Online project management system

The purpose of this project is to design and create a system that can be used by a wide variety of groups who do projects. The system created has been specifically tailored for a medium-level company that has employees in different locations and levels, and also has customers for whom they do projects

Use of off-label drugs in the neonatal intensive care unit in India

Background: Off-label use of drugs is widespread in pediatrics and almost all neonates hospitalized in NICU are affected by the use of off-label drugs regardless of gestational age and birth weight. This is because of the lack of regulation for medications in the neonatal population and the delays in updating drug instructions. This is mainly due to the ethical difficulty in the research and difficulties in conducting clinical trials in this vulnerable population. Hence, the study was planned to assess the extent of the use of off-label drugs in the NICU. Methods: An observational study was carried out in the NICU of a tertiary care center from May 2021 to Oct 2022 and case records of neonates admitted to the NICU were evaluated. Results: Among 1745 drug prescriptions in 360 neonates, 1208 (69.22%) were off-label. Anti-infectives were the most commonly used off-label class of drug, Piperacillin+tazobactam was the most commonly used off-label drug and most common reason for off-label prescriptions was indication and administration. It was found that 79.44% of neonates received at least one off-label drug. Conclusions: Off-label use of drugs, specifically anti-infective drugs, is common in NICUs of India as in other countries. So, more research should be done to generate evidence-based guidelines for the rational use of drugs in neonates

Knowledge and practices in community regarding antibiotic usage

Background: One of the major causes of concern in medical world is rapid development of antibiotic resistance. World Health Organisation started an initiative in 2011 with a policy designed to curb this danger of antibiotic resistance. This study was designed to know the knowledge, attitude and belief of community regarding antibiotic use so that data can be generated in this region for the proper designing and implementation of awareness campaigns for the community.Methods: A single point cross sectional study was conducted in 1500 adults attending the Out Patient Department of a tertiary care hospital in Northern India. The tool used for the study was a predesigned questionnaire. The data was evaluated using descriptive statistical analysis.Results: In our study 92.8% participants admitted of having used an antibiotic at any time in their lifetime. The most common reason for use of antibiotics was common cold (36.2%). The most common antibiotic used by the participants was amoxycillin. The most common source of information regarding antibiotics and their use (63.2%) was physicians. 78.6% of the participants believed that they have awareness about rational use of antibiotics. 68.6% respondents were of the view that antibiotics are effective against both viral and bacterial infections. 52.3% of the participants believed antibiotics are not safe to use.Conclusions: The existence of a significant gap between practice of antibiotic usage and knowledge about their usage was found prevalently in the community. After noting the results of this study it is believed that there is a dire necessity to take steps to curb the menace of rapid development of resistance to antibiotics.

Patterns and practice of self-medication among children presenting with acute respiratory tract infection or diarrhoea

Background: Self-medication is quite prevalent in many parts of the world and has led to wastage of precious manpower and time due to many adverse consequences. As a result there is great burden on a country both financially as well as health point of view. The purpose of this study was to identify the pattern and practice of self-medication among children presenting with Acute Respiratory Tract Infection or Diarrhoea in a tertiary care hospital of northern India.Methods: A single point cross sectional study was conducted in 500 parents accompanying the children in the Paediatrics out Patient Department (OPD) of a Medical College in Northern India. The tool used for the study was a predesigned questionnaire. The data was evaluated using descriptive statistical analysis.Results: Out of 500 subjects 486 were found eligible for enrolment. Out of these eligible subjects, 308 (63.3%) parents reported history of self-medication. 143 (51.3%) male children were administered self-medication. This number was proportionately higher in females (79.7%). The drug most commonly administered were non-steroidal anti-inflammatory drugs (64.3%) followed by antibiotics and cough and cold preparations. The most common source of drug procurement was the left over drugs from previous treatment (75.2%) followed by purchase from a medical store. Most common reason for self-medication was previous experience with the prescribed drugs (76.6%).Conclusions: The problem of self-medication of prescription only drugs is quite prevalent in this part of the country. As self-medication has its complications and adversities proper orientation and awareness of the population about self-medication is of utmost importance for proper utilization of resources and manpower. Further the government agencies should ensure proper implementation and supervision of laws related to sale of ‘Prescription only drugs’

Management practices for west syndrome in south Asia: A survey study and meta-analysis

Objectives: Considering the dearth of literature on West syndrome (WS) from South Asian countries, this study aimed to evaluate the management practices in South Asia by an online survey and meta-analysis.Methods: An online questionnaire was sent to 223 pediatric neurologists/pediatricians in India, Pakistan, Myanmar, Sri Lanka, Bhutan, Nepal, and Bangladesh. Their responses were evaluated and supplemented by a meta-analysis.Results: Of 125 responses received (response rate: 56%), around 60% of responders observed male preponderance and an approximate lead-time-to-treatment (LTTT) of 4-12 weeks. The commonest etiology observed was a static structural insult (88.6% of responders). Most commonly used first-line drug (country-wise) was as follows: India-adrenocorticotropin hormone (ACTH, 50%); Pakistan-oral steroids (45.5%); Myanmar, Sri Lanka, and Nepal-oral steroids (94.4%); Bangladesh-ACTH (2/2); Bhutan-vigabatrin (3/5). ACTH and vigabatrin are not available in Myanmar and Nepal. The most commonly used regime for ACTH was maximal-dose-at-initiation-regime in India, Sri Lanka, and Bangladesh and gradually escalating-regime in Pakistan. Maximum dose of prednisolone was variable-most common response from India: 3-4 mg/kg/d; Pakistan, Bhutan, and Bangladesh: 2 mg/kg/d; Sri Lanka, Nepal, and Myanmar: 5-8 mg/kg/d or 60 mg/d. The total duration of hormonal therapy (including tapering) ranged from 4 to 12 weeks (67/91). Most responders considered cessation of spasms for four weeks as complete response (54/111) and advised electroencephalography (EEG; 104/123) to check for hypsarrhythmia resolution. Difficult access to pediatric EEG in Bhutan and Nepal is concerning. More than 95% of responders felt a need for more awareness. The meta-analysis supported the preponderance of male gender (68%; confidence interval [CI]: 64%-73%), structural etiology(80%; CI 73%-86%), longer LTTT (2.4 months; CI 2.1-2.6 months), and low response rate to hormonal therapy(18% and 28% for ACTH and oral steroids respectively) in WS in South Asia.Significance: This study highlights the practices and challenges in the management of WS in South Asia. These include a preponderance of male gender and structural etiology, a longer LTTT, difficult access to pediatric EEG, nonavailability of ACTH and vigabatrin in some countries, and low effectiveness of hormonal therapy in this region

Sex differences in oncogenic mutational processes.

Sex differences have been observed in multiple facets of cancer epidemiology, treatment and biology, and in most cancers outside the sex organs. Efforts to link these clinical differences to specific molecular features have focused on somatic mutations within the coding regions of the genome. Here we report a pan-cancer analysis of sex differences in whole genomes of 1983 tumours of 28 subtypes as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium. We both confirm the results of exome studies, and also uncover previously undescribed sex differences. These include sex-biases in coding and non-coding cancer drivers, mutation prevalence and strikingly, in mutational signatures related to underlying mutational processes. These results underline the pervasiveness of molecular sex differences and strengthen the call for increased consideration of sex in molecular cancer research

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts