Manipal University

About: Manipal University is a education organization based out in Manipal, Karnataka, India. It is known for research contribution in the topics: Population & Medicine. The organization has 9525 authors who have published 11207 publications receiving 110687 citations.

Strategies for drug delivery to the central nervous system by systemic route.

Abstract: Context: Delivery of a drug into the central nervous system (CNS) is considered difficult. Most of the drugs discovered over the past decade are biological, which are high in molecular weight and polar in nature. The delivery of such drugs across the blood–brain barrier presents problems.Objective: This review discusses some of the options available to reach the CNS by systemic route. The focus is mainly on the recent developments in systemic delivery of a drug to the CNS.Materials and methods: Databases such as Scopus, Google scholar, Science Direct, SciFinder and online journals were referred for preparing this article including 89 references.Results: There are at least nine strategies that could be adopted to achieve the required drug concentration in the CNS.Conclusion: The recent developments in drug delivery are very promising to deliver biologicals into the CNS.

Assessment of Drug-Drug Interactions among Renal Failure Patients of Nephrology Ward in a South Indian Tertiary Care Hospital

Abstract: Polypharmacy is common in drug prescriptions of chronic kidney disease patients. A study of the prescription patterns of drugs with potential interactions would be of interest to prevent drug related adverse events. A prospective observational study of six months (Dec 2009-May 2010) was carried out among the chronic kidney disease patients admitted to the nephrology ward of a South Indian tertiary care hospital. The pattern and rates of drug-drug interactions seen in the prescriptions of these patients was studied. Among the 205 prescriptions included, a total of 474 interactions were reported, making 2.7 interactions per prescription with incidence rates of 76.09%. Around 19.62% of interactions were of major severity. Most common interactions were found between ascorbic acid and cyanocobalamine (12.45%), clonidine and metoprolol (3.80%) respectively. Hypo or hypertension (31.65%), decreased drug efficacy (29.11%) and hypo or hyperglycemia (14.14%), were the most commonly reported clinical outcomes of the drug interactions. Cardiovascular drugs (calcium channel blockers and beta blockers; 52%) constitute the major class of drugs involved in interactions. As most of the interactions had a delayed onset, long term follow-up is essential to predict the clinically significant outcomes of these interactions. Hence, drug interactions are commonly seen in the prescriptions of chronic kidney disease patients which can lead to serious adverse events if not detected early. Need for collaboration with a clinical pharmacist and electronic surveillance, which are absent in developing countries like India, is emphatic.

Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial.

Abstract: Objectives: Radiotherapy (RT) is treatment of choice for Elderly Head and Neck Cancer (HNC) patients. Oral mucositis (OM) during RTaffects patient's routine oral activities and overall health. LowLevelLaser Therapy (LLLT)provided some promising results against cancer therapy induced OM in children and adults. Nostudy specifically evaluated effects of LLLTagainst RTinduced OMin elderly HNCpatients until date, hence we did this study, Material and methods: This double blinded study randomized 46 elderly HNCpatients scheduled for RT [Dosage = 66 Gray (2 Gy/fraction), 5 fractions/week, total 33 fractions for 6.5 weeks]. into laser (22) and placebo (24) groups. Laser group patients received LLLT[Helium-Neon, ,.\= 632.8 nm, power density = 0.024 W/cm2, dosage = 3.0J/point at six anatomical sites bilaterally I.e. 12 locations, total dose/session = 36 J, beam aperture diameter = 0.6 mm, beam spot size = 1 crrr', irradiated area diameter = 1 crrr', irradiation time/point = 125 s, 5 sessions/week, non-contact method-distance between probe and irradiated tissues <1 ern, whereas placebo group did not receive laser. OM grades (RTOG/ EORTCScale), oral pain, weight loss, need for morphine analgesics and tube feeding, and RTbreak were recorded by a blinded assessor. Descriptive statistics and repeated measures ANOVAwere used for analysis keeping p <0.05. Results: Significant reduction in the incidence and duration of severe OM (p = 0.016) and severe pain (p = 0.023) and weight loss (p = 0.004) was observed in laser than placebo group. No difference was found for enteral feeding use (p = 0.667) between two groups. Conclusions: LLLTdecreased the severity of OMand oral pain in elderly HNCpatients. Also, lesser weight loss, morphine analgesic use and radiation break happened in laser group.

Co-expression of Tbx6 and Sox2 identifies a novel transient neuromesoderm progenitor cell state

Abstract: Elongation of the body axis is a key aspect of body plan development. Bipotential neuromesoderm progenitors (NMPs) ensure axial growth of embryos by contributing both to the spinal cord and mesoderm. The current model for the mechanism controlling NMP deployment invokes Tbx6, a T-box factor, to drive mesoderm differentiation of NMPs. Here, we identify a new population of Tbx6+ cells in a subdomain of the NMP niche in mouse embryos. Based on co-expression of a progenitor marker, Sox2, we identify this population as representing a transient cell state in the mesoderm-fated NMP lineage. Genetic lineage tracing confirms the presence of the Tbx6+ NMP cell state. Furthermore, we report a novel aspect of the documented Tbx6 mutant phenotype, namely an increase from two to four ectopic neural tubes, corresponding to the switch in NMP niche, thus highlighting the importance of Tbx6 function in NMP fate decision. This study emphasizes the function of Tbx6 as a bistable switch that turns mesoderm fate 'on' and progenitor state 'off', and thus has implications for the molecular mechanism driving NMP fate choice.