Birth Preparedness and Complication Readiness among Pregnant and Recently Delivered Women in Gandhinagar District, Gujarat, India: A Community-based Cross-sectional Study

Background: Birth Preparedness and Complication Readiness (BPCR) helps in improving the effective utilization of available maternal and newborn health care services through knowledge of danger sign, identifying birth place and attendant, means of transportation, managing fund for an emergency, birth companion and identification of blood donor. Aim: To find the association between socio-demographic characteristics and BPCR index indicators. Settings and Design: A cross-sectional study was conducted among the recently delivered and pregnant women in urban and rural areas of the Gandhinagar district of Gujarat. Methods and Material: Total 420 pregnant and recently delivered women from urban and rural areas were interviewed for study. A pretested semi-structured questionnaire was used to interview women at household setting. BPCR index is estimated by set of 7 quantifiable indicators and expressed in the percentage of women with specific characteristics. Results: Regarding ANC registration within 12th weeks of pregnancy and skilled birth attendant for delivery. Significant difference was observed with variable like APL/BPL status, education of women and their husband, parity and type of family. Conclusions: Hindu religion, APL economic status, higher education level, joint family, high parity and joint family were found important predictor of better BPCR practice.

Severe acute respiratory syndrome for COVID-19 by RT-PCR test during its intensifying phase, Gujarat, India

Background: The COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) originated from Wuhan, China, a pandemic. By knowing different demographic and clinical data, one can have a better idea about the progress and fate of disease, which will help others to plan accordingly to manage patients in terms of decreasing morbidity and mortality caused by it. Aims and Objectives: The study was done to describe the RT-PCR diagnostic profiles of SARS-CoV-2 patients in Gujarat from three districts (Arvalli, Sabarkantha, and Gandhinagar) and their correlation with respect to age, sex, travel history, symptoms, and underlying conditions. Materials and Methods: This was a retrospective cohort study of patients with COVID-19, who were screened for SARS-CoV-2 from April 16 to May 25, 2020, from three districts of Gujarat (Arvalli, Sabarkantha, and Gandhinagar). Positive cases were confirmed by qRT-PCR and analyzed for epidemiological, demographic, and clinical characterization among different groups. Results: Of 4000 suspects screened, a total of 199 patients were confirmed with SARS-CoV-2 infection. Among them, middle-aged group (5.4%) and young adult patients (4.3%) were infected with SARS-CoV-2. The median age was 33 years, including 143 males and 56 females. The positivity rate from breathlessness was 8 (28.5%), nasal discharge 2 (25%), and nausea/vomiting 2 (25%) followed by fever 28 (20%) among total cases in respective categories. Among asymptomatic 3536 patients, 146 patients were confirmed for SARS-CoV. Among 256 patients with comorbidities, 14 patients were confirmed for SARS-CoV. Conclusion: Clinical investigation in initial SARS-CoV-2 patients in the western Indian region revealed that young adult male was more susceptible than female. Symptoms such as fever, cough, and sore throat reports are useful for screening the SARS-CoV-2.

Bacteriological profile and antibiotic susceptibility of blood culture from neonates in GMERS Medical College, Gandhinagar

Background: Neonatal sepsis refers to an infection involving bloodstream in newborn infants <28 days old. Neonatal sepsis contributes substantially to neonatal morbidity and mortality and is an ongoing major global public health challenge. Aim and Objectives: The objectives of this study were to study bacteriological profile and antibiotic susceptibility of blood culture from neonates in GMERS Medical College, Gandhinagar. Materials and Methods: For culture and antimicrobial susceptibility test, blood samples were taken from the suspected cases admitted in NICU. Total 271 blood culture positive NICU admitted patient with septicemia were taken in this study. Results: Total 271 septicemic neonates having blood culture positive septicemia, neonatal septicemia was predominantly caused by Gram-negative organism Klebsiella pneumoniae (40.60%). Among the all Gram-negative organisms, Piperacillin/Tazobactam was most sensitive drug followed by Meropenem. Moreover, for the all Gram-positive organism, vancomycin and linezolid were the most sensitive drugs. Conclusion: Neonatal septicemia is major cause of morbidity and mortality in India. Multiple antibiotic resistance among the isolates worsen the condition more. A high level of suspicions is needed on clinical ground for diagnosis. Judicious use of antibiotics should be promoted.

Detection and correlation of antimicrobial resistance pattern in Enterobacteriaceae from UTI patients in GMERS Medical College, Gujarat

Background: Bacterial resistance to antibiotics is a growing public health threat worldwide. The increasing rate of antimicrobial resistance among bacterial pathogens causing both hospital- and community-acquired infections is a serious threat to public health world-wide. This inappropriate and non-judicious usage of antibiotics has resulted in the development of worldwide antibiotic resistance in bacteria, leading to the emergence of multi-resistant strains of bacterial pathogens. This study focuses on the prevalence of antibiotic resistance in the Enterobacteriaceae group of organisms in urine samples and also detects various methods of antibiotic resistance. Antibiotic resistance detection may be useful for epidemiological and research purposes, as well as for preventing the spread of drug-resistant organisms within hospitals through good infection control practices. Aims and Objectives: The aim of the study was to detect occurrence of ?-lactamases, extended-spectrum beta-lactamases (ESBL) and Carbapenemase by phenotypic methods in Enterobacteriaceae from urine samples along with pattern of antibiotic resistance for various antibiotics in them. Materials and Methods: A descriptive study was conducted at a tertiary-care hospital. Testing of ESBL and carbapenemase production detection done according to CLSI (M100) guideline by the Kirby-Bauer disk diffusion method, combination disc diffusion test, and modified Carbapenem inactivation method. Results: A total of 220 Enterobacteriaceae organisms were isolated from processed urine samples of tertiary care Hospitals. Rate of cephalosporin resistance in ESBL and carbapenem-resistant Enterobacteriaceae (CRE) is more than 90% while in non-ESBL more than 70% and in non-CRE 75–80%. Carbapenem resistance in ESBL and non-ESBL is the same. Resistance to fluoroquinolone group, Aminoglycoside group, and Cotrimoxazole and Tetracycline group of antibiotics were more noticed in ESBL and carbapenemase producing organisms. In our study, fosfomycin and Nitrofurantoin are effective treatment in case of ESBL and CRE producing organism. Conclusion: The ESBL and Carbapenemase producing isolates were multi-drug resistant making therapeutic choices limited. Fosfomycin and Nitrofurantoin are effective treatment in multidrug resistance urinary tract infection.

A Study of Role of Medical Thoracoscopy in Undiagnosed Pleural Effusion

Aim and objectives: To know the diagnostic yield of pleuroscopy (medical thoracoscopy) in cases of pleural effusions which remain undiagnosed after routine initial investigations. To notice the different gross pleuroscopic findings during the procedure. To observe various histopathological reports of pleural biopsy taken through medical thoracoscopy. To know the various complications of pleuroscopy in patients undergoing this procedure. Materials and methods: A total of 56 patients having undiagnosed pleural effusion were taken for study after informed written consent. All patients underwent medical thoracoscopy. The clinical, demographic, and radiological profile of patients was recorded. Gross pleuroscopic findings and histopathological reports of the pleural biopsy were noted. All patients were observed for any complications that occurred during or after the procedure. Result: Diagnostic yield of thoracoscopy in the present study was 91.07% (malignant pleural effusion 75% and tuberculous pleuritis 12.5%). Adenocarcinoma was the commonest malignancy in 60.71% of patients amongst malignant pleural effusion in the present study. Very few complications were recorded. The most common postprocedure complication was subcutaneous emphysema (12.5%) followed by pneumothorax (10.78%). Conclusion: Thoracoscopy gives excellent diagnostic yield in undiagnosed pleural effusion without major complications, and should be utilized wherever feasible.

A study on Instinctive Feelings, Perceived Stressors and Factors that helped in reducing Stress during COVID 19 pandemic among Health Care Workers

Background: Healthcare workers at the forefront of the battle against COVID 19 are not only putting their own health and lives at risk but are also fighting to keep their own worries and emotional stress at bay. Aim & Objective: To evaluate emotions, perceived stressors, and factors that helped in reducing stress of healthcare workers who worked during a COVID19 pandemic. Settings and Design: This cross sectional study was conducted among Health Care staff involved in COVID 19 duty in tertiary care hospital of Gujarat. Methods and Material: Google form link was shared though what’s up and mail. The questionnaire was completed online. Consent for voluntarily participation was also obtained through online Google form. Statistical analysis used: Data was entered and analysed through Microsoft Excel 2010. Results: Total 106 participants responded to the questionnaire. It was extremely stressful for health care workers to see their colleagues getting infection, as well as the fear that they could transmit the disease to their families or friends. Main factors that helped to reduce the stress were positive attitude from colleagues, improvement of patients conditions and availability of protective equipment. Conclusions: Personal safety, the protection of family members and unpredictability of pandemic were the main concerns. Hospitals should prioritise stress monitoring for health care workers and provide targeted psychological guidance for HCWs during the pandemic.

Prevalence of Asymptomatic Bacteriuria Among Pregnant Women Attending a Tertiary Care Hospital in Western India

Introduction: Asymptomatic bacteriuria refers to the presence of bacteria in urine having overall inci-dence during pregnancy ranges between 2%-10%. The study was conducted to assess prevalence of asymptomatic bacteriuria in pregnant women. The study also aimed to find out the most common Path-ogenic organism isolates from urine sample. Methodology: Pregnant women with varying gestational periods attending the tertiary care hospital without any symptoms of UTI were included in the study. Their urine was tested for routine microscopy, culture, and certain biochemical testing. Results: Prevalence rate of asymptomatic bacteriuria was seen 13.8% in pregnant women. Proportion of asymptomatic bacteriuria is highest 14.70% in age group 26-30 year, 23.33% in first trimester. Both gram negative and gram-positive bacteria were isolated, but gram-positive cocci isolates were higher comparatively gram-negative bacilli. Organisms recovered in order of frequency were E. coli, Coagulase Negative Staphylococci (CONS), S. aureus, Klebsiella spp, Acinetobacter spp, Citrobacter spp and Entero-bacter spp. Conclusion: High prevalence of asymptomatic bacteriuria demands routine bacteriological screening of pregnant women. This will help in early treatment of asymptomatic bacteriuria which will help in pre-vention of acute and chronic pyelonephritis.

Familial Primary Open Angle Glaucoma

Primary open-angle glaucoma (POAG), also known as chronic simple glaucoma, is usually an inherited disease. Inheritance is considered multifunctional and polygenic. Glaucoma is the second leading cause of irreversible blindness worldwide, of which POAG is the most common. First-degree relatives of POAG patients are at increased risk. A reasonable risk for siblings is four and twice the risk of the normal population for the offspring, although the number of surveys varies. This case series of eight family members with POAG illustrates the stealth nature of POAG and the devastating vision loss it can cause as it progresses; emphasizing regular and comprehensive eye examinations during its early stage.

Is A Journal indexed? Here's How to Find it

Quality of the journal is very important while selecting a journal for publication. One of the criteria is to check indexing status of the journal in good manuscript indexing databases. This article describes simple method to check indexing status of any journal on the internet. Author can use this method to check in-dexing status of the journal before submission of their article.

Drug utilization study in ophthalmology outpatient department of a tertiary care teaching hospital

Background: Drug utilization studies (DUS) provide insight into recent trend of drug usage and facilitate rationality of prescribed drugs. Few DUS have been conducted in ophthalmology. Aim and Objective: To analyse the prescription pattern in outpatients of the ophthalmology department at a tertiary care teaching hospital. Materials and Methods: A prospective, observational and cross-sectional study was conducted at GCS Medical College Hospital and Research Centre, Ahmedabad. All patients who visited ophthalmic outpatient department were enrolled and necessary data were recorded regarding drugs prescribed in pre-defined case record form. Data analysis was carried out using Microsoft Excel. Results: A total of 388 prescriptions were analysed. Average number of drugs and fixed-dose combinations (FDCs) per prescription were 2.47 (95% CI, 2.29–2.64) and 0.44 (95% CI, 0.36–0.51), respectively. Drugs were prescribed in different dosage forms with eye drops being the most common (95.1%) followed by tablet (12.3%), ointments (8.5%), capsules (2.8%), syrup (1.1%), and injections (0.3%). One or more dosage forms were seen per prescription. Total 957 drugs were prescribed, out of which drugs with brands name and generic name were 88.4% and 11.6%, respectively. Total FDCs prescribed were 17.5%. Overall, 43.5% of prescriptions had antibiotics ranging from 1 to 5 per prescription and 25% of antibiotics were seen out of total drugs. Conclusion: Most of the drugs prescribed were in the form of drops. FDCs and antimicrobial use have been increasing in the management of ophthalmic diseases. Less numbers of drugs were prescribed by generic names.

An open randomized cross over study to compare the clinical effectiveness and safety of economical generic with branded generic telmisartan in essential hypertension

Background: Hypertension is a chronic disease and is a major risk factor for chronic heart disease, stroke, coronary heart disease, and its complications include heart failure, peripheral vascular disease, renal impairment, retinal hemorrhage, and visual impairment. Antihypertensive drugs are important to avoid such complications but compliance of patient is needed which may depend on the cost of therapy. Aim and Objective: This study aimed to assess the efficacy and safety of a branded generic with an economical generic. Materials and Methods: Out of 110 patients, 105 patients (53 patients in group A and 52 patients in group B) completed the study with follow-up over a period of 6 months. Group A patients received generic Telmisartan 40 mg in the beginning (0th day) which was continued for 12 weeks, cross-over was done with branded generic Telmisartan (Telma 40) which was given for further 3 months. Group B patients received the branded generic followed by generic Telmisartan in that sequence for 3 months each. Blood pressure (BP) was recorded at the baseline visit and at the end of 4, 8, 12, 16, 20, and 24 weeks. The adverse events were assessed throughout the study period. Results: Intra-group comparison show significant reduction in systolic (SBP) and diastolic BP (DBP) in each groups (P < 0.001) but when we compare the reduction of SBP and DBP in between the two groups the difference was not significant. Common adverse events were headache, dizziness, light-headedness, and vertigo. Conclusion: There was a huge difference between the prices of branded generic and unbranded generic. This study showed that both branded generic and unbranded generic are comparable in terms of efficacy, safety except the cost of therapy. Thus substitution of a Pharmacological generic (unbranded generic) drug could save lot of expenses.

Efficacy and safety of intravenous ferric carboxymaltose in moderate to severe postpartum iron deficiency anemia

Background: PPA affects 50–75% of women. Traditional treatments such as oral iron therapy and blood transfusion have significant disadvantages. Oral iron is not usually absorbed or well-tolerated because of gastrointestinal disturbances and requires long time (months) to reach target of hemoglobin (Hb). Due to limitations of prior parenteral iron preparation, search of novel drug resulted in iron sucrose and latest is Ferric carboxymaltose (FCM). Intravenous FCM has a neutral pH and physiological osmolarity allowing for higher single doses over a shorter time periods. It also does not cause dextran- associated immunogenic reactions. Aims and Objectives: Aims and objectives of the study is to evaluate the safety and efficacy of IV FCM in treatment of postpartum iron deficiency anemia. Materials and Methods: It was prospective intervention study conducted at the tertiary care center from January 2019 to June 2019. Total 151 postnatal women aged 18–45 years with moderate and severe anemia were included in the study. FCM was administered as an intravenous infusion of 500–1000 mg dose based on requirement in 100 ml of 0.9% normal saline solution over 15 min. Hb and serum ferritin were recorded at baseline and at the end of 6 weeks. Safety and tolerability were assessed by recording the adverse events during the study period. Results: Mean age of the study participants was 26.4 ± 4.54 years. Total 112 women (74.1%) had moderate anemia and 39 women (25.8%) had severe anemia. Average baseline Hb was 7.82 ± 0.84 g/dl which was significantly increased up to 12.4 ± 1.33 g/dl at 6 weeks (P < 0.05). Serum ferritin was also significantly improved from 16.22 ± 7.54 baseline to 136.21 ± 66.12 at 6 weeks (Difference 115.12 ± 53.21, P < 0.05). No any serious adverse events were reported. Only minor adverse events such as mild itching at injection site (5, 3.3%) palpitation (2, 1.3%) and nausea (1, 0.6%) were reported. Conclusion: Intravenous FCM therapy was well-tolerated and effective for management of moderate?to?severe anemia among postpartum women. It improved Hb and iron stores in the form of serum ferritin with a very few side effects such as mild itching at injection site, palpitation, and nausea.

Medical students’ perception of online learning during COVID-19 pandemic in India-a survey

Background: The COVID-19 pandemic situation has immensely affected teaching in all institutions, especially in medical colleges. To minimize the impact of lockdown, current technology enabled online learning (E-learning) to be the important method of teaching the student during the COVID-19 pandemic. Aim and Objectives: The main objective of the present study to analyze perception of online teaching approach of medical students after 1 month of online learning without faceto-face learning. Materials and Methods: A survey was conducted by distributing an online questionnaire to 710 medical students. This research study was conducted from May 15 to May 16, 2021. Data gathered from the survey were analyzed with Epi info 7.1.5.0 software. Results: A total of 452 (63.66%) were male and 258 (36.34%) were female. Learning on your own place (80.1%), ability to stay at home (72.1%), access to online materials (59.2%), and ability to record meeting (49.8%) were the most frequent advantages of e-learning selected by medical students. The majority of students chose lack of interaction with patients (66.8%), technical problems (53.9%), reduced interaction with faculty (50.3%), social isolation (44.9%) as the main disadvantages. E-learning was considered less effective than face-to-face learning in terms of increasing skills (M = 2.1, M = 4.6, respectively) (P < 0.001) and social competences (M = 2.8, M = 4.8, respectively) (P < 0.001). Conclusion: The online learning was found to be advantageous as it provided flexibility and convenience for the learners. All these factors should be considered while developing an online course to make it more effective and productive for the learner.

Role Of Ultrasound In First Trimester Bleeding Per Vaginum

Background:Bleeding per vaginum in the first trimester is a common obstetric situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic, and molar pregnancy. Ultrasonography is playing an increasing role in the management of such patients. The aim of this study was to determine the role of first trimester bleeding on obstetrical ultrasound.Material And Methods:This was a retrospective observational study done at urban health care Hospital Ahemdabad, a tertiary care teaching hospital. All obstetric cases with a history of bleeding per vaginum in the first trimester of pregnancy between July2019 and December2019 were included. A complete general physical and pelvic examination was done to arrive at a clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical diagnosis and ultrasound diagnosis were correlated.Result:150 of all 2000 obstetric cases had the first trimester bleeding (incidence of 7.5%). Commonest causes were abortion (78.66%), ectopic (6%), and molar pregnancy (2%). Of 150 cases, 106 cases were correctly identified by ultrasonography. 44 cases proved by sonography were misdiagnosed by clinical examination with a disparity of 52.38%. In this study, 56% pregnancies were clinically diagnosed as viable, but only 34% pregnancies were viable.Conclusion:When the first trimester of pregnancy is complicated by vaginalbleeding, the history and clinical findings are often misleading and if relied upon can only lead to a delay in diagnosis and management.This study reinforces that USG is important to establish a definitive diagnosis, differential diagnosis and subsequent management.

Prospective Study Of Efficacy And Perinatal Outcome Of Hydrotherapy In Oligohydroamnios Patients

Background:Oligohydramniosmeans a low level of amniotic fluid during pregnancy. It is defined by an amniotic fluid index that is below 5th percentile for the gestational age. It may cause IUGR, fetal anomalies, malpresentations and fetal distress in labour. Oral or intravenous fluid therapy may increase the amount of amniotic fluid and may improve perinatal outcome. Aims And Objectives:To study efficacy and perinatal outcome of hydrotherapy in patients with oligohydamnios. Material & Methods:A prospective observational study wascarried out at tertiary care centre for 6 months. 30 cases of oligohydramnios were enrolled in this study. Results:In present study, maximum (50%) patients admitted for oligohydramnios were between 28 –32 weeks gestational age and 66% were having severeoligohydramnios. After giving hydration therapy, difference in AFI, was 2.57±0.13, which was statistically significant. 83.3% patients were delivered after 36 weeks and 80% were delivered by normal vaginal delivery. 53.3% babies were live healthy, whereasothers needed resuscitation and admitted to NICU. Conclusion:Oligohydramnios has higher impact on perinalal outcome due to antenatal and intrapartum complication. Because of early diagnosis by ultrasonography or clinical analysis, fluid therapy is an option to increase amniotic fluid volume and so perinatal outcome may be improved.

Study Of Maternal And Perinatal Outcome In Patients With Abruption Placenta

Background:Abruptionplacenta is one of a serious obstetrics emergency. It is defined as partial or complete separation of normally implanted placenta after 28 weeks of gestation, prior to delivery of the fetus. Placental abruption complicates about 1% of pregnancies and is aleading cause of vaginal bleeding in the latter half of pregnancy.1 AIMS:To study maternal outcome in patients with abruption placenta. To study perinatal out come in patients with abruption placenta. Material And Methods:A prospective observational study was carried out at tertiary hospital for 6 months from September 2019 to February 2020. 30 cases of abruption placenta were enrolled in this study. Results:Maximum patients (56.6%) were from 26 –30 year age group. (63.3%) were having second gravida. Maximum (56.6%) patients admitted were between 33 –36 week gestational age group. Most of (60%) patients were having revealed type of bleeding. (52.3%) patients were having grade 2. Major maternal morbidities were PPH (36.6%), severe shock (23.3%) and DIC (6.6).(26.6%) babies had birth asphyxia, (16.6%) developed ARDS. Sepsis and ICH was seen in (10%) each whereas necrotizing enterocolitis and stillbirth was found in (13.3%). Perinatal death was seen in (6.6%). Conclusion:Abruption placenta is associatedwith poor maternal and fetal outcome. Early diagnosis and prompt resuscitative measures are essential to prevent both perinal and maternal morbidity and mortality.

An Evaluation Of The Retention Property Between Cream Type And Strip Type Denture Adhesive With And Without Salivary Substitutes: An In Vitro Study

Background:Patients with xerostomia complain of not only dryness of mouth but also discomfort during routine normal oral functions like speaking and swallowing. These complainis worse in individuals wearing removable intraoral dental prosthesis. In such situations, when salivary flow decreases, denture adhesives and salivary substitutes are recommended; which aid in denture retention and improve patient comfort.Material & Method:A total 150 samples were prepared using heat-cure acrylic resin of 30mm×30mm×5mm. All samples were equally divided in A,B,C,D,E groups,wherein Group A was control group with salivary substitutes.Group B was denture adhesive cream without salivary substitutes.Group C was denture adhesive cream with salivary substitutes.Group D was denture adhesive strips without salivary substitutes.Group E was denture adhesive strips with salivary substitutes.The retentive force was measured for all samples usinguniversal testing machine.Results:Data was collected and statistical analysis was done by one-way ANOVA test followed by post hoc test. The significant difference was found between the retentive forces of cream type and strip type denture adhesives withor without salivary substitutes.Conclusion:From this study, it is concluded that denture adhesive will definitely increases the denture retention. The cream type denture adhesive with salivary substitutes has the most retention than among all groups.

Venlafaxine Hydrochloride Controlled Release Bilayer Tablets: Optimization Of Formulation Variable By Using Dyspnea On Exertion

The current research work was to develop bilayer tablet of venlafaxine hydrochloride to increase drug efficacy for efficient treatment of depression. The satisfactory result of treatment can be achieved upon the maintenance of drug concentration within an effective level in the body, so a uniform and constant drug supply are desirable. An immediate layer of venlafaxine HCl was formulated using super disintegrants, i.e., croscarmellose sodium (CCS) and sodium starch glycolate (SSG); tablet compact by direct compression. HPMC K100M and ethylcellulose (EC) were utilized as release retarding polymers in sustained release layer by wet granulation technique with the help of PVP K30 in IPA solution (10%) as a granulating agent. Full 32 factorial designs were used to find out the optimum quantity of release retardant polymers. Bilayer tablet was evaluated for various parameters, i.e. hardness, friability, weight variation, % drug content, disintegration time (IR layer), and % drug release study. Statically, an analysis was carried out using factor X1 (HPMC K100M) and X2 (EC) for dependent variable % drug release at 8, 12, and 20 hours. A formulation was optimized and a formulation containing 305.36 mg of HPMC K100M and 54.03 mg of ethyl cellulose. Optimized formulation show 47.12 ± 2.1, 59.89 ± 2.2, and 89.06 ± 2.3 drug release at 8, 12, and 20 hours, respectively, which is almost similar to theoretical dose calculation with similarity factor f2 97, 99, and 98%, respectively. Bilayer tablet formulation was observed to be stable and fulfilled all compendia specifications.

Reasons for the delay in the initiation of treatment and initial default among drug-resistant tuberculosis patients in Ahmedabad corporation area

The emergence of drug-resistant tuberculosis (DR-TB) has become a significant health problem in India. Delays in diagnosis and treatment initiation are frequently observed among patients with DR-TB, resulting in an increased risk of disease complications and high mortality and pretreatment lost to follow-up rates. To understand the factors associated with delays between the diagnosis and treatment, the study was carried out in Ahmedabad Municipal Corporation Area. A total of 177 DR-TB patients diagnosed in the year 2014 who had a delay in the initiation of treatment, and 23 initial defaulters were studied using a structured questionnaire. Fifty-four DOTS providers were also interviewed. Of 177 patients, 62.15% initiated treatment between 7 and 15 days and nearly 12% of them started the treatment after a month. The median duration of delay was 12 days (range: 8–144 days and interquartile range: 9–20 days). The most common reason for the delay in the initiation and initial default was the social and personal factors (48.80%), and in 34 (20%) of the patients, the delay was attributed to the effect of the previous treatment.

Quantitative Analysis Of Pamabrom And Ibuprofen In Synthetic Mixture Using 1st Order Derivative Spectroscopy

Objective: The preliminary goal was to develop and validate 1st order derivative spectroscopic method for quantitative analysis of Pamabrom (PAMA) which is a xanthine diuretic and ibuprofen (IBU) which is a non-steroidal anti-inflammatory agent from its synthetic mixture. Methods: Analytical method was developed on Shimadzu double beam spectrophotometer equipped with UV probe 2.42 as software using methanol as solvent. Quantification of PAMA was carried out at zero cross over point of IBU that is 291 nm and for IBU, it was achieved at 278 nm which is zero cross over point of PAMA. Method was validated according to ICH Q2 R1 guidelines. Results: Method showed a linear response in the range of 2-12 µg/ml of PAMA and 20-120 µg/ml of IBU. Method was found to be accurate with recovery between 99.7–100.9 % for PAMA and 100.3–100.7 % for IBU. The method was found to be accurate and precise for quantitative analysis of PAMA and IBU. Conclusion: The developed method was successfully validated as per ICH Q2 R1 guidelines and was successfully applied for quantitative analysis of a synthetic mixture of PAMA and IBU.