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1.
Article | IMSEAR | ID: sea-200524

ABSTRACT

Background: Asthma is a chronic inflammatory disease requiring long term treatment. For an effective control of asthma symptoms background knowledge of the prescribing pattern of anti-asthmatic drugs is a must.Methods: A prospective, observational study was conducted in the Department of Respiratory Medicine OPD, King George's Medical University, Lucknow. 114 patients of asthma were recruited for the study. A case report form was filled from patient’s prescription containing the demographic details of the patients, presenting complaints, investigations and drugs prescribed along with their dose, duration, frequency, route of administration.Results: 114 patients’ prescriptions were assessed which showed average number of drugs per prescription - 3.22. 42.8% and 50% of the drugs were prescribed in accordance with World Health Organization model list of essential medicines and National list of essential medicines. Short acting ?2 agonist (salbutamol), 61.4% was the most commonly and frequently prescribed single anti asthmatic drug. Combination of inhaled corticosteroid and long acting ?2 agonist, 86.8% was the most commonly prescribed fixed dose combination anti asthmatic drug. Inhalational route (75%) was the most preferred one over oral route (25%).Conclusions: Asthma being a chronic disease requires prolonged treatment which imposes economic burden on the patients. Judicious prescription of drugs not only improves the patient clinically but also removes the unnecessary burden. Data obtained from these studies can be used as a guide to make future decisions regarding standard prescription.

2.
Article | IMSEAR | ID: sea-211256

ABSTRACT

Background: There were 4.1% of all new cases and 19% of previously treated patients were diagnosed with either multidrug resistant or rifampicin resistant tuberculosis in 2016. In the state of Uttar Pradesh, there were 2.16 new cases and 44,531 previously treated cases. The objectives of the study were to assess the predisposing factors, causality assessment, severity grading and avoidability of the adverse drug reactions (ADRs) of the antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This prospective observational study was conducted for 12 months at a tertiary care hospital. The patients with MDR tuberculosis on treatment with DOTS Plus regimen under RNTCP and who met the inclusion exclusion criteria were recruited after informed consent. ADRs were monitored daily till the patients remained admitted and thereafter monthly. Predisposing factors were recorded. Causality assessment was performed by Naranjo scale and WHO UMC scale, severity by Hartwig’s scale and avoidability by Halla’s scale.Results: There were 115 patients were recruited, 70 developed at least one ADR. 98 ADRs were reported. The commonest ADR reported were – gastrointestinal (38.76%), neurological (21.24%) and hepatobiliary (8.16%). Diabetes and HIV predisposed to development of ADRs. 58.18% ADRs were classified as possible and 37.5% as probable by Naranjo’s scale. 51.02% ADRs were classified as probable and 42.83% as possible by WHO-UMC. 56% were classified as mild, 36% moderate, and 6% severe via Hartwig’s scale. 51 ADRs were classified as avoidable and 40 ADRs were possibly avoidable.Conclusions: Monitoring and assessment of ADRs is necessary to promote awareness, curb resistance and maintain adherence.

3.
Article | IMSEAR | ID: sea-200074

ABSTRACT

Use of animals in experimentation and research has always been a topic of great debate. Some express their strong support while others are against animal research practices and want their complete abolition.1 At present, there is a pill for every ill. Rapid advancement in the field of science and technology contributed in discovering cure and medications even for the rarest of the rare diseases. Most of the present day discoveries in medical science lay their foundation on animal experimentation. The use of drugs in clinical practice have been possible only after going through successful animal studies for safety, efficacy and toxicity.

4.
Article | IMSEAR | ID: sea-200020

ABSTRACT

Background: Between 2006 and 2015, the prevalence of MDR-TB has been found to be as high as 39.9% in some states. Approximately 35.8% of all previously treated patients developed MDR-TB. The objective of the present study was to identify demographic and health characteristics of patients as well as incidence and pattern of the adverse drug reactions caused by antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This 12 months study of observational study was conducted at a DOTS centre. MDR-TB diagnosed patients treated with DOTS Plus regimen were enrolled after getting informed consent. Patient information was recorded. Patient follow-up was conducted to identify the incidence and pattern of ADRs.Results: A total of 115 patients were enrolled. Maximum number of cases were in the 31-40 age group (25.21%) followed by the 41-50 age group (20.86%). 76 (66.08%) were males and 39 (33.91%) were females. 52 patients (45.21%) had concomitant diseases, out of which 15 (13.04%) were HIV positive and 21 (18.26%) were diabetic. 70 patients (60.86%) developed ADRs. The adverse drug reaction that were seen are -38 (38.76%) cases of gastrointestinal adverse drug reactions, 8 (8.16%) jaundice/hepatitis, 7 (7.14%) impaired hearing/vertigo, 21 (21.24%) central nervous system adverse drug reaction, 6 (6.12%) peripheral neuropathy, 6 (6.12%) rash and itching, 5 (5.10%) arthralgia, 3 (3.06%) renal impairment, 2 (2.04%) hypothyroidism and 2 (2.04%) blurred vision.Conclusions: Determining which population groups are affected most by ADRs can help physicians to better monitor and make an early diagnosis to reduce ADR-related morbidity and mortality.

5.
Article | IMSEAR | ID: sea-184788

ABSTRACT

Background:Poisoning in childhood is major health concern. But the profile of substances used & their relative outcome change according to age, availability of substances, pattern of life and medical awareness in different geographical areas.In this hospital-based study, we sought to investigate the epidemiology and outcome of acute poisoning among children admitted to a pediatric emergency department. Methods: This is a retrospective descriptive study conducted in Pediatric department of Rajendra Institute of Medical Sciences, a tertiary care hospital in Ranchi, Jharkhand .Children and adolescents less than 18 years of age with diagnosis of acute poisoningduring January 2018 –June2018 were included in the study. Results:In our study,97children presented with diagnosis of acute poisoning (3.32% of admissions). 59patients (60.8%)were boys. The greatest proportion of patients (45%) were aged between 1 and 5 yrs. Regarding the intention of poisoning, 91.8% were accidental .Bites accounted for 32.9%, drug ingestion- 19.5%, hydrocarbon ingestion & pesticide,rodenticide for 13.4% , corrosives-1%, household items- 2%, unknown substance -17% of the total cases.14 patients (14.4%)required admission to intensive care unit.Mean duration of hospital stay was 40 hrs. 2 children succumbed to complications during the study period, others were discharged successfully. Conclusion:Most of pediatric poisoning cases are preventable calamities. Death due to poisoning in children can largely be avoided if sufficient awareness can be created among parents and guardians.

6.
Ann Card Anaesth ; 2016 Oct; 19(4): 653-661
Article in English | IMSEAR | ID: sea-180930

ABSTRACT

Background and Objectives: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery. Methodology: Fifty infants <6 months of age were prospectively randomized in the trial for enteral nutrition (EN) postoperatively from day 1 to 10, after obtaining the Institute Ethics Committee’s approval. They were equally divided into two groups on the basis of the feed they received: Control group was fed with expressed breast milk (EBM; 0.65 kcal/ml) and intervention group was fed with EBM + energy supplementation/fortification with human milk fortifier (7.5 kcal/2 g)/Simyl medium‑chain triglyceride oil (7.8 kcal/ml). Energy need for each infant was calculated as per EER at 90 kcal/kg/day, as the target requirement. The intra‑ and post‑operative variables such as cardiopulmonary bypass and aortic cross‑clamp times, ventilation duration, Intensive Care Unit (ICU), and hospital length of stay and mortality were recorded. Anthropometric and hematological parameters and infection control data were recorded in a predesigned pro forma. Data were analyzed using Stata 14.1 software. Results: The duration of mechanical ventilation, length of ICU stay (LOIS), length of hospital stay (LOHS), infection rate, and mortality rate were lower in the intervention group compared to the control group although none of the differences were statistically significant. Infants in control group needed mechanical ventilation for about a day more (i.e., 153.6 ± 149.0 h vs. 123.2 ± 107.0 h; P = 0.20) than those in the intervention group. Similarly, infants in control group stayed for longer duration in the ICU (13.2 ± 8.9 days) and hospital (16.5 ± 9.8 days) as compared to the intervention group (11.0 ± 6.1 days; 14.1 ± 7.0 days) (P = 0.14 and 0.17, respectively). The LOIS and LOHS were decreased by 2.2 and 2.4 days, respectively, in the intervention group compared to control group. The infection rate (3/25; 5/25) and mortality rate (1/25; 2/25) were lower in the intervention group than those in the control group. The energy intake in the intervention group was 40 kcal more (i.e., 127.2 ± 56.1 kcal vs. 87.1 ± 38.3 kcal) than the control group on the 10th postoperative day. Conclusions: Early enteral/oral feeding after cardiac surgery is feasible and recommended. In addition, enriching the EBM is helpful in achieving the maximum possible calorie intake in the postoperative period. EN therapy might help in providing adequate nutrition, and it decreases ventilation duration, infection rate, LOIS, LOHS, and mortality.

7.
Article in English | IMSEAR | ID: sea-124980

ABSTRACT

Pancreatic cancer is a deadly disease with no effective therapy short of surgical resection. Unfortunately, only a minority of patients are candidates for potential curative surgery as the tumor spreads early to extrapancreatic sites. Patients with metastatic pancreatic cancer survive less than 1 year following diagnosis. The current challenge for both clinicians and scientists is to translate the growing body of knowledge of the molecular basis of this disease into effective strategies for early diagnosis and systematic treatment. Molecular studies of pancreatic cancer have revealed that this cancer is associated with several genetic mutations. Although our knowledge of the molecular alterations in pancreatic cancer has grown significantly, there is still much to learn. It is clear that oncogenes, tumor suppressor genes, growth factors and DNA mismatch repair genes all play a role in pancreatic tumorigenesis. However, a better understanding of the relative contribution of each of these molecular alterations is necessary and will aid the development of more effective diagnostic and therapeutic strategies to deal with this deadly and aggressive cancer.


Subject(s)
Cyclooxygenase 2/physiology , DNA Repair/physiology , Genes, Tumor Suppressor/physiology , Humans , Oncogenes/physiology , Pancreatic Neoplasms/genetics
8.
Rev. bras. genét ; 20(3): 511-6, Sept. 1997. ilus, tab
Article in English | LILACS | ID: lil-219006

ABSTRACT

Um novo caso de supressäo e inversäo intersticial parcial do braço longo do cromossomo X em combinaçäo com uma alta incidência de associaçöes teloméricas foi mostrado em uma jovem do sexo feminino de 18 anos com características sexuais secundárias subdesenvolvidas, incluindo seios pequenos e amenorréia primária. Seu cariótipo foi considerado 46,X,del(Xq13 q22)inv(X)(q23-q27). As células mucosas bucais apresentaram ausência de um típico corpúsculo de Barr e os estudos de incorporaçäo de 5'-bromo-2-deoxiuridina revelaram que nem o cromossomo X normal nem o anormal tinham replicaçäo tardia. Este caso foi apresentado por sua extrema raridade.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Chromosome Deletion , Chromosome Inversion , Sex Chromosome Aberrations , X Chromosome , Amenorrhea/complications , Telomere
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