Cost variation analysis of antimalarial drugs available in India

Background: Malaria has been a problem in India for centuries. There are innumerable brands of antimalarial present in the market. Malaria can be extremely fatal if not treated promptly. Costly drugs can lead to economic burden which results in decreased compliance or even non-compliance. Non-compliance leads to incomplete treatment which tends to increase morbidity. Increase in the patient medication cost was found to be associated with decreased adherence to prescription medication. Hence this study was done to assess the cost variation of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2017 edition and Drug Today January to March 2017, Vol 2. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of 10 tablets was calculated in case of oral drug and the cost of 1 ampoule or vial was noted in case of injectable drug. At last the cost ratio and % cost variation of various brands was compared.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Artemether injection showed the highest cost ratio and cost variation (cost ratio = 16.96 and % cost variation = 1596). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents. Chloroquine which is one of the most used antimalarial showed very low values for cost variation and cost ratio.Conclusions: The analysis showed that there is not much significant price variation among oral antimalarial drugs. The maximum variation shown by oral antimalarial was found to be for fixed dose combination of Artemether and Lumefantrine [cost ratio>2 (2.03) and % price variation >100 (103.7)]. But there was significant price variation among injectable antimalarial. Injectable antimalarials are often the choice of drug when dealing with critically ill malaria patients specially when suffering from complicated malaria. So, such significant price variation creates burden on poor patients economically which leads to non-compliance and hence increased morbidity and mortality due to incomplete treatment

Risks of obesity among Indian adolescents

Obesity is connected to a wide range of ECG abnormalities that take place in adolescents leading to risks of Cardio Vascular Disease (CVD) mortality and sudden cardiac death. Some of the ECG abnormalities are being caused by the position of the diaphragm being pushed-up as a result of obesity (1). The position of the R wave might change, the QT might be prolonged or various malignant arrhythmias could develop. In obesity, the ECG signals of ventricular hypertrophy tend to be less informative because of the subcutaneous and epicardial adipose tissue. This study revealed that in adolescents, general and abdominal obesity is correlated to long PR intervals, wide duration of QRS, leftward shifts of the frontal P-wave, T-wave and QRS axes, free from the ECG variables like gender, age, blood pressure and ethnicity

Diastolic dysfunction among hypothyroidism patients

Background:Hypothyroidism has been reported as one of the most common forms of thyroid disorder worldwide. Studies claim that this clinical state is caused by deficiency of thyroid hormone due production to functional and/or structural abnormalities. Diastolic dysfunction is the abnormality of functioning of the diastolic elasticity, distensibility or relaxation of the left ventricle. This is active regardless of the normality of left ventricle ejection fraction or the symptomatic or asymptomatic of the patient. Aims: The aim of the study will be to examine the effects of diastolic dysfunction among patients of hypothyroidism. Research questions:1. What percentage of hypothyroid patients have left ventricle diastolic hypothyroidism?2.Can diastolic dysfunction be reversed by thyroxine treatments?3.Does any correlation exist between Doppler echocardiography findings and serum TSH regarding left ventricle diastolic dysfunction?Materials: In this study, 100 hypothyroidism patients were included. The sample was divided into two groups: the first group consisted of patients with normal levels of TSH, FT3 and FT4, the second group consisted of patients with normal TSH but lower than 10 mU/L with normal FT3 and FT4. Tests like Eliza, spirometry and echocardiography for left ventricular diastolic dysfunction assessment. Results: This study found that in group 1 there was lower TSH, FT3, E/A ratio with an increase of A wave velocity, reduction of E wave velocity, prolongated DT, inter-ventricular relaxation time, and low percentage of FVC, FEV1, FEF25-75. The results also showed a negative connection between TSH and E wave velocity and E/A ratio but a positive connection between the three pulmonary function indices and IVRT. Conclusion: Hypothyroid patients, mostly of subclinical hypothyroidism are prone to left ventricular diastolic dysfunction. As a result, they should be screened by Doppler echocardiography for early diagnosis