Generic drugs: a study on awareness among medical students and interns

Background: Use of generic drugs and its availability is one of the less discussed topics in the medical education but at the same time holds a lot of importance in providing affordable health care to the general public.Methods: All 150 II MBBS students and 80 interns who were willing were included in the study. After explaining the aims and objectives and obtaining the informed consent, a set of 14 semi structured questionnaire were given to the students through an online link. A total duration of 15 minutes was given to complete the questionnaire and submit to prevent bias.Results: Most of the students 98 (75.4%) believe that generic drugs are non-inferior to branded drugs compared to interns 33 (49.3%) who are still doubtful about its efficacy (p=0.0003). Most of the students 101 (77.7%) and interns 52 (77.6%) think that composition, dose and indications are same as branded drugs (p=0.987). 75 (57.7%) students and 25 (37.3%) of interns know that generic medicines are marketed only after the expiry of patent period of innovator drug (p=0.005). About 102 (78.5%) students and 44 (65.7%) interns prefer to prescribe generic drugs to their patients (p=0.061). Only 34 (26.2%) students and few interns 19 (28.4%) knew about jan aushadhi sugam app (p=0.744).Conclusions: Lack of awareness about the jan aushadhi sugam app and location of nearby generic stores was acting as the main hindrance in optimal utilization of generic drugs

A randomized, open-labelled study of the sedative, analgesic and anxiolytic effect of dexmedetomidine and tramadol in postoperative patients

Background: In the post-operative period, it has always been an important consideration for clinicians, to keep the patient comfortable, calm and pain free. So there is a constant need for an ideal sedative for postoperative patients. Alpha 2 adrenoreceptor agonists such as dexmedetomidine could provide an answer to this problem because they have several relevant physiological properties like sedation, anxiolysis, analgesia and arousability. This prospective, randomized trial was conducted to compare the safety and efficacy of dexmedetomidine and tramadol in the management of postoperative pain.Methods: In the present study 60 patients operated under general anaesthesia with a pain score of 1-3 were randomly allocated into two groups to receive either dexmedetomidine (group D) or tramadol (group T). In both groups, pain score, sedation score, heart rate, blood pressure, SPO2, respiratory rate were monitored for every 5 min for first 30 min, every 10 min for next 1hr, every 15 min for next 1 h, every 30 min for the next 1 h, every 1 h for 3 h and 6th hourly till 24 h. The need for rescue analgesic was also noted. The data were tabulated and analysed using descriptive statistical tool. Mean, standard deviation and comparison between the groups was done by student’s ‘t’ test. A p value less than 0.0001 was considered significant.Results: Mean duration of sedation of dexmedetomidine was 129.6±41.02 and for tramadol was 117.3 ± 47.75 (p=0.14), mean degree of sedation in both group was -1, mean duration of analgesia 139 min in Group D and 280 min in Group T (p<0.0001), rescue analgesia was required at 169th min in Group D and 288th min in Group T (p<0.0001), mean heart rate in Group D was 67.8±5.24 and 69.4±4.79 (p=0.12), mean Mean Arterial Pressure (MAP) in Group D was 78.0±8.97 and in Group T was 89.2±10.63 (p<0.00001), mean respiratory rate in Group D was 15.8±2.33 and in Group T was 15.9±2.09 (p=0.41), mean SPO2 in Group D was 99.5±0.56 and in Group T was 99.4±0.62 (p=0.14). There was no significant difference in degree and duration of sedation, duration of analgesia, vital parameters, and adverse effects in both groups but there was a statistical difference in the duration of analgesia and the need for rescue analgesia in Group D.Conclusion: Though there is no statistical difference in both groups, dexmedetomidine significantly reduced anxiety, agitation and produced calmness in postoperative patients which was not seen with tramadol

Assessment on awareness of rational prescribing practices among medical interns in a tertiary care hospital: a questionnaire based study

Background: Awareness about rational use of Medicines is required to improve the quality of health care system. Attitude towards rational drug use is also an utmost importance as they constitute the future generation doctors.Methods: A set of 13 questionnaire is given to the interns through an online link to their e-mail which contains informed consent and questionnaires. Respondents has to select the best suitable option and after which the data will be compiled and statistically analyzed.Results: Age of the study participants range from 22-26yrs. Half of them have finished major postings. Almost 96.1 % of them were aware of the term essential drugs. Only 25% of them said that they have NLEMI at work place, 75% of them were aware of the term Rational use of Medicines. Only 32% of them were aware of the term P drugs. 44% of them were aware of STEP criteria for selection of drug and 47% of them were aware of the updated prescribing format. 8% knew the difference between old and new prescription format, 25% of them always prescribe. Almost 82% of them narrate regarding the disease and drug therapy, 31% of them prescribe only generic name.Conclusions: Educational intervention like CME and practical hands on training in Rational use of Medicines would help them in better understanding of the subject and its clinical implications thereby decreasing the prescribing errors

Antimicrobial and Antioxidant Potential of Streptomyces sp. RAMPP- 065 isolated from Kudremukh soil, Karnataka, India

Actinomycetes are among the industrially and therapeutically relevant microorganisms and are known to produce useful products such as antibiotics, enzymes, vitamins etc.  Among actinomycetes, genus  Streptomyces is known to produce a great array of products. In the present study, we have recovered a Streptomyces species RAMPP-065 from Western ghats soil of Kudremukh, Karnataka, India and determined its  antimicrobial and antioxidant activity. The isolate was recovered on Starch  casein agar and identified as Streptomyces species on the basis of  cultural, microscopic, staining and biochemical characteristics. Fermentation was carried out in Starch casein broth for 7 days and filtered. The culture filtrate was extracted with ethyl acetate and the solvent was evaporated to get the extract. Antimicrobial activity of extract was tested against 8 bacteria and 2 fungi by agar well diffusion method. Gram positive bacteria were more sensitive to extract than Gram negative bacteria. Among fungi, susceptibility to extract was higher in Candida albicans than Cryptococcus neoformans. The extract showed a dose dependent scavenging of DPPH free radical as revealed by bleaching of DPPH radical color with increase in concentration of extract. In ferric reducing assay, the absorbance was  found to increase with increase in extract concentration. Total phenolic content of extract, as estimated by Folin-Ciocalteau method, was 59mg Gallic acid equivalents/gram. The scavenging and reducing activity of extract were lesser when compared to reference compounds. The soils of Western ghats are rich sources for microorganisms with potent biological activities. To the best of our knowledge, this is the first report on  bioactivity of Streptomyces species from Kudremukh soil. Further studiesare to be carried out to characterize the Streptomyces isolate and the active principles present in the extract

Enhancing Productivity of Guinea Grass Variety JHGG-08-1 through Agro-Techniques in Southern Dry Zone of Karnataka

Guinea grass (Panicum maximum) is a major pan tropical grass used throughout the tropics for pasture, cut-and-carry, silage and hay. It is a fast growing and leafy grass, which is palatable to livestock with a good nutritional value. However, it is generally recommended to supplement it with sources of protein in order to meet nutritional requirements or improve animal performance. It grows well on a wide variety of well drained soils of good fertility and it is a good vegetative barrier. It can survive quick moving fires which does not harm the underground roots and drought because of the deep, dense and fibrous root system. The potentiality of the varieties varies with agro climatic situation and soil type, keeping these things in view, the present investigation was undertaken to identify the optimum plant population and nutrient levels for enhancing the productivity and quality of guinea grass variety JHGG-08- in southern Zone of Karnataka

Performance of Guinea Grass Variety JHGG-08-1 in Southern Region of Karnataka

Guinea grass (Panicum maximum) is native to Africa but this grass was introduced to almost all tropical countries as a source of animal forage. It grows well on a wide variety of well drained soils of good fertility and it is suitable for vegetative barrier and conservation of soil. It can survive quick moving fires which does not harm the underground roots and drought because of the deep, dense and fibrous root system. The Potentiality of the varieties varies with agro climatic situation and soil type. Keeping these things in view, the present investigation was taken up to study the performance of Guinea grass varieties in southern dry zone of Karnataka under protective irrigation

MFC-09-1: A New Forage Cowpea (\u3cem\u3eVigna unguiculata\u3c/em\u3e (L.) Walp) Variety for South Zone of India

Cowpea (Vigna unguiculata (L.) Walp) is a leguminous crop grown throughout West Africa, often in association with pearl millet and sorghum. Cowpea is well adapted to the harsh growing conditions, including low soil fertility, high temperatures, and drought. Cowpea can fix atmospheric nitrogen to improve soil fertility and cropping system productivity. Additionally, farmers feed cowpea fodder to livestock to increase income, and collect the manure produced for use in their fields thereby reduces farmers’ reliance on commercial fertilizers and sustains soil fertility. Previous studies with cowpea indicated that this legume improves soil fertility and enhances the intake and utilization of poor quality roughage consequently improving livestock production and productivity

Performance of Dual Purpose Pearl Millet Genotypes as Influenced by Cutting Management and Nitrogen Levels

Pearl millet (Pennisetum glaucum L.) is important minor millets cultivated both for food and fodder. The dual purpose nature of pearl millet has recently identified due to its profused tillering, repeated harvesting and absence of anti nutritional factor. In fodder crops, the production potential can be manipulated by fertilizer management and time of harvest. In this regard, peal millet no exception, scientific study on cutting and nitrogen management on green fodder yield, quality and grain yield is meagre. Therefore, the present investigation was under taken to study the influence of cutting management and nitrogen levels on green forage and grain yield of dual purpose pearl millet

A study on evaluation of risk factors and anti-microbial prophylaxis in the prevention of surgical site infection

Background: Surgical site infections are potential complications associated with a type of surgical procedure. Although surgical site infections are among the most preventable healthcare associated infections, they still represent a significant burden in terms of morbidity, mortality and addition costs to healthcare systems and service payers worldwide. Appropriate antibiotic prophylaxis has shown to be effective in reducing the incidence of surgical site infections. Aim: The aim of the study is to carry out an evaluation of the risk factors and prophylactic antibiotics used to prevent surgical site infection in surgeries performed in an NABH accredited quaternary care hospital in Bengaluru, Karnataka. Objective: To evaluate patient related risk factors contributing to the incidence of surgical site infection. To evaluate the prophylactic anti-biotic used in the prevention of post-operative surgical site infection and to determine the incidence of surgical site infection. Methodology: Subjects who meet the study criteria will be enrolled in the study. Collection of patient related data with subsequent identification and evaluation of risk factors and prophylactic anti-biotics, and calculation of incidence of surgical site infection using statistical analysis. Results: In this study, on observation of 372 surgical cases, it was estimated that 1 in 10 patients acquired Surgical Site Infection within 30 days post-surgery. Conclusion: Conclusively, it can be said that the incidence of surgical site infection varies by different patient and procedure factors as well as prophylactic anti-biotic properties. They particularly show greater association to age, gender, certain comorbidities (like diabetes mellitus, chronic lung disease, and renal insufficiency), and duration of surgery, administration of prophylactic antibiotic, frequency, timing and dose. Therefore, greater care must be taken for every specific patient and procedure and also choice of antibiotic prophylaxis

The Effect of Macular Hole Duration on Surgical Outcomes: An Individual Participant Data Study of Randomized Controlled Trials

Topic: To define the effect of symptom duration on outcomes in people undergoing surgery for idiopathic full-thickness macular holes (iFTMHs) by means of an individual participant data (IPD) study of randomized controlled trials (RCTs). The outcomes assessed were primary iFTMH closure and postoperative best-corrected visual acuity (BCVA). Clinical Relevance: Idiopathic full-thickness macular holes are visually disabling with a prevalence of up to 0.5%. Untreated BCVA is typically reduced to 20/200. Surgery can close holes and improve vision. Symptom duration is thought to affect outcomes with surgery, but the effect is unclear. Methods: A systematic review identified eligible RCTs that included adults with iFTMH undergoing vitrectomy with gas tamponade in which symptom duration, primary iFTMH closure, and postoperative BCVA were recorded. Bibliographic databases were searched for articles published between 2000 and 2020. Individual participant data were requested from eligible studies. Results: Twenty eligible RCTs were identified. Data were requested from all studies and obtained from 12, representing 940 eyes in total. Median symptom duration was 6 months (interquartile range, 3–10). Primary closure was achieved in 81.5% of eyes. There was a linear relationship between predicted probability of closure and symptom duration. Multilevel logistic regression showed each additional month of duration was associated with 0.965 times lower odds of closure (95% confidence interval [CI], 0.935–0.996, P = 0.026). Internal limiting membrane (ILM) peeling, ILM flap use, better preoperative BCVA, face-down positioning, and smaller iFTMH size were associated with increased odds of primary closure. Median postoperative BCVA in eyes achieving primary closure was 0.48 logarithm of the minimum angle of resolution (logMAR) (20/60). Multilevel logistic regression showed for eyes achieving primary iFTMH closure, each additional month of symptom duration was associated with worsening BCVA by 0.008 logMAR units (95% CI, 0.005–0.011, P < 0.001) (i.e., ∼1 Early Treatment Diabetic Retinopathy Study letter loss per 2 months). ILM flaps, intraocular tamponade using long-acting gas, better preoperative BCVA, smaller iFTMH size, and phakic status were also associated with improved postoperative BCVA. Conclusions: Symptom duration was independently associated with both anatomic and visual outcomes in persons undergoing surgery for iFTMH. Time to surgery should be minimized and care pathways designed to enable this