bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective study of efficacy and safety of olopatadine versus azelastine in allergic conjunctivitis at a tertiary care hospital
Authors: C. R. Jayanthi , R. Nanthini , Vijayalakshmi .
Published: July 2017

Background: Allergic conjunctivitis, an ocular surface inflammatory disease with significant social and economic impact affects approximately 25% of the general population. H1 receptor blockers, mast cell stabilizers and drugs that block cytokine and prostaglandin formation form the treatment armamentarium. Olopatadine hydrochloride and Azelastine hydrochloride are dual-acting selective H1 receptor antagonist with mast-cell stabilizing property. This study was undertaken to assess the efficacy and safety of olopatadine hydrochloride 0.1% and Azelastine hydrochloride 0.05% in allergic conjunctivitis amongst Indians.Methods: After obtaining Institutional Ethics Committee approval and written informed consent, 120 patients diagnosed with allergic conjunctivitis fulfilling the inclusion/exclusion criteria were enrolled in the study. Study was done from April 2014 to June 2015 at Minto eye hospital. Study subjects were treated with olopatadine hydrochloride 0.1% and Azelastine hydrochloride 0.05% eye drops BD for 15 days. Ocular symptoms, instead of and signs and adverse events, if any were recorded on the day 8 and day 15 follow up visits.Results: At the end of the study period, the reduction in the ocular itching score from baseline was higher in the olopatadine group compared to the azelastine group (p<0.002). Similarly, the scores of ocular congestion (p<0.008), foreign body sensation (p<0.009), tearing (p<0.001), erythema (p<0.002) and chemosis (p<0.015) also showed larger reduction in the olopatadine treated patients. The common adverse events encountered in both the groups were stinging after instillation, burning, bitter taste and headache.Conclusions: In allergic conjunctivitis, both olopatadine and azelastine were found to be effective in relieving ocular signs and symptoms, but olopatadine was found to be superior in terms of efficacy, safety and tolerability with minimal side effects.
A randomized controlled open label comparative clinical study of cephalexin versus doxycycline in patients with acne vulgaris in a hospital based population of South India
Authors: Banerjee Prithwijt , Maity Somnath , Bubna Aditya , Das Manisha
Published: July 2017

Background: Oral antibiotics are frequently used for acne vulgaris. Cephalexin has documented some success against acne vulgaris in earlier studies. Here the efficacy and safety of Cephalexin have been compared against the standard therapy of Doxycyline.Methods: From September 2010 to June 2011, 100 patients of moderate Acne vulgaris were randomized into two groups to receive oral Doxycyline (100mg once daily) or Cephalexin (500mg thrice daily) in an open label manner for eight weeks. All participants were allowed to use topical 5%Benzoyl peroxide gel twice daily. Efficacy was measured in terms of reduction in the number of facial comedones and inflammatory lesions from baseline after eight weeks.Results: 44 patients from Cephalexin group and48 patients from Doxycyline group completed the study. Both drugs have significantly decreased comedone count as well as the inflammatory lesion count after eight weeks. However, Doxycycline appeared better in terms of Comedone count (14.5±3.07 versus 12.9±4.31, p=0.045) as well as inflammatory lesion count (8.64.1±2.14 versus 7.67±2.46, p=0.047) at the end. The total adverse event was slightly more with Cephalexin (6.81% versus 6.25%, p= 0.912), where Diarrhoea remained the commonest adverse effect (4.54%).Conclusions: Although for the first time oral Cephalexin has displayed efficacy against moderate acne vulgaris in a prospective clinical study, it appeared inferior to Doxycycline over eight weeks. Therefore, it becomes an option only when other oral antibiotics are contraindicated or not tolerated.
Comparative evaluation of cost-effectiveness between typical antipsychotic haloperidol and atypical antipsychotics olanzapine, risperidone and aripiprazole in the treatment of stable schizophrenia
Authors: Vishal Subhash , Beg Mirza A. , Dutta Shakti B. , Khatri Sumit , Garg Shobhit , Singh Nand Kishore , Kaur Amanjot
Published: July 2017

Background: Schizophrenia patients mostly require life-long treatment. For such long-term treatments, cost is an important factor. Estimate of cost in terms of efficacy can give idea to prescribers about the relative financial burden posed by various typical and newer antipsychotics in schizophrenic patients.Methods: A total of 98 stable schizophrenic patients were enrolled in this open label study over a period of 1 year. Patients were divided in four groups, group-I received Haloperidol (n=24), group-II received Olanzapine (n=25), group-III received Risperidone (n=25) and group-IV received Aripiprazole (n=24). The patients were given drugs on the basis of physician’s discretion, depending upon the condition of the patient at the time of presentation. Patients were followed up to 16 weeks. Direct treatment costs and efficacy of treatment in terms of Clinical Global Impression - Efficacy Index CGI (EI) noted and average cost-effectiveness worked out.Results: In this open label study, the mean age of patients was 35.05±1.30. The average cost-effectiveness ratio was 26.25 for haloperidol, 10.12 for Olanzapine, 9.83 for Risperidone and 25.92 for Aripiprazole.Conclusions: Risperidone was found to be most cost-effective, followed by olanzapine, then by aripiprazole, whereas haloperidol was found least cost effective.
Screening of alcohol de-addiction potential of zinc: a study on albino rats
Authors: Gandigawad Priya , Hiremath Sharanabasayyaswamy B.
Published: July 2017

Background: With regard to tobacco and alcohol addiction, involvement of NMDA receptors and glutamate as neurotransmitter has been highlighted. Few indirect evidences support possible de-addiction potential of zinc being mediated through their interaction with nicotinic and NMDA receptors. The objectives of the present study were planned to analyze the alcohol de-addiction potential of oral zinc sulfate as a monotherapy and as a supplement to topiramate, in male wistar albino rats.Methods: Male wistar albino rats were exposed to ‘two-bottle free choice’ model of voluntary ethanol consumption, wherein each animal had access to water and 10% v/v ethyl alcohol in two separate bottles. Thirty male rats divided into five groups, each containing six rats were treated as control group, receiving 1ml/kg/d distilled water orally; zinc sulfate group receiving 18mg/kg/d of elemental zinc orally; topiramate group receiving topiramate 5mg/kg/d, orally and Topiaramate plus Zinc sulfate group receiving both zinc sulfate (18mg/kg/d) and topiramate (5mg/kg/d) orally for two weeks.Results: There were no significant differences with regard to all the three parameters in two-way ANOVA. However, there were significant differences with regard to amount of alcohol and water consumed but not API, in all the treatment groups in post-hoc test.Conclusions: It is unclear on to the alcohol de-addiction potential of zinc as monotherapy and combination therapy with topiramate.
Role of Emblica officinalis (amla) in the prophylaxis of hepatic injury by carbon tetrachloride (CCl4) in albino rats
Authors: Deori Chinmoyee , Das Swarnamoni , Bordoloi Sushanta Kumar
Published: July 2017

Background: The objective of the study was to evaluate the hepatoprotective activity of fruits extract of Emblica officinalis on carbon tetrachloride induced hepatotoxicity in Albino rats. Liver is vulnerable to wide variety of metabolic, toxic, microbial, circulatory and neoplastic insults. The dominant primary diseases of the liver are viral hepatitis, alcoholic liver disease and hepatocellular carcinoma. Due to absence of reliable drugs management of liver ailments in the modern medicine, plants and natural products are providing to be good hepatoprotectants as evident from voluminous published work on their hepatoprotective potentials.Methods: The required amount of fresh fruits of Emblica officinalis was collected and dried at room temperature. The dried fruit ground into powdered and was prepared by percolation method using 95% ethanol. Acute oral toxicity test of the fruits extract was performed as per OECD 423 guidelines. Carbon tetrachloride was used as the hepatotoxin. Silymarin suspension 100mg was used as a standard drug in this study.Results: The study was carried out with an attempt to evaluate the hepatoprotective activity of Emblica officinalis in carbon tetrachloride induced hepatic injury in albino rats. The results were analysed by using one way ANOVA followed by Dunnett’s test and (p <0.05) was considered significant.Conclusions: The present study shows that the Emblica officinalis has significant hepatoprotective activity in rats with carbon tetrachloride induced liver injury. Emblica officinalis is a commonly used traditional herb, which is safe, cost effective and grows widely in India and used by different ethnic groups for various diseases. That is why Emblica officinalis, a commonly used natural herb, deserve further consideration in order to establish its potential as safe economical hepatoprotective agent.
Comparative evaluation of efficacy and safety of methotrexate either alone or in combination with hydroxychloroquine in patients suffering from rheumatoid arthritis
Authors: Kaur Amanjot , Dutta Shakti B. , Singh Amandeep , Varma Amit , Beg Mirza A. , Vishal Subhash
Published: July 2017

Background: Rheumatoid arthritis (RA) a chronic autoimmune inflammatory disease and Methotrexate being widely used as monotherapy and in combination for the treatment of RA. Combination therapy provides additional or even more potentiating effects, therefore have been widely used. This study is aimed at comparing the efficacy and safety of Methotrexate either alone or in combination.Methods: This study was conducted for one year from 1st January to 31st December 2015. 52 patients diagnosed with RA were included in this study and were divided in two groups, Group-1 (n=29) patients received methotrexate (MTX) 7.5-15mg/week and Group-2 (n=23) patients received methotrexate 7.5mg once a week + Hydroxychloroquine (HCQ) 200mg twice daily. The patients were followed up for a period of 16 weeks. Statistical analysis was done by using graph pad insta and p value of <0.05 was considered significant.Results: A total of 52 patients were included in the study. The mean age of patients was 50.53±14.81 years. 43 (82.69%) patients were females and 9 (17.30%) were males. 23 (44.23%) patients had positive family history of the disease. The Rheumatoid factor was positive in 42 (80.70%) and anti-CCP was raised in 50 (96.15%) patients. The RAPID-3 and DAS-28 scores on intragroup comparison was highly significant (p <0.0001) and the intergroup comparison was significant (p <0.01) between baseline and 16 weeks in both the groups. The improvement in inflammatory marker CRP was highly significant on intragroup (p <0.0001) and intergroup (p<0.001) comparison between baseline and 16 weeks in both the groups. The mean changes in Vitamin-D3 between baseline and at 16 weeks were insignificant (p >0.05) in both the groups. Total of Adverse drug reactions reported were 42 (50.60%) in group-1 and 41 (49.40%) in group-2.Conclusions: The combination therapy was found to be more efficacious than MTX monotherapy in improving symptoms and quality of life. The adverse drug reactions were mild, more in combination therapy and none of the patients required withdrawal of treatment.
Knowledge, attitude, practice of rational use of medicines among junior residents in a tertiary care hospital
Authors: V. Hooli Tanuja , Srikanth . , S. C. Somashekara , B. Suraj
Published: July 2017

Background: Irrational use of prescribing is on the rise due to many factors like false beliefs, following a prescribing pattern of senior doctors, inadequate knowledge, ignorance, promotional activities for the profit of professionals by pharmaceutical industry and lack of enforcement of regulations by regulatory authorities. Junior residents are exposed to variety of prescribing patterns in the first year and are the future physicians and specialists. There are very few studies among JRs, hence the present study was conducted to assess the knowledge, attitude and practice of junior residents about rational use of medicines.Methods: This was a cross-sectional, questionnaire based study conducted among JRs at a tertiary care hospital in South India in June 2015. The participants were explained about the study and consent was taken. Permission was obtained from institutional ethics committee. Identity of the residents was kept confidential. A self-developed, pre-validated, semi-structured questionnaire consisting of both open-ended and closed-ended items was used. Questionnaire was designed to obtain information about the knowledge, attitude and practice of RUM. The data was recorded and analyzed using Microsoft Excel (2013 version) and the results are explained in frequency and percentage.Results: The knowledge related to essential medicines list (EML), P drugs and schedule H drugs was limited. Participants had limited knowledge about the revision of EML list, number of fixed dose combinations (FDCs)in EML, STEP criteria for choosing a P drug and advantages of choosing a P drug Most of the JRs frequently prescribed drugs from EML. Trade name and newer drugs were prescribed around 50%. The prescription of FDCs from EML was very low (6%). Around 50% of JRs prescribe medicines with both generic and brand name.Conclusions: Majority of JRs were aware about various issues concerned with RUM but the knowledge related to EML, P drugs, schedule H drugs and number of FDCs in EML was limited.  As junior residents are future prescribers, they need to be aware of all the aspects of RUM. Inadequate/improper knowledge in the above areas is a matter of concern and needs to be addressed.
A prospective study comparing the safety and efficacy of combination of topical tacrolimus 0.1% and mometasone furoate 0.01% with topical tacrolimus 0.1% alone in vitiligo
Authors: Puthiyapurayil Febina C. , Mothalampet Anuradha , Riyaz Najeeba
Published: July 2017

Background: Vitiligo is a common acquired skin disorder. Corticosteroids are considered to be the first line treatment for vitiligo, but have side effects on prolonged use. Calcineurin inhibitors like Tacrolimus are found to be effective which is used either alone or in combination with steroids. The advantage of combination therapy of Tacrolimus with Mometasone is that it provides additional benefit for the disease as well as the adverse effects of steroids can be minimised. The main objective of this study is to compare the safety and efficacy of combination of topical Tacrolimus 0.1% and Mometasone furoate 0.01% with topical Tacrolimus 0.1% alone in vitiligo.Methods: In this study 90 patients were divided into two groups to receive either combination treatment of topical Tacrolimus 0.1% and Mometasone furoate 0.01% or topical Tacrolimus 0.1% alone. The efficacy was measured in terms of mean improvement in VASI (Vitiligo Area Scoring Index) scores at 2weeks, 4weeks, 6weeks, 12weeks, and 24weeks from the start of therapy. Safety of the drugs were measured in terms of adverse effects reported during therapy.Results: At the start of the study, mean VASI scores of both groups were comparable. At the endpoint, mean VASI improvement score was statistically significant among the combination group (57.82vs31.45, p <0.001). Adverse effects were found to be less in combined treatment group (p= 0.046).Conclusions: Combination treatment (Tacrolimus+ Mometasone) found to be superior to Tacrolimus alone in the treatment of vitiligo in terms of efficacy and safety.
To evaluate the effect of neostigmine on blood glucose levels in euglycemic albino rats through OGTT
Authors: R. N. Suresha , Amoghimath Siddamma , M. K. Jayanthi
Published: July 2017

Background: Diabetes mellitus (DM) consists of a group of syndromes characterised by hyperglycaemia, altered metabolism of lipids, carbohydrates and proteins and an increased risk of complications from vascular disease. There are genetic and environmental components that affect the risk of developing either type 1 or type 2 diabetes mellitus.Methods: Twelve Swiss albino rats weighing around 150-200gmsof either sex were randomly selected from the central animal facility, JSSMC, Mysore and divided into two groups. The control group received distilled water (25ml/kg body wt.) per orally, test group received Neostigmine (0.5mg/kg/day) per orally for 5 days. On the fifth day, following overnight fasting, 1 hour after drug administration in all the group of rats OGTT was performed, by administering oral glucose in dose of 0.6gm/kg body weight. The capillary blood glucose level was measured at 0, 60 and 150 minutes, by rat tail snipping method using (ACCUCHEK) glucometer.Results: The Capillary Blood Glucose levels of Neostigmine group was less when compared to control group at all-time intervals.Conclusions: Neostigmine showed the hypoglycemic activity when given for 5 days orally in euglycemic albino rats through OGTT.
Effects of vitex agnes castus on hormonal imbalances in Polycystic Ovary Syndrome
Authors: Saul Sugantha
Published: July 2017

Background: The polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women. Its incidence is assessed at 6-8% of the female population in the reproductive age. It is caused by an imbalance of the female sex hormones and higher levels of male hormones called androgens.Methods: In women with PCOS, the ovaries make more androgens than normal. High levels of these hormones affect the development and release of eggs during ovulation. Hence the hormonal imbalance were studied in three groups. In the present study ,8mg of estradiol valerate was used to induce PCOS in female albino rats. The levels of leutinizing hormone, follicle stimulating hormone, testosterone, dehydroepiandrosterone sulphate, Estradiol, Progesterone, and Prolaction were studied.Results: The phytochemical analysis of vitex agnus castus was carried out and the positive effects of vitex agnus castus on the hormonal irregularities of PCOS were also studied. The present findings indicated that vitex agnus castus was found to be rich in phytochemicals.Conclusions: The hormonal levels highly reflect the underlying hormonal imbalance in PCOS and the results obtained in the present study also proved that vitex agnus castus is more efficient in reversing the adverse effects of hormonal imbalance of PCOS.
Longitudinal study of self-medication practices in 2nd year MBBS students through their internship
Authors: Burute Shreyas R. , Gaidhankar Smita L. , Patil Praveeenkumar T. , Murthy Mangala B. , Ramanand Sunita J. , Pore Shraddha M.
Published: July 2017

Background: Self-medication is common in medical students but few studies address the concern regarding knowledge of adverse drug reactions (ADRs) among them. None of the study compares the practice of self-medication among the same medical students as their level of education increases. Hence the study was planned to compare the pattern, source, reason of self- medication and assess the level of awareness about potential ADRs to the consumed drugs in medical students during second year through their internship.Methods: It was a longitudinal cross sectional questionnaire-based study conducted among under graduate second year MBBS students of a medical college and repeated during their internship few years later in order to avoid variability in questionnaire. Chi-square and Fischer’s exact test were used for testing statistical significance. p value less than 0.05 was considered to be statistically significant.Results: 80 students were present on the day of study during their IInd MBBS and 73 students during their internship. Comparatively more students self-medicated during their internship than during their IInd MBBS (68% vs 55%). Analgesics (56.8% and 80%) were most commonly used. 35(70%) of interns were aware of potential ADRs and was statistically very significant in comparison to their awareness during IInd MBBS [9(20.45%)]. Interns rely more on themselves (96%) for self-medication.Conclusions: The practice of self-medication begins early in the career of medical students and is carried forward into their future. Hence it is imperative to educate students regarding responsible self- medication very early in their curriculum.
Pharmacoepidemiological profile and appropriateness of drug use in paediatric diarrhoea patients: a cross sectional study in western India
Authors: Chaudhari Vipul P. , Patel Juhi , Shah Rima , Shah Amit
Published: July 2017

Background: The background of the study was to analyze the prescribing pattern and appropriateness of drug treatment of diarrhoea.Methods: Total 194 pediatric patients with diarrhoea (140 admitted at tertiary care centre and 54 patients attended primary health care centre) were included and their demographic details; disease related parameters, drug treatment and adverse drug reactions were recorded. Appropriateness of drug treatment was analyzed using the WHO and Indian Academy of Pediatrics (IAP) guidelines for management of diarrhoea.Results: Most patients (27.32%) were less than 1 year of age and majority 54.64% were males. Most common presenting symptoms was diarrhoea with dehydration (100%) followed by vomiting (60%), fever (54.29%). Stool cultures were carried out only in 22.86% patients at tertiary health care centre while no investigations were carried out at PHC. Average number of drugs prescribed per patient was 8.25 ± 1.3. All the patients were given fluid replacement therapy. 94.29% and 85.19% patients were prescribed antimicrobials at tertiary centre (THC) and PHC respectively. Most common antibiotic used was cephalosporins (82%) followed by aminoglycosides (48.57%) of patients at THC while ofloxacin (82.60%) and metronidazole (17.40%) were commonly used at PHC.  Analgesic/antipyretic was required in 70.71% and 85.19% of patients at THC and PHC respectively. Comparing with the WHO diarrhoea management guidelines and IAP guidelines, only 8 (14.81%) prescriptions were considered as rational. 2.85% patients developed mucocutaneous rash as ADR.Conclusions: Inappropriate prescribing for diarrhoea is highly prevalent in society. Emphasis on proper diagnosis and treatment, education and availability of locally effective guidelines may help in a better and judicious use of drugs in children.
Assessment of prescription pattern using WHO drug prescribing indicators in medicine wards of a tertiary care teaching hospital: a retrospective observational study
Authors: Bachewar Narendra P. , Choudhari Sachin R. , Dudhgaonkar Sujata
Published: July 2017

Background: Rational prescribing is an essential skill for every prescriber. However many times it seems a difficult task for various reasons. Such practices ultimately increase the mortality, morbidity and financial burden on the patient. Hence, we aimed our study to evaluate appropriateness of prescription pattern according to WHO drug prescribing indicators, few complementary indicators and classify prescription errors.Methods: A retrospective observational study, conducted in medical record section of tertiary care teaching hospital of Maharashtra during the period of 6 months. Total 400 randomly selected prescriptions from Medicine inpatient wards were scrutinized.Results: Average number of drugs per prescription was 5.20 trending towards polypharmacy. Drugs prescribed by generic name were 13.88%, injectable drugs were part of 93.50% prescriptions, 78.25% prescriptions contained an antimicrobial agent and Percentage of drugs prescribed from NELM 2011 was 72.36%. Illegible handwriting in 68% cases was the important cause of prescription errors. These errors found in 73% of prescriptions.Conclusions: The present study showed that the practices were trending towards irrational prescribing. Polypharmacy and illegible prescriptions were dominated. Regular prescription audit will help to rectify such practices. Also, there is an urgent need of sensitization of prescriber through new treatment guidelines, seminar, presentations and discussions on regular basis.
Tinea incognito with unjustified use of potent Topical Corticosteroids: a case series
Authors: Sheth Haiya J. , Rathod Santosh P. , Chaudhary Raju G. , Malhotra Supriya D. , Patel Pankaj R.
Published: July 2017

Topical corticosteroids prescribed for various dermatological conditions, if used haphazardly have their adverse effects too, like aggravation of underlying infections - tinea, herpes etc. Tinea incognito is a fungal infection of skin masked and often exacerbated by application of topical immunosuppressive or steroid agent. Tinea incognito results because local physicians/chemists might mistake tinea with a simple rash. Availability of a topical steroid cream as an over the counter (OTC) drug is also one of the causes. Once it is diagnosed (clinically with or without KOH mount preparation), it should be thoroughly treated with oral and topical antifungal agents. Four cases presenting to Dermatology OPD VSGH with chief complaints of itching and aggravation of existing lesions due to application of potent topical corticosteroids like Clobetasol and Beclomethasone have been discussed here. They were diagnosed as cases of Topical Corticosteroids induced Tinea Incognito. The patients were recovering with oral and topical antifungals prescribed by dermatologist. These were also reported to nearest ADR Monitoring Centre under PvPI with Probable causality according to WHO UMC Criteria for Causality Assessment. The wide use of topical corticosteroids is due to its immediate symptomatic relief. However, the normal presentation of superficial infection gets altered with their inappropriate use. Lack of awareness among population, steroid abuse by local physicians or no strict regulations for local chemist shops have led to its inappropriate use. Its incidence ranges from 5-15%. These figures point towards the fact that implementation of appropriate regulations for the safe use of topical corticosteroids is essential.
Olanzapine-induced black hairy tongue: a rare case
Authors: Giri Vishal P. , Datta Debranjan , Devi Parvathi
Published: July 2017

Olanzapine is second generation antipsychotic drug. It alters affinities for serotonin and dopamine receptors and provides mild sedating and calming effect. It is indicated for the treatment of schizophrenia, acute mania and the prevention of relapse in bipolar disorder. We present a case report of a 65- year- old man with bipolar disorder I, who developed black hairy tongue following treatment with olanzapine and completely recovered after withdrawal of treatment. Awareness about this particular adverse drug reaction will ensure proper management and avoid unnecessary investigations.
Recurrent pregnancy loss: challenge to obstetricians
Authors: Shetty Mamatha B. , Malyala Mounica , Swarup Asha , Pocha Suneha , Pathadan Davis Sabu , Raju Ankush
Published: July 2017

Background: Recurrent pregnancies loss (RPL) is physically and emotionally devastating situation for the parents, along with difficult situation for obstetrician to handle. Present study aimed at investigation of the significance of various etiology in relation to pregnancy outcome in cases of recurrent pregnancy loss.Methods: It is a retrospective analysis of patients who presented to M. S. Ramaiah Medical college with recurrent miscarriage between April 2014 and August 2015. ANA was done on the basis of clinical and laboratory data which was obtained and eventually diagnosis was made. The study results were analysed in terms of term live births, maternal and fetal complications.Results: Out of the RPL cases that were studied, 78 patients came with recurrent pregnancy loss. Out of these cases, endocrine abnormalities, like diabetes mellitus and hypothyroidism were the maximum 26.92% and 12.82% respectively. Followed by unexplained causes were 37.3%. Thrombophila and APLA positive cases constituted for 16.66% and 3.4% respectively. ANA positive and cervical incompetence were 6.4% each.Conclusions: Recurrent pregnancy loss is very difficult situation to handle. Various etiology need various specialists, and requirements, and management mainly depends on the cause for recurrent pregnancy loss.
Prediction of preterm delivery with a novel bedside test
Authors: Vishwekar Pallavi S. , Chauhan Anahita R. , Turakhia Naju
Published: July 2017

Background: Preterm birth occurs in 7 to 12 % of all deliveries but account for 85% of perinatal morbidity and mortatity. Hence, there is a need for a reliable test to predict the onset of preterm labour. One such test is detection of phosphorylated insulin like growth factor binding protein 1 (phIGFBP- 1) in cervical secretion with a simple bedside kit that is recently commercialized Actim Partus kit.Methods: This was a prospective study carried out at a tertiary hospital over a period of 2 years from October 2006 to November 2008. Women between 28 to 37 weeks with intact fetal membranes, who presented with threatened preterm labour were included and followed up till delivery. Time interval between test and delivery, weeks of gestation at the time of delivery, labour and delivery details as well as neonatal outcome were documented. Diagnostic accuracy of the test was determined by sensitivity, specificity, positive and negative predictive value.Results: It was found that this test was extremely sensitive in prediction of preterm delivery and negative test results implied low chance of preterm delivery as in the patients with positive test result the average time of prolongation of pregnancy was less than 24 hours and in patients with negative test result it was more than 7 days which was statistically significant (P value = 0.001). The need for NICU and perinatal morbidity was significantly less in patients with negative test result.Conclusions: There is a role of detection of cervical IGFBP-1 test in the management of women presenting with suspected preterm labour which allows us to focus on patients who are more likely to deliver preterm and also to reduce perinatal mortality and morbidity.
A comparative study of outcomes of Lichtenstein repair and Desarda tissue repair in patients of inguinal hernia
Authors: Neogi Probal , Gupta Vivek , Tripathi Neeraj
Published: July 2017

Background: Inguinal hernia is a very common surgical problem for which, mesh-based techniques, particularly the Lichtenstein repair is considered standard. However, problems like foreign body sensation, wound infection, cord fibrosis, chronic pain and recurrence are major concern. Desarda tissue repair (non-mesh technique), which was given by an Indian surgeon, is now being used in many countries because of low cost of procedure with very low recurrence rates. The objective of this study was to evaluate the feasibility of Desarda tissue repair at a tertiary care centre of Central India as a treatment of primary inguinal hernia, by comparing it with Lichtenstein repair in terms of various post-operative parameters.Methods: Patients between age of 18 and 70 years with primary inguinal hernia were included in this randomised controlled trial. Patients with strangulated, obstructed or recurrent hernia, surgically unfit patients and patients having unmanaged urinary obstruction, cough or constipation were excluded. Randomization was done by sealed envelope method into Lichtenstein and Desarda arm and respective surgeries were performed.Results: 90 patients were included in the study and average duration of follow-up was 15.1 months. Operative time was significantly less in Desarda arm (14.75 min compared to 21.32 min in Lichtenstein arm). Cost, incidence of seroma formation, post-operative pain, foreign body sensation and chronic pain were also significantly less in Desarda arm. No recurrence was observed in both arms.Conclusions: Desarda repair is easy to perform and takes less time to perform and proves cost effective. Desarda repair is comparable to Lichtenstein repair in terms of many parameters and superior in terms of post-operative pain and foreign body sensation and can be preferred for young patients. In infected and strangulated cases, Desarda repair can be used effectively without fear of mesh infection.
Diagnosis and management of acute appendicitis by Alvarado scoring with ultrasonography as supportive tool
Authors: Chada Chenna Krishna Reddy , Malepati Srikrishna , Kandati Jithendra , Satish Sreeram
Published: July 2017

Background: Acute appendicitis remains as one of the most common surgical entity requiring early intervention. Delay in management results in complications and misdiagnosis results in negative appendectomy. Hence there is always a need to develop a well-designed protocol for diagnosis and to reduce negative appendectomy. Alvarado score for diagnosis of acute appendicitis is an easy, affordable and diagnostic which has been evaluated early with variable reports. In cases with equivocal score, additional tools like sonography may provide a reliable result in accurate diagnosis of acute appendicitis. Objective of the study was to determine the diagnostic accuracy of Alvarado score and ultrasonography in diagnosis of acute appendicitis. To determine the sensitivity, specificity and predictive values of ultrasonography in cases operated with histopathological correlation.Methods: A prospective observational study was conducted at our hospital by department of general surgery for a period of six months. All suspected cases of appendicitis were scored by Alvarado score and cases with>5 were performed additional USG for further evaluation. All the cases of appendicitis that underwent surgery were further confirmed by histopathological correlation with USG and clinical Alvarado score.Results: A total of 200 cases were enrolled with male predominance (57.5%) and mean age of study group was 34.26±8.64 years and male to female ratio of 1.3:1.69% of cases presented with Alvarado score of 7 and above, while 21% of cases with 5-6. Migratory pain in RIF was the commonest symptom and tenderness RIF was the most common sign.160 cases (80%) were operated totally with 75% cases lap appendectomy and 25% cases by open appendectomy. USG was performed on 160 cases and 146 were positive and 14 were negative whereas histopathologically 142 cases were confirmed as Acute appendicitis. The sensitivity, specificity, PPV and NPV of USG is 97.18%, 55.56%, 94.52% and 71.43%. The accuracy of USG is 92.5.Conclusions: Acute appendicitis is first and foremost a clinical diagnosis with scoring systems and imaging being necessary adjuncts in equivocal cases. USG is an easily available tool in diagnosis of acute appendicitis. Application of USG as adjunct tool to Alvarado scoring improves the diagnostic accuracy.
Clinico-etiological profile of neonatal seizures in term neonates
Authors: Reddy K. Venkataramana , Soren C. , Jagtap Snigdha , Pardhasaradhi Y. , Satish S.
Published: July 2017

Background: Neonatal seizures or neonatal convulsions are epileptic fits occurring from birth to the end of the neonatal period. Neonatal seizures are a common neurological problem with a frequency of 1.5-14/1000 neonates. Neonatal seizure is common in this part of the Telangana and there was paucity of data from this area. Identification of etiology will help in management there by reducing morbidity and mortality.Methods: This prospective study was done in NICU of S.V.S. Medical College and Hospital, Mahabubnagar, from Jan 2016 to Jan 2017. Term neonates with clinically identifiable seizure were included in the present study. This study was approved by institutional ethical committee and written consent was obtained from parents of the studied neonates.Results: Of 84 studied neonates, 46 were males and 38 were females. 29 neonates had seizures within first 24 hours and 22 neonates had seizures on day 2. Perinatal asphyxia was seen in 28 neonates and septicemia was seen in 21 neonates.Conclusions: Perinatal asphyxia was the most common cause for neonatal seizures in term neonates, followed by septicaemia and metabolic disturbances.
Antimicrobial resistance: the next BIG pandemic
Authors: Chaudhry Divya , Tomar Priyanka
Published: July 2017

Pandemics have indefinitely threatened the resilience of health systems worldwide. Based on the costs inflicted by some of the deadliest pandemics in human history, economists have projected that global pandemics could cost over USD 6 trillion and generate an annual estimated loss of over USD 60 billion. While the global health community is tirelessly trying to curb the burden of premature mortality from several old and new forms of pathogens, it is now faced with the silently emerging antimicrobial resistance (AMR) pandemic that could endanger some of the most significant advances in modern medicine. Owing to rampant antibiotic consumption in India, the article shows why the country may become the ‘AMR capital of the world’. It shows how health systems may be strengthened both at the national and international levels to reduce premature mortality and morbidity attributable to AMR and pandemics.
Is vitamin D deficiency contributing to high predisposition to non-communicable diseases in Indians? A review article
Authors: Sarkar Amrita , Roy Debjit
Published: July 2017

Vitamin D deficiency is highly prevalent in Indians. The role of vitamin D in infectious diseases is a well-known fact. However, more recently, several studies have linked vitamin D deficiency with various non-communicable diseases like hypertension, cardiovascular diseases, diabetes, cancer and psychiatric illnesses amongst others. Indians are known to be prone to developing non-communicable diseases so a co-existing vitamin D deficiency will lead to a synergistic effect towards developing the same. Since vitamin D deficiency is completely preventable, opportunistic screening of people, screening the vulnerable population like the pregnant women and the elderly, patients with hepatic or renal failure, patients on retroviral or immunosuppressant therapy can be useful. Health education and promotion activities should be done to bring awareness in the community. This might as well reduce the growing burden of non-communicable diseases in India.
Hypertensive patients’ adherence to pharmacological and non-pharmacological treatment methods, in Turkey
Authors: Selçuk Kevser Tarı , Çevik Celalettin , Mercan Yeliz , Koca Haydar
Published: July 2017

Background: The present study was aimed at determining hypertensive patients’ adherence to pharmacological and non-pharmacological treatment methods and factors affecting their adherence. Methods: This cross-sectional study was conducted with 418 patients aged 18 and over who met the inclusion criteria. Adherence to pharmacological and some non-pharmacological treatment methods is the dependent variable of the study. Data were collected using the personal information form, Morisky medication adherence scale. In the analysis, descriptive statistics, the chi square test, and logistic regression analysis were used. The significance level was accepted as p<0.05. Results: The rate of adherence to the pharmacological treatment was 78.2%. The rates of adherence to smoking cessation, diet and physical activity were 49.0%, 55.7% and 20.6% respectively. Age, employment status and perceived health status were associated with the adherence to smoking cessation; perceived income, resort to complementary alternative treatment methods and having regular controls (check-ups) were related to the adherence to the diet, and gender and perceived economic status were related to the adherence to physical activities (p<0.05). Conclusions: While approximately four out of five patients complied with the pharmacological treatment, rates of adherence to non-pharmacological treatment methods were low. Multidisciplinary intervention programs should be planned in order to regularly monitor patients at family health centers, to assess their adherence to treatment modalities and to promote adherence.
Is knowledge and practice of oral rehydration therapy suboptimal? Assessment at Federal Medical Center, Asaba, South-South Nigeria
Authors: Ezeonwu Bertilla U. , Ayodele Ayodeji , Ajaegbu Obinna C. , Mbagwu Nkemjika E. , Ovemeso Odiri , Okolo Angela A.
Published: July 2017

Background: Oral rehydration therapy (ORT) is a core component of the childhood survival strategies to reduce child mortality and morbidity due to diarrhoeal disease with its fatal dehydrating complication of acute kidney injury. This strategy is indispensable to the attainment of the International Society of Nephrology’s (ISN) aim to eliminate preventable deaths from acute kidney injury (AKI) by year 2025. Diarrheal disease is the second most common cause of morbidity and mortality in children at our centre. This interventional study assessed the knowledge and the practice of ORT among caregivers, educated and trained them on the management of diarrhoeal diseases and practice of ORT. Oral rehydration salt (ORS) and zinc tablets were also distributed. Methods: An interviewer-administered questionnaire was used following informed consent. Consented care givers of wards attendees of FMC Asaba were assessed on their knowledge and their practice of ORT, educated on childhood diarrheal diseases, trained on practice of ORT and had ORS and zinc tablets distributed to them. These assessments were done on the spot and 6 weeks after the health talk, from July 2015 to December 2015. Results: There were 266 respondents and 231 were mothers. The immediate impact of the health talk on the knowledge and the practice of ORT was laudable, p≤0.0001 and educational attainment of the respondent influenced the immediate post health talk knowledge of ORT, p=0.009. The age of the respondent predicted the long term impact of health talk on practice of ORT, p=0.020. Conclusions: Knowledge and practice of ORT are not optimal but can be improved by regular education.
Fasting blood glucose level and its association with sex, body mass index and blood pressure: a cross sectional study on a Bangladeshi public university students
Authors: Hossain Md Imam , Islam Md. Shariful , Hasan Mirza Rokibul , Akter Moriom , Khoka Md. Sadek Hosen
Published: July 2017

Background: In resource-limited countries like Bangladesh, there is a scarcity of epidemiological researches examining the relationship of blood glucose level with hypertension and BMI among the graduate level students. This research was therefore undertaken to evaluate fasting blood glucose levels of Mawlana Bhashani Science and Technology University students and to check its associations with sex, body mass index (BMI) and hypertension. Methods: For the study the 240 students (120 male and 120 female) were randomly selected. The demographic data of the study subjects were collected by interviewing the subjects with standardized questionnaires. Their fasting blood glucose levels were measured using portable blood glucose meter. The BMI and blood pressure of the subjects were also recorded following standard protocol. Finally the data were analyzed with SPSS software. Results: The fasting blood glucose levels of the study subjects indicated that 0.4% of subjects were diabetic and, 5.4% of subjects were pre-diabetic. The blood glucose levels (mean±SE) of female subjects (4.88±0.07) were higher than that of the male (4.61±0.04) subjects. The mean blood glucose levels of hypertensive subjects (4.81±0.07 mmol/L) were higher than that of the normotensive counterpart (4.73±0.05 mmol/L). The fasting blood glucose levels shows significant positive associations with SBP (r=0.155, p<0.05) and DBP (r=0.149, p<0.05).The fasting blood glucose levels also showed a significant positive association with the BMI (r=0.193, p<0.01) of the subjects. Conclusions: This study reveals the diabetic and hypertension status of the Bangladeshi graduate level students. The result of the study is very important in the context of public concern health of Bangladesh.
Impact of workplace environment on health of leather factory workers
Authors: Yogaraj G. Arunkumar , Ravi Rama
Published: July 2017

Background: The working environment and basic facilities available in the workplace have impact on physical and psychological health of leather workers. The objective was to study the effect of workplace environment on health of leather workers.Methods: A cross section study was carried out in eight permitted leather factories at rural area in Sripuram near Chromepet, Chennai. Using a pretested scheduled questionnaire, 230 workers were interviewed, their corresponding socio-demographic profile was collected and various health scores were recorded based on the general and physical examination. Scoring technique and student ‘t’ test was used to identify the correlation and degree of association between workplace environmental factors and health status of workers. Results: The scoring technique and correlation coefficient revealed an association between workplace health status and clinical symptoms (p<0.001), duration of work and clinical symptom scores (p=0.001), duration of work and workplace health (p<0.001), Workplace health status and occupation (t-test value 5.562, p<0.001), and facilities available and occupation (t value 3.758, p<0.001). Conclusions: The above results show the impact of workplace environment on the health status of workers and require adequate measure to improve the facilities and thereby the health status of workers.
Risk factors for depression among elderly in Bangalore urban district: a case control study
Authors: N. R. Ravindra , M. R. Rashmi , Maheswaran R.
Published: July 2017

Background: With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. The objective of this study is to estimate the prevalence of depression and to assess risk factors of depression among elderly in an urban population. Methods: A case control study was conducted in May-June 2016 in the Bagalgunte area in Bangalore urban district. Purposive sampling technique was employed and all elderly persons (≥60 years) residing in that area were included. Participants were assessed for depression using validated 15 item (short version) geriatric depression scale (GDS).Those with GDS score >5 were considered as cases and those with GDS score ≤5 as controls. Final sample size was 201. Study variables included socio-demographic parameters and all possible risk factors of depression. Results: Of the 201 respondents interviewed, 90 (44.8%) were cases and 111 (55.2%) were controls. 159 (79.1%) were aged 60–69 years and 116 (58%) were male. Low socioeconomic status, elderly who were living alone (single/divorced/death of spouse), h/o dependency on others for daily living, negligence, abuse, economic loss in last 5 years, substance abuse, change of residence, insomnia and anorexia were found to be significantly associated with depression among elderly. Conclusions: In this study, depression among elderly was found to be high. These study findings can help programme managers to focus on mental health of elderly and implement practical and comprehensive strategiesand timely interventions to promote mental health and prevent depression.