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in collaboration with the Rheumatology clinic of the same institute over a period of one year. Among the patients attending RA clinic, newly diagnosed cases of RA according to "The 2010 ACR-EULAR criteria for classification of Rheumatoid Arthritis" (ACR-American College

Background:Pulmonary tuberculosis (PTB) is an age old disease described in Vedic Medicine as ‘Yakshma’. Later on, in Ayurveda it earned a prefix and found way into mythology as ‘Rajayakshma’. After the discovery of streptomycin, the therapeutic management of PTB received a major breakthrough. The treatment module changed remarkably with the formulation of newer anti-tubercular drugs (ATD) with appreciable success. Recent resurgence of PTB in developed countries like United States posed a threat to the medical community due to resistant strains. Consequently, WHO looked toward traditional medicine. Literature reveals that Ayurvedic treatment of PTB was in vogue in India before the introduction of ATD with limited success. Records show that 2766 patients of PTB were treated with Ayurvedic drugs in a tertiary care hospital in Kolkata in the year 1933-1947.Objectives:To evaluate the toxicity reduction and early restoration by adjunct therapy of Ayurvedic drugs by increasing the bio-availability of ATDs.Materials and Methods:In the present study, treatment response of 99 patients treated with ATD as an adjunct with Aswagandha (Withania somnifera) and a multi-herbal formulation described in Chikitsa-sthana of Charaka samhita i.e. Chyawanprash were investigated. Hematological profile, sputum bacterial load count, immunoglobulin IgA and IgM, blood sugar, liver function test, serum creatinine were the assessed parameters besides blood isoniazid and pyrazinamide, repeated after 28 days of treatment.Results:The symptoms abated, body weight showed improvement, ESR values were normal, there was appreciable change in IgA and IgM patterns and significantly increased bioavailability of isoniazid and pyrazinamide were recorded.Conclusion:This innovative clinical study coupled with empowered research may turn out to be promising in finding a solution for the treatment of PTB.

Objectives:The objective was to assess the views of clinicians in teaching hospitals of Kolkata regarding the use of antibiotics in their own hospitals, focusing on perceived misuse, reasons behind such misuse and feasible remedial measures.Materials and Methods:A total of 200 clinicians from core clinical disciplines was approached in six teaching hospitals of Kolkata through purposive sampling. A structured, validated questionnaire adopted from published studies and modified to suit the responding population was completed by consenting respondents through face-to-face interaction with a single interviewer. Respondents were free to leave out questions they did not wish to answer.Results:Among 130 participating clinicians (65% of approached), all felt that antibiotic misuse occurs in various hospital settings; 72 (55.4% of the respondents) felt it was a frequent occurrence and needed major rectification. Cough and cold (78.5%), fever (65.4%), and diarrhea (62.3%) were perceived to be the commonest conditions of antibiotic misuse. About half (50.76%) felt that oral preparations were more misused compared to injectable or topical ones. Among oral antibiotics, co-amoxiclav (66.9%) and cefpodoxime (63.07%) whereas among parenteral ones, ceftriaxone and other third generation cephalosporins (74.6%) followed by piperacillin-tazobactam (61.5%) were selected as the most misused ones. Deficient training in rational use of medicines (70.7%) and absence of institutional antibiotic policy (67.7%) were listed as the two most important predisposing factors. Training of medical students and interns in rational antibiotic use (78.5%), implementation of antibiotic policy (76.9%), improvement in microbiology support (70.7%), and regular surveillance on this issue (64.6%) were cited as the principal remedial measures.Conclusions:Clinicians acknowledge that the misuse of antibiotics is an important problem in their hospitals. A system of clinical audit of antibiotic usage, improved microbiology support and implementation of antibiotic policy can help to promote rational use of antimicrobial agents.

(ADR) is a severe drawback of the therapeutics in the recent world. Pharmacovigilance is the practice of keeping records of these ADRs. The practice of pharmacovigilance is thus essential to decrease the incidence of adverse drug reaction occurring from different drugs. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Correspondence

In recent years, chronic obstructive pulmonary disease (COPD) has increased several folds in the developing countries and the disease is accompanied with several co-morbidities among which depression is a major one. Still now there is a lack of data regarding the prevalence and risk factors of depression among the patients with COPD in India. The aim of the study is to assess the prevalence of depression and associated risk factors in patients with COPD in Kolkata, India. In this cross-sectional study, 214 COPD patients were selected by purposive sampling at OPD of Pulmonary Medicine, RG Kar Medical College, Kolkata, India. The patients were diagnosed and grouped into different stages of COPD by clinical examination and spirometry. A questionnaire was administered among the respondents to collect the data regarding their socio-demographic conditions followed by Patient Health Questionnaire 9 (PHQ-9) to measure the level of depression. The mean age of the respondents was 59.37±11.37 years and 99% were male. The proportion of depression among patients with COPD was 86%. Among the respondents, 36.9% had moderately severe depression, 32.2% had moderate depression and 6.1% had severe depression. The risk factors of depression among COPD patients were urban residence (OR=4.79, p=0.02), income group of 5000-9999 Rupees per month (OR=18, p=0.38), teetotalers (OR=8.36, p=0.02), Stage 2 COPD (OR= 83, p=0.001) and onset of COPD ≥70 years of age (OR=20, p=0.02). The study showed that more than 8 out of 10 COPD patients and it can be considered very high proportion. The study highlight the importance of routine screening for depression of all COPD patients in all healthcare settings and implementation of effective strategies for proper prevention and management of depression in those patients.

Background: Contribution of physicians, in adverse drug reaction (ADR) reporting and monitoring, to develop a global database is enormously significant to ensure safety of medicine. But, in reality, due to lack of awareness among the healthcare providers, under-reporting of suspected ADRs is a major problem, especially in countries like India. Present study aimed to evaluate the knowledge, attitude, and practices (KAP) of the physicians regarding self-reporting of ADR in a tertiary care hospital in Kolkata, West Bengal, India.Methods: This was a cross-sectional, observational and questionnaire-based study involving physicians of different clinical departments. This questionnaire-based study was conducted to obtain the demography as well as information on knowledge, attitude and perception of physicians towards ADR reporting. Ethical clearance was obtained prior to start the study.Results: 50 doctors were included in the study after their verbal consent. It was revealed that average time taken to complete the answering of questionnaire by the physicians was 15 minutes. Among the study population (n=50), 54% of the participants were Postgraduate doctors and the rest 46% were graduates. 92% believed that it is necessary and would be beneficial for the patient to report ADRs. 74% also believed that ADR reporting is a professional obligation for doctors.Conclusions: Present study evaluated that majority of the healthcare professionals had good knowledge and attitude about pharmacovigilance and understand the need for reporting, but the rate of reporting was very low. More interactive training programme is needed to increase the awareness of reporting ADRs by healthcare professionals.