A comparative randomized controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia

Background: The objective of the current study was to compare the efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia.Methods: We carried out a prospective randomized controlled parallel group study on 100 outpatients of Obstetrics and Gynaecology Department of Government Medical College, Patiala, a tertiary care teaching hospital. Pregnant patients (20-40 weeks gestational age) newly diagnosed with blood pressure (BP) of ≥140/90 mm Hg were included in the study. All patients with systolic BP (SBP) ≥160 mm Hg and diastolic BP (DBP) ≥110 mm Hg after 20 weeks of gestation, history of hypertension, renal diseases, diabetes mellitus, epilepsy, and thyroid diseases were excluded from the study. After taking the informed consent, 50 patients each were randomized to either of the two treatment arm-oral labetalol or oral methyldopa. Difference in the BP measurements at the time of admission and at the time of delivery were analyzed by applying paired t-test. For intergroup analysis, we applied independent t-test using SPSS version 16. A p<0.05 was regarded as significant.Results: Both methyldopa and labetalol cause significant fall in SBP, DBP and mean arterial pressure (MAP) in their groups (p<0.001). However, when we compared both groups it was labetalol, which causes significant fall in MAP as compared to methyldopa (p<0.001). The incidence of adverse effects like hypotension, headache, and sedation were also less in labetalol group.Conclusion: Labetalol has an upper edge over methyldopa in control of BP during pregnancy with minimal adverse effects

A comparative study of benzalkonium chloride-free latanoprost versus benzalkonium chloride-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma

Background: Prolonged use of anti-glaucoma therapy leads to development of ocular surface disease (OSD). The purpose of this study was to compare the effect of Benzalkonium chloride (BKC)-free latanoprost and Benzalkonium chloride (BKC)-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma (POAG).Methods: This was a prospective, open-label, randomized, interventional, switch trial. 30 established cases of POAG who were already on BKC-preserved latanoprost for atleast more than three months were enrolled. Their Schirmer test and Tear film break-up time (TBUT) were recorded at the baseline. They were required to answer an ocular surface disease index (OSDI) questionnaire from which an OSDI score was calculated. They were switched to BKC-free latanoprost for another three months. On their follow-up visit at 6 weeks and 12 weeks, Schirmer test and Tear film break up time were performed again and OSDI score was calculated.Results: Schirmer test increased from 6.73±3.77 mm at baseline to 9.53±3.67 mm at 6 weeks and 11.97±3.53 mm at 12 weeks (p=0.001). Mean TBUT improved significantly from 6.77±3.82 seconds at baseline to 8.63±3.91 seconds at 6 weeks to 10.47±3.76 seconds at 12 weeks (p=0.001). OSDI score decreased from 31.55±23.32 at baseline to 23.42±21.93 at 6 weeks to 15.82±20.10 at 12 weeks (p=0.001).Conclusions: BKC-free latanoprost led to improvement in tear film status or ocular surface health of glaucoma patients as compared to BKC-preserved latanoprost

PHYTOCHEMICAL AND PHARMACOLOGICAL STUDY OF DHATURA: A REVIEW

Dhatura is a well known medicinal plants belonging to solanaceae family and also known as devil’s trumpet or thorn apple. According to ayurvedic text it’s all part is used as medicinal drug and as a preparation with other drugs in various diseases. Preparation with other drugs is depends on Rog (disease), Desh (region), Kaal (time), Ritu (season) and Ras panchak. In modern era selection of drug and route of administration very much depends upon the chemical composition or alkaloids present in drug. Dhatura is a rich source of alkaloids such as Hyoscyamine, hyoscine, scopolamine, atropine, withanolides (lactones) and other tropanes. According to alkaloid present, the formulation containing Dhatura having antibacterial, antioxidant, herbicidal, antifungal, antiviral and antiulcer activity. Traditionally it is used in skin disorder, ear pain, cough, fever and asthma etc. The present review summarizes the phyto-chemistry, pharmacological and traditional uses of the Dhatura

Colposcopic evaluation in cases of persistent inflammatory Pap smear

Background: The aim of the study was to assess the colposcopic evaluation in cases of persistant inflammatory Papanicolaou (Pap) smear.Methods: This was a prospective analytical study, conducted amongst 78 women attending the outpatient department of obstetrics and gynaecology at Subharti Medical College. Pap smear was performed by the conventional method and colposcopy was done for all 78 sexually active women who came with complaints of pain abdomen, irregular cycles, white discharge per vaginum and urinary tract infections. Final correlation of Pap smear and colposcopy were based on histopathology and human papillomavirus deoxyribonucleic acid (HPV DNA).Results: In this study of 78 women, 21% of women had normal colposcopic findings whereas 79% had abnormal colposcopic findings. Histopathological examination (HPE) findings revealed that 69% women had cervical intraepithelial neoplasia (CIN) 1, 23% had CIN II, 6% had CIN III and 3% had SCC. 25% women tested positive for HPV DNA and 75% women tested negative for HPV DNA.Conclusions: Patients with persistent inflammatory Pap smear despite undergoing treatment show changes on Colposcopic directed biopsies.

A review on thimerosal: an irreplaceable element of long-term immunisation strategy in low income countries

Thimerosal, an organic-mercury (Hg) compound containing 49.55% Hg by weight, is added to vaccines as a preservative permitting formulation of multi-dose vaccine vials. Being a derivative of ethylmercury, it has been linked with autism as a possible risk factor based on the assumption that exposure to ethylmercury would have similar neurotoxic effects as another mercurial compound, methylmercury. In 1999, AAP issued a joint statement emphasising the removal of thimerosal from vaccines. Subsequently, several studies have been conducted; those showing positive association between thimerosal exposure and autism have been recognised to be fraught with methodological flaws. On the other hand, many well controlled studies have failed to find any such causal relation and there are others that have clearly demonstrated a much favourable kinetic profile of ethylmercury as compared to methylmercury. Owing to the lack of data, AAP retired its original statement in 2002. Recently, thimerosal has been exempted from regulation by Minamata Convention on Mercury resulting in the continued use of low cost thimerosal containing vaccines in low income countries which cannot afford to run their immunisation program using single dose thimerosal free vaccines, that comparatively cost much higher, as is the case in high income countries. Some bodies view this as a discrimination on the basis of wealth of a nation and have opposed this decision. This review presents various studies regarding the causal association between thimerosal containing vaccines and autism. The current evidence fails to support any such association. Hence this review supports the exemption of thimerosal from regulation and also justifies its use in LICs for uninterrupted vaccination of the most vulnerable population

Knowledge, attitude, and practice of kangaroo mother care among doctors in a tertiary care hospital from North India

Introduction: Kangaroo mother care (KMC) has been established as having an important role in the care of all the babies; especially, the preterm and low birth weight babies. Successful implementation of KMC depends on knowledge, attitude, and practice (KAP) of healthcare workers, mothers, fathers, and other family members. Objectives: The objectives of the study ws to determine the KAP of KMC among the faculty and residents of the departments of neonatology and obstetrics in a tertiary care hospital. Methods: The study was a cross-sectional descriptive study in which data were collected from departments of neonatology, maternal health, and reproductive health. The study subjects were faculty and residents from both the departments. They were interviewed using a structured pre-tested questionnaire in three domains, knowledge (11), attitude (8), and practice (4). The responses were tested against standard predefined answers and were expressed in percentages. Results: A total number of 25 doctors were interviewed; among knowledge domain, approximately 60% doctors responded correctly for the need of KMC, duration of KMC, feeding during KMC and type of baby’s clothes during KMC. In the domain of attitude, response of KMC for who can give, when to start/stop, position of mother, and feasibility of KMC during non-invasive ventilation was correct for all subjects. For practice aspect, there was a lack of counseling and re-checking, though almost everyone felt the need of separate KMC room and counselor. Conclusions: From the above results, it is apparent that knowledge and attitude, among health-care professionals, is optimum. However, there is lots of scope for filling a few gaps to improve practices and training workshops are required to bring in behavior change among doctors

Factors Influencing Acceptance Of Contraceptive Methods

Research Problem: What are the factors influencing acceptance of contraceptive methods. Objective: To study the determinants influencing contra­ceptive acceptance. Study design: Population based cross - sectional study. Setting: Rural area of East Delhi. Participants: Married women in the reproductive age group. Sample:Stratified sampling technique was used to draw the sample. Sample Size: 328 married women of reproductive age group. Study Variables: Socio-economic status, Type of contraceptive, Family size, Male child. Outcome Variables: Acceptance of contraceptives Statistical Analysis: By proportions. Result: Prevalence of use of contraception at the time of data collection was 40.5%. Tubectomy and vasectomy were most commonly used methods. (59.4%, n - 133). Educational status of the women positively influenced the contraceptive acceptance but income did not. Desire for more children was single most important deterrent for accepting contraception. Recommendations: (i)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Traditional method of contraception should be given more attention. (ii)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Couplesshould be brought in the contraceptive use net at the early stage of marriage

A Research Update: Significance of Cytokine Storm and Diaphragm in COVID-19

Emerging research on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) shows that it is spreading to multiple organs in addition to the respiratory system. Though the SARS-CoV2 enters the human body by binding to ACE2 receptors on pulmonary alveolar cells, recent studies indicate that it is spreading to the central nervous system, cardiac and skeletal muscles leading to various pathological conditions in these organs. In particular, the effects of SARS-CoV-2 on triggering the cytokine storm and its consequential effects on skeletal muscles has generated a lot of discussion. The effects of this virus on muscular function especially in susceptible elderly populations is still being explored. However, its effects on diaphragm, a respiratory muscle which plays an important role in determining lung capacity are not completely explored. Currently, as new evidence on using lung ultrasounds to confirm COVID-19 diagnosis is gaining traction, it is necessary to explore the role of diaphragm in treating COVID-19 patients. This article will review the effects of cytokine storm triggered by the SARS- CoV-2 and its resultant effects on skeletal muscle with a specific focus on the diaphragm in order to identify knowledge gaps in effectively treating COVID-19 patients, especially those who are on a mechanical ventilator