The role of pharmacy workers as providers of correct and complete information on safe and effective use of MA needs to be recognized and policies formulated to allow them to provide MA drugs for first trimester use.

Background: An early treatment and the appropriate and the rational use of antibiotics would minimize the risk of severe morbidity and mortality in neonatal sepsis, and reduce the emergence of multi-drug resistant organisms in intensive care units. For the success of an early empiric treatment, a periodic review of the cases to assess any changing trends in the infecting organisms and their antimicrobial susceptibility is important. AIM:To study the most commonly encountered bacterial pathogens which caused neonatal sepsis and their sensitivity patterns, so that guidelines could be prepared for a rational antibiotic therapy. Setting and Design:This was a retrospective study which was conducted in the Department of Microbiology and the Neonatal Intensive Care Unit (NICU) at SGRDIMSAR, Amritsar, during June 2011 to June 2012. Methods and Materials:Blood specimens for culture were drawn from 311 newborns who were admitted in an NICU with sepsis. The specimens were inoculated into brain heart infusion broth. Subcultures were performed on days 1, 2, 3, 5, 7 and 10. The isolates were identified by doing standard biochemical tests. The antibiotic resistance patterns of the isolates were studied by the Kirby Bauer disc diffusion technique.Results: A total of 131 organisms were isolated from the 311 blood cultures. These included Staphylococcus aureus (n=68), Coagulase Negative Staphylococcus (CoNS) (n=30), Klebsiella pneumoniae (n=10), Acinetobacter baumannii (n=9), Escherichia coli (n=05), Enterobacter cloacae (n=04), Citrobacter diversus (n=02), Pseudomonas aeruginosa (n=02) and Candida (n=01). Staphylococcus aureus was the main pathogen in both early and late-onset sepsis. On antibiotic sensitivity testing, 57.35% of the Staphylococcus aureus isolates were found to be methicillin resistant. More than 90% gram negative rods were resistant to amikacin. The resistance to the third generation cephalosporins varied between 50-55%. The resistance to ciprofloxacin was quite high; however, most of the isolates were susceptible to levofloxacin. A majority of the isolates were susceptible to piperacillin-tazobactum and imipenem. Conclusion:The present study emphasized the importance of periodic surveys on the microbial flora which was encountered in particular neonatal settings to recognize the trend.

To investigate the combined effect of aliskiren, a renin inhibitor, and AVE 0991, a Mas-receptor agonist, in experimental hypertension (HT) in rats. HT was produced by administration of deoxycorticosterone acetate (DOCA) and mean arterial blood pressure (MABP) was assessed by tail-cuff method. Treatments were started from 4th week onwards and were continued for 9 days. A significant increase in MABP was noted after 1 week in DOCA control rats, as compared with the base line value. A stable HT developed after 4 weeks of DOCA administration. Treatments with aliskiren and AVE 0991 alone, dose-dependently decreased MABP in DOCA-treated rats. Further, combination of low doses of aliskiren and AVE 0991 significantly reduced MABP, as compared with DOCA control rats and with either drug alone in low doses. It may be concluded that treatment with aliskiren produced down-regulation of both harmful Ang II-AT1-receptor and survival Ang(1-7)/Mas-receptor axis of RAAS. Treatment with combination of low doses of aliskiren and AVE 0991, for the first time, has been shown to produce synergistic blood pressure lowering effect. Therefore, combination of renin inhibitor with Mas-receptor agonist may prove beneficial for the treatment of hypertensive patients.

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Endothelial nitric-oxide synthase (eNOS) acts as a common pathogenic pathway in diabetic nephropathy (DN). However, its functional consequences are still not fully understood. Caveolin, a membrane protein, inhibits the eNOS by making caveolin-eNOS complex, and its expression is upregulated during diabetes mellitus (DM). This study was designed to determine the role of caveolin in eNOS-mediated NO synthesis and release in DN. DM in rat was induced by feeding of high-fat diet (HFD) for 2 weeks, followed by single dose of streptozotocin (STZ) (35 mg/kg, ip) further followed by HFD for further 8 weeks. Serum nitrite/nitrate ratio was measured to determine the plasma level of NO. Diabetic rat, after 6 weeks of STZ, developed elevated level of BUN, protein in urine, urinary output, serum creatinine, serum cholesterol, kidney weight, kidney weight/body weight, and renal cortical collagen content, while serum nitrite/nitrate concentration was significantly decreased as compared to normal control group. Treatment with sodium nitrite (NO donor), L: -arginine (NO precursor), daidzein (caveolin inhibitor), and combination of L: -arginine and daidzein for 2 weeks markedly attenuated these changes and increased serum nitrite/nitrate ratio. However, treatment with L-NAME, a eNOS inhibitor, significantly attenuated the L: -arginine-, daidzein-, or combination of L: -arginine and daidzein-induced ameliorative effects in DN. The finding of this study suggests that caveolin plays a vital role in the eNOS-mediated decrease in renal level of NO, which may be responsible for the development of DN in rats.