ABSTRACT
Background Type 2 diabetes mellitus (T2DM) arises due to a range of pathological abnormalities, necessitating a combination therapy to achieve optimal glycemic control. Vildagliptin, an effective and selective DPP-4 inhibitor, and pioglitazone, an insulin sensitizer, offer distinct mechanisms of action. Hence, the integration of these medications represents a logical and justified therapeutic strategy Objective To compare the efficacy, safety, and tolerability of vildagliptin and pioglitazone 50 mg/15 mg fixed-dose combination (FDC) tablets with individual monotherapy vildagliptin 50 mg and pioglitazone 15 mg tablets in Indian T2DM patients who were inadequately controlled on metformin monotherapy. Methods This was a randomized, open-label, comparative, multicenter, phase III study involving 195 T2DM patients with inadequate glycemic control on metformin ≥ 1000 mg/day. Patients were randomly assigned in a 1:1:1 ratio to the test product group (n=65) (vildagliptin 50 mg + pioglitazone 15 mg FDC tablets), reference product group 1 (n=65) (vildagliptin 50 mg tablet), or reference product group 2 (n=65) (pioglitazone 15 mg tablet reference product). The primary endpoint was the mean change in HbA1c levels from baseline to end of the study visit (12 weeks (84 days ±2)). The secondary endpoints were the mean change in fasting plasma glucose (FPG) and 2-hr postprandial plasma glucose (2-hr PPG) levels. Safety parameters were assessed till the end of the study. Results A total of 178 patients completed the study. At 12 weeks, the mean HbA1c level in the test group reduced to 6.85 ± 1.27%, in the reference product 1 group to 7.56 ± 1.72%, and in the reference product 2 groups to 7.37 ± 1.59%. The mean change in Hb1Ac from baseline in the test group was statistically significant compared to the reference groups (p=0.037). Similarly, the mean changes in the FPG and 2hr-PPG with the test product were statistically significant compared to reference products (p=0.041). The adverse events were comparable across all the treatment groups. Conclusion In Indian T2DM patients inadequately controlled on a daily maximum dose of metformin, treatment with vildagliptin and pioglitazone FDC showed better glycemic control than either vildagliptin or pioglitazone along with a good tolerability profile.
ABSTRACT
Background: Antibiotic resistance is increasing at an alarming rate. Many reasons are there which need urgent attention toward this problem. Efforts in all directions are required to address this serious issue. The irrational prescribing habits of physicians lead to increasing morbidity, mortality, and treatment costs. One of the key components of the system is the prescriber and their practices. In the present study, efforts were made to know the understanding of the medical students about the severity of the problem and to find out the focus area that needs to be modified. Materials and methods: A cross-sectional, questionnaire-based survey was conducted among the second-year medical students of a teaching hospital after the ethical approval study was explained to the student and written consent was taken. The questionnaire was given before and after exposure to formal lectures on antimicrobial agents. The collected data was analyzed. Results: It was clear that inappropriate use of antimicrobials causes antimicrobial resistance (AMR) (87.3%) and can harm patients (82%). Interactive patient-oriented problem-solving modules on the internet (35%) and small group problem-based learning are preferred by (32%) students. Preparedness about antimicrobial use was seen only in 50% of the students in a few essential aspects. Learning during the medical course only does the purpose of sensitization, for the thorough knowledge repeated exposure is essential. Conclusion: Most of the students were partially aware of the AMR. The only concern was their casual attitude regarding antibiotic use. Further educational interventions are necessary to improve their understanding and perceptions of antibiotic resistance, as well as their attitude toward antibiotic use. How to cite this article: Deogaonkar A,Dawane J. Impact of UG Training on Understanding the Severity of Antimicrobial Resistance. J Assoc Physicians India 2023;71(11):14-18.
