Background: In a climate of economic uncertainty, cost effectiveness analysis is a potentially important tool for making choices about health care interventions. Patients with knee osteoarthritis are treated mostly with Diclofenac (NSAID) + Proton Pump Inhibitors (PPI) and Tramadol (Opioids) in everyday practice.Aim: Present study was aimed to assess clinical effectiveness, adverse events and cost-effectiveness between Diclofenac + PPI and Tramadol.Methods: Authors conducted prospective randomised control open label study on 40 patients at Orthopedic OPD of tertiary care hospital. Patients were given either Tramadol controlled releases tablets (200mg CR OD) or Diclofenac sustained release tablets (100mg SR OD) + PPI (Omeprazole 20mg OD) for two weeks. Clinical effectiveness was assessed by KOOS osteoarthritis index score consisting of five parameters and visual analogue scale. Suspected ADRs were recorded and incremental cost effective ratio for both drugs was calculated.Results: After application of KOOS questionnaire Authors found net quality gain in symptoms was 24.45 in diclofenac +PPI group which was much higher against 14.15 found in tramadol group. Again ADR profile of tramadol was 29 with nausea and somnolence topping the list which was far more than only 10 in DIC +PPI group. Lastly cost-effective analysis was done where again DIC+PPI showed average cost effective ratio 5.73 verses tramadol 11.8 with an incremental cost-effectiveness ratio (ICER) of -2.72.Conclusions: Diclofenac +PPI is as effective as tramadol in the treatment of pain due to knee osteoarthritis with the potential for feAuthorsr side effects. Diclofenac + PPI was also found to be cost-effective when compared with tramado.
Background: Medical and dental students are among the frontline workers in the battle against COVID 19. As such their vaccination is mandatory. We conducted this study to assess perception and attitude of medical and dental students towards COVID-19 disease and its vaccination. Methods: A total of 185 medical and 170 dental students were included in our study. A questionnaire based on previous studies was prepared. The respondents were interviewed telephonically and appropriate responses were recorded. Results: Among 355 students enrolled in our study, higher percentage of dental students were infected with COVID-19 (26%) as against only 20% medical students. 60% dental students had been tested for COVID-19 as against 70% medical students. Majority students in both the groups had done rapid antigen test (RAT). Academic loss was the major COVID-19 disease related concern among medical students, while in dental group there were two major concerns i.e academic loss and fear of passing the infection to family. Both the groups feared anaphylaxis the most as a sequel of vaccination. The other vaccination concerns in both the groups were fever, myalgias, infertility, thrombus formation while few female students feared that vaccination may disturb their menstrual cycles. The preferred vaccine in both the groups was Covishield. Conclusion: Our study concluded that there are many hurdles in the path of vaccination even among medical and dental students. It is important to address these hesitancies especially among health care workers since their opinion and recommendation is held supreme by common masses.
Background: The purpose of this study was to find correlation between vitamin D, Physical exercise on glycaemic control in patients of type2DM. Methods: The study was conducted from November 2019 to December 2020 among subjects above 40 years of age at sub-district hospital Sopore, North Kashmir. Total 400 patients diagnosed with diabetes were registered for the study. Questionnaire containing relevant patient information was collected at regular intervals. Statistical analysis were performed. Results: Biochemistry values in the studied subjects with Type2DM compared to healthy controls in the study revealed that fasting glucose level,HbA1c,LDL,triglycerides,uric acid were higher inT2DM group compared to the control group. The results of our study showed that Vitamin D deficiency, lack of physical exercise, family history of T2DM, hypertension and smoking were significant predictors of diabetes. In Type2DM patients, mean vitamin D value was 21.45ng/ml opposed to 40ng/ml in the control group. Also physical activity was found to be higher in control group when compared to cases with p -value less than 0.00001. Also family history of DM was significantly higher in cases when compared to control group with p-value of 0.044.There was also statistically significant difference when parameters like HTN and smoking were compared (both higher in cases as against the control group) between two groups with p value 0.044 and 0.029 respectively. Conclusion: Vit D, physical exercise,family history of diabetes may be contributing factors for the rising burden of diabetes globally and in India.We need to take cognisance of the factors leading to the rising global burden of DM and take appropriate and necessary measures to stop this growing menace.
Background: Chemotherapy involves highly complex regimens and hence accounts to high susceptibility towards Adverse Drug Reactions. All antineoplastic drugs have potential to cause one or more Adverse Drug Reactions which may vary from mild to severe form. So the aim of this study was to determine the prevalence of Adverse Drug Reactions in patients treated with chemotherapy.Methods: After getting approval from the Institutional Ethical Committee, the prospective observational study was conducted in the Department of Pharmacology in association with Department of Radiation Oncology and Department of Medicine, Government Medical College, Srinagar between April 2015 to October 2016. All patients of either sex and any age receiving anti-cancer drugs in the inpatient department of radiation oncology were included. The mean age of the study population was 51 years and 53.9% of them were males and 46.1% of them were females. The WHO-UMC system was used for assessment of case programme and case reports. The severity of adverse drug reactions was determined by using modified Hart wig and Siegel scale.Results: Most of the reported ADR’s were moderate to mild in severity according to modified Hart wig and Siegel scale. Most of the frequent ADR’s were certain followed by probable and possible according to WHO-UMC causality assessment.Conclusions: Antineoplastic drugs have a narrow therapeutic index and the dosage needed to achieve a therapeutic response usually proves toxic to the body’s rapidly proliferating cells. Measures need to be put into place to reduce the physical, emotional and economic burden on the patient due to adverse drug reactions. Therefore, there is a need for vigilant ADR monitoring to decrease morbidity and mortality due to ADR’s which require further studies on large populations.
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