Antihistamines are effective in reducing majority of symptoms of allergic rhinitis, but are ineffective for nasal congestion and nighttime symptoms. Montelukast have been found to provide quick relief. Comparison of Montelukast has been done with Antihistamines but data is limited. Hence, this study was done to compare the effectiveness of montelukast combined with levocetirizine once daily to levocetirizine alone for a 6-week treatment course of allergic rhinitis. In this randomized, open, parallel study, out of 102 patients were randomly assigned to receive montelukast and levocetirizine (treatment group) or levocetirizine alone (control group), 95 patients completed the entire 6 weeks of study. The primary outcome measure was the mean change of the total daytime nasal symptom score (PDTS) and secondary outcome measures were mean change of night time nasal, daytime eye and composite symptom (PNTS, PES, PCS). The change in total daytime nasal symptom, composite symptoms and nighttime nasal symptom scores was significantly (p<0.05) greater in montelukast and levocetirizine group than in levocetirizine alone group. The change in daytime eye symptom scores was comparable in both the groups but not statistically significant (p=0.94). Montelukast combined with levocetirizine was effective in reducing daytime, nighttime, composite and daytime eye symptom score as compared to levocetrizine alone.
Background: The need for case-based learning in basic subjects is being recognized world over. Early clinical illustrations and actual clinical exposure enable students to associate basic science and real patient situations, probably increasing their retention of knowledge. The study was conducted to introduce an alternate method of teaching-learning in pharmacology in a large classroom setting to integrate pharmacology into clinical setting for better learning and understanding of the subject. Methods: Ninety-four students of second professional MBBS of a medical college in Punjab were divided into 2 groups and were taught a 2-hour topic in pharmacology using case-based learning (CBL) method and didactic lecture (DL) method using a crossover design. Their attendance and written test score at the end of teaching session were compared. Feedback from students and faculty was taken by prestructured questionnaires. Results: There was an increase in students’ attendance ( P = .008) in CBL sessions but insignificant difference in their performance ( P = .98) in the tests. Most (84%) of the students felt that CBL is a better method of teaching-learning than traditional DL. The teaching faculty felt that the students looked more interested and were themselves more motivated for the newer method of teaching. Conclusions: Case-based learning led to improvement in student motivation, satisfaction, and engagement. Most students and faculty accepted that CBL was an effective learning tool for pharmacology teaching in a large group setting and supported the incorporation of CBL into traditional DL teaching.
Rationale: Chronic Obstructive Pulmonary Disease (COPD) is associated with physical and psychological burdens. The impact of disease has been studied on patients but it also has a profound and pervasive effect on family and friends resulting in psychological strain, social isolation, relationship strains and financial strains from the added responsibilities of managing the patients. Few studies have found a significant burden on both caregivers and patients alike, but the data from the Indian setup in lacking. Hence, we designed this study to assess the Quality of Life (QOL) of caregivers and patients suffering from COPD. Methods: A cross-sectional study was carried out with forty-six COPD patients and their primary caregivers. Patients were assessed with St. George's Respiratory Questionnaire (SGRQ), and WHO-QOL-Bref scores. The caregivers were divided into two groups. Group 1 volunteers were caregivers of patients recently diagnosed with COPD (Last 1 year), whereas Group 2 were caregivers of patients with COPD diagnosed more than 1 year back. The caregivers in both the groups were subjected to Zarit Burden Interview (ZBI) and WHO-QOL-Bref scores. Results: 46 patients and caregivers were enrolled in the study. Majority of patients were over the age of 50 years (55.67 ± 12.45), and 67% caregivers were females. Patients had poor QOL as per SGRQ. The caregivers in Group 1 had significantly lower (p < 0.05) burden as compared to Group 2 as evident by ZBI scores. The WHO-QOL-Bref scores in all the 4 domains were significantly higher in Group 1 which predicts a better quality of life. Conclusion: COPD takes a toll not only on the patient but also the caregiver of the patients. The amount of burden increases as the disease progress with worsening quality of life.
Objectives:Although antidepressant medications are effective, they have a delayed onset of effect. Mirtazapine, an atypical antidepressant is an important option for add-on therapy in major depression. There is insufficient data on mirtazapine in Indian population; hence this study was designed to study the add-on effect of low-dose mirtazapine with selective serotonin reuptake inhibitors (SSRIs) in major depressive disorder (MDD) in Indian population.Materials and Methods:In an open, randomized study, 60 patients were divided into two groups. In Group A (n=30) patients received conventional SSRIs for 6 weeks. In Group B (n=30) patients received conventional SSRIs with low-dose mirtazapine for 6 weeks. Patients were evaluated at baseline and then at 1, 2, 3, 4, 5, and 6 weeks.Results:There was significant improvement in Hamilton Depression Rating Scale (HDRS), Montgomery and Asberg depression rating scale (MADRS) scores (P<0.05) in both groups. Mirtazapine in low dose as add on therapy showed improvement in scores, had earlier onset of action, and more number of responders and remitters as compared to conventional treatment (P<0.05). No serious adverse event was reported in either of the groups.Conclusion:Low-dose mirtazapine as add-on therapy has shown better efficacy, earlier onset of action and more number of responders and remitters as compared to conventional treatment in MDD in Indian patients.
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