ABSTRACT
Introduction: Cardiac dysfunction in patients with cirrhosisoccurs in the setting of a circulatory dysfunction characterizedby a marked splanchnic arterial vasodilation. Circulatory changescan lead to the cardiac dilatation of the left chambers and thedevelopment of functional changes in the heart. The present studyis intended to assess cardiac functions in patients of liver cirrhosis.Material and methods: It was a cross sectional study conductedamong 74 diagnosed cases of liver cirrhosis, admitted todepartment of general medicine, KIMS Hospital during the 6months study duration.Results: Overall LVDD was diagnosed in 59 cases (79.73%).Out of which, 47.29% cases presented with Stage 1 (impairedrelaxation) LVDD, Stage 2 LVDD (pseudo normal) among31.08% and only one patient had severe restrictive type of(Stage 3) LVDD.Conclusion: Left ventricular diastolic dysfunction iscommonly associated with advancement of hepaticdysfunction while systolic function is maintained till advancedhepatic failure
ABSTRACT
Tuberculosis (TB) is one of the main causes of deaths related to antimicrobial resistance and the leading killer of people with HIV. The emergence of strains with multidrug-resistant TB (MDR-TB) has led to a resurgence of TB as a major public health menace worldwide, and MDR-TB has been an area of growing concern in recent years and is posing threat to global efforts for TB control. It has been seen that apart from physical symptoms, TB patients face various problems that are social, economic, and psychological in nature. Therefore, for the assessment of patients’ health status, it is necessary to consider the overall effect of TB on health and patients’ perception of well-being, besides routine clinical, radiological, and bacteriological assessments, so this present cross-sectional study was conducted to explore the burden of MDR-TB on the social, economic, and psychological well-being of the patients residing at Ballari. Methods: There are 79 MDR-TB cases registered at DR-TB center and residing in Ballari district. The data were collected from individual patients by home visits according to TB units, using a pre-designed pre-tested semi-structured questionnaire to measure the social, economic, and psychological burden of MDR-TB using standard tools. The data were entered into Microsoft Excel 2007 spreadsheet. Final analysis was done using SPSS for Windows 20.0 version. Social, economic, and psychological burden was analyzed with 95% confidence interval. Results: 68.3% patients became unemployed because of disease, 62 (78.5%) patients have to depend on others/family member for their daily routine work, and 69 (87.3%) patients are worried or had mental anguish about their disease status. The mean total cost incurred per patient is ₹58,061.99 (approximately US$ 855). The mean total direct cost incurred per patient is ₹21,318.8 (US$ 314). The mean total indirect cost incurred per patient is ₹36,743 (US$ 514). The mean pre-diagnosis and diagnosis cost per patient is ₹11,628 (US$ 171). The mean guardian cost per patient is ₹3,991.3 (US$ 59). The mean direct hospitalization cost incurred per patient is ₹6,315.44 (US$ 93). 14 (35%) patients from upper and middle class (Classes 1, 2, and 3) are shifted to lower socioeconomic classes (Classes 4 and 5). 60 (75.9%) patients have stopped working/doing household work for more than equal to 6 months because of disease. Conclusions: Study finding indicates that there is a significant social, economic, and psychological impact of MDR-TB that has a direct impact on the quality of life of MDR-TB patients and their families. There is a need for psychosocial intervention model (strategies) for MDR-TB patients and their caregivers to mitigate the negative effects of disease.Key words: Burden, multidrug-resistant tuberculosis, socioeconomic burden, tuberculosis
ABSTRACT
Background: Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) within 4.5 hours of symptom onset is currently approved for treatment of acute ischemic stroke. It improves the rate of favourable outcomes despite the risk of hemorrhagic transformation. Aim: To study the outcomes of IV thrombolysis. Materials and methods: All patients who came to the emergency with in window period with signs and symptoms suggestive of acute ischmeic stoke were included in the study. CT brain plain was done to rule out ICH. Base line glucose and BP was recorded. NIHSS was calculated. Patients whose score was between 5-25 were given IV thrombolysis with rTPA or tenecteplase. Drug was given according to availability and it was free of cost Results: Total of 41 patients was given thrombolysis. 28 were given alteplase and 13 were given tenecteplase. Improvement in NIHSS was 3.34 points at the time of discharge. Almost 40% improved significantly improved in follow up mRS scores Conclusion: Our study concluded that thrombolysis for ischemic stroke provides early functional ability and decreased morbidity without any significant risk of bleeding
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The poor bioavailability and therapeutic response exhibited by conventional ophthalmic solutions due to rapid pre-corneal elimination of the drug may be overcome by the use of in situ gel forming systems that are instilled as drops into the eye and then undergo a sol-gel transition in the cul-de-sac. The present work describes the formulation and evaluation of an ophthalmic delivery system of an antibacterial agent ofloxacin, based on the concept of ion-activated in situ gelation. Sodium alginate was used as the gelling agent in combination with HPC [Hydroxy Propyl Cellulose] that acted as a viscosity-enhancing agent. In vitro release studies indicated that the alginate/HPC solution retained the drug better than the alginate or HPC solutions alone. The formulations were therapeutically efficacious, sterile, stable and provided sustained release of the drug over a period of time. These results demonstrate that the developed system is an alternative to conventional ophthalmic drops, patient compliance, industrially oriented and economical
Subject(s)
Drug Delivery Systems/methods , Ophthalmic Solutions , Alginates , Hexuronic Acids , Glucuronic Acid , Delayed-Action PreparationsABSTRACT
Most of the floating systems have an inherent drawback of high variability in the GI transit time, invariably affecting the bioavailability of drug. To overcome it, a multiple unit floating system with extended GI transit time, capable of distributing widely throughout the GIT for effective enteric release of the drug has been sought. Microballoons loaded with drug in their outer polymer shells were prepared by novel emulsion solvent diffusion method. The ethanol: dicloromethane solution of drug and Eudragit-S were poured into an aqueous solution of PVA that was thermally controlled at 40°C. The gas phase generated in the dispersed polymer droplet by the evaporation of solvent formed an internal cavity in the microsphere of the polymer with the drug. The flowability of the resulting microballoons improved when compared to pure drug. The microballoons on floatation along with the surfactant, floated continuously for more than 12 hours in the acidic medium in-vitro conditions. The in-vitro drug release profile of the formulation in the simulated gastric buffer showed no drug release, which emphasizes the enteric release property and in simulated intestinal buffer, a slow and controlled drug release of 60 to 84% was obtained over a period of 8 hours. Drug release was significantly affected by increased drug to polymer concentration at pH 6.8. The formulation was found to be physically and chemically stable as per the ICH guidelines