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Background: The practice and teaching in the MBBS curriculum has changed over the last few decades and most of it caters to the making of the Indian Medical Graduate (IMG) and the first contact physician of the community. The most notable change in pharmacy in modern times has been the virtual disappearance of the preparation and compounding of medicines. Pharmacy practical classes still form a part of the MCI curriculum in Pharmacology undergraduate teaching in many states of India including West Bengal. This study was undertaken to assess the attitude of students as well as teachers towards continuation of these practical classes in the curriculum and possible alternatives.Methods: Second year pharmacology students were included in the study (n=143). Along with this 10 faculty members were provided a structured and pre-tested questionnaire to be answered anonymously.Results: It was seen that 89 percent students and 100 percent faculty members wanted these practical classes to be discontinued. The most popular alternative to these classes were ADR reporting from the faculty members (90%) and demonstration of clinical effects of drugs and dosage calculation (86%) among the students.Conclusions: Given the lessening importance and relevance of the pharmacy practical classes in today’s day to day practice, a change in curriculum and examination system in Pharmacology must be considered.
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In an attempt to improve the patient comfort after thyroidectomy, various methods of pain-relief have been tried to prolong the duration and to improve the quality of postoperative analgesia. Cervical plexus block using steroids like dexamethasone, administered as an adjuvant along with local anaesthetic agents, could be of particular interest. Methods: Fifty patients undergoing elective thyroidectomy were randomly assigned to one of the following groups containing twenty five patients each. Group D patients received 8 mg (2 ml) of dexamethasone added to 13 ml of 0.25% levobupivacaine as cervical plexus block (total volume 15 ml). Group L patients received 13 ml of 0.25% levobupivacaine and 2 ml of isotonic saline (15 ml in total) as cervical plexus block. Analgesic effect was evaluated by measuring pain intensity (VAS score) and duration of analgesia. Results: A longer delay was observed for first requirement of supplementary analgesic in group D (572.24±68.42 minutes ) compared to group L (402.46±52.34 minutes). Total consumption of diclofenac sodium in first 24 hours in postoperative period was significantly less in group D. No significant side effects were noted. Conclusion: Dexamethasone, used as adjuvant to levobupivacaine for cervical plexus block in patients undergoing thyroidectomy, improve the quality and prolong the duration of post operative analgesia.
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Antimicrobials are very frequently used medications in Obstetrics and Gynaecology in there wide range of operative procedures and in treating various infections. Administering antimicrobial prophylaxis is a standard practice in caesarean section which is given in pre, intra and postoperative peroids. The present study was aimed to explore the antibiotic usage pattern in caesarean section in Bankura Sammilani Medical College , Bankura. Methods: A prospective observational study was conducted in the Department of Gynaecology and Obstetrics (G&O) in collaboration with the Department of Pharmacology of the Bankura Sammilani Medical College, Bankura. The study was carried out for a period of two months from February to March 2019. Results: Among 364 cases mostly were primigravida, commonest prescribed antibiotic being ceftriaxone parenteral followed by cefuroxime by oral route. Conclusion: Appropriate dose with proper duration of antimicrobial therapy in both elective and emergency Caesarean Section reduces the infective complication of mother and the new born.
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Informed consent remains an important ethical and legal document ensuring autonomy of the research participants. Objective: The present study was undertaken with the idea to find out the gap in respect to knowledge, attitude and practice in acquiring Informed Consent so that we can improve the procedure of acquiring consent in accordance with the present regulations. Methods: Questionnaire based close ended cross sectional study within 1 week time frame in Bankura Sammilani Medical college involving the resident doctors pursuing their post graduate degrees. Results: Though 83.4% had the knowledge but 68% do not feel necessary to take consent. The major limitation being excessive work load and lack of time. Conclusion: The study revealed that there was lot of lacunae in their knowledge giving rise to improper attitude and practice regarding Informed consent procedure in a research project.
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In the absence of effective vector control measures and vaccines against leishmaniasis, effective chemotherapy remains the mainstay of treatment. Identification of post-kala-azar dermal leishmaniasis (PKDL) is important due to the long and toxic treatment and the fact that PKDL patients may serve as a reservoir for visceral leishmaniasis (VL). This retrospective study was done to assess the outcome of pharmacotherapy in post-kala-azar dermal leishmaniasis (PKDL) patients in a specialty public hospital in Kolkata. Methods: The hospital records of all consecutive PKDL patients admitted at Calcutta School of Tropical Medicine (CSTM), Kolkata during the last five years - 2010-2014, were reviewed and the relevant information inputs as documented studied to realize the noted objectives. Clinical presentation on admission including presence of co-infections (particularly HIV), trends and patterns of treatment regimens and rationale thereof, if available; treatment (anti-leishmaniasis) outcomes in reference to efficacy, safety and tolerability, fatality like serious complications and mortality and adverse drug reactions (for anti-leishmaninal drugs primarily), if any was noted. Results: PKDL cases presented with insidious onset skin lesions of different types without much systemic illness. 2 out of 19 cases presented with fever and 2 other cases had mild anemia. PKDL cases presented with 4 types of skin lesions. Multiple macular or hyppigmented macular lesions were commonest, 8 out of 19 cases (42.10%). In PKDL cases treatment outcome was difficult to say unless parasitologically declared negative, though clinically regression of the lesions were visible in all cases. Tolerability was least with AmB followed by SSG and best with miltefosine. Conclusion: So, it can be concluded from this study that in this institute PKDL were treated with conventional and liposomal AmB as well as with SSG, miltefosine and combination therapy. Among the regimens short course L-AmB was found to be the most efficacious and tolerable in respect to ADRs and hospital stay.
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Osteoarthritis (OA) is the most common type of arthritis. Its high prevalence, especially in the elderly, and the high rate of disability related to disease make it a leading cause of impaired mobility in the elderly. To evaluate the efficacy, safety and tolerability of tapentadol in OA of knee joint in Indian population this study was undertaken. Methods: A prospective observational study involving patients of 40 years and above suffering from moderate to severe pain due to OA of knee joints attending the orthopaedics OPD of the National Medical College were recruited according to inclusion and exclusion criteria. Pain intensity was measured by 10 point VAS score on baseline and 2 follow up visits at 1st and 2nd week. Patients were given 50 -100 mg twice daily oral tapentadol tablets. ADRs were noted and data analysis done. Results: Total of 84 with baseline mean VAS score was 4.7 (SD 0.62). Significant reductions from baseline were noted at 1 week and 2 weeks follow up visits. At first follow up visit i.e on week 1 the mean pain intensity score was 2.48 (SD 1.45) whereas in 2nd follow up visit on week 2 it was 1.7 (SD 1.39). The change in pain intensity score were statistically significant (p<0.0001) for both the situations. Adverse drug events were mostly non serious. Commonly presented ADRs were diarrhoea, nausea, dizziness, constipation and hyperhidrosis. The incidence were around 6%. Conclusion: This observational study of pain relief in patients suffering from moderate to severe pain due to OA had been treated with tapentadol showed significant clinical improvement with few adverse effects. There are limitations due to small sample size and non-comparative design.
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Introduction: Laparoscopic cholecystectomy (LC) is the gold standard treatment of symptomatic cholelithiasis. The need of the hour is to understand the fact that PSI is a totally different subset of infection and antibiotics are not a solution to this problem. The core issue of “prevention” is the principal solution. The study was undertaken to revalidate these well known facts with an effort to bring about a radical reform to this “social” rather than clinical problem. Material and Methods: The study comprised of 60 patients admitted for elective LC. The first thirty patients undergoing elective LC were given single dose (SD) ciprofloxacin (500 mg) within an hour between the induction and making of the first port. While the control group received ciprofloxacin (500mg) post-operatively in the ward from ward nurses (MD). Operation-room anesthetic assistant administered prophylactic antibiotics at induction of anaesthesia to all the patients. Results: Of the 30 cases that received single dose prophylactic antibiotic pre-operatively, 16.67% were males and 83.3% were females. And, of the 30 cases that received multiple dose prophylactic antibiotic pre as well as post-operatively, 10% were males and 90% were females. Analysis showed that there was no statistically significant difference across the groups in regard to the duration of preoperative hospital stay. Of the 30 cases that received single dose prophylactic antibiotic preoperatively, only one patient suffered gross contamination during the surgery. Conclusion: The rate of early PSI after administration of single dose ciprofloxacin (500 mg) intravenously at induction of anesthesia and multiple dose ciprofloxacin (500 mg given thrice or four times) intravenously post-operatively for two or three days in addition to peri-operative dose is comparable in elective laparoscopic cholecystectomy. Furthermore, hospital cost can be reduced with single dose antibiotic regimen. So single dose of ciprofloxacin 500 mg can be used safely in elective cases of laparoscopic cholecystectomy to avoid infection at port site.
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Background: Rural Bengal has one of the highest snakebite prevalence in India. This prospective observational study was initiated with the motive to analyse the effects and adherence to implementation of the new national snakebite protocol 2016.Methods: Data were collected from the patients admitted with snake bite on a pre-designed and pre tested case study form and analysed with the help of descriptive statistics.Results: A total of 75 patients arrived in the hospital during the study period out which 53 were male (most in the age group of 31-40 years) and majority of them were farmers (26.6%) or housewives (25%). Maximum of them were bitten in the lower limbs (54.6%) and peak time of bite was between 6 am-12 pm (40%). Most of them reached the hospital late, i.e., beyond 2 hours (70.6%). It was found that there were 26 neurotoxic, 16 hemotoxic and 1 neuro-hemotoxic cases and the rest were non-venomous cases. Fifty-one of them received ASV and 4 died. There was 80% adherence in the indication of ASV administration, 73.3% in the ASV dose, 32% in the monitoring after ASV administration, 94.66% in the monitoring 20 WBCT, 100% in adherence to haemodialysis as indicated.Conclusions: The results showed good adherence in all the parameters. Protocol guided treatment has also resulted in rational use of ASV. So, from this study, it was concluded that protocol guided treatment is effective in snakebite management, but its continuous revision and amendments should be considered in future.