EFFICACY OF SUPPLEMENTATION OF PROBIOTICS ALONG WITH ANTIMICROBIAL AGENTS IN VULVOVAGINAL INFECTIONS IN A TERTIARY CARE HOSPITAL

Objectives: The objectives of the study were to ascertain the efficacy of probiotics along with antimicrobials in the treatment of vulvovaginitis and to evaluate the rate of recurrence. Methods: The study was done on 60 patients who were randomly selected and divided into two groups of 30 each. Prior permission from the Institutional Ethics Committee and higher authorities was obtained before conducting the study. One group received standard treatment including antibacterial, antiviral, and antifungal as per the gynecologist discretion and in other group along with standard treatment, probiotic capsules containing combination of Saccharomyces boulardii, Lactobacillus sporogenes (50 million), Streptococcus faecalis (30 million), Clostridium butyricum (2 million), and Bacillus mesentericus (1 million) given orally twice daily and followed up for a period of 3 months. The drugs were started on the 5th day after menstruation taking starting of the bleeding as day 1. Results: The parameters compared were symptoms and signs (significantly reduced – p-value), clue cells (significantly reduced in number), and recurrence rates (significantly reduced), in 80% of patients smears which were not consistent with BV. Maximum number of patients showed negative KOH mount (71.5%), saline wet mount was negative in 80% of patients in antimicrobial agents + probiotics group. Conclusion: From the present interventional study, probiotics along with antimicrobial agents showed better improvement than antimicrobial agents alone. Hence, supplementation of probiotics along with antimicrobial agents provides better efficacy than antimicrobial agents alone in treating vulvovaginal infections

A comparative clinical study to access the role of Basti and Virechana Karma followed by Rasayana in post menopausal Asthikshaya (Osteoporosis)

Rajonivrutti condition manifests in the end phase of Jarawastha; but its Samprapti begins from the Sandhikala of Madhyamawastha and Jarawastha due to Vatavruddi in womens reaching Rajonivrutti. Postmenopausal Asthikshaya is a disabling disease, which renders women a bedridden life. Here 40 subjects diagnosed with postmenopausal Asthikshaya fulfilling the inclusion criteria were selected for the study and randomly categorized intp two groups as group A and group B each consisting of 20 subjects. Group A received Amapachana with Hinguvachadivati, Yastimadhu Siddha Ksheerabasti administered in Yoga Basti schedule followed by Tritiyatriphala Rasayana. Group B received Amapachana with Hinguvachadivati, Sadhyosnehapana with Amrita Ghrita, Sarvanga Abyanga with Murchita Tilataila followed by Sarvanga Swedana and Sneha Virechana was admistered with Eranda Taila followed by Tritiyatriphala Rasayana was given. Tritiya Triphala Rasayana selected for the present study by adapting all the general principles of prevention and management of Asthikshaya and as it is a well known Rasayana

Prachanna Karma - An effective procedure in the management of Indralupta followed by Icchabhediya Rasa as Lepa and Shamanoushadi - A Case Report

Hair is the first most noticeable part of body. It enhances personality. As the cliché goes “your hair is your crown and glory” no matter the gender. The hair, after all is your best accessory. It forms an important anatomical structure of the body which not only have protective function. Increased industrialization and urbanization has constituted greater exposure to pollution contamination of water, air, food habits, and life style modification due to their intrinsic factors. Hence there is definite increase in the incidence of hair fall. Hair disorders cause negative impact towards the individual quality of life. Indralupta is a Kshudraroga characterized by loss of hair. It can be correlated with alopecia areata, which is having chief complaint of hair loss on scalp without any clinical inflammatory signs. In modern science treatment modalities like use of corticosteroid, laser therapy but all have lots of adverse effect. In Ayurveda literature Acharyas had briefly explain hair and mentioned many more modalities to treat hair loss. Nidana Parivarjana, Prachanna, Shamanoushadhi and externally use of Lepa

A CONTROLLED CLINICAL STUDY ON THE EFFECT OF CERTAIN INDIGENOUS DRUGS IN SHAKHASHRITA KAMALA WITH SPECIAL REFERENCE TO VIRAL HEPATITIS-B

Hepatitis-B is an infective disease predominantly affecting liver. Along with AIDS, which has been a major concern since 90s. Many of the Ayurvedic herbal medicines have been tried and have been proved to be effective in treating Shakhashrita kamala. The objective of the study was to see the effect of tablet Nirocil and indigenous drugs Kashaya in Shakhashrita kamala (Hepatitis-B) and to compare both of them. A Total of 26 patients, after considering the inclusion and exclusion criteria, having signs and symptoms of Shakhashrita kamala were included in the study and after diagnosing Hepatitis-B by elevated liver function tests and HBsAg (Elisa). Patients were assessed and scores were given with regards to the subjective parameters like Peetata of netra, Peetata of Mootra, Peetata of Jihwa jala, Swethavarchas, Kandu and objective parameters like total bilirubin, and HBsAg. All the subjective parameters are recorded and assessed on initial day, during and after treatment. Objective parameters are assessed before and after treatment. Out of 26 patients, 10 patients got completely cured, 8 patients got improvement and 8 patients got slight improvement. Overall assessment of the study revealed that, after treatment of 26 patients, there were 8 patients having HBsAg positive result and 18 patients were having HBsAg negative result which was highly significant. Both the groups showed significant positive in subjective parameters. Thus study revealed that indigenous drugs Kashaya has significant role to play in the management of Shaksahashrita kamala. To conclude, the study emphasized that indigenous drugs Kashaya has significant role to play in the management of Shaksahashrita kamala

Evaluation of Awareness of Knowledge, Attitude and Practices of Nursing Students on Monitoring and Reporting of Adverse Drug Reactions in a Tertiary Care Hospital

Abstract: To assess the Knowledge, Attitude and Practices of nursing students on monitoring and reporting of adverse drug reactions in a tertiary care hospital. This questionnaire based study was conducted in a tertiary care hospital on 85 Prefinal and final year nursing students. The study instrument was a pre designed questionnaire which included the Knowledge of the ADRs reporting, the attitudes towards the reporting, and the factors which could hinder the reporting. The students were given an educative and interactive session for clearance of their understanding about Pharmacovigilance. The post-session questionnaire was also completed to assess their understanding. A total of 85 students participated. The median knowledge, attitude scores before the intervention were 42.5%, 46.6% respectively. After the intervention the scores increased significantly to 89.4%, 98.8% respectively

Personalised Precision Medicine - A Novel Approach for Oral Cancer Management

Oral Cancer is one of the most common malignancies of the head and neck region. Despite technological advancements and improvements in Oral cancer diagnosis and treatment modalities, the 5-year survival rate remains low and is associated with poor prognosis and high mortality rate especially when detected at a later stage. The empirical therapy followed for the treatment of oral cancer includes surgery, radiotherapy and chemotherapy. The treatments are not equally efficacious for all patients, are associated with side effects and poor prognosis. The need of the hour is early diagnosis and tailored treatment therapies for individual patients. With the advent of immunotherapy, the cancer treatment has moved toward personalised precision medicine which tailors’ treatments to each individual. Personalised precision medicine incorporates, molecular profiling of tumours with OMICS technology, biomarkers and companion diagnostics to build databases of patients and devise tailor made treatment approaches for individual patients. This article discusses the role of precision medicine in OSCC prevention, detection, and management by reviewing our understanding of OC from both genetic and OMICS perspectives

Studies on the hepatic and renal status of patients with sickle cell disease from western zone of Maharashtra, India

Background: Sickle cell disease (SCD) is the most common inherited monogenic genetic disorder in Indian tribal and non-tribal population. This condition is caused by mutations in the hemoglobin gene and inherited in an autosomal recessive pattern. Pathogenesis in SCD varies widely from patient to patient. Most of the infections affect SCD pathogenesis, so early diagnosis of the same is important.Methods: The present study was designed to evaluate the biochemical parameters to assess the hepatic and renal status in SCD subjects from west zone of Maharashtra, India. Patients with sickle cell disease (n=50) from primary health centres of Palghar were included in this study and age and sex matched healthy persons (n=50) were controls. Informed written consent was obtained from all the study subjects.Results: Our findings showed that Aspartate trasaminase (AST), Alanine transaminase (ALT), bilirubin and creatinine increased significantly above normal level in SCD subjects. Albumin and urea levels in SCD were found to have decreased in the SCD subjects. There is a slight increase in uric acid and creatinine levels; this indicates an adverse effect on hepatic function and moderate effect on renal function in sickle cell anemia patients. Most common events of SCD pathogenesis, can be categorized into hemolytic events and vaso-occlusive crisis-based events. Adverse effect on hepatic function can lead to further hemolytic events.Conclusions: Although specific biomarkers related to these different events needs to understand for assessment of pathogenesis, the ones we have studied can be useful to assess the status of hepatic and renal function to follow the effectiveness of therapeutic interventions.

Pattern of drug utilization and factors influencing long term blood sugar control among diabetics in a tertiary care hospital- an observational study

Background: To study the Pattern of drug prescribing, utilization, analyse effectives of different therapies and factors influencing medication failure and adherence to treatment among diabetics.Methods: The clinical study was conducted in JJM Medical College and Karuna Trust, Davangere, Karnataka. The patients with diabetes as diagnosed by consultant physician were observed for the pattern of blood glucose control. The fasting blood glucose of the patients were recorded at the end of 1st month, 6th month and 12th month of their treatment period. The study period was from June 2012 till August 2014. The study was conducted after institutional ethical clearance and informed consent was taken from all the patients. The pattern of drugs prescribed for the patients were also analysed. The pattern of control among patients with co morbidities were also analysed using paired sample t test.Results: The results showed that the prescribed drugs were able to control the blood glucose levels of the patients. The percentage of patients with FBS in controlled, mild to moderate control and uncontrolled group were 21%, 33.3% and 45.5% in early treatment period and 36%, 40.9%, and 22.7% after one year treatment period (Significant p value). The pattern of drug utilization showed that the most commonly used drugs were the combination of pioglitazone+glimipride+metformin (19%), combination of glibenclamide+ metformin (18%), only insulin (9%), combination of glimipride+metformin (8%) and combination of gliclazide+metformin (5%).Conclusions: The results show that the intervention by the consultant physician was successful in controlling the blood sugar levels and the reasons for failure of treatment and adherence to treatment were helpful for further treatment of patients. Further such studies in a larger sample will help the consultants in their treatment methods

Plasma homocysteine levels in Indian patients with acute ischemic stroke

Background: Homocysteine has primary atherogenic and prothrombotic properties. The present study aimed to assess serum homocysteine levels in patients with ischemic stroke and to find association of serum homocysteine levels with various patient related variables.Methods: This observational study included patients who were admitted with the diagnosis of stroke in Sri Ventateswara Ramnarain Ruia Government General Hospital. Patients were evaluated for risk factors like hypertension, diabetes mellitus and hyperlipidemia. Total homocysteine estimation was done and survival of the patients was assessed at the time of discharge from the hospital.Results: Most common risk factor for stroke in our study population was dyslipidemia (40%), followed by hypertension (36%). Total homocysteine levels were raised in 92% of the patients. Patients with homocysteine levels less than 15mM/L had lacunar infarcts. Homocysteine levels higher than 100mM/L were found in 18% of the patients and they all had large sized lesions. Significantly higher mean homocysteine levels were found among patients with large lesions (70.15±2.65 vs 21.68±8.02, p value <0.05). Among various risk factors, higher mean homocysteine levels were found to be associated with dyslipidemia (p value <0.05). No association between hypertension, diabetes mellitus or smoking history was found with higher homocysteine levels. Patients who survived had significantly lower homocysteine levels as compared to non survivors (39.3±19.84 vs 100±18.82, p value<0.001).Conclusions: Further studies are needed on homocysteine and stroke fur using homocysteine as screening test and for initiation of preventive therapy of stroke based on homocysteine levels

Cardiovascular profile of patients with chronic kidney disease

Background: Frequency of fatal and nonfatal cardiovascular events increase even in early stages of chronic kidney disease (CKD). This study was aimed to understand the cardiovascular profile of patients with CKD.Methods: This observational study was conducted on patients who were admitted with chronic kidney disease in Sri Venkateswara Rama Narayan RUIA Government General Hospital, Tirupati. Patients were classified according to their severity of CKD. All patients had an electrocardiogram and echocardiogram. Results of various biochemical investigations, electrocardiogram and echocardiogram were compared between patients with mild, moderate and severe CKD.Results: Combined diabetes mellitus and hypertension was found to be the most common case of CKD in Authors patient population (43%), followed by diabetes mellitus alone (37%). Serum creatinine and blood urea nitrogen were found to be significantly higher and creatinine clearance and haemoglobin were significantly lower among patients with severe CKD. Electrocardiography revealed 50% had left ventricular hypertrophy (LVH), 30% had tall ‘T’ waves and 15 % had ST-segment changes. Mean inter-ventricular septal end diastole thickness and mean left ventricular mass was found to be significantly in patients with severe CKD as compared to mild CKD.Conclusions: Extensive cardiovascular evaluation of patients with CKD is warranted even if the classical symptoms are not absent and early cardiovascular rehabilitation should be instituted in such patients