ABSTRACT
Background: Type 2 Diabetes mellitus (DM) is a heterogeneous group of disorders associated with both microvascular and macrovascular complications. Due to progressive nature of type 2 DM, dual / triple drug therapy produce additive effects, less side effects and allows the use of submaximal doses of individual agents. Therefore, the present study was designed to study the effect of voglibose in comparison to pioglitazone on glycaemic and lipid profile as an add-on drug in patients with DM whose glycaemic status was uncontrolled with glimepiride and metformin. Methods: The present study was open, randomized parallel group comparison of two active treatment groups over a six months period. Sixty patients of either sex in the age group of 30-75 years, suffering from type 2 DM, with FBG> 126 mg/dl and HbA1c between 7- 10 % were selected at random. The effect of voglibose and pioglitazone were observed on various parameters i.e. FBG, PPBG, HbA1c and lipid profile (Total cholesterol, TG, LDL, VLDL). Results: At the end of 6 months it was observed that though both pioglitazone and voglibose reduced FBG, PPBG and HbA1C significantly but pioglitazone caused a significantly greater percentage change in FBG as well as in PPBG whereas the difference in mean percentage change in HbA1C was not significant. Also, fall in total cholesterol, TG, LDL and VLDL was significantly greater with pioglitazone than voglibose. Few side effects were observed with voglibose and not with pioglitazone. Conclusions: Though pioglitazone and voglibose were equally effective in lowering HbA1C levels yet pioglitazone showed better results in improving FBG, PPBG and lipid profile as compared to voglibose. Pioglitazone had minimal side effects as compared to voglibose.
ABSTRACT
Background: Stroke is a medical emergency with mortality rate higher than most forms of cancer. Acute ischemic stroke is a complex entity with variable clinical manifestations depending on the site and extent of infarction. Besides standard treatment given to the patients, neuroprotection is being targeted to antagonize molecular events that lead to irreversible ischemic injury. Methods: In this study, role of Citicoline in acute ischemic stroke was studied. It was open label study of 12 weeks duration undertaken in Medicine department (emergency unit) of Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Amritsar. Total 40 patients were randomly divided into Group 1 and Group 2. Group 1 received standard treatment for acute ischemic stroke and Group 2 received citicoline in addition to standard treatment. Patients were assessed at admission and after every 24 hours till hospital discharge. Follow up of the patients was done at three weeks, six weeks and twelve weeks after discharge using National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS) and Modified Barthel Index (MBI). The data was statistically analysed using Mann Whitney test. Results: No significant difference was found between two groups with respect to MRS and MBI score throughout the study period. Statistically significant improvement was seen in citicoline group on NIHSS score by 2nd and 3rd day of admission and then on 12th week. Conclusions: Citicoline was found to be safe but with no statistically significant difference in treatment outcome between two groups.
ABSTRACT
Cannabis sativa L preparations have been used therapeutically since many years. Inspite of their medicinal value, the danger of its abusive potential led to the ban on its use in clinical practice in many countries. The recent research and in depth knowledge about the cannabinoid system which throw a light on their disease management potential has paved way for the cannabinoids to become a new therapeutic focus of attention. Cannabinoids are a group of compounds that mediate their effects through cannabinoid receptors which include CB1, predominantly expressed in the brain and CB2 which is primarily found in the cells of the immune system. Despite the addictive properties of cannabis, the therapeutic value of cannabinoids is too high to be put aside. Numerous diseases such as anorexia, pain, inflammation, obesity, cardiovascular disorders, neurodegenerative diseases, cancer, gastrointestinal diseases, hepatic disorders, skin related diseases, respiratory disorders like asthma and eye diseases like glaucoma have suggested cannabinoid agonists/ antagonists/ cannabinoids related compounds as potential treatment options. Developments of new specific ligands for the cannabinoid receptors are now underway and it needs to be seen, if in future, they can prove to be a boon for the medical world. The paper reviews the current understanding of the cannabinoid receptors, their ligands and their possible role in various diseases supported by preclinical and clinical studies.
ABSTRACT
Background: Diabetes mellitus is a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia associated with disturbances of carbohydrate, fat and protein metabolism. The treatment constitutes lifestyle management, exercise, weight control and antihyperglycaemic drugs like sulfonylureas, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, and meglitinide. Garlic has shown to have anti-hyperglycaemic and lipid lowering effects in various animal and human studies. Thus, this study was conducted to assess the antihyperglycaemic and lipid-lowering properties of Garlic in type2 diabetes patients with obesity. Methods: This was an open labelled prospective comparative study conducted on Type 2 diabetes mellitus patients with obesity where a total of 60 patients divided into two groups of 30 each (of either sex) were enrolled. Group 1 was given Tab. metformin 500mg BD/TDS after meals. Group 2 was given Tab. metformin in a dose of 500mg BD/TDS after meals along with Cap. Garlic (Allium sativum) 250mg BD. Patients were routinely investigated for fasting blood sugar, HbA1c and lipid profile i.e. Serum Cholesterol, HDL-C, Triglycerides and LDL-C at the start of the study. Patients were followed up at an interval of two weeks upto 12 weeks. Data obtained at the end of the study was statistically analysed using Student’s –t test. Results: It was observed that both metformin and garlic reduced FBG and HbA1c significantly but percentage reduction in FBG was more with garlic but, change in HbA1c was not significant. Fall in total CHL, TG, LDL and an increase in HDL were more pronounced in patients treated with Garlic when given along with Metformin. Conclusions: Therefore, garlic showed better results as an antihyperglycaemic and lipid lowering agent.
ABSTRACT
Background and Objectives: Assessment is a matter of continuing concern for medical teacher as it is supposed to steer student learning. Globally there is an increasing trend to move from subjectivity to objectivity. While the universities are custodial for modifying the examinations system as a summative assessment, what is more important for teachers is to mould their formative assessment. University examinations are criticized to be highly subjective and inadequate for covering full range of topics in Pharmacology. Further there is little scope for providing feedback to the students for continuous learning and improvement. In response to this it was decided to introduce multiple choice questions (MCQs) as a tool for formative assessment. Methodology: In the present study, the multiple choice questions were given along with the subjective questionsfrom the same topic to the students. The main aim was to improve the objectivity in students’ assessment by introducing MCQs as a formative assessment tool. To evaluate the affectivity of this pattern of assessment from the student’s viewpoint, we designed a feed back questionnaire which was analyzed. The MCQs were evaluated by doing Item analysis. Results: The overall feedback revealed that 89% of the students were of opinion that MCQs preparation and examination helped them in learning the subject, self studying, reasoning and enhancement of clinical skills. The present study also clearly indicates that MCQs alone are not sufficient to assess learning and should be used along with subjective tests. Conclusion: To make testing and assessment both fair and consequently valid, MCQs should be used strategically to test important subject content and it should be aligned with subjective tests.