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Introduction: This study assumes significance as it compareshead on DPP-IV inhibitors along with other oral hypoglycemicagents with respect to glycemic and non-glycemic targets.Study was done to evaluate the DPP-IV inhibitors andother oral hypoglycemic agents (OHA) either alone or incombination, with reference to glycemic targets like fastingplasma glucose (FPG), post prandial glucose (PPG) andglycosylated hemoglobin (HbA1c) in type 2 diabetes mellitus.Material and Methods: This was an open labelledcomparative study and included 90 patients with Type 2 DM.These patients were divided into 3groups: Each group wascontaining 30 patients i.e. Group A: DPP-IV inhibitors (n=30); Group B: Oral hypoglycemic agents other than DPP-IVinhibitors (n= 30) and Group C: DPP-IV inhibitors + other oralhypoglycemic agents (n= 30). The patients were given drugson the basis of physician’s discretion, depending upon theglycemic of the patients at the time of presentation. A detailedhistory regarding age, sex, profession, duration of disease,treatment history, family history and personal history wastaken for each patient. After stabilization patients observed at0 weeks, 6 weeks, 12 weeks and 24 weeks.Results: Mean duration of diabetes was 5.35±0.53 years, andthe mean age of onset of diabetes was 46.98±0.91years. Therewas no significant difference between the study groups withrespect to FPG, PPG, and HbA1c levels. The HbA1c showedsignificant improvement in each group at the end of studyperiod.Conclusion: In summary, this study showed that treatmentwith sitagliptin, either alone or in combination with other oralhypoglycemic agent led to clinically meaningful reductionsin HbA1c, FPG and PPG over a 24 week period. Sitagliptinpresents an alternative therapeutic strategy for patientswith type 2 diabetes and, in general, showed significantimprovements in glycemic control and is well tolerated,particularly with regard to weight change and hypoglycemia.
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Background: Postgraduates when join Pharmacology department, they don’t have much idea about guidelines and methods to do animal experiments. This study was designed to sensitize postgraduate students to animal experiments by evaluating the anti-inflammatory effects and the efficacy of diclofenac, tramadol and etoricoxib in reducing paw edema in wistar rats.Methods: The wistar rats of 225-250gram were divided into four groups (n=10 each). In all the groups the paw edema on right paw was created using 0.1ml of 1% formalin subcutaneously. Group 1 rats (control), group 2 were given diclofenac, group 3 were given tramadol and group 4 were given etoricoxib orally. The parameters assessed were water displacement in plethysmography after 2, 4, 24, 48 hours of giving the drug. The circumference of edematous paws after 4 hours, licking of paw was observed over 30minutes of giving the drug and was compared. Pre and post study feedback were obtained from the students by using a preformed questionnaire to assess the knowledge gained by the students.Results: The test showed that all the drugs were effective in reducing inflammation, circumference of edema and the licking duration significantly (p<0.05). The post study answering of questions by postgraduate was 100% in comparison to pre-study answering which was 33%.Conclusions: A short animal study conducted as a teaching tool to postgraduate students was able to teach the guidelines of animal experiments and handling of animals effectively.
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Background: Depression is an important global public health problem and is a major cause of disability and premature death. The present study was conducted to compare effi cacy and safety of amisulpride and escitalopram on Hamilton anxiety rating scale (HAM-A) among depression patients in a tertiary care teaching hospital in Nepal. Methods: The study was conducted in patients for 1-year in the Department of Neuropsychiatry, Nepalgunj Medical College and Teaching Hospital. A total of 117 depression patients were divided into two groups. Group I (58 patients) received amisulpride tablet at a dose of 50 mg/day and Group II (59 patients) were given escitalopram at a dose of 10 mg/day. The patients were required to follow-up at 4, 8 and 15 weeks. The effi cacy of the drugs was calculated by HAM-A. Adverse drug reactions (ADRs) were monitored at every follow-up. Appropriate statistical tools using Graphpad instat 3.0 were used for analysis p<0.05 was considered signifi cant. Results: HAM-A score in group receiving amisulpride at 0 and 15 weeks was 19.83±0.33 and 8.17±0.32 (p<0.0001). HAM-A score in group receiving escitalopram at 0 and 15 weeks was 20.76±0.28 and 8.98±0.24 (p<0.0001). Gastrointestinal disturbances, sexual disturbances, amenorrhea, lactation, agitation, and insomnia were the commonly encountered ADRs. Conclusion: Both amisulpride and escitalopram were highly effective in the treatment of anxiety in depression patients during the study period. Further, more clinical studies with longer follow-up duration are needed to substantiate the therapeutic effects of amisulpride.
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Background: There is a need to introduce clinical pharmacology at the undergraduate level in order to improve rational prescribing of medicines. The present study was undertaken to analyze drug utilization pattern of genitourinary infections to teach certain basic skills to MBBS students which will form an integral component of practicing rational therapeutics. Methods: The retrospective study was conducted by Pharmacology Department in Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIM and HS). A total of 92 prescriptions were collected by second professional MBBS students and randomly evaluated for prescribing pattern using WHO drug indicators. Results: A total of 92 prescriptions were analyzed. Male:female ratio was 1.96:1. Age wise distribution was done: 0-15 years were 14 (15.21%), 16-30 years were 26 (28.26%), 31-45 years were 24 (26.08%), 46-60 years were 19 (20.65%), and >60 years were 9 (9.78%). A total of 260 drugs were prescribed. 116 (44.61%) antimicrobials, 70 (26.92%) antacids and antiemetics, 40 (15.38%) analgesics, 11 (4.23%) urinary alkalizers, 9 (3.23%) antifibrinolytics, and 14 (5.38%) miscellaneous drugs were prescribed. 144 (55.38%) injectable and 116 (44.61%) oral drugs were prescribed. Numbers of fi xed-dose combinations were 32 (34.78%). 2.82 drugs per prescription were prescribed. 171 (65.76%) drugs were prescribed from National List of Essential Medicines 2013 (NLEM 2013). Majority of drugs were prescribed by brand names. Conclusion: Majority of drugs were prescribed from NLEM 2013. The main purpose of undergraduate medical curriculum is to develop the requisite diagnostic and therapeutic skills of a basic doctor. It is only by drug utilization studies that burden of diseases and corresponding utilization of drugs can be measured.
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Background: The effects of statins apart from their role as cholesterol lowering agents have prompted this study to evaluate their antihypertensive role. Beta-blockers (BB) are one of the most effective drugs in hypertension. The present study was designed for comparative evaluation of BB with or without statins in the treatment of essential hypertension in a tertiary health care setup. Methods: This study was conducted in 20 hypertensive patients by Pharmacology Department in Medicine outpatient department at SGRRIM and HS Dehradun for 1 year. Initially, patients were stabilized for 4 weeks by BB and then subdivided into 2 groups. Group I: BB (n=10) and Group II: BB+statins (n=10). Patients were followed up every 4 weeks for 16 weeks. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), waist hip ratio (WHR), body mass index (BMI) were done every visit. Lipid profile was done at 4 and 16 weeks. Analysis was performed using t test. p≤0.05 was significant. Results: At 4 and 16 weeks, SBP in Group I was 133.6±3.7 and 127±1.61 mmHg (p>0.05) and in Group II was 141.2±2.97 and 130.6±0.71 mmHg (p<0.01). At 4 and 16 weeks DBP in Group I was 79.6±2.37 and 81±0.54 mmHg (p>0.05) and in Group II was 84.6±1.39 and 83.8±1.45 mmHg (p>0.05), respectively. At 16 weeks intergroup SBP and DBP comparison was done, which was not significant (p>0.05). At 4 and 16 weeks improvement in lipid profile in Group I (p>0.05) was not significant, but a significant improvement in Group II (p<0.05) have been observed and no significant changes in BMI and WHR in Groups I and II (p>0.05), respectively. Conclusions: Both groups showed significant improvement in BP. However, no significant difference was seen on intergroup comparison. Larger studies with more patients are needed to establish the role of statins in hypertension.
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Background: Adverse drug reactions (ADRs) are one of the major causes of hospital admissions. The objective of this study was to ascertain the various ADRs occurring in a tertiary care teaching hospital at Dehradun, Uttarakhand. Methods: The ADRs were collected from January 2010 to June 2014 by the Department of Pharmacology in Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand. A total of 123 ADRs were collected, analyzed and assessed on WHO causality assessment scale. Results: A total of 123 ADRs were assessed. Male:female ratio was 1.5:1. Age-wise distribution of ADRs was done: 0-15 years had 15 (12.19%), 16-30 had 50 (40.65%), 31-45 showed 25 (20.32%), 46-60 years 22 (17.88%) and >60 years had 11 (8.94%). 112 (91.05%) ADRs were serious, and 11 (8.94%) were non-serious. As per the WHO causality assessment scale, 91 (73.98%) ADRs were probable, 30 (24.39%) were possible, and 2 (1.62%) were certain. Most commonly occurring ADRs were fixed drug eruption in 42 (34.14%) patients, erythematous maculopapular rash in 20 (16.26%) patients and urticarial rash in 15 (12.19%) patients, followed by others. The drugs most frequently associated with ADRs were non-steroidal antiinflammatory drugs (NSAIDs), fluoroquinolones, penicillins, cephalosporins and phenytoin sodium, followed by others. Conclusions: Majority of ADRs were probable according to WHO causality assessment scale. Most common ADR was fixed drug eruption. Most frequent drugs associated with ADRs were NSAIDs. ADRs contribute to increased morbidity and mortality in patients; thereby pose a huge burden on the society.
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Background: Prehypertension is associated with an increased risk of the development of hypertension and persistent hypertension can lead to cardiovascular diseases. According JNC-7, prehypertension Is SBP of 120–139 mmHg or DBP of 80–89 mmHg. Aims & Objective: Estimation of prehypertension in young medical students and sensitizing them at an early stage about importance of life style modifications can help in preventing hypertension and subsequent cardiovascular diseases. Material and Methods: A total of 400 students were enrolled in the study. Information was collected related to their BMI, dietary habits, and exercising habits. After a rest of twenty minutes three readings of blood pressure, at one minute interval were taken and mean of three readings were recorded. Results: The overall prevalence of Prehypertension was 58.75%. Prevalence of prehypertension systolic and diastolic was 41.5% and 38.5% respectively. Prevalence of hypertension was 5%. Conclusion: There is a need for practicing life style modifications at an early stage. Modern life style is responsible for increasing prevalence of risk factors that increase the risk of cardiovascular events.