Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for patients with moderate-to-severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low-dose treatment protocols. Aims and Objectives: The aim of this study was to assess and compare the efficacy of oral isotretinoin in low-dose continuous and intermittent treatment of moderate-to-severe acne vulgaris. Materials and Methods: This was a prospective, randomized, open-labeled, comparative, efficacy study carried out at Outpatient Clinic in the Department of Dermatology in Mandya Institute of Medical Sciences, Mandya. Out of 120 patients screened, 100 patients were selected. Patients with moderate-to-severe acne were assigned equally (50 patients each) to one of the two treatment regimens using block randomization technique, Group A was given lowdose continuous regimen -20 mg of oral isotretinoin once daily for 4 months and Group B was given low-dose intermittent regimen -20 mg of oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4 th week during the treatment period. A 6-month follow-up evaluation after the end of treatment was performed. The outcome of the therapy was based on the improvement in the global acne grading system (GAGS) score and patients' satisfaction with the treatment in the 4-point scale. Results: This study showed statistically significant clinical improvement and difference in GAGS score between Group A and Group B (P < 0.005). Conclusion: This study suggests that, considering clinical efficacy, low-dose continuous treatment is most suitable for patients with moderate-to-severe acne vulgaris.

Background: Underreporting of various adverse drug reactions (ADRs) by consultants is a common incurable problem. National pharmacovigilance program is one of the ongoing programs to monitor the adverse drug reactions & reporting at the earliest to the nearby AMCs. As medical interns are budding doctors, the focus of this study was to evaluate the knowledge, attitude and perception about ADRs and pharmacovigilance in them.Methods: A cross section questionnaire-based study was conducted after approval by our institutional ethics committee pretested and validated questions consisting of 20 questions (knowledge, attitude, perception) were administrated to medical interns. The filled questionnaires were collected and analysed.Results: In our study, medical interns have fair enough idea about ADR and pharmacovigilance. In knowledge domain they were aware of term ADRs (100%), pharmacovigilance (72.6%). In attitude domain majority of interns (80.6%) known availability of ADR forms, compulsory of pharmacovigilance unit (90.3%). In perception domain very poor response from interns, not even a single intern had reported any ADR filled form and they don’t know meaning of re-challenge and de-challenge, very few interns (9.7%) know how to manage the ADRs in emergency conditions.Conclusions: Under reporting problem can be improved by doing more teaching activities at undergraduate level and intern’s level including various workshops, CMEs, problem-based teaching of adverse reactions in their curriculum. These exercises will improve their reporting frequency and sensitize the interns from the undergraduate days itself in their upcoming clinical practice in community.

Background: In our ophthalmology outpatient department, routinely to observe the posterior segment of the eye and the fundus of the eye, we use various mydriatics such as atropine, cyclopentolate, and tropicamide for various indications. As there are a lot of mydriatics clinically used, taking much time for dilation, any add-on drug can be used for dilatation of pupils helping the underlying drugs for a better outcome. This study provides information regarding the effect of topical administration of gentamicin on horizontal pupillary diameter (HPD) over and above use of other mydriatics in rabbit’s eye. There are no similar studies in the past. Aims and Objectives: The aim of this study was to evaluate the effect of gentamicin on the HPD of rabbit’s eye. Materials and Methods: After taking the Institutional Ethics Committee clearance, 48 rabbits were taken into this study and were divided into 2 groups of 24 rabbits each. HPD was measured in both eyes before starting the experiment. Gentamicin eye drops were instilled in the right eye (test) and normal saline in the left eye (control) in both groups of 24 each. HPD was measured in both eyes after 30 min of instilling drops, and readings were noted. Thereafter, homatropine hydrobromide was instilled in both eyes in the first group (24 rabbits), and phenylephrine hydrochloride in the second group (24 rabbits). HPD in both eyes was measured every 5 min for 30 min. Results: After 30 min of instilling gentamicin eye drops in the test eye, there was no change in HPD; however, after instilling a mydriatic agent (homatropine or phenylephrine), there was an early onset of mydriasis as well as marked mydriasis in test eye compared to control eye in both groups. Hence, the differences in HPD between both eyes (test and control eye) were statistically not significant (P = 0.083). Conclusion: Topical application of gentamicin does not have a mydriatic effect, but it potentiates the mydriatic effect of homatropine and phenylephrine in rabbit’s eye.

Background: Antimicrobials are routinely used for variety of clinical conditions but are also misused leading to drug resistance bacteria in clinical practice. Consultants can gain the knowledge about it and can also have the depth of problem faced, their prescribing behavior mainly depends on their attitude and understanding of condition. Our aim of this study is to evaluate the knowledge and beliefs about antibiotics prescribing among health care workers in a tertiary care hospital of Sangli. Methods: Our present study was conducted in the Bharati hospital, BV (DU) medical college and hospital, Sangli. Ethical clearance from the institutional ethics committee was obtained and it was, cross-sectional questionnaire-based study carried out in the form of a survey in which a pretested, semi-structured, validated questionnaire was provided to junior residents, senior residents and faculty of different specialties and responses were recorded. Questionnaire comprises of 9 in knowledge, 10 in attitude and 10 in practice section. Results: Out of all participants 84.5% believed that no need of antibiotics for running and blocked nose. Majority 89.6% were expressed that sample culture should be sent before starting antibiotics. 90.4% participants believed that education of patients will help. Only 76.8% strictly adhere to the antibiotic policy of our hospital. Conclusions: The present study on antibiotic usage gives useful information about the knowledge, attitudes and practices of prescribers and help plan suitable educational modifications that aim at improving the antimicrobial prescribing and minimizing the development of drug resistance in our developing country.

Background: Acne Vulgaris is chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for moderate to severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low dose treatment protocols. However, long term daily use of this drug results in frequent side effects such mucocutaneous and systemic side effects. Our aim was to assess and compare the various side effects and patient satisfaction of oral isotretinoin in low dose continuous and intermittent treatment of moderate to severe acne vulgaris.Methods: This was a prospective randomized open labeled comparative study carried out at outpatient department in the Department of Dermatology in Mandya Institute of Medical sciences, Mandya. Patients with moderate to severe acne were assigned equally (50 subjects each) to one of the two treatment regimens by using block randomization technique, Group A was given low dose continuous regimen-20 mg oral isotretinoin once daily for 4 months and Group B was given low dose intermittent regimen-20 mg oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4th week during the treatment period. The patients were examined and side effects were noted in each visit. A six month follow-up evaluation was done to analyze patient satisfaction.Results: Muco-cutaneous dryness was most common adverse effect noted in both the groups A and B. Itching (42%), Alopecia (44%), Myalgia (36%) were seen most commonly in group A and Acne flaring (47%) was most common with group B. With regard to patient satisfaction, in group A 42% were satisfied and 20% were very satisfied, in group B 36% were satisfied and 14% were very satisfied.Conclusions: Study suggests that, Muco-cutaneous dryness was most common side effect in both treatment regimens. Side effects were more frequent with low dose continuous than low dose intermittent isotretinoin regimen. Patient satisfaction was better in continuous regimen.