Generic Name Research Articles

ASPECTS OF THE USE OF ANTIDIABETIC DRUGS IN PHARMACEUTICAL PRACTICE ON THE BASIS OF RATIONAL PHARMACOTHERAPY

The aim of the article. To study of the incidence of diabetes mellitus in Ukraine and to determine the prospects for the use and pharmaceutical development of antidiabetic drugs. Materials and methods. Data from the State Registers of Medicinal Products of Ukraine, of Wholesale and Retail Prices for Medicinal Products declared in Ukraine under an international non-proprietary or generic name (01.01.2024). Were used: systematic and comparative analysis, processing and synthesis, and generalization to determine the forecasted prospects. Results. In Ukraine the number of diabetes patients increased by 11% in the group of children and adolescents; in the group of elderly patients – by 12.5%, among the adult working – 20%, diabetes of the II type predominates. The trend of increase in the number of studies on the search for therapeutic alternatives for the treatment of type II diabetes and list of medicines on the pharmaceutical market has been revealed. In Ukraine drugs for oral use include APIs of the following pharmacological groups: sulfonylureas; meglitinides; biguanides; thiazolidinedione; α-glucosidase inhibitors; DPP-4 inhibitors; SGLT-2 inhibitors. Mechanism of action of the new class of oral hypoglycemic agents, approved by the FDA, consists in blocking SGLT-2 proteins from the proximal convoluted tubule in the kidney, leads to the prevention of reabsorption and excretion of the glucose molecule. This allows its use in combination with insulin and other antidiabetic drugs for the treatment of type I and II diabetes in patients of various age categories. According to the volume of clinical studies, SGLT-2 inhibitor SGLT-2 derivative gliflozin API drugs are the second largest group of antidiabetic drugs recommended for use by FDA and EMA regulatory bodies. Conclusions. The pharmaceutical development of mono and combined drugs with APIs SGLT-2 inhibitors gliflozin derivatives in combination with APIs with metformin, DPP-4 inhibitors, APIs thiazolidinedione derivatives is promising for solving the problem of diabetes treatment and prevention of complications for patients of different age groups including working population in Ukraine.

Reviewing forgotten “Pre‐Linnaean” generic names validly published in the third volume of Diderot and d'Alembert's Encyclopédie in 1753

AbstractThis paper presents a comprehensive review of previously overlooked names published in the third volume of the Encyclopédie by Diderot and d'Alembert in 1753. These names primarily originate from Tournefort's pre‐Linnaean work, including textual copies of Tournefort's descriptions. We identified 21 names as having been validly published. Notably, among these are five generic names (Castanea, Chamaemelum, Chrysanthemoides, Citreum, Cydonia) wherein the taxonomic authorship shifts from Miller to Daubenton according to priority. Consequently, by our typifications, Miller's names from 1754 are later isonyms. Additionally, the generic name Chamaebuxus takes priority over Polygaloides. As a result, we propose a new combination, Chamaebuxus paucifolia and designate types for 31 generic names and isonyms: Caprifolium, Castanea, Chamaebuxus, Chamaecerasus, Chamaemelum, Chamaerhododendros, Chrysanthemoides, Cichorium, Cicuta, Cicutaria, Clandestina, Clymenum, Colocynthis, Citreum, Clematitis, Coa, Comaroides, Cydonia, Gramen, Scorpioides, and Sisarum, and lectotypes for two species names: Chamaebuxus paucifolia and Polygala uniflora.

Prescription Pattern of Cholelithiasis at Surgery Ward in Tertiary Care Hospital

Background: Cholelithiasis is a chronic recurrent disease of the hepatobiliary system. The impaired metabolism of cholesterol, bile acids and bilirubin are characterized by gallstone formation.The number of surgical procedures for cholelithiasis has risen markedly in developed countries since 1950. An estimated 90% of cholecystectomies are now performed by the laparoscopic approach worldwide. Objectives: The aim of the study was to study prescription pattern of Cholelithiasis at surgery ward in B&C medical college teaching hospital and research Centre Pvt. Ltd. Materials and Methods: A Retrospective study was conducted and data of Cholelithiasis cases admitted at Surgery ward from 2077/01/01 BS to 2077/12/31 BS were collected. Coding of data , result and interpretation of data were drawn using SPSS version 16 and MS Excel 2016 . Result: The present study included 137 patients.Among them,80.3% were females and 19.7% were males. The high incidence of cholelithiasis was found in the age group 30-39 years (27%). 98.5% of total hospitalized patient were prescribed with antibiotics followed by Proton Pump inhibitors (93.4%) and NSAIDS(92%) .Among antibiotics, Ceftriaxone (65.7%) were the most prescribed one. During discharge , antibiotics (98.5%) were the most prescribed group of medicine followed by Proton Pump Inhibitors (88.3%) and NSAIDS(67.9%). And among antibiotics, Cefixime (52.6%) were mostly prescribed. While analyzing prescription pattern of discharge medication it was found that percentage of drugs prescribed by generic name was 13.86% and percentage of drugs prescribed from essential drug list was 43.36%. Conclusion: The present study revealed that there was greater incidence of Cholelithiasis in females (80.3%) than in males and in the age group 30-39 years (27%) .The results obtained from this study showed that most commonly prescribed medicines were antibiotics. Prescription through generic name and essential drug list was low. Therefore, prioritization on prescribing drugs by generic name and from essential drug list needs to be encouraged.

Rising cases of drug-induced pulmonary fibrosis: Analysis of the Food and Drug Administration Adverse Event Reporting System (FAERS) database, 2000-2022.

Pulmonary fibrosis (PF) is a severe, progressive disease, which may be caused by exposure to certain medications. We queried the U.S. FDA Adverse Event Reporting System (FAERS) from 2000 to 2022, using the search terms "pulmonary fibrosis" and "idiopathic pulmonary fibrosis" and excluded reports with patients under the age of 18 years, and patients with unknown sex or age. Reports were sorted by generic drug names, counted, and plotted over time using a best-fit trendline based on an exponential function. From 2000 to 2022, there were 24 095 935 adverse drug events reported in FAERS, of which 17 520 (0.07%) were reported as PF. After excluding reports containing patients with unknown age (5255, 30%), sex (122, 0.7%), and age below 18 years old (155, 0.9%), our study included 11 988 reports. The mean age of the study sample was 66.5 ± 13.1 years, and 6248 patients (52.1%) were male. Plotting the 11 988 reports by year revealed an exponential best fit line (R2 = 0.88) with a positive slope over time. The top five drug classes associated with PF were disease modifying antirheumatic drugs (DMARDs, 39.4%), antineoplastic agents (26.4%), cardiovascular agents (12.6%), corticosteroids (4.6%), and immunosuppressive agents (4.0%). A 23-year analysis of the FAERS database revealed exponentially increasing adverse event reports of PF. Significant annual increases in reporting of PF suspected with DMARDs and antineoplastic agents were identified. Our study highlights important trends, which should be used to guide PF research related to drugs of potential importance.

Retrospective Study on Prescription Pattern on the Management of Chronic Obstructive Pulmonary Disease (COPD)

Background: COPD is a disease caused by chronic bronchitis, emphysema, or combination of both conditions. As per the Global Burden of Disease 2017 prediction, COPD is the second leading cause of death in Nepal, the fourth leading cause of premature death and the third cause for disability-adjusted life years (DALYs) in Nepal. The prevalence of COPD in Nepal was 11.7%. If current situation prevails, the burden of COPD might increase continuously in the nation. Hence, the findings from this study might provide baseline information to medical and paramedical students and other researchers to conduct further study in similar area. Objectives: The study was done to assess the prescription pattern for management of COPD in multispecialty hospital of Nepal. Method: A retrospective study was conducted at 100 bedded multispecialty hospital located at Lalitpur, Nepal. A total of 200 inpatient records, from Baishak 2075 to Chaitra 2078 were reviewed and data was collected as per the objectives and analysed by using SPSS version 16 and MS Excel 2013. Result: Out of 200 COPD patients studied, female patients (58%) were higher than male patients and maximum patients (42.5%) were from the age group 70-79. The most common symptom was shortness of breath (77.5%) followed by cough (50%) and fever (33.5%) Hypertension (38.5%) was the most frequent co morbidity seen among COPD patients followed by corpulmonale (20%) and diabetes mellitus type II (19%). Doxophylline was the most prescribed methylxanthines during hospitalization (47.5%) and discharge (51%) as well. Among inhalers, Tiotropium bromide and combination of Salbutamol and Fluticasone (52.5%) was prescribed most to the hospitalised patients. Hydrocortisone (68.5%) was the most prescribed corticosteroids during hospitalization where as Prednisolone (49.5%) was the most prescribed corticosteroids during discharge. 85.5% of patients were prescribed Ipratropium bromide for nebulisation in hospitalised patients. Pantoprazole (55.5%) was the most prescribed proton pump inhibitors followed by Rabeprazole (34%). Maximum patients (103) preferred Rotacap than metered dose inhaler (MDI) and dry powder inhaler (DPI). Azithromycin (52.5%) was most frequently prescribed antibiotics during hospitalization followed by ceftriaxone (85%), whereas among discharge patients, Cefpodoxime (35%) was most frequently prescribed antibiotics followed by Azithromycin (32%). The drugs prescribed with generic name were 31.31% and from essential drug list (EDL) was 37.72 %. Conclusion: The prescription pattern of COPD was studied and found that Doxophylline, Tiotropium bromide, Hydrocortisone and Azithromycin were most prescribed methylxanthnes, antimuscarinic agents, corticosteroids and antibiotics respectively. The findings from the study showed that prescribing drugs with generic name and from EDL was low so prioritization on prescribing drugs by generic name and EDL needs to be encouraged.

Antimicrobial utilization pattern in indoor patients of obstetrics and gynecology ward of a tertiary care hospital

Background: Rational prescribing of antimicrobials is fundamentally necessary to reduce incidence of antimicrobial resistance. To evaluate the rationality of antimicrobial prescribing practices in patients admitted to obstetrics and gynecology ward of a tertiary care hospital using ICMR guidelines and to check how many drugs were prescribed from NLEMI.          Methods: It was a prospective observational study. Study included newly admitted patients in obstetrics and gynecology ward receiving antimicrobial therapy. Drugs prescribed to the patients during their hospital stay were noted from case sheets in case record form. WHO core and economic indicators were used to analyze prescribing patterns. Medguideindia.com was referred for prices of drugs. Results: Average number of drugs prescribed for a patient admitted in the obstetrics and gynecology ward were 3.22 and 4.31 respectively. Percentage of drugs prescribed by their generic name were 37.11% and 39.42% in obstetrics and gynecology ward respectively. 26.85% and 34.14% of patients received drugs through parenteral route in obstetrics and gynecology wards respectively. All antimicrobials were prescribed from NLEMI. Conclusions: WHO recommends prescribing all drugs by their generic names. Average duration of antimicrobial treatment was higher than recommended average duration suggested by ICMR. ICMR recommends use of 2nd generation cephalosporins but in the present study 3rd generation cephalosporins were used. For rational use of antimicrobials and to reduce their cost it is recommended to prescribe antimicrobials by their generic names and reduce treatment duration by referring to ICMR Guidelines and NLEMI.

Drug utilization and prescribing pattern in the treatment of urolithiasis: a perspective on World Health Organization recommendations

Background: Drug utilization research (DUR) is essential in promoting rational use of medicine, aimed at understanding the patterns of prescription, administration, and utilization of medications. It provides valuable insights into the actual drug usage patterns for specific disease conditions. To evaluate the current utilization pattern of drugs in patients of urolithiasis in the Department of General Medicine and Surgery at Integral Institute of Medical Science and Research Hospital, Lucknow. Methods: Following the approval of the institutional ethics committee, a prospective observational study was conducted at Integral Institute of Medical Science and Research Department of general medicine and surgery over a six-month period. Urolithiasis patients’ prescriptions were analyzed to study the prescribing patterns. Information about patient demographics, co-morbidities, and the number and types of medications prescribed were collected and analyzed. Results: Out of 102 patients studied, a female preponderance over male patients was observed. The co-morbidities that are encountered most commonly were hydronephrosis, cystitis, and renal cyst. There is averaged 7 medicines per prescription, 15.25% of medicines written by the generic name, 83.33% of patients receiving antibiotics, 54.70% of patients receiving injections, and 83% of drugs prescribed are mentioned in the essential medicine list. Analgesics, antibiotics, nutritional supplements, antiemetic, alkalizing agents, and antispasmodics were among the class of medicines given. Conclusions: This study highlights the current use of medicines and drug utilization in urolithiasis management. The findings show important insights for healthcare professionals to enhance medication therapy, encourage cost-effective healthcare delivery and improve quality of patient in urolithiasis management.

The impacts of national centralized drug procurement policy on drug utilization of medical institutions: an empirical study in a county-level hospital in China

PurposeUnder the background of the regular implementation of the National Centralized Drug Procurement (NCDP) policy, this study aimed to assess the impacts of the NCDP policy on drug utilization of county-level medical institutions, and probe into the influencing factors of the changes in drug utilization.MethodA pre-post study was applied using inpatient data from a county-level medical institution in Nanjing. Drug utilization behavior of medical institutions of 88 most commonly used policy-related drugs (by generic name, including bid-winning and bid-non-winning brands) was analyzed, and the substitution of bid-winning brands for brand-name drugs after policy intervention was evaluated.ResultsAfter policy intervention, 43.18% of policy-related drugs realized the substitution of bid-winning brands for bid-non-winning brands (6.82% of complete substitution, 36.36% of partial substitution). Meanwhile, 40.90% of policy-related drugs failed to realize brand substitution. Multiple factors affected brand substitution, including: (1) Policy effect: brand substitution was more obvious after the intervention of the first and third round of NCDP. (2) Drug market competition: the greater the price reduction of bid-non-winning brands, the more the drugs for the same indication, the more likely that medical institutions keep using the same brands as they did before policy intervention. (3) Previous drug utilization of medical institutions: brand substitution was more obvious in drugs with large number of prescriptions and weak preference for brand-name drugs.ConclusionThe NCDP policy promoted the substitution of bid-winning brands for bid-non-winning brands. However, the NCDP policy remained to be further implemented in county-level medical institutions. Policy implememtation efforts, drug market competition and drug utilization of medical institutions would affect the implementation of the NCDP policy.

Effect of propranolol on pharmacokinetics of clozapine in schizophrenic patients: a meta-analysis.

Clozapine is the effective therapy for treatment-refractory schizophrenia. However, the use of clozapine is limited by its adverse effects. As propranolol is frequently used for the prevention and treatment of clozapine-induced tachycardia, we performed a meta-analysis to evaluate the effects of propranolol on steady state pharmacokinetics of clozapine in schizophrenic patients. We included 16 retrospective studies on the effects of propranolol on steady state pharmacokinetics of clozapine in schizophrenic patients, with data from both generic and brand name treatment phases in eight clozapine bioequivalence studies conducted in a single center in China from 2018 to 2022. Review Manager 5.4 was used for meta-analysis of the included studies. The SMDs with 95% CIs of AUC0-12, Cmax,ss, C, and C were calculated to be 0.44 (0.23, 0.64), 0.40 (0.20, 0.61), 0.43 (0.22, 0.63), and 0.44 (0.23, 0.64), respectively. These findings proved that combination with propranolol would increase the systemic exposure of clozapine. T1/2 of clozapine was significantly longer in the presence of propranolol than in the absence of propranolol (SMD = 0.32, 95% CI [0.12, 0.52], p = 0.002). There was no statistically significant difference for T of clozapine in the presence or absence of propranolol (SMD =  - 0.05, 95% CI [- 0.25, 0.15], p = 0.63). The combination with propranolol could significantly increase systemic exposure and extended T1/2 of clozapine, and thus need to be considered in prescribing decisions.

Meeting Necessity instead of Serendipity: Miscellaneous Nomenclatural Notes on Asteraceae

While compiling a continuously updated checklist of families and genera of world embryophytes, the authors find it necessary to resolve some nomenclatural issues in Asteraceae (Compositae). Here we propose a new supertribal classification for Asteroideae with five supertribes, two of which (Calendulodae and Anthemidodae) are new and one (Ambrosiodae) is a replacement name. A new tribe Leucomerideae in Stifftioideae is described, with the monotypic Nouelia newly treated as a synonym. Two older generic names, Anacis and Epilepis, are resurrected to follow the revision of Coreopsis s.l. and to avoid later homonymy or superfluity, alongside with necessary new combinations. A new nothogenus ×Coreacis is thereby established. The correct spelling Malacotrichinae of the subtribe ‘Malacothricinae’ is discussed.

A disproportionality analysis of FDA adverse event reporting system (FAERS) events for ticagrelor.

Ticagrelor is a commonly used antiplatelet agent, but due to the stringent criteria for trial population inclusion and the limited sample size, its safety profile has not been fully elucidated. We utilized OpenVigil 2.1 to query the FDA Adverse Event Reporting System database and retrieved reports by the generic name "ticagrelor" published between 1 October 2010 and 31 March 2023. Adverse drug events (ADEs) were classified and described according to the preferred terms and system organ classes in the Medical Dictionary of Regulatory Activity. Proportional reporting ratio (PRR), reporting odds ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) were used to detect signals. The number of ADE reports with ticagrelor as the primary suspect drug was 12,909. The top three ADEs were dyspnea [1824 reports, ROR 7.34, PRR 6.45, information component (IC) 2.68], chest pain (458 reports, ROR 5.43, PRR 5.27, IC 2.39), and vascular stent thrombosis (406 reports, ROR 409.53, PRR 396.68, IC 8.02). The highest ROR, 630.24, was found for "vascular stent occlusion". Cardiac arrest (137 reports, ROR 3.41, PRR 3.39, IC 1.75), atrial fibrillation (99 reports, ROR 2.05, PRR 2.04, IC 1.03), asphyxia (101 reports, ROR 23.60, PRR 23.43, IC 4.51), and rhabdomyolysis (57 reports, ROR 2.75, PRR 2.75, IC 1.45) were suspected new adverse events of ticagrelor. The FAERS database produced potential signals associated with ticagrelor that have not been recorded in the package inserts, such as cardiac arrest, atrial fibrillation, asphyxia, and rhabdomyolysis. Further clinical surveillance is needed to quantify and validate potential hazards associated with ticagrelor-related adverse events.

ANALYSIS OF DRUG UTILIZATION PATTERN IN CHRONIC KIDNEY DISEASE PATIENTS IN A TERTIARY CARE HOSPITAL, SOUTH INDIA

Objective: The objective of the study is to assess the drug utilization pattern of various drugs prescribed in chronic kidney disease (CKD) patients in a tertiary care hospital. Methods: As a cross-sectional study 200 prescriptions were randomly selected from both the nephrology outpatient department and the inpatient ward. Patient demographics details, CKD staging, classes of drugs prescribed, and number of drugs prescribed were noted and data were analyzed with the World Health Organization core prescribing indicators. Results: Incidence of CKD is more common in the age group of 40–50 years (45%) with male predominance (70%). Hypertension, diabetes, and anemia are the common comorbid conditions seen with CKD. Anti-hypertensives, anti-anemic drugs, calcium supplements, and anti-diabetic drugs are the commonly prescribed drugs in CKD. Number of prescription contains that generic names are near optimal and drugs from the National List of Essential Medicine are optimal. Majority of the prescriptions contain on average 5 drugs. Conclusion: Diabetes and high blood pressure are the two most common causes of CKD with male dominance. Since polypharmacy is common in CKD patients , they should be monitored for drug – drug interaction and adverse drug reactions.

Challenges Associated with Forming Generic Names for Herbal Medicinal Products

INTRODUCTION. The lack of a unified approach to establishing generic (grouping) names, which must be specified for herbal medicinal products, presents a challenge to developers and manufacturers preparing registration dossiers, as well as to regulators reviewing their submissions.AIM. This study aimed to set forth common approaches to establishing generic names for herbal medicinal products based on studying the terminology used in different legal systems.DISCUSSION. The authors analysed the pharmaceutical terminology used for herbal medicinal products at national and  supranational  levels  in  the  Russian  Federation, the Eurasian Economic Union (EAEU), the Republic of Belarus, the European Union (EU), the United Kingdom, and the United States. This analysis revealed differences in the terminology used in the Russian Federation and the EAEU. For example, the definition of “herbal drugs” is more detailed in the EAEU documents than in the Russian documents, and the definitions of “herbal drug preparation” and “herbal medicinal product” are not the same as well. The authors analysed the approaches to generic naming of herbal medicinal products and detected some improperly formed generic names in the regulatory documentation and Russian State Register of Medicinal Products. In addition, the study revealed variability in generic names proposed by different manufacturers for medicinal products having the same trade name. The authors described the selection of generic names for herbal medicinal products, including fatty or essential oils and liquid or dry extracts. The authors touched upon generic naming of some types of source plants when the morphological group of the herbal drug or the name of the source plant is ambiguous, the Latin name and the Russian name of the herbal drug are inconsistent, or the Latin name of the resulting product or the morphological group of the herbal drug is erroneous. The authors systematised and unified approaches to generic naming of herbal medicinal products with due regard to the species of source plants, the morphological groups of herbal drugs, and the production technology and composition of herbal medicinal products. The authors analysed typical errors in establishing conventional and generic names for herbal drugs and herbal medicinal products associated with incorrectly identified morphological groups of herbal drugs, incorrect source plant names, mismatching structures of Latin and Russian names of herbal drugs, erroneous Latin names of the resulting products, or wrongly assigned morphological groups of herbal drugs.CONCLUSIONS. According to the analysis of  the  names  of  herbal  drugs,  herbal drug preparations, and herbal medicinal products used in  the  State  Pharmacopoeia of the Russian Federation (editions XI–XV), the Pharmacopoeia of the EAEU, and the European Pharmacopoeia, the terminology of these legal systems is harmonised to a high degree. The alignment of terminology is the closest between the regulatory documents of  the  EAEU  and the EU. The terms and names used in Russia need further unification. The results of this study can be used in Russian pharmacopoeial practice to develop regulatory documents, prepare  registration dossiers, and conduct expert reviews of submissions for herbal medicinal products.

Is Delicata Krammer a validly published genus name? Trying to put light on Article 20.2

SummaryThis paper delves into the intricacies of botanical nomenclature, specifically focusing on the interpretation and application of Art. 20.2 of the International Code of Nomenclature (ICN). It critically analyzes the case of Delicata Krammer, against the backdrop of Art. 20.2. The investigation shows that Delicata does not coincide with any established Latin technical term used in morphology and hence fulfills the ICN requirements, confirming its validity. This finding highlights the need for clearer guidelines in distinguishing descriptive Latin terms from technical terms used in morphology. This paper contributes to the ongoing discourse in botanical taxonomy by advocating for revised practices and interpretations of nomenclatural rules, ensuring stability and precision in the naming of taxa.

Proposal of Shuttleworthella gen. nov. and Nostocoides gen. nov. as replacement names for the illegitimate prokaryotic generic names Shuttleworthia and Tetrasphaera, respectively.

The prokaryotic generic name Shuttleworthia Downes et al. 2002 is illegitimate because it is a later homonym of the plant genus Shuttleworthia Meisner 1840 and the mollusk genus Shuttleworthia Baker 1941 (Principle 2 and Rule 51b(5) of the International Code of Nomenclature of Prokaryotes). We therefore propose the replacement generic name Shuttleworthella, with type species Shuttleworthella satelles comb. nov. The prokaryotic generic name Tetrasphaera Maszenan et al. 2000 is illegitimate because it is a later homonym of Tetrasphaera Popofsky 1913 (Protozoa, Radiolaria) and of Tetrasphaera Górka 1965 (a fossil dinoflagellate) (Rule 51b(4) of the International Code of Nomenclature of Prokaryotes). We therefore propose the replacement generic name Nostocoides, with type species Nostocoides japonicum comb. nov.

School shooting: are psychiatrists capable of preventing tragedies?

Armed attacks with numerous victims committed in educational institutions of various levels, mainly (but not always) with the use of firearms, have received the generic name “school shooting”, and attackers are most often called “school shooters”. The United States is the leader in the prevalence of mass murders in educational institutions, although these tragic incidents also occur in other countries, and their number shows a tendency to constantly increase. Since any murder is an abnormal phenomenon, the question of the mental health of school shooters naturally arises. Research shows that not all assailants show symptoms of mental disorders; the most common cause of armed attacks is bullying and the desire to take revenge on offenders for cruel humiliation. In cases where a mental disorder is still diagnosed, not all students, as well as their family members, agree to receive psychiatric care. The prevention of armed attacks must be carried out by the efforts of school counsellors and school psychologists with the possible involvement of psychiatrists, although the potential of psychiatric care in the prevention of school murders, according to the authors of the article, is quite limited.

A new generic name for the “Lepadichthys” lineatus complex with a rediagnosis of Discotrema, a senior synonym of Unguitrema, and comments on their phylogenetic relationships (Gobiesocidae: Diademichthyinae)

Abstract Rhinolepadichthys, a new genus of the gobiesocid subfamily Diademichthyinae, is described for the “Lepadichthys” lineatus complex (including Rhinolepadichthys geminuscomb. nov., R. heemstraorumcomb. nov., R. lineatuscomb. nov., and R. polyastrouscomb. nov.). Detailed investigation of external morphology and osteological anatomy of the new genus and related genera suggests that Rhinolepadichthys represents the sister genus to Discotrema, based on the following putative synapomorphies: (1) presence of a hardened (potentially keratinized) cap on the surface of at least some disc papillae (vs. surface of disc papillae soft, without hardened cap); and (2) the anterolateral part of the ventral postcleithrum extended anteriorly as a well-developed rod-like process, its tip close to the base of pelvic-fin soft ray 4 (vs. only weakly pointed, or irregular). Compared with Discotrema, Rhinolepadichthysgen. nov. is distinguished by the presence of a row of 8–12 large papillae on the inner surface of the upper and lower lips (vs. inner surface of lips smooth, without distinct papillae); the absence (vs. presence) of a well-developed lateral process on the pterotic immediately posterior to the opening of the otic canal; the presence (vs. absence) of gill rakers on the anterior edge of ceratobranchials 1–3; the presence (vs. absence) of gill rakers on the posterior edge of ceratobranchial 4; having the upper pharyngeal teeth arranged in a loose patch on the ventral surface of the pharyngobranchial 3 toothplate, with tooth tips directed posteroventrally (vs. arranged in a single row along posteroventral edge of the pharyngobranchial 3 toothplate, with tooth tips directed posteriorly); features of the adhesive disc, including outline of disc papillae roughly hexagonal or ovoid and with a flattened surface (vs. outline circular, at least some with raised, dome-like surface); the absence (vs. presence) of a deep cavity at the center of disc region C; the absence (vs. presence) of three paired and one median cluster of small papillae (reminiscent of bunches of grapes) across the surface of the adhesive disc; and having the ventral postcleithrum entire, not divided into two separate, articulating elements (vs. ventral postcleithrum divided into an anterior and posterior element, separated via a specialized joint). Reexamination of materials of the poorly known genus Unguitrema, considered a close relative of Discotrema, revealed no morphological differences between the two genera. Unguitrema therefore represents a junior synonym of Discotrema.

New insights into the stipitate hydnoid fungi Sarcodon, Hydnellum, and the formerly informally defined Neosarcodon, with emphasis on the edible species marketed in Southwest China

Sarcodon and Hydnellum are two ectomycorrhizal genera of important ecological and economic value in Southwest China, and they are common in the free markets in this region. It was estimated that more than 1,500 tonnes of them were sold as edible per year, but there was little information about the taxonomic placements of these edible mushrooms sold in the markets. Traditional concepts of the two genera have also been challenged recently, and circumscription of Sarcodon and the informally defined clade “Neosarcodon” remained unresolved. In the present study, specimens collected in the field and purchased from the markets in Southwest China were analyzed based on morphological characters and DNA sequences. Phylogeny of the traditional Sarcodon s. lat. and Hydnellum s. lat. was reconstructed from the combined internal transcribed spacer (ITS), nuclear large ribosomal subunit (nLSU) and RNA polymerase II second largest subunit (RPB2) dataset based on expanded samples to reevaluate the taxonomic placements of the two genera. In the present molecular analyses, four distinct clades were recovered and strongly supported: Hydnellum, Neosarcodon, Phellodon and Sarcodon. Neosarcodon is formally introduced as a generic name to include nine species previously placed in Sarcodon, and the delimitation of Sarcodon is revised based on phylogenetic and morphological studies. Phylogenetic analyses also revealed an unexpected species diversity (17 phylogenetic species) of Sarcodon and Hydnellum in the markets; nine phylogenetic species of Sarcodon and eight of Hydnellum were uncovered from the samples collected in the markets. Eight species were resolved in the traditional S. imbricatus complex, with S. imbricatus s.str. being the most common edible stipitate hydnoid fungal species. Three of the edible Hydnellum species (H. edulium, H. subalpinum, and H. subscabrosellum), and five separated from the S. imbricatus complex (Sarcodon flavidus, S. giganteus, S. neosquamosus, S. nigrosquamosus, and S. pseudoimbricatus), are described as new. Three new Chinese records (H. illudens, H. martioflavum, and H. versipelle), and the notable S. imbricatus and S. leucopus are also reported.

Prescribing patterns and analyzing the usage of corticosteroid therapy at tertiary care hospital

Corticosteroids are used extensively in treating inflammation. They provide short-term symptomatic relief in abnormalities of conditions like Auto immune diseases, Dermatological and Respiratory diseases. Adverse effects of Corticosteroids include Cushing’s syndrome, Skin atrophy, contact dermatitis, tachyphylaxis, Myelosuppression, Diabetes mellitus, Hypertension, pleural effusion. As per the sources available from the regulatory authority of Central Drugs Standard Control organization, inappropriate use of Corticosteroids is more commonly practiced in India almost all the drugs are prescribed rationally. The Pharmacist can promote better patient care and drug safety. Most of the Physician is recommending the drugs are mostly branded names. Our study suggests provide it in generic names. Clinical Pharmacists in associations with clinicians must play a crucial role in minimizing the problems associated with irrational usage of corticosteriods.

Commonly prescribed medicines, core prescribing indicators, and prescription errors in a tertiary healthcare setting in Sri Lanka: a descriptive cross-sectional study

Abstract Objectives To describe the commonly prescribed medicines, WHO/INRUD core prescribing indicators, and prescription errors from a tertiary healthcare setting in Sri Lanka. Methods This study was conducted at clinics and wards in a group of tertiary hospitals from Colombo, Sri Lanka. A total of 1600 prescriptions (800 in-ward [IW] and 800 out-patient clinic [OP]) were analysed and evaluated against WHO/INRUD core prescribing indicators. Prescription errors and medication interactions were also analysed. Key findings Number of medicines per encounter on average was 4.2 ± 2.9 (median: 4.0; range: 1–18) (IW vs. OP: 5.0 ± 3.1 vs. 3.4 ± 2.1; P < 0.001). Overall, the percentage of prescriptions with an antibiotic was 25.9% (n = 415) (IW vs. OP: 45.0% vs. 6.9%, P < 0.001). Percentage of encounters with an injection was 20.4% (n = 326) (IW vs. OP: 36.9% vs. 3.9%, P < 0.001) and percentage of medicine prescribed by generic name was 90.7% (IW 92.9% vs. OP 87.3%, P < 0.001). Prescribing from the essential medicines list (EML) was 76.9% (IW 77.7% vs. OP 75.7%, P-NS). Among IW prescriptions details regarding allergies were not mentioned in 643 (80.4%), while in paediatric prescriptions weight was not specified in 242 (75.6%). At least a single abbreviation was used in 638 prescriptions (39.9%). One or more medication interactions were identified in 744 (46.5%) prescriptions (major: 86 [5.4%]). Conclusions We identified a relatively high number of average medicines per encounter, indicating a degree of polypharmacy. In addition, generic prescribing and usage of EML medicines are areas recommended for further improvement. Prescription errors were common, and several commission/omission errors had potential for preventable patient harm.