Articles

  1. Assessment of risk factors and medication adherence of diabetes mellitus patients in a tertiary care teaching hospital Download Article

    Syeda Sunaina Firdous, Ayesha Siddiqua, K.Navaneetha, P.Srujana, S.Mahesh kumar.
    • Article Type: Research Article
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    • Pages (1-7)
    • No of Download = 157

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    Diabetes mellitus is a group of metabolic diseases characterized by inappropriate hyperglycemia resulting from defects in insulin secretion, insulin action, or both Objective The main objective of this study was to assess the risk factors and medication adherence for diabetes patients in rural tertiary care teaching hospital by using risk assessment form and morisky medication adherence questionnaire form respectively. Methods These forms contains closed ended questionnaires. It is a prospective observational study conducted over a period of six months. Results In this study 290 subjects consisting of 144 (49.7%) men and 146(50.3%) women had diabetes. In this study Age, gender, BMI, Family history, Smoking and Alcoholic were observed for risk factor assessment and morisky medication adherence scale is used to assess adherence of the patient towards medication. In diabetes patients, age is a major risk factor, in which more number of patients of age 51-60 years were 71 (24.5%) found. Commonly seen risk factors were age, gender, BMI, and family history. More no of patients were highly adherent to their medication i.e., 67.2%. Conclusion By this study we concluded that more number of female diabetes patients were exposed to risk factors than male and more patients are highly adherent to their medication.

  2. Asymptomatic candiduria in HIV seropositives attending an ART centre in a tertiary care hospital Download Article

    Vishwanatha Reddy M.S, Murugesh K, Amrutha Kumari B, Venkatesha D.
    • Article Type: Research Article
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    • Pages (8-12)
    • No of Download = 185

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    BACKGROUND Most of patients with candiduria are asymptomatic. However, in immunocompromised patients like HIV-infected individuals, it has high risk of morbidity and mortality as it is a good indicator of disseminated infection and fungemia. AIM To isolate and characterize Candida species in HIV seropositives patients with asymptomatic candiduria and to determine distribution of Candida species in different CD4+ cell counts categories. MATERIALS AND METHODS The study group comprised of 55 males and 45 females, of which 50 were on ART and 50 were not on ART. Clean catch mid stream urine specimens were collected from patients and urine was inoculated on SDA, incubated at 370 for 48-72 hours. RESULTS 14 of 100 subjects had candiduria. Out of 14 Candida species, 5 candida albicans and 9 non-albicans candida species were isolated. The prevalence of candiduria was high among patients who were not on HAART (43%) than in individuals who were on HAART (18%) with CD4+ count >200 cells/μl. CONCLUSION Measures to reduce candiduria prevalence, such as early diagnosis, prompt treatment with appropriate antifungals and strict compliance with HAART regimen are advocated to reduce the morbidity and mortality in HIV positive patients.

  3. Liver cancer: Recent developments in diagnosis and treatment Download Article

    Neema Johnson, Nelta S Tharakan, Vijayabaskaran. M, Sambathkumar R
    • Article Type: Review Article
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    • Pages (13-18)
    • No of Download = 209

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    Only cancers that start in the liver are called liver cancer (hepatocellular carcinoma). Liver cancer is the third leading cause of cancer death and the fifth most common solid tumor worldwide. Its incidence has increased dramatically in the past few years in all over the world. Despite advances in surgical and nonsurgical therapies in the treatment of liver cancer, a number of controversial issues regarding appropriate screening methods, diagnosis, staging, and management continue to evolve.[1] The aim of this review is to help the practicing Pharm D students, clinical pharmacist and physicians to identify high-risk patients, implement an appropriate screening strategy, order relevant tests to confirm the diagnosis, and formulate an appropriate management plan which include newer treatment options like virus therapy, nano knife, magnetic targeting, therasphere etc.

  4. A study on pattern of delirium in the patients admitted to MICU in a tertiary care teaching hospital Download Article

    Dr.M Sureswara Reddy, Gangula Amareswara Reddy, P Venkata Ramana.
    • Article Type: Research Article
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    • Pages (19-26)
    • No of Download = 159

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    Aim To study the prevalence of various base line risk factors, precipitating and iatrogenic factors in the study population and the effect of delirium on the outcome of patients admitted to the MICU. Methods This is a cross sectional, descriptive study conducted for a period of six months in the Medical Intensive Care Unit (MICU). Socio-demographic data sheet, risk factor checklist, confusion assessment method (CAM), and Simplified acute physiology score (SAPS -II) were the instruments used in the study. Results Majority of the study group (63%) were males and uneducated. Mean days spent in delirium were high for males (4.92 days) when compared to females (3.72 days). The mean score of SAPS-II for development of delirium is 27 (26.95). Mean days spent in delirium (5.95 days) was high when there is no visible day light. 60% of study population were hyperactive and were forcibly restrained to cots. From the total study population, 18 were discharged from MICU (M=14, F=37); 62 were transferred to medical wards (M=37, F=25); 9 were transferred to other wards (M=5, F=4) and11 patients were dead (M=7, F=4). Conclusion Being male, lower socio-economic statuses, substance abuse (57%) were found as significant predisposing factors. Type of delirium had no statistically significant effect over outcome. Delirium outcomes were either in higher number of deaths or prolonged hospital stay. The mean SAP score was considerably higher in the death group compared to the other groups and the differences are also significant with P<0.001.

  5. Diffuse alopecia in females: An update Download Article

    Dr.Usha Kataria, Dr.Dinesh Chhillar.
    • Article Type: Review Article
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    • Pages (27-31)
    • No of Download = 242

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    Scalp hairs complete the body self-image and patients with diffuse alopecia suffer from overt disfiguration, leading to psycho-social embarrassment and significant lack of self-esteem. Diffuse alopecia is a non-scarring type of alopecia. Telogen effluvium is the most common cause of diffuse alopecia in females. Abrupt, rapid, generalized shedding of club hairs, 2-3 months after a triggering event like parturition, high fever, major surgery etc. indicates telogen effluvium, while gradual diffuse hair loss with thinning or widening of central parting line indicates female pattern hair loss, another common cause of diffuse alopecia. Excessive alarming diffuse hair loss, from a normal looking ahead without an obvious cause, is the hallmark of chronic telogen effluvium, which is a distinct entity different from telogen effluvium and female pattern hair loss. Hence an early diagnosis and an aggressive treatment in the case of active hair loss are crucial in the management of diffuse alopecia.

  6. Case series report: 3 Cases of gallbladder perforation of three defferent types Download Article

    Pukhraj Chaudhary, Mukesh, Ashok Kumar, Mahendra Kumar, Sitaram G, Dharamveer.
    • Article Type: Case Report
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    • Pages (32-35)
    • No of Download = 114

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    Gallbladder perforation (GBP) is a rare clinical entity but life threatening condition with high morbidity and mortality rates because of delay in diagnosis. Thus GBP still remains a big challenge for the surgeons. Most cases can only be diagnosed during surgery. Niemeier in 1934, classified gallbladder perforation on the basis of his observation. Inspite of many modifications this classification is still in use. GBP was classified as acute or type I for free perforation and generalized biliary peritonitis, sub acute or type II for pericholecystic abscess and localized peritonitis, and chronic or type III for cholecystenteric fistula. Here we are presenting a case series of 3 cases of gallbladder perforation of three different types as mentioned above. Common clinical symptoms in these patients were abdominal pain mainly in upper quadrant, tenderness , lump in Rt. Hypochondrium ,and peritonitis. Surgical management and some specific presentation varied according to type of gallbladder perforation . All the patients were treated surgically.

  7. Role of quality assurance and quality control in clinical trials – Need for harmonization Download Article

    Mohammad Younis Bhat, Samina Farhat, Rehana Tabassum, Rayees Ahmad4
    • Article Type: Research Article
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    • Pages (36-39)
    • No of Download = 134

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    Clinical trials may be defined as biomedical or health related research studies in human beings that follow a pre-defined protocol. Clinical trials are the link between the results of preclinical testing and actual clinical practice. They are conducted to collect the data necessary to provide information for academia, industry and regulators and it is only through trials that progress is made on new medicines including drugs, vaccines, and devices, as well as improved treatments for diseases. Clinical trials involves interplay between clinical investigators (often referred as Principal Investigator or PI), patients, sponsors, control research organization (CRO), clinical laboratories with the overall objective of improving healthcare to ensure subject safety, validity, accuracy and credibility of data generated. To ensure that these concerns are adequately addressed in a study, regulations and guidelines have been developed like following the protocol, complying with regulatory and Good Clinical Practice (GCP) standards, collecting and reporting quality data and overall monitoring of the progress of trial. Maintaining accuracy and quality throughout the clinical study is a continuous dynamic process. There is increasing focus on having quality system in place throughout the planning stages of clinical trials with specific standards for each clinical trial process to produce a more reliable and useful end product – high quality data without compromising the rights and welfare of human subjects. Globalization, outsourcing and increasing complexity of clinical trials have made the target of achieving global quality challenging. Although the study requirements are carefully set forth initially, expectation and requirements can change during a study and coordination and harmonization throughout the trial is essential.

  8. Diabetes mellitus associated mortality: Therapy and awareness Download Article

    Sara Nikhat, Ali Fatma, Unnisa Begum Faiz , Muqtader Mohammed.
    • Article Type: Research Article
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    • Pages (40-44)
    • No of Download = 136

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    United States studies have estimated nearly 1 million Americans, or 9.3% of the population had diabetes mellitus in the year 2012 and contributed to 234,051 deaths per annum which lead to Diabetes remains the 7th leading cause of death in the United States. This study revealed risk factors associated with various co-morbidities due to increased blood glucose levels such as hypertension, stroke, heart attacks, kidney diseases, lower limb amputations. The report from “American Diabetes Association” survey to examine awareness and pharmacological treatment of uncontrolled diabetes mellitus among age groups with special emphasis on three groups which includes, Persons unaware of diabetes, Persons who are aware but not treated with medication, Persons who are aware and pharmacologically treated with medication but still have uncontrolled. The objective of present work is to create the awareness for diabetes mellitus and it’s therapy. The “National Diabetes Statistics” 2014 report of United States reveals in year 2012 about 86 million Americans age 20 and older had pre diabetes. Out of the 29.1 million, 8.1 million were undiagnosed. We assessed in our findings that maximum percentage of patients who are diabetic but not adhering to medicine due to its high cost. We should use different strategies and various awareness programs viz Marathons, flash mobs to significantly reduce the Diabetes associated mortality cases. This article represent the application of selected statistical tools such as "SPSS" software for data analysis for assessing the increasing mortality due to Diabetes.

  9. Case report on generalized bullous recurrent fixed drug eruption caused by co-trimoxazole Download Article

    Sowmya Nadendla, Sahithi.Kalari, Shaik Shafiya, Nallani Venkata Rama Rao,Rama Rao Nadendla
    • Article Type: Case Report
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    • Pages (45-47)
    • No of Download = 196

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    Fixed drug eruption is a allergic reaction to particular medicine. This is case of 65-year-old male patient with complaints of multiple discrete dusty macules over hands, legs and feet and various other areas associated with burning sensation with history of similar complaints in the past two to three times & on enquiry patient was prescribed co-trimoxazole by a local practitioner without taking adequate medication history. Cotrimoxazole was suspected as the offending drug in causing fixed drug eruption in this case and its role was confirmed by patch test. According to WHO-UMC & Naranjo assessment scales this adverse effect comes under possible adverse effect.

  10. Antinociceptive activity of aqueous leaf extracts of Boussingaultia gracilis Download Article

    *Dr.Bijoy Chirayath, N.Sriram
    • Article Type: Research Article
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    • Pages (48-51)
    • No of Download = 163

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    The aqueous leaf extracts of Boussingaultia gracilis is used for hepatoprotective, ulcer, fever and rheumatism. The present study was undertaken to evaluate the analgesic activity of the aqueous extract of Boussingaultia gracilis (Bassellaceae) aqueous leaf (BGPE) was investigated in chemical models of nociception in mice. BGPE at doses of 100, 200 and 400 mg/kg p.o produced an inhibition of 29.22%, 51.80% and 79.87% of the abdominal writhes induced by acetic acid in mice. In the formalin test, the administration of 100, 200 and 400mg/kg p.o had no effects in the first phase (0–5 min) but produced a dose-dependent analgesic effect on the second phase (15–40 min) with inhibitions of the licking time of 31.54%, 45.27% and 60.52% respectively. Based on the results of this study, we suggest that the peripheral analgesic effect of Boussingaultia gracilis may be attributed to inhibition of prostaglandin release and other mediators involved. Further studies are needed to evaluate the mechanism of action of the analgesic activity of the Boussingaultia gracilis. The result obtained shows that the Boussingaultia gracilis possesses an adequate significant analgesic activity which confirms the claims of traditional uses of the plant leaf.

  11. Academic failures among high school students: A comparative case study Download Article

    Milu Maria Anto, Santhosh A J, Sangeetha P.L
    • Article Type: Research Article
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    • Pages (52-55)
    • No of Download = 160

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    Background: The reasons for academic failures are very complex. They are multifaceted and interrelated, compounding and exacerbating the problem of school failure. The causes can be student related, school related or society related. Objective: The aim of the current study was to find out the factors behind the failures of the high school students in Kerala. Methods: exploratory case studies were conducted among high school students with academic failures in government, government aided and private schools to get insight into the factors related to their underachievement. In-depth interviews were conducted along with standardized IQ tests and NIMHANS battery for specific learning disability to get multidimensional data about the students. Results: Contrary to popular belief, the study did not find any significant relation between IQ of the students and their academic failures. Results also indicate that the type of school along with the socio economic status of the family, educational level and alcoholism of the parents are the key factors behind the academic failures of the high school students. Conclusion: Identifying the factors that interfere with academic success is the first step in the process of choosing interventions to address the issue of academic failures. This study has found the relevance of school climate and family atmosphere along with personal factors such as hyperactivity and substance use in academic failures. Majority of the students with academic failures are found to have normal or above average IQ. Therefore, Individual counseling sessions for students with academic underachievement could be of help to overcome the barriers for academic success.

  12. Bacteriology of diabetic foot Infection Download Article

    Premchandran, V. Shantha sheela, G.Shanthi
    • Article Type: Research Article
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    • Pages (56-60)
    • No of Download = 105

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    Objective: To determine the microbiological profile and antibiotic susceptibility pattern of organisms isolated from diabetic foot ulcer in RMMCH Chidambaram Methods: This is a retrospective study with a review of the bacteriology results of specimens taken from 100 consecutive patients with diabetic foot infection at RMMCH in Chidambaram during the period of 2010 to 2011. The specimens were cultured using optimal aerobic and anaerobic microbiologic technics. Antimicrobial susceptibility testing to different agents was carried out using the diffusion method. Result: Staphylococcus aureus was the commonest isolate being recovered from 20% cases , including methicillin resistant staphylococcus aureus in 9 of 27(30) patients wounds. The organism isolated were pseudomonas aeruginosa(16%), proteousmirabilis (18%), klebsiella pneumonia(0.7%), Escherichia coli(13%), and klebsiellaoxytoca(0.6%).The antimicrobial suscepteblity testing , showed that vancomycin was the most effective against gram positive and amikoscin and ceftazidime was the most effective against gram-negative organism. Conclusion: Staphylococcus aureus, pseudomonas aeruginosa, proteous mirabilis, klebsieella pneumonia, Escherichia coli and Klebsiella oxytoca were the most common causes of diabetic foot infection. These wounds require use of combined antimicrobial therapy for initial patient.

  13. Role of early indicators in the diagnosis and outcome of neonatal sepsis in tertiary care hospital Download Article

    B. Sasi Kumar, B. Manohar, Nalini.P, Shankar Reddy Dudala, P.Ravi Kumar, M.mallikarjuna
    • Article Type: Research Article
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    • Pages (61-65)
    • No of Download = 175

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    Sepsis is the commonest cause of neonatal mortality. Septicemia was the commonest clinical category with an incidence of 23 per 1000 live births. Number of screening procedures like micro ESR ,band cell count, I/T ratio, gastric aspirate for polymorphs, C –Reactive protein, alpha haptoglobin, serum fibrinogen levels have been tested in their efficacy of predicting neonatal sepsis. Positive CRP was found to be the single most sensitive and specific test in diagnosis of neonatal septicemia. The present study 180 neonates with clinical suspicion of septicemia included to evaluate the usefulness of combination of tests in septic screen in predicting neonatal sepsis. CRP was positive in 94 cases (91.3%) of culture positivity with statistical significance. Case fatality rate was 26.1%.

  14. A case study on hemolytic uremic syndrome- Leading to acute renal failure Download Article

    Jiguru Prasant, Mohammad Kaleemullah Quraishi, Amer Khan.
    • Article Type: Case Report
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    • Pages (66-69)
    • No of Download = 181

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    A 65 yrs female patient was presented with complaints of vomiting, loose stools, pain, fever, high grade chills, giddiness, loss of appetite acute renal failure, hemolytic anemia and thrombocytopenia She was diagnosed with Escherichia coli associated hemolytic-uremic syndrome and treated with plasmapheresis and other medications for 3 weeks. She recovered without sequelae.

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