We prospectively evaluated the bone changes associated with proteasome inhibition using single agent bortezomib in relapsed or refractory myeloma patients. Ten patients received bortezomib 1.3 mg/m 2 per days 1, 4, 8 and 11 for three 21-day cycles, and 6 patients received 1 mg/m 2 per day with the same schedule. Bone architecture and metabolism changes were assessed by bone markers, micro-CT, bone histomorphometry, tetracycline labeling and serum parathormone levels. Bone parameter variations were compared by response to treatment. Microarchitectural changes were observed in all evaluable responsive patients. Bone alkaline phosphatase changes were associated with disease response (≥PR vs. others P=0.03 cycle 1, day 11) serum parathormone levels were also significantly increased (P=0.04 on days 11, 21, 33) in responding individuals.This study demonstrates that the myeloma control produced by proteasome inhibition is associated with bone changes and to a discrete pattern of hormonal variation. (Clinicaltrials.gov identifier: NCT00569868)

Introduction Workplace violence (WPV) has been defined as, “violent acts including physical assault and threats of assault directed toward personnel at work or on duty”. Healthcare staff are at highest risk of WPV among the professionals and it is more common among the critical care services. Prevalence of WPV among doctors all over the world is around 56–80% and in Indian scenario, it is around 40.8–75%. There is scarcity of studies on WPV among doctors from India. To our knowledge, this is the first of its kind survey conducted to know about the incidence of WPV amongst critical care physicians in India. Materials and Methods This survey was conducted after taking due ethical committee clearance amongst critical care physicians attending a critical care conference. The purpose of the study was informed to the participants and a pretested, self-administered, semi-structured questionnaire was distributed among them for their voluntary and anonymous response. Results Out of 160 delegates who were given the questionnaire, 118 responses were collected and their forms were analyzed. Maximum responses (84%) received were of age group 20–40 years. Seventy-two percent respondents experienced WPV during their work hours. Most common type of violence reported was verbal violence (67%). Sixty-five percent respondents reported that poor communication was the leading cause of WPV. Due to WPV, most of the respondents (60%) had to change their place and pattern of work. Proper communication (76%) was the most common measure among multiple measures suggested by respondents for avoiding WPV. Eighty-three (98%) respondents opined that conflict management should be part of regular curriculum in medical education. Conclusion Improving the communication skills amongst critical care physicians, teaching doctors about conflict management in their regular curriculum of medical education, spreading awareness in public about patient rights and taking initiatives in propagating an idea to “Fight against the diseases and not against the doctors” are the key measures to combat WPV. How to cite this article Kumar NS, Munta K, Kumar JR, Rao SM, Dnyaneshwar M, Harde Y. A Survey on Workplace Violence Experienced by Critical Care Physicians. Indian J Crit Care Med 2019;23(7):295–301.

Resolution of the racemic amino alcohol derivatives 1-6 is readily achieved to obtain enantiomerically enriched compounds using chiral 1,1'-bi-2-naphthol and boric acid in solvents such as CH(3)CN, THF, and MeOH. Purification of the diastereomeric mixture 7 has also been carried out following this method. The corresponding intermediate ammonium borate complexes were also characterized by X-ray diffraction methods.

Microorganisms are the major part of earth's biological diversity. Due to most of the microbes being nonculturable, it is necessary to use culture independent techniques to study the uncultured microbes. Metagenomics is the molecular tool which helps to understand the genetic makeup of the wide variety of uncultivable microorganisms. Currently, Next Generation Sequencing (NGS) is one of the most advanced technologies used in metagenomics studies and different computational tools have been developed for the analysis of large metagenomic dataset. This review demonstrates the different tools used in NGS analysis and its applications in microbial ecology.