ABSTRACT
Objective: The objectives of the study were to clinically evaluate the role of Rhus toxicodendron, a homoeopathic medicine, in its various attenuations (Q, 30C, 200C, 1M) prescribed as a single medicine or with other homeopathic medicines for relieving the signs and symptoms of arthritic disorders and also to determine their useful potencies, frequency of administration and building up a new dose repetition protocol and guidelines for practice. Methods: It was a multi-centric, observational study carried out between the years 2016-2018. A total of 91 patients with arthritic disorder were selected according to the pre-defined parameters. The detailed case recording was done for each case and the patients were monitored for assessing the status of their condition according to the pre-defined criteria and the results were evaluated. Results: Out of the 91 patients, 78 patients improved in varying degrees with marked improvement seen in 34 patients, moderate in 27 patients and mild in 17 patients. No improvement was seen in 13 patients. Conclusion: Outcome of the study shows that homeopathic medicines are useful in managing arthritic disorders. However, further study with predefined laboratory and radiological investigation needs to be conducted. Other objectives of the study which included identifying the most useful potencies of Rhus toxicodendron and their frequency of administration could not be achieved. From the available results, a dose repetition observation has been provided and further study for new repetition protocol and guidelines is being formulated for conducting further trials.
ABSTRACT
Objective@#Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons. In this study, we proposed the concept of C-NTS, a scoring criterion for NTS based on real scenarios (for example, history taking) and video recording, and verified its practical application effects.@*Methods@#Study objects were divided into the tutor group and the student group. The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree). The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females). Before and after the training, the tutor rated the same anonymous video by C-NTS. One-factor analysis of variance was used to compare the differences between and within the groups, and Kendall concordant coefficient was used to test the consistency by SPSS 22.0.@*Results@#After the tutor receiving training, Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017), which confirmed the effectiveness of the training.@*Conclusion@#C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment. Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.
ABSTRACT
Background: The benefits of optimum blood pressure (BP) control in patients with diabetes exceed the benefits of glycaemic control and extend to the prevention of both macro-vascular and micro-vascular complications in patients suffering from both hypertension and diabetes mellitus. Aims & Objective: To investigate the utilization patterns of anti-hypertensive drugs and to evaluate blood pressure (BP) control among diabetic-hypertensive patients with and without reduced renal function. Material and Methods: A prospective, observational study carried out at medicine department of SBKS Medical College and Research Centre, Piparia. The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function. Results: Total 63 antihypertensive medication episodes were prescribed for 50 patients. Out of which 76% patients were receiving 1 drug, 22% receiving 2 drugs and 2% receiving 3 drugs of different antihypertensive class. Most patients were receiving Angiotensin-Converting-Enzyme-Inhibitors (ACE-I)/Angiotensin-Receptor-Blockers (ARBs) (60%), followed by CCBs (24%), beta-blockers (20%), and diuretics (16%). Patients on monotherapy were mostly receiving ACE-I/ARB (65.78%). Beta blockers were more commonly prescribed in patients with reduced renal function (p=0.005). BP control was achieved in 63.15% patients in monotherapy and 33.33% in polytherapy group. Control of systolic and diastolic BP was significantly higher in patients without reduced renal function than patients with reduced renal function (p<0.05). Conclusion: There was suboptimum use of combination therapy among diabetic-hypertensive patients in general and specifically in developing countries as reflected by control achieved in systolic and diastolic BP which requires concern of all healthcare professionals.