Background: Respiratory infections are increasing globally with parallel increase in world population, pollution, urbanization, overcrowding, global warming and poverty. Multi drug resistant virulent bacteria are growing very rapidly. The objective of this study was to know the prescribing pattern of antibiotics in hospitalized patients suffering from different common respiratory disorders.Methods: This was a retrospective and observational study. Data was captured from 1st January 2016 to 31st December 2016 at ICARE Institute of Medical Sciences and Research and Dr. B.C.Roy Hospital. Total 200 patients were taken for the study of age range from 10 to 50 years.Results: COPD, bronchial asthma, pneumonia and ARIs were the most frequent respiratory illnesses among patients attended Medicine OPD. Most common antibiotics prescribed were co-amoxyclav, ceftriaxone, moxifloxacin, clarithromycin, azithromycin and aminoglycosides.Conclusions: Injudicious use of antibiotics in trivial viral respiratory infections may give rise to antibiotic resistant strains in the community.
Background: Neonatal sepsis (NS) has significant morbidity and mortality rates and it is still difficult to diagnose on presentation. Early diagnosis and treatment decreases the mortality and morbidity of neonatal sepsis (NS). The study’s aim was to detect the levels of IL-6, CRP and hs-CRP in clinically suspected cases of neonatal sepsis and establish its association with the pathogenesis of the disease.Methods: The case control study consists of 70 neonates of whom 36 were clinically suspected case of sepsis admitted in NICU of paediatric department and were taken as cases and 34 were normal healthy neonates taken as control subjects. The cases as well as controls were within 28 days of age. Preterm and term neonates (<28 days of age) of both sexes showing signs of both early and late onset sepsis and also blood culture positive were included in the study. About 4 ml of venous blood was taken for measurement of hs CRP and IL 6. Serum hs-CRP levels was determined with a high-sensitivity nephelometric method while the serum level of IL 6 was measured by immunoassay Kits (Raybiotech, USA).Results: Serum IL 6 levels were increased in sepsis cases as compared to controls and were statistically significant (68.94±36.32 versus 8.26±3.82 pg/ml; P <0.0001). However, a high positive correlation was observed between ESR with serum IL 6 level (r=0.825; P = <0.001) among neonatal sepsis subjects while no correlation was seen in controls (r=0.279; P=0.098).Conclusions:It was observed that a significant rise in IL-6 or hs-CRP which may be suggested as specific marker for the identification of neonatal sepsis. The combination of IL-6 or CRP or hs-CRP could therefore be vital for the diagnosis and would be better predictors of neonatal sepsis and may be crucial in the pathogenesis of the disease.
Introduction: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The present study was conducted to study on various facets of antihypertensive drugs prescribing at present scenario at Dr B.C. Roy Hospital, Haldia, and with objectives of studying prescribing patterns and rationality of antihypertensive drugs in essential hypertension with or without specific co-morbid conditions and to check compliance of treatment as per JNC-8 hypertension treatment guidelines in the outpatients attending the Department of Medicine. Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation for rational drug therapy by evaluating average number of drugs per prescription, fixed dose combination (FDC) prescription rate, prescription laying down importance of lifestyle management, prescription with defined anti-HTN goals, prescriptions with correct dose strength and dosage schedule was evaluated. Results: Out of 100 hypertensive patients under evaluation 67 was males (67%) with a M:F ratio of 2.03:1. Mean SBP was slightly higher in male patients. Hypertension was classified according to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension), and 13% (stage 2 hypertension) cases. Dyslipidemia was noted much more common associated disorders among newly diagnosed hypertensive of either sex. Conclusion: Diuretics (8%) were most widely prescribed drugs followed by ARBs (6%), ACE Inhibitors (5%) and calcium channel blockers (4%) as monotherapy. Adherence of JNC 8 guidelines among all study hypertensive participants while prescribing medications varied between 62% to 92%, with an average of 75%. None of the prescriptions mentioned ban drug formulation(s). Still 15% of the prescriptions had suggested combined drugs with debated rationality formulations.
Background: This comparative study was done to evaluate the change from baseline in HbA1c levels with teneligliptin vs. metformin treatments at week 12 among recently diagnosed type 2 DM patients attending Medicine OPD of Dr. B. C. Roy Hospital, Haldia, West Bengal (a tertiary care teaching hospital).Methods: In this prospective parallel group clinical study patients were divided into two groups. Group A patients were on metformin monotherapy therapy and Group B patients were on teneligliptin monotherapy. Data of 40 patients (20 patients in each group) were available for analysis in the present study. Secondary endpoints included changes from baseline FPG and 2h-PPG values at 12 weeks were evaluated. Safety and tolerability were assessed by the incidence of adverse events (AEs) throughout the study period.Results: The mean age of patients was 50.05±12.35 years and out of the entire patient population 70% were males and 30% were females. At the end of 12 weeks or 3 months of metformin therapy, mean HbA1c, FBG, and PPG were significantly reduced by 0.52%, 16.2mg/dL, and 36.8mg/dL, respectively, and 37.75% of patients achieved the HbA1c target of <7%. At the end of 12 weeks or 3 months of teneligliptin therapy, mean HbA1c, FBG, and PPG were significantly reduced by 0.60%, 19.4mg/dL, and 49.8mg/dL, respectively (Table 2), and 40% of patients achieved the HbA1c target of <7%.Conclusions: Teneligliptin, a DPP4 inhibitor reduced HbA1C significantly compared with monotherapy of metformin in treatment naive patients at week 12. It also reduced FBG and 2-h PPBG as compared with metformin at week 12.
Background: Teneligliptin was introduced in India in May 2015. It has gained popularity and is already widely prescribed in type 2 diabetes mellitus (T2DM). The main aim of our study was to assess the efficacy and superiority of teneligliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor as add-on third drug along with metformin and glimepiride in the treatment of type 2 diabetes mellitus in rural India.Methods: In this comparative observational study, three groups of uncontrolled type 2 diabetes (on monotherapy) patients each comprising 50 in number were studied for 3 months. Groups were divided into patients on triple drug regimens (Group A- Metformin+Glimepiride+voglibose; Group B- Metformin+Glimepiride+Pioglitazone and Group C- Metformin+Glimepiride+Teneligliptin). In each group FBS and PPBS were tested at the beginning and at 4 weeks intervals. HbA1c was tested at the start of study and at the end of 12 weeks.Results: After 12 weeks of therapy, it was observed that FBS, PPBS and HbA1c were significantly reduced in Group-C patients containing teneligliptin in comparison to Group-A and B containing voglibose and pioglitazone respectively.Conclusions: Teneligliptin significantly improves glycemic control in Indian patients with T2DM when prescribed as an add-on to one or more other commonly prescribed antidiabetic drugs, even in patients of rural India. It may be an ideal add-on third drug in the treatment of T2 DM patients.
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