International Journal of Basic & Clinical Pharmacology
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A study of serum sodium and potassium levels in subjects of acute myocardial infarction in a tertiary care hospital in Eastern India
Get PDFBackground: Cardiovascular disease is one of the most common causes of morbidity and mortality around the world. In countries like India, there is difference in the lifestyle and behavioural risk factors among different areas. There is existence of rural-urban, Eastern-Western-Northern-Southern zonal differences. Studies done in other parts of India may not completely be applicable to Eastern Indian population. Serum electrolytes play an important role in maintaining electrophysiological homeostasis of the myocardial membrane, and alterations of these electrolyte levels can affect the pathogenesis, complications of myocardial infarction. Major serum electrolytes affecting the myocardial electrophysiological properties are sodium, potassium. Hence, this study was undertaken keeping in mind the miniscule lacunae in current knowledge especially pertaining to diseases in Eastern Indian population.Methods: 50 consecutive patients in the age group of 30-70 years admitted in the medicine department of Burdwan medical college with recent onset acute chest pain, diagnosed to be acute myocardial infarction were taken, their serum sodium, potassium levels were determined and these levels were compared among these patients with and without risk factors.Results: Serum sodium was decreased among patients with history of smoking, hypertension, BMI ≥25, complicated by atrial fibrillations. Serum potassium was decreased in patients with hypertension, BMI ≥25, ventricular premature complexes and increased in smokers, alcoholics.Conclusions: Electrolyte imbalances are common in patients of Acute Myocardial Infarction. Hypokalemia and hyponatremia were present and they were associated with cardiac complications. They adversely affect prognosis, so should be corrected
Immunosuppressants in Behcet’s disease: a boon or a bane?
Get PDFAdalimumab is a disease-modifying antirheumatic drug and monoclonal antibody that works by antagonising tumour necrosis factor-alpha prescribed in many rheumatological conditions like Rheumatic arthritis, Ankylosing spondylitis and Behcet’s disease. Serious side effects with this drug include heart and liver failure, nervous and blood disorders, allergic and immune system reactions and opportunistic infections. A 27-year-old female patient, known case of Behcet’s disease presented to the hospital with complaints of fever, cough and breathlessness following administration of Adalimumab, six doses over three months. Chest X-ray and BAL-CBNAAT was suggestive of Tuberculosis. AKT was started and Adalimumab was suspended until patient recover
Comparative study between effectiveness of low molecular weight heparin injection and unfractionated heparin in terms of morbidity and outcome in COVID-19 cases
Get PDFBackground: The novel coronavirus 2019 presented a variety of disease spectrums that range from asymptomatic to sepsis with multi-organ dysfunction and death. One of the mechanisms being a hypercoagulable state with micro and macro-circulatory thrombosis is found in critically ill COVID-19 patient with ARDS with pathology consistent with a vascular occlusive aetiology of respiratory failure rather than more classic finding of ARDS. Venous thromboembolism, MI, acute peripheral arterial thrombosis is seen in COVID-19. Endothelial cells dysfunction induced by infection causing excess thrombin generation, fibrinolysins shutdown, hypoxia inducible transcription factor dependent signalling pathways, increasing blood viscosity leading to Hypercoagulable state. Early application of anticoagulant therapy in severe COVID-19 was suggested for improving outcome in patients with elevated d-dimer. Aim of study was comparing effectiveness of LMWH with unfractionated heparin in outcome of COVID-19.Methods: This retrospective observational study including 400 patients meeting inclusion criteria were divided 2 groups out of which 200 patients were treated with inj. LMWH and other 200 were treated with injection heparin and various parameters were compared. A probability value (p value) of less than or equal to 0.05 was considered statistically significant.Results: Death rate is seen lower with LMWH in critically ill patients with high discharge rate with minimal lab parameter derangement and high efficacy to lower down inflammatory markers (LDH, ferritin, CRP, D-dimer, ESR) in comparison to unfractionated heparin.Conclusions: Early use of LMWH may be beneficial for the outcome
A systematic review of reactivation of tuberculosis due to use of corticosteroids for COVID-19 treatment between January 2020 to January 2022
Get PDFCoronavirus-19 disease became a matter of concern for the whole world and WHO declared it as pandemic on 11 March 2020. Soon a number of clinical trials started to check for the treatment modalities, to compare their efficacy and safety. Out of which corticosteroids in trials showed decrease in mortality in severe COVID-19 patients. However existing diseases such as tuberculosis still remains a leading killer and matter of concern. One out of four individuals are said to be having tuberculosis (mostly in inactive form or latent form) but there remains a threat of reactivation of tuberculosis in presence of risk factors such as corticosteroid administration as it causes immunosuppression. This is a retrospective observational study on reactivation of tuberculosis due to corticosteroids used in COVID-19 treatment. Most commonly given corticosteroid was found to be dexamethasone and the duration of corticosteroid therapy ranged between 5 to 12 days. Majority of patients (5 out of 6) showed reactivation of tuberculosis within 30 days of starting of corticosteroid therapy and most common co-morbidity associated was found to be diabetes mellitus followed by hypertension in such patients. Symptoms of 4 out of 6 patients resolved after starting of anti-tubercular therapy
A cross-sectional observational drug utilisation study of antipsychotic drugs prescribed in patients suffering from psychiatric illnesses at a tertiary care hospital
Get PDFBackground: The rapidly expanding field of psychopharmacotherapy is challenging the traditional concepts of psychiatric treatment and research and is constantly seeking new and improved drugs to treat psychiatric disorders.Methods: The present study was undertaken to analyse the pattern of drug utilization of antipsychotic medications in outdoor patients of psychiatry department of a tertiary care hospital. 600 prescriptions of 600 patients suffering from different psychiatric illnesses were taken for analyses in which antipsychotic agents were prescribed either as a main drug or as a concomitant agent after proper taking written informed consent.Results: A total of 1681 drugs were prescribed in our study population The average number of drugs prescribed per prescription in the study population was 2.61±1.32. Schizophrenia, bipolar disorder, depression were among the most common illnesses for which antipsychotics were prescribed. Atypical antipsychotics were most commonly prescribed in the study population out of which olanzapine was prescribed in most of the patients. Considering the cost analysis of the present study, the average cost per prescription was 475.02 INR. Average cost of antipsychotics per prescription was 208.1 INR.Conclusions: The present study provides valuable insight into the overall pattern of antipsychotic drugs prescribed in patients suffering from different psychiatric illnesses and mental health disorders and the principles of rational prescribing were followed in accordance with the various drug use indicators mentioned by WHO
Clinicoepidemiological study of fixed drug eruption in tertiary care hospital
Get PDFBackground: Adverse cutaneous drug reactions pose diagnostic difficulties due to a varied clinical manifestations and broad categories of causative agents. Fixed drug eruptions (FDE) are one of them. Present study aims i) to record various clinical features of FDE, their causative agents and ii) to study the pattern of morbidity in patients with FDE in a tertiary care hospital, Rajkot, Gujarat, India.Methods: The 88 patients with FDEs attending department of dermatology, venereology and leprosy at PDU govt. medical college and hospital, Rajkot, Gujarat from September 2018 to September 2020 were included after informed consent. After taking thorough history, complete blood count and biochemical tests were done. HIV testing was done in severe reactions with generalised involvement. Appropriate treatment was given with counselling regarding the offending drug for prevention of reaction in future.Results: The male patients were more affected than female patients with M: F ratio of 1.3:1. The most common age group affected was 21-30 years (22.7%). Antimicrobials were the most common offending drugs (43.2%). None of the patients were HIV reactive in our study. No mortality was reported in our study.Conclusions: The patterns of FDE and the causative drugs are remarkably different in our study. Knowledge of patterns and the causative agents helps in prevention of same reactions in future in patients
Novel strategy of skill lab training for parenteral injection techniques: a promising opportunity for medical students
Get PDFBackground: To set up an experimental pharmacology skill lab to facilitate training of specific modules for development of core competencies of parenteral drug administration and intravenous drip settings using mannequins for development of skills in administering injections for undergraduate medical students, which will be assessed using Objective Structured Practical Examination.Methods: High quality mannequins were procured from reputed companies in coordination with the biomedical engineering department of the tertiary care teaching institution. Sufficient number of multi-venous access arms, buttock injection model and models for subcutaneous and intradermal injections were obtained to facilitate individual training of 150 students in small groups during practical classes according to the checklist for the procedure. Ethical committee approval was deemed unnecessary for this study as it was a part of curriculum development.Results: Students practiced the technique confidently, without the fear doing it in a patient. This gave them the opportunity to practice in a real human surface texture, which gave them better understanding about the depth and extent of insertion of devices. Moreover, they could easily follow the steps in the check list which enabled them to practice as per protocol.Conclusions: Because of the hands-on training the students receive, we have seen a greater trend toward self-learning and better adherence to the injection technique protocol. Hence mannequin-based learning can be considered as very effective in acquiring procedural skills under the new medical curriculum in India. However, considering the high initial investment and further need of constant maintenance, cost effective mannequins need to be introduced and popularized
Carcinogen tainted generic drugs: a matter of concern
Get PDFThe burden of non-communicable diseases is progressively on a rise across the globe with India contributing to a substantial quantum. Nearly 63% of total deaths in India are due to non-communicable diseases, of which 27% are due to cardiovascular diseases (CVDs). High blood pressure is among the most important risk factors for CVDs. Data (from 1950 to 2014) on hypertension in the Indian populace, revealed a high overall prevalence of 29.8% (95% CI 26.7-33.0), showing a constant rise and a marked increase in urban (33.8%) population than in rural (27.6%),
A questionnaire-based exploratory study on self medication among second year MBBS students
Get PDFBackground: The practice of self-medication is expected to be higher in health science students due to their exposure to knowledge about different diseases and drugs. This study was done to assess the knowledge, attitude and practice of self-medication and to compare the impact of knowledge of Pharmacology on it, among second-year MBBS students.Methods: A semi-structured questionnaire consisting of both open-ended and close-ended questions was prepared and given to second-year medical students of Kurnool medical college, Kurnool. Data was analysed and entered in Microsoft Excel (version 2019), and associations were tested using the Chi-square test. The results are expressed as counts and percentages. Statistical significance was p<0.05.Results: Among the respondents, 37.33% are practising self- medication, 54.66% think knowledge of Pharmacology aids students to practice without any dire consequences. Most of the students take for fever (95.33%), (97.33%) for cough, cold, sore throat.84% were aware that it’s not safe to take drugs pertaining to alternate systems of medicine like Ayurveda, homoeopathy. A statistically significant association between knowledge, attitude, practice and gender and residence has been observed.Conclusions: The study shows that students are aware that self-medication is dangerous when followed by lay people. On the other hand, health professionals with knowledge about medications can take self-medication for common conditions without any dire consequences. They are also aware that it’s not safe to take medications that come under alternate systems of medicines, and WhatsApp consultation is not to be encouraged
A case report on wegener’s granulomatosis
Get PDFWegener’s Granulomatosis, also known as granulomatosis with polyangiitis, is a rare multisystem autoimmune disease with an unknown etiology that can affect persons of all ages. In most cases, the condition affects the respiratory tract and the kidneys. The initial symptoms include a runny nose (rhinorrhea), nasal crusting, and nasal blockage or congestion. More significant symptoms include nose bleeds, ulcerations of the nasal mucous membranes with subsequent bacterial infection, sinus discomfort, sinus inflammation, and hoarseness. The patient was presented with symptoms like reddish staining of the eyes, hearing loss, and numerous joint discomfort and swelling of the lower limbs. The antineutrophil cytoplasmic antibody, cytoplasmic (C-ANCA), and human leukocyte antigen- B27 (HLA-B27) were both positive, and renal biopsy revealed necrotizing and crescentic glomerulonephritis. The treatment was initiated with corticosteroids and monoclonal antibodies. The patient responded positively to the therapy, and her health appears to be improving