Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 3.510
Filter
1.
Ann. afr. med ; Ann. afr. med;24(1): 113-123, 2025. figures, tables
Article in English | AIM | ID: biblio-1586429

ABSTRACT

Background: Hepatitis B virus(HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB­BD) and maternal tetanus­diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB­BD and maternal Td vaccine administration among health facility staff in Nigeria. Materials and Methods: This was a cross­sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. Amultistage sampling approach was used to select 40 facilities and 79 health­care workers(HCWs) from each state. Astructured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB­BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics. Results: The survey of 80 facilities revealed that 73.8% implemented HepB­BD and maternal Td vaccination policies. HepB­BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB­BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns. Conclusions: The limited implementation of national policies on HepB­BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps.


Contexte: Le virus de l'hépatite B (VHB) et les infections néonatales au tétanos restent endémiques au Nigéria malgré la disponibilité de vaccins sûrs et efficaces. Notre objectif était d'évaluer la capacité des établissements de santé à administrer la dose de naissance du vaccin contre l'hépatite B (HepB-BD) et le vaccin antitétanique et diphtérique (Td) maternel, ainsi que d'évaluer les connaissances, les attitudes et les pratiques du personnel des établissements de santé concernant l'administration du vaccin HepB-BD et du vaccin Td maternel au Nigéria. Matériel et méthodes: Il s'agissait d'une étude transversale portant sur les établissements de santé primaires et secondaires publics des États d'Adamawa et d'Enugu. Une approche d'échantillonnage à plusieurs degrés a été utilisée pour sélectionner 40 établissements et 79 agents de santé (AS) dans chaque État. Un outil d'évaluation structuré des établissements et un questionnaire standardisé ont permis d'évaluer les caractéristiques des établissements et les connaissances, attitudes et pratiques des AS en matière de vaccination par le HepB-BD et le Td maternel. Les fréquences et les proportions ont été rapportées sous forme de statistiques descriptives. Résultats: Les résultats de l'enquête menée auprès de 80 établissements ont révélé que 73,8 % d'entre eux appliquaient des politiques de vaccination par le HepB-BD et le Td maternel. Le HepB-BD était administré dans les 24 heures suivant la naissance dans 61,3 % des établissements et à tout moment dans 57,5 % d'entre eux. Cependant, l'administration se faisait rarement en salle de travail et d'accouchement (35 %) ou en maternité (16,3 %). Près de la moitié des établissements (46,3 %) comptaient des AS qui pensaient qu'il existait des contre-indications à la vaccination par le HepB-BD. Parmi les 158 AS, 26,5 % pensaient que le tétanos pouvait être transmis par des relations sexuelles non protégées, qu'il pouvait être prévenu par la vaccination à la naissance (46,1 %) ou en évitant de partager la nourriture et les ustensiles. Soixante-cinq pour cent des AS savaient que l'infection par le VHB avait les pires conséquences pour les nouveau-nés. Conclusion: La mise en œuvre limitée des politiques nationales sur la vaccination par le HepB-BD et le Td maternel, associée aux lacunes de connaissances parmi les AS, constituent des défis importants pour la vaccination à temps, ce qui nécessite des interventions pour combler ces lacunes.


Subject(s)
Tetanus , Attitude , Hepatitis B virus , Vaccination , Hepatitis B Vaccines , Parturition , Diphtheria , Contraindications , Infections
2.
Article | IMSEAR | ID: sea-240429

ABSTRACT

Background: COVID-19 vaccine precaution dose has emerged as an essential tool to control the spread of COVID-19 infections worldwide. The acceptance of vaccines is influenced by various factors such as knowledge, perception of the likelihood of COVID-19 spread, vaccine safety, logistics, vaccine efficacy, and perceived risk. Aim and Objectives: This study aimed to assess knowledge, attitude, and practice of COVID-19 vaccine precaution dose among health-care professionals (HCPs) at a tertiary care teaching hospital. Materials and Methods: A cross-sectional study was conducted among 147 participants using a self-designed, semi-structured, and pre-validated questionnaire circulated through Google Forms to HCPs. Results: The results showed that all the participants were aware of the COVID-19 vaccine precaution dose. However, only 68.49% of the participants had received the dose. The major source of information was the World Health Organization. About 79.4% of the participants were worried about serious unknown long-term effects of the precautionary dose, but the majority were willing to take it without any hesitation. About 14.3% of the participants experienced side effects, with pain at the injection site being the most common. Conclusion: The study demonstrates that participants had a good understanding of the COVID-19 precaution dose, but their attitudes were slightly lesser compared to their knowledge, and also, there was a lot of hesitation with respect to practicing the COVID-19 vaccine precaution dose.

3.
Article | IMSEAR | ID: sea-240258

ABSTRACT

Background: Lower backache is a highly prevalent condition among middle-aged individuals and is often caused by muscle spasms. It is one of the most common reasons why people seek medical assistance from a primary care physician. Aims and Objectives: The aims and objectives of the study are to evaluate the safety and efficacy of the drug combinations thiocolchicoside 4 mg and aceclofenac 100 mg versus aceclofenac 100 mg and paracetamol 500 mg. Materials and Methods: The study was conducted using a prospective, randomized, double-blind, comparative, and parallel group design. A total of 80 patients who met the specified criteria were selected to participate in the trial over a period of 3 months. A total of 30 cases were selected for each group, with consideration given to excluding outliers. The patients were allocated randomly into two groups: Group A, consisting of 30 individuals, and Group B, consisting of 30 individuals. The primary efficacy assessments include the visual analog scale, muscle spasm assessment by finger-to-floor distance, and Lasegue’s maneuver. The secondary efficacy measures were assessed using a 4-point scale global assessment, which included ratings of excellent, good, average, and poor. Results: The majority of study participants were in the age group 39–48 years and above 48 years consisting of 25 patients and 33, respectively. Males constituted 51.6% and females were 48.3%. On day 28, results were calculated on 26 patients in Group A and 24 patients in Group B as 10 patients discontinued the treatment after 3rd week. Conclusions: It is concluded that the best possible medical intervention to treat acute low back pain is to use drug combinations of analgesics and skeletal muscle relaxants. The combination of tablet thiocolchicoside and aceclofenac proved to be more efficacious and safer when compared to the combination of tablet aceclofenac and paracetamol.

4.
J Cancer Res Ther ; 2024 Sep; 20(5): 1595-1598
Article | IMSEAR | ID: sea-238280

ABSTRACT

Background: We aimed to investigate effect of radiotherapy (RT) applications with different dose rates on cytogenetic damages, which focused on micronucleus (MN) formation, and evaluate how this damage varies by cisplatin in rats receiving head–neck RT. Material and Methods: Thirty?six Sprague Dawley rats were divided into five groups. The first and second groups were irradiated at a dose rate of 300 monitor unit/minute (MU/min) and 600 MU/min, respectively. The third group was irradiated at a dose rate of 300 MU/min and given cisplatin. The fourth group was irradiated at a dose rate of 600 MU/min and given cisplatin. The fifth group received neither irradiation nor cisplatin (control group). One thousand polychromatic erythrocytes were scored, and MN frequency in polychromatic erythrocytes was determined for each rat. Results: There was a significant difference among five groups in terms of the number of MN (p: 0.001). The number of MN was significantly higher in the 600 MU/min + cisplatin group (fourth group) compared to the control group [9.5 (1.0–23.0) vs. 1.5 (1.0–2.0), respectively]. It was also significantly higher in 600 MU/min + cisplatin group (fourth group) compared to 300 MU/min group (first group) [9.5 (1.0–23.0) vs. 2.0 (1.0–3.0), respectively]. On the other hand, there was no significant difference among other groups. Conclusions: Our findings suggest that RT given at a higher dose rate causes more cytogenetic damage, and this damage is increased by concurrent administration of cisplatin.

5.
J Cancer Res Ther ; 2024 Sep; 20(5): 1570-1577
Article | IMSEAR | ID: sea-238276

ABSTRACT

Objective: To develop new two?dimensional geometric parameters for pulmonary and cardiac dose estimation in left?sided breast cancer radiation therapy without dose?volume histogram (DVH). Methods: On the CT image of 90 patients with left breast cancer, treatment planning was performed using two opposed tangent fields with/without supraclavicular. The field?in?field technique and 6MV photons were used. From DVH dosimetric parameters of mean dose, Vx (x (Gy) =5, 10, 15, 20, 30, 40, 50) were calculated, and from heart and lung outlines on the beam’s eye view, new geometric parameters of percent of lung area in tangent and supraclavicular fields (%area of the lung in the tangent (ALT), %ALS) and percent of heart in tangent field (%area of the heart in the tangent (AHT)) were measured. Correlation, regression, and diagnostic performance by receiver operating characteristic curve (ROC) were investigated for statistical analysis. Results: The Pearson coefficient between %ALT and Vx (x = 10, 15, 20, 30, 40) show strong correlation in patient treatment with only opposed tangents (>0.85) and weaker in treatment by opposed tangents with supraclavicular (0.56?0.88), the %ALS indicate weak correlation (<0.5) and %AHT show strong correlation (0.93?0.98). The regression analysis shows a positive relation between %ALT and mean dose (R2 = 0.8), V20Gy (R2 = 0.9) in the lung (tangent treatment), and between %AHT and mean dose (R2 = 0.9), V20Gy (R2 = 1.0) in the heart. The ROC analysis shows by %ALT <20.3 for treatment by just opposed fields, %ALT <22.1% for treatment tangents with supra, and %AHT <11.6%, practical lung and heart dose constraints are addressed. Conclusion: The proposed geometric parameters could replace previous one?dimensional maximum and central distances for predicting doses to lung and heart. Advances in Knowledge: This study presents simple geometric parameters that could estimate pulmonary and cardiac dose in left breast cancer treatment from a 2D radiograph.

6.
J Cancer Res Ther ; 2024 Sep; 20(5): 1564-1569
Article | IMSEAR | ID: sea-238275

ABSTRACT

Introduction: Radiotherapy alone or in combination with chemotherapy is an effective and standard treatment of head and neck carcinoma. Oral mucositis is an unavoidable consequence of chemoradiation which is seen in almost all the patients. This painful condition leads to deterioration of the quality of life and thus interferes with the overall outcome of cancer therapy. As no study has been conducted in an Indian context, we conducted this study for better identification of factors influencing the occurrence and severity of oral mucositis in this patient population. Objectives: Evaluation of the factors influencing the occurrence, severity, and resolution of radiation induced oral mucositis (RIOM) in patients with head and neck cancer. The relationship between RIOM and treatment volume (TV) and mean dose to oral mucosa were also explored. Methods: This prospective study was conducted in patients with a histopathological diagnosis of head and neck carcinoma treated with radiation and chemoradiation. The patient, tumor, and treatment?related factors influencing RIOM were evaluated. Results: Univariate logistic regression analysis of correlated factors with acute radiation oral mucositis revealed TV in phase one (up to 40 Gy) having P value of 0.029 with odds ratio of 1.008. Spearman rank correlation coefficient demonstrated significant positive correlation between oral mucosa dose and TV in all three phases of radiation. Conclusion: Our study concluded that the most important factor influencing RIOM is TV during phase one of radiation. We found positive correlation between TV and oral mucosa dose through all the phases of radiation treatment.

7.
J Cancer Res Ther ; 2024 Sep; 20(5): 1551-1556
Article | IMSEAR | ID: sea-238273

ABSTRACT

Introduction: High dose rate (HDR) intracavitary brachytherapy (ICBT) is an integral element in the treatment of carcinoma uterine cervix. The main objective of brachytherapy in carcinoma cervix is to deliver a lethal dose to tumor cells without inducing unacceptable damage to the surrounding normal tissue. Because the absorbed dose falls off rapidly, higher doses can be safely delivered to the targeted tissue over a short time. The quest for optimum dose and fractionation schedule in HDR ICBT is still ongoing, and there is no uniform consensus. This study aimed to assess the acute dose?related toxicities of HDR brachytherapy schedule of 7 Gy x 3 fractions over 6 Gy x 4 fractions in the treatment of cervical cancer. Objective: The aim of this study was to study the acute treatment?related gastrointestinal (GI) and genitourinary (GU) toxicities between two HDR brachytherapy regimens. Material and Methods: This is a prospective institutional study carried out from May 2018 to September 2018. In this time period, 66 patients of cervical cancers fulfilling our inclusion criteria were treated with concurrent chemoradiation (CCRT) following brachytherapy. During treatment, patients were randomized to arm A—7 Gy per fraction for three fractions and arm B—6 Gy per fraction for four fractions. Acute GI and GU toxicities were assessed using Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03. All patients were kept for follow?up for 3 months in this study. Results: There is no statistically significant difference between the two arms for acute GI and GU toxicities, and the results were comparable. Conclusions: Considering the increased hospital burden of locally advanced cervical cancer patients in the Indian context, the HDR brachytherapy schedule of 7 Gy per fraction is preferable to 6 Gy per fraction for a lesser fractionation schedule.

8.
Article | IMSEAR | ID: sea-242596

ABSTRACT

Cough is an essential reflex for clearing mucus and irritants from the respiratory tract and is a common complaint in health-care settings worldwide, including India. Acute cough typically occurs multiple times a year and lasts for 7–9 days, whereas chronic cough persists for over 8 weeks. The presence of phlegm or mucus can be particularly bothersome. Treatment options include expectorants, decongestants, antitussives, and antihistamines. Fixed-dose combinations (FDCs) have demonstrated greater clinical efficacy compared to single-agent therapies. Clinical evidence supports the efficacy and safety of an FDC containing terbutaline, ambroxol, and guaifenesin in treating productive cough in Indian patients, as it effectively reduces cough severity and frequency. This paper discusses the role of terbutaline, ambroxol, and guaifenesin in treating productive cough and the clinical expertise of different physicians of this FDC in productive cough patients.

9.
Article | IMSEAR | ID: sea-242250

ABSTRACT

Background: Acute appendicitis is one of the most common acute surgery events. Appendicitis must be considered in every patient who presents with acute abdominal pain. Its main treatment is surgery. However medical management before and after the surgery has an important impact on the treatment. Single or multiple-dose regimens of antibiotics may rely on the patient’s medical situation and the patient’s susceptibility to infection. The present study was therefore planned to evaluate the effectiveness and outcomes of the single dose of antibiotics in patients undergoing laparoscopic appendectomy. Aim of the study is whether a single dose of antibiotic in laparoscopic appendectomy is sufficient. Materials and Methods: The retrospective case study was conducted in Department of General Surgery, Dhiraj Hospital, SBKS, Vadodara, Gujarat, India from March 2023 -September 2023 among 50 patients scheduled for laparoscopic appendectomy. Results: Out of 50 patients, majority 80% were males and 20% were females. Most common symptom was right iliac fossa pain. Out of 50, 34 patients underwent planned laparoscopic appendectomy while 16 underwent emergency laparoscopic appendectomy. Out of 50 patients, 10 patients had SSI. In 10 patients with SSI, swab culture of the wound was done out of which 8 patients were negative and 2 patients were positive for infection. Only 10% of the patients had wound infection. Conclusion: For basic, uncomplicated acute appendicitis, single dose of prophylactic antibiotics will help in cases of laparoscopic appendectomy. There is no necessity for the post-operative administration of antibiotics.

10.
Article | IMSEAR | ID: sea-242241

ABSTRACT

Introduction: Ectopic pregnancy (EP) is a significant cause of maternal morbidity and mortality, particularly in developing regions like India. Methotrexate, administered either as a single-dose or multiple-dose regimen, is commonly used for medical management of EP. This study aims to compare the efficacy and safety of these two regimens in women from Jammu and Kashmir, India. Materials and Methods: This observational analytical study was conducted retrospectively over six months at Government Medical College Anantnag. A total of 90 women with EP were admitted, of which 32 were managed medically with methotrexate. Fourteen patients received the multiple-dose regimen, while the remaining 18 were treated with the single-dose regimen. Data on sociodemographic characteristics, clinical presentations, treatment outcomes, and adverse events were collected and analyzed. Results: The majority of participants were aged between 25-29 years. Nulliparity was observed in 47.1% of the single-dose group (group S) and 71.4% of the multiple-dose group (group M). Common symptoms included abdominal pain (88.2% in group S, 92.9% in group M), amenorrhea, and vaginal bleeding. Ampullary pregnancy was the most common type of EP (82.4% in group S, 50% in group M). The success rate was significantly higher in the multiple-dose group (85.7%) compared to the single-dose group (58.8%) (p=0.013). Adverse events such as nausea and vomiting were reported by 10 participants in group M and 6 in group S. Both groups had similar ICU admission rates (four each), and no fatalities were recorded. Conclusions: The multiple-dose methotrexate regimen demonstrated a significantly higher success rate in the management of EP compared to the single-dose regimen. Although the multiple-dose group experienced more adverse events, these differences were not significantly different. These findings support the preferential use of the multiple-dose regimen for better efficacy.

11.
Article | IMSEAR | ID: sea-242103

ABSTRACT

Background: The study assessed the effect of the patient's weight on hemodynamic variables after intrathecal administration of a fixed dose of 0.5% hyperbaric bupivacaine. Methods: This descriptive cross-sectional study included 200 patients in tertiary health care. All patients were monitored for 1 hour to assess blood pressure and heart rate. Systolic blood pressure, mean blood pressure and heart rate were recorded at the following periods: preoperatively, just after giving a supine position following SAB, after 5 min, 10 min, 15 min, 30 min, and 1 hour and observations were recorded on a pre-structured proforma. Results: The effect of weight was clinically and statistically significant with p value<0.05 after intrathecal administration of the fixed dose of 0.5% hyperbaric bupivacaine. However, the height impact is clinically essential but statistically non-significant with a p-value>0.05. Conclusion: From the observations, results, and statistical analysis of this study, we concluded that patients with higher weight achieve more blood pressure falls than thin patients after administering a fixed dose of intrathecal bupivacaine 0.5%, 3 ml.

12.
Article | IMSEAR | ID: sea-240360

ABSTRACT

Background: As a part of the COVID-19 preventive strategy, India began its vaccination drive on January 16, 2021, and was expanded in a phased manner. A significant percentage of India’s adult population is yet to receive the third dose. Hence, to know any hesitancy prevailing in undergraduate medical students who are supposed to be role models for the public, this study is undertaken. Aims and Objectives: The aim of the study was to estimate the proportion and factors associated with COVID-19 precautionary dose vaccine hesitancy among undergraduate medical students of a Government Medical College in Karnataka. Materials and Methods: A mixed-method study was conducted among 420 undergraduate medical students at a Government Medical College in Karnataka. Students from all professional years of MBBS were selected for the study based on stratified random sampling. A semi-structured questionnaire and focus group discussions were used to collect data. Results: Among 420 participants, 19.05% exhibited vaccine hesitancy, primarily driven by concerns about efficacy, safety, and the non-mandatory nature of precautionary doses. In contrast, fear of COVID-19 transmission, societal responsibility, and the availability of free vaccines were key motivators for vaccine acceptance among the majority. Using thematic analysis of focus group discussions, four key themes emerged were vaccine-related factors, personal factors, media influence, and external factors. Conclusion: The results underscore the vital importance of education, communication, and public health initiatives in enhancing vaccine confidence and uptake among medical students, paving the way for more effective interventions in the future.

13.
Article | IMSEAR | ID: sea-239554

ABSTRACT

Aims: Phyllanthus odontadenius is one of the genus Phyllanthus species, used for number diseases treatment including malaria. Malaria today poses a real public health problem for more than hundred countries, afflicted millions people and killed an estimated 405 000 in the World. The chemoresistance of Plasmodium falciparum to modern antimalarials which are either expensive, toxic or ineffective leads to the search for new antimalarials at lower cost, non-toxic and effective within plant biodiversity. Given the interest in various P. odontadenius crude extracts in vitro on P. falciparum, an in vivo study seems necessary in order to judge the extracts effectiveness of this plant. This study therefore aims to find justification for P. odontadenius secondary metabolites antiplasmodial activity which would have been revealed in the three samples from three different province sites. Study Design: Plants P. odontadenius samples from three province harvested and dried separately, plant phytochemistry screening realized, extracts preparation for antiplasmodial test, mice parasitization with P. berghei strain, orally administration drug; Parasiteamia determination using an immersion microscope. Place and Duration of Study: Department of Radiobiology, Applied Microbiology section, General Atomic Energy Commission, Regional Nuclear Studies Center of Kinshasa. MPI and pharmacognosy laboratories in the National Biomedical Research Institute (INRB). This work took place over the period from October 11, 2020 to March 12, 2021. Methodology: Phytochemical screening P. odontadenius samples was previously determined with the chemical reagent reactions and TLC. Then, P. odontadenius methanol extracts from aerial parts harvested in three sites (Kinshasa, Kasangulu and Kwango-bridge) were administered to test mice (12.5 mg/kg and 25 mg//kg bw) after infected mice with the Plasmodium berghei strain. DMSO 10% and quinine 10 mg/kg bw were also used as controls for comparison with the samples of P. odontadenius extracts. After 5 days, parasitemia of each test and controls mice was determined. Percent of parasitemia, parasite density and percent of inhibition were calculated. Finally, the effect dose 50 of each P. odontadenius specimen was finally determined. Results: Parasiteamia rates of negative control (DMSO 10%) was high (69.98±15.03%) comparing to positive control (27.43±11.46%) and tested mice with P. odontadenius extracts (12.5 and 25 mg/kg bw) which percent’s varied from 24.66±15.84% to 59.01±22.44%. Negative control presented high parasite density with 11,342 (±2,436) comparing to the positive control (4,447±1,857) and all P. odontadenius methanol extracts which varied from 3,995±2,343 for 25 mg/kg bw to 9,570±3,319 for 12.5 mg/kg bw. Parasiteamia reduction rates followed inversely parasite density, thus, Po3 25 mg/kg bw had high parasiteamia reduction rate (65.23%) comparing to positive control with 61.32% and to P. odontadenius methanol extracts. Po3 presented 2.44 mg/kg bw as effect dose 50 comparing to Po1 (2.93 mg/kg bw) and Po2 (2.68 mg/kg bw). Males mice were highly affected to P. berghei than the females. Conclusion: This study revealed that all specimens of P. odontadenius had good in vivo antiplasmodial activities on P. berghei. All P. odontadenius extracts showed good parasitaemia inhibition compared to negative control, but P. odontadenius from Kwango-brigde (Po3) presented good behavior concerning in vivo antiplasmodial activity in comparison to P. odontadenius from Kasangulu (Po2) and that from Kinshasa (Po1). However, further studies are necessary on the in vivo toxicity of the plant and on the medicinal form that could be applied.

14.
Article | IMSEAR | ID: sea-237638

ABSTRACT

This study aimed to evaluate the effects of pharmacist-led counseling on the rural parents’ knowledge and technique of oral antibiotic suspension reconstitution, storage, and dose measurement. This was a multicenter interventional study involved 330 parents from four government health clinics in Sik, Malaysia. A checklist and infographic handout were developed for the counseling purpose. A questionnaire was used to evaluate parents’ knowledge, and they were tasked with demonstrating their reconstitution and dose measurement techniques during the counseling session. The knowledge and technique were evaluated through scoring both before and after counseling sessions, and the comparison was performed using Wilcoxon signed rank test. The parents’ median score of reconstitution knowledge improved significantly (p < 0.001) from 5 (pre-counseling) to a perfect score of 7 (post-counseling). Meanwhile, the antibiotic storage knowledge showed a similar trend of significant improvement (p < 0.001) from a median of 2 to a perfect score of 3. Significant improvement (p < 0.001) was found in the reconstitution technique with the median score increased from 3 to a perfect score of 7. After the counseling, majority of parents (96.4%) performed the correct dose measurement technique as compared to 37.7% at pre-counseling. In conclusion, the pharmacist-led counseling guided with checklist and visual handout was effective.

15.
Article | IMSEAR | ID: sea-240294

ABSTRACT

Background: Fixed-dose combinations (FDCs) constitute a substantial portion of prescribed medications worldwide and offer benefits such as enhanced efficacy, reduced pill burden, and improved patient compliance. However, their improper utilization can lead to inefficacies, increased costs, and adverse health outcomes. The assessment of clinicians’ understanding, attitudes, and practices regarding FDC prescription at a tertiary care teaching hospital in South India serves as a crucial step toward ensuring informed and rational medication practices. Aims and Objectives: The aim and objectives of the study are to evaluate the knowledge, attitude, and practice of prescribing FDCs among medical doctors. Materials and Methods: Following approval from the Ethics Committee at Mysore Medical College and Research Institute, as well as obtaining written informed consent from medical doctors working in the institute, a self- administered, structured, and pre-tested questionnaire was utilized. This questionnaire had been adapted from prior studies with similarities and was adjusted to align with the specific context of the present study. Results: The study of 72 doctors highlighted high FDC awareness (91.7%). The generic name of FDC was employed by 69.4% of the participants in the study. Most advocated proper prescriptions (84.8%). 57% of them identified FDC rationality. 22.2% relied on drug indexes, among other varied sources, for FDC information. Conclusion: It is essential to emphasize gaps in knowledge, attitude, and practice as it increases the risk of irrational prescriptions. Measures aiming to educate and rectify this issue, particularly in a tertiary hospital setting, help in mitigating the irrational use of drugs and optimizing patient care.

16.
Article | IMSEAR | ID: sea-232628

ABSTRACT

Background: Approximately 5-10 % of pregnancies are complicated by pre- eclampsia and it is a prime cause for maternal and perinatal mortality and morbidity worldwide, particularly in developing countries. In pre-eclampsia insufficient invasion of maternal spiral arteries by the trophoblast early in gestation due to abnormal implantation or maternal vascular disease results in impaired placental perfusion. Aspirin is a potent anti-inflammatory drug, has been shown to inhibit the biosynthesis and release of prostaglandins, even in low dosage. Ingestion of low dose aspirin may result in a decrease in the incidence of pre-eclampsia and fetal growth restriction and the precise mechanism by which it prevents preeclampsia in some women is also uncertain.Methods: The present prospective observational study was carried out in females between 18-20 weeks of gestation with raised uterine artery PI attending antenatal clinic in obstetrics and gynaecology department in SVP Hospital Ahmedabad from May 2023 to December 2023 using Microsoft excel and SPSS version 23.Results: In this study all the females were with raised uterine artery PI in 18-20 weeks ultrasound among them 51.85% were normotensive in later pregnancy. 48.14% developed pre-eclampsia in later pregnancy. In our study the middle cerebral artery indices in doppler ultrasound showed increased diastolic flow (including brain sparing effect) among 37% of the patients. The umbilical artery doppler showed that 62.9% of subjects were having normal umbilical artery indices, 18.5% of the patients were having decreased diastolic flow, 11.1% of the patients were having reversal of diastolic flow and 7.4% of the patients were having absent end diastolic flowConclusions: Doppler study for fetal surveillance in pre-eclampsia is a very useful and non-invasive method and abnormal uterine artery velocimetry lead to the worse pregnancy outcomes in the present study. The knowledge of uterine and umbilical artery doppler is very helpful to improve pregnancy management and to identify and assess hypertensive disorder of the pregnancy at early gestational age compared to other antepartum test modalities.

17.
Article | IMSEAR | ID: sea-232589

ABSTRACT

Background: In abnormal uterine bleeding due to ovulation dysfunction, unopposed estrogen causes persistent proliferative or hyperplastic endometrium and periods of amenorrhea followed by excessive bleeding. This is managed medically by cyclical use of some hormonal agents. The aim of the study was to compare the effectiveness and acceptability of cyclical progestin alone and low dose estrogen progestin pill as medical management of AUB-O in premenopausal women.Methods: The study composed of 57 premenopausal women with anovular type of bleeding. The study participants were randomly allocated to take either norethisterone 10 mg daily from 16th to 25th day of menstrual cycle or low dose estrogen progesterone pill, one pill daily from 1st day of menstrual cycle up to 24th day. These patients were followed up after three and six months to assess subjectively the persistence of abnormal uterine bleeding, patient’s satisfaction, need for hysterectomy and any side effects.Results: The symptomatic improvement was more apparent with estrogen progestin pill than cyclical norethisterone. More patients chose hysterectomy in the norethisterone group because they were not satisfied with medical management.Conclusions: Symptomatic improvement is more with low dose estrogen progestin pill than cyclical norethisterone in women with AUB-O. More women decline hysterectomy as they accept estrogen progestin pill.

18.
Article | IMSEAR | ID: sea-240083

ABSTRACT

Background: Improved patient compliance and cost effectiveness are two benefits of fixed-dose combination drugs. Irrational fixed-dose combinations (FDCs) raise the most urgent issue since they put patients at needless risk for negative medication responses. Aims and Objectives: The present study was done with objective of analyzing prescribing pattern of FDCs in department of fixed-dose combination in department of obstetrics and gynecology in a tertiary care hospital of central India. Materials and Methods: This study, which was both prospective and observational, was conducted at the tertiary care hospital of central India. This study comprised the prescriptions of all patients who visited the obstetrics and gynecology Outpatient Department during the study period. Results: In the present study, 1605 prescriptions were analyzed, comprising total 3016 drugs. Out of these 1262 were prescribed as FDCs and 1754 were prescribed as single drugs. On analyzing system-wise prescriptions, it was found that majority drugs were prescribed pertaining to gastrointestinal tract, that is, 1720 prescriptions, of which 722 (38.8%) were prescribed as FDCs. Four hundred and sixty-three drugs were prescribed related to hematological system, of which 97 (14.9%) were FDCs. Four hundred and thirty-three drugs were prescribed related to anti-infective class, comprising 196 (36.6%) FDCs. Among FDCs prescribed in gastrointestinal system, Vitamin D3 + Calcium carbonate was most commonly prescribed, accounting for 644 (51%) prescriptions. Clotrimazole + Clindamycin was most commonly prescribed FDC in anti-infective system comprising 118 (9.3%) patients. Ferrous ascorbate + folic acid was most commonly prescribed hematological FDC, accounting for 49 (3.8%) patients. Dextromethorphan + phenylephrine + Chlorpheniramine was most commonly prescribed FDC in respiratory segment accounting for 39 (2.9%) patients. Conclusion: The present study highlights a considerable number of drugs prescribed as FDCs. FDCs reduce pill burden and also help to improve patient compliance. However, rationality of FDCs should be thought before prescribing it to patients.

19.
Article | IMSEAR | ID: sea-240074

ABSTRACT

Background: Methotrexate (MTX) is the anchor drug for the management of many systemic inflammatory diseases. High-dose MTX is associated with various toxicities which may lead to drug discontinuation or interruption of therapy. Low-dose MTX is widely used for treating various systemic autoimmune diseases and is considered relatively safe. Aims and Objectives: In this study, we describe the clinical features and factors affecting adverse effects of low-dose MTX in a large cohort of patients with autoimmune rheumatic diseases (AIRDs) from a tertiary health center in South India. Materials and Methods: This was a retrospective analysis wherein we aimed to characterize the clinical features seen in and factors associated with adverse effects due to low-dose MTX. We reviewed the medical records of patients who were receiving MTX for their underlying AIRD from the Department of Clinical Immunology and Rheumatology and General Medicine. Inclusion: Patients with AIRDs being treated with MTX, who suffered from adverse events. Excluded: Patients on other csDMARDs and bDMARDs. Clinical profile, indications of therapy, dose of MTX, adverse effects, and deranged laboratory parameters were noted. Results: A total of 815 subjects using MTX were identified over a period of 6 months duration (n = 713 (87%) females). Underlying autoimmune conditions included rheumatoid arthritis (n = 675, 82.8%). The most common adverse event noted was hair loss (7.7%), followed by nausea (3.9%). Cytopenia and transaminitis were noted in 1.6% and 2.2%, respectively. Higher incidence of adverse events was seen in those without folic acid intake (81.2%; P = 0.0001). Conclusion: Low-dose MTX, although causes mild adverse effects and has the potential to cause life-threatening adverse events like cytopenia, is usually well tolerated. Identification of toxicities early improves the outcomes of patient care. Folate supplementation ameliorates side effects.

20.
Article | IMSEAR | ID: sea-239266

ABSTRACT

Introduction: The escalation of community-acquired pneumonia cases amidst the COVID-19 pandemic has engendered a concerning phenomenon characterized by the unwarranted utilization of antimicrobial agents. Aims: To analyze the utilization trends of antimicrobial agents within the cohort of hospitalized individuals diagnosed with community-acquired pneumonia (CAP). Material and methods: A prospective observational study was conducted for 6 months within the Department of Medicine to investigate patients diagnosed with CAP. Detailed records of drug prescriptions were meticulously recorded, with subsequent computation of both the Daily Defined Dose (DDD) and Antibiotics Consumption Index (ACI). A dataset comprising information from 130 patients was meticulously examined and subsequent analysis conducted. Descriptive statistical analyses were undertaken to utilize both Microsoft Excel and SPSS software version 27. Results: The predominant empirical therapy for antibacterial agents was found to be amoxicillin-clavulanic acid, utilized by 73 (56.2%) patients, succeeded by levofloxacin, administered to 33 (25.4%) patients. Following culture and sensitivity testing, the most frequently employed antibacterial agents for definitive therapy included levofloxacin for 33 (25.4%) patients. Notably, the highest Antibiotics Consumption Index (ACI) value recorded was 14.4 for amoxicillin-clavulanic acid in empirical therapy, while in definitive therapy, levofloxacin exhibited an ACI of 14.8. A significant disparity in ACI values between empirical and definitive therapy was observed (p<0.05), signifying statistically meaningful differences. Conclusions: The findings of the current investigation accentuate a discernible trend in the administration of antibiotics for managing community-acquired pneumonia (CAP) within the Medicine Department amidst the COVID-19 pandemic.

SELECTION OF CITATIONS
SEARCH DETAIL