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BACKGROUND Coronavirus disease 2019 (Covid-19) is an evolving disease with newly generated evidence related to the clinical management of Covid-19 patients. We aimed to compare two online learning schedules for disseminating new cardiopulmonary resuscitation (CPR) guidelines in terms of knowledge gain and acceptability among nurses. METHODS In a prospective randomized controlled study, 61 nurses trained in comprehensive cardiopulmonary life support (CCLS) were randomized to synchronous (n=31) and asynchronous learning groups (n= 30). The enhanced training module on CPR (ETMCPR) prepared by a team of experts was used to impart training to the nurses. Baseline data and pre-intervention knowledge of participants were collected using a structured demographic sheet and knowledge questionnaire (25 items) in a google form. Nurses in the synchronous group were provided training using ETMCPR through a licensed Zoom platform, while the nurses in the asynchronous group had access to the uploaded ETMCPR module in the e-learning platform. At the end of the intervention, the knowledge of the nurses was assessed along with their acceptability to the online learning schedule. RESULTS Both schedules of online learning were effective in improving the knowledge scores of the nurses (11.93 [3.26] v. 21.15 [1.90], p=0.01 and 11.71 [3.12] v. 20.32 [1.71], p=0.01). The mean acceptability scores of nurses in the asynchronous group were statistically lower than in the synchronous group (38.93 [2.50] v. 42.5 [3.08], p=0.007). CONCLUSION Both synchronous and asynchronous schedules of online learning were effective in disseminating updated CPR guidelines; however, nurses in the synchronous group were more satisfied with the learning schedule.
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Objective: Though systemic corticosteroid is used for treatment of COVID 19, questions regarding the appropriate dose, duration and type of corticosteroid use still remain unanswered. This study aimed to address, whether choice of systemic corticosteroid significantly influences the clinical outcome of COVID 19 patients. Materials and Methods: Studies reporting the comparison between clinical outcome of dexamethasone and methylprednisolone in treatment of COVID 19 were searched from inception till April, 2021. Random-effect model was used. Odd’s ratio (OR) and 95% confidence interval was expressed. I 2 statistics used for test of heterogeneity. Result: Three studies with 373 patients (160 in dexamethasone group and 213 in methyl prednisolone group) were included. Though, statistically significant reduction in all-cause mortality with methyl prednisolone group in comparison to dexamethasone group (OR=1.80, 95%CI: 1.08 to 3.01, P=0.02) estimated, sub group analysis of observational studies did not support the finding (OR=1.60, 95% CI: 0.88 to 2.92, P=0.12). No significant difference in terms of need for invasive ventilator or intensive care unit (ICU) between the 2 groups. The grade of evidence was very low for both the outcomes. Conclusion and Relevance: In the present context, both dexamethasone and methyl prednisolone are equally effective in the management of COVID 19.
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Background: Type 2 diabetes mellitus (DM) is a common chronic disease with increasing prevalence worldwide. Prolonged uncontrolled hyperglycemia, dyslipidemia are major risk factor for its complication like neuropathy. Since there is no definite treatment for diabetic neuropathy, this study aims to evaluate the effect of resveratrol on diabetic neuropathy in high fat diet with low dose streptozotocin induced type-2 DM model in wistar albino rats.Methods: First type 2 diabetic rat model was established. Wistar albino rats, fed with high-fat diet (HFD) rendered diabetic with streptozotocin, were divided into 6 groups, disease control (DC) treated with vehicle, standard control (SC) which received metformin, test groups treated with 5, 10, and 20 mg/kg b.w. of resveratrol and combination of half dose of metformin and resveratrol (10 mg/kg) (TC). A group of six normal animals served as normal control (NC), another six as HFD control. Fasting plasma glucose, lipid profile were measured one week after induction of diabetes. The animals were then treated orally for 2 weeks after which the same parameters were repeated. Behavioral biomarkers for neuropathy are measured in 4 weeks and 6 weeks of treatment. The in-vivo results were analyzed by one way ANOVA followed by Tukey抯 multiple comparison test for biochemical parameters and Kruskal Wallis test followed by Dun抯 multiple comparison test for behavioral biomarkers.Results: Increase in fasting plasma glucose (FPG), deranged lipid profile, increased neuropathy in DC compared to NC, HFD control while a significant decrease in FBG, improved pain behavior with SC, test groups (p<0.05) as compared to the DC group.Conclusions: Resveratrol prevents diabetic neuropathy.
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Background: Adverse drug reactions (ADRs) are one of the prime causes of morbidity and mortality, increase in hospital stay and socioeconomic burden on the patients. Periodic monitoring aids in formulating methods for safe usage of medicines in hospitals. This study was undertaken to study the patterns, assessment of causality, severity, preventability, body systems affected from ADRs received by the Pharmacovigilance cell, Department of Pharmacology between April 2018 to June 2019.Methods: The present study is an observational, retrospective, non-interventional analysis of voluntarily reported ADRs. Demography of patients, causative drugs, reactions, outcome, and severity are recorded. Data were analysed and expressed in numbers, percentages.Results: A total of 180 ADRs were spontaneously reported. Dermatology (42.8%), psychiatry (23.9%) and general medicine (18.3%) are the major departments reporting ADRs in our hospital. 60.6% reports were in males. The body system with maximum reactions is dermatological (51.1%). Drug class most commonly affected is anti-microbials (36.1%). Paracetamol (8.9%) is the most common drug with reactions. Causality assessment stated that 41.7% ADRs are probable and 58.3% were possible. Severity assessment showed 86.7% as mild and 13.3% as moderate. Preventability assessment stated that 93.3% ADRs not preventable, 5.6% probably preventable and 1.1% definitely preventable.Conclusions: The study provides a valuable insight with regards to the pattern of ADRs in our hospital. This will be useful in initiating a reporting culture, increase awareness, reducing under-reporting of ADR in our set up.
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Background: Nursing staffs spend most time in patient care and are bedside caregivers. To expect voluntary reporting of adverse reactions, it is essential that they possess proper knowledge, right attitude and practice reporting. Therefore, the present study was aimed to assess the Knowledge, Attitude and Practice of Pharmacovigilance towards ADRs reporting.Methods: A prospective, cross sectional, observational, questionnaire-based survey was conducted among nurses in a tertiary care teaching hospital in Eastern India. Questionnaire containing 15 questions was used to assess knowledge, attitude and practice. The questionnaire was administered to 150 nurses. Analysis of data was done using statistical software..Results: The response rate in our study was 86.67%. Nurses have good knowledge of pharmacovigilance and adverse reaction. However, only 10% have reported an adverse reaction in our study. This shows that in spite of having a good knowledge of reporting, nurses have poor attitude, which is reflected by a low reporting rate. Nurses opined that taking patient care is of prime importance than report an adverse reaction. This corroborates the low reporting rate in our set up.Conclusions: Majority of nurses have good knowledge on pharmacovigilance and adverse drug reaction. The concern remains on the low reporting rate. Continuous training programmes, and reminders likely to enhance the voluntary reporting from the nursing staffs.
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Background: Diabetes mellitus is a common chronic disease. One of the pathophysiology is found to be oxidative stress. This study aims to evaluate the effect of resveratrol on oxidative stress in high fat diet (HFD)/streptozotocin induced diabetic rats.Methods: Wistar albino rats, fed with HFD rendered diabetic with streptozotocin, were divided into 6 groups, namely the diabetic control treated with vehicle (DC), standard control which received metformin (SC), test groups treated with 5,10, and 20 mg/kg b.w. of resveratrol and combination of half dose of metformin and resveratrol (10 mg/kg)(TC). A group of six normal animals served as normal control (NC), another six as HFD control. Fasting blood glucose, lipid profile and serum MDA and SOD were measured one week after induction of diabetes. The animals were then treated orally for 2 weeks after which the same parameters were repeated. The in-vivo results were analysed by one way ANOVA followed by Tukey抯 multiple comparison test.Results: The DC group demonstrated a increase in the fasting blood glucose compared to NC, HFD control while a significant decrease in the fasting blood glucose was observed with SC, Test groups (p<0.05) as compared to the DC group. TC showed a significant improvement in dyslipidemia compared to their baseline values (p<0.05). There was significant change in the serum MDA level and SOD activity.Conclusions: Resveratrol improves oxidative stress in diabetic rats.