Evaluation of Efficacy and Tolerability of Fixed Dose Combination of Metformin with Voglibose Versus Metformin with Pioglitazone in Prediabetics: An Open label, prospective, RCT

Background: ADA has cut-off value for IGT (140-200 mg/dL) but has a lower cut-off value for IFG (100-125 mg/dL) and has additional hemoglobin A1c (HbA1c) based criteria of a level of 5.7% to 6.4% for the definition of prediabetes. Due to progressive nature of prediabetes, dual drug therapy produces additive effects, allows the use of submaximal doses, and less side effects of individual agents. Therefore, the present study was designed to study the effect of voglibose in comparison to pioglitazone on glycemic control as an add-on drug in prediabetes patients whose glycemic status was uncontrolled with metformin alone. Methods: The present study was open, randomized, parallel group comparison of two active treatment groups over a period of six months. Sixty-seven patients of either sex in the age group of 30-60 years, suffering from prediabetes, with FBG: 100-125 mg/dl and PPBG:140-200 mg/dl as per ADA were selected at randomly. The effect of FDC of Voglibose with Metformin and Pioglitazone with Metformin were observed on various parameters of Glycemic Triad (FBG, PPBG, HOMA-IR, HbA1c and Serum Insulin). Results: At the end of 6 months it was observed that though both FDC of Voglibose with Metformin and Pioglitazone with Metformin reduced Glycaemia Statistically significantly but Pioglitazone with Metformin caused a significantly greater percentage change in Glycaemia as compared with Voglibose with Metformin. Few side effects were observed with Voglibose but not with Pioglitazone. Conclusions: Though Voglibose with Metformin and Pioglitazone with Metformin were equally effective in lowering Glycemia yet Pioglitazone with Metformin showed better results in improving glycaemia, as compared to Voglibose with Metformin. Pioglitazone with Metformin had minimal side effects as compared to Voglibose with Metformin. Keywords: Voglibose, Metformin, Pioglitazone, Prediabetes, Glycemi

Comparative study to evaluate efficacy and safety of azilsartan and telmisartan in patients with grade I-II essential hypertension

Background: Objectives of the study was to study the effect of Azilsartan 40mg once daily versus Telmisartan 40mg once daily in patients with Grade I-II essential hypertension.Methods: A prospective study was conducted at MGM Medical college and Hospital which included 80 patients in each group with Grade I–II essential hypertension. The sex, age, presenting illness, and family history of the patients were recorded. Investigations such as blood sugar, urine analysis, kidney function test, lipid profile, and ECG were performed before starting the treatment. Any adverse effects during the treatment were noted. Blood pressure was recorded at baseline and during follow-up. One group received Azilsartan 40mg once daily and another group Telmisartan 40mg once daily. Patients were followed-up every week for 5 weeks.Results: Patients receiving Azilsartan 40mg and Telmisartan 40mg showed a significant fall (P 0.05). Adverse effects such as Nasopharyngitis, Upper respiratory tract inflammation, Gastroenteritis, headache, dizziness, and fatigue were reported with both drugs.Conclusions: Reduction of blood pressure with Azilsartan and Telmisartan was similar, but fall in blood pressure from baseline was highly significant in both groups

Comparative study of safety and efficacy of pregabalin and gabapentin in management of neuropathic pain associated with chronic lumbar radiculopathy

Background: Chronic lumbar radiculopathy a clinical condition in which there is back and leg pain associated with sensory, reflex, or motor deficits in the area of nerve root distribution lasting for more than 12 weeks. The prevalence of lumbar radiculopathy has been reported to be 5.3% in men and 3.7% in women. Pregabalin and gabapentin, which fit in to a new category of drugs called as alpha-2-delta (α2δ) modulators, have been discovered to be effective in the treatment of neuropathic pain related with multiple conditions. So this study was done to compare safety and efficacy of pregabalin and gabapentin in management of pain associated with chronic lumbar radiculopathy.Methods: This was a randomized two arm comparative prospective study. Total 160 patients were enrolled and randomized equally into 2 groups. Group A patients were given capsule pregabalin 75 mg two times a day orally, Group B patients were given tablet gabapentin 300 mg two times a day. Pain intensity was assessed at the start of study i.e. at baseline (0 week), at 6 weeks and at 12 weeks of starting the treatment using numeric pain rating scale.Results: There was significant reduction in pain at the end of 12 weeks in both the groups (p<0.0001), but there was no significant difference between these two groups. The incidence of adverse effects was also more in group A.Conclusions: Both the drugs are having comparable efficacy but gabapentin is more tolerable in such cases

To Study on Common Allergens Causing Contact Dermatitis

Introduction:Contact dermatitis (CD) is a skin disorder characterized by redness, itching and vesiculation. In chronic cases, scaly desquamation and lichenification may also be present. CD results from contact with environmental substances that elicits an allergic and/or irritant response.Material and Methods:A total of 100 patients of contact dermatitis of either sex who attended the Out-Patient Department of Dermatology, Venereology and Leprosy at Tertiary care teaching hospital over a period constituted the subject material for the present study. Inclusion Criteria: Patients clinically suspected to have contact dermatitis. Patients with active dermatitis were first treated and then subjected to patch testing so as to avoid false positivity and excited skin syndrome (Angry back syndrome).Results: Maximum number of cases (21%) showed worsening of disease in summer. Most common clinical pattern was hand dermatitis (30%) followed by foot dermatitis (25%), Air borne contact dermatitis (ABCD) (16%), kumkum dermatitis (11%), Hand and foot dermatitis (7%). In males potassium bichromate (10%), parthenium (9%) and thiuram mix (6%) were the most common allergens whereas in females nickel (9%), kumkum (9%) and fragrance mix (6%) were the most common allergens. In males positive reaction to potassium bichromate (P&lt;0.05), parthenium (P&lt;0.05), thiuram mix (P&lt;0.01), were significantly more common in males. Females showed significantly more positive reactions to nickel (P&lt;0.05), fragrance mix (P&lt;0.05) and kumkum (P&lt;0.01).Conclusion:In our study, the commonest allergens in our patients from hospital adjoining places were potassium bichromate, thiuram mix and parthenium in males, whereas nickel, fragrance mix and kumkum in females. In view of the differences in clinical patterns, positivity rates etc. reported from different parts of India, we owe it to our patients to clarify the epidemiology of this important problem

To evaluate the efficacy and safety profile of rosuvastatin, simvastatin and atorvastatin in newly diagnosed type 2 diabetic patients with dyslipidaemia

Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus. The lipid changes associated with diabetes mellitus are attributed to increased free fatty acid flux secondary to insulin resistance. Newly diagnosed 90 cases of patients of Type II Diabetes Mellitus well controlled on oral hypoglycemic drugs were randomly divided into 3 groups of 30 each. The mean difference of Triglycerides between baseline versus after 6 months was 65.04 mg/dl in Group A, 39.99 mg/dl in Group B and 37.04 mg/dl in Group C. The mean difference of HDL between baseline versus after 6 months was 10.04 mg/dl in Group A, 10.26 mg/dl in Group B and 9.13 mg/dl in Group C. The mean difference of LDL between baseline versus after 6 months was 79.4 mg/dl in Group A, 67.6 mg/dl in Group B and 33.82 mg/dl in Group C. The mean difference of VLDL between baseline versus after 6 months was 13.01 mg/dl in Group A, 7.58 mg/dl in Group B and 7.41 mg/dl in Group C.&nbsp

To evaluate the efficacy and safety profile of Rosuvastatin, Simvastatin and Atorvastatin in newly diagnosed type 2 diabetic patients with dyslipidaemia

Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus. The lipid changes associated with diabetes mellitus are attributed to increased free fatty acid flux secondary to insulin resistance. This is prospective, comparative, open label, randomized and parallel group. The subjects enrolled for this study were selected from the Out-Patient Department of Medicine collaboration with Department of Pharmacology, Tertiary care teaching hospital over a period of month. Newly diagnosed 90 cases of patients of Type II Diabetes Mellitus well controlled on oral hypoglycemic drugs were randomly divided into 3 groups of 30 each. Group A was received Rosuvastain 10 mg O.D for 3 months, Group B: Simvastatin 10 mg O.D and Group C was received Atrovastatin 10 mg O.D. In Group ‘A’ the mean difference of Total Cholesterol between baseline versus after 6 months was 82.37 mg/dl, 64.92 mg/dl and 52.23 mg/dl in Group B and Group C respectively. The mean difference of Triglycerides between baseline versus after 6 months was 65.04 mg/dl in Group A, 39.99 mg/dl in Group B and 37.04 mg/dl in Group C.&nbsp

Association of visceral fat with cardiopulmonary fitness, oxidative stress and inflammatory markers in asymptomatic individuals with and without family history of type 2 diabetes mellitus

Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia with derangement of carbohydrate, fat, and protein metabolism due to absolute or relative deficiency of insulin secretion and action, or both. DM, especially type-2 DM, is a serious general medical issue which has arrived at scourge extents because of the quickly expanding paces of this ailment around the world. Target organ confusions, auxiliary to diabetes, are one of the most significant restorative worries of right now. The main findings of our research were no significant differences in baseline characteristics like age and height of both groups. Weight, BMI and waist hip ratio was significantly high in cases. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product were significantly high in Cases individuals; however, no significant difference was noticed in pulse pressure (PP). Significantly higher body fat and visceral fat %, lower levels of cardio respiratory fitness assess by cooper 12min run test and significantly higher levels of fasting blood sugar (FBS) was observed in cases

Comparative study to evaluate the efficacy and safety of Pioglitazone and Metformin on HOMA IR and HbA1c in patient of prediabetes

In India, the number of people with diabetes is increasing day-by-day. Due to a sole “Asian Indian Phenotype,” Indians develop diabetes an era earlier and have an earlier onset of complications. Hence, it is essential to evaluate earlier stage of disease progression. Prediabetes, typically defined as blood glucose levels above normal but below the thresholds of diagnosis of diabetes, is a risk state that defines a high chance of developing diabetes. The present study was Prospective, open label, comparative, randomized, parallel group, single center study. Comparison of two active treatment groups over a period of six months. Sixty patients of either sex in the age of more than 40 years with prediabetes, with HbAlc in the range of 5.7 to 6.4 % at screening as per ADA. The effect of metformin and pioglitazone were observed on various parameters i.e. Serum Insulin, FBG, HbA1c, HOMA-IR. In metformin group the mean change in HOMA-IR from baseline to 6 months was 3.44 to 2.21 (-1.23); on the other hand, in Pioglitazone group from baseline to 6 months was 3.30 to 1.91 (-1.39). Whereas, serum insulin from 35.58 to 26.73 (-8.85) in metformin group; in Pioglitazone group from 35.13 to 21.77 (-13.36).&nbsp

Comparative study to evaluate safety and efficacy of Metformin versus sitagliptin alone and combination in type 2 diabetes mellitus

Type 2 Diabetes mellitus (Type 2DM) is chronic, lifelong progressive metabolic disease characterized by hyperglycaemia due to absolute or relative insulinopaenia. The metabolic dysregulation that contributes to hyperglycaemia includes diminished insulin secretion, impaired glucose utilization or increased glucose production, and eventually causes pathophysiological changes in multiple organs and organ systems. Our study showed Sitagliptin was superior in reducing HOMA-IR when compared with metformin. If combination of Sitagliptin and metformin is used far superior reduction will be achieved on HOMA- IR. Limitation of our study was short duration of study and small sample size