Asian Journal of Pharmaceutical and Clinical Research

BISALBUMINEMIA: STILL UNREVEALED FOR CLINICIANS AND RESEARCHERS – A SYSTEMIC REVIEW

2024-05-30T12:37:58+0530

Bisalbuminemia, a rare finding on serum protein electrophoresis, presents as a double band in the albumin region. Inherited Bisalbuminemia is a benign condition with autosomal dominant inheritance whereas Acquired Bisalbuminemia can be associated with various conditions like diabetes, pancreatitis, and myeloma. Capillary electrophoresis is the preferred method for diagnosis due to its superior resolution compared to agarose gel electrophoresis. Bisalbuminemia itself has no clinical significance, but acquired forms warrant further investigation for underlying diseases. Future research focuses on the functional consequences of albumin mutations and potential disease associations. This review summarizes the current knowledge on Bisalbuminemia, covering its types, causes, clinical significance, and diagnosis.

AN ASSESSMENT OF PATIENT SATISFACTION IN DAY CARE SURGERY: A PROSPECTIVE OBSERVATIONAL STUDY

2024-06-02T21:15:34+0530

Objective: This study aims to evaluate the patient’s satisfaction with anesthesia who underwent daycare surgery in terms of a “core questionnaire for the assessment of patient satisfaction for general daycare” (COPS-D) questionnaire.

Methods: In this prospective observational study, we included 72 patients posted for day care surgery, belonging to ASA physical status 1 and 2. The patient’s demographic details, pre-operative assessment, anesthetic technique, and surgical consideration were all recorded, and informed consent was obtained from the respective participants in the pre-operative room. Once the post-anesthesia discharge scoring system criteria are fulfilled by the patient, a COPS-D questionnaire was obtained.

Results: Results were analyzed according to the average score per question and average score per domain of the COPS-D questionnaire. It was found that the highest score was achieved by the question number (Q4) ‘‘How satisfied were you with the personal attention of the operation staff? which achieved an average score of 4.72±0.48 and the lowest score was achieved by (Q10) “How satisfied were you with the discharge procedure? which achieved an average score of 4.17±0.79. The overall satisfaction was 80%.

Conclusion: The COPS-D questionnaire proved to be a useful tool in identifying points of patient satisfaction and these were correlated with patient variables such as age, sex, ASA physical status, anesthesia type, and surgical specialty with the ultimate goal of improving patient satisfaction in relation to anesthesia care.

A CROSS-SECTIONAL STUDY ON IMPLEMENTATION OF e-SANJEEVANI SERVICES IN RURAL AREAS OF KALABURAGI DISTRICT

2024-08-10T16:42:08+0530

Objectives: India adopted national telemedicine service – “e-Sanjeevani” on November 2019, based on “Hub and Spoke Model” where Health and Wellness Centers under Ayushman Bharat (AB-HWCs) will be the spokes and MBBS/specialty doctors will be the hub. It aims to overcome the shortage of doctors/specialists at the ground level, reduce the burden at higher centers, and inculcate expert medical advice seeking behavior among rural people. The objectives of the study are to assess the implementation of e-Sanjeevani services in rural Kalaburagi and to identify the challenges faced by the service providers of e-Sanjeevani in rural Kalaburagi.

Methods: A cross-sectional study was conducted across the AB-HWCs in the rural areas of Kalaburagi district over a period of 3 months. Multistage sampling was done, maintaining a constant of 50%. The total sample size was 75 HWCs. The implementation of e-Sanjeevani was assessed using a pre-designed, pre-tested, and semi-structured questionnaire. The data collected were entered into MS Excel and frequency, percentage, t-test, and Chi-square test were employed for analysis.

Results: e-Sanjeevani is implemented in all the selected subcenters (100%) whereas it was implemented only in 14 (58.35%) of the selected PHCs in Kalaburagi district. The service providers face multiple challenges such as unavailability of specialists online (52.3%), long waiting time (43.1%), network issues (41.5%), and unavailability of investigations/drugs prescribed by specialists (40%). Mean grading of e-Sanjeevani on a scale of 1-10 by service providers in subcenters (7.25±1.76) was also statistically significant than in PHCs (6.07±1.82).

Conclusion: Although e-Sanjeevani is implemented in all subcenters in Kalaburagi district, its smooth functioning is hampered by various factors which call for strengthening of specialist availability and other facilities.

ADHERENCE TO ANTIHYPERTENSIVE MEDICATION AND ITS DETERMINANTS IN A PRIMARY CARE SETTING OF KALABURAGI DISTRICT

2024-08-07T14:30:27+0530

Objectives: Hypertension is a chronic condition of concern and it is the most common non-communicable disorder posing a major public health challenge in many aspects. Adherence to prescribed medicine is a crucial issue that is directly related to the management of hypertension. To control high blood pressure and to avoid associated repercussions, good antihypertensive medication adherence is an effective strategy. The study aimed to estimate adherence to medication among hypertensive patients attending the non-communicable disease clinic at Urban Primary Health Centre (UPHC), Kalaburagi. To assess the determinants of adherence to antihypertensive medication.

Methods: A facility-based cross-sectional study was conducted among adult hypertensive patients receiving treatment from the UPHC. A semi-structured questionnaire and an 8-item Morisky medication adherence scale (MMAS-8) were used to assess the determinants and medication adherence status.

Results: Assessing the adherence level using the Morisky scale (MMAS-8), it was observed that 35 (38.9%) had low adherence, while 26 (28.9%) had medium adherence and 29 (32.2%) had high adherence.

Conclusion: The majority of study participants have poor adherence to antihypertensives. The adherence level can be further improved by providing health education and efficient counseling drug adherence assessment needs to be an integral component of routine care.

DETECTION OF BONE MARROW EDEMA IN VERTEBRAL COMPRESSION FRACTURES USING THIRD-GENERATION DUAL-ENERGY COMPUTED TOMOGRAPHY AND VIRTUAL NONCALCIUM TECHNIQUES

2024-07-31T12:00:50+0530

Objectives: Vertebral compression fractures (VCFs) are a significant clinical concern worldwide, often resulting in increased morbidity and mortality. Malignancies, secondary osteoporosis, post-menopausal osteoporosis, and trauma are the most common causes of this. Early detection and appropriate treatment are crucial to alleviate pain, initiate therapy, prevent complications, and reduce the risk of new fractures. Various imaging modalities, including magnetic resonance imaging (MRI) and computed tomography (CT), are used to diagnose VCFs. However, MRI has limitations, and CT advancements, particularly dual-energy CT (DECT) with virtual non-calcium (VNCa) imaging, offer the best alternatives for detecting bone marrow edema.

Methods: This observational study was conducted at Kovai Medical Center and Hospital, Coimbatore, involving 46 adult patients with detectable VCFs. Approval was obtained from the Institutional Ethical and Scientific Committee, and informed consent was received from all participants. Patients underwent spine MRI and DECT on the same day. MRI was performed using Siemens 3T Skyra or Philips Ingenia 1.5T scanners, and DECT scans were taken using a third-generation 192-slice dual-source CT scanner. DECT images were processed to create VNCa images. Image analysis was conducted blindly, with MRI images showing increased STIR signal intensity and decreased T1 signal considered positive for bone marrow edema. DECT images were evaluated for edema presence.

Results: The study participants had a mean age of 58.65±15.47 years, with 54.3% females and 45.7% males. A total of 84 fractures were detected across 782 vertebral bodies, with 57.14% acute and 42.86% chronic. Fractures were evenly distributed between the dorsal (57.14%) and lumbar (42.86%) levels, predominantly at the dorsolumbar junction. Using the Genant grading system, fractures were classified into grades 0–3, with most fractures being grade 1 (35.7%) and grade 3 (35.7%). DECT demonstrated high diagnostic performance, with a sensitivity of 87.50%, specificity of 91.66%, positive predictive value of 93.33%, negative predictive value of 84.62%, and overall accuracy of 89.29%. The positive and negative likelihood ratios were 10.50–0.14, respectively.

Discussion: The study confirms that third-generation DECT with VNCa imaging is highly effective in detecting bone marrow edema in VCFs, showing diagnostic accuracy comparable to MRI. Previous studies corroborate these findings, indicating that DECT can serve as a reliable alternative, especially for patients with MRI contraindications. The advancements in DECT technology enhance its ability to differentiate and visualize bone marrow abnormalities, making it a valuable diagnostic tool in clinical practice.

A STUDY OF NON-INFECTIOUS PRURITUS IN PREGNANCY: CAUSES AND EVALUATION

2024-08-08T11:50:33+0530

Objectives: Itching is one of the most common complaints related to dermatosis during pregnancy occurring in 14–23% of pregnant women. Pregnancy-specific dermatoses constitute a heterogeneous group of pruritic skin eruptions seen exclusively during pregnancy and the postpartum period. These dermatoses may be linked to increased activity of maternal adrenal and pituitary glands, the development of fetal endocrine glands and are influenced by hormones such as progesterone, estrogen, and cortisone.

This study aims to evaluate various skin lesions during pregnancy. To explore the prevalence and variations of non-infectious pruritus in pregnancy and to evaluate the impact of non-infectious pruritus on maternal wellbeing.

Materials and methods: An observational prospective study was carried out on pregnant women presenting with complaints of pruritus. Data on socioeconomic status, demographics, obstetric history, medical conditions, and factors such as age, parity, and mode of delivery were collected. Neonatal outcomes, birthweight, NICU admission, morbidity, and mortality were documented.

Results: Majority of the subjects were in the age group of 20–30 years (77.5%). 88.1% resided in rural areas and 50% of the patients were primigravida. The majority (73.4%) of subjects had an onset of pruritus in the third trimester. The most common cause of pruritus was infectious (46.3%), specific dermatosis of pregnancy was observed in 37.6%, and in 13.8% of cases, pruritus was of unknown origin. IHCP was the most common cause of pruritus (40%). IHCP had the maximum number of preterm deliveries (36%), 48.5% of subjects had LSCS and induction was done in 45.4%.

Conclusion: Intrahepatic cholestasis of pregnancy is most prevalent among specific dermatosis of pregnancy which was associated with preterm deliveries, higher rate of induction, and LSCS.

VITAMIN D DEFICIENCY IN PREGNANCY: EFFECT ON MATERNAL AND FETAL OUTCOME

2024-06-29T17:33:26+0530

Objective: Vitamin D deficiency (VDD) during pregnancy is known to affect the neonatal morbidity and mortality. This study was conducted in pregnant women with the aim of assessing the prevalence of VDD in pregnant women and its effect on expecting mother and newborn.

Methods: This was a cross-sectional study done over a period of 2 years. 25(OH)D3 level was tested by Chemiluminescent Immunoassay in clinical biochemistry laboratory. Subjects were classified into Vitamin D-deficient, insufficient, and sufficient group.

Results: Mean level of Vitamin D in the study population was 21.82±12.95. The level of Vitamin D was found to be sufficient only in 28% (28/100) of subjects. A significant correlation was observed between newborn birth weight and serum Vitamin D level of the mother. Appearance, pulse, grimace, activity, and respiration (APGAR) score was moderately and severely depressed in 17% and 3% of babies, respectively. Pre-eclampsia was observed in 8% (8/100) of the subjects. A significant correlation was observed between the occurrence of pre-eclampsia and maternal Vitamin D. APGAR score was found to be significantly associated with serum Vitamin D.

Conclusion: There is a high prevalence of VDD in pregnant women. VDD in pregnancy is associated with several complications to the expectant mother as well as the fetus. Complications such as pre-eclampsia, low birth weight (LBW) babies, and low APGAR score were observed in the present study. There is a need of extensive clinical research on the impact of VDD in pregnancy on mother and fetal health.

EVALUATING EXPULSION RATES: POSTPARTUM VERSUS INTERVAL INTRAUTERINE DEVICE INSERTION IN A TERTIARY CARE SETTING

2024-06-22T16:39:24+0530

Objective: The intrauterine contraceptive device (IUCD) is a safe, reversible, feasible, and cheap form of contraception, yet its popularity is limited partly due to the risk of expulsion. Increased institutional deliveries can enhance family planning services, including postpartum IUCD (PPIUCD) insertion. This study compared the expulsion rates of PPIUCD and interval IUCD and aimed to educate, motivate, and counsel pregnant women about IUCD use.

Methods: This was a comparative study conducted in a tertiary care teaching institute. After counseling, 900 women were willing for IUCD insertion. Outcomes were studied at 6 weeks and at 12 months.

Results: A total of 4605 women were counseled regarding the benefits of IUCD, among which 900 women accepted IUCD as a method of contraception. Six hundred women accepted PPIUCD and 300 opted for interval IUCD. Among PPIUCD acceptors, 402 cases opted for intracesarean insertion of IUCD, and 198 cases opted for post-placental (n=114) and early postpartum (n=84) insertion of IUCD after vaginal delivery. The overall expulsion rate in the PPIUCD group was 6.16% and 1.66% in the interval IUCD group. The expulsion rate was more in multiparas than in primiparas. In the PPIUCD group, the patients who had IUCD insertion in the early postpartum period had a higher expulsion rate than the post-placental and intracesarean group.

Conclusion: Proper counseling helps women make informed choices about IUCDs. Despite higher expulsion rates, PPIUCD can be recommended as an ideal method in developing countries like India, where women often do not return for contraceptive needs.

PATTERN OF DRUG UTILIZATION DURING PREGNANCY AT A TEACHING HOSPITAL – A PROSPECTIVE OBSERVATIONAL STUDY

2024-06-10T15:20:31+0530

Objectives: The objective of the study is (1) to assess the drug utilization pattern in pregnancy and (2) to assist in ensuring rational drug therapy.

Methods: A prospective, cross-sectional observational study was conducted at the Obstetrics and Gynecology Outpatient Department of KRIMS, Karwar. 546 pregnant women aged 18–40 years were included. Data collected from prescriptions were analyzed for adherence to the World Health Organization core prescribing indicators and classified as per the US Food and Drug Administration (FDA) pregnancy categories.

Results: The average age of study participants was 26.96 years with an urban preponderance (77.65%). Morning sickness (35.71%) and upper respiratory tract infections (20.7%) were the most frequent ailments encountered. 6383 drugs were prescribed in 2555 prescriptions with an average of 2.5 drugs per prescription. Iron and calcium supplements (28.75% each) were the most common drugs prescribed. 12.25% of prescriptions had fixed-dose combinations. 86.28% of drugs were from the National List of Essential Medicine (NLEM) and the majority of drugs belonged to FDA pregnancy category B (39.02%).

Conclusion: Rational prescribing was demonstrated in our study by a fewer number of drugs per prescription and lesser utilization of antibiotics and injections. Generic names were commonly used and drugs were selected from NLEM. It is essential to prescribe medicines with established efficacy and safety to ensure maternal and fetal well-being.

A STUDY OF PACKAGE INSERTS: HOW ACCURATE IS THE INFORMATION PROVIDED?

2024-06-12T19:52:05+0530

Objectives: The objective of this study was to critically analyze the accuracy of the drug package inserts. An accurate package insert that is patient-friendly, written in a regional language, and based on guidelines can benefit patients, prescribers, and health-care providers, improving overall healthcare in our society.

Methods: The study was a cross-sectional observational type of study. One hundred and fifty package inserts were collected from the pharmacy store of a tertiary care teaching hospital in Gujarat. Package inserts with the same drug formulation and from the same company were excluded from the study. The collected package insert data were analyzed for accuracy and compliance concerning guidelines based on the “Drug and Cosmetics Act (1940) and Rules (1945).”

Results: A total of 150 drug package inserts, among them 89 were injectable, 53 were oral, and 8 were topical preparations. In therapeutic indication, posology and method of administration were present in 150 (100%) package inserts. Contra-indications, interaction with other medicaments and other forms of interaction, undesirable effects/side effects, and antidote for overdosing parameters were present, respectively, in 145 (96.66%), 133 (86.66%), 148 (98.66%), and 127 (84.66%) package inserts. In pharmaceutical information; list of excipients, shelf life in the medical product as packaged for sale, special precautions for storage, and instructions for use/handling were present, respectively, in 26 (17.33%), 81 (54%), 145 (96.66%), and 82 (54.66%).

Conclusion: We found that all package inserts included in our study were not accurate as per the Central Drugs Standard Control Organization guideline. If accurate information in the package insert is available, it can be beneficial for the patient’s healthcare.

EPIDURAL DEXAMETHASONE FOR POST-OPERATIVE ANALGESIA IN PATIENTS UNDERGOING INFRAUMBILICAL SURGERIES

2024-06-06T11:16:05+0530

Objectives: This study was designed to evaluate the effect of adding dexamethasone to epidural bupivacaine for post-operative analgesia in infraumbilical surgeries. This study aimed to evaluate the efficacy of epidural dexamethasone used as an adjuvant to bupivacaine to compare sensory and motor block characteristics, intraoperative hemodynamic parameters, duration of post-operative analgesia, and any side effects of study drugs in both the groups.

Methods: Seventy-two patients undergoing any infraumbilical surgeries were divided into the following two groups. (1) Group D (n=36): 18 mL of isobaric bupivacaine 0.5% and 2 mL (8 mg) of dexamethasone given epidurally and (2) Group B (n=36): 18 mL of isobaric bupivacaine 0.5% and 2 mL of normal saline given epidurally. Intraoperative hemodynamic parameters, onset, and duration of sensory and motor blockade, two-segment regression time, and duration of post-operative analgesia were assessed.

Results: The time of onset of sensory and motor blockage was faster in the dexamethasone group as compared to the control group (p<0.05). The time taken to achieve the T10 sensory block was comparatively shorter in Group D compared to Group B (p<0.001). Duration of analgesia was markedly prolonged in the dexamethasone group (p<0.001). One patient (0.36%) in the dexamethasone group and five patients (13.88%) in the control group had nausea (p>0.05). None of our patients had vomiting in the two groups.

Conclusion: The study showed that adding dexamethasone to bupivacaine (0.5%) epidurally shortened the onset of sensory and motor block, reduced post-operative visual analog scale score, prolonged the duration of analgesia with hemodynamic stability and minimum side effects.

OUTCOME FOLLOWING STEROID THERAPY IN CASES WITH ACUTE OPTIC NEUROPATHY REPORTING TO TERTIARY CARE CENTER

2024-06-04T11:24:48+0530

Objectives: The objective of the study was to evaluate the etiological factors in patients of acute optic neuropathy reporting to tertiary care centers and response to steroid therapy in acute optic neuropathy.

Methods: All the patients selected were subjected to the detailed ocular examination which included best-corrected visual acuity and fundus examination. After ocular and systemic examination and relevant investigations, the underlying etiological diagnosis of acute optic neuropathy was established after this, they were started on intravenous methylprednisolone followed by oral prednisolone.

Results: A total of 30 patients with acute optic neuropathy presented in the tertiary care center during the study period. A visual improvement of more than two lines, after steroid therapy, was observed in 54.5% of cases of traumatic optic neuropathy, 53.8% of cases of optic neuritis, and 33.3% of cases of anterior ischemic optic neuropathy.

Conclusion: Marked visual recovery and prognosis can be seen in timely managed patients. In traumatic optic neuropathy, steroid therapy should always be considered in diagnosed patients of traumatic optic neuropathy irrespective of the timing of presentation.

DEVELOPMENT AND VALIDATION OF RP-HPLC METHOD FOR THE QUANTITATIVE DETERMINATION OF ORGANIC IMPURITIES OF DOCETAXEL IN PARENTERAL FORMULATION OF DOCETAXEL USING UV DETECTOR

2023-12-29T21:05:40+0530

Objective: The objective is to develop a novel, rapid, simple, precise, accurate, and reproducible reverse-phase high-performance liquid chromatography (RP-HPLC) method for quantitative estimation of organic impurities of docetaxel (DTX) parenteral formulation through high-performance liquid chromatography (HPLC).

Methods: Finalized chromatographic conditions were used for a reversed-phase C18 column with particle size of 3 μm and dimension of 4.6×150 mm, water as mobile phase-A and acetonitrile mobile phase-B. The flow rate is 1.2 mL/min with gradient elution and ultraviolet (UV) detection at 232 nm. Acetonitrile: water:glacialcetic acid in the ratio of 100:100:0.1 (v/v/v) as diluent.

Results: Analytical test method for the quantitative determination of organic impurities of DTX in parenteral formulation of DTX using HPLC with UV detector was verified and found to be linear over the tested concentration range for all impurities (10-deacetylbaccatin: 0.032–0.466 μg/mL; DTX: 0.015–0.151 μg/mL; 6-oxodocetaxel: 0.023–2.080 μg/mL; 4-epidocetaxel: 0.022–1.380 μg/mL; 4-epi-6-oxodocetaxel: 0.021–0.673 μg/mL). The calibration charts plotted were linear with a regression coefficient of R2>0.999. Method-precise results were found to be within the acceptance criteria. Limit of detection and limit of quantification for the active ingredients and their impurities were established with respect to test concentration.

Conclusion: It was concluded that the method is simple, sensitive, precise, and accurate and hasthe ability to separate the drug from degradation products and excipients found in the dosage form.

COMPARISON BETWEEN THE POSTERIOR AND LATERAL APPROACHES OF THE POPLITEAL BLOCK FOR LOWER-LIMB EMERGENCY MINOR SURGICAL PROCEDURE: A PROSPECTIVE STUDY

2024-05-31T13:50:06+0530

Objective: The objective of this study was to compare various factors such as technical difficulties, the onset of anesthesia, duration of anesthesia and analgesia, and the branches of the sciatic nerve stimulated for both the posterior and lateral approaches of the block.

Methods: A study was conducted in a tertiary care hospital from March 2021 to September 2022. With the patients’ informed written consent, a total of 50 individuals undergoing lower-limb emergency minor surgical procedures were randomly assigned to two groups: Group L and Group P. Each group received a popliteal block (PB) using either a lateral or posterior approach. The patients were closely monitored to assess any technical difficulties associated with both approaches.

Results: According to the study findings, the participants in Group L had a median age of 46, while those in Group P had a median age of 37. Our investigation revealed that patients in Group L required a notably higher number of attempts and a greater depth for induction (p=0.004; p<0.0001 respectively). However, there were no notable distinctions observed between the two approaches in terms of the time it took for pain relief to begin, the length of the surgical procedure, and the overall duration of pain relief (p=0.80; p=0.54 and p=0.36, respectively).

Conclusion: The study found that patients who received lateral approaches for PB experienced more challenges during induction compared to those who received posterior approaches.

WHO’S AWARE CLASSIFICATION AS A TOOL OF ANTI-MICROBIAL STEWARDSHIP PROGRAM: A TEACHING HOSPITAL-BASED STUDY

2024-05-31T10:04:41+0530

Objectives: The aim of the study was to evaluate the antimicrobial utilization pattern and compare it with the World Health Organization’s (WHO’s) access, watch, and reserve (AWaRe) framework for the effective implementation of anti-microbial stewardship program (ASP) for tackling antimicrobial resistance (AMR).

Methods: This was a prospective, observational study conducted by the Department of Pharmacology in association with the Department of Orthopedics, Sher-I-Kashmir Institute of Medical Sciences. Data pertaining to all 208 patients was obtained from the wards of Medical College and Hospital, Bemina, Srinagar, India, for 6 months.

Results: The total number of patients in our study was 208, among them 74 patients received anti-microbial agents (AMAs) from the WHO’s access category whereas 134 were prescribed AMAs from the watch category. The percentage of AWaRe AMAs usage in comparison to the WHO criteria was 35.5% for the access list (WHO optimal value ≥60%), whereas it was 64.4% for the watch list (WHO optimal value ≤40%).

Conclusion: The government of India has no doubt taken a few steps to address this issue but a proactive approach is the need of the hour to minimize AMR saving precious lives and reduce global economic burden, further prescribing doctors should undergo periodic training to update their knowledge. Standard guidelines as developed by AIIMS and WHO should be followed across all the health facilities in India.

FUNCTIONAL CONSTIPATION IN CHILDREN: SOCIODEMOGRAPHIC AND RISK FACTORS ANALYSIS FROM A TERTIARY CARE TEACHING HOSPITAL OF NORTHERN INDIA

2024-05-28T21:30:56+0530

Objectives: This study was done to evaluate demography and probable/potential risk factors for functional constipation (FC) in children.

Methods: This was a single-center and cross-sectional study; 100 patients ages ranging from early infancy to 17 years, who were suffering from FC defined by Rome IV criteria were recruited for 6 months. Data were gathered from individuals on sociodemographic characteristics, child’s bowel habits, and psychosocial risk factors by their caregivers using a questionnaire. All patients were examined abdominally and rectally.

Results: Among the studied children 60% were females aged <2 years (54%). Most of the parents were illiterate belonging to urban areas (70%) having low (72%) socioeconomic status. Hard stools were the most common presenting complaint in 76% whereas vomiting was least common in 20% of the studied subjects. Abdominal distension was the most common finding on clinical examination in 42% of cases whereas fecal soiling was the least common only in 8%. Dietary habits were found one of the major probable risk factors. Living in the hostel or madrasa/religious residential institute was found to be a potential risk factor. Among psychological factors, history of fear of using a toilet was the most common type in 30% of cases.

Conclusion: Female gender, low fiber diet, positive family history of constipation, low socioeconomic status, and illiteracy of the mother were all risk factors of FC. Fear of using the toilet was the most common psychological insult.

COST ANALYSIS OF BRANDED VERSUS GENERIC ANTI-DIABETIC DRUGS USED FOR THE TREATMENT OF TYPE 2 DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL

2024-05-29T07:05:45+0530

Objectives: This study aims to assess the percentage cost variation among branded anti-diabetic drugs prescribed in a tertiary care hospital with its generic equivalent.

Methods: A cross-sectional study was performed in a tertiary care hospital among 51 diabetic patients attending the endocrinology outpatient department. Demographic data and details of anti-diabetic drugs prescribed were collected from case sheets. Costs of branded anti-diabetic drugs were obtained from the current index of medical specialties April–July 2023 and their generic equivalents from Janaushadhi price list 2023. The percentage cost variation of these drugs per prescription was determined.

Results: The mean age of the patients included in the study was 58.12, with 23 male and 28 female participants. Thirty-eight (74.5%) prescriptions contained oral hypoglycemic agent (OHA) alone, and 12 (23.54%) contained insulin and OHA. Metformin–glimepiride combination was the most common drug prescribed. The mean cost of the branded anti-diabetic drugs per prescription per day was 28.15±13.85 and the estimated mean cost of their generic equivalent was 12.10±6.68. A 135.61% cost variation was observed for the antidiabetic drug prescriptions studied.

Conclusion: In this study, it was observed that there is a significant cost variation among branded and generic anti-diabetic drugs.

MICRORESEARCH ON ANTIMICROBIAL RESISTANCE IN TERTIARY CARE HOSPITAL OF ANDHRA PRADESH

2024-05-26T18:39:24+0530

Objective: In this study, we aim to investigate the prevalence of antimicrobial resistance (AMR) in an isolated bacteria from the infected population admitted in a tertiary care hospital. By this, we can the evaluate resistance load and be aware of the future danger of antibiotic resistance.

Methods: A descriptive study was conducted on a total of 127 patients admitted to tertiary care hospitals of Andhra Pradesh between September 2023 and April 2024, respectively. Bacteria isolated were tested for antibiotic resistance with 13 different antibiotics by disk diffusion methods. A comparative analysis was performed to identify the differences in resistance rate among the bacterial strains and observed the multiple antibiotic resistance load in the individual bacteria.

Results: Our descriptive analysis reveals varying degrees of antibiotic resistance in the organisms we studied. Twenty-seven of the 127 samples, we had in total had no evidence of bacterial resistance. In the specific sample area we used, the prevalence of antibiotic resistance was 78.7%, with amoxicillin having the highest rate of resistance at almost 55%, and the Chi-square test’s p=0.001 showed a strong correlation between antibiotic resistance and bacteria isolated.

Conclusion: Our finding revels that there is increasing AMR load in South India district. Those resistance reports indicate the urgent need of antimicrobial stewardship coordination program and start the surveillance program to combat the antibiotic resistance on the general population. Furthermore, microsurveillance should be conducted in every district to detect antibiotic resistance load and develop new treatment strategies.

KNOWLEDGE, ATTITUDE, AND PRACTICES OF UNDERGRADUATE MEDICAL STUDENTS REGARDING THE USE OF SOCIAL MEDIA FOR EDUCATIONAL PURPOSES: A CROSSSECTIONAL, OBSERVATIONAL STUDY IN A TERTIARY CARE MEDICAL INSTITUTION IN THE EASTERN ZONE OF INDIA

2024-05-23T22:09:01+0530

Objectives: The objective of the study was to seek knowledge, attitude, and practice of medical students toward the use of social media for their educational purposes.

Materials and Methods: A questionnaire-based study has been conducted among undergraduate medical students in Medical College, Kolkata. A pre-structured questionnaire was circulated among the students and they were asked to fill it.

Results: A total of 275 medical students were included in the study. Almost all the students (98.9%) were aware of social media. The frequency of using social media is seen multiple times in 66.5% of respondents and about 27.6% used social media once or twice daily. Around 42.5% of the students acknowledged that social media has helped them in improving regarding their academic performance, whereas the rest disagreed with it. Most of the students (66.9%) have agreed that social media have made their learning more interesting and simplified, thereby contributing to their educational purposes.

Conclusion: We conclude from our study that the medical students informed that social media is an essential tool for acquiring information. Medical students informed that they use social media not only to amass knowledge but to improve their interprofessional communication as well.

EVALUATION OF CONCEPT OF ANTIMICROBIAL STEWARDSHIP AMONG UG MEDICAL STUDENTS FOR BETTER UNDERSTANDING OF USE OF ANTIMICROBIAL AGENTS AND MINIMIZING ANTIMICROBIAL RESISTANCE

2024-05-23T11:08:07+0530

Objectives: The objective of this study is to assess interns perception and knowledge about antibiotic stewardship and their preparedness for appropriate use of antimicrobials and to prescribe antimicrobials.

Methods: The 164 medical interns of BLDE (DU)’s Shri B.M. Patil Medical College who provided consent to participate in the study were included in this cross-sectional web-based online survey. The study was carried out using a validated questionnaire. The data were analyzed using the statistical tool for the social sciences (Version 20).

Results: Out of the 164 interns, 133 (83.1%) completed the entire survey. The term “antimicrobial stewardship” was familiar to 51% (n=68). 50% (n=66) agreed that antibiotics are inappropriately used at the hospital. Approximately 88% (n=104) and 85% (n=113) of the interns thought that insufficient infection control practices and the use of wide spectrum antibiotics were the main causes of resistance development, respectively. About 90% (n=119) thought that lecture series and grand round discussions on the responsible use of antibiotics were good educational tools. About 37% (n=49), 41% (n=54), and 24% (n=32) of the interns understood the proper antibiotic selection for treating simple cases of urinary tract infections, could de-escalate antibiotic therapy, understand an anti-biogram, and could match a different combination of antimicrobials and microorganisms, respectively.

Conclusion: The major findings of our study were, despite students having good perception, the knowledge component was inadequate, that is, they lacked their preparedness and confidence to prescribe antibiotics which emphasizes that the students are aware of the antimicrobial stewardship but their knowledge domain needs to be improved for better application in their clinical practice.

A STUDY OF KNOWLEDGE, ATTITUDE, AND PRACTICE OF PHARMACOVIGILANCE AMONG II-YEAR UNDERGRADUATE MEDICAL STUDENTS AND INTERNS AT A TERTIARY CARE TEACHING HOSPITAL

2024-04-27T12:20:35+0530

Objectives: Understanding the importance of adverse drug reactions (ADRs) reporting in a timely and accurate manner is essential for the success of pharmacovigilance. The underreporting or delayed reporting of ADRs can hinder the effectiveness of pharmacovigilance efforts. Assessing the knowledge, attitude, and practice (KAP) of pharmacovigilance among medical students and interns is indeed crucial as they are future health-care practitioners.

Methods: The study was carried out at the tertiary care teaching hospital in Kallakurichi after receiving approval from the Institutional Ethics Committee of the Government Medical College, Kallakurichi. The participants of the study included interns and II-year MBBS students. They were enrolled in the study and given a questionnaire on the KAP of pharmacovigilance through Google Forms. The collected responses were analyzed using Microsoft Excel, and the findings were presented in the form of percentages.

Results: In the knowledge domain, 85.2% of participants demonstrated awareness regarding the individuals responsible for reporting ADRs. In the attitude domain, according to 92.8% of participants, pharmacovigilance and ADR should be integrated into the undergraduate curriculum. However, in the practice domain, the percentage of participants who actually practiced reporting ADRs was lower (33%). Despite the majority of participants exhibiting commendable knowledge and attitude, a noticeable disparity was observed in their practical implementation.

Conclusion: Our study has shown the importance of raising awareness on ADR reporting along with the recommendation for effective training in institutions and health-care centers, which is crucial for bridging the existing gap.

CO-MORBID DEPRESSION IN ADULTS WITH TYPE 2 DIABETES MELLITUS – A STUDY OF PREVALENCE, SOCIO-DEMOGRAPHIC PROFILE, AND IMPACT ON GLYCEMIC CONTROL

2024-04-26T20:21:37+0530

Objectives: The objectives are to study the prevalence of depression in established type 2 diabetes mellitus (T2DM) patients and the association of the severity of depression with the level of glycemic control, second, to explore the relationship of co-morbid depression with the sociodemographic variables and diabetic complications, and third, to assess the association of co-morbid depression with the ongoing diabetic treatment regimen.

Methods: Data of OPD patients with established diagnosis of T2DM who came for follow-up were collected. A total of 224 patients underwent a clinical and psychiatric evaluation and details were analyzed as per the objectives of the study.

Results: The total sample of diabetic patients included 126 (56%) males and 98 (44%) females with the majority seen in the 45–60-year age group. The sociodemographic parameters were assessed and comorbid depression was seen in 83 diabetic patients. Among them, 42 had moderate depression. Females (n=43) outnumbered males and the majority were seen in the 45–60-year age group (n=39). Comorbid depression was most prevalent among unemployed (n=41), urban residents (n=48), joint family (n=49), Hindus (n=73), and people on only insulin treatment regimen (n=33) but all this was statistically insignificant, whereas illiterates (n=45), HbA1C level >7% (n=71), diabetes-related complications (n=50), and diabetic neuropathy being the most common (n=28) among all the complications were seen and this difference was statistically significant.

Conclusion: By taking all our research findings, it can be concluded that comorbid depression modifies the course and prognosis of diabetes.

A STUDY ON WORK SAFETY FOR EMPLOYEES IN DIAGNOSTIC SERVICES – RECOMMENDATIONS TO IMPROVE WORK SAFETY

2024-01-13T11:17:53+0530

Objectives: To assess the effectiveness of the safety training program in preventing occupational hazards for workers in clinical laboratories and radiology and make recommendations.

Methods: During the course of 2 months, health-care workers in radiology and central laboratory, including doctors, radiology technicians, and laboratory technicians were the subjects of this prospective analytical study. The design of the study was based on the lean methodology. Every participant received a structured questionnaire. Next, they attended a workshop on workplace safety, after which they completed a post-test questionnaire.

Results: Of the participants in the study, 38% were between the ages of 31 and 40. Almost 56% had completed their postgraduation education, and 62% had worked for more than 10 years. Of these, 42% were laboratory technicians, 24% were from the phlebotomy and radiology departments, and there was a highly significant difference (p<0.01) in the participants’ awareness of OSH perceptions as well as prevention of physical risks and injury.

Conclusion: The laboratory workers’ knowledge and actions addressing the prevention of laboratory hazards and safety environmental condition dangers have been improved by the training safety program.