AN OBSERVATIONAL STUDY ON IMPLICATION OF EDUCATIONAL LEVEL ON CONTROL AND LONG-TERM COMPLICATIONS OF DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL OF EASTERN INDIA

Introduction: The strongest environmental risk factor for diabetes, obesity, is related to socio-economic status. Due to lack of education in India, several myths and social stigma add to the problems of managing Diabetes Mellitus. The purpose of the project is to establish association of educational of the patient with complications and control of diabetes mellitus. Materials and Methods: An epidemiological cross sectional study of descriptive observational nature was conducted at the Diabetic OPD in a tertiary care centre in Eastern part of India on 303 patients. Patients of both sexes suffering from diabetes mellitus attending the Diabetic OPD in the tertiary care hospital and selection on random basis. The patients were asked to fill a pretested predesigned questionnaire prepared by Stanford Patient Education Research Centre. Observations and Results: Though the timing of taking pill regularly is high of lower socioeconomic classes, regular exercise and probability of complications is higher for the lower education level and it gradually decreases as the Education level increases. Conclusion: Treatment can be improvised by spreading awareness about the disease and its complications along with proper education on exercise, following diet plans and treatment regimen

A STUDY ON THE ASSESSMENT OF SAFETY OF A POLYHERBAL FORMULATION IN ACUTE DIARRHOEA

Objective: To explore the safety profile of the proposed polyherbal formulation LQ 14 which is composed of various antimicrobial ingredients in rodents according to OECD (423) for acute oral toxicity study and OECD (407) for 28-days repeated dose toxicity study. Materials and methods: Acute toxicity studies and 28-days repeated dose toxicity were done on male Swiss slbino mice and Wistar albino rats. The animals were randomly divided into four groups of five animals each (n=20). In acute toxicity study, three doses of the extract (2.5-10 ml/kg body weights) were administered to 3 groups of the animals respectively. All animals were observed for 24 hours and general symptoms of toxicity and mortality were recorded. In 28-days repeated dose toxicity study, wistar male rats were grouped by randomized design and assigned to three groups of 6 animals each (n=18). Two doses of the extract (2.5, 5 ml/kg body weight) were administered daily to 2 groups. The last group was control in both and received 10, 5 ml/kg body weight of deionized water. Route of administration was oral in all the groups of animals. Results: No treatment related toxicity was found in both acute and repeated dose toxicity studies. Conclusion: The absence of biologically significant differences in the toxicological endpoints supports the safety of LQ14 in the treatment of diarrhea

Evaluation of prescribing indicators in prescriptions of private practitioners in Kolkata, India

Background: To assess the prescribing indicators in prescriptions of private practitioners in Kolkata.Methods: In the observational, retrospective, cross-sectional survey, 1830 prescriptions of private practitioners were collected over a 5 years period and assessed using core prescribing indicators as per the World Health Organization “How to investigate drug use in health facilities” tool.Results: Overall the average number of drug per prescription was 3.05±0.91. No drug was prescribed by generic name. Prescriptions with an antibiotics and injections were 30% (549/1830) and 8.12% (149/1830), respectively. Drugs prescribed from essential drug list (EDL) were 29.38% (1640/5582).Conclusion: Poly-pharmacy, lack of generic prescribing, low rate of prescriptions from EDL is the present prescribing scenario of private set-up based practitioners of Kolkata. Regulation and intervention is required to improve the irrational prescribing practices

A rare case of Weil's disease with alveolar haemorrhage

Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is important as sometimes the disease may be life threatening. Proper antibiotics results in dramatic improvement. We hereby presented a case that had clinical features of Weil's disease with cough, dyspnoea and haemoptysis. Leptospirosis was detected on ELISA testing. Patient was cured rapidly with antibiotics

Cefditoren pivoxil associated rash and arthralgia in a child

Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered as ‘probable’. Analyzed by the Naranjo's ADR probability scale, the score was 7, which also makes it a ‘probable’ event

An observational study of abdominal organ involvement detected by ultrasound and computed tomography in children suffering from lymphoreticular malignancy at a tertiary care hospital in Eastern India

Introduction: Abdominal organs are usually involved in lymphoreticular malignancies (LRM), and the detection is crucial for Initial staging, determination of the location and extent of disease, and is the hallmark for the choice of treatment. At present, the established radiological technique for staging Hodgkin's disease is computed tomography (CT) and ultrasonography (USG) in our country. Objective: The objective of the study was to evaluate the pattern of abdominal organ involvement in childhood LRM by USG and CT and to analyze the findings. Methods: The study included 121 children with newly diagnosed childhood LRM who underwent real time USG and contrast enhanced CT scan. The records of the US and CT scanning were analyzed with respect to size, shape, margins, echogenicity/density pattern of various abdominal organs and lymph nodes to evaluate the extent and pattern of abdominal organ involvement by the disease process. Results: Out of 121 cases of LRM, US detected significant portal lymphadenopathy in 9 (7.44%) cases where CT detected enlarged portal nodes in only 3 and missed in 6 cases. However in the retroperitoneal lynphadenopathy CT scored over US, as CT detected 16 (13.22%) cases as against 13 (10.74%) cases detected by US. Conclusion: In our study we observed abdominal organs are commonly involved at the time of initial presentation in childhood LRM, with diffuse organomegaly being commoner than focal lesions. Abdominal symptoms and GIT involvement were also found more common in NHL patients at their initial presentation. There are no characteristic patterns of involvement either on US or CT which are specific to any individual disease entity. Although organomegaly and focal lesions are not diagnostic, but in a known case of childhood LRM these are highly suggestive of involvement by the existing disease process. There is no significant difference in the detection rate of abdominal organ involvement by US and CT in our study. However US being safer and cheaper, US may be suggested as the primary imaging modality to detect abdominal organ involvement in childhood LRM at initial presentation

PERCEPTION OF QUALIFIED MEDICAL PRACTITIONERS TOWARD PRESCRIBING IN INTERNATIONAL NON-PROPRIETARY (GENERIC) NAMES – AN OBSERVATIONAL, CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL IN INDIA

Objectives: The study was conducted to assess the perception and practice of medical practitioners, working in tertiary care, and teaching institutions in Eastern India, regarding the use of generic (non-proprietary) names while prescribing. The study tried to assess their perception toward using drugs from the National List of Essential Medicine (NLEM), as well. Methods: An observational, cross-sectional study was conducted. Medical practitioners attached to the institution were considered for the study and those who gave voluntarily consent were included. Hundred participants were interviewed based on convenient random sampling. They were provided with the study questionnaire and the responses were analyzed using Microsoft Excel 2007 using charts and tables. Results: Majority (43/100) did not feel that generic medicines are as effective as reputed brands, while 32 felt they are of equally effective. About 45% (45/99) felt generics to be equally safe as and 24% (24/99) did not feel so. About 86% considered generics to be cheaper. About 56% did not prefer to substitute with generics in all conditions. About 73% had doubts regarding the quality of production of generics. The decision to use generics was mostly influenced by the lower cost (73%) and by administrative pressure (53%). About 58% felt that the NLEM does not contain all the medicines they would require in practice. About 94% agreed to prescribe more in generics if the quality may be ensured. Conclusion: Awareness of the NLEM and about generics needs to be improved. Authorities need to ensure the quality of generics and assure the prescribers about it

Evaluation of prescribing indicators in prescriptions of private practitioners in Kolkata, India

Background: To assess the prescribing indicators in prescriptions of private practitioners in Kolkata.Methods: In the observational, retrospective, cross-sectional survey, 1830 prescriptions of private practitioners were collected over a 5 years period and assessed using core prescribing indicators as per the World Health Organization “How to investigate drug use in health facilities” tool.Results: Overall the average number of drug per prescription was 3.05±0.91. No drug was prescribed by generic name. Prescriptions with an antibiotics and injections were 30% (549/1830) and 8.12% (149/1830), respectively. Drugs prescribed from essential drug list (EDL) were 29.38% (1640/5582).Conclusion: Poly-pharmacy, lack of generic prescribing, low rate of prescriptions from EDL is the present prescribing scenario of private set-up based practitioners of Kolkata. Regulation and intervention is required to improve the irrational prescribing practices