Objective:To compare the efficacy and safety with a fixed dose of two parenteral iron preparations, iron sucrose complex and iron sorbitol citric acid as per the current practice.Materials and Methods:A prospective randomized open label study was conducted. In this study, 60 pregnant women with hemoglobin less than 8.5 g/dl received a fixed dose of either IV iron sucrose or IM iron sorbitol citric acid therapy. The efficacy of the therapy was assessed by laboratory parameters such as hemoglobin, hematocrit, MCV, MCH, and serum ferritin level after 14 and 28 days. To assess the safety, adverse drug reactions with both the therapies were recorded.Results:Hemoglobin concentration increased significantly (P < 0.001) with respect to time in both the groups. The rise in the hemoglobin level in third and fourth weeks was significantly higher in iron sucrose (0.92 g/dl) than iron sorbitol citric acid therapy (0.56 g/dl). There was no significant change in the rise of the serum ferritin level after both the therapies. Adverse events were common with iron sorbitol citric acid therapy. However, no serious adverse drug reactions were observed.Conclusions:No significant difference in the efficacy of both of the therapy. However, adverse events and dropout rates were much more common in the group of pregnant women who received iron sorbitol citric acid.

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Background:Current treatment guidelines support the role of lifestyle modification, in terms of increasing the quantity and quality of physical activity to achieve target glycemia in patients with type 2 diabetes mellitus.Objective:To assess the effect of structured exercise training and unstructured physical activity interventions on glycemic control.Materials and Methods:This was a randomized six-month exercise intervention study conducted with previously inactive 279 patients of type 2 diabetes mellitus. Before randomization, all enrolled T2DM participants (n: 300; 30 to 60 year old, having diabetes for more than a year with HbA1c levels of 6.5% or higher) entered a one-month run-in phase to reduce dropout and maintain adherence.Results:A recommendation to increase physical activity was beneficial (0.14% HbA1c reduction; P = 0.12), but was not bringing significantly declines in HbA1c, whereas, structured exercise training is associated with a significant HbA1c decline of 0.59%. (P = 0.030). In a subgroup analysis limited to participants with a baseline HbA1c value > 7%, both the unstructured (0. 48%; P = 0.04) and structured exercise training (0.77%; P < 0.01) groups experienced significant decline in HbA1c Vs the control, whereas among participants with baseline hemoglobin A1c values less than 7%, significant reduction occurred only in the structured exercise training group. Changes in blood pressure; total cholesterol, HDL-cholesterol (high-density lipoprotein), LDL-cholesterol (low-density lipoprotein) and the atherogenic index factors did not statistically significantly differ within (baseline to follow-up) and among groups.Conclusion:Supervised structured training was more efficacious than unstructured activity in achieving declines in HbA1c. Although both structured and unstructured training provide benefits, only the former was associated with significant reductions in HbA1c levels. Therefore, T2DM patients should be stimulated to participate in specifically designed exercise intervention programs.

Background: Bacterial sepsis is one of the most common causes of mortality and morbidity in neonates. The spectrum of bacteria that cause neonatal sepsis varies, and antibiotic resistance is an increasing problem of these bacteria. Objective: To determine the bacteriological profile and antibiotic sensitivity pattern of neonatal sepsis in the neonatal intensive-care unit (NICU), so that the empirical antibiotics can be decided to tackle the organisms in the NICU.

Background: Diabetic autonomic neuropathy is a serious and common complication of diabetes mellitus and in fact it is one of the most overlooked complications, thus very limited clinical and research data are available on early renal and cardiovascular autonomic complications in type 2 diabetes mellitus. Aims & Objective: To determine the possible association of elevated albumin excretion rate with cardiovascular autonomic activity in type 2 diabetes mellitus. Materials and methods: A cross-sectional study was conducted with one hundred and fifteen patients of type 2 diabetes mellitus. Microalbuminuria was defined as Albumin Excretion Rate (AER) > 30 mg/24 hr in an early morning urine sample. Nine parameters reflecting different aspects of cardiovascular autonomic function were measured and were summarized in a single cardiovascular autonomic function score (CAFS).The association between cardiovascular autonomic dysfunction and microalbuminuria was estimated by multiple linear regressions. Results: Patients with microalbuminuria had low levels of the autonomic function parameters i.e. mean CAFS, indicating impaired autonomic function. This association was consistent with increasing AER, and remained significant after multivariate adjustment for other clinical factors predictive of microalbuminuria. In additional analysis, we examined the autonomic function tests combined on the part of autonomic nervous system they predominantly represent. The results of these alternative combinations were comparable to those of the CAFS score. Conclusion: Cardiovascular autonomic dysfunction was independently associated with microalbuminuria in patients with type 2 diabetes mellitus, and that this association is independent of other previously identified determinants of albuminuria in type 2 diabetes mellitus. Therefore cardiovascular autonomic function tests should be monitored to pay attention to major potential cardiovascular complications even in asymptomatic patients, but especially among those with microalbuminuria.

Background: Medical knowledge is expanding everyday with increasing complexity of the health-care system. For that, it is important for faculty to have self-motivation for their update and self-development. Self-directed learning in today's scenario is mostly done by online learning or e-learning. Of many tools, massive open online course (MOOC) is a relatively new phenomenon blooming the adult learning. They fill the role of continuous education and professional development.Objective: To find out the awareness and use of MOOC and educational video series by the medical faculties. Materials and Methods:It was a questionnaire-based cross-sectional study. Thus, predesigned and pretested questionnaire forms were distributed to faculty members of a medical school. Questionnaires were about usage of information technologies and Internet tools, various messaging and discussion tools, and use of MOOC and video series by medical faculties. The filled up forms were collected, and statistical analysis was done by using Microsoft Excel.Result: A total of 108 faculty members participated in the study. More than 64% participants were using Internet more than 5 h per week. Among all participants, 63.89% participants were using online messaging and discussion tools such as email, google and yahoo groups, blogging, forums, and others. Awareness of MOOCs and web portal such as edX, coursera, Udacity, and others was only 18.52% (20) among the faculty members. Of them, 14 reported that they had enrolled in such courses at least once. Of 108 faculties, 25 were aware of availability of educational video series, and 22 reported using video series. Conclusion:Use of Internet and online discussion tool for educational purpose is very good among the faculty members. But, the study shows that the awareness of online learning tools such as MOOCs and educational video series are very low among faculty members. However, after some awareness program, they will start using these resources for selfdirected learning.

Background: Health-care expenses are booming nowadays. India is one of the biggest generic medicine manufacturers in all over the world still generic medicines are less prescribed in India. In the USA, 86% prescriptions contain generic medicines which saved 1.5 trillion dollars of USA consumers in the past decade. Less knowledge of generic medicine is correlated to less prescribing. Previously, studies were carried out on pharmacist and general practitioner to assess knowledge, attitude, and practice of generic medicine among them. Such study was not done on MBBS students who will be future doctors. Aims and Objectives: This study was planned with the aim of assessing knowledge, attitude, and practice of medical students toward generic medicines. Materials and Methods:This was a questioner-based cross-sectional survey kind of study. This preformed and pre-evaluated questioner was given to third semester of second year MBBS students. Questioner contains 10 items for knowledge, 10 items for attitude, and 2 items for practice. These are multiple choice kind of questions. Data were analyzed by MS Excel. Results: In this study, 110 students participated. Only 14.55% of students said that generic drugs only be marketed after expiry of patent of innovator drug. Only 27.27% of students said that generic drug manufacturer need not to repeat the preclinical studies and clinical trials as required by innovator medicines. Most of the students (65.45%) know that innovator drugs are more costly than their generic substitute. Only 23.64% of students were aware about the Government of India scheme called Jan Aushadhi whose sole purpose to set up generic drug stores in the country. Just 30.91% of participants know that patients or pharmacists are not legally empowered to sell or purchase generic medicines over innovator medicine. There were a good number of participants (54.55%) not agree with Generic drugs cost less because they are inferior to innovator (patented) drug. About 88.18% of students gave the opinion that there should be a training program to increase the awareness regarding generic drugs among doctors and patients. Nearly 81.82% of students gave the opinion that there should be a generic medicine store at every government hospital. 80% of participants had not read any article regarding the comparison of safety and efficacy of generic versus innovator (patented) drugs. Conclusion: This study showed that medical students having good knowledge, attitude about safety, efficacy, and cost of generic medicines. Students know less about government scheme such as Jan Aushadhi. They also support that patients and pharmacist are legally empowered to sell or purchase generic medicine in place of costly innovator medicines. Students also agree with there should be some change in policy by medical insurance company to improve generic drugs prescribing.

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