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Background: Cardiovascular disease (CVD) is the most common contributor of morbidity and mortality in underdeveloped and developing countries including the South Asian countries (including India and Pakistan). Amongst the cluster group of CVDs, Hypertension (HTN) represents the most common cardiovascular risk factor. The aim of this trial was to evaluate of antihypertensive efficacy and effect on biochemical parameters of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension with a randomized controlled trial.Methods: This was a prospective, randomized controlled trial of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension. The primary endpoint on treatment was analysis of antihypertensive efficacy of these drug combinations. The variables were compared at different time points- baseline, 3 and 6 months.Results: In the present study, 76 patients were enrolled with 38 patients each allocated to each treatment groups. The effect of Losartan 50mg + Hydrochlorthiazide 12.5mg OD was found to be significant on SBP and DBP in both supine as well as sitting position than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group at 3 and 6 months.Conclusions: The results on anti- hypertensive efficacy was far better in Losartan 50mg + Hydrochlorthiazide 12.5mg OD group than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group.
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Background: The objective of the study was to determine level of adherence and recognize various causative factors which can affect the compliance in the diabetic patients.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. To assess adherence, a questionnaire was administered to the patients - Morisky Medication Adherence Scale (MMAS) -8 item questionnaire. The various factors affecting compliance was determined by a researcher made questionnaire.Results: Out of a total of 100 subjects, age range extended from 18 years to 80 years. The mean age was 57.52±12.33years. 51% of patients were females and 49% was males. Analysis of MMAS- 8 item scores of patients showed that 52% of patients had low adherence, 29% had medium while 19% had high adherence to the treatment. Only 30% patients were compliant i.e. with HbA1C value of 7 or less while 70% patients were non-compliant i.e. with HbA1C value of more than 7.Conclusions: Compliance to medical treatment is influenced by a myriad of factors. In order to promote compliance, it is necessary to increase awareness about the disease, possible complications and treatment guidelines among patients as well as their family members.
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Objectives: To study the changing pattern of antimicrobial resistance of Escherichia coli isolates from patients of urinary tract infections over last three years Materials and Methods: A retrospective, record based study carried out based on the records of Culture and sensitivity (C/S) reports of indoor patients, during past three years (2012 - 2014). The type of organisms most common in urine sample was noted and the drugs still effective for the particular organism were noted. Results: E. coli was the most frequent isolate throughout the three years (67.66 % of the total isolates). Analysis of the results year wise indicated that the lowest percentage of resistance was manifested against imipenem between 11.86 % (2012) and 11.36 % (2014). Resistance for nitrofurantoin decreased over the three consecutive years from 36.1 % (2012) to 18.15 % (2014). Over the successive years, resistance to ceftriaxone tends to increase from 53.39 % (2012) to 73.33 % (2014). E coli showed absolute resistance (100 %) to cotrimoxazole and tetracycline. On an average over the three years E. coli showed high amount of resistance to fluoroquinolones (75 %) and aminoglycosides (67 %).While Multi drug resistant (MDR) E. coli range between 63 % (2012) to 65 % (2014). Conclusion: The antimicrobial resistance patterns are constantly evolving and vary from region to region it has become a necessity to do constant antimicrobial sensitivity surveillance. This will help clinicians to provide safe and effective empirical therapies.
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Background: The objective of the current study was to compare the efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia. Methods: We carried out a prospective randomized controlled parallel group study on 100 outpatients of Obstetrics and Gynaecology Department of Government Medical College, Patiala, a tertiary care teaching hospital. Pregnant patients (20-40 weeks gestational age) newly diagnosed with blood pressure (BP) of ≥140/90 mm Hg were included in the study. All patients with systolic BP (SBP) ≥160 mm Hg and diastolic BP (DBP) ≥110 mm Hg after 20 weeks of gestation, history of hypertension, renal diseases, diabetes mellitus, epilepsy, and thyroid diseases were excluded from the study. After taking the informed consent, 50 patients each were randomized to either of the two treatment arm-oral labetalol or oral methyldopa. Difference in the BP measurements at the time of admission and at the time of delivery were analyzed by applying paired t-test. For intergroup analysis, we applied independent t-test using SPSS version 16. A p<0.05 was regarded as significant. Results: Both methyldopa and labetalol cause significant fall in SBP, DBP and mean arterial pressure (MAP) in their groups (p<0.001). However, when we compared both groups it was labetalol, which causes significant fall in MAP as compared to methyldopa (p<0.001). The incidence of adverse effects like hypotension, headache, and sedation were also less in labetalol group. Conclusion: Labetalol has an upper edge over methyldopa in control of BP during pregnancy with minimal adverse effects.
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Background: The objective was to study quality-of-life in patients of acne vulgaris before and after treatment by benzoyl peroxide 2.5% gel and clindamycin 1% gel or benzoyl peroxide 2.5% gel and nadifloxacin 1% cream or tretinoin 0.025% and clindamycin 1% gel. Methods: This was a prospective, open, randomized, parallel comparative study of 60 patients of acne vulgaris attending the Department of Dermatology and Venereal Diseases, Government Medical College, Rajindra Hospital, Patiala. Three groups were made 20 in each group, one group received benzoyl peroxide 2.5% gel and clindamycin 1% gel, the second group received benzoyl peroxide 2.5% gel, and nadifloxacin 1% cream and the third group received tretinoin 0.025% and clindamycin 1% gel. Cardiff acne disability index questionnaire was filled before starting and after the treatment. Results: In these three groups, it was found that the group on benzoyl peroxide 2.5% gel and clindamycin 1% gel, mean score, before starting treatment was 8.35±3.48 and after treatment was 2.95±2.09 (p<0.001), group on benzoyl peroxide 2.5% gel and nadifloxacin 1% cream, mean score, before starting treatment was 7.60±3.75 and after treatment was 5.80±2.98 (p<0.001) and group on tretinoin 0.025% and clindamycin 1% gel mean score is 8.00±3.06 and after treatment was 5.40±2.93 (p<0.001). Conclusion: Quality-of-life improves more in patients taking benzoyl peroxide 2.5% gel and clindamycin 1% gel, and then, tretinoin 0.025% and clindamycin 1% gel and then benzoyl peroxide 2.5% gel and nadifloxacin 1% cream.
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A cross sectional study was conducted to study the diet pattern of children less than 2 years with regard to certain infant and young child feeding (IYCF) indicators. A total of 374 children less than 24 months of age coming to the immunization clinic were studied using a standard pretested and prevalidated questionnaire. Exclusive breastfeeding was followed by 57.1% of children under 6 months of age. Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were seen adequate in 32.6%, 48.6%, and 19.7% of children between 6 months and 2 years of age, respectively.
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To determine the prescribing information resources and the types of information about new drugs that Indian doctors perceived as important before prescribing and how they keep their information upto date . Also to determine if hospital doctors and General practitioners differed in their use of the sources. Two hundred general practitioners (GPs) and 200 hospital doctors were asked to rate information sources in terms of their importance for prescribing ‘old’ and ‘new’ drugs, and then to name the source from which information about the last new drug prescribed was actually derived. The study was carried out by information collection, by filling a questionnaire. Among 200 GPs, the Monthly Index of Medical Specialties (MIMS), pharmaceutical representatives and medical journal articles were most frequently rated as important for information on both old and new drugs . Among 200 hospital doctors, Refreshers courses by Govt.(Trainings),Monthly Index of Medical Specialties (MIMS) , and Hospital clinical meetings were of greatest importance. Information on the last new drug prescribed was derived from a broad range of sources. GPs and hospital doctors differ in their utilization of the prescribing information resources .This study generates the information that can be sought to help in shaping the development of health policy and the implementation of the Primary Health Care Strategy.
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A Comparison of efficacy & tolerability of brimonidine (0.2%) versus dorzolamide (2.0%) in primary open angle glaucoma or ocular hypertension. In this open, randomized, cross over comparative study, 30 subjects of primary open angle glaucoma with IOP > 22 mmHg were taken. The patients fulfilling the inclusion criteria and after verifying the exclusion criteria were included in the study after a written informed consent. These subjects were randomized to receive brimonidine (0.2%) TDS or dorzolamide (2.0%) TDS for 4 weeks. After a wash out period of 4 weeks the subjects were crossed over to other therapy .The IOP was measured at 8.00 am before dosing and at 10.00 am i.e. 2 hours after dosing at each baseline and at the end of each treatment period. Monotherapy with brimonidine (0.2%) TDS and dorzolamide (2.0%) TDS given for 4 weeks had caused overall reduction in IOP of 5.833+2.102mmHg (23.48%) and 5.433+ 2.582mmHg (22.42%) respectively at peak levels. The difference is statistically insignificant (p>0.05). Overall monotherapy with brimonidine and dorzolamide appear to produce equivalent IOP lowering efficacy and have well tolerated adverse effect profile, although a trend was observed at 10.00 a.m. of greater brimonidine efficacy compared with dorzolamide.
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OBJECTIVE: To assess the immunization coverage of BCG, DPT, OPV, Measles, MMR and Hepatitis B vaccines in two urbanized villages of East Delhi and study the factors affecting the coverage. METHODS: Children of age 24-47 months were selected using systematic random sampling. Information on socio-demographic factors and immunization status was obtained by house-to- house visit. Immunization coverage of all vaccines was computed and analysis of association between immunization coverage and socio-demographic factors was done. RESULTS: The coverage levels were 82.7% for BCG, 81.5% for DPT/OPV 1, 76.8% for DPT/OPV 2, 70.7% for DPT/OPV 3 and 65.3% for measles vaccine. It was 41.4% and 41.6% for DPT booster and MMR vaccine. Higher education of mother (OR=1.96) and father (OR=1.80), father's occupation (OR=1.86), residential status (OR=1.76), place of birth (OR=2.64) and presence of immunization card (OR=5.8) were significant determinants for complete immunization on univariate analysis. On regression analysis mother's education (OR=1.43), presence of immunization card OR=2.05 and place of birth (OR=3.80) remained significant. CONCLUSION: Immunization evaluation surveys have shown a wide variation across regions, states and different strata of the society.