VACCINE-INDUCED DEVELOPMENTAL DELAY: A CASE REPORT

Vaccines are weakened or dead microbes injected for the development of an acquired immunity as a preventive measure, also including the use of microbial proteins. The spectrum of adverse events following vaccination has been increasing as well with increasing number of reports detailing the events following immunization. The rate of morbidity and mortality of many communicable diseases has significantly decreased with time with relieve to the quality of life as well as the overall pharma economic cost. In this case report vaccine-induced developmental delay was observed in a child of 16 months of age. The child was born with low birth weight despite which the child was administered with hepatitis B vaccine, poliomyelitis vaccine, and bacillus Calmette-Guerin within 24 h of birth. Consecutive clinical outcomes followed throughout the years, which induced a developmental delay in this child. This case clearly signifies the need for more evidence-based implementation for the management of various diseases at secondary care hospitals

Toxicoepidemiology of acute poisoning cases in a secondary care hospital in rural South India: A five-year analysis

Objective: To ascertain the trend of poisoning cases admitted to the Government District Headquarters Hospital, a secondary care center in Udhagamandalam, Nilgiris District, Tamil Nadu, India, over a five-year period. Materials and Methods: The number of cases that presented to the hospital annually (incidence, mortality, and case fatality rates), socio-demographic pattern, and the nature of the poison were noted. Results: A total of 1860 poisoning cases (80 deaths) were reported during the period from October 2008 to September 2013. The incidence of poisoning was found to increase every year. The average incidence was 1.60 per 1000 population, while the average case fatality rate and mortality rates were 40.51 and 0.07, respectively. A total of 1148 (62%) were males. The majority of cases were seen in the 21-30 age group (41.24%). The poisonings were largely deliberate self-harm (n = 1,755; 94.35%), followed by accidental (n = 85; 4.57%). Agrochemicals were the main choice of poisoning agents and among these, organophosphates were the major cause. Conclusion: The data generated can help policy makers take decisions on the sale and availability of pesticides in this region

A Phenytoin Induced Toxic Epidermal Necrolysis (TEN) -A Case Report

A B S T R A C T Toxic Epidermal Necrolysis (TEN) is a rare, potentially life threatening dermatological condition that is usually induced by medications. The usage of anticonvulsants like carbamazepine, phenytoin, lamotrigine, phenobarbital, fosphenytoin are associated with high risk for occurrence of TEN. A 36 year old female patient was brought with the history of Phenytoin induced Toxic Epidermal Necrolysis. This patient was prescribed tablet phenytoin 300mg/day, 100mg in the morning and 200mg at night for her generalized tonic-clonic seizure disorder and patient had history of using the drug for a period of 28 days. Patient developed macular rashes on the skin and consulted a general physician who prescribed her with cetirizine 5mg, bid. The drug phenytoin was continued till she visited Government District Head Quarters Hospital,Udhagamandalam in spite of treatment with cetirizine the rashes spread all over the body with an additional ocular redness with discharge. This case report describes the management of this patient

Impact of prediabetes education program on Knowledge, attitude and practice among prediabetic population of south India

Education plays a vital role not only in the management of diabetes but also for the effective prevention of diabetes and its complications. Prediabetes awareness and knowledge is grossly inadequate in India and massive prediabetic screening and management programs are urgently needed. This study was an initiative to conduct education program among the prediabetic subjects after assessment of their knowledge attitude and practice using a newly developed and validated prediabetes questionnaire. A total of 308 prediabetic participants were recruited through prediabetes screening camps conducted in the selected districts of Kerala and Tamilnadu. A newly developed and validated KAP-PAQ Questionnaire was used to analyze the Knowledge Attitude and Practice among the prediabetic population. The impact of Prediabetes Education Program was assessed by administration of questionnaire before and after PEP with an interval period of 30 days. Baseline assessment of knowledge among prediabetics shown that 90% had poor knowledge but after PEP program 43% had average knowledge and 44% could score good knowledge. Baseline assessment of attitude exhibited 30% with negative attitude but after counseling 68% shown positive attitude. Regarding practice assessment 35% had very poor and 52% shown poor practice but after PEP 71% shown good practice and 15% shown very good practice. Baseline KAP survey shows the need for health literacy among the newly diagnosed prediabetics. Prediabetes education program could bring significant improvement in knowledge attitude and practice and KAP-PAQ was found to be an efficient tool to conduct survey among the newly diagnosed prediabetics of south India

Cytochrome P450 Inhibitory Potential of Triphala—A Rasayana from Ayurveda

Ethnopharmacological relevance: ‘Triphala’ is one of the age-old, most commonly used polyherbal preparation from Ayurveda as Rasayana drug. Aim of the study: This study was aimed at evaluating the effect of ‘Triphala’ on drug modulating enzymes to assess its safety through its potential to interact with co-administered drugs. Materials and methods: The cytochrome P450 inhibitory effect of ‘triphala’ formulation was investigated on rat liver microsomes using CYP450–CO complex assay and on individual isoform such as CYP3A4 and 2D6 using fluorescence screening. RP-HPLC method was developed to standardize ‘triphala’ and its individual components using gallic acid as analytical marker compound. Results: RP-HPLC analysis demonstrated the presence of gallic acid (4.30±2.09 mg/g) in the formulation. The formulation showed 23% inhibition of the rat liver microsomes through CYP450–CO complex assay which is comparatively less when compared with the individual components. Further, the effect of standardized formulation dissolved in ethanol showed CYP3A4 and CYP2D6 inhibitory activity at the IC50 values of 119.65±1.91�g/ml and 105.03±0.98�g/ml respectively. Gallic acid was also found to inhibit both the isoforms at the IC50 values of 87.24±1.11�g/ml and 92.03±0.38�g/ml respectively. Conclusions: Various concentrations of the formulation and its individual components showed significantly less inhibitory activity (p < 0.001) on individual isoforms when compared with the positive control. Assessment on the in vitro effect of ‘triphala’ on drug modulating enzymes has important implications for predicting the likelihood of herb–drug interactions if these are administered concomitantly

POST-STROKE PSYCHIATRIC DISORDERS: AN OVERVIEW ON ITS SCREENING AND MANAGEMENT

Stroke is the third leading cause of death. Stroke occurs when an insufficient amount of blood is supplied to the brain due to a thrombus or an emboli leading to permanent tissue damage. Lesions in the brain can lead to psychiatric complications. The prevalence of psychiatric complications after stroke is very common. Psychiatric complications such as depression, anxiety, apathy, pseudobulbar effects (laughing and crying), mania, psychosis, and bipolar disorders are seen after stroke. In this review, various psychiatric disorders are reported among post-stroke survivors in which depression and anxiety are common. Consequently, apathy, pseudobulbar effects, catastrophic reactions, psychosis, bipolar disorder, and mania are also observed after stroke. Therefore, early detection and management of psychiatric disorders prevent further complications and improve the quality of life in post-stroke patients