This document discusses unethical clinical drug trials conducted in Madhya Pradesh, India. It notes that over 3,300 patients, including 1,833 children, were enrolled in 73 trials at a government hospital without proper consent or oversight. Many patients suffered serious adverse effects, including 18 children and 81 total patients. The trials were carried out by doctors who received over Rs. 5 crores from drug companies. Several politicians raised questions in the state legislature about the trials and deaths. The state government eventually banned new trials and conducted investigations into the irregularities.
This document discusses erectile dysfunction and oral phosphodiesterase type 5 (PDE5) inhibitors for its treatment. It provides information on:
1) Currently available PDE5 inhibitors like sildenafil and those in development like tadalafil and vardenafil which are potent and selective for the PDE5 isoenzyme.
2) The mechanism of action of PDE5 inhibitors in inhibiting the PDE5 isoenzyme and increasing cGMP levels in the corpus cavernosum for improved erectile function.
3) Clinical trial results showing PDE5 inhibitors like tadalafil can provide successful intercourse for over 24 hours, improving erections, with a generally well tolerated safety profile
This document lists 200 drugs along with their brand/trade names, therapeutic classes, and primary indications. For each drug, the name, most common brand or trade name, main therapeutic category or class, and primary medical condition or purpose for use is provided. The drugs span a wide range of categories including analgesics, antibiotics, antihypertensives, antidepressants, and more.
A 55-year-old man was found unconscious at home after ingesting kratom and alcohol. At the emergency department, he was comatose with low vital signs. Treatment with naloxone had no effect. He was given supportive care and woke up 10 hours later, admitting to ingesting kratom and whiskey. Kratom contains compounds that are opioid receptor agonists and can cause respiratory depression, especially in combination with other depressants like alcohol.
Medgenics presented an overview of their Biopump technology for sustained protein delivery and their lead product candidates. The Biopump uses skin tissue to continuously produce and deliver therapeutic proteins from a patient's own skin for 6-36 months to treat chronic diseases like anemia, hepatitis, and hemophilia. Clinical trials have demonstrated sustained protein levels and disease treatment for this duration from a single treatment. Medgenics' experienced management team is advancing lead programs in Phase I/II trials while pursuing strategic partnerships for their disruptive platform technology addressing large markets exceeding $130 billion annually.
The impact of innovation on travel and tourism industries (World Travel Marke...Brian Solis
From the impact of Pokemon Go on Silicon Valley to artificial intelligence, futurist Brian Solis talks to Mathew Parsons of World Travel Market about the future of travel, tourism and hospitality.
We’re all trying to find that idea or spark that will turn a good project into a great project. Creativity plays a huge role in the outcome of our work. Harnessing the power of collaboration and open source, we can make great strides towards excellence. Not just for designers, this talk can be applicable to many different roles – even development. In this talk, Seasoned Creative Director Sara Cannon is going to share some secrets about creative methodology, collaboration, and the strong role that open source can play in our work.
Reuters: Pictures of the Year 2016 (Part 2)maditabalnco
This document contains 20 photos from news events around the world between January and November 2016. The photos show international events like the US presidential election, the conflict in Ukraine, the migrant crisis in Europe, the Rio Olympics, and more. They also depict human interest stories and natural phenomena from various countries.
This document discusses erectile dysfunction and oral phosphodiesterase type 5 (PDE5) inhibitors for its treatment. It provides information on:
1) Currently available PDE5 inhibitors like sildenafil and those in development like tadalafil and vardenafil which are potent and selective for the PDE5 isoenzyme.
2) The mechanism of action of PDE5 inhibitors in inhibiting the PDE5 isoenzyme and increasing cGMP levels in the corpus cavernosum for improved erectile function.
3) Clinical trial results showing PDE5 inhibitors like tadalafil can provide successful intercourse for over 24 hours, improving erections, with a generally well tolerated safety profile
This document lists 200 drugs along with their brand/trade names, therapeutic classes, and primary indications. For each drug, the name, most common brand or trade name, main therapeutic category or class, and primary medical condition or purpose for use is provided. The drugs span a wide range of categories including analgesics, antibiotics, antihypertensives, antidepressants, and more.
A 55-year-old man was found unconscious at home after ingesting kratom and alcohol. At the emergency department, he was comatose with low vital signs. Treatment with naloxone had no effect. He was given supportive care and woke up 10 hours later, admitting to ingesting kratom and whiskey. Kratom contains compounds that are opioid receptor agonists and can cause respiratory depression, especially in combination with other depressants like alcohol.
Medgenics presented an overview of their Biopump technology for sustained protein delivery and their lead product candidates. The Biopump uses skin tissue to continuously produce and deliver therapeutic proteins from a patient's own skin for 6-36 months to treat chronic diseases like anemia, hepatitis, and hemophilia. Clinical trials have demonstrated sustained protein levels and disease treatment for this duration from a single treatment. Medgenics' experienced management team is advancing lead programs in Phase I/II trials while pursuing strategic partnerships for their disruptive platform technology addressing large markets exceeding $130 billion annually.
The impact of innovation on travel and tourism industries (World Travel Marke...Brian Solis
From the impact of Pokemon Go on Silicon Valley to artificial intelligence, futurist Brian Solis talks to Mathew Parsons of World Travel Market about the future of travel, tourism and hospitality.
We’re all trying to find that idea or spark that will turn a good project into a great project. Creativity plays a huge role in the outcome of our work. Harnessing the power of collaboration and open source, we can make great strides towards excellence. Not just for designers, this talk can be applicable to many different roles – even development. In this talk, Seasoned Creative Director Sara Cannon is going to share some secrets about creative methodology, collaboration, and the strong role that open source can play in our work.
Reuters: Pictures of the Year 2016 (Part 2)maditabalnco
This document contains 20 photos from news events around the world between January and November 2016. The photos show international events like the US presidential election, the conflict in Ukraine, the migrant crisis in Europe, the Rio Olympics, and more. They also depict human interest stories and natural phenomena from various countries.
This document provides an overview of pharmacogenomics. It defines pharmacogenomics as the study of how genetic variations influence individual drug responses. It discusses how single nucleotide polymorphisms (SNPs) can alter drug metabolism and response. Examples are provided of genes like G6PD, TPMT, CYP2D6 and CYP2C9 that influence drug toxicity and efficacy. Benefits of pharmacogenomics include more powerful and safer drugs through personalized treatment based on an individual's genetic profile. Ethical concerns around privacy, discrimination, and drug availability are also discussed.
This document discusses various categories of drugs and their potential teratogenic effects. It notes that Category A drugs have no risk, Category B have no risk in animal studies but inadequate human studies, Category C have potential risks that may outweigh benefits, Category D have proven risks but benefits may outweigh, and Category X are contraindicated. It provides numerous examples of specific drugs that fall into each category and potential fetal effects, such as heart defects from ACE inhibitors, limb defects from retinoids, and hearing loss from aminoglycosides. It emphasizes careful consideration of risks and benefits for the mother and fetus.
Teratogens jagadisha T V. and its effects in fetal developmentJagadishaTV
Teras-”monster” Gensis-”producing”
A teratogen is defined as any agent that results in structural or functional abnormalities (malformation ) in the fetus, or in the child after birth, as a consequence of maternal exposure during pregnancy.
Birth defects are known to occur in 3- 5% of all newborns.
They can do direct damage to the fetus, causing abnormal development.
This document discusses clinical neuro-modulation and nervous system balancing in integrative medicine and clinical neuropsychiatry. It begins with an introduction and disclosure statement from the author, Dr. Desiderio Pina. The discussion preview outlines how chronic illnesses can be treatable but not curable, and emphasizes the importance of integrating medicine and neuromodulation by addressing psycho-neuro-endocrine-immunology, biochemically relevant metabolism and physiology, and the neuroanatomy of symptomatology. It also discusses achieving and sustaining remission for complex disorders through treatment augmentation and neurotransmitter testing.
This document discusses various coagulants and anticoagulants. It describes vitamin K and its uses including in newborns and for overdose of oral anticoagulants. It also discusses other coagulants like fibrinogen, antihemophilic factor, and desmopressin. The document then covers oral anticoagulants like warfarin including its dosing, effects, interactions and newer oral anticoagulants. It provides details about parenteral anticoagulants including heparin, its uses, pharmacokinetics, administration and adverse effects. Low molecular weight heparins and direct thrombin inhibitors are also summarized.
The document discusses ocular pharmacology and the role of a lab assistant in healthcare. It covers various topics related to ocular drug delivery, classification and uses of common ocular drugs, pharmacodynamics, pharmacokinetics, drug delivery methods to the eyes, potential complications, and diagnostic agents. Examples of different drug classes are provided, including antibiotics, antifungals, and antivirals, along with their mechanisms of action and ocular uses. Team activities are also described to build knowledge of disease, drug dosages, routes of administration, and ocular conditions.
This document discusses various coagulants and anticoagulants. It describes vitamin K and its uses including for prolonged antimicrobial therapy, liver disease, and in newborns. It also discusses other coagulants like fibrinogen, antihemophilic factor, and desmopressin. The document then covers oral anticoagulants like warfarin including its dosing, monitoring, and drug interactions. Newer oral anticoagulants like rivaroxaban and dabigatran are also mentioned. Finally, the document discusses parenteral anticoagulants including unfractionated heparin, low molecular weight heparins, and direct thrombin inhibitors like lepirud
Dr Libby Radcliffe talks about the aches & pains suffered by aspergillosis patients, the different causes and what can be done to reduce them. Professor Malcolm Richardson talks about the types of moulds we all come across every day and the damage they can cause in the wrong places. Dr Graham Atherton talks about the correct specification for facemasks used to reduce the inhalation of mould spores when carrying out routine daily tasks & hobbies.
Personalized medicine involves the prescription of specific therapeutics best suited for an individual based on their genetic or proteomic profile. This talk discusses current approaches in drug discovery/development, the role of genetics in drug metabolism, and lawful/ethical issues surrounding the deployment of new health technology. I highlight some bioinformatic roles in the drug discovery process, and discuss the use of semantic web technologies for data integration and knowledge discovery..
This document provides information on various anticoagulant drugs including heparin, low molecular weight heparins, synthetic heparin derivatives like fondaparinux, direct thrombin inhibitors, and oral vitamin K antagonists like warfarin. It discusses their mechanisms of action, indications, dosing, advantages and disadvantages, interactions, and adverse effects. Key anticoagulants covered are heparin, enoxaparin, fondaparinux, dabigatran, rivaroxaban, and warfarin.
Adverse drug reactions (ADRs) are unintended harmful reactions that occur when taking medications. ADRs account for 3-5% of hospitalizations and can be life-threatening in some cases. Factors that influence ADRs include patient characteristics like age and genetics, as well as drug properties like dose and interactions. ADRs are classified as either type A, predictable reactions, or type B, unpredictable reactions. Pharmacovigilance programs monitor ADRs to improve drug safety.
This document summarizes several case studies related to pharmacology. It discusses appropriate antibiotic treatment for various infections, potential drug interactions, side effects of medications, and important counseling points for patients. Key drugs mentioned include amoxicillin, cephalosporins, ciprofloxacin, metronidazole, and various antidepressants and benzodiazepines. The case studies provide examples to illustrate proper medication use and management of side effects or risks.
The document presents a case study and article on organophosphate poisoning, describing examples of organophosphates, the history of their development and use, their mechanism of action in poisoning, clinical features depending on route of exposure, and management including gastric lavage, ventilation, and antidotes like atropine and pralidoxime. It then provides details of a specific case of alleged organophosphate poisoning in a 33-year-old male patient who was treated with atropine, pralidoxime, fluids, antibiotics, and counseling.
A 45-year-old male presented to the ICU with chest pain, sweating, backache and vomiting. Examination found normal vitals except elevated heart rate. Tests showed elevated cardiac enzymes and ECG changes consistent with ST-elevated myocardial infarction (STEMI). He was treated with fibrinolytics, anticoagulants, antiplatelets and beta blockers. Over subsequent days his symptoms improved and he was discharged on aspirin, clopidogrel, atorvastatin and metoprolol with counseling on cardiac risk factors and medications.
Organophosphate (OP) compounds irreversibly inhibit acetylcholinesterase (AChE), leading to accumulation of acetylcholine and overstimulation of muscarinic and nicotinic receptors. Clinical features include muscarinic, nicotinic, and central nervous system effects. Diagnosis is based on exposure history and low AChE levels. Treatment involves atropine for muscarinic effects, pralidoxime for reactivation of AChE, supportive care, and monitoring for intermediate syndrome or delayed neuropathy. Prevention focuses on safe use of pesticides and other OP sources.
molecular markers for antimalarial drug resistanceAnil kumar
this presentation deals with the drugs for choice for malaria, their mode of action, resistance development and its distribution, how to evaluate resistance development and reasons for developing resistance.
Viruses are obligate intracellular parasites that contain genetic material enclosed in a protein coat. They replicate using host cell processes and lack cell structures. Antiviral drugs work by inhibiting virus development rather than destroying them. There are several classes of antiviral drugs that target different stages of the viral lifecycle, including reverse transcription, viral entry, assembly, and integration. Common antiviral drugs include nucleoside analogs, protease inhibitors, and integrase inhibitors. These drugs have varied mechanisms of action, pharmacokinetics, efficacy against different viruses, and potential adverse effects.
Kidney transplantation is the most effective therapy for end-stage renal disease. The transplanted organ can come from a live or deceased donor. Immunosuppressive medications are used to prevent rejection and include corticosteroids, calcineurin inhibitors, mTOR inhibitors, and antimetabolites. Common post-transplant complications include acute rejection, infections like cytomegalovirus, and chronic allograft dysfunction.
This document provides a historical overview of local anesthesia techniques from the 18th century introduction of chemical compounds to modern developments. It discusses key events and discoveries such as the first use of nitrous oxide and ether for dental procedures. The era of inhalation anesthesia gave way to injection techniques using hypodermic syringes and localized drugs like cocaine and procaine. Modern techniques for mandibular nerve blocks and vasoconstrictors that prolong anesthesia are also covered. The document concludes with sections on interactions, side effects, contraindications and toxicity of local anesthetic drugs and recommended maximum dosing.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
This document provides an overview of pharmacogenomics. It defines pharmacogenomics as the study of how genetic variations influence individual drug responses. It discusses how single nucleotide polymorphisms (SNPs) can alter drug metabolism and response. Examples are provided of genes like G6PD, TPMT, CYP2D6 and CYP2C9 that influence drug toxicity and efficacy. Benefits of pharmacogenomics include more powerful and safer drugs through personalized treatment based on an individual's genetic profile. Ethical concerns around privacy, discrimination, and drug availability are also discussed.
This document discusses various categories of drugs and their potential teratogenic effects. It notes that Category A drugs have no risk, Category B have no risk in animal studies but inadequate human studies, Category C have potential risks that may outweigh benefits, Category D have proven risks but benefits may outweigh, and Category X are contraindicated. It provides numerous examples of specific drugs that fall into each category and potential fetal effects, such as heart defects from ACE inhibitors, limb defects from retinoids, and hearing loss from aminoglycosides. It emphasizes careful consideration of risks and benefits for the mother and fetus.
Teratogens jagadisha T V. and its effects in fetal developmentJagadishaTV
Teras-”monster” Gensis-”producing”
A teratogen is defined as any agent that results in structural or functional abnormalities (malformation ) in the fetus, or in the child after birth, as a consequence of maternal exposure during pregnancy.
Birth defects are known to occur in 3- 5% of all newborns.
They can do direct damage to the fetus, causing abnormal development.
This document discusses clinical neuro-modulation and nervous system balancing in integrative medicine and clinical neuropsychiatry. It begins with an introduction and disclosure statement from the author, Dr. Desiderio Pina. The discussion preview outlines how chronic illnesses can be treatable but not curable, and emphasizes the importance of integrating medicine and neuromodulation by addressing psycho-neuro-endocrine-immunology, biochemically relevant metabolism and physiology, and the neuroanatomy of symptomatology. It also discusses achieving and sustaining remission for complex disorders through treatment augmentation and neurotransmitter testing.
This document discusses various coagulants and anticoagulants. It describes vitamin K and its uses including in newborns and for overdose of oral anticoagulants. It also discusses other coagulants like fibrinogen, antihemophilic factor, and desmopressin. The document then covers oral anticoagulants like warfarin including its dosing, effects, interactions and newer oral anticoagulants. It provides details about parenteral anticoagulants including heparin, its uses, pharmacokinetics, administration and adverse effects. Low molecular weight heparins and direct thrombin inhibitors are also summarized.
The document discusses ocular pharmacology and the role of a lab assistant in healthcare. It covers various topics related to ocular drug delivery, classification and uses of common ocular drugs, pharmacodynamics, pharmacokinetics, drug delivery methods to the eyes, potential complications, and diagnostic agents. Examples of different drug classes are provided, including antibiotics, antifungals, and antivirals, along with their mechanisms of action and ocular uses. Team activities are also described to build knowledge of disease, drug dosages, routes of administration, and ocular conditions.
This document discusses various coagulants and anticoagulants. It describes vitamin K and its uses including for prolonged antimicrobial therapy, liver disease, and in newborns. It also discusses other coagulants like fibrinogen, antihemophilic factor, and desmopressin. The document then covers oral anticoagulants like warfarin including its dosing, monitoring, and drug interactions. Newer oral anticoagulants like rivaroxaban and dabigatran are also mentioned. Finally, the document discusses parenteral anticoagulants including unfractionated heparin, low molecular weight heparins, and direct thrombin inhibitors like lepirud
Dr Libby Radcliffe talks about the aches & pains suffered by aspergillosis patients, the different causes and what can be done to reduce them. Professor Malcolm Richardson talks about the types of moulds we all come across every day and the damage they can cause in the wrong places. Dr Graham Atherton talks about the correct specification for facemasks used to reduce the inhalation of mould spores when carrying out routine daily tasks & hobbies.
Personalized medicine involves the prescription of specific therapeutics best suited for an individual based on their genetic or proteomic profile. This talk discusses current approaches in drug discovery/development, the role of genetics in drug metabolism, and lawful/ethical issues surrounding the deployment of new health technology. I highlight some bioinformatic roles in the drug discovery process, and discuss the use of semantic web technologies for data integration and knowledge discovery..
This document provides information on various anticoagulant drugs including heparin, low molecular weight heparins, synthetic heparin derivatives like fondaparinux, direct thrombin inhibitors, and oral vitamin K antagonists like warfarin. It discusses their mechanisms of action, indications, dosing, advantages and disadvantages, interactions, and adverse effects. Key anticoagulants covered are heparin, enoxaparin, fondaparinux, dabigatran, rivaroxaban, and warfarin.
Adverse drug reactions (ADRs) are unintended harmful reactions that occur when taking medications. ADRs account for 3-5% of hospitalizations and can be life-threatening in some cases. Factors that influence ADRs include patient characteristics like age and genetics, as well as drug properties like dose and interactions. ADRs are classified as either type A, predictable reactions, or type B, unpredictable reactions. Pharmacovigilance programs monitor ADRs to improve drug safety.
This document summarizes several case studies related to pharmacology. It discusses appropriate antibiotic treatment for various infections, potential drug interactions, side effects of medications, and important counseling points for patients. Key drugs mentioned include amoxicillin, cephalosporins, ciprofloxacin, metronidazole, and various antidepressants and benzodiazepines. The case studies provide examples to illustrate proper medication use and management of side effects or risks.
The document presents a case study and article on organophosphate poisoning, describing examples of organophosphates, the history of their development and use, their mechanism of action in poisoning, clinical features depending on route of exposure, and management including gastric lavage, ventilation, and antidotes like atropine and pralidoxime. It then provides details of a specific case of alleged organophosphate poisoning in a 33-year-old male patient who was treated with atropine, pralidoxime, fluids, antibiotics, and counseling.
A 45-year-old male presented to the ICU with chest pain, sweating, backache and vomiting. Examination found normal vitals except elevated heart rate. Tests showed elevated cardiac enzymes and ECG changes consistent with ST-elevated myocardial infarction (STEMI). He was treated with fibrinolytics, anticoagulants, antiplatelets and beta blockers. Over subsequent days his symptoms improved and he was discharged on aspirin, clopidogrel, atorvastatin and metoprolol with counseling on cardiac risk factors and medications.
Organophosphate (OP) compounds irreversibly inhibit acetylcholinesterase (AChE), leading to accumulation of acetylcholine and overstimulation of muscarinic and nicotinic receptors. Clinical features include muscarinic, nicotinic, and central nervous system effects. Diagnosis is based on exposure history and low AChE levels. Treatment involves atropine for muscarinic effects, pralidoxime for reactivation of AChE, supportive care, and monitoring for intermediate syndrome or delayed neuropathy. Prevention focuses on safe use of pesticides and other OP sources.
molecular markers for antimalarial drug resistanceAnil kumar
this presentation deals with the drugs for choice for malaria, their mode of action, resistance development and its distribution, how to evaluate resistance development and reasons for developing resistance.
Viruses are obligate intracellular parasites that contain genetic material enclosed in a protein coat. They replicate using host cell processes and lack cell structures. Antiviral drugs work by inhibiting virus development rather than destroying them. There are several classes of antiviral drugs that target different stages of the viral lifecycle, including reverse transcription, viral entry, assembly, and integration. Common antiviral drugs include nucleoside analogs, protease inhibitors, and integrase inhibitors. These drugs have varied mechanisms of action, pharmacokinetics, efficacy against different viruses, and potential adverse effects.
Kidney transplantation is the most effective therapy for end-stage renal disease. The transplanted organ can come from a live or deceased donor. Immunosuppressive medications are used to prevent rejection and include corticosteroids, calcineurin inhibitors, mTOR inhibitors, and antimetabolites. Common post-transplant complications include acute rejection, infections like cytomegalovirus, and chronic allograft dysfunction.
This document provides a historical overview of local anesthesia techniques from the 18th century introduction of chemical compounds to modern developments. It discusses key events and discoveries such as the first use of nitrous oxide and ether for dental procedures. The era of inhalation anesthesia gave way to injection techniques using hypodermic syringes and localized drugs like cocaine and procaine. Modern techniques for mandibular nerve blocks and vasoconstrictors that prolong anesthesia are also covered. The document concludes with sections on interactions, side effects, contraindications and toxicity of local anesthetic drugs and recommended maximum dosing.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
2. Disturbed patients afraid of their
surroundings, Doctors above the
law and a government on siesta …
the story of India.
The doctors go through their day
ignoring the Hippocrates oath
they took when they started their
careers.
Many doctors in M.P. give more
importance to their earnings than
to the life of their patients. Lured
by the offers of big Pharma
companies these doctors have
deliberately violated all
regulations and have reduced
clinical trials to a money spinning
excercize. GUINEA PIG
3. Indore – the commercial capital of
Madhya Pradesh is surrounded on all
sides by backward and predominantly
tribal districts. Poor patients from
surrounding districts flock to Indore for
secondary and tertiary care.
Indore has hospitals, great air
connectivity and has transformed itself
into a clinical trial hub.
4.
5. M.P. Government’s Economic Offences Wing
investigates clinical trials in Maharaja
Yeshwant Rao Hospital, government
teaching hospital – in all 73 trials were
carried out on nearly 3300 patients that
included 1833 children.
The trials were carried out by six senior
doctors who received Rs 5.1 crores from
drug companies.
81 including 18 children patients suffered
serious adverse effects which included
death.
In the private sector 60 trials were carried
out involving 40 doctors – the number of
patients not disclosed. In CHL Apollo
hospital there were five deaths.
6. Dr. Apoorva Dr. Ashok Dr. Anil
Pauranik Bajpayee Bharani
Dr. Puspa Dr. Salil Dr.Hemant
Varma Bhargava Jain
7.
8. 8 Indian companies and institutions sponsored
these trials while multinational sponsorship
was of 22 companies and institutions
Indian:
Cipla Pharmaceuticals, Panacea Bio-Tech,
Cadilla Pharmaceuticals, Ipca, Serum Institute
of India, St. John’s Medical College and
Population Research Centre Bengaluru,
Himalaya Drugs
9. Multinational:
Boehringer Ingelheim, Schering Plough
Research Institute, Theravance Inc, Speedal,
Eli=Lilly, Australian Medical Council,
MacMaster University, Servier, Duke Medical
University, Daiichi-Sankyo-Phaema
Development, Novaartis, Schwarz Biosciences,
Merck, Eisai, Pfizer, Biogen Idec, Crucell,
Bayer, Thrombosis Research Institute,
GlaxoSmithKline, Johnson and Josnson,
Alcon, Servier
10. Name of the drug Indication
Ipratropium Salbutamol inhaler Chronic obstructive pulmonary disease
B1 1744 CL &Forodil Chronic obstructive pulmonary disease
Momentosone Furate/Formetrol Chronic obstructive pulmonary disease
Telavancin v/s Vancomycin Hospital acquired pneumonia
Avocsantan Diabetic Nephropathy
Prasugrel & Clopidogrel Unstable angina
Aggrenox v/s Clopidogrel Second Stroke
With and without Micardis
Dabigatran Etexilate with Prevention of Stroke
Open label Warfarin
Apixaban v/s Warfarin Nonvalvular Atrial fibrillation
Ivabradine v/s Amlodipin Stable angina
Apixaban v/s Aspirin Stroke
11. Name of the drug Indication
Aliskerin Heart failure
Pramipexole ER Parkinsonism
Pramipexole ER L-Dopa Parkinsonism
Rotigotin Parkinsonism
Donepezil SR Dementia
Pregablin Epilepsy
BG 9928 Adenosone Antagonist Acute decompensated heart failure
E-5555 PDGF Antagonist Acute coronary syndrome
Rameltonv/s Zolpidem Insomnia
Telmisartan, Dipyremidol, AspirinSecond stroke
& Clopidogrel
Quetiapine Schizophrenia
Desvenlafaxine Succinate ER Major depressive disorder
Clonazopam v/s Depression and Anxiety
Paroxetine Hydrochloride
12. Name of the drug Indication
Aliskerin Heart failure
Pramipexole ER Parkinsonism
Pramipexole ER L-Dopa Parkinsonism
Rotigotin Parkinsonism
Donepezil SR Dementia
Pregablin Epilepsy
BG 9928 Adenosone Antagonist Acute decompensated heart failure
E-5555 PDGF Antagonist Acute coronary syndrome
Rameltonv/s Zolpidem Insomnia
Telmisartan, Dipyremidol, AspirinSecond stroke
& Clopidogrel
Quetiapine Schizophrenia
Desvenlafaxine Succinate ER Major depressive disorder
Clonazopam v/s Depression and Anxiety
Paroxetine Hydrochloride
13. Name of the drug Indication
Depoxetine Premature Ejaculation
IN-AQUL-001 Primary Insomnia
Armodofinil v/s Modafinil Shift work disorder
Remelton v/s Zolpidom Insomnia
Asinapin v/s Risorpidon Schizophrenia
AL-46383 A Ophthalmic Adenoviral conjunctivitis
Solution
Moxifloxacin AF Bacterial conjunctivitis
Ophthalmic Solution
Ophthacare Conjunctivitis
14. No. of children
Name of Drug/ vaccine Sponsor
involved
Hib Conjugate vaccine Panacea Biotech 24
Easy five vaccine Panacea Biotech 50
I/V Montelukast Merck 05
Quadrivalent study L.G. Life Science 100
Men ACWYTT Conjugate vaccine GlaxoSmithKline 194
DTWP Vaccine Panacea Biotech 100
VALSARTAN Novartis 05
Bivalent OPV vaccine WHO 400
Pentavalent L.G. Lifescience 160
Rabeprazole Johnson & Johnson 03
Imovax Polio Vaccine
Sanofi Pasteur 65
v/s Panacea Biotech vaccine
12AH1N1 Vaccine Serum Institute of
50
12BH1N1 Vaccine India
HPV Multivalent vaccine V-503 Merck and Dome 44
Hepatitis A Crucell 90
Bivalent oral polio vaccine Panacea Biotech 100
Total 1838
15. Adjuvant Name Side Effect & Details
(1) THIOMEROSAL It is 49.6% mercury by weight and is
Adjuvant used in Hib-vaccine, Easy Five metabolized in to Ethyl mercury and
Vaccine, Quadrivalent Study by LG Life Thiosalicylate.
science, Pentavolent Study LG Life Science US FDA banned THIOMEROSAL since
(on 100 Trial Subject & 60 Trial Subject), H1 1999
N1 Vaccine; combination vaccine of Diptheria, In special condition Maximum recommended
Tetanus, whole cell pertusis, Hepatitis B; Dose is 1 Mircro Gram Per DOSE but in
Combination vaccineLBVF0101 H-1 N1 CNBC Hospital, Indore 25 micro gm per dose
influenza vaccine & many more trials done at used.
CNBC, Indore. Side Effect: - (1) Neurodevelopment disorder
(2) Autism, (3) Attention deficit Hyper Activity
disorder (ADHD) (4) Speech or language
delay.
16. Adjuvant Name Side Effect & Details
(2) ALLUMINIUM PHOSPHATE GEL / SIDE EFFECTS:
ALLUMINIUM HYDROXIDE GEL/ AMORPHUS Alluminium is particularly dangerous Neurooxin. It
ALLUMINIUM HYDROXY PHOSPHATE has the ability to slip fast your body’s natural
SULPHATE (AAHS) defenses and enters, brain potentially causing brain
As adjuvant used in: - Easy five vaccine, Hib damage, alzheimers disease, Dementia,
vaccine, DTWP, Pentavalent study by LG Life convulsions & coma, Alluminium can even cause
Science (On 100 and 60 trial subject), HPV vaccine, nerve death.
combination vaccine – Deptheria, Tetanus, Patusis,
Hep-B, LBVF0101, V503 Multivalent HPV vaccine &
many more, Vaccine trials done at CNBC Indore
(M.P.)
18. MGM Memorial Medical College has 27
members as opposed to 12 laid down. No
layman representation. Of the total 22 are
professors in the college
Netaji Subhash Chandra Medical College
has an Ethics Committee chaired by a
Veterinary Doctor
Bombay Hospital, Indore also has an Ethics
Committee chaired by a Veterinary Doctor
19. Ethics and Scientific Review Committee, MGM Medical College Indore
Clinicom Ethics Committee, Bengaluru
Aditya Ethics Committee
Shatabdi Hospital Ethics Committee
Cerebral Ethics Committee
Unique Independent Ethics Committee
Independent Ethics Committee, Consultant, MGM College and MY hospital, Division of
Cardiology, Indore
North Maharashtra Ethics Committee, Jalgaon
Kotbagi Hospital Ethics Committee
Independent Ethics Committee, Dhanasree Hospital, Pune
Ethics Committee of Diabetes, thyroid hormone research Institute Pvt. Ltd., Indore
C.H.L. Apollo Hospital Ethics Committee, Indore
Choithram Hospital Ethics Committee. Indore
Bangalore Central Ethics Committee
Naitik Independent Ethics Committee
Manav Independent Ethics Committee
These committees are not independent as in most cases the chairperson is part of the
institution. None have representation of lay persons.
20. Members of Ethics committee MGM Medical College were the
principal investigators in many trials. The Secretary of the
Committee Dr. Anil Bharani failed to follow the GCP guidelines and
the ICMR guidelines.
Principal investigatos failed to fulfil their responsibility in cases of
serious adverse events
The basic tenets of informed consent were violated.
Code of MCI Act 1958 (20A) in respect of Professional Conduct
was violated.
Patients enrolled for clinical trials stated that the process was not
transparent.
Insurance provisions for patients suffering serious adverse events
were violated. Consent was not taken properly.
10% stipulated income for trials has not been deposited with the
institution
21. Protests against unethical clinical trials in Indore resulted in the
state government appointing a committee headed by the Principal
Secretary, Medical Education to look into the irregularities. This
committee banned all new trials in the state on 29th October 2010.
A public hearing was organized by the committee in MGM Medical
College on 30th October 2010. 168 persons made deposition before
it and gave their suggestions.
M.P. Government, Department of Public Health and Family Welfare
made the following suggestions to the DCGI on 22nd March 2011.
1. Representative of the state government should be included in
granting permission and licences under Rule 21(B) of the Drugs
and Cosmetics Act.
2. Any drug trial taking place within the state must have the
clearance of the state government also before it is approved by the
DCGI
3. Serious adverse events must be reported to the CMHO within 24
hours by the Principal Investigator.
4. Director Health/Medical should have the right to audit and
monitor the records relating to drug trials.
22. Agency Complainant
1. NHRC through SHRC Dr. Anand Rai
2. Lokayukt, M.P. Mr Rajendra Gupta
3. State Economic Offences Dr. Anand Singh Raje
Investigation Bureau
4. DCGI Mr Ajay Naik
5. MCI through M.P. Medical Counci Mr Rajendra Gupta& Mr. Sharad
Gite
6. CBI through MCI Vigilence officer Mr. Rajendra Gupta
7. M.P. Police, Sanyogitaganj, Mr. Ajay Naik
Indore
8. Health Minister, M.P. Government Mr Sharad Gite
9. Joint Director Health, Indore Dr. Anand Rai
Division
23.
24. Date/Q.no. Name of M.L.A Subject
July 23,2010 Q.No. 540 Mr. Pratap Grewal Trials on patients of government
hospitals
July 30, 2010 Q 1369 Mr. Paras Sakhlecha Foreign travel of doctors organized
by trial sponsor
July 30, 2010 Call attention Ajay Singh, Mr. Paras Discussion on Drug and and
Motion 284/507/533 Sakhlecha, Mr. Pratap vaccine trials
Grewal
Nov 23, 2010 Qno 544 Mr. Paras Sakhlecha Hazardous vaccine trials on girls
Nov 30, 2010 Q no 1193 Mr. Pradumn Tomar Deaths during trial
Nov 30, 2010 Q no. 2692 Mr. Arif Akeel Action against erring officials
Nov 30, 2010 Q. no. 2748 Mr. Paras Sakhlecha Enquiry into drug trials and and
making rules for them
Nov 30, 2010 Q.No.2794 Mr Umang Singhar Action taken on complaints of trial
victims
Nov 30, 2010 Q. No. 2793 Mr Umang Singhar MY Hospital Supdt. in trials at Gyan
Pushpa Research Centre
25. Date/Q.no. Name of M.L.A Subject
March 10, 2011 Q.No. Mr. Pratap Grewal Trial with Pigvalin in Neurology Dept.
3505
March 10, 2011 Q.No Mr Sanjay Shah Victimization of whistle blower
1795
March 17, 2011 Q.No. Mr. Pratap Grewal Trials and Ethics committees in private
5715 hospitals
March 30, 2011 Q.No. Mr. Paras Sakhlecha Tadalafil, PDE-5 inhibitor being tried in
6790 PAH patients
March 31, 2011 Q.No. Mr. Paras Sakhlecha Trials on mental patients
5626
July 12, 2011 Q.No 519 Mr. Paras Sakhlecha Adverse effects of drug trials
July 12,2011 Q. No 521 Mr. Paras Sakhlecha On information provided during Call
attention motion on trials
July 19,2011 Q.No.182 & Mr. Shrikant Dube, Mr. On complaints about drug trials
2165 Paras Sakhlecha
July 19,2011 Q.No.1850 Mr. Pratap Grewal Info on deaths during trials in govt. and
private hospitals
July 19,2011 Q.No. 554 Mr. Mahendra Singh On drug trials
26. Date and Question No. Name of M.P. Subject of Question
15.03.2011, Q.No. 2117 Smt. Kusum Rai Carrying out of clinical Trial
15.03.2011, Q.No. 2082 Shri N.K. Singh Irregularities in studies of HPV
vaccine.
15.03.2011 , Q.No. 2113 Shri. T.M. Selvaganapati Rejection of HPV vaccine
project by PHFI
15.03.2011, Q. No. 269 Shri K.N. Balgopal Development of Biomedical
Stents for cardiovascular
Treatment
02.08.2011, Q.No. 241 Shri Mahendra Mohan Mechanism for monitoring
clinical trials of drugs.
02.08.2011, Q.No. 249 Shri Mahendra Mohan Safety & Ethical issues in
clinical trails of drugs.
09.03.2011, Q.No. 137 Shri purushotham Protection of patients under
Khodabhai Rupala going clinical trials.
09.03.2011, Q.No. 1037 Shri. K.E. Ismail Death during clinical trials of
drugs.
09.03.1064, Q.No. 1046 Shri Mahendra Mohan Illegal clinical trails of drugs
27. An empowered committee should work out the necessity
of clinical trials in the country based on the death toll and
disease burden. Only such trials should be allowed in the
country.
A new drug proposed to be introduced in the country
should be cost effective. All trials should be sponsored
by/through the government.
Placebo control trials should be stopped.
Concurrent trials should not be allowed and only those
drugs from outside India should undergo trials which are
already licensed in the home country.
28. There should be no restriction on publishing results of a
trial and in fact publication of results in reputed scientific
journals should be a requirement for the benefit of
patients.
An independent apex agency needs to be established to
oversee the functioning of the DCGI office and various
Ethics committees.
The office of the DCGI should be strengthened
professionally to have more technical persons and
inspectors. DCGI should have regional centres so that
trial sites can be monitored effectively. Help lines must be
set up for complainants.
All Ethics committees should be registered with the GoI.
When they fail to carry ot their duty properly their
registration should be cancelled.
29. Failure to carry out their duties in respect of ethical
clinical trials should result in punishment to Principal
Investigator, Drug companies, chairman of the ethics
committee and contract/clinical research organization
which should include fine and imprisonment.
Funds for clinical trials should be channelled through
institutions and not privately.
A copy of the informed consent form, patient information
sheet and clinical trial liability insurance policy should be
given to each trial participant for the ultimate protection
of her/his well being.
If a drug is granted a licence after the trial, trial subjects
must be given a share of the profit.