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Introduction: Cancer related fatigue, a problem often less understood and under-diagnosed. It is imperative to find non-invasive and non-pharmacological solutions for managing it. The aim of the study was to assess the effect of pranayama on reducing the level of Fatigue during External Radiation Therapy (ERT) among the patients in a selected cancer hospital of Guwahati, Assam. Materials and methods: The study adopted Quantitative evaluative approach; randomized pre-test post-test control group design. Simple random sampling technique without replacement was used and 84 cancer pa-tients were equally divided in control group (42) and experimental group (42). The pre-test level of fatigue was assessed from both the groups and pranayama as intervention was given to experimental group. Result: Pranayama was found to be effective in patients receiving ERT. It was found that following pranaya-ma, majority in experimental group 41 (97.6%) had mild level of fatigue whereas in control group 27 (64.3%) experienced severe level of fatigue. There is significant mean difference in the experimental group as com-pared to control group after the intervention of pranayama (t=17.99, df=41, p-value=<.001). Conclusion: Pranayama is found to be effective intervention in reducing fatigue among cancer patients re-ceiving ERT.
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Background: Iron-folic acid deficiency is the most common complication during pregnancy. Iron deficiency is responsible for various health complications among pregnant women. Compliance with IFA supplementation is variable across India several factors are associated with compliance with IFA supplementation. Objective: The objective of this systematic review is to assess the factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Methods: The primary search was carried out using PubMed, Google scholar, the WHO website, and Research Gate which provide access to full?text research articles from January 2012 to 25th January 2022 published data were searched. Result: A total of 74 studies were identified, and 20 were included in this review. Out of the 20 studies, sixteen were cross-sectional, two mixed methods, and two randomized control trials. knowledge of IFA, education, socioeconomic status, the timing of registration and number of antenatal visits, type of family, and age of the pregnant women were the factors that affect the compliance of IFA supplementation. Conclusion: Knowledge of iron-folic acid supplementation, Timing of registration and number of Antenatal Care visits, educational level of the pregnant women, and age of the pregnant women were factors associated with the compliance of IFA supplementation among pregnant women in India.
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Background: Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of peripheral vertigo. Vitamin D3 is an indispensable part of bone mineralization and calcium homeostasis. Vitamin D3 also plays a role in BPPV and therefore may offer a therapeutic option. Aim and Objective: This study aims to evaluate the relationship of BPPV with Vitamin D deficiency. Materials and Methods: This observational case–control study was done on 80 subjects out of which 40 were confirmed cases of BPPV patients and 40 were controls. Ear, throat, and nose were examined in all patients. Measurement of Vitamin D3 was done in all subjects. Assessment of quality of life was done using Dizziness Handicap Inventory score (DHI) and Visual Vertigo Analog Scale (VVAS). Results: In our study among cases, 14 patients (35%) had normal Vitamin D levels, Vitamin D deficiency was seen in 15 cases (37.5%) and 11 patients (27.5%) had Vitamin D insufficiency. In control group, 22 patients (55%) had normal Vitamin D levels and 9 patients (22.5%) each had Vitamin D insufficiency and deficiency. Mean of Vitamin D concentration in the case group was 23.78 ± 10.43 and in the control group had 35.99 ± 15.99. The relationship between the two groups was significant (P = 0.001). The mean of body mass index in case and control group was 22.46 ± 2.48 and 23.43 ± 2.38, respectively, with P-value of 0.032 indicating significant relationship statistically. Furthermore, VVAS and DHI scores were higher in cases with deficiency and insufficiency of Vitamin D. Conclusion: The present study shows a significant relationship of reduced concentration of Vitamin D with idiopathic BPPV.
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The aim of this study was to find out how Biomedical Waste (BMW) is disposed of in the Leh district and whether the healthcare facilities are following BMWM Rules 2016. A total of 19 health care facilities from Leh district were selected for this study. The data were collected through a semi-structured questionnaire from June 2021-August 2021. After analysis, it was found that all the health care facilities are involved in the disposal of BMW inside their premises. There is no involvement of the municipality or CBMWTF in handling BMW in Leh district. All the healthcare facilities have adopted the BMWM Rules 2016 but only partially.
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Background: Intravenous iron is associated with oxidative stress, and very few studies have assessed change in oxidative stress markers post infusion. Objectives: The study aimed to measure the change in levels of hemoglobin (Hb), serum ferritin, and select oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], and ferric reducing ability of plasma [FRAP]) 4 weeks following the administration of intravenous iron sucrose (IVIS) among moderately anemic pregnant women who were attending a secondary-level health-care facility, Haryana, North India. Methods: An observational study was conducted (May 2016 to Jan 2018) among pregnant women receiving intravenous iron sucrose i.e., IVIS (300 mg per dose) diluted in 300 mL of normal saline over 20� min and were followed up for a period of 4 weeks after the last dose of IVIS (end line). The study outcomes were measured in the levels of Hb, serum ferritin, MDA, SOD, and FRAP from the baseline to the end line. Results: The mean (95% confidence interval) change in the Hb and serum ferritin level 4 weeks after the last dose of IVIS was an increase of 2.5 (2.1�0) g/dL (P < 0.001) and 63.0 (44.7�.3) ng/mL (P < 0.001), respectively. There were no significant changes (baseline to end line) in mean (standard deviation [SD]) MDA level and mean (SD) FRAP level. The mean (SD) SOD level declined significantly (2.2 [0.4] U/mL to 1.6 [0.5] U/mL [P < 0.001]). No life-threatening adverse events were encountered during the study. Conclusion: IVIS was well tolerated and effective in treating moderate anemia in pregnancy. Body iron store was replenished following IVIS administration. There was no increase in oxidative stress following IVIS therapy.
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Objective: In the present study, transdermal nanoemulsion (NE) gel of lovastatin was investigated for its anti-osteoporosis effect on the long bones of rat i.e. tibia. Methods: Male wistar rats (n=30, weighing 180-200g) were taken for this study and grouped as: 1) control (normal saline daily), 2) Dex (dexamethasone sodium; 25 mg/kg subcutaneously twice a week), 3) Dex+LNG5 (lovastatin nanoemulsion gel; 5 mg/kg/d transdermally daily), 4) Dex+LNG10 (lovastatin nanoemulsion gel; 10 mg/kg/d transdermally daily), and 5) Dex+ALN (alendronate sodium; 0.03 mg/kg/d orally daily). All the treatments were carried out for 60 d. At the end of the experiment, all animals were anesthetized using diethyl ether and collected blood samples from retro-orbital venous plexus of rats in dry eppendorf tubes followed by the sacrifice of animals by cervical dislocation method and collected tibia bones of both the legs for analysis. Results: Bone formation biomarkers (OC: osteocalcin, b-ALP: bone-specific alkaline phosphatase, PINP: N-terminal propeptides of type I procollagen) were significantly improved and resorption biomarkers (CTx: C-terminal cross-linking telopeptides of type-I collagen, TRAcP5b: isoform 5b of tartarate resistant acid phosphatase) were significantly reduced in the LNG5 (p<0.05) and LNG10 (p<0.05) treatment groups when compared to Dex. In vivo anti-osteoporotic results demonstrated the formation of new bone in osteoporotic rat tibias. Biomechanical strength testing demonstrated increased load-bearing capacity of rat tibias in the treated animals in comparison with the osteoporotic group (p<0.05 for LNG5 and p<0.01 for LNG10). Conclusion: Thus, the transdermal NE gel formulation of lovastatin demonstrated the greater potential for the treatment of osteoporosis.
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Introduction: Diabetes mellitus frequently leads to development of peripheral neuropathies in almost 30-50% of patients and the most common type of neuropathy associated with this condition is Distal Symmetric Sensorimotor Polyneuropathy (DSPN). Gabapentin and Amitriptyline are two drugs frequently used for the treatment of neuropathic pain associated with type 2 diabetes. Aim of the study: The aim of this study was to compare efficacy and safety of Gabapentin and Amitriptyline in subjects of Type 2 diabetes mellitus with peripheral neuropathic pain. Material and Methods: A prospective, open, randomized, parallel group, comparative study was conducted in 60 patients coming to Department of Medicine, Rajindra Hospital attached to Government Medical College Patiala, to evaluate the efficacy and safety of Gabapentin and Amitriptyline in patients with diabetic peripheral neuropathic pain. The patients fulfilling the inclusion criteria were included in the study after taking written informed consent. The patients were divided into two groups of 30 cases each by simple randomization. Group I patients received Gabapentin 300 mg HS by oral route. Group II patients received Amitriptyline 25 mg HS by oral route. Therapeutic efficacy of both drugs, by using Michigan Neuropathy Screening Instrument (MNSI) was compared at the baseline and at the end of 4 months. Any adverse drug reactions of the respective drug observed in patient were also noted. All the observations thus made were statistically analysed using appropriate tests. Results: Baseline characteristics of the patients in two groups such as age, sex, duration of diabetes were similar (p>0.05). The mean age in group I and group II were 53.40±8.41 years and 57.17±8.55 years, respectively. There was statistically significant reduction in mean MNSI scores in questionnaire part and physical examination part in both the groups. Also, there was statistically significant difference between the two drugs in reducing mean MNSI score. Mean difference between two drugs in reducing MNSI score in history part (0.77±0.16, p<0.01) and physical examination part (0.75±0.19, p<0.01) favoured Gabapentin. No. of adverse drug reactions reported were significantly higher in Amitriptyline group, p value (<0.05) for the difference in ADRs between two drugs was statistically significant. Conclusion: In this study, we concluded that both drugs lead to improvement in signs and symptoms of diabetic neuropathy. Gabapentin was proved to be more efficacious than Amitriptyline. Gabapentin treated patient’s mean MNSI score at the study end point was significantly lower as compared to the Amitriptyline treated patient’s end-point score. Adverse drug reactions reported in our study were mild in both the groups and a significantly higher number of adverse effects were reported in the amitriptyline group. Dizziness and somnolence were two most commonly reported adverse drug reactions.
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Introduction: Diabetes mellitus frequently leads to development of peripheral neuropathies in almost 30-50% of patients and the most common type of neuropathy associated with this condition is Distal Symmetric Sensorimotor Polyneuropathy (DSPN). Gabapentin and Amitriptyline are two drugs frequently used for the treatment of neuropathic pain associated with type 2 diabetes. Aim of the study: The aim of this study was to compare efficacy and safety of Gabapentin and Amitriptyline in subjects of Type 2 diabetes mellitus with peripheral neuropathic pain. Material and Methods: A prospective, open, randomized, parallel group, comparative study was conducted in 60 patients coming to Department of Medicine, Rajindra Hospital attached to Government Medical College Patiala, to evaluate the efficacy and safety of Gabapentin and Amitriptyline in patients with diabetic peripheral neuropathic pain. The patients fulfilling the inclusion criteria were included in the study after taking written informed consent. The patients were divided into two groups of 30 cases each by simple randomization. Group I patients received Gabapentin 300 mg HS by oral route. Group II patients received Amitriptyline 25 mg HS by oral route. Therapeutic efficacy of both drugs, by using Michigan Neuropathy Screening Instrument (MNSI) was compared at the baseline and at the end of 4 months. Any adverse drug reactions of the respective drug observed in patient were also noted. All the observations thus made were statistically analysed using appropriate tests. Results: Baseline characteristics of the patients in two groups such as age, sex, duration of diabetes were similar (p>0.05). The mean age in group I and group II were 53.40±8.41 years and 57.17±8.55 years, respectively. There was statistically significant reduction in mean MNSI scores in questionnaire part and physical examination part in both the groups. Also, there was statistically significant difference between the two drugs in reducing mean MNSI score. Mean difference between two drugs in reducing MNSI score in history part (0.77±0.16, p<0.01) and physical examination part (0.75±0.19, p<0.01) favoured Gabapentin. No. of adverse drug reactions reported were significantly higher in Amitriptyline group, p value (<0.05) for the difference in ADRs between two drugs was statistically significant. Conclusion: In this study, we concluded that both drugs lead to improvement in signs and symptoms of diabetic neuropathy. Gabapentin was proved to be more efficacious than Amitriptyline. Gabapentin treated patient’s mean MNSI score at the study end point was significantly lower as compared to the Amitriptyline treated patient’s end-point score. Adverse drug reactions reported in our study were mild in both the groups and a significantly higher number of adverse effects were reported in the amitriptyline group. Dizziness and somnolence were two most commonly reported adverse drug reactions.
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Aims: The main objectives of our study were to evaluate the role of Multiparametric MRI (mp-MRI) in diagnosis of carcinoma prostate and to compare the various MRI sequences used in MRI in evaluating carcinoma prostate with histopathological diagnosis kept as reference standard. Materials and Methods: This prospective cross-sectional study of 40 patients was performed by using various sequences used in mp-MRI i.e. T2 weighted imaging (T2WI), Diffusion Weighted Imaging (DWI), Magnetic Resonance Spectroscopy (MRS) and Dynamic Contrast Enhanced study (DCE). Findings of mp-MRI sequences were compared with histopathological diagnosis. Statistical analysiswasperformed using SPSS computer statistical program for window release 16. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of DCE in diagnosing carcinoma prostate were 88.89%, 50.00%, 94.12% and 33.33% respectively where assensitivities, specificities, PPVs, NPVs of DWI and MRS were same in our study i.e. 94.44%, 75.00%, 97.14% and 60.00%respectively. Overall sensitivity, specificity, PPV, NPV of mp-MRI by combining these sequences were found to be 97.22%, 75%, 97.22% and 75% respectively. Diagnostic accuracies of DWI, DCE and MRS were 92.5%, 85% and 92.5% respectively and overall diagnostic accuracy after combining these sequences in mp-MRI was 95%. Conclusions: mp-MRI including all the sequences has very good role in evaluation of carcinoma prostate. Diagnostic accuracy of mp-MRI increases when all sequences used together to assess prostatic lesions, so all the sequences should be used together in prostate cancer evaluation rather than using individual sequences.
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Background & objectives: Globally, there is an effort to eliminate the measles and control rubella as these diseases lead to considerable morbidity and mortality especially among under-five children and are important public health problems. This study was aimed to estimate the seroprevalence of measles, mumps and rubella (MMR) antibodies among children of age 5-10 yr in Chandigarh, north India, to provide evidence on prevalent immunity levels. Methods: This cross-sectional study was conducted in Chandigarh, among 196 randomly selected healthy children (5-10 yr), who received either one or two doses of measles or MMR combination vaccine. Socio-economic background and immunization history were recorded. Blood sample (2 ml) was collected to estimate the MMR IgG antibody titres by using ELISA kits. Results: Protective seroprevalence of MMR antibodies was 40.8, 75.5 and 86.2 per cent, respectively. The geometric mean titres of MMR IgG antibodies in the study children were 11.3, 50.6 and 54.3 international units (IU)/ ml, respectively. The proportion of seroprotected children for measles was significantly higher among those who had received two or more doses (46.4%) of measles vaccine compared to those who had received single dose (35.6%) ( P <0.001). About 16 per cent of children had received single dose of MMR vaccine. Among these, 71.4 and 100 per cent were seroprotected against mumps and rubella, respectively. Interpretation & conclusions: A large proportion of children aged 5-10 yr lacked protective immunity against measles (60%); about one-fourth (15-25%) were susceptible to infection with mumps and rubella virus. Mumps vaccination may be considered to be included in National Immunization Schedule for children with periodic serosurveillance.
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Background: Urinary tract infection (UTI) is one of the most frequently reported bacterial infections in the community coming second to respiratory tract infections. Empirical antibiotic therapy is usually applied in the management of UTIs, which has resulted in rapidly emerging antimicrobial resistance in hospitals and the community. Objective: The objective of this study was to study the prevalence and antibiogram of bacterial pathogens causing UTI in our hospital. Materials and Methods: A cross-sectional retrospective study was done among patients visiting a tertiary care hospital in North India, for February–March 2018. Clean catch midstream urine samples were taken from patients. Urine culture was done using cystine lactose electrolyte deficient agar medium. A modified semi-quantitative technique was employed for culture (standard wire loop method). Single species count of more than 100000 organisms per ml of urine was considered as significant. Identification of the organism was done on the basis of colony morphology, motility testing, and biochemical tests using standard microbiological methods. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: Of the total 3172 samples - 341 (10.75%) were culture positive. Of these 341 culture-positive samples, the most commonly reported organism was Escherichia coli (53.9%), followed by Klebsiella spp. (24.9%). Among the Gram-positive organisms, only Enterococcus spp. was isolated in 10.8% of the total culture-positive samples. The Gramnegative isolates were found to be highly resistant to norfloxacin (nx) (56.3%) followed by cotrimoxazole (54.5%). Among Gram-positive isolates also, highest resistance was reported for nx (83.4%) and resistance to vancomycin was seen in only 5.4% of the cases. Conclusion: The study shows that Gram-negative organisms are the leading cause of UTIs among adult population and periodic monitoring needs to be done to keep their emerging resistance in check.
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Maternal anemia has been reportedly associated with increased risk of maternal and fetal morbidity and mortality. Adverse pregnancy outcomes such as preterm birth, low birth weight, and stillbirth have been reported to be associated with anemia. However, different studies have shown inconsistent results. In the present study, we report the association between maternal hemoglobin levels at the time of delivery and outcomes among women at a secondary care hospital in northern India. Secondary analysis of routinely collected hospital data from January 2015 to December 2016 was carried out. Sociodemographic details, hemoglobin levels at the time of admission, and birth outcomes were retrieved from the records of women admitted for delivery. The outcomes were compared among anemic and nonanemic women. About 78% of the women were found to have anemia at the time of delivery. A significantly higher proportion of anemic women had preterm labor.
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Background & objectives: Psoriasis is a chronic inflammatory skin disease with unknown aetiology. So far studies have confirmed that interleukins, pro-inflammatory factors and T-cell activation play major role in the development of disease. Interleukin-17 (IL-17) a T helper inflammatory cytokine, was found to be positively correlated with severity of psoriasis. However, the specific mechanism has not been clarified. IL-17A and IL-17F are group members of IL17 family cytokines and found to be located adjacent to one another on the same human chromosome, 6p12. The present study was designed to identify the association between IL-17A and IL-17F gene polymorphism with susceptibility of psoriasis in north Indian population. Methods: A total of 166 psoriasis patients and 150 healthy controls were genotyped for IL-17A and IL-17F gene polymorphism by amplification refractory mutation system-polymerase chain reaction method. One single nucleotide polymorphism (SNP) was analysed in IL-17A (rs10484879) and one SNP in IL-17F (rs763780) to look for an association with psoriasis. Results: Our study indicated decreased frequency of IL-17A (rs10484879) G allele (51.8 vs. 65.0%), and IL-17F (rs763780) C allele (36.5 vs. 45.7%) in psoriatic patients as compared to healthy controls. Interpretation & conclusions: The present findings suggest that IL-17A (rs10484879) G/T and IL-17F (rs763780) C/T gene polymorphisms may contribute in pathogenesis of psoriasis. Further studies need to be done to confirm these findings.
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This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one‑third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs.
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Background: Obesity is the first of the “diseases of civilization” to appear. Its prevalence is escalating at an alarming rate. Environmental and behavioral changes brought about by economic development, modernization and urbanization has been linked to the rise in global obesity. Obesity may induce systemic oxidative stress. Objective: The present scenario suggests that higher oxidative stress is the key factor of obesity and hence a management strategy aiming at control of lipid peroxidation in obesity by use of maize diet is envisaged. Material and methods: This study has been conducted on 1001 Gujarati and non Gujarati girls aged between 18-30 years. They were further distributed according to age, inhabitance, socio economic status, dietary habits, family history and blood pressure. Every subject in each group was asked to replace the wheat chapatti by maize chapatti for 30 days; the girls were examined for oxidative stress parameter MDA before and after maize diet along with the statistical evaluation. Results: There was a positive effect of maize diet on biochemical parameter of all the girls in all the subgroups Malondialdehyde level in total girls before the maize diet was 2.35 ± 0.76nmol/ml which reduced to 1.8 ± 0.46nmol/ml after the diet (P<0.001). Conclusions: The oxidative stress showed improvement in normal, overweight and obese girls, most significantly on overweight and obese girls after taking the diet (P<0.001). Current dietetic practice is to recommend a healthy eating plan of reduced fat, and increased fiber intake.
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During the last decade herbal drugs has been gaining growing popularity throughout the world. According to world federation for mental health, the mental and neurological disorders affect more than 450 million people around the world. Modern science is trying to control this problem but in most cases it has become unsuccessful. Under such conditions herbal drugs can produce beneficial effects. Modern psychotropic drugs have many side effects. So there is a need to find an alternative treatment from herbal plants which can cure these diseases. Studies undertaken in different parts of the world have proved presence of important pharmacological activities in many plants. This review describes some important plants effective in mental disorders.
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Background: Substituted dihydropyridine calcium channel blockers are used in the treatment of cardiovascular diseases. Dihydropyridines are considered as analogue of dihydropyrimidines. Objectives: In present study newly synthesized test compound 5- Acyl-6-methyl-4(2’,3’-methylenedioxy) phenyl - 2 - S - ethyl - 1, 4- dihydropyrimidine, a dihydropyrimidine derivative was investigated with an aim to get valuable substitute for the well known dihydropyridine, Nifedipine. Material & Methods: The Calcium Channel blocking actiuity of test compound was studied on Rabbit’s Heart and its effects were compared with Nifedipine used as control. Results: Test compound has dose-dependent negative chronotropic and negative inotropic effect on Rabbit’s heart but these effects appeared at doses higher than those of Nifedipine. Test compound had no significant change in coronary flow however Nifedipine show significant increase in coronary flow at lower doses. Conclusion: Test compound appears to be less potent myocardial depressant compared to Nifedipine. Test compound produced calcium channel blocking activity which was dose related and in order to ascertain the status of this compound as a drug, further studies are needed not only in other animals and tissue models but also in various pathophysiological models.
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Bacteriological Techniques/methods , Clinical Laboratory Techniques/methods , Culture Media/chemistry , Humans , Latex Fixation Tests/methods , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Sensitivity and Specificity , Staphylococcal Infections/diagnosis , Staphylococcal Infections/microbiology , beta-Lactams/pharmacologyABSTRACT
The use of drugs to increase human happiness and to improve the quality of life physically, mentally and socioeconomically is a serious matter of concern. Chronic disabling conditions become common in old age and affect the quality of life. Quality of life (QOL) is an important measure of health care, which measures the gap between expectations and achievements. Effect of Drug use on quality of life in elderly Indian population with hypertension was studied using Mc Master Health Index. The study population was divided into test group (hypertensive patients on regular treatment) and control group (Not on any treatment or on treatment for less than 3 months). All three parameters of QOL namely physical, emotional and social were studied using Mc Master Health Index questionnaire. The results were statistically compared using ANOVA and chi square. Our results point toward better overall QOL in patients on regular treatment