Introduction: One of the prime causes of infertility is reproductive tract infections as they can produce marked cervical inflammation. These can be seen in Pap smears at various stages as cervical health plays an imperative role in blocking ascending infections. This study assesses infections and related changes in Pap smears from women with infertility and its association with clinical and microbiological findings. Materials and Methods: A prospective observational study was done for 3.5 years. Pap smears of women with infertility were taken, and those showing significant inflammation (>50%) were studied. Relevant history and “per-speculum” findings were noted. Pap smear changes, infections or intraepithelial changes, and lactobacilli were studied. High vaginal swab culture was done, and follow-up conception data were correlated. Results: Almost 50% of women with inflammatory smears showed the presence of an infection; of which the most common was candidiasis followed by bacterial vaginosis. Out of the 12 women whose culture reports were available, 11 showed growth (90%). Most women showed depleted lactobacilli. On follow-up, the conception rate despite assisted reproductive technology was significantly lower in women with Pap smear changes (P = 0.0002). Conclusion: These observations show a strong and significant association between inflammatory Pap smears, infections in the reproductive tract, depleted lactobacilli, and conception. It is advisable that a Pap smear should be done in all cases of infertility to look for infections and inflammation, and a follow-up with high vaginal swab culture should be done in cases where inflammation is detected in a Pap smear. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, Practice-based learning and improvement.
{"title":"Pap smear changes and cervical inflammation in women with infertility in correlation to clinical and microbiological findings","authors":"Arshiya Bose, Mousumi Acharya, Kumudini Panigrahi, Prita Pradhan, Kanakalata Dash","doi":"10.4103/ijam.ijam_39_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_39_22","url":null,"abstract":"Introduction: One of the prime causes of infertility is reproductive tract infections as they can produce marked cervical inflammation. These can be seen in Pap smears at various stages as cervical health plays an imperative role in blocking ascending infections. This study assesses infections and related changes in Pap smears from women with infertility and its association with clinical and microbiological findings. Materials and Methods: A prospective observational study was done for 3.5 years. Pap smears of women with infertility were taken, and those showing significant inflammation (>50%) were studied. Relevant history and “per-speculum” findings were noted. Pap smear changes, infections or intraepithelial changes, and lactobacilli were studied. High vaginal swab culture was done, and follow-up conception data were correlated. Results: Almost 50% of women with inflammatory smears showed the presence of an infection; of which the most common was candidiasis followed by bacterial vaginosis. Out of the 12 women whose culture reports were available, 11 showed growth (90%). Most women showed depleted lactobacilli. On follow-up, the conception rate despite assisted reproductive technology was significantly lower in women with Pap smear changes (P = 0.0002). Conclusion: These observations show a strong and significant association between inflammatory Pap smears, infections in the reproductive tract, depleted lactobacilli, and conception. It is advisable that a Pap smear should be done in all cases of infertility to look for infections and inflammation, and a follow-up with high vaginal swab culture should be done in cases where inflammation is detected in a Pap smear. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, Practice-based learning and improvement.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"44 1","pages":"145 - 150"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuan Nguyen, Eliza Beal, Anthony Gerlach, Ahmad Shabsigh, Syed Husain, Kristin Brower
Introduction: Postoperative urinary retention (POUR) is a complication of surgery defined as the inability to empty a full bladder. POUR can prolong hospital length of stay and increase rates of urinary tract infection in the postoperative period. Risk factors for the development of POUR include male sex, older age, select medications, and certain comorbid conditions. Surgical factors may also increase the risk of POUR. POUR occurs in up to 50% of patients undergoing colorectal surgery. Materials and Methods: This retrospective, single-center cohort study evaluated the incidence of POUR in patients admitted for colorectal surgery and were enrolled in a Colorectal Enhanced Surgical Recovery (CERAS) protocol. Our primary objective was to determine the incidence of POUR in patients treated under the CERAS protocol. Secondary objectives included evaluating the incidence of POUR in patients receiving intrathecal anesthesia. Results: Two hundred and twenty-eight patients were included. Sixty-six patients (28.9%) developed POUR during their hospitalization. Patients who developed POUR were more likely to be male (61.6% vs. 44.4%, P = 0.029) and tended to be older (mean ± standard deviation age, 61.4 ± 17.7 years vs. 56.8 ± 16.4 years; P = 0.069) compared to the non-POUR group. Regional anesthesia did not affect the incidence of POUR. Conclusions: We identified a rate of POUR in our CERAS patients consistent with previous studies. The risk of POUR increased with increasing age, male sex, and history of benign prostatic hyperplasia and diabetes mellitus. We found no difference in POUR incidence with the type of regional anesthesia utilized. The following core competencies are addressed in this article: Practice-Based Learning and Improvement and Medical Knowledge.
简介术后尿潴留（POUR）是一种手术并发症，是指膀胱无法排空。尿潴留会延长住院时间，并增加术后尿路感染的发生率。发生 POUR 的风险因素包括男性、高龄、特定药物和某些合并症。手术因素也会增加发生 POUR 的风险。在接受结肠直肠手术的患者中，POUR的发生率高达50%。材料与方法：这项回顾性单中心队列研究评估了加入结直肠强化手术恢复（CERAS）方案的结直肠手术患者的 POUR 发生率。我们的首要目标是确定在接受 CERAS 方案治疗的患者中 POUR 的发生率。次要目标包括评估接受鞘内麻醉的患者中 POUR 的发生率。结果：共纳入 228 名患者。66名患者（28.9%）在住院期间发生了POUR。与未发生 POUR 的患者组相比，发生 POUR 的患者更可能是男性（61.6% 对 44.4%，P = 0.029），且年龄更大（平均 ± 标准差年龄，61.4 ± 17.7 岁对 56.8 ± 16.4 岁；P = 0.069）。区域麻醉不会影响 POUR 的发生率。结论：我们在 CERAS 患者中发现的 POUR 发生率与之前的研究结果一致。POUR的风险随着年龄、男性、良性前列腺增生和糖尿病病史的增加而增加。我们发现，POUR发生率与所使用的区域麻醉类型没有差异。本文涉及以下核心能力：基于实践的学习与改进和医学知识。
{"title":"Postoperative urinary retention in colorectal surgery patients on an enhanced surgical recovery pathway","authors":"Tuan Nguyen, Eliza Beal, Anthony Gerlach, Ahmad Shabsigh, Syed Husain, Kristin Brower","doi":"10.4103/ijam.ijam_30_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_30_23","url":null,"abstract":"Introduction: Postoperative urinary retention (POUR) is a complication of surgery defined as the inability to empty a full bladder. POUR can prolong hospital length of stay and increase rates of urinary tract infection in the postoperative period. Risk factors for the development of POUR include male sex, older age, select medications, and certain comorbid conditions. Surgical factors may also increase the risk of POUR. POUR occurs in up to 50% of patients undergoing colorectal surgery. Materials and Methods: This retrospective, single-center cohort study evaluated the incidence of POUR in patients admitted for colorectal surgery and were enrolled in a Colorectal Enhanced Surgical Recovery (CERAS) protocol. Our primary objective was to determine the incidence of POUR in patients treated under the CERAS protocol. Secondary objectives included evaluating the incidence of POUR in patients receiving intrathecal anesthesia. Results: Two hundred and twenty-eight patients were included. Sixty-six patients (28.9%) developed POUR during their hospitalization. Patients who developed POUR were more likely to be male (61.6% vs. 44.4%, P = 0.029) and tended to be older (mean ± standard deviation age, 61.4 ± 17.7 years vs. 56.8 ± 16.4 years; P = 0.069) compared to the non-POUR group. Regional anesthesia did not affect the incidence of POUR. Conclusions: We identified a rate of POUR in our CERAS patients consistent with previous studies. The risk of POUR increased with increasing age, male sex, and history of benign prostatic hyperplasia and diabetes mellitus. We found no difference in POUR incidence with the type of regional anesthesia utilized. The following core competencies are addressed in this article: Practice-Based Learning and Improvement and Medical Knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"75 1","pages":"151 - 155"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Dash, Sunil Jena, Pritam Chhotray, S. Panda, Shakti Mishra, Biswajit Nayak
Introduction: Aggressive fluid replacement is done in septic shock to compensate for the decreased stressed volume in view of peripheral vasodilatation. However, excessive fluid administration may lead to fluid overload, edema formation, and organ damage such as renal congestion and acute kidney injury. Hence, this study was conducted to estimate the effect of fluid balance in the 1st week of septic shock on mortality. Materials and Methods: We conducted a retrospective analysis of the use of intravenous fluids and cumulative fluid balance (CFB) during the first 7 days of septic shock in a 25-bed multidisciplinary intensive care unit (ICU) in Northern India at a tertiary care teaching hospital. Results: Based on the CFB, we classified patients as low CFB when CFB is <20 mL/kg and high CFB when it is >20 mL/kg. The 28-day mortality in the low CFB group was 4.7% and in the high CFB group 26.15%, which was statistically significant. With an odds ratio of 7.17, CFB in septic shock was a predictor of ICU mortality (confidence interval of 3.87–13). The length of stay between the two groups was also found to be statistically significant (11.7 ± 3.2 vs. 12.6 ± 3.8; P = 0.02). Conclusions: In patients with septic shock, a higher CFB on day 7 of ICU admission is independently associated with an increased risk of mortality and a longer ICU stay. The following core competencies are addressed in this article: Practice-based learning and improvement, Medical knowledge.
{"title":"Association between cumulative fluid balance and clinical outcome in patients with septic shock: A retrospective observational study","authors":"A. Dash, Sunil Jena, Pritam Chhotray, S. Panda, Shakti Mishra, Biswajit Nayak","doi":"10.4103/ijam.ijam_27_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_27_23","url":null,"abstract":"Introduction: Aggressive fluid replacement is done in septic shock to compensate for the decreased stressed volume in view of peripheral vasodilatation. However, excessive fluid administration may lead to fluid overload, edema formation, and organ damage such as renal congestion and acute kidney injury. Hence, this study was conducted to estimate the effect of fluid balance in the 1st week of septic shock on mortality. Materials and Methods: We conducted a retrospective analysis of the use of intravenous fluids and cumulative fluid balance (CFB) during the first 7 days of septic shock in a 25-bed multidisciplinary intensive care unit (ICU) in Northern India at a tertiary care teaching hospital. Results: Based on the CFB, we classified patients as low CFB when CFB is <20 mL/kg and high CFB when it is >20 mL/kg. The 28-day mortality in the low CFB group was 4.7% and in the high CFB group 26.15%, which was statistically significant. With an odds ratio of 7.17, CFB in septic shock was a predictor of ICU mortality (confidence interval of 3.87–13). The length of stay between the two groups was also found to be statistically significant (11.7 ± 3.2 vs. 12.6 ± 3.8; P = 0.02). Conclusions: In patients with septic shock, a higher CFB on day 7 of ICU admission is independently associated with an increased risk of mortality and a longer ICU stay. The following core competencies are addressed in this article: Practice-based learning and improvement, Medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"10 1","pages":"121 - 125"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Kalabharathi, Ayesha Mariam, V. Doddawad, S. Shivananda, C. Sanjay
Introduction: The aim of this study was to examine the anticonvulsant properties of an ethanolic extract derived from the leaves of Harpagophytum procumbens (commonly known as devil's claw) in Swiss albino mice. Materials and Methods: The ethanolic extract of H. procumbens leaves (EHPL) was administered orally at doses of 400 and 800 mg/kg body weight, and two animal models were used to assess its anticonvulsant activity: the maximal electroshock (MES) and pentylenetetrazole (PTZ) models of convulsions. The duration of tonic phase of hind limb extension and extended seizure latency period were recorded. Results: The results showed that the EHPL at a dosage of 400 mg/kg significantly reduced the duration of tonic convulsions in the hind limbs in the MES-induced seizures model, while EHPL at 800 mg/kg significantly increased the latency period of clonic convulsions in the PTZ-induced seizures model. Conclusion: These findings suggest that EHPL may be useful in managing grand mal epilepsy and absence seizures as it displayed significant antiepileptic activity in both models at 400 and 800 mg/kg p.o. The study is important as it will help to identify new sources of anticonvulsant drugs and contribute to the development of alternative treatment options for seizure disorders. The following core competencies are addressed in this article: Medical knowledge.
{"title":"Evaluation of anticonvulsant activity of Harpagophytum procumbens leaves (Devil's claw) in Swiss albino mice","authors":"H. Kalabharathi, Ayesha Mariam, V. Doddawad, S. Shivananda, C. Sanjay","doi":"10.4103/ijam.ijam_32_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_32_23","url":null,"abstract":"Introduction: The aim of this study was to examine the anticonvulsant properties of an ethanolic extract derived from the leaves of Harpagophytum procumbens (commonly known as devil's claw) in Swiss albino mice. Materials and Methods: The ethanolic extract of H. procumbens leaves (EHPL) was administered orally at doses of 400 and 800 mg/kg body weight, and two animal models were used to assess its anticonvulsant activity: the maximal electroshock (MES) and pentylenetetrazole (PTZ) models of convulsions. The duration of tonic phase of hind limb extension and extended seizure latency period were recorded. Results: The results showed that the EHPL at a dosage of 400 mg/kg significantly reduced the duration of tonic convulsions in the hind limbs in the MES-induced seizures model, while EHPL at 800 mg/kg significantly increased the latency period of clonic convulsions in the PTZ-induced seizures model. Conclusion: These findings suggest that EHPL may be useful in managing grand mal epilepsy and absence seizures as it displayed significant antiepileptic activity in both models at 400 and 800 mg/kg p.o. The study is important as it will help to identify new sources of anticonvulsant drugs and contribute to the development of alternative treatment options for seizure disorders. The following core competencies are addressed in this article: Medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"3 1","pages":"132 - 137"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Archana Buch, Mangesh Londhe, Tushar Patil, Hetal Rathod, S. Dhaliwal, C. Gore
Introduction: The liquid-based cytology (LBC) has shown significant advantages over conventional preparation in cervical cytology. The use of LBC in aspiration and exfoliative nongynecologic cytology has been on the rise since the last few years with relatively few studies being available depicting its role in fine-needle aspiration cytology (FNAC) from other sites. The study aimed to determine the diagnostic efficacy of LBC in nongynecological exfoliative as well as FNAC samples and compare the conventional and LBC methods for cytomorphological differences. Materials and Methods: This is a cross-sectional, analytical study that included the samples collected from two tertiary care centers over 8 months (January 2022 to August 2022). A total of 168 consecutive samples of aspiration and exfoliative nongynecological cytology were included. In each case, two passes were carried out one for a conventional smear (CS) and the other for LBC by Eziprep/Thin Prep (TP) method followed by smear staining with H and E stain and Leishman's stain. The slides were studied by two observers for cellularity, background (blood and necrotic cell debris), informative background (such as colloid, stromal fragments, etc.), presence of monolayer cells, and cell architecture with nuclear and cytoplasmic details by a semiquantitative scoring system. Statistical analysis was performed using Wilcoxon signed-rank test on the SPSS program and histopathology correlation was attempted wherever available by using OpenEpi software version 3. Results: The mean age was 40 years, with the majority being females (70%). The TP smears were qualitatively superior to CS with statistical differences observed in fluid cytology. There was no statistical difference observed at other sites; except TP being superior to CS with regard to the background in breast cytology. The arithmetic mean in TP was higher than CS in all the parameters. Conclusions: The cytology smears of TP were qualitatively superior to CS in aspiration and nongynecological cytology. Overall diagnostic accuracy was comparable in both techniques. The core competencies addressed in this article are: Medical knowledge, Procedural skills, Practice-based learning and improvement, and Professionalism.
{"title":"Comparison of liquid-based cytology and conventional preparations in nongynecological cytology","authors":"Archana Buch, Mangesh Londhe, Tushar Patil, Hetal Rathod, S. Dhaliwal, C. Gore","doi":"10.4103/ijam.ijam_25_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_25_23","url":null,"abstract":"Introduction: The liquid-based cytology (LBC) has shown significant advantages over conventional preparation in cervical cytology. The use of LBC in aspiration and exfoliative nongynecologic cytology has been on the rise since the last few years with relatively few studies being available depicting its role in fine-needle aspiration cytology (FNAC) from other sites. The study aimed to determine the diagnostic efficacy of LBC in nongynecological exfoliative as well as FNAC samples and compare the conventional and LBC methods for cytomorphological differences. Materials and Methods: This is a cross-sectional, analytical study that included the samples collected from two tertiary care centers over 8 months (January 2022 to August 2022). A total of 168 consecutive samples of aspiration and exfoliative nongynecological cytology were included. In each case, two passes were carried out one for a conventional smear (CS) and the other for LBC by Eziprep/Thin Prep (TP) method followed by smear staining with H and E stain and Leishman's stain. The slides were studied by two observers for cellularity, background (blood and necrotic cell debris), informative background (such as colloid, stromal fragments, etc.), presence of monolayer cells, and cell architecture with nuclear and cytoplasmic details by a semiquantitative scoring system. Statistical analysis was performed using Wilcoxon signed-rank test on the SPSS program and histopathology correlation was attempted wherever available by using OpenEpi software version 3. Results: The mean age was 40 years, with the majority being females (70%). The TP smears were qualitatively superior to CS with statistical differences observed in fluid cytology. There was no statistical difference observed at other sites; except TP being superior to CS with regard to the background in breast cytology. The arithmetic mean in TP was higher than CS in all the parameters. Conclusions: The cytology smears of TP were qualitatively superior to CS in aspiration and nongynecological cytology. Overall diagnostic accuracy was comparable in both techniques. The core competencies addressed in this article are: Medical knowledge, Procedural skills, Practice-based learning and improvement, and Professionalism.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"14 1","pages":"126 - 131"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allincia Michaud, Maria Martinez-Baladejo, Rachel Birk, Anna Ng-Pellegrino
{"title":"The 2023 St. Luke's University Health Network Annual Research Symposium: Event highlights and scientific abstracts","authors":"Allincia Michaud, Maria Martinez-Baladejo, Rachel Birk, Anna Ng-Pellegrino","doi":"10.4103/ijam.ijam_61_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_61_23","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"2 1","pages":"156 - 176"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stanislaw Stawicki, Maria Martinez-Baladejo, Anna Ng-Pellegrino
{"title":"What's new in academic international medicine? Artificial intelligence and machine learning is here to stay, forcing rapid adoption and adaptation","authors":"Stanislaw Stawicki, Maria Martinez-Baladejo, Anna Ng-Pellegrino","doi":"10.4103/ijam.ijam_63_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_63_23","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"59 1","pages":"117 - 120"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deeksha Saxena, Anju Sharma, Mohammed Siddiqui, Rajnish Kumar
Introduction: The blood–brain barrier (BBB) is a semipermeable border that is responsible for maintaining central nervous system (CNS) homeostasis in the brain. Screening compounds based on their BBB permeability is an important consideration for CNS-acting drug development. Several studies have attempted to link physicochemical properties to specific BBB permeability; however, there is no widely accepted rule that can determine how and to what extent molecular properties affect the BBB permeability of compounds. To understand the complex phenomenon of BBB permeability, we explored the vast molecular space of the compounds to determine whether some features could differentiate the compounds based on their BBB permeability. Materials and Methods: A dataset of 1951 compounds containing 1246 BBB-permeable and 705 BBB-nonpermeable molecules was used in the study. Each compound encoded 499 molecular features. Feature selection was performed using feature selection algorithms, feature-to-feature, and feature-to-permeability correlation analysis. The findings of the feature selection algorithms were merged to select the best set of 53 features. Results: The descriptive analysis of the molecular features suggests that nCXr (number of X on ring C[sp3]) feature values for BBB nonpermeable compounds are zero for all considered compounds except for compounds with PubChem ID 71260, Flurithromycin. In addition, the majority of compounds were found to have nCrq (number of ring quaternary C[sp3]) feature values of zero for BBB nonpermeable compounds. For BBB-permeable compounds, MACCS fingerprints 8 feature values for all 1951 compounds were found to be zero except for the compound with PubChem ID 146291, Dezinamide. Conclusion: The descriptive and nonparametric tests confirm that molecular feature distributions are significantly different for BBB permeable and BBB nonpermeable compounds. The following core competencies are addressed in this article: Medical knowledge.
{"title":"Investigating molecular features that influence blood − brain barrier permeability of compounds","authors":"Deeksha Saxena, Anju Sharma, Mohammed Siddiqui, Rajnish Kumar","doi":"10.4103/ijam.ijam_13_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_13_23","url":null,"abstract":"Introduction: The blood–brain barrier (BBB) is a semipermeable border that is responsible for maintaining central nervous system (CNS) homeostasis in the brain. Screening compounds based on their BBB permeability is an important consideration for CNS-acting drug development. Several studies have attempted to link physicochemical properties to specific BBB permeability; however, there is no widely accepted rule that can determine how and to what extent molecular properties affect the BBB permeability of compounds. To understand the complex phenomenon of BBB permeability, we explored the vast molecular space of the compounds to determine whether some features could differentiate the compounds based on their BBB permeability. Materials and Methods: A dataset of 1951 compounds containing 1246 BBB-permeable and 705 BBB-nonpermeable molecules was used in the study. Each compound encoded 499 molecular features. Feature selection was performed using feature selection algorithms, feature-to-feature, and feature-to-permeability correlation analysis. The findings of the feature selection algorithms were merged to select the best set of 53 features. Results: The descriptive analysis of the molecular features suggests that nCXr (number of X on ring C[sp3]) feature values for BBB nonpermeable compounds are zero for all considered compounds except for compounds with PubChem ID 71260, Flurithromycin. In addition, the majority of compounds were found to have nCrq (number of ring quaternary C[sp3]) feature values of zero for BBB nonpermeable compounds. For BBB-permeable compounds, MACCS fingerprints 8 feature values for all 1951 compounds were found to be zero except for the compound with PubChem ID 146291, Dezinamide. Conclusion: The descriptive and nonparametric tests confirm that molecular feature distributions are significantly different for BBB permeable and BBB nonpermeable compounds. The following core competencies are addressed in this article: Medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"22 1","pages":"138 - 144"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bansal, Punam Jakhar, K. Trivedi, Nidhi Bansal, Smita Jain, N. Sharma
Introduction: The World Health Organization (WHO) recommends quality-based “AWaRe classification of antibiotics” for the monitoring of antimicrobial consumption. It classifies commonly used antimicrobials into five main categories: Access, Watch, Reserve, Not-recommended (NR), and Others. At least 60% of total consumption should be from the Access category and <10% should be from the Reserve category to minimize the further development of resistance. However, we do not know how these recommendations compare with current trends in antimicrobial consumption in India. Hence, a study was planned to statistically evaluate the AWaRe classification-based trend of antimicrobial consumption over 5 years. Materials and Methods: A retrospective study was conducted to retrieve the antimicrobial consumption data of SMS Hospital, Jaipur, from January 2017 to December 2021 as per AWaRe classification. Regression and statistical process control analysis was carried out separately for all five categories of antimicrobials on MATLAB 2016a (9.0.0.341360). Results: Regression analysis revealed that the consumption of Access, NR, and Others significantly decreased while that of Watch and Reserve increased between 2017 and 2021. Statistical process control analysis showed that the use of Access, Watch, and Others was within prescribed statistical limits but that of Reserve and NR was higher than statistical thresholds at times. Conclusion: The increased consumption of Watch and Reserve antimicrobials combined with surpassing of upper control limit by Reserve and NR antimicrobials at certain times raises concern. Hence, there is an acute need to take measures to generate awareness about the incorporation of the WHO recommendations in practice to support the antimicrobial stewardship program. The core competencies addressed in this article are: Medical knowledge, Systems-based practice, Practice-based learning and improvement, Professionalism.
{"title":"Use of a regression model and a statistical process control method to assess AWaRe classification-based antimicrobial consumption in an Indian tertiary care hospital over 5 years","authors":"A. Bansal, Punam Jakhar, K. Trivedi, Nidhi Bansal, Smita Jain, N. Sharma","doi":"10.4103/ijam.ijam_77_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_77_22","url":null,"abstract":"Introduction: The World Health Organization (WHO) recommends quality-based “AWaRe classification of antibiotics” for the monitoring of antimicrobial consumption. It classifies commonly used antimicrobials into five main categories: Access, Watch, Reserve, Not-recommended (NR), and Others. At least 60% of total consumption should be from the Access category and <10% should be from the Reserve category to minimize the further development of resistance. However, we do not know how these recommendations compare with current trends in antimicrobial consumption in India. Hence, a study was planned to statistically evaluate the AWaRe classification-based trend of antimicrobial consumption over 5 years. Materials and Methods: A retrospective study was conducted to retrieve the antimicrobial consumption data of SMS Hospital, Jaipur, from January 2017 to December 2021 as per AWaRe classification. Regression and statistical process control analysis was carried out separately for all five categories of antimicrobials on MATLAB 2016a (9.0.0.341360). Results: Regression analysis revealed that the consumption of Access, NR, and Others significantly decreased while that of Watch and Reserve increased between 2017 and 2021. Statistical process control analysis showed that the use of Access, Watch, and Others was within prescribed statistical limits but that of Reserve and NR was higher than statistical thresholds at times. Conclusion: The increased consumption of Watch and Reserve antimicrobials combined with surpassing of upper control limit by Reserve and NR antimicrobials at certain times raises concern. Hence, there is an acute need to take measures to generate awareness about the incorporation of the WHO recommendations in practice to support the antimicrobial stewardship program. The core competencies addressed in this article are: Medical knowledge, Systems-based practice, Practice-based learning and improvement, Professionalism.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"53 - 59"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44447504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The need for bilateral collaborations between the Global North and Global South to mitigate parasitic disease burden in the United States","authors":"Shilah Waters, Roberta L. Gilman","doi":"10.4103/ijam.ijam_38_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_38_23","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"35 - 38"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41633175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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