Prescribing pattern of proton pump inhibitors in the management of acid peptic disorders, focus on ilaprazole

Background: Acid peptic disorders (APDs) result from characteristic but overlapping pathogenic mechanisms that involve acid effects on diminished mucosal defense. Proton pump inhibitors (PPIs) have become a mainstay in the APDs. This survey was aimed to determine the usage profile of different proton pump inhibitors and overall physicians’ opinion about the clinical experience with newer PPI, ilaprazole.Methods: This survey was based on the clinical experience of 107 randomly selected physicians on an aggregate patient basis in the management of acid-peptic disorders from different parts of India. A data report form (DRF) comprising of various questions was answered by these physicians. The responding physicians answered the DRF of patients who suffered from acid-peptic disorders and were eligible for PPI therapy. A minimum of 50 patients per physician were evaluated in this survey.Results: The commonly encountered APD in physicians’ clinical practice were gastroesophageal reflux disorder (GERD) followed by non-ulcer disease. 58.88% physicians highlighted the prevalence of night time symptoms of APD reported by the patients. About 1/4th physicians were of the opinion that long-acting PPIs would be the preferred to offer 24 hour control of gastric acid secretion thereby controlling the nocturnal symptoms. 63.73% of physicians reported significantly better symptomatic relief with once daily dose of ilaprazole than existing PPIs.Conclusions: This survey highlights the lack of 24 hour acid control in APDs with use of conventional PPIs leading to variety of symptoms, especially at night, seriously hampering the sleep quality. Ilaprazole displays important advantages in the clinical settings, with regard to better probability of extending the inhibition of acid secretion over 24 hours as compared to conventional PPIs

ENV-612: A NOVEL SLUDGE-BED ANAEROBIC MEMBRANE BIOREACTOR FOR SUSTAINABLE TREATMENT OF INDUSTRIAL WASTEWATER

Dissolving pulp mill wastewater called prehydrolysis liquor (PHL) obtained from steam (at 150-1700C) treatment of wood had a total chemical oxygen demand (COD) of approximately 100 g/L contains mainly sugars, furfural, lignin, and acetic acid, poses a considerable wastewater disposal problem. Replacement of the current energy intensive disposal method (evaporation and use of recovery boiler) is a requirement of dissolving pulp industry. The bioreactors were fed with PHL at organic loading rates (OLR) ranging from 0.8 to 5 kg-COD/m3-d to study the performance with respect to the COD removal, methane (bio-energy) production, effluent characteristics, and membrane fouling. Average COD removal of 91% and specific methane yield of 0.36 m3/kg-CODremoved/day were achieved during the pseudo-steady period of the continuous mesophilic operation at each loading rate. Whereas, in thermophilic conditions, a methane yield of 0.38 m3/kg-CODremoved/day was observed. There was no sugar and furfural found in the effluent of the SB-AnMBR at both temperatures (350C and 550C) during the pseudo-steady period. High effluent COD can be attributed to lignin in the effluent (0.2 to 1.6 g/L). Flat-sheet membranes used in the SB-AnMBRs did not show significant fouling based on monitoring of temporal variations in the trans-membrane pressure at a sustained flux of 0.1 m3/m2/d during the 550 days of the continuous operation

A study comparing the change in drug utilization pattern in medical intensive care unit of a tertiary care hospital in seven years

Background: Medical intensive care unit is a type of intensive care unit that takes care of a range of medical illnesses with patients who are seriously ill and/or suffer from severe chronic illnesses. These patients are usually prescribed multiple drugs. Use of antimicrobial agents and injectable medications in setting of MICU is high as compared with other class of drugs and other hospital settings respectively. Periodic evaluation of drug utilization pattern needs to be done to enable suitable modifications in prescription of drugs to increase the therapeutic benefit and decrease the adverse effects. There could be changes in drug utilization pattern due to changes in disease pattern, development of newer drugs, resistance to antimicrobial agents. Hence comparison of past and present data needs to be done to find out the changes that occurred in drug utilization pattern over the years. Methods: Data was collected from June 2021 to Dec 2021 for prospective arm and June 2014 to December 2014 for retrospective arm was obtained from MICU of tertiary care hospital and Medical Record Department. Drug utilization pattern was analysed and compared with appropriate statistical tests. Results: Most common cause of MICU admission was infective diseases (71% and 67% respectively in retrospective and prospective arm). The drug prescribed frequently was pantoprazole and antimicrobial was ceftriaxone in both the study arms. Half of the drugs were prescribed by generic names in both arms. Conclusions: There was no change observed in drug utilization pattern and disease pattern in patients admitted to medical intensive care unit over the years in our institute

COMPARATIVE STUDY OF BALADI GHRITA NASYA WITH GOGHRITA NASYA IN THE MANAGEMENT OF NASAPRATINAHA

Aim: To compare the effect of Baladi Ghrita Nasya with Goghrita Nasya in the management of Nasapratinaha.Objective: 1. To evaluate the effect of Baladi Ghrita (trail drug) Nasya in management of Nasapratinaha.2. To evaluate the effect of Nasya with Goghrita (control drug) in management of Nasapratinaha.Method: Patients were divided into 2 groups. i.e., Group A and Group B.Group A - Baladi Ghrita Nasya was administered for seven days, once daily in the morning.Group B- Nasya with Goghrita for seven days was administered, once daily in the morning.Types of study: Comparative Clinical Study.Period of Study: After seven days of treatment, both the groups were followed at regular intervals of 15 days for a period of two months.Follow Up: Both the groups were followed at regular intervals of 15 days.Results: By comparing both the groups, Group A patients those who were administered Baladi Ghrita Nasya showed a significant improvement / relief in the management of Nasapratinaha. Statistical Analysis: The Statistical Analysis reveals that In Nasapratinaha the efficacy of treatment with Baladi Ghrita Nasya has an effective role in treating Nasapratinaha than Nasya with plain Goghrita.Conclusion: In Nasapratinaha the efficacy of treatment with Baladi Ghrita Nasya has an effective role in treating Nasapratinaha than Nasya with plain Goghrita

Clinical profiling of patients with Acid Peptic Disorders (APD) in India: a cross-sectional survey of clinicians

Background: Acid peptic disorders (APD) which include GERD and peptic ulcer disease (PUD) are common conditions reported in daily clinical practice. This survey aimed to understand the epidemiology, clinical presentation and associated overlapping comorbidities in Indian patients with APD.Methods: This was an interview based cross-sectional survey of 1000 clinicians (specialist gastroenterologists and non-specialists) across India who treated patients of APD in their practice. Information related to patient demographics, diagnosis and clinical presentation (common symptoms and their duration, alarming, lower GI and extra-esophageal symptoms) were assessed. Indications for upper GI endoscopy, esophageal pH monitoring and esophageal manometry were also collected. Descriptive analyses were done.Results: About 39.2% and 37.1% patients had reported GERD and PUD respectively (duodenal ulcer: 10.5%, gastric ulcer: 9.9% and peptic ulcer-non-specified: 16.7%); 25.2% patients were reported to have non-ulcer dyspepsia. Heartburn was the most common symptom in GERD (60.5%); epigastric pain was common in PUD (72.3%); 49% GERD patients presented with alarming symptoms, mainly dysphagia (67%), whereas for PUD, GI bleeding was the most common alarming symptom (47.6%). Profiles of patients visiting clinicians were similar with respect to the presenting symptoms and associated conditions. Functional dyspepsia (25.9%), constipation (23.4%) and irritable bowel syndrome (23.4%) were the most common overlapping conditions associated with both GERD and PUD.Conclusions: APD (GERD and PUD) was more common in 18-59 yrs. age group with heart burn as the common symptom for GERD and epigastric pain for PUD. Diagnosis was mostly based on clinical symptoms; nearly 50% patients of APD presenting with alarming symptoms needed prompt endoscopy. Thus, there is need to focus on these overlapping disorders while managing patients of APD

Cancer awareness among females of urban slums in their reproductive age group

Background: Cancer is major public health problem affecting millions of people worldwide. The prevalence of cancer is increasing in developing world due to increase in life expectancy, increased urbanization and adoption of western life styles. Thus, the present study was carried out to assess the extent of awareness towards cancer among women of urban slums in their reproductive age group. Methods:Community based cross sectional study was carried outby interviewing women of reproductive age group residing in urban slums using pre-designed and pre-tested proforma to assess awareness towards cancer. Descriptive statistics was applied to assess the awareness level and the association between two attributes was calculated bychi-square test. Results: A total of 182 women were interviewed. Out of which 39.56% were in 20-24 years age group. 46.15% were housewives and most of them belonged to middle class families. Though the knowledge regarding cancer, especially about modes of transmission, symptoms and laboratory diagnosis was found satisfactory but was accompanied by misconceptions. 71.43% women were aware about its prevention, mostly by changing life styles and by getting screening done at regular intervals. Conclusion: Thus, impetus has to be laid upon screening regarding cancer during reproductive age group and enlightenment of the women about cancer screening centres available at the hospitals, so as to heighten the knowledge of facilities for a better reproductive life

Optimization of chemical parameters to develop lead-free piezoelectric films for energy harvesting applications.

Piezoelectric material is one of the popular ways to harvest ambient mechanical energy in to electrical energy. The most widely used piezoelectric material is Lead Zirconate Titanate (PZT) as it possesses high electromechanical and piezoelectric properties in numerous applications but it not eco-friendly. In search of the lead free piezoelectric material Sodium Bismuth Titanate (NBT)is one of the potential piezoelectric materials to give more piezoelectric constants compared to other lead-free materials.The present work is focused on to achieve pure stoichiometric Sodium Bismuth Titanate (NBT) phase in the film which is spin coated by NBT sol prepared by sol gel technique. The preparation of NBT sol and spin coating it on a substrate (platinized silica) involves many process parameters which affects the film thickness as well as its qualitative properties. Chemical parameters like rheology, pH & concentration of NBT sol change its viscosity which in turn changes the film properties. Spinning parameters like spin speed, spinning time and heating conditions also affects the final thickness of the film

A Hospital-based Observational Study of Type 2 Diabetic Subjects from India

Aim: The aim of this study was to describe the profile of the subjects with type 2 diabetes mellitus (T2DM) to obtain aclear picture from Western India, that would help in management of diabetes. Methods: An observational study wasconducted with newly diagnosed 622 type 2 diabetic subjects attending Dept. of Diabetology, All India Institute ofDiabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad during the period from August 2006 to January 31, 2009. Subjects completed an interviewer-administered comprehensive questionnaire, which included variables such as sociodemographic presenting symptoms, risk profile (hypertension, obesity, dyslipidemia and glycemic status), family history of diabetes, physical activity and behavioral profile. Blood pressure, body mass index (BMI), glycosylated hemoglobin (HbA1c) and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using SPSS version 11.5. Results: A total of 622 T2DM cases with mean age (years) 47.7 ± 10.9 were studied. Of these, 384 (62%) were male. The majority of T2DM subjects were obese (68%) and 67% had positive family history of diabetes. Renal dysfunctions and vision impairment were found in 10% (62/622) and 9% (57/622), respectively in T2DM subjects. The mean HbA1c level was 9.02% ± 1.67 and good glycemic control (HbA1c level <7%) was achieved only in 7.4% T2DM subjects. The Chi-square (χ2) analysis showed that higher BMI (≥25 kg/m2) is significantly associated with hypertension among T2DM subjects (p < 0.01). There were statistically significant differences between male and female study subjects with respect to mean age, BMI, waist and hip circumference and mean low-density lipoprotein (LDL) level (p < 0.05). Conclusions: The present study revealed that obesity, family history of diabetes, dyslipidemia, uncontrolled glycemic status, sedentary lifestyles and hypertension were more prevalent in T2DM subjects. Hence, the overall risk profile was very poor and needs improvement. The characterization of this risk profile will contribute in defining more effective and specific strategies for screening and controlling T2DM in Western India

Prevalence of functional constipation and constipation-predominant irritable bowel syndrome in Indian patients with constipation

Background: Evaluate prevalence of functional constipation (FC) and irritable bowel syndrome-constipation (IBS-C) in Indian constipated patients and assess their demographic/socio-economic/clinical characteristics.Methods: Patients (≥18 years) who visited their general physician with symptoms of constipation (Rome III criteria for FC or IBS-C as per physician assessment) and willing to participate were enrolled in this prospective, clinical-epidemiological study. Demographic, socioeconomic status, lifestyle and dietary habits, comorbid conditions, treatment history, concomitant medications, stool form (Bristol stool form scale), severity of constipation (constipation scoring system [CSS]), constipation-related symptoms (patient assessment of constipation symptoms [PAC-SYM]) and quality of life (patient assessment of constipation-quality of life questionnaire [PAC-QoL]) were recorded.Results: Out of 925 constipated patients, 75.6% were diagnosed with FC against 24.4% with IBS-C (P < 0.0001). Patients of both subtypes had high average scores of PAC-SYM (FC: 27.1 ± 6; IBS-C: 30.1 ± 4.9) and CSS (FC: 8.4 ± 3.1; IBS-C: 11.2 ± 3), leading to high PAC-QoL score (FC: 38.1 ± 16.8; IBS-C: 42.2 ± 13.6). Hypertension (16%) and diabetes (10%) in patients with FC while acid peptic disorders (21.7%) amongst IBS-C patients were the most common comorbid conditions observed. Laxatives were the most common medication used; osmotic (32.6% versus 40.7%) and bulk laxatives (22.8% versus 37.4%) were the commonest laxatives. However, about 1/5th patients of FC were using home remedies.Conclusions: There was a higher prevalence of FC over IBS-C in Indian constipated patients; both subtypes had high frequency and severity of constipation-related symptoms and poor QoL