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DRUG UTILIZATION PATTERN FOR SKIN DISEASES IN DERMATOLOGY OPD AT TERTIARY CARE HOSPITAL OF WESTERN MAHARASHTRA
Get PDFBackground: Periodic auditing of prescriptions in terms of drug utilization study is an important tool to enhance the efficacy of the treatment, to decrease the risk of the adverse effects, to give cost-effective treatment and to provide useful feedback to the clinician. Prevalence of dermatological diseases is very high throughout the world, and in day to day practice, a quarter of the cases are related to dermatological manifestations. In studies conducted in the Out Patient Department (OPD) of dermatology in North Palestine and Western Nepal, irrationalities in the prescriptions have been reported. Aim: To study the drug utilization pattern for skin diseases in dermatology OPD at tertiary care hospital of Western Maharashtra. Methodology: The retrospective analysis of dermatology OPD records of 6 months (1st March 2018- 31st August 2018) was carried out during the study period (1st September 2018 to 30th November 2018). The proforma for collecting data was designed. Demographic details, diagnosis and treatment are given for each patient were recorded. The data collected was condensed, and the master chart was prepared for data analysis. Result: During the study period, a total of 3869 patient’s case records were studied and analysed. A maximum number of patients (26.5%) found in the age group 31-40 years, followed by 23.5% of patients in the age group 21- 30 years. Fungal infection was found in 39.6 % of patients followed by acne in 14.2% patients and eczema in 9.1% of patients. Drugs most commonly prescribed were antihistaminics (45.02%) followed by antifungal (39.6%) and steroids (27.8%). Levocetirizine (74.07%) and hydroxyzine (16.5%) were the most commonly prescribed antihistaminics. Itraconazole (58.17%) and Griseofulvin (24.67%) were the most commonly used oral antifungal drugs. Miconazole (73.73%) was the most commonly used topical antifungal drug, followed by ketoconazole (12.45%). Among steroids, prednisone (52%) and betamethasone (38.05%) were the most commonly used steroids by oral route while clobetasol (68.09%) and mometasone (19.5%) were the most commonly used steroids by topical route. Our study revealed that the percentage of drugs prescribed by the WHO essential drug list was only 23.87%. Drugs which prescribed by the generic names were less than <1%. Conclusion: Treatment protocols used in the management of skin disorders were near to the standard guidelines.
Keywords: Drug utilization; Prescription pattern; Dermatology; Skin disorders
Conceptual, sociological and materialistic view of innovation-translation dynamics in medicine: The need and directions for a novel multi-pronged initiative
Get PDFThe recent decades have witnessed overwhelming advancements in medical technologies and the quality of healthcare. A vast majority of the advancements which are capable of revolutionising healthcare still remain dormant within laboratories which is certainly due to the tardive translation and assimilation of these innovations. Innovation-translation is explained by an over-simplified linear model which provides the users with just two option- either to adopt or not. The translation of medical innovation is a cyclical and dynamic process which includes the conception of novel ideas, generation of proof of concept, adoption, post-adoption analysis and emergence of new innovations. Conceptual factors like principle, validity, contextual appropriateness and performance; sociological factors like political climate, professional involvement, interdisciplinary interaction and investment policies; and materialistic factors like resource availability, affordability and apt human resource management are the chief determinants of innovation translation. Loose knit configuration of national policies favour innovation translation than close knit configuration. India suffers from lack of drive for local innovation, lack of succinct aptitude, inadequate local investment and lack of efficient regulation. Innovation studies expose the determinants of successful and failed innovations. Ensuring a favourable political and financial environment that provides systematic innovation assessment, evaluation and regulation, valid operational guidelines, encourage local innovation, and promote intellectual aptitude can drive further innovation. Competitively promoting sustaining and disruptive innovation will enable remarkable advancements. Post-adoption analysis and feedback and Precision medicine are significant tools. Efforts should be made to introduce and ensure meticulous innovation surveillance.
Keywords: Innovation-translation dynamics; Cyclic dynamic model; Innovation surveillance; Regulation
Analysis of pesticide poisoning cases in a tertiary care hospital, Mumbai
Get PDFThe pesticide poisoning is a common medical emergency and leads to morbidity and mortality in developing countries due to easy accessibility and less cost. A prospective analysis of pesticide poisoning cases admitted to the emergency department of tertiary care, teaching hospital, Mumbai, Maharashtra from 1st January 2006 to 31st December 2006. The main objectives, to assess the pattern and socio-demographic profile of pesticide poisoning. The most cases observed in the age group 21-30 years (n:72, 41.37%)). Total males affected were 94 (54.02%) dominating the females 80 (45.98%) and male to female ratio (1.17:1). But in younger age group, females were more affected than males. The maximum cases belonged to the lower socioeconomic class (n:82, 47.12%) and urban areas (n:106, 60.91%). Majority of the victims married and belonged to Hindu religion (n: 140, 80.4%). The occurrence of pesticide poisoning was more frequent in the evening (n:82,47.12%) and during the, monsoon (73, 41.95%).There is a need for adequate guidelines for sale, use, storage and safety practices for the pesticide. These will be helpful for the enhancement of the knowledge, awareness and safety practices among the population for prevention and reduction of the pesticide poisoning. It also emphasized on the early availability of treatment in the poisoning cases
A study of the Oxidative stress and Antioxidant status in diabetic subjects who are on treatment with Metformin
No full textBackground: Oxidative stress plays an important role in the pathogenesis of DM and its complications. However, antioxidant status and its contribution to type 2 DM are less explored in South Indian population. Metformin, is a biguanide anti hyperglycemic agent used for the management of type 2 diabetes. Aim:Â To study the alteration in oxidant and antioxidant status in type 2 diabetic subjects on treatment with Metformin and to evaluate the effect of metformin in improving the total antioxidant status. Methodology: In this cross sectional study, all subjects were T2DM patients, on metformin monotherapy (500 mg, bd) and were grouped into two - Group 1 and Group 2 for the study purpose, based on their HbA1c values. Baseline parameters (B.P, Waist Hip ratio, BMI, family history), glycemic status, lipid profile, FRAP, TBARS and serum Metformin levels were assayed. Fasting and postprandial blood specimens were collected and plasma glucose concentrations were measured by standard methods. Fasting plasma total antioxidant capacity (TAC) was measured by ferric reducing ability of plasma (FRAP) assay. Oxidative stress was evaluated and measured as TBARS and the values were compared among the two groups. Results: TBARS levels were higher and FRAP levels were significantly lower in Group I subjects compared to Group II subjects and can be explained due to increased superoxide ions and reduced activity of S. O. D. Conclusion: It may be concluded that total antioxidant status is lower in type 2 diabetic subjects of Group 1 category compared to diabetic subjects in the Group 2 and it may be related to the beneficial effects of the biguanide, Metformin
Knee Osteoarthritis Revisited; But Only After KL Grading Is Tested: A Retrospective Analysis
Get PDFBackground: Osteoarthritis (OA) of the knee is one of the major causes in musculoskeletal condition leading to functional loss in patients. Determining the progression of the disease is a useful tool which will help in the planning of the exercise programme to slow or halt the disease progression. Measuring the joint space width of the tibiofemoral joint is one of the best options for knowing the disease progression and helps in designing an exercise programme. Aim: Retrospective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of the knee joint. Methodology: Data was retrieved from the picture archiving and communication system (PACS) from 1st of February to 22nd of June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment was measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In the rural population of Maharashtra the medial joint space is markedly decreased as compared to the lateral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased.
Keywords: Osteoarthritis; Knee; Joint space width; Rural Maharashtra
Effectiveness of Surgical Management of Ankle Fractures in Attaining the Stability of Ankle
Get PDFIntroduction: Ankle injuries comprise a major group of lower limb trauma. Many of these injuries can be treated by manipulative reduction and conservative treatment and some of these yield satisfactory results, so present study was undertaken to know the effectiveness of surgical management of ankle fractures. Method: 42 surgically treated displaced fractures are included and studied in detail of age, sex, occupation, type of fracture, mode of injury, type of treatment, Clinical evidence of fracture union, Radiological evidence of fracture union, Relation of talus in the ankle mortise, Range of mobility of the ankle, Residual disability and pain, Ability to walk and time of return to duty and complications were noted. Result: 42 cases were surgically treated, most of the patients were operated on an emergency basis within 24 hours of injury. Based on the mechanism of injury Pronation- External Rotation (30.9%) and Based on Ao Classification Type B - B2 (53.3%) were the major type of fractures. In the majority of cases, Malleolar screws type of implants used. In overall the final status of patients is good (ability to walk). Conclusion: Displaced ankle fractures need accurate open reduction and internal fixation and postoperative immobilization for 6 weeks. This will suffice to get good results. Post-operative rigid immobilization and protected weight bearing for 12 weeks is minimal to achieve good union followed by physiotherapy to restore the maximum range of movements
Keywords: Ankle Fractures; Surgical management, Stability; Effectiveness
The potential effect of pandan wangi leaf “pandanus amaryllifolius roxb.’’ extract from Indonesia as time sleep inductor
No full textSleep plays a role in restoring the body\u27s biochemical and physiological processes which decrease when awake. People is not familiar yet with sleep disturbances, so they rarely seek help. Sleep disturbances can cause family problems and are at risk of fatal traffic accidents. Fragant Pandan leaves (Pandanus amaryllifolius Roxb.) contains alkaloids, saponins and flavonoids which can provide a hypnotic sedative effect. The purpose of this study was to determine the effect of fragant Pandan leaf extract (Pandanus amaryllifolius Roxb.) administration in shortening the sleep induction time of male Swiss Webster strain mice. A post-test only design experimental laboratory study was conducted with control group design. The test animals used were 25 Swiss Webster male mice divided into five groups randomly : G1 group was given distilled water, G2 was given diazepam dose 1 mg / KgBB, the G3, G4 and G5 groups were given fragant Pandan leaf extract with a dose of 4 mg/25g BB, 6 mg/25g BB and 8mg/25g BB, respectively. One Way ANOVA statistical test showed significant differences in mice sleep onset (p=0.000) between groups. The results of the Post Hoc test using LSD analysis showed that there were significant differences between positive controls with groups G3, G4 and G5. Fragrant Pandan leaf extract dose of 8 mg/g BB can shorten the time of mice sleep induction male Swiss Webster strain mice. While the dose of 4 mg/g BB cannot shorten the time of induction of sleeping mice.
Keywords: Fragant Pandan leaf extract; Hypnotic-sedative; Sleep disturbances
EFFECT OF AFLATOXIN M1, "A HYDROXYLATED METABOLITE OF B1" ON SPERM CELL QUALITY OF ADULT MALE WISTAR RATS.
Get PDFThe effect of aflatoxin on reproductive health takes a systematic approach as it indicates that a significant number of people living in the third world regions are exposed to these toxins due to the poor storage of grains. To expose the effects of aflatoxin M1 a hydroxylated metabolite of aflatoxin M1 Twenty four Adult male Wister rats were acclimatized and broken down into four groups, Test Group one (Two weeks exposure), Group Two ( four weeks exposure), Group Three ( Six weeks exposure) and Group Four ( Control Group). The Test Group 1, 2 and 3 were orally administered 7.2g/kg (LD50) of Aflatoxin M1 for the desired weeks of exposure and the sperm cell quality was assessed to determine the effect of Aflatoxin M1 on sperm cell quality in Adult male wister rat. The predetermined level of sperm cell quality is its ability to be motile as the motility of the sperm cell determines its viability. Group three had the highest presence of sluggishly immotile cells with very low progressive motility, followed by group, two and one, 37.5+ 9.97, 55.00+9.91, and 71.67+3.07 as against the control groups 85.8+2.17 with the highest significance at the group three which showed an extended exposure of aflatoxin m1 (p=0.05). This study links infertility and aflatoxin consumption, as the higher the doses the more spermatotoxicity is built which invariably could lead to sterility and azoospermia
Effects of alpha, beta momorcharin fruit extract with the combination of paclitaxel in the treatment of glioma cancer in-vivo.
Get PDFThe vegetable Momordica charantia L., (family: Cucurbitaceae) is a scientific name of the plant and its fruit. It is also known by other names, for instance in the USA it is known as Bitter gourd or balsam pear while its referred to as the African cucumber in many African countries. M.charantiais believed to posse’s anti-carcinogenic properties and it can modulate its effect via xenobiotic metabolism and oxidative stress. This study was specifically designed to investigate the cellular mechanisms whereby α, β momorcharin an extract of M. charantiacan induce cell death with the combination of paclitaxel. Different concentration (200µM - 1000µM)of the α, β momorcharin fruit extract were treated (24 hrs incubation) separately with three different cancer cell lines 1321N1, Gos-3, U87-MG and normal L6 muscle cell line. The results also show that paclitaxel(250 µg) with (1000 µM) of the α, β momorcharinextract of M. Charantia,and result in significant decreases in cell viability for each cell line, these effects were additive compared to the individual effect of paclitaxel.
 
Efficacy, tolerability and safety of intravenous iron sucrose in postpartum anaemia
Get PDFBackground: Anemia is one of major contributing factor in maternal mortality and morbidity in third world countries and according to the WHO, contributes to 40% maternal deaths. Postpartum anemia is observed in up to 27% of women.It is a common problem throughout the world. Treatment of postpartum iron deficiency anemia includes oral and parenteral iron supplmentaion as well as blood transfusion in severe cases. Methods: This was a prospective longitudinal study carried out in Department of Obstetrics & Gynaecology of PRH, Loni. Total 80 women suffering from postpartum anemia of age above 18 years with haemoglobin (HB) level below 11gm/dl and above 6gm/dl were included for the study. After history taking, clinical examination and baseline Hb level, all of them were administered intravenous iron sucrose 200 mg per dose per day till the total calculated dose was administered. The post therapy evaluation was done with the estimation of Hb on day 1, day 7, day 14 and day 21. Results: 31.25% women belonged to the age group each of 19-21 years and 22-24 years. Maximum number of patients received 3 doses of IV Iron sucrose (i.e. total 600mg) followed by 2 doses (i.e. total 400mg), 4 doses (i.e. total 800mg) and 5 doses (i.e. total 1000mg) respectively. Hb level rises extremely significantly (p<0.001) after IV Iron Sucrose administration on day 1, 7, 14 & 21 as compared to corresponding values before delivery as analyzed by Friedman Test (Nonparametric Repeated Measures ANOVA) . 16 patients (20%) experienced thrombophlebitis to IV Iron Sucrose administration. About 12 (15%) patients experienced rigor followed by sweating in 10 patients (12.5%) and fever in 8 patients (10%). About 62 patients (77.5%) from total 80 reported well tolerability to IV Iron Sucrose while remaining 18 patients (22.5%) reported poor tolerability to IV Iron Sucrose Conclusion: Intravenous iron sucrose increases the haemoglobin more rapidly in first week as compared to second and third week in women with postpartum iron deficiency anemia. Hypersensitivity reaction, chest pain, dyspnoea reported with iron dextran and iron sorbitol citric acid were not observed with iron sucrose. Intravenous iron sucrose can be used safely to fill a rift between blood transfusion and oral iron in treatment of postpartum iron deficiency anemia