PREVALENCE AND SEVERITY OF POSSIBLE DRUG-DRUG INTERACTIONS AMONG THE GERIATRIC PATIENTS AT AN INDIAN TERTIARY CARE TEACHING HOSPITAL

Objective: The objective of this study was to study the prevalence and severity of possible drug-drug interactions (DDIs) among the geriatric patients.Methods: The present study was a retrospective cross-sectional study. Case records of geriatric inpatients from the medical records department were included in the study and the case records of all the remaining age group inpatients were excluded from the study. All the collected cases were subjected to check for the DDIs using the software Micromedex 2.0 and were categorized into minor, moderate, and major based on the severity.Results: In this study, a total of 85 cases were screened for possible DDIs, and among them, 54 cases were found to be with 179 possible DDIs. The prevalence was observed to be 63.5%. Most of the possible DDIs were found to be with moderate severity (65.4%) followed by major (25.7%). Majority of the possible DDIs were observed in the Department of General Medicine (83.2%) followed by chest and tuberculosis (7.8%).Conclusion: Majorly, the severity of interactions was found to be moderate in this study. To reduce the DDIs, rationale prescriptions have to be prescribed by considering the risk-benefit ratio. Geriatrics should be prescribed very cautiously because the age-related pharmacokinetics plays a significant role. By taking all the above aspects into consideration, clinical pharmacist should play a crucial role in the prevention and management of DDIs, especially in geriatrics.Â

A STUDY ON THE PREVALENCE AND SEVERITY OF POSSIBLE DRUG-DRUG INTERACTIONS IN PEDIATRICS DEPARTMENT AT AN INDIAN TERTIARY CARE TEACHING HOSPITAL

Objective: To study the prevalence and severity of possible drug-drug interactions in the department of pediatrics.Methods: Case records of the in-patients of the pediatrics department from the medical records department were included and the records of the ambulatory patients were excluded from the study. All the collected cases were subjected to check for the drug-drug interactions by using the software micromedex 2.0 and the interactions were categorized based on the severity into minor, moderate and major.Results: A total of 142 cases were screened for possible drug-drug interactions (DDIs) and among them 76 cases were observed to be with possible DDIs.  The prevalence was found to be 53.5% in this study. Majority of the cases with possible DDIs were observed to be in females. Results of the age wise categorization revealed that majority of the possible DDIS were observed in children (2-12 y) followed by the infants (1 mo–2 y). The drug combinations amikacin+ampicillin, paracetamol+phenytoin and ofloxacin+ondansetron were found to be the frequently observed possible DDIs of minor, moderate and major severities respectively.Conclusion: Majority of the possible DDIs were of moderate severity followed by major. Clinical pharmacists should take the responsibility in assisting the pediatricians for screening the possible DDIs in the prescriptions there by preventing them and providing a better pharmaceutical care for the pediatric population. Â

Sulfotransferase 1A1 (SULT1A1) Polymorphism and Breast Cancer Risk: A Case-control Study in South India

Introduction: Breast cancer is the most common cancer among women worldwide. Sulfotransferase plays an important role in the formation of estrogen which is usually conferred as a risk factor for breast cancer. The SULT1A1*2 polymorphism is likely to play an important role in the susceptibility to breast cancer. This polymorphism (G638A) in the sulfotransferase 1A1 (SULT1A1) gene may causes Arg213His amino acid change and consequently results in significantly reduced enzyme activity and thermostability.Materials and Methods: In this case-control study, we investigated the role of SULT1A1 G638A polymorphism in breast cancer patients. We genotyped 144 patients with breast cancer and 116 healthy control subjects, using a Polymerase chain reaction –Restriction Fragment length polymorphism (PCR-RFLP) method.Results: The frequencies of SULT1A1 G638G, G638A and A638A were 83.5%, 17.8%, and 1.4% in the breast cancer group and 89.5%, 4.0% and 0.0% in the control group. The results of our study indicate that the SULT1A1 G638A genotype showed 4.6 folds increased risk of breast cancer (p = 0.002).Conclusion: In conclusion, our results suggest that, SULT1A1 G638A variant is significantly associated with risk of breast cancer in south Indian women

A study on the prevalence of obesity and metabolic syndrome among students of a medical college

Background: Obesity is emerging as a serious problem throughout the world. The overall life expectancy is significantly shortened and the quality of life decreased in those who are excessively overweight. Metabolic syndrome (MetS) is characterized by a constellation of individual risk factors of cardiovascular disease. Central obesity is a key feature of this syndrome, reflecting the fact that the syndrome’s prevalence is driven by strong relationship between waist circumference and increasing obesity. Awareness about MetS in medical students is the need of the hour.Methods: This cross-sectional study was conducted at Dr. PSIMS and RF, Chinnoutpalli, Andhra Pradesh, India involving 400 medical students. A pre-tested questionnaire, measurement of blood pressure, fasting glucose level, fasting lipid profile, anthropometric variables such as height, weight, waist circumference and hip circumference were taken. Metabolic syndrome was defined based on the International Diabetes Federation criteria. Data was processed using SPSS version 16. T-test, chi-square test, fisher’s exact test, anova and odd’s ratio were used for statistical analysis.Results: 59% of the study population was female. The prevalence of obesity was 4%, with majority being males (81.25%) The MetS prevalence as per the International diabetes federation (IDF) criteria was 6% (n=24). The prevalence of MetS in males was 12.19% (n=20) and in females 1.69%. (n=4). The risk of developing metabolic syndrome is high among those who smoke, consume alcohol, consume junk food and sleep for longer durations.Conclusions: The prevalence of metabolic syndrome is 6%. A significant association is established between life style habits like smoking, alcohol consumption, junk food consumption, sleep duration and MetS

Isolated HbA1c identifies a different subgroup of individuals with type 2 diabetes compared to fasting or post-challenge glucose in Asian Indians: The CARRS and MASALA studies.

AIMS: Guidelines recommend hemoglobin A1c (HbA1c) as a diagnostic test for type 2 diabetes, but its accuracy may differ in certain ethnic groups. METHODS: The prevalence of type 2 diabetes by HbA1c, fasting glucose, and 2 h glucose was compared in 3016 participants from Chennai and Delhi, India from the CARRS-2 Study to 757 Indians in the U.S. from the MASALA Study. Type 2 diabetes was defined as fasting glucose ≥ 7.0 mmol/L, 2-h glucose ≥ 11.1 mmol/L, or HbA1c ≥ 6.5%. Isolated HbA1c diabetes was defined as HbA1c ≥ 6.5% with fasting glucose < 7.0 mmol/L and 2 h glucose < 11.1 mmol/L. RESULTS: The age, sex, and BMI adjusted prevalence of diabetes by isolated HbA1c was 2.9% (95% CI: 2.2-4.0), 3.1% (95% CI: 2.3-4.1), and 0.8% (95% CI: 0.4-1.8) in CARRS-Chennai, CARRS-Delhi, and MASALA, respectively. The proportion of diabetes diagnosed by isolated HbA1c was 19.4%, 26.8%, and 10.8% in CARRS-Chennai, CARRS-Delhi, and MASALA respectively. In CARRS-2, individuals with type 2 diabetes by isolated HbA1c milder cardio-metabolic risk than those diagnosed by fasting or 2-h measures. CONCLUSIONS: In Asian Indians, the use of HbA1c for type 2 diabetes diagnosis could result in a higher prevalence. HbA1c may identify a subset of individuals with milder glucose intolerance

Association of acculturation levels and prevalence of diabetes in the multi-ethnic study of atherosclerosis (MESA

OBJECTIVE: The prevalence of type 2 diabetes among Hispanic and Asian Americans is increasing. These groups are largely comprised of immigrants who may be undergoing behavioral and lifestyle changes associated with development of diabetes. We studied the association between acculturation and diabetes in a population sample of 708 Mexican-origin Hispanics, 547 non-Mexican-origin Hispanics, and 737 Chinese participants in the Multi-Ethnic Study of Atherosclerosis (MESA). RESEARCH DESIGN AND METHODS: Diabetes was defined as fasting glucose >/=126 mg/dl and/or use of antidiabetic medications. An acculturation score was calculated for all participants using nativity, years living in the U.S., and language spoken at home. The score ranged from 0 to 5 (0 = least acculturated and 5 = most acculturated). Relative risk regression was used to estimate the association between acculturation and diabetes. RESULTS: For non-Mexican-origin Hispanics, the prevalence of diabetes was positively associated with acculturation score, after adjustment for sociodemographics. The prevalence of diabetes was significantly higher among the most acculturated versus the least acculturated non-Mexican-origin Hispanics (prevalence ratio 2.49 [95% CI 1.14-5.44]); the higher the acculturation score is, the higher the prevalence of diabetes (P for trend 0.059). This relationship between acculturation and diabetes was partly attenuated after adjustment for BMI or diet. Diabetes prevalence was not related to acculturation among Chinese or Mexican-origin Hispanics. CONCLUSIONS: Among non-Mexican-origin Hispanics in MESA, greater acculturation is associated with higher diabetes prevalence. The relation is at least partly mediated by BMI and diet. Acculturation is a factor that should be considered when predictors of diabetes in racial/ethnic groups are examined.http://deepblue.lib.umich.edu/bitstream/2027.42/60948/1/Association of Acculturation leveks and Prevalence of Diabetes in MESA.pd