-year-old male patient receiving multiple antihypertensives including hydrochlorothiazide presented with muscle weakness and easy fatigability. Investigations revealed hypokalemia; he was advised to stop hydrochlorothiazide and consume potassium-rich diet; since he did not respond to this, spironolactone was added. The patient improved symptomatically but developed painful swelling of the right breast after 12 months of treatment which was suspected to be spironolactone-induced gynecomastia. Within a month of stopping the drug, pain in the right breast subsided followed by decrease in size of swelling. Literature search indicates bilateral gynecomastia by spironolactone, but when clinician encounters unilateral presentation, they should consider the possibility of drug-induced etiology. Patients should be educated about this while prescribing, and eplerenone can be a safe alternative.
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INTRODUCTION: Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child. AIM: To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain. MATERIALS AND METHODS: Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia. Severity of pain was assessed using Visual Analogue Scale (VAS) and side-effects to study drugs were noted. Rescue analgesic butorphanol 2mg was administered if VAS score was more than four. Patient's satisfaction score was assessed at 12 hours post-operatively. RESULTS: Mean age in piroxicam and tramadol groups were 23.32±3.43 and 22.03±2.0 years respectively. Significant reduction in pain was observed at 2, 4, 8, 12 and 24 hours in both groups (p<0.001). Pain relief was significant at 2, 4 and 8 hours in piroxicam group compared to tramadol. Twenty-one and 12 patients in tramadol and piroxicam groups received rescue analgesic respectively. Sedation and nausea was significantly higher in tramadol group (p<0.001), 46.66% of patients graded their satisfaction score as good and 15% as excellent in piroxicam group. CONCLUSION: Intra-muscular piroxicam was effective in reducing post-caesarean section pain for 24 hours with minimal side-effects compared to tramadol.
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OBJECTIVE: The objective of the following study was to assess the knowledge, practice, perception and adverse reactions among hair dye users. SETTINGS AND DESIGN: A cross-sectional study was conducted on patients, their attenders and staff of SDUMC. MATERIALS AND METHODS: A questionnaire (28) pertaining to use of hair dyes and reactions to them was administered randomly. STATISTICAL ANALYSIS: The demographic data are expressed as mean ± standard deviation, quantitative data expressed as percentages. RESULTS: A total of 263 volunteers responded of which 52.5% and 47.5% were females and males respectively with mean age of 32.40 ± 6.01 years. The participants started using hair dye at an age of 27 (±3.63) years. Synthetic dyes were used by 91%. Frequency of use in a year was 2-5 times in 51%. Instruction of the package insert was followed by 63.5%. Skin test was never performed in 34% prior to their use. Nearly 96% expressed hair dyeing was unsafe during pregnancy, lactation and in children. Adverse reactions were reported by 42%, with headache (63%) and itching (38%) being the most common. CONCLUSION: Hair dyeing was started at very early age. Majority used semi-permanent dyes even though they perceived natural dyes were safe. They continued dyeing despite adverse reactions, which indicates cosmetic importance.
