International Journal of Basic & Clinical Pharmacology
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Thyroid dysfunction in type 2 diabetes mellitus patients attending diabetic clinic in a tertiary care centre: a cross-sectional study
Get PDFBackground: Thyroid disease and type 2 diabetes mellitus are two common co-existing endocrinopathies found in the general population. Since thyroid dysfunction complicates the metabolic derangement observed in diabetes, its treatment is necessary in order to achieve stability of metabolic control. Therefore, the aim of the present investigation was to estimate the functional thyroid disorders and the associated factors in type 2 diabetes patients.Methods: In 230 diabetic patients, the blood sugar level and thyroid function tests were performed and compared. Most of the patients were in the age group of 51-60 years (36.08%).Results: The prevalence of thyroid dysfunction in diabetic patients was 15.21% with a higher rate in female patients. Subclinical hypothyroidism (12.17%) was the commonest thyroid dysfunction.Conclusions: The data suggest that subclinical hypothyroidism was more prevalent in type 2 diabetes mellitus, and may confer a greater risk of diabetic complications. It is therefore important to diagnose thyroid dysfunction in diabetic patients and the practice should be inculcated in diabetic care
Use of levocetrizine in the management of type IV hypersensitivity to lidocaine: a case report
Get PDFLidocaine is a commonly used local anesthetic in the field of dentistry. It has been known to cause allergic reactions, mainly immunoglobulin (IgE)-mediated and T-cell –mediated type IV reactions, which require the use of alternative drugs without adverse effects. Here we present the case of a 29 year old female patient who developed Type IV hypersensitivity reaction in the vicinity of the injection site after the administration of lidocaine local anesthetic for performing exodontia. Levocetrizine tablet was prescribed in order to relieve the symptoms of the reaction. Levocetrizine is a selective, potent, oral histamine H(1) receptor antagonist that is used for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria. It has been reported to be effective and generally well tolerated by the patients. In our case also it was able to cure Type IV hypersensitivity reaction to lidocaine without producing any adverse events. Apart from curing allergic rhinitis and urticaria, levocetrizine is a wonderful option for treating Type IV hypersensitivity reaction to a local anesthetic, and it hardly produces any adverse effect. More cases are required to be reported in the future in order to support this article
COVID-19 vaccines: the dilemma when thinking as a patient
Get PDFWhat is the truth about the conspiracy theory of the COVID-19 microchip vaccine? The outbreak of the COVID-19 witnessed a vicious race of pharmaceutical firms to develop a vaccine that ends this disaster. Claims were forwarded that some firms funded by well-known foundations are in the process of developing such a vaccine so people wide world can be tracked. Such claims may have been based on Mr. Bill Gate’s announcement in an interview that through vaccination "we will have some digital certificates" which would be used to show who had recovered, been tested and ultimately who received a vaccine but he made no mention of microchips. The conspiracy theory is spreading around the world and its supporters are on the increase among the public as well as many healthcare professionals. The spread of the virus has been attributed to the introduction of 5G technology and many religious leaders attributed the crisis to punishment from God to the spread of local wars and mass killing, torturing and killing of Muslims in China and Myanmar gay and lesbian movement and marriages
A comparative study of efficacy and safety of anti-oxidants as an add-on therapy to metformin on glycemic parameters in newly diagnosed type 2 diabetes mellitus patients at a tertiary care hospital
Get PDFBackground: Oxidative stress plays major role in diabetes mellitus (DM), abnormal high free radicals decline antioxidant defence mechanism can lead to damage of cellular organelles and enzymes, increased lipid peroxidation and insulin resistance leads to development of complications. Supplementation of antioxidants protects free radical induced damage and further complications. The objective was to evaluate the efficacy and safety of metformin versus metformin with vitamin C and E on glycaemic parameters in newly diagnosed type 2 diabetes mellitus (T2DM).Methods: 60 newly diagnosed T2DM patients were randomized into two groups of 30 in each to receive metformin (500 mg BD) alone in group A versus metformin (500 mg BD)+vitamin C (500 mg OD)+vitamin E (400 mg OD) in group B for 12 weeks. Efficacy was measured by improvement in glycaemic (FBS fasting blood sugar, PPBS postprandial blood sugar and HbA1c glycosylated haemoglobin) parameters at week 4, 8 and 12 from baseline. Safety was assessed by monitoring treatment emergent adverse effects.Results: The baseline characteristics were comparable between the two groups. There was a significant reduction of glycaemic parameters seen in both the groups from baseline to week 12 (p<0.001) but the difference was not statistically significant between the two groups (p>0.05). No significant adverse effects were noted.Conclusions: Both the groups are effective in improving glycaemic indices and supplementation of vitamins along with metformin as compared to metformin alone with no significant adverse effect. Hence, daily consumption of vitamins may be beneficial in decreasing blood glucose in patients with T2DM and thus reducing the risk of complications
Study on drug use pattern in the management of the cardiovascular diseases and with comorbidities
Get PDFBackground: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs
Expectant versus surgical management of incomplete abortions caused by self-intake of abortifacient drugs: results from a randomized controlled trial
Get PDFBackground: Termination of unwanted pregnancies with medical method using recommended protocol based abortifacient drugs is a standard practice followed by obstetricians and gynaecologists worldwide which has a very successful outcome. However, self-administration of these drugs has become rampant because of certain social and practical issues resulting in complications and incomplete abortions as when these drugs are self-administered, recommended protocol is not generally followed. Traditionally incomplete abortions are managed by surgical curettage which itself is associated with procedure related complication and has been challenged by recent studies. Based on these studies many international guidelines have come out in support of expectant management of incomplete abortions. This study compared both of these management protocols to treat incomplete abortions caused by unprescribed intake of abortifacient drugs.Methods: This was a one-year long prospective randomized controlled study in which total 782 females were randomized into two groups of 371 and 411. Group 1 was offered expectant management while group 2 was offered surgical curettage. Results were analysed using appropriate statistical tests.Results: Group 1 showed a success rate of 86% while group 2 showed a success rate of 90% which was comparable. Overall complication rate was found to be higher in Surgical curettage group than in the group which underwent expectant management group.Conclusions: Considering a very high number of patients coming with incomplete abortions caused by self-medication in present practice, expectant management seems to be a safer and more effective method and should be practice more widely
A comparative study of azelastine, cromolyn and olopatadine ophthalmic solution in vernal keratoconjunctivitis in a tertiary care hospital-open label parallel group study design
Get PDFBackground: Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, external ocular inflammatory disease primarily affecting young boys living in warm, dry climates with seasonal variations. The disease causes lot of discomfort to the patient and sometimes can predispose to serious problems like shield ulceration and keratoconus. A number of drugs are used in the management of the condition, with variable results. The aims and objectives of this study was to compare the efficacy and safety of the drugs, cromolyn sodium, azelastine and olopatadine ophthalmic solutions in the treatment of VKC.Methods: Sixty patients of VKC were studied over a period of 6 weeks. They were divided into 3 groups randomly to receive one of the drugs under study. Symptoms and signs were recorded after detailed questioning and examination according to modified criterion of Tabbara and Arafat.Results: There was significant reduction in the mean itching scores with olopatadine as compared to cromolyn sodium and azelastine (p<0.05). Olopatadine significantly decreased mean lacrimation scores as compared to cromolyn sodium and azelastine (p<0.005). Olopatadine, cromolyn and azelastine showed significant reduction of corneal stippling, but no drug was significantly better than the other. Both cromolyn and olopatadine showed reduction of limbal edema equally (p<0.05), olopatadine reduced limbal edema more significantly as compared to azelastine (p<0.05).Conclusions: All the three drugs were found to be safe in the treatment of VKC. Olopatadine may be preferred over the other two drugs since it reduced both itching and discharge most significantly
Painful neuropathy: comparative observational analysis of safety profile of pregabalin and amitriptyline
Get PDFBackground: Chronic neuropathic pain, caused by a lesion or disease of the somatosensory nervous system is a common debilitating condition in clinical practice. Pregabalin and Amitriptyline are most commonly used drugs for its management. The aim of the study was to study the safety of Pregabalin and Amitriptyline in chronic neuropathic pain.Methods: Prospective observational study at Department of Medicine and Orthopaedics at All India Institute of Medical Sciences, Rishikesh. Newly diagnosed patients of neuropathic pain who were prescribed either Pregabalin or Amitriptyline were included in the study. Patients were followed up telephonically or during routine visits for a period of 3 months after initiation of any of these drugs. Appropriate measures of central tendency were used to describe demographic and clinical parameters and Correlation test was used between different variables and occurrence of adverse drug reactions.Results: 317 patients were prescribed these drugs. A total of 276 ADRs were observed (128 with Pregabalin and 148 with Amitriptyline). Central nervous system symptoms like sedation and dizziness were most commonly present in both the groups. Diabetes mellitus (47.1%) was most common etiology for neuropathic pain. Causality assessment showed probable association with Amitriptyline (n=140) and Pregabalin (n=118). Majority of ADRs with Amitriptyline group (49.32%) were moderate in severity whereas it was mild with Pregabalin (59.7%). A weak positive correlation (R=0.273) was seen with number of ADRs occurrence and total drug exposure in patients taking Pregabalin whereas a weak negative correlation (R=-0.623) was seen in Amitriptyline treated group.Conclusions: Safety profile of Pregabalin was better than Amitriptyline in the present study. The study findings must be replicated in larger patient population and for a prolonged duration for better understanding of the pattern of adverse drug reactions.
Risperidone induced tardive dyskinesia
Get PDFRisperidone is an atypical antipsychotic drug which has been less likely to produce extrapyramidal symptoms. The aim of this case report is to illustrate that low dose risperidone may cause tardive dyskinesia. A 29 year old male patient with 9 year history of paranoid schizophrenia, developed tardive dyskinesia after receiving risperidone 2 mg for 7 years. He had received small dosages of Haloperidol before the therapy of risperidone for short periods
Efficacy and safety of remogliflozin etabonate in type 2 diabetes mellitus patients in a tertiary care hospital
Get PDFBackground: Incidence and prevalence of diabetes have been steadily increasing with a raise of global prevalence about 8.5%. The major types of diabetes are differentiated by insulin deficiency versus insulin resistance. SGLT2 inhibitors are a new class of drugs that act by inhibiting glucose reabsorption in the proximal renal tubules. Remogliflozin a prodrug of remogliflozin, which is a potent and selective sodium-glucose co-transporter-2 inhibitor was used for the study. The objective of the study was to evaluate the efficacy and safety of Remogliflozin etabonate in reducing HbA1C and serum glucose in type II diabetics.Methods: This was a prospective observational study was done for 3 months. HbA1C, FBS and PPBS readings were noted and then the subjects were introduced to Remoglifozin 100 mg twice a day. At the end of 12 weeks HbA1C, FBS and PPBS were noted. The obtained data was analysed for its efficacy and safety.Results: The study included 22 male subjects and 28 females. Before Remoglifzoin was given the mean HbA1C level was 8.23± 0.798, mean FBS was 179± 29.79 and PPBS was 299.38± 24.21. Remoglifozin 100 mg was given and the mean HbA1C level was 7.52± 0.765, mean FBS was 166.30± 32.13 and mean PPBS was 249.46± 18.21. Post 3 months of Remoglifzoin induction a reduction in HbA1C, FBS and PPBS was seen.Conclusions: This study concludes Remoglifozin etabonate of 100 mg when given twice daily reduced the HbA1C levels, FBS and PPBS levels significantly