Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss

Abstract Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene. Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss. Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids. Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used. Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.

A prospective, randomized, comparative clinical study to compare the safety and efficacy of different hydrophobic aspheric monofocal intraocular lenses

Purpose: To report the 1?year clinical outcomes related to safety, efficacy, predictability, contrast sensitivity, patient satisfaction, complications, and overall results with Optiflex Genesis and Eyecryl Plus (ASHFY 600) monofocal aspheric intraocular lenses (IOLs) and compare the same with Tecnis?1 monofocal IOL. Methods: This prospective, single?center, single?surgeon, randomized, three?arm study included 159 eyes of 140 eligible patients who underwent cataract extraction with IOL implantation with any of the three study lenses. Clinical outcomes related to safety, efficacy, predictability, contrast sensitivity, patient satisfaction, complications, and overall results were compared at a mean follow?up of 1 year (12 ± 1.20 months). Results: Preoperatively, age and baseline ocular parameters of all the three groups were matched. At 12 months post?op, no significant differences were noted among the groups in terms of mean postoperative uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) sphere, cylinder, and spherical equivalent (SE; P > 0.05 for all parameters). Eighty?nine percent eyes in the Optiflex Genesis group as against 96% eyes in the Tecnis?1 and Eyecryl Plus (ASHFY 600) groups were within ± 0.5 D, and 100% of eyes in all the three groups were within ± 1.00 D of SE accuracy. Postoperative internal higher?order aberrations (HOAs) and coma, and mesopic contrast sensitivity at all spatial frequencies were comparable across all the three groups. Two eyes in the Tecnis?1 group, two eyes in the Optiflex group, and one eye in the Eyecryl Plus (ASHFY 600) group underwent YAG capsulotomy at the last follow?up. No eye in any of the groups showed glistenings or required IOL exchange due to any reason. Conclusion: At 1?year post?op, all the three aspheric lenses showed comparable results in visual and refractive parameters, post?op aberrations, contrast sensitivity, and posterior capsule opacification (PCO) behavior. Further follow?up is needed to evaluate the long?term behavior for refractive stability and PCO rates of these lenses. Trial registry: CTRI/2019/08/020754 (www.ctri.nic.in).

Pharmacokinetics of rifampicin, isoniazid & pyrazinamide during daily & intermittent dosing: A preliminary study

Background & objectives: The National Tuberculosis (TB) Control Programme has transitioned from thrice-weekly to daily drug treatment regimens in India. This preliminary study was conceived to compare the pharmacokinetics of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) in TB patients being treated with daily and thrice weekly anti-TB treatment (ATT). Methods: This prospective observational study was undertaken in 49 newly diagnosed adult TB patients receiving either daily ATT (n=22) or thrice-weekly ATT (n=27). Plasma RMP, INH and PZA were estimated by high-performance liquid chromatography. Results: The peak concentration (Cmax) of RMP was significantly higher (RMP: 8.5 ?g/ml vs. 5.5 ?g/ml; P=0.003) and Cmax of INH was significantly lower (INH: 4.8 ?g/ml vs. 10.9 ?g/ml; P<0.001) in case of daily dosing compared to thrice-weekly ATT. Cmax of drugs and doses was significantly correlated. A higher proportion of patients had subtherapeutic RMP Cmax (8.0 ?g/ml) during thrice-weekly compared to daily ATT (78% vs. 36%; P=0.004). Multiple linear regression analysis showed that Cmax of RMP was significantly influenced by the dosing rhythm, pulmonary TB and Cmax of INH and PZA by the mg/kg doses. Interpretation & conclusions: RMP concentrations were higher and INH concentrations were lower during daily ATT, suggesting that INH doses may need to be increased in case of a daily regimen. Larger studies are, however, required using higher INH doses when monitoring for adverse drug reactions and treatment outcomes.

Determining attributed factors of hearing handicap in individuals with auditory sensory and neural pathology

Abstract Introduction: There is a modest relationship between speech perception skills and perceived hearing handicap in individuals with hearing loss. In this study, an attempt is made at linking psychoacoustic results and speech perception skills to understand the subjective handicap and quality of life. Objective: To investigate how speech perception in noise (signal to noise ratio-50), difference limen frequency, temporal modulation transfer function, hearing handicap inventory for adults, and quality of life in auditory neuropathy spectrum disorder differs from sensorineural hearing loss. Further we attempt to discern attributed factors of hearing handicap in auditory neuropathy spectrum disorder and sensorineural hearing loss. Methods: A cross-sectional study with comparative and correlational research designs were utilized. Eighty-four participants were grouped into sensorineural hearing loss (n = 49), and auditory neuropathy spectrum disorder (n = 35) was sub-grouped into mild, moderately severe, and severe. We evaluated signal to noise ratio-50, difference limen frequency, and temporal modulation transfer function. In addition, hearing handicap inventory for adults, and quality of life questionnaires were administered. Results: Mild auditory neuropathy spectrum disorder showed impairment in speech perception and discriminating frequency, which were similar to the severe sensory neural hearing loss. Temporal resolution impairment in auditory neuropathy spectrum disorder mild was significantly higher than in each sub-groups of sensorineural hearing loss. The severity of the hearing handicap in was similar to severe sensorineural hearing loss, quality of life was equally affected in sensorineural hearing loss and auditory neuropathy spectrum disorder. In sensorineural hearing loss, signal to noise ratio-50 was positively related, and quality of life was negatively related to hearing handicap. In auditory neuropathy spectrum disorder, no contributory factors were related to hearing handicap. Conclusion: Mild auditory neural pathology demonstrates impairment in speech recognition and psychoacoustic skills similar to severe cochlear pathology. In sensorineural hearing loss, hearing handicap is predicted from quality of life and speech perception, but none of the contributory factors predicted hearing handicap in auditory neuropathy spectrum disorder.

DRESS syndrome: Tricky to diagnose but easy to treat

A 27-year-old female presented to us with a short history of fever, jaundice, rash, and worsening hepatic dysfunction subsequent to treatment with intravenous antibiotics and alternative medicine for a urinary tract infection. The eosinophilia, lymphadenopathy, and transaminitis prompted us to consider a diagnosis of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) which can be fatal if not treated. The patient showed improvement in clinical and laboratory parameters after a course of steroids. This case is presented as DRESS syndrome that can prove rapidly fatal if not diagnosed and treated immediately.

Field evaluation of biosurfactants, surfactin and di-rhamnolipid produced by Bacillus subtilis subsp. subtilis (VCRC B471) and Pseudomonas fluorescens (VCRC B426) against immature stages of the urban malaria vector Anopheles stephensi

Background & objectives: Bacillus subtilis subsp. subtilis (VCRC B471) and Pseudomonas fluorescens (B426) produce mosquitocidal biosurfactant, surfactin and di-rhamnolipid. The objective of the study was to carry out a small-scale field evaluation of the two biosurfactants to determine the efficacy, application dosage, residual activity and frequency of application against Anopheles stephensi immatures in selected sites in Goa, India. Methods: Surfactin (VCRC B471) and di-rhamnolipid (VCRC B426) were formulated as aqueous suspensions (5% AS), and were applied at the dosages of 34, 51 and 68 mL/m2 and 27, 41 and 54 mL/m2 respectively. Two experiments were carried out with the two formulations. Results: Surfactin (VCRC B471) formulation was effective at all the dosages and there was sustained reduction (>80%) in immature density in the treated sites up to 18 days in experiment 1 and up to 15 days in experiment 2. No pupae were found in the treated sites throughout the study. Di-rhamnolipid (VCRC B426) formulation was also found to reduce the immature density in the treated sites up to 14 days in experiment 1 and up to 15 days in experiment 2. Interpretation & conclusion: For VCRC B471, the optimum application dosage determined was 51 mL/m2 and for VCRC B426, 27mL/m2 . The formulations are to be applied fortnightly for effective control of Anopheles. The application dosage determined in the present study can be used for large scale field evaluation to assess their suitability for use in public health programmes for the control of Anopheles mosquitoes vectoring malaria

Níveis ascíticos e soros de biomarcadores tumorais (CA 72-4, CA 19-9, CEA e CA 125) em discriminação de causa de ascites: um estudo prospectivo / Ascitic and serum levels of tumor biomarkers (ca 72-4, ca 19-9, cea and ca 125) in discrimination of cause of ascites: a prospective study

ABSTRACT Background: The role of ascitic and serum levels of various tumour biomarkers in the discrimination of cause of ascites is not well established. Objective: To evaluate the role of serum and ascitic levels of tumor biomarkers (CA 72-4, CA 19-9, CEA and CA 125) in discrimination of cause of ascites. Methods: A prospective study was conducted in consecutive patients presenting with ascites. Serum and ascitic levels of CA 19-9, CA 125, CA 72-4 and carcinoembryonic antigen (CEA) were determined at the presentation. The patients with cirrhotic ascites, tuberculous peritonitis (TBP) and peritoneal carcinomatosis (PC) were eventually included in analysis. Results: Of the 93 patients (58 males, mean age 47 years) included, the underlying cause was cirrhosis in 31, PC in 42 and peritoneal tuberculosis in 20. The best cutoff for discriminating benign and malignant ascites for serum CEA, CA 19-9 and CA 72-4 were 6.7 ng/mL, 108 IU/mL and 8.9 IU/mL, respectively. The best cutoff for discriminating benign and malignant ascites for ascitic CA 125, CEA, CA 19-9 and CA 72-4 were 623 IU/mL, 8.7 ng/mL, 33.2 IU/mL and 7 IU/mL, respectively. Conclusion: The performance of single biomarker for the prediction of underlying PC is low but a combination of serum CA 19-9 and CA 72-4 best predicted the presence of peritoneal carcinomatosis.

RESUMO Contexto: O papel dos níveis ascíticos e séricos de vários biomarcadores de tumores na discriminação da causa das ascites não está bem estabelecido. Objetivo: Avaliar o papel dos níveis séricos e ascíticos de biomarcadores tumorais (CA 72-4, CA 19-9, CEA e CA 125) na discriminação da causa das ascites. Métodos: Estudo prospectivo foi realizado em pacientes consecutivos que apresentaram ascite. Foram determinados níveis do soro e ascítico de CA 19-9, CA 125, CA 72-4 e antígeno carcinoembrínico (CEA). Os pacientes com ascites cirróticas, peritonite tuberculosa e carcinomatose peritoneal (CP) foram eventualmente incluídos na análise. Resultados: Dos 93 pacientes (58 homens, média de idade 47 anos) incluídos, a causa básica foi cirrose em 31, CP em 42 e tuberculose peritoneal em 20. O melhor corte para discriminação de ascites benignas e malignas para soro CEA, CA 19-9 e CA 72-4 foram 6,7 ng/mL, 108 UI/mL e 8,9 UI/mL, respectivamente. O melhor corte para discriminação de ascites benignas e malignas para CA 125 ascitico, CEA, CA 19-9 e CA 72-4 foram 623 UI/mL, 8,7 ng/mL, 33,2 UI/mL e 7 UI/mL, respectivamente. Conclusão: O desempenho do biomarcador único para a previsão do CP subjacente é baixo, mas uma combinação de soro CA 19-9 e CA 72-4 melhor previu a presença de carcinomatose peritoneal.

Representation of amplified speech at cortical level in good and poor hearing aid performers / Representação da fala amplificada ao nível cortical em bons e maus usuários de aparelhos auditivos

Abstract Introduction: Hearing aid users reject their own hearing aid because of annoyance with background noise. The reason for dissatisfaction is located anywhere from the hearing aid microphone to the integrity of neurons along the auditory pathway. In this preview, the output of hearing aid was recorded at the level of ear canal and at auditory cortex in good and poor hearing aid users, who were classified using acceptable noise level. Objective: To study the representation of amplified speech in good and poor hearing aid performers. Methods: A total of 60 participants (age ranged 15-65 years) with moderate bilateral sensorineural hearing impairment grouped into good (n = 35) and poor (n = 25) hearing aid performers. Gap detection test and aided SNR 50 were administered. In addition, ear canal acoustic measures and cortical auditory evoked potentials were recorded in unaided and aided conditions at 65 dB SPL. Results: Hearing aid minimally alters temporal contrast of speech reflected in envelope difference index. Although having similar temporal impairment, acoustic characteristics of amplified speech sounds and SNR 50 scores from both groups, the aided cortical auditory evoked potentials surprisingly showed significant earlier latencies and higher amplitudes in good performers than poor performers. In addition, good and poor performers classified based on annoyance level was predicted by latencies of 2N1 and 2P2 components of acoustic change complex. Further, a follow-up revealed hearing aid use has relation with acceptance towards noise. Conclusion: Participants who are willing to accept noise from those who are not willing to accept noise have subtle physiological changes evident at the auditory cortex, which supports the hearing aid usage.

Resumo Introdução: Usuários de aparelhos auditivos rejeitam seu próprio aparelho pelo incômodo relacionado ao ruído de fundo. O motivo da insatisfação varia desde o microfone do aparelho auditivo até a integridade dos neurônios ao longo da via auditiva. Nesta análise prévia, a saída da prótese auditiva foi registrada no nível do meato auditivo externo e no córtex auditivo em bons e maus usuários de prótese auditiva, que foram classificados com um nível de ruído aceitável. Objetivo: Estudar a representação da fala amplificada em bons e maus usuários de aparelhos auditivos. Método: Foram examinados 60 participantes (de 15 a 65 anos) com deficiência auditiva neurossensorial bilateral moderada divididos em bons (n = 35) e maus (n = 25) usuários de aparelhos auditivos. Teste de detecção de gap e SNR 50 assistido foi administrado. Além disso, as medidas acústicas do meato externo e os potenciais evocados auditivos corticais foram registrados em condições não assistida e assistida a 65 dB NPS. Resultados: O aparelho auditivo altera minimamente o contraste temporal da fala, refletido no envelope difference index. Embora tenham uma deficiência temporal similar, as características acústicas de sons de fala amplificados e escores do SNR 50 de ambos os grupos, os potenciais evocados auditivos corticais assistidos surpreendentemente demonstraram latências iniciais significativas e maiores amplitudes em bons do que em maus usuários. Além disso, os bons em comparação com os maus usuários, classificados com base no nível de incômodo, foram previstos pelas latências dos componentes 2N1 e 2P2 do complexo de alteração acústica. Além disso, os resultados do seguimento revelaram que o uso de aparelhos auditivos têm relação com a aceitação do ruído. Conclusão: Os participantes dispostos a aceitar o ruído, quando comparados com aqueles que não estão dispostos a aceitá-lo, apresentam evidência de sutis alterações fisiológicas no córtex auditivo, que apoiam o uso da prótese auditiva.

Wilson disease: early screening for better living

Autosomal recessive diseases are more common among consanguineous marriages noted particularly in southern parts of India. There is a gradual increase in the genome wide homogenecity with the increasing levels of consanguinity. Here we are reporting a case series of such an autosomal recessive condition, namely Wilson Disease (WD), where three children were affected with the disease, who were born out of consanguineous marriages. The first case presented with neuropsychiatric manifestations, the second case and third cases were diagnosed through screening of family members leading to earlier identification of the disease. In these cases consanguinity has been emphasised as the major predisposing factor leading to their manifestations. This case series highlights the importance of screening the other family members of the index case. Conditions such as Wilson disease have an excellent prognosis if pharmacotherapy is initiated appropriately.

Etiology and clinical profile in chronic cor pulmonale

Background: Cor pulmonale is a synonym for pulmonary heart disease. The term 揷or pulmonale� if broken into its constituents 揷or� (heart) and 損ulmo� (lungs), means cardiac involvement due to pulmonary diseases. Chronic cor pulmonale is not a single disease entity but resulting secondary to many bronchopulmonary vascular diseases and also from thoracic cage abnormalities. Cor pulmonale accounts for 5-10% of all heart diseases, 20-30% of all admissions for heart failure and 9.2% in the cardiac autopsies.Methods: This was a hospital-based study carried among patients diagnosed with chronic cor pulmonale admitted to the medical wards of Karnataka institute of medical sciences, Hubli. during December 2011- November 2012 using simple random sampling method.Results: The following observations were made in 50 representative cases the age group of patients was between 24 to 85 years. Chronic cor pulmonale was commonly seen in middle and elderly age groups. Incidence below 35 years is very less. Almost every patient of chronic cor pulmonale presented with breathlessness and cough. All patients in the study had Tachypnoea, Diminished chest movements, Prominent use of accessory muscles of respiration, Cyanosis, Clubbing (in some patients), Crepitations and rhonchi on chest auscultation, Loud P2 and pansystolic murmur in Tricuspid area on cardiac auscultation.Conclusions: The peak incidence of chronic cor pulmonale was found to be in the middle and older age groups with high incidence during winter season. Smoking and dusty environment at the site of occupation were aggravating the primary lung disease. Breathlessness, cough and edema of the feet were the most common symptoms.

The Effect of Digital Noise Reduction on Annoyance and Speech Perception in Low and High Acceptable Noise Level Groups

Introduction: Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives: (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method: Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results: Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion: Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value (AU)

Anti-stress activity of Ocimum sanctum and alprazolam in animal models

Background: Stress is the physiological, psychological and behavioral response by individuals when they perceive a lack of equilibrium between the demands placed upon them and their ability to meet those demands, which over a period of time leads to ill health. There are several ways of coping with stress. Some techniques of time management may help a person to control stress.Methods: Forced swim test- mice were randomized into two groups according to the body weights. Each group contains six animals. Each individual animal was allowed to swim inside the jar (25-12-25 cm) containing fresh water up to 15 cm height. Mice were allowed swim for 6 min. After initial struggle to escape the animal became immobile. Total immobility period was measured. Rotarod test- mice were randomized into two groups according to body weights. Each group contains six animals. Rats were placed on the lanes. Latency period was recorded at which each rat falls off the rod.Results: In first experiment, anti-stress activity of Ocimum sanctum in mice was demonstrated by measuring the immobility period during forced swim test and in the second experiment the measurement of the latency period of rats in rotarod apparatus was performed. Both the experimental procedures were compared with standard anti stress drug alprazolam.Conclusions: The present study suggests that Ocimum sanctum possess significant anti stress activity but less when compared to alprazolam.

Prevalence of delirium in elderly intensive care unit patients of a tertiary care medical college hospital

Background: Delirium is an acute disorder of attention and cognition. It occurs in 20% to 79% of hospitalized older patients. It is also common in ICU patients, occurring in 20% to 50% of non-mechanically ventilated ICU patients and in 60% to 80% of mechanically ventilated ICU patients. Hence delirium is a common, serious, and often fatal condition among older patients. The present study attempts to address the prevalence of Delirium in the Indian elderly population.Methods: A cross sectional study was conducted between January 2019 to June 2019 in a 50 bedded intensive care unit of a tertiary care hospital in Bengaluru, Karnataka. A total of 300 elderly patients aged 60 years and above, satisfying the inclusion criteria was included in the study. Patients were assessed for the presence of delirium within 24 hours of admission using Confusion Assessment Method for Intensive Care Unit (CAM-ICU). Various qualitative variables were expressed in terms of proportions.Results: Prevalence of delirium among elderly, non-ventilated ICU patients was 30% (90 out of 300 patients). Among them, 50 (55.5%) were females and remaining 40 (44.5%) were males. Mean age of the patients was 76 years. About 50 (55.5%) of them belonged to age group of 70-79 years. Most of the delirium patients (44.5%) belonged to hypoactive type of delirium followed by hyperactive (33.3%) and mixed (22.2%) type of delirium.Conclusions: Delirium in elderly ICU patients is significantly prevalent, which is a poor prognostic factor, leading to higher morbidity and mortality. Of the three subtypes- hypoactive delirium is the most common type of delirium among elderly. Yet, it is often overlooked or under-diagnosed. Hence clinicians and/or trained nursing staff managing the patients in the ICUs, should routinely screen the patients for delirium, using brief screening measures, which in turn can improve the patients’ outcome.

Clinical Spectrum of Congenital Anomalies of Kidney and Urinary Tract in Children

Objective: To evaluate the clinical spectrum and patterns of clinical presentation incongenital anomalies of kidney and urinary tract. Methods: We enrolled 307 consecutivelypresenting children with congenital anomalies of kidney and urinary tract at the pediatricnephrology clinic. Patients were evaluated clinically, with serum biochemistry, appropriateimaging and radionuclide scans. Results: The most common anomaly was primaryvesicoureteric reflux (VUR) (87, 27.3%), followed by pelviureteral junction obstruction(PUJO) (62,20.1%), multicystic dysplastic kidney (51 16.6%), non-obstructivehydronephrosis (32, 10.4%) and posterior urethral valves (PUV) (23, 7.4%). 247 (80.4%)anomalies had been identified during the antenatal period. Another 33 (10.7%) werediagnosed during evaluation of urinary tract infection, and 21 (6.8%) during evaluation forhypertension at presentation. Obstructive anomalies presented earlier than non-obstructive(7 (3, 22.5) vs 10 (4, 24) mo: (P=0.01)). The median (IQR) ages of presentation for childrenwith PUV (n=23), VUR (n=87) and PUJO (n=62) were 4 (2, 14) mo, 10 (5, 27) mo, and 7 (3,22.5) mo, respectively. Nine (2.9%) children had extrarenal manifestations. Conclusions:The median age at clinical presentation for various subgroups of anomalies indicatesdelayed referral. We emphasize the need for prompt referral in order to initiate appropriatetherapeutic strategies in children with congenital anomalies of kidney and urinary tract

Repurcussions of Concurrent Chemoradiotherapy for Head and Neck Cancers

Cancer is a potentially lethal disorder with abnormal cell growth and metastasis, warranting multimodal treatment owing to its diversity and complexity. Head and neck cancers are physically and emotionally devastating disease, with profound impact on the most fundamental activities of the subjects’ daily life such as the ability to speak, breathe, eat, drink, and socialize. The side-effects of radiotherapy and chemotherapy get superimposed on the existing problems and cause new problems resulting in significant morbidity and suffering. Methods: This Prospective Observational study was conducted at the Department of ENT, Southern Railway Headquarters Hospital, Chennai, India. All subjects were evaluated for toxicities using RTOG/EORTC toxicity criteria and Common Toxicity Criteria (CTC). Results: Hypopharynx was the most common site of malignancy observed (31.6 %). Pain (90%) and appetite loss (84.2%) secondary to Mucositis and Xerostomia were the most predominant, serious and lasting adverse effects noted. Subjects also experienced markedly altered smell (63%) and taste (78%). Skin changes and alopecia was observed in all the subjects. Overall treatment duration was prolonged in 78.9% owing to severe toxicities, which necessitated withholding of last few cycles of chemotherapy. Conclusion: Subjects receiving concurrent Chemo-Radiotherapy experience a substantial number of treatment related adverse events, which had considerable effect on their Quality of life.

Comparison of impact of undergraduate teaching program to assess the knowledge and attitude towards pharmacovigilance and adverse drug reporting among undergraduate medical students at a teaching medical institute in South India

Background: Pharmacovigilance has become an important tool to ensure the safety of patient in recent years. To ensure right practice of pharmacovigilance, proper understanding is very essential and the medical colleges with the undergraduate teaching program become a vital platform to educate and train the medical students towards pharmacovigilance. This study compares the impact of teaching program of the undergraduate curriculum in assessing the knowledge and attitude of the undergraduate medical students towards pharmacovigilance.Methods: The study includes 158 undergraduate medical students of second year being trained in pharmacology at Mysore Medical College. A validated and standardized questionnaire was distributed to all the students twice, once during their 3rd term (pre-sensitization) and the second time during their 5th term (post sensitization). Willingness to answer and complete the questionnaire was considered as consent.Results: The pre and post sensitization questionnaires were analyzed individually. A decrease from 114 to 90 students (15.19 % decrease) willing to complete the questionnaire was seen. The mean total knowledge score was 6.37±1.90 during the pre-test as compared to 6.35±1.78 in the post test analysis. An overall increase was seen with the knowledge of ADRs and pharmacovigilance. Only 18.4% knew of the presence of an ADR monitoring center in the institute pre-test which increased to 64.4% post sensitization. 81.6% answered rightly the type of ADRs that needs to be reported as compared to the 67.3% pre-sensitization. The overall attitude towards ADR reporting was seen to be in the right direction, with 71% saying that pharmacovigilance covered adequately in the curriculum. Voluntary reporting attitude increased from 74.6% to 88%. 70% of the students feel ADR reporting as a professional obligation, while only 54% felt so pre-sensitization.Conclusions: Pharmacovigilance should be included in the curriculum with more hours dedicated to teaching. Various interesting methods should be implemented to train and made aware of its importance to ensure patient safety on a global scale.

Study of anticonvulsant activity of acetazolamide on albino rats and its influence on anticonvulsant activity of sodium valproate

Background: Epilepsy is a common neurological disorder. 30-40% of patients will continue to have seizures despite the use of antiepileptic drugs either alone or in combination. The present study is undertaken to evaluate the anticonvulsant activity of Acetazolamide (ACZ) in albino rats and its influence on anticonvulsant activity of sodium valproate.Methods: Albino rats (150-200gms) of male sex were randomly selected, from central animal facility, MMCRI, Mysore. They were divided into 6groups (per model) of 6 rats each, control group-normal saline 0.5ml, standard group-sodium valproate (300mg/kg), dose 1-ACZ (8.75mg/kg), dose 2-ACZ (17.5mg/kg) and dose 3-ACZ (35mg/kg), dose 4-ACZ (8.75mg/kg) with sodium valproate (150mg/kg). The anti-convulsant activity was screened using MES model and PTZ model.Results: Results were analysed by ANOVA followed by post hoc Fisher’s LSD test. The ACZ has shown anticonvulsant activity at the dose of 17.5mg/kg and 35mg/kg body weight and combination of ACZ 8.75mg/kg with sodium valproate 150mg/kg both in MES model and PTZ model. The anticonvulsant activity of ACZ was less when compared to Sodium Valproate in both MES model and PTZ model. The anticonvulsant activity of combination, ACZ 8.75mg/kg with Sodium valproate 150mg/kg was comparable and more significant when compared to standard drug alone in MES model and PTZ model.Conclusions: The ACZ has shown anticonvulsant activity in MES model and PTZ induced seizure model of epilepsy. This study has shown that ACZ potentiated the effect of sodium valproate and can be used as add on drug with sodium valproate in epilepsy.

Knowledge and perception towards pharmacovigilance and adverse drug reactions reporting among medical students at a teaching hospital in South India

Background: Pharmacovigilance and adverse drug reactions monitoring has become an integral part to ensure patient safety. Targeting the younger doctors for sensitization towards pharmacovigilance is the key to ensure practice of ADR reporting in clinical practice. The objective of the study is to understand and assess the knowledge and perception of students towards pharmacovigilance and adverse drug reactions reporting.Methods: The study included undergraduate medical students of second, pre-final and final years of Mysore Medical College. A validated and standardized KAP based questionnaire was distributed to all students. Willingness to answer and complete the questionnaire was considered as consent.Results: The questions were statistically analysed individually and compared. Q1-Q10 compared knowledge towards pharmacovigilance, Q11-Q20 on the attitude and Q21-Q23 on the practice of ADR reporting. 325 questionnaires were distributed of which only 280 consented (second year - 114, pre-final - 98, final - 68). 112(49.1%), 137(69.9%) and 79(58.1%) of the three groups respectively knew what pharmacovigilance and ADR is. 79.8%, 76.5% and 75% knew who can report ADRs while 18.4%, 32.7% and 33.8% did not know what ADRs to report. 73(64.1%); 93(81.6%), 18(18.4%); 69(70.4%), 13(19.1%); 37(54.4%) knew the existence of AMC in the institute and the PvPI respectively. More than 92% agreed that ADR reporting is necessary. Majority (>90%) agreed that PV and ADR reporting should be taught to all health care students while 28%, 30% and 54% said that it was not well covered in their curriculum.73(64%), 51(52%) and 63(93%) were not familiar with the ADR reporting form.Conclusions: Pharmacovigilance and ADR reporting needs to be made compulsory, have better, interesting ways to learn and understand it, so that the students can practice it with confidence in their clinical practice.