Event reporting can provide data to study the failure points of an organization's work process. As part of the ongoing efforts to improve transfusion safety, a Medical Event Reporting System Transfusion Medicine, (MERS - TM) as designed by Kaplan et al was implemented in the Transfusion Medicine Unit of the University Malaya Medical Centre to provide a standardized means of organized data collection and analysis of transfusion errors, adverse events and near misses. An event reporting form was designed to detect, identify, classify and study the frequency and pattern of events occurring in the unit. Events detected were classified according to Eihdhoven Classification model (ECM) adopted for MERS - TM. Since our system reported all events, we called it Event Reporting System - Transfusion Medicine (ERS-TM). Data was collected and analyzed from the reporting forms for a period of five months from January 15th to June 15th 2002. The initial half of the period was a process of evaluation during which 118 events were reported, coded, analyzed and corrective measures adopted to prevent the recurrence of the same event. The latter half saw the reporting of 122 events following the adoption of corrective measures. There was a reduction in the occurrence of some events and an increase in others, which were mainly beyond the organization's control. A longer period of evaluation is necessary to identify the underlying contributory causes that can be useful to develop plans for corrective and preventive action and thereby reduce the rate of recurrence of errors through proper training and adoption of just culture.
Reporting ; Transfusion, NOS ; Medicine ; experience ; seconds

The Mi III phenotype of the Miltenberger subsystem (or GP Mur) is relatively common in Southeast Asia especially along the south-east coast lines of China and Taiwan. The term anti-"Mia" describes antibodies that react with the Mi III phenotype. Since the Peninsula Malaysian population is a multiethnic one with a significant proportion of Chinese, a study was conducted into the prevalence of anti-"Mia" in patients from its 3 major ethnic groups--Chinese, Malays and Indians, as well as the GP Mur phenotype in blood donors (healthy individuals). Blood samples from 33,716 patients (general and antenatal) were screened for anti-"Mia" from January 1999 to December 2000. The investigation for the GP Mur phenotype representing the corresponding sensitizing antigen complex was carried out in 655 blood donors. Serum anti-"Mia" antibody was found to be the third most commonly occurring antibody detected in our patients and was found in all the ethnic groups. The antibody was detected in 0.2% of 33,716 antenatal and general patients with a prevalence in Chinese of 0.3%, Malay 0.2% and Indian 0.2%. The detection of these antibodies in the ethnic groups other than the Chinese is a noteworthy finding as such information is not well documented. The GP Mur red cell phenotype was detected in 15/306 (4.9%) of Chinese blood donors, a lower prevalence than in Chinese populations in other countries in the region. More significant was its detection in the Malays (2.8%) and the Indians (3.0%). Because of the many reports of clinical problems associated with the "Mia" antibody including the causation of fetal hydrops and haemolytic transfusion reactions, it is warranted that the GP Mur red cells be included in screening panels for group and screen procedures in countries with a significant Asian population.
seconds ; Glycoproteins ; Chinese People ; Antibodies ; Prevalence aspects

Introduction: Health educators and accrediting bodies have defined objectives and competencies that medical students need to acquire to become a safe doctor. There is no report in Malaysia, about the ability of medical students to perform some of the basic surgical skills before entering the houseman ship. The aim of this study is to determine whether the teaching/ learning methods of practical skills in our undergraduate program have been effective in imparting the desired level of competencies in these skills. Methods: A list of basic practical skills that students should be competent has been identified. These skills are taught in a structured way and assessed as part of the composite end- of- semester examination. Practical skills stations form part of an Objective structured practical examination (OSPE). Results: The results of 244 students who participated in three ends of semester examinations were analyzed. The mean score for the practical skills stations were higher than the mean OSPE (of all 18 stations) and overall score (of the written, practical and clinical examination). However the failure rate in the practical skills stations is higher in most of the stations (7 out of 8 stations) compared to overall failure rates. Conclusions: In spite of the formal skills training many students failed to demonstrate the desired level of competencies in these stations. Assessment of practical skills as part of overall composite examination may not be effective in ensuring that all students have achieved the required level of competency. Practical skills should be assessed through dedicated formative assessments to make sure that all the students acquire the required competencies.

In the present study, polyvoltine germplasm stock of Andhra Pradesh State Sericulture Research and Development,0 Institute (APSSRDI) was evaluated for its performance based on quantitative and qualitative traits. Twenty-one oval and 10 peanut cocoon shaped lines were reared in different seasons of the year. Since the polyvoltines are non-diapausing, six generations were reared and evaluated for various economically important traits based on evaluation index and sub-ordinate function statistical methods. Ten top ranked lines obtained by using both the methods were identified as potential parental strains. Among oval lines,APM14, APM11, APM18, APMW9, and APM19, and among peanut lines APMD5, APMD1, APMD3, APMD9 and APMD8were selected as base material. The identified high yielding lines will be used in various breeding programmes as initial parents for the synthesis of superior polyvoltine breeds/hybrids.

Self-expanding metal stents are a useful therapy to palliate malignant and benign luminal gastrointestinal obstruction. Self-expanding metal stents has been widely reported for colonic, esophageal, and gastric obstruction. However, endoscopic delivery and placement to the small bowel is more challenging and difficult. This case illustrates the usefulness and technical advantages of the balloon-overtube and enteroscopy technique for the palliative treatment of neoplastic stenosis affecting the small intestine.
Colon ; Constriction, Pathologic ; Double-Balloon Enteroscopy ; Intestine, Small ; Palliative Care ; Phenobarbital ; Stents

OBJECTIVEToxic metal ions have been implicated in the generation of reactive oxygen species (ROS) and nitric oxide (NO). Metallothionines (MT) and plant flavonoids have been reported in the intervention against oxidative damage. We investigated the effect of zinc induced MT and green tea polyphenol (GTP) in reducing the oxidative responses induced by nickel and platinum.

METHODSZinc (10 mg/kg b. wt, sc) was administered to rats twice at a gap of 24 hrs and GTP (10 mg/100 mL in drinking water) was fed ad libitum for 8 days. Nickel chloride (150 umol/kgb.wt, ip) and cisplatin (50 mumol/kg b.wt, sc) was administered to rats 24 h after Zn or GTP pre-treatment. Animals of all the groups were sacrificed 16 hrs after treatment and biochemical markers for toxicity were monitored.

RESULTSZinc or GTP pre-treatment caused significant protection against nickel or cisplatin enhanced mortality in rats, and reduction in lipid peroxidation and NO.

CONCLUSIONIt is proposed that inhibition of ROS and NO by GTP and zinc may prove useful as a selective pharmacological agent in the amelioration of metal toxicity.

Animals ; Antioxidants ; pharmacology ; Biomarkers ; Cisplatin ; administration & dosage ; toxicity ; Flavonoids ; administration & dosage ; pharmacology ; Free Radical Scavengers ; pharmacology ; Lipid Peroxidation ; drug effects ; Metallothionein ; metabolism ; Mortality ; Nickel ; administration & dosage ; toxicity ; Nitric Oxide ; metabolism ; Phenols ; administration & dosage ; pharmacology ; Polyphenols ; Rats ; Tea ; chemistry ; Time Factors ; Zinc ; administration & dosage ; pharmacology

ary phytochemical screening. The resultsshowed that the ethanolic crude extract of the leaf containhigh phytochemical activity hence B.oleraceavaracephalais rich in flavonoids, phenolic compounds, carbohydratesand phytosterols. Materials and methods: The ethanolic extract was used tosynthesise copper nanoparticles. The copper nanoparticleswere successfully synthesised from copper sulphatesolution which was identified by the colour change fromdark green colour of the extract. Thus the B.oleracea varacephala is a good source to synthesis coppernanoparticles. The synthesised copper nanoparticles werecharacterised using Scanning Electron Microscope (SEM)analysis. The SEM image displayed the high-densitynanoparticles synthesised by leaf extracts and that thenanoparticles were crystals in shape. Results: The copper nanoparticles (CNP) bind to the leafextract. B.oleraceavaracephalaalso has shown theantimicrobial and antioxidant activity. A comparative studywas done between ethanolic its crude extract andnanoparticles. Both extracts exhibited zone of inhibition andbetter antioxidant potential but the CuNPs shows majorzone of inhibition and showed more antioxidant activity.Anticancer activity of B.oleraceavaracephalaagainstCervical HeLa cell line was confirmed using ethanolic crudeextract and CNP. The results showed that HeLa cellsproliferation was inhibited with increasing concentration ofethanolic crude extract and copper nanoparticles. From theresults, it was seen that percentage viability of the cancercells decreased with increased concentration of the sampleswhereas cytotoxicity against HeLa cell lines increased withthe increased concentration of the samples. Conclusion: Thus B.oleraceavaracephalapossessesanticancer activity against HeLa cell lines.

Taurine, a cysteine-derived zwitterionic sulfonic acid, is a common ingredient in energy drinks and is naturally found in fish and other seafood. In humans, taurine is produced mainly in the liver, and it can also be obtained from food. In target tissues, such as the retina, heart, and skeletal muscle, it functions as an essential antioxidant, osmolyte, and antiapoptotic agent. Taurine is also involved in energy metabolism and calcium homeostasis. Taurine plays a considerable role in bone growth and development, and high-profile reports have demonstrated the importance of its metabolism for bone health. However, these reports have not been collated for more than 10 years. Therefore, this review focuses on taurine–bone interactions and covers recently discovered aspects of taurine’s effects on osteoblastogenesis, osteoclastogenesis, bone structure, and bone pathologies (e.g., osteoporosis and fracture healing), with due attention to the taurine–cartilage relationship.

Background and object:The burden of neurological disorders in India is expected to increase due to the rapid demographic and epidemiological transition,with irrational drug use,which is also a global concern.Thus,drug utilization evaluation is designed to ensure appropriate medicine use within the healthcare settings.The aim of the study was to assess the rate and pattern of drug utilization in the management of neurological disorders.Materials and methods:A hospital-based cross-sectional drug utilization evaluation study on neurological drugs was carried out at the Department of Neurology over a span of six months.All legible prescriptions consisting neurological medications irrespective of patient's gender,aged ≥18 years were included for the study.The World Health Organization(WHO)core drug use indicators were used to assess the drug prescribing and utilization patterns.Results:A total of 310 prescriptions were reviewed,where male predominance was found to be 56.45％.Out of 310 prescriptions,drugs belonging to 26 neurological classes were prescribed for the management of various neurological disorders.The majority of patients were diagnosed with epilepsy and the most prescribed drugs per patient were phenytoin(14.8％)and valproic acid(6.45％).By following the WHO core drug prescribing indicators,65.47％of drugs prescribed from the India National List of Essential Medicines,2022,followed by 29.83％of drugs prescribed in generic name and 10.86％of prescriptions including injections.Conclusion:The study findings showed that the prescribing pattern in the Department of Neurology was in accordance with the WHO core prescribing indicators.But,the extent of polypharmacy prescriptions was very high.Therefore,interventions are very necessary to promote rational drug prescribing patterns and thus clinical pharmacists can contribute to assess and review the drug utilization pattern to optimize the drug therapy and improvement in patient safety.

This review briefly describes the origin, chemistry, molecular mechanism of action, pharmacology, toxicology, and ecotoxicology of palytoxin and its analogues. Palytoxin and its analogues are produced by marine dinoflagellates. Palytoxin is also produced by Zoanthids (i.e. Palythoa), and Cyanobacteria (Trichodesmium). Palytoxin is a very large, non-proteinaceous molecule with a complex chemical structure having both lipophilic and hydrophilic moieties. Palytoxin is one of the most potent marine toxins with an LD50 of 150 ng/kg body weight in mice exposed intravenously. Pharmacological and electrophysiological studies have demonstrated that palytoxin acts as a hemolysin and alters the function of excitable cells through multiple mechanisms of action. Palytoxin selectively binds to Na(+)/K(+)-ATPase with a Kd of 20 pM and transforms the pump into a channel permeable to monovalent cations with a single-channel conductance of 10 pS. This mechanism of action could have multiple effects on cells. Evaluation of palytoxin toxicity using various animal models revealed that palytoxin is an extremely potent neurotoxin following an intravenous, intraperitoneal, intramuscular, subcutaneous or intratracheal route of exposure. Palytoxin also causes non-lethal, yet serious toxic effects following dermal or ocular exposure. Most incidents of palytoxin poisoning have manifested after oral intake of contaminated seafood. Poisonings in humans have also been noted after inhalation, cutaneous/systemic exposures with direct contact of aerosolized seawater during Ostreopsis blooms and/or through maintaining aquaria containing Cnidarian zoanthids. Palytoxin has a strong potential for toxicity in humans and animals, and currently this toxin is of great concern worldwide.
Acrylamides ; chemistry ; isolation & purification ; toxicity ; Animals ; Anthozoa ; pathogenicity ; physiology ; Dinoflagellida ; pathogenicity ; physiology ; Dogs ; Guinea Pigs ; Haplorhini ; Humans ; Lethal Dose 50 ; Marine Toxins ; chemistry ; isolation & purification ; toxicity ; Mice ; Rabbits ; Rats ; Seaweed ; pathogenicity ; physiology ; Shellfish Poisoning ; physiopathology ; Sodium-Potassium-Exchanging ATPase ; metabolism