Prevalence of depression, anxiety and Quality of life among North Indian Polycystic ovary syndrome Women: Evidence from a prospective observational study

Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous gynaecological endocrine disorder characterized by clinical features including oligo-amenorrhea/ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. PCOS increases the risk of depression and anxiety which leads to poor quality of life. Aim of the study were to determine the prevalence of anxiety and depression among women suffering from PCOS and to determine the quality of life (QOL) in PCOS women.Methods: The study was prospective, observational, non-interventional and questionnaire-based. 192 women with PCOS voluntarily helped in filling the questionnaires consisting of questions using PHQ-9 for depression, GAD-7 for anxiety, SF-12 for general health and PCOSQ-50 for disease-specific domains. All data were recorded in pre-designed case record forms and analysis of data was done using different statistical methods.Results: Majority of PCOS women were either overweight or obese. Based on PHQ-9 20% of women was suffering with major depression and based on GAD-7, 25% with major anxiety. It is found that psychosocial and emotional domain and coping domain of PCOSQ-50 is significant in patients with major depression and major anxiety. Significant effects were seen on their general health as per SF-12 domain. Lack of physical exercise was found in 83% of women.Conclusions: PCOS is a complex disease which decreases the overall quality of life. Therefore, treatment of PCOS women should include psychological counselling along-with with medication, especially in obese PCOS women. Women should be educated with the benefits of lifestyle modification in PCOS

Evaluation of prescribing patterns in diabetic and hypertensive patients in a South Delhi Hospital

Background: Drug utilization studies (DUS) defined by World Health Organization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, and economic. The increasing importance of DUS as a valuable investigation resource in pharmacoepidemiology has been linking it with other health related areas, such as public health, pharmacovigilance, pharmacoeconomics, and pharmacogenetics.Methods: The study was a prospective DUS carried out in medicine OPD of Indian Institute of Technology Hospital, New Delhi, India in which a total of 595 prescriptions of hypertensive and diabetic patients were reviewed. All diabetic and/or hypertensive patients; irrespective of age, gender; who had least one drug in the prescription were included. Data were collected by screening of physician’s prescribing record and patient medication profile.Results: A total of 595 prescriptions were recorded. 57.31% were males as compared to 42.69% females. 54.62% patients were hypertensive (325 prescription); 14.78% patients were diabetic (88 prescription) whilst 30.58% had both the diseases. Of 507 prescriptions having antihypertensive drugs, combination therapy was utilized (40.8%) in the prescriptions and out of 270 prescriptions having antidiabetic drugs, 143 (52.96%) prescription were of combination therapy. Among antihypertensive drugs, angiotensin-converting enzyme inhibitors were the most frequently prescribed class of drugs (19.18%). The combination most commonly prescribed was amlodipine and atenolol (14.05%). Antidiabetic drugs made up for 11.05% of the total drugs prescribed. 28.78% of all hypoglycemic agents were sulfonylurea. Glimepiride and metformincombination was the most prescribed anti-diabetic drugs combination (16.16%).Conclusion: Both hypertension and diabetes are considered to be lifestyle diseases. Hence, apart from optimal and appropriate prescribing, there is a need for lifestyle modification to obtain improved outcomes. Combination therapy was observed in a high percentage of prescriptions. Though monotherapy is associated with improved compliance and fewer side effects, combination therapy is desirable for synergistic actions and to overcome complications

DRUG UTILIZATION PATTERN AND ADVERSE DRUG REACTION MONITORING IN URINARY TRACT INFECTION PATIENTS IN A TERTIARY CARE HOSPITAL

Background: Urinary tract infection is a key public health issue causing morbidity, especially in women population. This problem is further aggravated in pregnant women. Aims:This study was designed to evaluate the drug prescribing behaviour and adverse drug reaction monitoring in urinary tract infection patients in a tertiary care hospital. Materials and Methods:The present study was prospective, observational and carried out for four months, and done to assess the drug utilization pattern, adverse drug reactions (ADRs) and to identify the bacterial pathogens associated with UTI and their susceptibility to antibiotics.Results:A total of 327 female patients were evaluated, out of which 248 (75.84%) cases were symptomatic. The study reflected maximum of 50.46% UTI in the age group 21-30 years. Pathogens isolated after a urine culture were of both Gram positive 131 (40.07%) and Gram negative 196 (59.93%) type. The maximum incidence (45.80 %) occurred in last trimester of pregnancy. The most frequently prescribed antibiotic to the pregnant patients in our study was Nitrofurantoin, whereas Amoxicillin with Clavulanic acid was most frequently used in non pregnant cases. Most common ADRs reported with almost all classes of antibiotics was nausea and vomiting followed by vaginal irritation, skin rash and photosensitivity.Conclusion:To ensure appropriate therapy, current knowledge of the pathogenic organism and their antibiotic susceptibility pattern is mandatory, especially in cases of UTI with pregnancy. Keywords: Drug utilization pattern,Adverse Drug Reactions, Urinary Tract Infection, Renal Pharmacolog

Limited Knowledge of Chronic Kidney Disease among Type 2 Diabetes Mellitus Patients in India

Diabetes and hypertension are the two major causes of chronic kidney disease (CKD). Epidemiological studies have found poor knowledge about the CKD among the general population. Hence, this study aimed to assess the awareness of CKD among type 2 diabetes mellitus (T2DM) patients in India. Patients with confirmed T2DM were included in the study. Patients receiving dialysis or with a history of a kidney transplant were excluded. A validated questionnaire was used to assess knowledge about CKD. Demographic characteristics were presented using descriptive statistics and trends in groups were calculated using the chi-square test. Statistical analysis was performed using SAS v9.4. A total of 323 patients completed the study. The mean age of the patients was 56 ± 11.25 years, and 51.7% were female. Only 33.43% of the patients correctly identified diabetes and hypertension as risk factors for CKD, while 44.27% were aware of the kidney’s function. Statistically significant associations were observed between kidney disease knowledge and education status (p = 0.004), socioeconomic status (p = 0.000), and income status (p = 0.003). No association was observed between the knowledge about CKD and age, gender, hypertension stages, CKD stages, duration of diabetes as well as hypertension and co-morbidities. Based on the results of this study, we found poor knowledge of CKD among Indian T2DM patients. The government should start a CKD awareness programme to deal with this rising co-morbid condition

Effect of amiloride: An Na+ / H+ exchange inhibitor in the middle cerebral artery occlusion model of focal cerebral ischemia in rats

Purpose : The effect of pretreatment with amiloride (AML), an Na + / H + exchange inhibitor was studied in the middle cerebral artery occlusion (MCAO) model of focal cerebral ischemia in rats. Materials and Methods : Male wistar rats were subjected to 2 hr of MCAO followed by 22-hr reperfusion. Grip strength, locomotor activity, and spontaneous alternation performance were assessed after 24 hr. Immediately after behavioral activities, animals were sacrificed and the oxidative stress markers were estimated in brains. Results : An elevation of thiobarbituric acid reactive substances (TBARS), reduction in glutathione, and antioxidant enzymes activities, namely glutathione-S-transferase, glutathione peroxidase (GPx), glutathione reductase (GR), and superoxide dismutase (SOD) were observed following MCA occluded rats. Pretreatment with AML (0.91 and 1.82 mg/kg p.o) significantly reversed the MCAO-induced elevation in TBARS but could not reverse the other parameters. Paradoxically, AML further reduced the levels of GPx, GR, and SOD, but no significant changes were observed in the catalase activity, grip strength, and spontaneous alternation behavior of rats. Locomotor activity was reduced slightly but reversed on pretreatment with AML. Conclusions : Although pretreatment with single dose of AML showed reduction in oxidative stress markers, further multiple doses of AML as pre- and post-treatments are required to establish its potential to be used in cerebral ischemia

Nigella sativa protects against isoproterenol-induced myocardial infarction by alleviating oxidative stress, biochemical alterations and histological damage

Objective: To evaluate the cardioprotective effect of Nigella sativa L. (N. sativa) in isoproterenol-induced myocardial infarction (MI). Methods: Groups were treated with different doses of ethanol extract of N. sativa (EENS) and N. sativa oil alone and along with enalapril for 28 days. MI was induced by subcutaneous administration of isoproterenol (85 mg/kg) in two consecutive doses. Levels of cardiac biomarkers and antioxidant enzymes such as creatine kinase–N-acetyl-l-cysteine, lactate dehydrogenase, aspartate aminotransferase, malondialdehyde, superoxide dismutase, reduced glutathione and catalase were evaluated along with gross histopathological examination. Results: Isoproterenol (85 mg/kg) induced MI by causing the significant (P < 0.01) reduction in the activity of cardiac biomarkers (creatine kinase–N-acetyl-l-cysteine, lactate dehydrogenase, aspartate aminotransferase) and antioxidant markers (superoxide dismutase, catalase, glutathione) along with significant (P < 0.01) increase in the level of malondialdehyde. Furthermore, histopathological evaluation also confirmed the isoproterenol-induced MI. Pretreatment with EENS (800 mg/kg) and combination of EENS (800 mg/kg) with enalapril (1 mg/kg) significantly (P < 0.01) prevented the development of these alteration and restored activity of cardiac biomarkers as well as antioxidant markers almost near to normal levels. Histopathological evaluation of cardiac tissue further confirmed the restoration of biochemical activity. Conclusions: Experimental findings thus indicate that EENS (800 mg/kg) demonstrated cardioprotective effect against isoproterenol-induced MI by restoring cardiac biomarkers and antioxidant status

Caspase Mediated Synergistic Effect of Boswellia serrata Extract in Combination with Doxorubicin against Human Hepatocellular Carcinoma

The study investigated the growth-inhibiting and apoptosis mediating effects of B. serrata extract as monotherapy and combination therapy with DOX against hepatocellular carcinoma cell lines. Boswellic acid rich fraction of B. serrata extract was prepared. MTT assay on HepG2 and Hep3B cells was carried out using B. serrata alone and in combination with DOX. Further, caspase-3 activity, TNF-α level, and IL-6 level were estimated. Isobolographic analysis was carried out to evaluate the effect of combination therapy. Additionally, protective effect of B. serrata extract on DOX induced hepatic toxicity was also evaluated in Wistar rats. B. serrata extract inhibited growth of HepG2 (IC50 value of 21.21±0.92 μg/mL) as well as HepG2 (IC50 value of 18.65±0.71 μg/mL). DOX inhibited growth in HepG2 and Hep3B cells with an IC50 of 1.06±0.04 μg/mL and 1.92±0.09 μg/mL. Isobolographic analysis showed combination index (CI) of DOX and B. serrata extract of 0.53±0.03 to 0.79±0.02 suggesting synergistic behavior against the two cell lines. B. serrata extract also caused dose dependent increase in caspase-3 activity, TNF-α level, and IL-6 level which was higher (P<0.001) with DOX (1 μM) and B. serrata extract (20 μg/mL) combination. B. serrata extract also protected Wistar rats against DOX induced hepatic toxicity