Résumé
The posterior communicating arteries (PCoA) are important component of collateral circulation between the anterior and posterior part of circle of Willis (CW). The hypoplasia or aplasia of PCoA will reflect on prognosis of the neurological diseases. Precise studies of the incidence of hypoplastic PCoA in Andhra Pradesh population of India are hitherto unreported, since the present study was undertaken. Two hundred and thirty one magnetic resonance angiography (MRA) images were analyzed to identify the hypoplasia of PCoA and presence of fetal type of posterior cerebral artery (f-PCA) in patients with different neurological symptoms. All the patients underwent 3.0T MRI exposure. The results were statistically analysed. A total of 63 (27.3%) PCoA hypoplasia and 13 cases with f-PCA (5.6%) cases were identified. The hypoplastic PCoA was noted more in males than females (P<0.05) and right side hypoplasia was common than the left (P<0.04); bilateral hypoplasia of PCoA was seen in 37 cases out of 63 and is significant. The hypoplastic cases of the present study also were associated with variations of anterior cerebral arteries and one case was having vertebral artery hypoplasia. Incidence of PCoA as unilateral or bilateral with other associated anomalies of CW is more prone to develop stroke, migraine and cognitive dysfunction. Knowledge of these variations in the PCoA plays a pivotal role in diagnoses of neurological disorders and in neurovascular surgeries and angiographic point of view.
Résumé
The posterior communicating arteries (PCoA) are important component of collateral circulation between the anterior and posterior part of circle of Willis (CW). The hypoplasia or aplasia of PCoA will reflect on prognosis of the neurological diseases. Precise studies of the incidence of hypoplastic PCoA in Andhra Pradesh population of India are hitherto unreported, since the present study was undertaken. Two hundred and thirty one magnetic resonance angiography (MRA) images were analyzed to identify the hypoplasia of PCoA and presence of fetal type of posterior cerebral artery (f-PCA) in patients with different neurological symptoms. All the patients underwent 3.0T MRI exposure. The results were statistically analysed. A total of 63 (27.3%) PCoA hypoplasia and 13 cases with f-PCA (5.6%) cases were identified. The hypoplastic PCoA was noted more in males than females (P<0.05) and right side hypoplasia was common than the left (P<0.04); bilateral hypoplasia of PCoA was seen in 37 cases out of 63 and is significant. The hypoplastic cases of the present study also were associated with variations of anterior cerebral arteries and one case was having vertebral artery hypoplasia. Incidence of PCoA as unilateral or bilateral with other associated anomalies of CW is more prone to develop stroke, migraine and cognitive dysfunction. Knowledge of these variations in the PCoA plays a pivotal role in diagnoses of neurological disorders and in neurovascular surgeries and angiographic point of view.
Résumé
Background: Insulin and thyroid being intimately involved in cellular metabolism, excess or deficit of one of these hormones leads to abnormality of the other. Association between type 1diabetes and hypothyroidism may be autoimmune. Association of poorly controlled diabetes and thyroid results in a low T3 state and loss of TSH response to TRH. The objective of the present endeavor is to study the thyroid functions in diabetics and to know the spectrum of thyroid dysfunction in DM.Methods: It is a prospective cross-sectional study of 100 diabetic patients admitted in medical wards in a duration of 6 months from November 2017 to May 2018 of both sexes in between age group of 30-80years. All these patients underwent thyroid profile tests. Detailed history and examination done on these patients.Results: Out of total 100 patients included in the study, thyroid disorder was present in 29%. Hypothyroidism in 1 patient, sub clinical hypothyroidism in 15 patients, hyperthyroidism was present in 13 patients. Females (36%) had high incidence than males (22%). Elderly people had higher incidence of subclinical hypothyroidism (18.2%), clinical features of hyperthyroidism present in 8 patients, Poor hypoglycemic control seen in hyperthyroid individuals (55.5%). Duration of diabetes had no relation with incidence of thyroid disorders.Conclusions: Prevalence of thyroid disorders in diabetic patients was 29%. Elderly population had more incidence. Subclinical hypothyroidism more common than other conditions. It was more common in females than in males. There is no relation in between duration of diabetes and thyroid disorder. Severe complications were noted in patients with sub clinical hypothyroidism.
Résumé
Background: To conduct economic analysis in tertiary care hospital with a view to identify the categories of drugs needing stringent management control.Methods: The annual consumption and expenditure data is obtained from the drug store of government general hospital, Vijayawada, for the period of April 2015 to March 2016. ABC-VED analysis of the drugs are done based on cost and criticality criteria respectively. ABC-VED matrix analysis was done to classify drugs into category I, II, III.Results: The total annual drug expenditure incurred on 299 drug items for the year 2015-2016 was found to be Rs:4,47,04,446. On ABC analysis, 4%, 9.36%, 86.64% of drugs were found to be Always, Better, and Control category items respectively, amounting to 68.92%, 20.05%, 11.03% of annual drug expenditure. VED analysis showed that 32.10%, 45.5%, 22.4% of drug items were Vital, Essential, and Desirable category items respectively, amounting to 35.3%, 37.1%, 27.6% of annual drug expenditure respectively. By ABC-VED matrix analysis, 34.11%, 46.49%, 19.4% of drug items were found to be category I (high stringent), II (medium stringent), III (low stringent) respectively, amounting to 80.76%, 17.46%, 1.77% of annual drug expenditure respectively.Conclusions: The study identified 34.11% of drug items belonging to category I which require high priority monitoring. Inventory management tools must be routinely used for the better control and judicious use of the resources.
Résumé
Background: In 2016, FDA recommended that 搒erious side effects associated with flouroquinolones generally outweigh the benefits for the patients with acute sinusitis, acute bronchitis and uncomplicated UTI�. Throughout India the most commonly used flouroquinolones for above conditions are Ciprofloxacin, Ofloxacin, and Levofloxacin. In this scenario, the present study was undertaken to monitor, evaluate and compare the adverse effect profile of Ciprofloxacin and Ofloxacin in acute exacerbation of chronic bronchitis patients.Methods: Prospective, observational study done in 200 patients of tertiary care teaching hospital. The patients diagnosed with, acute bronchitis treated with Ciprofloxacin 500mg BD or Ofloxacin 400mg BD for 7 days were included in the study. The study duration was 6 months. ADR causality assessment was done with Naranjo algorithm. Statistical test applied was chi- square test.Results: 63 ADR were reported in Ofloxacin group and 19 ADR in Ciprofloxacin group. Insomnia was most frequent ADR (40%) in patients treated with Ofloxacin. There is high incidence of ADRs in ofloxacin group. chi square test showed this difference is statistically significant (p<0.05). Insomnia was significantly higher in ofloxacin group (p<0.05).Conclusions: In India frequently used and misused antimicrobials are fluoroquinolones. The present study concluded that no serious ADRs but ofloxacin group of patients have shown increased incidence of ADRs associated with CNS especially Insomnia. However, further large scale, multi-centric studies are needed to confirm these results.
Résumé
The objective of this research was to formulate and evaluate hydrodynamically balanced controlled drug delivery system of Losartan. This dosage form is associated with many advantages especially increased bioavailability and reduction in dosing frequency. The formulation was designed adopting optimization technique, which helps in setting up experiments in such a manner that the information is obtained as efficiently and precisely as possible. Initially, considering buoyancy as the main criteria, blank tablets were compressed for different formulae with various polymers like HPMC, MC and EC. The formula selected for design had a combination of Losartan, HPMC, EC and MC. The tablets were prepared by direct compression method and evaluated for Losartan content in vitro release profile and buoyancy. The dissolution study was carried out in simulated gastric fluid using USP dissolution test apparatus employing paddle stirrer. Duration of buoyancy was observed simultaneously when the dissolution has carried out The variation in weight was within the range of ±4% complying with pharmacopoeial specifications (±Z5%). The drug content of Losartan floating tablet 8.455±0.0085 mg in of optimized formulations indicating content uniformity. The buoyancy of the tablets was range 15.345±0.1321 hrs the maximum buoyancy was seen in P6, which has a high level of drug to polymer ratio. The in-vitro release was found to be in the range between the 79.12% to 90.45%.. The formulation P6 has an in vitro release of 79.12% showed the release of the drug in the controlled manner. The optimized formulation P6 exhibited responses that were comparable with that of the predicted values of the design in optimization technique. This indicates the suitability of the technique chosen for the present dosage form.
Résumé
Chromium is known to be highly toxic to biological systems. This study was designed to determine the mutagenic effects of different concentrations [0, 10, 25, 50, 100 and 200 mg/L] of hexavalent chromium on root tip cells of blackgram [Vigna mungo L. Hepper]. The blackgram seeds were equi-spacially arranged in sterilized petriplates lined with filter paper and they were treated with different concentrations of chromium solution. In germination studies, the morphological growth parameters such as germination percentage, root length, shoot length fresh weight and dry weight of blackgram seedlings were decreased with increasing dose of chromium concentrations. No germination of blackgram seeds was recorded at 300mg/l chromium concentration. Chromosome aberration assay was used to determine the mitotic indices and rate of chromosome aberration in blackgram root tip cells due to chromium treatment. The results showed that the mitotic indices were complicated due to different concentrations of chromium. However, the increase in chromium concentration has led to a gradual increase in the percentage of chromosomal aberration and mitotic index. The chromosome length, absolute chromosome length and average chromosome lengths were gradually found to decrease. There was no considerable change in 2n number of chromosome with the increase in chromium concentrations. It is concluded that the hexavalent chromium has significant mutagenic effect on the root tip cells of blackgram