ABSTRACT
Background: The child is the stylish creation among God's brutes. The most precious gift is a healthy child. The children of the moment will shape the India of hereafter. Head lice infestation is an ongoing global health issue, particularly among academ y-age children. An ongoing issue with public health on a global scale, particularly with the academy- age children. Methods: Total 60 maters are included as the sample. An accessible slice system was used. A structured knowledge questionnaire was used to gather information, and Chi-square analysis was used to uncover the relationship between knowledge about pediculosis forestallment through the use of natural remedies with socio-demographic factors. Results: The post-test score was more advanced than the pre-test knowledge score, at 71.63. Using natural curatives, the VATP was helpful in precluding Pediculosis to the tune of 33.47 0f the overall score. The reckoned knowledge t-value (15.84) was significantly advanced than the table value for the degree of freedom 59 and 0.05% position of significance (1.96). The videotape- supported tutoring approach was successful as a result. Conclusion: After evaluation of knowledge on Pediculosis, it was established that utmost maters had average knowledge regarding pediculosis forestallment through natural remedies. As a result, exploration has shown that VATP was relatively helpful in raising awareness of natural remedies.
ABSTRACT
Purpose: The aim of the study was to understand the clinical profile and anatomical and visual outcome in Tractional/Combined (Tractional + Rhegmatogenous) Retinal Detachment due to vasculitis after surgical intervention. Methods: It was an interventional retrospective study of all cases who underwent surgery for RD with vasculitis at a single tertiary eye care center for over a period of 6 years. Patients with retinal detachment due to vasculitis were included in the study. All patients underwent the following surgical procedures: 240 belt buckle with three?port pars plana vitrectomy with membrane dissection and peeling with fluid gas exchange/with endolaser with silicon oil/C3 F8 gas injection. Results: In our study, 83.33% had preoperative vision of less than 6/60, whereas postoperatively 66.66% had vision of less than 6/60. Postoperatively 33.33% patients had vision better than 6/36. Of the six eyes operated for vasculitis with RD, retina was attached in five eyes following surgery. One patient had recurrent retinal detachment due to extensive proliferative vitreoretinopathy changes, and he was advised re?procedure but was lost for follow?up. The anatomical success was 83.33% on the first surgery. Conclusion: The overall anatomic success rate of retina reattachment surgery in vasculitis patient was good, and the visual outcome following the surgery can improve in majority of the cases. Hence, timely intervention is advocated.
ABSTRACT
Background: Two new classes of drugs approved by USFDA for the treatment of acute migraine are non-peptide Calcitonin Gene-Related Peptide (CGRP) receptor antagonists (rimegepant and ubrogepant) and 5-HT1F receptor agonist lasmiditan. There are no clinical trials comparing these two classes of newer drugs. Aim and Objectives: The present network meta-analysis was conducted with the objective to compare the efficacy of orally administered lasmiditan versus CGRP-receptor antagonists (rimegepant and ubrogepant) in the treatment of acute migraine. Materials and Methods: Electronic database search in PUBMED and Cochrane library was conducted using MeSH search terms “Lasmiditan” AND “Migraine” for articles on lasmiditan; while MeSH terms “Ubrogepant” AND “Migraine;” “Rimegeapnt” AND “Migraine” were used for articles on CGRP-antagonists. Randomized or cross-over studies comparing efficacy of oral lasmiditan and two FDA approved CGRP-antagonists (rimegepant, and ubrogepant) versus other active treatment or placebo in adults with acute attack of migraine were included in the analysis. Incidence of 2 h pain-free event was the primary outcome measure while the incidence of 24 h pain-free was the secondary outcome measure compared. Both frequent and Bayesian network meta-analysis were conducted by CRSU MetaInsight software. Results: In 12 eligible studies, seven interventions were compared with total 13795 patients analyzed in the network. Higher treatment ranking for 2 h and 24 h pain-free events was observed for lasmiditan 200 mg and rimegepant 150 mg, respectively. Conclusions: There is strong evidence to conclude that lasmiditan at 200 mg is better drug for immediate (2 h) headache freedom. There is limited evidence to support rimegepant for sustained effect (beyond 24 h).
ABSTRACT
Background: Stress produces physiological and mental reactions in the body. Stressful life is most common experiences in human life. Mild stress is beneficial in performance but constant high stress may lead to anxiety and depression. Examination stress act as stressor and decreases the performance of student. A stressor is a change in the personal event or an environment that can cause stress. AIM: Present study was done to evaluate the muscle strength variations and fatigue under examination stress among medical students. Material and Method: Study involved 100 healthy boys and girls between 18-21 years of age. Who have no history of tobacco or alcohol consumption. Each students muscle strength was assessed by calculating work done using hand grip dynamometer and Mosso’s ergo graph, once during routine schedule in relaxed state (with no examination) and again during stressed state (during mid- term examination). Result: The amount of work done and handgrip strength was significantly higher on relaxed state compared to during examination. Conclusion: This study suggests that as examinations act as unavoidable stressors, which lead to the variation in the performance of the students. The medical teachers as well as students should be made aware of the negative consequences of stress faced during medical training. Effective relaxation program and psychological counselling services should be provided to students so that they cope better with examination stress.
ABSTRACT
Background: Acute respiratory tract infections (ARTIs) are a major burden to child health in developing countries like India. Preschool children have 4–8 episodes of the upper respiratory tract infection (URTI) per year on average, while school-aged children experience 2–6 episodes per year. They are the most prevalent reason for visits to the outpatient section of a hospital and general practice. Aim and Objective: The aim of this study was to evaluate the prescribing patterns in patients aged 1–18 years with URTIs. Materials and Methods: A prospective study conducted in the department of pharmacology at a tertiary health care center. Two hundred and fifty patients with URTI visiting pediatric and ENT department of tertiary health care center during December 2014–June 2015 were studied. Data included detailed history, physical examination, investigations, antimicrobial treatment given, and other treatment given were noted. This data was gathered from the records of Pediatric and ENT department. Statistical tests were used to analyze the data. Results: The most common clinical presentation was fever and cough. The common diagnosis noted in the study were non-specific URTI, tonsillitis, and sinusitis. Antipyretics (99.6%) and antibiotics (52%) were the frequently prescribed drugs among the patients. Amoxicillin-clavulanic acid and cephalosporins were the common antibitoics prescribed. Beta-hemolytic streptococci were the common microbe isolated among the patients tested to know the etiology. Conclusion: Antipyretics (99.6%) and antibiotics (52%) were the frequently prescribed drugs among the patients. Antibiotics were prescribed in most of the non-specific URTI and pharyngitis which is a matter of concern.
ABSTRACT
Background: Assessment of severity of chronic obstructive pulmonary disease (COPD) is the cornerstone of therapy. Spirometric measurements have traditionally remained as the popular diagnostic tool of choice. Oxygenation and carbon dioxide removal cannot be assessed by Spirometry alone, especially during exercise. Therefore, we studied whether desaturation and hypercapnea occur in response to exercise in COPD patients. Aims and Objectives: To know whether bicycle pedaling as an exercise can unravel the gas exchange abnormalities and airflow limitation that might be precipitated by physical activity. This is done by estimating the changes in Oxygen saturation by pulse oximetry, and by estimating the changes in Blood CO2 levels by capnography. Materials and Methods: Thirty stable COPD patients and controls were included for the study. Here we measured the change in oxygen saturation from rest to submaximal exercise (done using bicycle ergometry). Concomitantly, we measured the change in carbon dioxide levels of expired air from rest to submaximal exercise. Results: We found that COPD patients experience oxygen desaturation. ?SaO2 (difference between resting and exercise SaO2) was only 1% in controls whereas 8.86% in COPD. Hypercapnia occurred in response to a submaximal exercise in COPD patients (End tidal carbon dioxide of 48.87 mmHg). We also found that they become tachypneic and show greater degree of exhaustion. Conclusion: Our study points out that exercise-induced desaturation and hypercapnia are a definite occurrence in COPD patients. It is a marker of progressive disease. It can be used as a form of stress test for the pulmonary system.
ABSTRACT
Background: Acute migraine is the most common disabling chronic neurological disorder in the world. There are a huge proportion of unmet needs in treatment efficacy and satisfaction with currently available drugs and hence need for newer agents. One such FDA-approved drug is 5-HT1F Agonist lasmiditan. Aim and Objective: The present review and meta-analysis were conducted with the objectives to analyze and review safety and efficacy of lasmiditan. Materials and Methods: Electronic database search in PUBMED and Cochrane Library was conducted using search terms ?Lasmiditan? OR ?5-HT1F Agonist.? Randomized or cross-over studies comparing safety and/or efficacy of oral lasmiditan versus other active treatment or placebo in adults with acute attack of migraine were included in the analysis. Incidences of ?2 h pain-free? events were the primary outcome measure while the incidences of adverse drug events and control of other migraine-associated symptoms were the secondary outcome measures compared. Inverse variance method and both random and fixed effect models were used in the analysis by RevMan 5.3 software. Results: At 2 h, freedom from pain (odds ratio: 2.02, 95% CI: 1.76, 2.31, n = 4395), most bothersome symptom, photophobia, and phonophobia were observed at significantly highest rates in 200 mg lasmiditan group than in placebo group. In decreasing order, incidences of dizziness, fatigue, ?1 serious adverse drug reaction, paresthesia, and somnolence were significantly higher with 200 mg lasmiditan than placebo. Conclusion: Higher the dose of lasmiditan used, rapid and stronger is its pain aborting action. Lasmiditan has effective and sustained effect up to 48 h, and hence, there is a need to analyze its potential migraine preventive effects.
ABSTRACT
Background: In India, the prevalence of heart failure (HF) is increasing at 1.2/1,000 people according to a study in northern India, and the mortality rate at 1 year (INTERnational Congestive Heart Failure [INTER-CHF]) is 37%. Due to the diverse phenotypes of HF, nonadherence to guideline-directed medical therapy (GDMT), resistance to uptitration of medication and underuse of mineralocorticoid receptor antagonists (MRAs), such as eplerenone, a uniform management approach may not be feasible. This review is aimed at assessing the burden of HF, reasons for underutilization of MRAs in treatment, evaluating the evidence and reappraising the disease-modifying role of eplerenone in HF management. Methods: An electronic database search was performed to identify relevant literature. Results: The review details various studies that demonstrate the role of MRA eplerenone as a disease-modifying agent in patients with mild-to-moderate hypertension and those with acute myocardial infarction (MI) complicated by left ventricular dysfunction and HF. It also outlines different patient profiles for eplerenone use and ways to handle minor side-effects. Conclusions: Eplerenone shows a promising effect in selectively blocking aldosterone receptors to suppress fibrosis and reverse cardiac remodeling.
ABSTRACT
Background: Cardiorespiratory endurance is the most important component of health fitness concerned with the aerobic efficiency of the body. The VO2 max (maximum oxygen uptake) is the criterion measure of cardiorespiratory fitness that determines amount of oxygen consumed per kilogram of body weight per minute of exercise. Aim and Objectives: The aim and objective of the study is (1). To assess the heart rate and VO2 max among Indian wrestlers and age and sex-matched healthy controls and (2). To find the correlation between resting heart rate and VO2 max (if any). Materials and Methods: About 35 wrestlers aged between 18 and 25 years practicing in district stadium Belgaum and 35 age and sex-matched students of KLE University, Belgaum were enrolled as controls. Resting heart rate was measured, and cardiorespiratory endurance test was done on treadmill to calculate the VO2 max using Bruce protocol. Results: The data were analyzed using Student unpaired “t-test” (P < 0.05 was considered as significant). Karl Pearson’s correlation coefficient was used to evaluate strength of association between heart rate and VO2 max. The mean resting heart rate of players was significantly less than that of the controls (P < 0.001). Mean VO2 max was significantly higher in wrestlers than in the controls (P < 0.001). Negative correlation was found between the resting heart rate and VO2 max among the wrestler’s and controls. Conclusion: The higher VO2 max in the wrestlers can be attributed to the duration of training which causes greater increase in cardiac output and arteriovenous O2 difference. Resting heart rate of the wrestlers was found to be lower than that of the sedentary people. High VO2 max and low resting heart rate are both associated with cardiovascular fitness and common among endurance players. These could be beneficial tools for trained wrestlers looking to improve their performance.
ABSTRACT
Background: Autism spectrum disorders (ASD) is diagnosed primarily by the presence of impaired social interaction, social communication, and stereotypical behaviors. Bumetanide, a loop diuretic which acts by inhibiting Na+-K+-2Cl co-transporters (NKCC): NKCC1 and NKCC2 are explored as a pharmacological agent for treatment of ASD. Aim and Objectives: The aim of the study was to analyze safety and efficacy of bumetanide in treatment of ASD. Materials and Methods: Electronic database search in PUBMED and Cochrane library was conducted using MeSH search terms “Autism” AND “Bumetanide.” Randomized or cross-over trials comparing efficacy of bumetanide versus placebo in ASD patients of any age group were included in analysis. Quantity of reduction in total Childhood Autism Rating Scale (CARS) score after 90 days of treatment with bumetanide was the primary outcome measure analyzed. Efficacy outcome measures were estimated by calculating the Mean Difference (MD) values and their 95% Confidence Intervals (CI) by both fixed and random effect models using Revman 5.4.1 software. Results: A total of six trials were found to be eligible and included in quantitative synthesis of efficacy. Small but significant decrease in total CARS score (MD: ?1.86, 95% CI: ?3.20, ?0.15, n = 352) and total social responsive scale score (MD: ?9.38, 95% CI: ?16.45, ?2.31, n = 171) on day 91 was evident in bumetanide treated group. Conclusions: Bumetanide appears to provide small but significant benefits in relieving ASD symptoms. These benefits are lesser in Chinese patients compared to European patients.
ABSTRACT
Introduction: Pregnancy-induced hypertension (PIH) is one of the risk factor in pregnancy leading to placental insufficiency which in turn is responsible for maternal and foetal morbidity and mortality. PIH causes morphological changes in placenta. Decreased placental surface area and variation in the attachment of umbilical cord on placenta are more commonly noted in PIH which hampers the uteroplacental perfusion resulting in foetal mortality and morbidity. Hence afforts were made to study the incidence of reduced placental surface area and mode of cord attachment on placenta. Materials and methods: The study was conducted in the Department of Anatomy, Sri Siddhartha medical college and Hospital, Tumakuru, Karnataka. A total of 100 (50 normal and 50 PIH) human placentae were studied. Placental surface area and mode of attachment of umbilical cord in normal and PIH pregnancy were measured and noted. This study was analysed statistically by using Unpaired t-test and Chi-square test. Results: The study revealed significantly decrease in placental surface area and also there is increased incidence of central and marginal attachment of umbilical cord in PIH cases. Conclusion: Study reveals, PIH cause morphological changes in placenta, it decreasing the uteroplacental blood flow which reduces foetal nutrition ultimately decreasing the neonatal weight.
ABSTRACT
Aim: To address the existing gaps in knowledge about long-acting nitroglycerine (LA-NTG) and provide recommendations to address these issues. Methodology: Approved LA-NTG questionnaire that included 17 questions related to the role of LA-NTG in the management of angina and chronic coronary syndrome (CCS) was shared with 150 expert cardiologists from different regions from India. Results of these survey questionnaires were further discussed in 12 regional level meetings. The opinions and suggestions from all the meetings were compiled and analyzed. Further, recommendations were made with the help of attending national cardiology experts and a consensus statement was derived. Results: This is the first consensus on LA-NTG, summarizing the clinical evidence from India and suggesting recommendations based on these data. The experts recommended early use of LA-NTG as a first-line antianginal therapy in combination with beta-blocker since it improves exercise tolerance in patients with CCS. A strong consensus was observed for using LA-NTG in patients with co-morbid hypertension, diabetes, chronic kidney disease and post-percutaneous coronary intervention angina. As a part of cardiac rehabilitation, LA-NTG allows patients with angina to exercise to a greater functional capacity. Conclusions: A national consensus was observed for several aspects of LA-NTG in the management of angina and CCS. The clinical experience of the experts confirmed an extremely satisfied patient perception about the efficacy of LA-NTG.
ABSTRACT
Background: Over-the-counter (OTC) drug is a medicine that is available without a prescription, and hence also referred to as “nonprescription drug.” The sale of OTC medicines from pharmacies can help individual’s self-manage symptoms. However, some OTC medicines may be abused, with addiction and harms being increasingly recognized and found to be more common in undergraduate medical students. Aim and Objective: Objective of this study to analyze the use of OTC drugs among 2nd year medical students. Materials and Methods: A prospective, cross-sectional, and questionnaire based study was conducted among 2nd year medical students of Belagavi Institute of Medical Sciences Belagavi. Details and purpose of the study were explained to students and informed consent was taken. Questionnaires consist of 25 questions related to use of OTC drugs, their knowledge and attitude toward OTC drugs. Questionnaires are then collected back from students on the spot after 15 min. All the data pooled and results are analyzed in descriptive statistics. Results: A total of 88 respondents were analyzed, 87.5% participants knew the definition of OTC and 69.5% use medication without prescription. All the students practiced self-medication however only 37.5% students agree with practice. Fever, cold, and headache are the most common condition for using OTC drugs. Analgesic, antipyretics, and antihistamines are the highest among OTC stocked at home. About 61.3% students have knowledge of Adverse Drug Reactions associated with OTC drugs. Conclusion: Use of OTC drugs is common form of health care having potential benefits and health hazards. Awareness should be created among students to restrict the use of self-medication and pharmacists toward sale of drugs without prescription.
ABSTRACT
The search for novel antibiotics is of immense importance in research areas around the world for agricultural,pharmaceutical, and industrial applications. The Streptomyces species are widely used as an importantbiological tool for the production of a wide range of novel secondary metabolites. In the present study, isolatedstrain RSA-14 from rhizosphere soil of Alternanthera sessilis was subjected to morphological, physiological,biochemical and 16S rRNA gene sequence analysis. The isolated RSA-14 was analyzed for antimicrobialactivities by cross streak method and exhibited a broad spectrum of antimicrobial activity against test pathogens.The isolate was tested for the ability to grow in the presence of antibiotics, such as penicillin, streptomycin,chloramphenicol, gentamycin, and tetracycline and resistant to only two antibiotics, and sensitive to others. The16S ribosomal RNA gene sequencing and analysis of the phylogenetic tree showed 100% sequence similaritywith Streptomyces cinereoruber strain P.B.373.
ABSTRACT
Most of the prior studies concentrated on warning letters issued for clinical investigation, Institutional review board,and infringement of promotional claims, no studies assessed the warning letters issued for infringements of CurrentGood Manufacturing Practice (cGMP) pertaining to medical devices. Hence, there is a need to carry out a crosssectional study of these warning letters. Publically available U.S. Food & Drug Administration (USFDA) letters underthe law of the freedom of Information Act sent to the pharmaceutical company were accessed from the USFDA website.A standard data collection tool (Excel Spreadsheet) with all letters of warning issued from January 2008 to July 2018was developed. Letters have been manually screened. Warning letters related to medical device breaches of cGMPwere screened based on the letter's subject and content. Overall, 669 warning letters issued for medical device cGMPviolations were reviewed between January 2008 and November 2018. From 2008 to 2013, there was a downward trendin the issuance of warning letters. The number of warning letters issued in 2014 was 101, followed by 106 in 2015,as the USFDA focused more on data integrity issues, while the number decreased to 53, 27, and 19, respectively, in2016, 2017, and 2018. The highest number of warning letters were issued to manufacturers located in the USA (379),followed by Canada (52), and China (37). Section 820.30 of Title 21 CFR was found to be most violated with 603infringements. This section represents the design control requirements for cGMP. Class 2 type of medical devices werefound to be most violated (82%), followed by Class 3 with 7%. Only 32% of the companies responded to the warningletters although 52% Not Issued the closeout letter followed by 16% of the letters were considered as non-applicableletters. With the time, scientific developments and increased awareness of both regulatory authorities and industries/academic organizations, overall improvement are observed with significant decrease in the number of warning letters.
ABSTRACT
Objective: The present goals of our study were biological synthesis, characterizations of silver nanoparticles, and evaluation of its antimicrobial activity against microbial pathogens like Escherichia coli, Enterococcus faecalis, Streptococcus pneumoniae and Staphylococcus aureus. Methods: The bacterial Strain NS-24 was isolated on nutrient agar medium and was selected for the synthesis of silver nanoparticles based on its gram-negative characteristics. The characterizations of silver nanoparticles were done by UV-Visible spectroscopy, Atomic Force Microscopy (AFM), High Resolution-Transmission Electron Microscopy (HR-TEM), Scanning Electron Microscopy (SEM) with Energy Dispersive Spectroscopy (EDX), X-ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR). Later, the molecular characterization of the Strain NS-24 was done by DNA extraction and 16S rRNA gene sequencing. Results: The UV-visible spectrophotometric observation of the Strain NS-24 supernatant and AgNO3 solution showed maximum absorbance at 423 nm. The AFM data confirmed that the particles were polydispersed and spherical in shape. Additionally, the FTIR analysis revealed the IR spectral band patterning and TEM analyzes showed the size of biological AgNPs was in the range of 12.56 nm to 27.32 nm, with an average of 18.06 nm in size. Further, the 16S rRNA gene sequencing revealed the identity of Strain NS-24 as Stenotrophomonas maltophilia. The antimicrobial activity of AgNPs was studied on different gram-negative and gram-positive bacterial strains like Escherichia coli (MTCC 40), Enterococcus faecalis (MTCC 6845), Streptococcus pneumoniae (MTCC 8874) and Staphylococcus aureus (MTCC 2825), which showed good inhibition of their growth at varying concentrations of AgNPs against all the pathogens. Conclusion: Our findings showed that the synthesized AgNPs from the isolated bacterium was small in size and had profound antibacterial activity against pathogenic micro-organisms.
ABSTRACT
Background: Infertility is the inability of a couple to achieve pregnancy over an average period of one year (in a woman under 35 years of age) or 6 months (in a woman above 35 years of age) despite adequate, regular (3-4 times per week), unprotected sexual intercourse. It is of two types, primary infertility and secondary infertility. It can be due to the woman, the man, or both men and woman. Though there are several factors plays role in the causing infertility, endocrine hormones play a crucial role in it. Among all the hormones, thyroid and prolactin hormone have profound effects on reproduction and pregnancy.Methods: A prospective analytical study was conducted among 200 female patients, of age group 20-40 years, attending the outpatient department of obstetrics and gynecology. Sent for analysis of thyroid profile and prolactin levels. The data of the patients who have been completely followed up after six months was entered in excel sheet and analyzed using SPSS (version 16).Results: In this study the mean age of the study participants were 31.33±4.12 years and 4 of them were below 25 years of age. There is high prevalence of hypothyroidism (23.5%) and hyperprolactinemia (31%) was noted among the infertile females.Conclusions: The assessment of thyroid function and prolactin levels is mandatory in the work up of all infertile women, especially those presenting with menstrual irregularities. Also, early initiation of treatment may help in restoring the fertility among the infertile woman.
ABSTRACT
Background: Under 5 mortality is a key indicator of health status of the country. Optimum care in postnatal period with immunization as per recommended schedule and exclusive breastfeeding with appropriate technology are the most essential factors for optimum growth and development of the child and to prevent under five mortality. The study was done to assess the knowledge and attitude of antenatal mothers on vaccination and postnatal care.Methods: Total 150 pregnant women were required to answer a series of questionnaire related to demographic data, awareness and attitude towards postnatal care, breastfeeding and immunization.Results: Total 90% of the women are aware regarding immunization at birth, 87% of them got the information from a person, who is directly related to health system. Statistically 97.3% mother were aware about importance to keep the baby covered. Every 3 out of 4 women knew that breastfeeding to be started within 1 hour of life. Only 40% were aware that prelacteal feed should never be given to newborns and 74% of the women think that jaundice in newborn requires evaluation.Conclusions: There is a need to educate antenatal mothers about various aspects of immunization and postnatal care including breastfeeding.
ABSTRACT
Scar ectopic pregnancy is a condition where the gestational sac implants into the previous caesarean scar site. Although it is a rare entity, its incidence is increasing due to rising rates of caesarean deliveries. Here authors report a case of caesarean scar ectopic pregnancy managed by laparotomy with caesarean scar ectopic excision following failed medical management. The patient recovered without any intraoperative or postoperative complications. An early diagnosis and management are vital in preventing maternal morbidity and mortality.