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Background: Antiepileptic drugs (AEDs) have been used for the treatment of epilepsy and other neurological disorders since 19th century. Several classes of AEDs are available for epilepsy, many of them are also used for migraines, bipolar disorder, schizophrenia, depression, and neuropathy. Methods: Total 212 patients participated in an Ambi-directional observational cohort study conducted at Mallige medical center, Bangalore. Reviewed and evaluated both inpatients and outpatients case sheets and the data were entered into Microsoft excel. The data was analysed using version 27 of SPSS and statistical significance was determined by using p value less than 0.05 and Pearson correlation. Results: The result show that among 212 patients 130 were males and 82 females and the major risk factors were hypertension and type 2 diabetes mellitus. Levetiracetam and pregabalin were the commonest AED prescribed. Among 109 adverse drug reaction (ADRs) occurred in 82 patients, dizziness, and sedation (20%) were common. Valproate (17.4%) was the main drug causing ADRs and treatment was discontinued in 2 patients due to phenytoin (PHT) toxicity. A total of 90 drug-drug interaction (DDI) was observed using online drug database. Conclusions: This study revealed that monitoring and evaluating the prescription pattern in these patients enables modification in prescribing pattern that improves the patient抯 quality of life and can reduce drug related problems. Clinical pharmacist plays an important role in evaluating the prescribing pattern of drugs based on standard treatment guidelines and rationality of prescriptions.
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A series of systematic, criterion-based drug evaluation known as Drug utilization review are conducted on a regular basis to ensure that medication is utilized appropriately. It’s a mean of learning more about the issues brought on by drug usage, if done properly, may help to solve the issues. Medication adherence generally refers to a patient’s ability to take prescription drugs as directed and their continued use of those drugs. The increasing body of research linking medication non adherence to unfavorable outcomes and increased healthcare cost has raised concerns among clinicians, healthcare institutions, and other stakeholders. Pharmacovigilance, in which the procedures keeping an eye on the assessing adverse medication reactions, is essential to clinical practice, public health and efficient drug regulating system. Aim of the study was wo study about the role of pharmacist in drug utilization review, medication adherence and pharmacovigilance.
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Background: Cerebral palsy (CP) is one of the leading causes of childhood disability worldwide with the greatest burden found in developing countries. This study is undertaken as there is limited data available regarding CP children in the Andhra Pradesh region. This study was done to evaluate the clinical spectrum, risk factors, and comorbidities associated with CP that will help in better understanding of etiology and for early intervention by District early intervention centers.Methods: This is a hospital-based prospective observational study conducted over 18 months among children from 6 months to 5 years of age visiting a tertiary care hospital.Results: Among 65 enrolled children majority of the children (74%) were between 2 to 5yrs with a male-to-female ratio of 4:1. Consanguinity was observed in 33.8% and the majority were from rural areas (71%). The most frequent presenting complaint was delayed milestones (33.4%). 67.6% of subjects were born at term with the most common risk factor being birth asphyxia (27.6%). The most common type was spastic CP (87%) in whom the Developmental quotient (DQ) was severely affected (56.7%) and 32.3% of children belong to GMFCS level III. Comorbidities like feeding difficulties and GERD (47.6%), visual problems (24.8%), and hearing problems (30%) were commonly associated. At the time of enrollment, only 21.5% of children had normal nutritional status which improved to 30.7% after 12 months of follow-up.Conclusions: Efforts should be made to increase awareness among parents regarding the availability of encouraging utilization of the services to relieve the burden of disorder.
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Background: In India, infectious diseases continue to be predominant with emerging non-communicable diseases, imposing a double burden of diseases on health care system. Hence, the tertiary health care hospital-based study was done to compare the morbidity pattern of communicable diseases with respect to non-communicable diseases. Methods: A 2 years’ record-based data of admitted patients was collected in a tertiary health care hospital. The data was analysed using Microsoft Excel version 365. Significance of association and difference in proportions has been checked with chi-square test and Z test for SEDP respectively at significance level of 0.05. Results: During the study period of two years, 6818 patients were admitted in the hospital, of which 74.51% suffered from communicable diseases while 25.49% suffered from other types of disease including non-communicable diseases. Of the 5080, patients with communicable diseases, 57.74% were males and 42.26% were females. Communicable diseases and non-communicable diseases had male predominance (p<0.05) and was higher amongst age group 0-15 years (p<0.05). Hospital stay was prolonged in patients suffering from communicable disease (p<0.05). Significant increased difference was found in AFI, Malaria, Dengue and in Leptospirosis prevalence and significant decreased difference was found in acute gastroenteritis, IV, Covid-19, Respiratory infections and enteric fever (p<0.05). Conclusions: Communicable diseases continue to be a major threat to public health system in India. Through effective surveillance programmes, any change in trends of disease can be identified and suitable measures can be adapted to control and prevent it.
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Background: The untoward events of COVID-19 led to the enforcement of work from home (WFH) for nearly every wage earner across the globe. One of the several fields that saw its implications was the IT sector. We conducted the following study to understand how the IT techies have been affected by the shift in their workspace- from their cubicles at work to the tables at home and the implications of this shift on their general and mental health. Methods: A cross sectional study was conducted in January 2021. A Google form was circulated among IT professionals. Sample size was calculated by universal sampling technique. Data collected was entered in MS Excel and analysed using SPSS version 26. Results: Among the 47 received responses, the mean age group of the study sample was 20-30 years. 73.9% felt that personal obligations interrupted their work which led to increased frustration. There is also a rise in the incidences of backpain and eyestrain. The mean stress score of the study sample was 17.85±5.729 and though 80.9% felt they had a comfortable place at home to work, 62.52% of them wished to return to their workplace. Conclusions: Better innovative strategies need to be thought of and implemented to help employees have an efficient work-life balance.
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Background: Nutrition in the first two years of life is important for growth and development among children. To tackle undernutrition during this period, timely initiation of breastfeeding and quality of complementary feeding practices are essential. So, this study was planned to determine feeding practices associated with severe acute malnutrition children. Methods: This was hospital-based case-control study with 1:1 ratio of cases (77) and controls (77). Cases and controls were matched for age and sex. Cases were selected from Nutritional Rehabilitation Centre and controls from Immunization clinic. Mothers were interviewed about feeding practices, immunization status and illness of their child. Weight and height of children were also measured. Results: Children who received pre-lacteal feeding were associated with SAM. Most of cases (62.3%) and controls (70.1%) had received breastfeeding within 1 hour of birth. Among children of <7 months age, 71.4% cases breast-fed <8 times in 24 hours. Among children of 7 months to 2 years, SAM was associated with children who were not received complementary feeding (CF) at correct age, not received semi-solid/solid diet, CF not added with ghee/oil and feeding frequency <5 times in day. Among cases 18.2% and only 1.3% controls had >3 ARI episodes in last 6 months. Conclusions: Among identified independent risk factors (p<0.05), type of CF, not adding ghee/oil in CF and feeding frequency (BF+CF) <5 times were associated with SAM among 7 months to 2 years. Hospitalization history and >3 ARI episodes in last 6 months were also associated with SAM.
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Malnutrition is a nationwide issue that is quickly getting worse. Malnutrition hinders social and mental development in addition to slowing down a child's growth and development and also pregnant, lactating women, adolescent girls. It also increases the likelihood and length of illness.Long-term consequences of under nutrition include cognitive and development deficiencies as well as lowered infection resistance.With the purpose of evaluating the nutritional security of farm households, the current study seeks to comprehend the value of nutrition gardens. The current study was carried out in Prakasam district, Andhra Pradesh, consecutively for two years.From the recipients of the KVK front line demonstration programme on nutrition security, 90 respondents (50 with nutrition gardens and 50 without) were chosen at random.The 200 m2 area wasfound appropriate for the medium family group of five members. Among the vegetables cultivated in nutria garden, highest benefit was obtained from the cultivation of okra (1: 2.38) followed by spinach (1: 1.48). There was increase of 90g of consumption of vegetables after nutri garden. After nutri garden the normal weight percentage of individuals was 51.1% and underweight individuals were 35.5%.The nutritional garden encouraged families to include freshly picked vegetables in their daily diets, which helped to improve their families' nutritional condition.
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Background: The burden of infectious disease is high among kidney transplant recipients because of concomitant immunosuppression. Methods: Study was a retrospective and prospective cohort study. The study was conducted for a period of 12 months and 30 transplant recipients were included. Results: Males comprised 86.66% of the study population. The mean age of the recipients was 37.96 years. UTI was the most common post-transplant infection observed in 15 patients (50%) of 30 patients. E. Coli infection was most predominant (50%) causing UTI. 5 patients (16.66%) in this study developed tuberculosis after renal transplantation. Two patients (6.66%) developed CMV infection in the study. Two patients (6.66%) developed COVID-19 infection in the study. Two patients (6.66%) developed herpes infection post-transplant. One patient (3.33%) in the study developed cryptococcal meningitis. One patient (3.33%) developed hepatitis C after 18 years of transplant. One patient (3.33%) developed hepatitis B after 10 years of transplant. Three patients (10%) developed lower respiratory tract infection and developed acute respiratory distress. Three patients (10%) had developed acute graft rejection within first year after transplantation. There are total of 13 deaths (43.33%) among 30 patients all of which were secondary to infections. Total of 4 patients among the 13 deaths had chronic graft rejection. Most common cause of death was tuberculosis (38.46%) followed by UTI (23%) and Lower respiratory tract infection (23%). Conclusions: The incidence of infections is relatively higher in kidney transplant recipients when compared to general populations due to immunosuppression.
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The management of Pink bollworm, a worldwide pest in cotton is mostly dependent on chemical insecticides which lead to several implications and warrant the exploration of other methods. Use of sex pheromones for management of insect pests is not a new-fangled one but need be studied extensively for effective pest management. Hence, a study was conducted at RARS, Lam, Guntur, Andhra Pradesh for two consecutive seasons to study the effectiveness of mass trapping in pink bollworm management. The experimental results showed that the mean moth catch was highest from sleeve traps when compared to funnel trap and delta traps with sticky liners irrespective of trap densities. The mean number of larvae and locule damage was significantly low coupled with high seed cotton yield from the plots with sleeve traps at trap densities of 50 and 20 traps/ha.
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Chilli is an important high value spice crop, its integrated crop management is an important area for the welfare andlivelihood security of farmers. Most of the farmers of Prakasam district of Andhra Pradesh are growing wide varieties and cultivars of chilli but so far the research findings on chilli integrated crop management were less aware. To know the yield potential of integrated crop management and its economic impact, evaluation on integrated crop management was conducted at Chandhaluru and Nallaguntla Guedm villages. The adopted package of practices was seed rate @1kg/ha, spacing 60x45cm, FYM 15t/ha, Urea, single super and muriate of potash256:150:80 kg/acre. There was wide variation between integrated crop management and farmers practice in fruit yield and economic returns. The results on yield and economic returns indicated that chilli integrated crop management was found superior to farmers practice. Integrated crop management could obtain 124 fruits per plant and yield of 47.00q/ha, thirps incidence (24.3%), whitefly incidence (9.67 %) and fruit rot infestation (6.0%). Whereas,in farmers practicefruits obtained were99per plant and yield of 43.00q/ha, thripsincidence (44.67 %),whiteflyincidence (28.33) and fruit rot(18 %) with a net income of Rs220000/- and B:C ratio 1: 1.88 compared to farmers practice with a net income of Rs113333/-with B:C ratio 1:1.36. The integrated crop management percent yield increased over farmers practices8.5 per cent. It was concluded that integrated crop management could help to improve the economy of the farmers.
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A study on effect of pre-sowing seed treatments with organics, chemicals and plant growth regulators on seed germination and seedlings growth of papaya cv. Arka Surya was carried out at YSRHU- College of Horticulture, Anantharajupeta during the year 2021 - 2022, under complete randomized design with eighteen treatments and replicated thrice. The papaya seeds were subjected to various organic, chemicals and plant growth regulators treatments. Papaya seeds soaked in KH2PO4 @ 0.5% (T7) had recorded minimum days for initiation of germination (8.67) and 50% germination (10.34). The treated seeds had also recorded maximum germination percentage (86.66), germination index (1.16), dry weight of shoots (2.00 g), tap root length (26.33 cm), number of lateral roots per seedling (22.84), dry weight of roots (0.79 g), quality index of papaya seedlings (0.47) and seedling survivability (100.00%). In addition the same treatment exhibited higher chlorophyll content (3.51 and 3.91 mg/g), photosynthetic rate (15.32 and 17.76 µmol Co2m-2s-1), transpiration rate (4.61 and 5.69 mmol m-2 s-1) and stomatal conductance (2.73 and 4.12 mol m-2 s-1) at 35 and 45 DAS, respectively. While the lowest values for germination and growth parameters were observed in treatment salicylic acid @ 2 mM (T16). Among all the treatments, KH2PO4 @ 0.5% (T7) was found to be superior to the other treatments followed by KNO3 @ 0.5% for the enhancement of germination, growth and physiological traits.
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One of the most essential inputs for agriculture is water. Moisture stress at critical growth stages in wheat severely effects the growth and yield. Hydrogel (water-absorbing polymer) can keep the appropriate moisture level at the root zone depth and protects the crop from adverse effect of moisture stress. The present trial was conducted during rabi season of 2020-21 to assess the performance of different hydrogels under different levels of irrigations on growth, yield, and water use efficiency of wheat. Results revealed that application of 3 irrigations recorded significantly maximum number of tillers per m2 at 90 Days After Sowing and at harvest. The application of Nano hydrogel @ 20 kg ha-1 significantly increased the number of tillers per m2 at 90 DAS and at harvest over control. Significantly maximum grain (26.1%) and straw (24.5%) yield were obtained with 3 irrigation levels over one irrigation. The Nano hydrogel increased grain (33.6%) and straw (22.9%) yield significantly over control. Water use efficiency significantly improved with one irrigation over 3 irrigation levels, application of Nano hydrogel @ 20 kg ha-1 significantly increased WUE.
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The experiment was carried out to study the genetic variability among 56 genotypes of cluster bean at Central Horticultural Experiment Station (ICAR-CIAH), Godhra, Gujarat during the year 2020, 2021 and 2022. Significant inter- genetic differences were recorded for all the plant characters. The highest estimates of genotypic co- efficient of variation (GCV) and phenotypic co- efficient of variation (PCV) were observed in case of pod yield per plant (86.50 and 86.30), pods per plant (65.27and 64.98) followed by pod weight (51.34 and 50.90), pods per plant (65.27and 64.98) and pod length (31.14 and 31.00) indicating that a greater amount of genetic variability which allow greater scope for selection in these traits. High heritability was recorded all the character under study viz., for plant height (98.60%), number of pods plant (99.10%), pod length (99.60%), pod girth (95.10%), pod weight (98.40%), days to first flowering (99.30), days to first harvest (95.60) and pod yield per plant (99.60%). High genetic advance as per cent mean was observed for plant height at (31.98%), number of pods per plant (133.30%), pod length (63.88%), pod girth (27.81%), pod weight (104.08%) and pod yield per plant (177.45%) whereas, the moderate genetic advance as per cent of mean was observed for days to first flower (14.83%) and days to first harvest (11.38%). Both high heritability (broad sense) and genetic advance were high for pod yield/ plant (99.60% and 177.45%), number of pods/ plant (99.10% and 133.30%) followed by pod weight (98.40% and 104.08%). Such high heritability, followed by such rapid genetic advancement, suggests that selection may be beneficial for such qualities. High heritability coupled with high genetic advance as per cent of mean traits were under the strong influence by additive gene action and hence simple selection based on phenotypic performance of these traits would be more effective and genetic improvement for these characteristics might be considered.
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Abstract Objective: Investigate the influence of posterior crossbite on masticatory and swallowing functions by videofluoroscopy examination and to analyze the effects of Rapid Maxillary Expansion (RME) on the same functions. Methods: A prospective longitudinal study was conducted on 32 children, 21 of them with posterior crossbite (10 girls and 11 boys, mean age 9.2 years, study group) and 11 children with no occlusal changes (6 girls and 5 boys, mean age 9.3 years, control group). The children were evaluated by an orthodontist for diagnosis, group characterization and occlusal treatment, by the otorhinolaryngology team for the assessment of respiratory symptoms, and by a speech therapist for videofluoroscopic evaluation of masticatory and swallowing parameters. The children with posterior crossbite were treated orthodontic ally using the Haas disjunctor for approximately six months and re-evaluated 5-months after removal of the appliance. Data were analyzed statistically by the Studentt-test for independent samples for comparison of the crossbite and control groups before and after treatment. Results: There was no significant difference in oral preparatory and oral transit times, nor in cycles and masticatory frequency, between the pre and post orthodontic treatment groups and the control group. Conclusion: Rapid maxillary expansion did not influence the masticatory and swallowing variables studied by videofluoroscopy. However, the data require caution in interpretation.
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Background: The debate of “is it worth spending the busy pathologist’s time on gall bladder specimens” has been there for decades. The selective approach may result in missing discrete pathologies such as premalignant lesions. We are presenting an interesting series of gall bladder histopathology diagnosed at our institute in the past two years. Methods: This is a retrospective study done at Bhaskar Medical College between 2020-2022 (specifically chosen as this is the period of COVID pandemic). This study included 43 patients who underwent cholecystectomy. All confirmed cases of acute abdomen operated for other reasons and trauma were excluded. Sections were taken from neck, fundus, body and cross section of cystic duct of each cholecystectomy specimen. The whole gallbladder was submitted and screened for the invasion in ICPN case. These sections were processed through routine paraffin embedding, microtome cutting and H&E staining for evaluation of spectrum of various gallbladder lesions. Results: In our study, 25 cases showed lymphoplasmacytic infiltration with fibrosis, 9 cases showed ulceration, congested blood vessels and neutrophilic infiltration. We encountered few rare cases like eosinophilic cholecystitis, xanthogranulomatous cholecystitis, and Intracholecystic papillary neoplasm (ICPN)”. Pyloric metaplasia was seen in 27.9% cases, which is also higher Conclusions: Our study emphasizes the need for the routine examination of these specimens, to have a detailed understanding of the etiology to prevent/predict the other associated medical conditions. We also could find 2% of the cases having pre-malignant lesions and 28% having metaplasia, which if missed shall progress to malignant conditions.
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Background: Rabies is a fatal but vaccine-preventable disease. Prevention of rabies in exposed individuals is possible by providing them with the proper post-exposure prophylaxis. This study aims to assess the compliance to post-exposure prophylaxis in animal bite cases and factors associated with it. Methods: A cross sectional study was conducted between September 2022 to November 2022 using a predesigned, pretested proforma to interview 300 patients attending anti-rabies vaccination clinic in a tertiary health care centre in central India. Results: Majority of the patients 268 (89.3%) suffered category 3 animal bite and 32 (10.7%) patients suffered category 2 animal bite. 125 (41.7%) patients washed the wound with water, soap and applied antiseptic. 234 (78%) patients completed their last dose of anti-rabies vaccine (ARV) while compliance to Rabies Immunoglobulin (RIG) was seen in 167 (63.3%) patients of all cases requiring it. Out of all the patients who took Equine RIG, 7 (4.5%) showed hypersensitivity reactions. Significant association was found between compliance to ARV with type of animal and status of animal after 10 days; and compliance to RIG with gender, socio-economic status, type of animal and type of wound. Conclusions: Compliance to ARV and RIG in our study was 78% and 63.3% respectively. Major reason for poor compliance to RIG was the price of immunoglobulin. Health education regarding significance of post-exposure prophylaxis is needed among the population.
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Background: The number of antenatal visit & timing of first visit are important for health of mother and outcome of pregnancy, it is proved by research studies that earlier registration and regular ANC visits helps in preventing adverse pregnancy outcomes. Various study shows that ANC utilization varies with mothers age, occupation, education, income, parity, place of resident, availability and cost of services. Methods: A Community based cross-sectional study was conducted. The Anganwadi centres were taken as the study area, the study participants were postnatal women up to 42 days after delivery. The primary data collection was done using semi-structured questionnaire by recall method after taking written informed consent. The details of antenatal visits and service utilization were asked. Results: Most of the participants uses the ANC packages however optimal utilization is lacking. 49.24% has taken ?4 ANC visits. 58.97% have taken ?180 IFA tablets while 30.40% have visited for their first Ante-natal visit within 12 weeks. Ante-natal mothers who were working and those belonging to lower middle class visited less than 4 times for ante-natal visits. Ante-natal mother below 20 years of age were having lower consumption IFA tablets. >12 weeks for 1st Ante-natal visit was taken by Ante-natal mothers who were working and belonging to middle class. Conclusions: There is suboptimal utilization of the ante-natal service package. Pregnant woman who were daily wage worker as well as middle class and lower class reported less visits and delay in reporting health facility.
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Background: Hypertensive emergency is defined by systolic blood pressure (SBP) ?180 mmHg and/or diastolic blood pressure (DBP) ?120 mmHg with acute target organ damage. Hypertensive emergencies can be life threatening and fatal unless timely treated. In the present study we aim to study the clinical profile and outcome of patients admitted with hypertensive emergency in the medical intensive care unit in our hospital. Methods: A cross-sectional observational study of all cases with hypertensive emergency admitted in Medical Intensive care unit (ICU) in Government General Hospital, Srikakulam during the study period was conducted. The clinical profile and outcome of the patients were assessed. Results: Out of the fifty patients in the present study, about 36 (72%) were males and 14 were females (28%) and about one third of the patients (36%) belonged to the age group of 60-69 years. Diabetes mellitus (30%) and dyslipidemia (40%) were the commonly encountered comorbidities in the study population. Most frequent presenting symptoms were neurological deficits (50%) followed by dyspnoea (32%) and chest pain (24%). Intracerebral haemorrhage was the commonest target organ damage found in 30% of the patients. Patients presenting with hypertensive emergencies with neurological target organ damage had statistically significant increased chance of mortality (p=0.007). Conclusions: As hypertension emergencies are consequence of uncontrolled hypertension, it is important to educate and bring awareness among public regarding the screening, early detection, and adherence to prescribed medication for hypertension to avoid adverse clinical outcomes.
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Seed coating is a method of encasing seeds in adhesive materials to improve germination and performance while lowering cost. Seed coating has been widely used in agriculture as an efficient way to reduce biotic and abiotic stressors, hence boosting crop growth, productivity, and health, in order to satisfy the demands of the development of precision agriculture. Plant-beneficial microorganisms include Trichoderma, rhizobium, arbuscular mycorrhizal fungusfungi and plant growth-promoting bacteria. Fungicide seed treatment is easy, affordable, and efficient. Additionally, it is well known that the selection of chemicals for seed treatment also has a favourable impact on seed viability and vigour during germination storage. Seed coating polymers are utilised in conjunction with active components like fungicides and insecticides. A new era of biocontrol techniques has recently begun. By utilising hostile microbes to fight seed-borne illnesses, new technology is being developed. Beneficial fungus like Trichoderma harzianum and Trichoderma viride are among the bioagents most powerful and efficient fungus- and soil-borne pathogen suppressants such as seedling blight, collar rot, stem rot, root rot, dry root rot, and their use may can effectively manage each of these illnesses, and thus encourage crop growth and yield.
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In recent days, several technological innovations were proposed in order to improve the production and sustainability through a significant reduction in use of agrochemicals. One 0f the best approach to increase crop productivity is the utilisation of environment-friendly organic products such as “Biostimulants”. There are different types of substances that act as biostimulants namely humic and fulvic acid, protein hydrolysates and other N-containing compounds, Seaweed extract and botanicals, Chitosan and other biopolymers, Inorganic compounds, beneficial fungi and bacteria. These biostimulants plays an important role in improving the plant growth, yield and quality of the product. The guava fruits coated with chitosan 1% and stored at 12°C had shown higher firmness, TSS, titratable acidity and maintained greenness with a slow increase in yellow colour by the end of storage. Knowledge on effective use of these biostimulants by understanding their properties has become a challenge to the researchers to improve yield, quality and shelf life of different horticultural products.