A rare occurrence of intrauterine death following an allergic reaction to iron sucrose.

During pregnancy, iron-deficiency anemia if untreated can affect the mother and child and hence iron is supplemented. Intolerance to oral iron therapy and malabsorption are common indications for parenteral iron therapy. The regularly used intravenous iron preparations are iron sucrose, sodium ferric gluconate, and iron dextran, of which iron sucrose has a satisfactory safety profile. We report a case of iron sucrose causing rare reaction with generalized edema in the mother, which was followed by intrauterine death. The oxidative stress due to immune-mediated mechanisms or adjuvant used in iron sucrose could cause mild rashes to severe anaphylactic reactions. This case report warns us toward the use of parenteral iron preparations in pregnant women, as one of the safe formulations could lead to an unusual fatal outcome in the fetus.

Perception and Quality of Life in Family Caregivers of Cancer Patients.

INTRODUCTION: Cancer has been most feared among all the significantly increasing chronic diseases, and is widely assumed to be fatal. The quality of life (QOL) of the patient pertaining to physical, psychological, social, and spiritual well-being is altered, which ultimately affects the QOL of the family caregivers. The study was conducted to assess the QOL among family caregivers of cancer patients and how cancer changes and alters the vision about life for the patient as well as the family caregivers. OBJECTIVE: The objective was to assess the QOL among family caregivers of the cancer patients. METHODOLOGY: A cross-sectional, questionnaire-based study was conducted after the protocol was approved by the institutional ethics committee and obtaining written informed consent from the participants. Two sets of validated questionnaire were used to assess the awareness and QOL of the family caregivers of the cancer patients. The filled questionnaires were received from the participants, and data were analyzed using descriptive statistics. RESULTS: Nearly 74% (148/200) of the participants responded, with majority of the caregivers being females (71.62%). Majority (72.9%) expressed that cancer cannot spread from one person to another and were positive (70.9%) toward cancer cure. The caregivers (76.3%) opined that the diagnosis of cancer should be informed to the family members. Approximately 50% of the participants were aware that environmental toxins and tobacco would predispose to cancer. Although most of them (87.8%) believed that the cancer treatment cause ill effects, they (93.2%) were satisfied with the hospital facilities. Among the QOL parameters, most of the participants had complaint of decreased general physical health, difficulty to cope, reduced concentration, anguish over the first treatment, disease, and interference in household activities. Among the spiritual parameters, the participants expressed sufficient support from religious activities, prayer, and general spiritual well-being. CONCLUSION: Majority of the caregivers had awareness regarding the cancer and carcinogens from the environmental toxins. The QOL among caregivers of cancer patients is affected in all dimensions of life, with more emphasis on the social and psychological dimensions.

Knowledge, attitude, practice, and barriers toward research among medical students: A cross-sectional questionnaire-based survey.

INTRODUCTION: Research in medicine has an impact on prevention, diagnosis, and newer treatment for the medical ailments. It has brought reforms in policies for health-care programs. Involvement of undergraduates in research was less, so this study was planned to determine the factors and their perception toward the same. OBJECTIVE: The objective of the study was to evaluate knowledge, attitude, experience, and the barriers of research among medical undergraduates. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was conducted after the protocol was approved by the Institutional Ethics Committee and obtaining written informed consent from participants. The predesigned validated questionnaire containing 34 questions was used. Filled questionnaires were received from the medical undergraduates of different phases of MBBS from our institute. Data were analyzed using descriptive statistics. RESULTS: A total of 89% (267/300) responded, 140/267 were females. The knowledge score regarding the concept of research and its methodology was 2405/3458 (70%). Sixty percent strongly agreed to include research in undergraduate curriculum, 57% believed that it would facilitate better understanding of the subject and clinical practice (41%). Nearly 56% opined that research was not waste of time and does not interfere in studies. Barriers for research were lack of awareness (53%), interest (54%), funds (62%), time (59%), and difficulty in follow-up of patients (67%). Almost 59% of students disagreed to lack of encouragement by faculty. CONCLUSION: Most of the participants had knowledge regarding research and expressed positive attitude toward involvement in research activity. Some of barriers were lack of awareness, time, funds, and difficulty in patient follow-up.

Randomized, double-blind, comparative study of oral metronidazole and tinidazole in treatment of bacterial vaginosis.

OBJECTIVE: To compare the efficacy and tolerability of oral metronidazole and tinidazole in patients with bacterial vaginosis (BV) using Amsel's criteria. PATIENTS AND METHODS: This was a randomized double-blind study, conducted by the Departments of Pharmacology and Gynecology of a tertiary care teaching hospital. Patients diagnosed with BV received either tablet metronidazole 500 mg twice daily for 5 days or tablet tinidazole 500 mg once daily + one placebo for 5 days and instructed to come for follow-up at the 1st week and 4th week. They were categorized as cured, partially cured, and not cured based on Amsel's criteria at the end of the study and compared between two groups using Chi-square test. RESULTS: A total 120 women were enrolled in the study, of which 114 completed the study. The treatment arms were comparable. The cure rate with low-dose tinidazole was significantly more compared to metronidazole at 4th week (P = 0.0013), but not at 1st week (P = 0.242). The adverse drug reactions were less with tinidazole compared to metronidazole. CONCLUSION: Tinidazole at lower dose offers a better efficacy than metronidazole in long-term cure rates and in preventing relapses with better side effect profile.

Perception of pharmacists regarding over-the-counter medication: A survey.

OBJECTIVE: To assess knowledge, attitude, and practice of the pharmacists toward dispensing the over-the-counter (OTC) medications using questionnaire. MATERIALS AND METHODS: cross-sectional questionnaire-based study was conducted to assess the knowledge, attitude, and practice among pharmacists regarding OTC medications. Eighty out of hundred filled questionnaires were received from various pharmacists from medical shops in and around Kolar. Data were analyzed using descriptive statistics. RESULTS: A total of 74.6% responded to the questionnaire. Most of the dispensers (97.3%) at pharmacy were qualified with a D.Pharma/B.Pharma degree. Pharmacists with B.Pharma (80%) were able to define OTC. Majority of them had more than ten consumers taking OTC per week. Among the OTCs dispensed, common were analgesics (75%), antacids (48%), antihistaminics (40%), and others (35%). The choice of OTC brand was made by pharmacists (58.7%) and consumers (41.2%). Most of them (96.5%) asked the consumer's complaints before dispensing the drug, but only few (51%) counseled them regarding the instructions to administer medication. The brand of OTC was influenced by prescriptions of local doctor (60%), consumer's choice (31.2%), cost of the drug (16.7%), and medical representatives (5%). OTCs were safe to dispense, according to 90% of the pharmacists; however, among them, 50% expressed that the consumers should first consult doctor. CONCLUSION: Majority of the pharmacists were qualified to dispense medication, but only few knew about OTC drugs. Analgesics were most commonly used OTC. These drugs were safe to dispense, however, consulting doctor before taking medications was suggested by some of them.

Prediabetes Awareness and Practice Among Indian Doctors- A Cross-sectional Study.

INTRODUCTION: Prediabetes is an intermediate state between diabetes and normoglycaemia, where the glucose levels are higher than normal but not significant to be diagnosed as diabetes mellitus. Guidelines from various associations suggest different types of management in this situation. OBJECTIVE: To assess knowledge and attitude of the doctors regarding prediabetes using questionnaire. MATERIALS AND METHODS: A cross-sectional questionnaire based study was conducted to assess the knowledge, attitude and practice among doctors regarding prediabetes treatment. One hundred twenty two (of 150) filled questionnaires were received from general practitioners, post graduates (PGs), physicians and super specialists in and around Kolar and Bangalore. Data was analysed using descriptive statistics and expressed as percentage. RESULTS: A total of 81.3% responded to the questionnaire, of which 14 were general practitioners (MBBS), 48 PGs in General Medicine, 46 physicians (MD General Medicine), and 14 super specialists (DM). Knowledge response was 85.7% (definition - 100%, prevalence - 50.8%, approved drug- 45.2%, progression- 86.2%). Screening for prediabetes was done by 71% of the general practitioners and physicians, but specialists would screen all. 100% general practitioners, 97.9% post graduates, 91.3% of physicians and 64.2 % specialist preferred diet and exercise and rest of them opted for oral antidiabetic drug (OAD) along with diet and exercise, but none of the doctors considered OAD alone for prediabetes. Among OADs metformin (77.45%) was the most preferred followed by voglibose (20.6%) and sitagliptin (1.9%). CONCLUSION: All doctors had awareness of prediabetes and most of them would regularly screen and treat prediabetes. Majority considered diet and exercise as first modality of treatment. The OAD opted commonly was metformin.

Seroprevalence of human immunodeficiency virus infection among tuberculosis patients at tertiary care combined hospital.

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) and the human immunodeficiency virus (HIV) infection have reached epidemic proportions in our country. This study was undertaken to know the seroprevalence of HIV infection among TB patients and to evaluate the various clinical features of TB in seropositive and seronegative patients. This study was undertaken in Vijayanagara Institute of Medical Sciences, Bellary. It was cross-sectional comparative observational study conducted from December 2010 to May 2012. MATERIALS AND METHODS: A total of 100 consecutive patients diagnosed with TB satisfying inclusion criteria were selected for the study. All patients went through a detailed evaluation along with testing for HIV seroprevalence. Chi-square and Student's t-tests used to find the significance between two groups. RESULTS: The overall HIV seroprevalence among TB patients was 8%. Seroprevalence was highest in the age group between 31 and 40 years at 29.41% (odds ratio [OR] = 11.11, P = 0.003). It was found that seropositive TB patients were more likely to present with significant weight loss (OR = 19.25, P= 0.000), and have lymphadenopathy OR = 13.24, P = 0.002) and oral candidiasis (OR = 49.44, P = 0.000) on examination. Bilateral chest radiographic involvement (OR = 57.40, P = 0.000) and the disseminated variety of the disease (OR = 29.67, P = 0.001) are also more probable. CONCLUSIONS: Human immunodeficiency virus seroprevalence is quite high among TB patients in Bellary. During the evaluation of TB patients, the possibility of HIV co-infection should be kept in mind, and thus adequate knowledge of the likely clinical features is absolutely necessary.