Background: Adverse Drug Reactions (ADRs) are one of the underestimated causes of morbidity and mortality. Monitoring of these ADRs is at the core of any pharmacovigilance program. ADR monitoring suffers from lack of reporting from health care personnels. Unless we know the current knowledge, attitude and practices of the budding doctors it’s difficult to design corrective measures to improve reporting. The present study was designed to assess the knowledge, attitude and practices of pharmacovigilance and ADR reporting among undergraduate and postgraduate medical students.Methods: This was a questionnaire-based, observational study. The questionnaire had six questions each pertaining to knowledge, attitude and practices of pharmacovigilance and ADR reporting. Factors discouraging ADR reporting were also studied. Descriptive statistics were carried out and one-way ANOVA was applied to find the statistical difference between the groups.Results: A total of 288 subjects were approached for the study of which 229 agreed to participate. It was observed that the knowledge of the participants regarding ADR reporting and pharmacovigilance was satisfactory. 68% of respondents felt that educational programmes have a positive effect on ADR reporting. 15% of respondents admitted of having reported an ADR. The mean scores of knowledge, attitude and practices of ADR reporting were considerably higher in postgraduates as compared to undergraduates (p-value <0.05).Conclusions: The study concluded that participants of study were aware of the importance of ADR reporting but it did not reflect in their practices. There is a need to create awareness and to educate these future physicians about Pharmacovigilance.
Background: Respiratory tract infections are one of the commonest types of infections affecting the Indian population and are a significant cause of morbidity and mortality. To deal with multidrug resistance one should be armed with region specific data about the susceptibility patterns of antimicrobials. This study was planned to identify the common pathogens responsible for the respiratory tract infection and their antibiotic susceptibility patterns.Methods: Smears were prepared from the specimens and gram stains of all clinical samples were done. The organisms were grown on various media and identified according to the standard procedures. The susceptibility patterns of the bacterial pathogens were determined following the panel of antimicrobial agents. Descriptive statistics were used for data analysis.Results: Out of 513 samples 471 samples were further processed. Klebsiella (30.42%) was found to be commonest pathogen followed by Pseudomonas (28.36%). Ampicillin and piperacillin /tazobactam combination were found to be highly efficient against Pseudomonas (83% and 58.8% respectively), E. coli (68% and 50.7% respectively), and Klebsiella (43% and 30.3% respectively). Conclusions: In our study, we found penicillins as the most efficacious antimicrobials to treat respiratory pathogens. The study reveals that the antibiotic susceptibility pattern varies across regions. The prescription of a right antibiotic, for a right patient will help to minimize the menace of emergence of antimicrobial resistance.
Background: The present prospective, open labelled study was designed to evaluate the efficacy and tolerability of escitalopram, selective serotonin reuptake inhibitors (SSRI) in comparison with milnacipran, dual serotonin and noradrenaline reuptake inhibitors (SNRI) in the treatment of major depressive disorder.Methods: Outpatients (N=120) with an ongoing/newly diagnosed ICD-10 major depressive episode and having a minimum score of 8 on the 21-item Hamilton Depression Rating Scale (HDRS) were assigned to escitalopram, 10–20 mg/day (54 patients) and milnacipran 50-100mg (66 patients), for an 8 week treatment period with follow up at 2nd, 4th and 8th week. The parameters for efficacy were improvement (decrease in HDRS scores at 8 weeks from baseline values), response (decrease of ≥50% in the HDRS scores) and remission (HDRS score of ≤7). Tolerability was assessed by comparing the frequency of adverse effects and drop out rate due to the same at the end of 2nd, 4th and 8th week in both the groups.Results: Improvement, Response rate and Remission rates at the end of eight weeks were 71.11%, 83.33% and58.33% for escitalopram and 59.35%, 34.14% and75.6% for milnacipran respectively. Adverse experiences were reported by 14% of patients in escitalopram group and 79.2% patients in milnacipran group at 8 weeks. Additionally, there were significantly lesser dropouts due to adverse events in escitalopram (3.70%) than in milnacipran group (30%).Conclusions: Escitalopram, the Senantiomer of citalopram, is a safe and effective antidepressant with potentially superior tolerability and comparable efficacy to the dual reuptake inhibitor, Milnacipran.
Aim: The present prospective clinical study was conducted to assess the long‑term spironolactone therapy and its effect with and without dietary‑induced weight‑loss, on insulin levels, lipid profile, and clinical features in females with PCOS (polycystic ovary syndrome). Methods: The present study included 22 females 12 normal weight and 10 obese within the age of 17-32 years having symptoms of PCOS including hyperandrogenism with clinical or biochemical evidence with amenorrhea and/or oligomenorrhea. These subjects were assessed before spironolactone therapy and after 100mg/day spironolactone orally for 12 months. Lifestyle modification was advised for obese females. Before starting and following antiandrogen therapy, metabolic, endocrine, and clinical parameters were assessed. Results: Spironolactone orally resulted in a significant reduction of triglycerides in overweight females and an increase in HDL (high-density lipoproteins) in subjects who were lean and have normal weight. After 12 months of oral spironolactone therapy, the area under the curve of insulin, insulin resistance with hemostasis model, and levels of insulin during OGTT at 60 minutes were significantly reduced in obese females. In females with PCOS following therapy, no negative change in insulin sensitivity and secretion and weight loss was seen after pharmacologic treatment.
Background: Most common endocrine disorders seen globally are Thyroid disorders which pose a high burden on the health care sector globally including in India. Assessing these disorders definitively is a challenging condition for treating physicians as no single definitive test exists for confirmatory diagnosis of thyroid disorders. However, various clinical, FNAC (Fine needle aspiration cytology), and histopathologic tests can be done to diagnose these disorders. Histopathology remains the gold standard for confirmatory diagnosis of thyroid nodules. Aims: The present retrospective clinical study was conducted to assess the incidence and prevalence of thyroid disorders along with the indications of Thyroid surgeries in Indian subjects. Materials and Methods: In 50 subjects with thyroid nodules who underwent thyroidectomy, clinical data were retrospectively collected and assessed concerning clinical and histopathologic parameters of the thyroid nodule. The collected data were assessed to form results and were expressed as mean, number, and percentage. Results: Most common finding was movement with deglutition seen in 98% (n=49) subjects followed by laryngeal crepitus in 84% (n=42) subjects, mobility in 78% (n=39) subjects, tenderness in 20% (n=10) subjects, and pressure effect and neck nodes in 2% (n=1) subject each.
Background” The purpose of this research was to examine the salivary groups of sodium chloride, magnesium, and calcium of unstimulated whole spit in pregnant women in three trimesters and compare the characteristics of non-pregnant women. Methods A longitudinal investigation. At the Acharya Vinoba Bhave Rural Hospital in Wardha, India, 75 women who were pregnant or were in the process of becoming pregnant and 75 women who were not pregnant were included in the study's sample of 75 pregnant and 75 non-pregnant women. Salivary Sodium, Chloride, Magnesium, and Ionic calcium concentrations were measured in unstimulated whole saliva. By using the Student t test and the ANCOVA, the data were examined (two-tailed α = 0.05). Results As the trimester progressed, the sodium, Chloride and ionic calcium concentrations continued to decline and magnesium levels were rising as the pregnancy progressed while the values in the non-pregnant women were in the normal range. Conclusion This research found differences in unstimulated whole saliva between pregnant and non-pregnant women.
Background: Comparative study of serum calcium, magnesium, uric acid and glucose in preeclampsia and normal pregnant women of malwa region of Madhya pradesh Methods: For the Study, a total of 100 women ranging in age from 18-35 years were recruited. They were divided in two groups. 50 were pre-eclamptic women with gestational age of ?20 weeks (Case group) and rest 50 were normal pregnant women of same gestational age (Control group).The levels of magnesium, calcium, glucose, and uric acid in the blood were measured. Result: Serum calcium and magnesium levels were significantly lower (p<0.001) in the pre-eclamptic group, whereas serum uric acid levels were significantly higher (p0<001) in preeclamptic group. The level of serum glucose was raised in preeclampsia. Conclusion: serum levels of calcium, magnesium, uric acid and glucose are altered in pre-eclampsia, implying that these factors may play a role in the aetiology and severity of pre-eclampsia.so assessing the serum level of this parameters will aid in the early detection of pre-eclampsia. Keywords: Calcium, Magnesium, Uric acid, Glucose, Pre-eclampsia, Pregnancy
Aim: The present prospective clinical study was conducted to assess the long‑term spironolactone therapy and its effect with and without dietary‑induced weight‑loss, on insulin levels, lipid profile, and clinical features in females with PCOS (polycystic ovary syndrome). Methods: The present study included 22 females 12 normal weight and 10 obese within the age of 17-32 years having symptoms of PCOS including hyperandrogenism with clinical or biochemical evidence with amenorrhea and/or oligomenorrhea. These subjects were assessed before spironolactone therapy and after 100mg/day spironolactone orally for 12 months. Lifestyle modification was advised for obese females. Before starting and following antiandrogen therapy, metabolic, endocrine, and clinical parameters were assessed. Results: Spironolactone orally resulted in a significant reduction of triglycerides in overweight females and an increase in HDL (high-density lipoproteins) in subjects who were lean and have normal weight. After 12 months of oral spironolactone therapy, the area under the curve of insulin, insulin resistance with hemostasis model, and levels of insulin during OGTT at 60 minutes were significantly reduced in obese females. In females with PCOS following therapy, no negative change in insulin sensitivity and secretion and weight loss was seen after pharmacologic treatment.
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