Background: The objective of the study was to determine level of adherence and recognize various causative factors which can affect the compliance in the diabetic patients.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. To assess adherence, a questionnaire was administered to the patients - Morisky Medication Adherence Scale (MMAS) -8 item questionnaire. The various factors affecting compliance was determined by a researcher made questionnaire.Results: Out of a total of 100 subjects, age range extended from 18 years to 80 years. The mean age was 57.52±12.33years. 51% of patients were females and 49% was males. Analysis of MMAS- 8 item scores of patients showed that 52% of patients had low adherence, 29% had medium while 19% had high adherence to the treatment. Only 30% patients were compliant i.e. with HbA1C value of 7 or less while 70% patients were non-compliant i.e. with HbA1C value of more than 7.Conclusions: Compliance to medical treatment is influenced by a myriad of factors. In order to promote compliance, it is necessary to increase awareness about the disease, possible complications and treatment guidelines among patients as well as their family members.

Background: The objective of the study was to analyze cost of medical therapy in patients of Metabolic syndrome.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. A total of 100 patients diagnosed with Metabolic syndrome were enrolled in the study. The total daily cost of the therapy was calculated by adding the direct cost of individual drugs taking in consideration the frequency of the drug. The daily cost of therapy was then extrapolated to calculate the monthly as well as annual cost of therapy.Results: The mean age of patients was 58.27±10.32 years. Out of a total of 100 patients, there were 57 female and 43 male patients, indicating a female preponderance of the disease. The average individual daily cost of medical therapy is INR 44.56 which upon extrapolation gives monthly and annual cost of INR 1336.90 and INR 16264.40 respectively. The cost of treatment in males is costlier than females (INR 50.09 in males versus INR 40.22 in females). The cost of treatment of age 31-40 years is INR 27.90 while it INR 36.97, 48.16 and 50.75 for age groups 41-50, 51-60 and 61-70 years. The various components of metabolic syndrome viz. diabetes mellitus, hypertension and dyslipidemia contribute differently to the cost of therapy. Daily cost of medical therapy for diabetes mellitus is INR 18.57 while for hypertension and dyslipidemia are INR 10.25 and INR 6.13 respectively.Conclusions: Chronic diseases like metabolic syndrome have a huge share of the healthcare budget. Given the fact that it is a lifestyle disease, its prevalence is likely to swell in the coming decades. Hence, formulation of preventive and innovative treatment guidelines is of utmost importance.

Background: Hypertension is one of the most common diseases in the world. It is an important and independent risk factor for atherosclerosis, heart failure, renal disease, and peripheral arterial disease. It is directly responsible for 57% of all stroke deaths and 42% of coronary heart disease deaths in India Objectives: To evaluate and compare efficacy and cost effectiveness in hypertensive patients receiving Olmesartan and Telmisartan in Stage I hypertension Material and methods: The present study was an open, prospective, randomized, parallel group comparative study conducted in 60 patients of stage I hypertension over a period of 16 weeks. Patients were randomly allocated to two, age and sex, matched groups of 30 patients each. Group I patients were started on Olmesartan at a dose of 20 mg & Group II patients were put on Telmisartan at a dose of 40 mg. The BP lowering efficacy and cost effective analysis of Olmesartan versus Telmisartan was calculated & compared. The data was entered in Microsoft excel and compiled. Statistical analysis was done using various tests. Results: Maximum patients in both the groups were in age group of 51-60 years. In group I there were 13 males and 17 females. In group II there were 14 males and 16 females. Both Olmesartan and Telmisartan are effective in lowering systolic & diastolic BP in supine & sitting positions & mean BP is also lowerer, more in Olmesartan group. By cost effective analysis Telmisartan was found more cost effective. Incremental cost effective ratio was found to be 218.35. Conclusion: Both Olmesartan and Telmisartan belong to the same antihypertensive drug class, effectively reduce systolic and diastolic blood pressure at various visits. Taking into account Total cost Telmisartan was more cost effective than Olmesartan. ICER was found to be 218.35.

BACKGROUND Chronic suppurative otitis media has been traditionally defined as a chronic inflammation of the middle ear and mastoid, usually associated with perforation of the tympanic membrane and otorrhoea. Understanding the pathology and pathogenesis of chronic suppurative otitis media is important in predicting the management, prognosis and sequelae of the disease. MATERIALS AND METHODS The present study was a cross-sectional study that was conducted to evaluate the clinical, intraoperative and histopathological changes in the middle ear cleft. 50 patients diagnosed with CSOM, who underwent surgery were taken. The mucosa and granulation tissue were removed along with ossicles wherever indicated and sent for histopathological examination. RESULTS Incidence of CSOM is highest in 3 rd decade of age with more prevalence in lower socioeconomic group. Females were involved more than males. Unilateral involvement was seen in 64% cases. Otorrhoea and diminished hearing was a constant feature among all cases followed by earache (26%), itching (22%), tinnitus (16%), vertigo (10%) and mass in the ear (6%). On otoscopic examination perforation was seen in 42 cases (84%), while retraction pockets were seen in 8 cases (16%), 7 cases had plastered TM (14%), tympanosclerosis was also found in 6 cases (12%), granulations in 2 cases (4%) and polyp was found in 3 cases (6%). On pure tone audiometry testing, 44 patients (88%) had conductive hearing loss and 6 patients (12%) had mixed hearing loss. CONCLUSION Main conclusion drawn from this study is that on clinical examination 38 cases were found to be of tubotympanic type and 12 cases of atticoantral variety. However, intraoperatively, of the tubotympanic cases, 4 were found to be of unsafe type, which was also proven histologically.

Background: To evaluate the change in mean IOP with BKC-preserved latanoprost versus BKC-free latanoprost in patients of primary open angle glaucoma (POAG).Methods: This was an open-label, randomized, interventional, switch trial. Thirty patients of primary open angle glaucoma (POAG) who were already on benzalkonium chloride (BKC)-preserved latanoprost for a minimum of three months were recruited. Their intraocular pressure (IOP) was recorded at the baseline. Then, they were switched over to benzalkonium chloride (BKC)-free latanoprost for another three months. Their intraocular pressure (IOP) was recorded at both 6 and 12 weeks of follow-up.Results: IOP decreased from 15.57±0.85mm Hg at baseline to 15.40±0.89mm Hg at 6 weeks to 15.30±0.70mm Hg at 12 weeks. p value was found to be 0.209 and 0.115 at 6 and 12 weeks respectively. No statistically significant change was observed between mean IOP at both 6 and 12 weeks as compared to the baseline.Conclusions: BKC-free medications have equal IOP lowering effect as BKC-preserved medications in glaucoma patients.