Personal financial literacy among Indian postgraduate residents

BACKGROUND Postgraduate residents’ ability to understand and effectively manage their finances is variable. We conducted this study to assess the awareness of personal financial literacy among Indian residents. METHODS We circulated a web-based cross-sectional Google Forms multiple-choice questionnaire having questions in three categories including financial awareness, current financial status and plans among 400 Indian residents. RESULTS A total of 215 Indian residents (53.75%) responded to the survey (men 80.9%, unmarried 74.4% and pursuing broad specialties 83.3%). The majority were unaware of stocks, special student/doctor loans, tax planning, life insurance, professional indemnity and tax/financial planning. The majority opined that personal finance and investing should be taught at medical school/residency. A financial pyramid based on the hierarchy of needs is proposed. CONCLUSION Lack of financial literacy and planning was seen among the majority of Indian residents. Our study highlights this gap in the medical curriculum and the need for formal structured financial education during training.

Prevalence of metabolic syndrome and its different components in patients with acute coronary syndrome

Background: Several components of the Metabolic Syndrome (MetS) are risk factor for cardiovascular diseases. So, this study was conducted to evaluate the prevalence of MetS and its components in patients with CAD.Methods: Author included all patients admitted with Acute Coronary Syndrome (ACS), who had CAD confirmed by coronary angiography. They were divided into two groups according to presence or absence of MetS based on International Diabetes Federation criteria. The prevalence of MetS and its individual components was estimated.Results: It was observed that there is a high prevalence of MetS (66%) in patients admitted with ACS. Metabolic syndrome is more prevalent in female patients (82.4%) than in male patients (57.6%) with ACS. Hypertension is the most prevalent (87.9) component of MetS. Diabetes Mellitus (DM) is the 2nd most prevalent (83.3%) component of MetS. About 65.2% patients with MetS had abnormally raised triglyceride levels and 32(48.5%) had abnormally low HDL-cholesterol level. Among the MetS 38(57.6%) had abnormal waist circumference. Among the study group, the most common triad of MetS components was DM + HTN + abnormal TG. There is significant association between MetS and microalbuminuria, with incidence of 22(33.3%) in this study. Similarly, a significant association between DM and microalbuminuria, 23(33.8%) was observed.Conclusions: This study confirms a very high prevalence of MetS in Indian patients with CAD. The prevalence of the risk factors was higher in CAD patients with MetS.

Development and validation of stability indicating liquid chromatographic (RP-HPLC) method for estimation of ubidecarenone in bulk drug and formulations using quality by design (QBD) approach

ABSTRACT A novel, accurate, precise and economical stability indicating Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) method, was developed and validated for the quantitative determination of ubidecarenone (UDC) in bulk drug, UDC marketed formulation and UDC loaded cubosomes (CBMs) nanocarriers through Response surface methodology (RSM) design with three factors and three levels was performed to optimize the chromatographic variables followed by forced degradation studies of UDC were performed to detect degradation peak. RP-HPLC separation was achieved using mobile phase consisting of Acetonitrile:Tetrahydrofuran:Deionised water in the ratio 55:42:3 and a flow rate of 1.0 mL/min was optimized with a standard retention time (Rt) of 2.15 min, through experiment. The method was found linear in the concentration range of 5-100 µg/mL with a regression coefficient of 0.999. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 3.04 µg/mL and 9.11 µg/mL, respectively.

Epidemic of Scrub Typhus in Haroti Region of Rajasthan.

Scrub typhus is a rare form of disease caused by gram negative bacterium Orientia tsutsugamushi, of family Rickettsiaceae, transmitted by bite of infected trombiculid mite larva (chigger). The present prospective study is undertaken with the aim of the clinical manifestations, course, complications and outcome of scrub typhus in Haroti region of Rajasthan state during the recent epidemic. Method: This prospective study was conducted in indoor patients of MBS hospital and various private nursing homes in Kota city from August 2012 to November 2012. Twenty cases with positive Scrub typhus card test in the age group of 20 years to 60 years, comprising of 14 males and 06 females were included in the study group in clinically suspected cases with fever, rashes, cough with or without eschar and regional lymphadenopathy. Cases were studied in detail and followed up for improvement and any permanent damage or death. Results: Out of 20 patients, 16 patients improved and discharged from hospital in stable condition without any disability. 02 patients (10%) died because of late presentation and multiorgan involvement especially respiratory failure or meningoencephalitis. Conclusion: Haroti witnessed recent epidemic of Scrub typhus. Renal, respiratory and neurological complications were main cause of mortality and morbidity.

Pharmacognostic and phytochemical investigation of young leaves of Triticum aestivum Linn.

The aim of the work is to perform the pharmacognostic study of the leaves of plant Triticum aestivum Linn., Family Poaceae, commonly known as ‘Wheatgrass’. It is cultivated on large scale all over India and also occasionally cultivated in garden. For the present study samples of the Wheatgrass leaves were collected over a specific period of nine days. The drug was cultivated with specific type of hybrid seeds obtained from most reputed institution of India and were scrupulously analysed. For standardization of the herbal drug morphological, phytochemical, physicochemical and microscopical examination was done. The leaves grown were found to be lax, cauline, flat, 0.6 to 0.25 inches (4 to 6 mm) wide, 6-9 inches long and green in color. The chemical compositions of the leaves are proteins, flavonoids, alkaloids, glycosides, terpenoides, saponins, fibers, tannins and phenolic compounds. The specific variety of seeds, specific time of collection made it more specific to be used for further pharmacological studies.

Localized Urticaria with Intravenous Ondansetron: A Case Report.

Ondansetron is an eff ective antiemetic agent widely used to control nausea and vomiting associated with malignancy and surgery. Although hypersenstivity reactions have been reported with ondansetron in connection with emetogenic chemotherapy, it has been rarely addressed under perioperative settings. Th is case highlights the need of increased awareness among anaesthesiologists regarding the allergic potential of ondansetron and emphasize for judicious administration of this drug with adequate emergency backup.

Pharmacognostic and phytochemical investigation of young leaves of Triticum aestivum Linn.

The aim of the work is to perform the pharmacognostic study of the leaves of plant Triticum aestivum Linn., Family Poaceae, commonly known as ‘Wheatgrass’. It is cultivated on large scale all over India and also occasionally cultivated in garden. For the present study samples of the Wheatgrass leaves were collected over a specific period of nine days. The drug was cultivated with specific type of hybrid seeds obtained from most reputed institution of India and were scrupulously analysed. For standardization of the herbal drug morphological, phytochemical, physicochemical and microscopical examination was done. The leaves grown were found to be lax, cauline, flat, 0.6 to 0.25 inches (4 to 6 mm) wide, 6-9 inches long and green in color. The chemical compositions of the leaves are proteins, flavonoids, alkaloids, glycosides, terpenoides, saponins, fibers, tannins and phenolic compounds. The specific variety of seeds, specific time of collection made it more specific to be used for further pharmacological studies.

Importance of adipocere in determining the cause of death.

Adipocere (term coined by Fourcroy in 1789) also known as corpse wax or grave wax or mortuary wax , derives its name „adipo‟ and „cire‟ meaning the affinity with both fat and wax. It is a late but sure sign of death. It becomes extremely difficult for crime investigators to determine the cause of death in bodies in an advanced stage of decomposition. In such instances, changes like the formation of adipocere and mummification help to preserve certain features and injuries that aid in the determination of identity and in determination of the cause of death of the body. This paper highlights a case in which adipocere was developed and its significance in determining the cause of death. However, decomposition changes like the formation of adipocere, helps to preserve injuries which can aid the forensic experts in opining about the cause of death and hence thereby assisting the law enforcers in administering of justice.

Inhibition of sodium current by carbamazepine in dorsal root ganglion neurons in vitro.

Carbamazepine (CBZ), one of the most commonly prescribed antiepileptic drug, is proposed to inhibit Na+ channel. In this study, we have investigated the effects of CBZ on Na+ current, evoked in cultured dorsal root ganglion (DRG) neurons from neonatal rats using whole cell patch clamp technique. In small DRG neurons (20–25 μm), Na+ current was obtained by blocking K+ and Ca2+ currents with appropriate ion replacement and channel blockers. Separation of the Na+ current components was achieved on the basis of response to the conditioning voltage. The CBZ depressed Na+ current in a dose-dependent manner. The maximal Na+ current was depressed at 300 μM of CBZ, where 94±5.1% of depression was observed. The depression of normalized current amplitude was found to be 72±13.2%, 84±10%, 85±7.1% and 95±5.2% at 10, 30, 100 and 300 μM of CBZ concentrations, respectively, at –20 mV test pulse, when compared with control. The depression of current amplitude was observed as 48±12.3%, 42±15.2%, 71±17.7% and 90±5.8% at 10, 30, 100 and 300 μM of CBZ concentration, respectively, at 0 mV voltage pulse. The depression of Na+ currents was found to be dose-dependant at –20 and –10 mV but not at 0 mV. It is concluded that the depression of Na+ currents by CBZ may be responsible for inhibiting the neurotransmitter release.

Adapalene pretreatment increases follicular penetration of clindamycin: in vitro and in vivo studies.

BACKGROUND: Topical retinoids normalize desquamation, reduce comedogenesis and may enhance the penetration of other topicals providing more effective treatment of acne. AIM: We evaluated the effect of adapalene on skin penetration of clindamycin phosphate when it is applied concomitantly or after various time durations following adapalene application. METHODS: The in vitro studies were carried out using excised rat skin, whereas the in vivo studies were conducted on healthy human volunteers. Radioactive clindamycin phosphate (1%) gel was applied to rat skin sections and to the hands of human volunteers concomitantly and after the pretreatment of the skin for 3, 5 and 10 min with 10 mg of adapalene (0.1%) gel. Quantification of clindamycin phosphate was performed by liquid scintillation. RESULTS: In vitro skin penetration and distribution of clindamycin phosphate was affected by the pretreatment time. Significantly higher skin concentration of clindamycin phosphate (15.5%) with largest proportion in viable skin layer (9.4% of applied dose) was found when clindamycin phosphate gel was applied after the pretreatment of the skin with adapalene gel for 5 min. Further increase in pretreatment time has no additive influence on the penetration of clindamycin phosphate. In vivo results were in corroboration with the in vitro results and demonstrate significantly higher concentration of clindamycin phosphate (19%) in the skin following pretreatment with adapalene gel for 5 min. Adapalene acts as a penetration enhancer and increases the penetration of topical clindamycin phosphate. CONCLUSION: Application of clindamycin phosphate gel after the pretreatment of skin with adapalene gel for 5 min may contribute significantly to the increased efficacy of therapy.

Expanding traumatic intracerebral contusion/hematoma.

BACKGROUND AND AIMS: Delayed traumatic hematomas and expansion of already detected hematomas are not uncommon. Only few studies are available on risk factors of expanding hematomas. A prospective study was aimed to find out risk factors associated with such traumatic lesions. MATERIALS AND METHODS: Present study is based on 262 cases of intracerebral hematomas / contusions out of which 43 (16.4%) hematomas expanded in size. computerized tomography (CT) scan was done in all the patients at the time of admission and within 24 hours of injury. Repeat CT scan was done within 24 hours, 4 days and 7 days. Midline shift if any, prothrombin time, activated partial thromboplastin time, bleeding time, clotting time and platelet counts, Glasgow coma scale at admission and discharge and Glasgow outcome score at 6 months follow up were recorded. RESULTS: Twenty six percent, 11.3 and 0% patients developed expanding hematoma in Glasgow Coma scale (GCS) of 8 and below, 9-12 and 13-15 respectively. The chances of expanding hematomas were higher in patients with other associated hematomas (17.4%) as compared to isolated hematoma (4.8%) (Fisher's exact results P =0.216). All the cases of expanding hematoma had some degree of midline shift and considerably higher proportion had presence of coagulopathy. The results of logistic regression analysis showed GCS, midline shift and coagulopathy as significant predictors for the expanding hematoma. Thirty nine patients (90.7%) of the total expanding hematomas developed within 24 hours of injury. CONCLUSIONS: Enlargement of intracerebral hematomas is quite common and majority of them expand early after the injury. These lesions were common in patients with poor GCS, associated hematomas, associated coagulopathy and midline shift.

Endoscopic third ventriculostomy in infants.

BACKGROUND: Endoscopic third Ventriculostomy (ETV) is one of the surgical options for obstructive hydrocephalus. There are varying opinions about results of ETV in infants. We are therefore presenting the results of ETV in 54 infants. MATERIALS AND METHODS: A prospective study of 54 infants undergoing ETV in our institution in the last 2 years was carried out. There were 48 cases of congenital hydrocephalus with aqueductal stenosis, 6 of post tubercular meningitis hydrocephalus. Average follow up was 18 months. RESULTS: There was 83.3% (45 cases) clinical success rate in our study. Infection, persistent cerebro-spinal fluid (CSF) leak and bleeding occurred in 4 (8%) cases each while blockage of stoma was observed in 8 (14.8%) patients. Majority of ETV stoma closure (6 out of total 8) occurred following infection (4) or bleeding during surgery (2). One patient (2%) had transient diabetes insipidus. Overall failure rate in our study was 16.7% (8 stoma blocks and 1 procedure abandoned). Low birth weight pre mature infants had higher failure rate (3 out of 5 infants 60%) compared to full term infants with normal birth weight (12.3%). Age did not have any impact on the success rate (P>0.05). Success rates were not significanlty different in patients with aqueductal stenosis (85.4%) and TBM (66.6%) (Fisher's exact test, P=0.3). CONCLUSION: ETV was fairly safe and effective in full term normal birth weight infants while the results in low birth weight pre mature infants were poor.