Study of the effect of vildagliptin, a DPP-IV inhibitor on learning and memory dysfunction of diabetic rats

Background: To evaluate whether vildagliptin, DPP-IV inhibitor possess a favorable effect on learning and memory dysfunction in the management of Diabetes mellitus.Methods: Forty Albino rats of either sex weighing 100-180g, were divided into 4 groups of 10 animals each. Streptozotocin was used for induction of diabetes in rats. The rats were divided into 4 groups of eight rats in each. Group-1 was taken as control with no further intervention whereas group-2,3,4 were injected 5mg/kg, 10mg/kg,20mg/kg of vildagliptin respectively for a period of 2 months. At the end of first and second month of treatment period, the rats were subjected to Y maze and EPM tests. The data were analyzed statistically using one-way analysis of variance followed by Student’s t test for paired analysis.Results: There was significant decrease in no of arm entries and SAP (p<0.05) in group-1 with induced diabetes. In addition, there was slight increase in no of open arm entries with time spent in open arm for the same group. The decrease in no of arm entries and SAP progressively declined and the no of open arm entries with time spent in open arm progressively increased from group-2 to group 4 till the end of 1st month. After 2nd month there was further decrease in no of arm entries and SAP (p<0.05) for group-1. There was significant increase in all parameters for rest of the groups after 2nd month as compared to 1st month. The findings clearly infer the potency of vildagliptin in treating diabetes induced learning and memory impairment.Conclusions: Vildagliptin significantly reduces the incidence of diabetes induced memory impairment and improves learning if continued further

Knowledge, attitude and practice study regarding pharmacovigilance programme of India among private practitioners in urban Odisha, India

Background: Private health care providers play an important role in health programmes of a country. Pharmacovigilance programme of India (PVPI) seeks involvement of different health sectors to make it successful. Knowledge, attitude and practice (KAP) studies provide a base line information about human behaviour and practices so that a properly planned acceptable intervention can be made.Methods: level of knowledge, attitude and practice regarding pharmacovigilance programme of India was evaluated among doctors working in private hospitals/clinics of Bhubaneswar and Cuttack city of Odisha. A thirty three item questionnaire was used to collect the data which contained 12 knowledge, 12 attitude and 9 practice based questions.Results: Only fifty four out of 124 participating doctors responded positively. The knowledge level of practitioners was found to be acceptable with 38.9% subjects scoring more than 70%. However a gap in knowledge was observed regarding some specific area and was not translated in terms of good quality reporting of ADRs. Only 13 (24.1%) practitioners were found to have actually reported ADR to Pharmacovigilance centre.Conclusions: Adequate awareness should be created among private practioners regarding the pharmacovigilance programme of India. Easy accessibility of ADR forms and appropriate educational intervention through media can improve ADR reporting

Study of analgesic property of diacerein in rat

Background: Diacerein has been known as an anti-osteoarthritic agent that is usually given along with other analgesic drugs. Still there is no evidence of the analgesic effect of diacerein alone. So this pilot study was undertaken to assess the analgesic property at supra-spinal level by using the tail-flick method.Methods: Diacerein at doses of 50, 100 and 200 mg/kg was given to Albino wistar rats weighing approximately 100-200 grams along with distilled water as placebo. All drugs were given by oral routes and the analgesic effect was evaluated using analgesiometer at baseline, 15 min, 30 min, 60 min and 120 min. Analgesic activity was measured as change in tail flick latency from baseline in animals.Results: Diacerein showed significant increase in tail flick latency and showed promising analgesic activity compared to placebo starting from 15 mins till 60 mins. However the effect persisted up to one hour only and after which it started decreasing.Conclusions: Diacerein at all the three doses possess dose dependant analgesic activity that is maximally effective up to 60 minutes

ANTI TUBERCULAR DRUGS INDUCED HEPATOTOXICITY IN A NEW TERTIARY CARE HOSPITAL OF A TRIBAL DISTRICT OF ODISHA

Objective: India accounts for about one-fourth of the global TB burden. WHO TB statistics for India for 2018 gives an estimated incidence fig. of 2.69 million cases (199 per one lakh population). Drug-induced Hepatotoxicity is responsible for significant morbidity and mortality of the TB patient if these drugs continued after symptoms of hepatotoxicity develop. Whether the hepatotoxicity is due to individual drugs or due to additive effects is still unclear. The management therapy for TB patients with anti-TB DIH is imperative to ensure successful TB treatment and not recurrence DIH. Aim of the current study is to find out the pattern of Liver enzyme raised after antitubercular therapy in the tribal population of Koraput district where different phylogenetic populations reside where clinically it was observed by the physician little early onset of hepatotoxicity than national and international data. Methods: A prospective study was done after clearance from the Institutional Ethical Committee, Saheed Laxman Nayak Medical College, Koraput, from January 2019 to December 2019. Patients with&gt;15 y of age with pulmonary and extrapulmonary tuberculosis with normal liver enzymes were included. Patients having abnormal liver enzymes before treatment, seropositive TB patients with human immunodeficiency virus infection, pregnant ladies and children&lt;15 y of age were excluded. Results: Out of 922 patients in total; 4.78% (44) tuberculosis patients developed anti TB DIH. 68.18% (30) patients are below 50 y of age and 31.82% (14) are above 50 y of age group among TB patients with DIH. Age has no statistically significant influence on the occurrence of anti-TB DIH, but there is a statistically significant influence of sex on the occurrence of anti TB DIH. The mean occurrence of anti TB DIH is 18±18.16 d. One case of anti TB DIH patients shows signs and symptoms as early as on day 6th. The commonest symptoms are nausea and vomiting in 64% of patients who developed DIH. Interruption of ATT after DIH occurred in 79.54% of patients with recurrence in only 9.9% of patients after the reintroduction of ATT. Conclusion: Anti TB DIH mostly occurred between 7-28 d of starting the ATT in this geographical region. The duration of the anti TB ATT regimen is prolonged due to DIH. We recommend that all patients should have LTs 2 w after starting ATT, even if asymptomatic

Diagnostic yield of cartridge based nucleic acid amplification test in Mycobacterium tuberculosis in a tertiary care medical college and hospital of Southern Odisha, India

Background: Tuberculosis is the ninth leading cause of death worldwide. India contributes to about one fifth of global TB burden. It is very important to diagnose early and treat tuberculosis to cut down transmission of tuberculosis.Methods: Author conducted a retrospective study in Department of Pulmonary Medicine SLN Medical College, Koraput, Odisha to analyze the utility and yield of CBNAAT. Study period was from April 2018 to March 2019. Inclusion criteria was all patients whose samples were subjected to CBNAAT were included in our study.  Sputum samples from pulmonary tuberculosis patients, and extra pulmonary samples (pleural fluid, ascitic fluid, CSF, synovial fluid and gastric lavage etc. were included in our study population. Exclusion criteria was patients who were under anti tubercular therapy for pulmonary, extra pulmonary and MDR TB were excluded from this study. Data were collected from Pulmonary Medicine Department, ART center, DOTS center and CBNAAT center. Total number of samples tested for CBNAAT, different sample collection sites, age and sex distribution of patients, HIV status of all patients, result of smear microscopy for AFB and CBNAAT and Rifampicin resistance status were analyzed.The detail statistical analysis was done in tabulation form.Results: A total of 2621 samples were tested in CBNAAT during the study period. Mean age of the study population was 38.03 years. 1881 tested were negative and 740 samples were positive for CBNAAT. Of these 2621 samples, 2526 were pulmonary samples (sputum, pleural fluid samples) and 95 were extra pulmonary samples. Author found rifampicin resistance rate of 0.54% (4/740)) in pulmonary tuberculosis cases. There was no rifampicin resistance detected in extra pulmonary samples. CBNAAT could identify 536 cases (23.2%) that were smear negative. Author found TB- HIV co-infection rate of 6.22%.Conclusions: CBNAAT is an important diagnostic modality especially in sputum negative patients for early diagnosis and treatment. In our study it detected Mycobacterium tuberculosis in 23.2% of patients with negative smear for microscopy. Rifampicin resistance rate detected was very low compared to other studies

Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha

Introduction: ST Elevation Myocardial Infarction (STEMI) is one of the most fatal emergencies contributing to significant morbidity and mortality due to coronary artery disease. Fibrinolytic agents are most effective agents used for the management of STEMI. However, there is a relative paucity of data comparing the effectiveness of thrombolytic agents that can provide insight for proper selection of this class of drugs. Aim: To compare the efficacy of streptokinase, tenecteplase, and reteplase in patients of STEMI in terms of post-thrombolytic resolution by observing reduction of ST-segment elevation at 90 minutes of thrombolytic and assessing for mortality within 30 days of therapy. Materials and Methods: This prospective, single-centre, observational, hospital-based study was conducted in the Department of Cardiology in collaboration with the Department of Pharmacology at Srirama Chandra Bhanja Medical College and Hospital, Odisha, India, from February 2020 to January 2022. The study involved 300 patients (100 patients in each group) being treated with streptokinase, or tenecteplase,or reteplase. A reduction of ≥50% of the initial ST elevation was considered as successful thrombolysis. The efficacy of the thrombolysis with these agents was assessed based on the extent of ST resolution in Electrocardiogram (ECG) at 90 minutes and observing 30 day mortality thereafter. Categorical data were evaluated using Chi-square test and the means were evaluated using Analysis of Variance (ANOVA). Results: There was no statistically significant difference between the three groups with respect to ST segment reduction. At 90 minutes of thrombolysis, 75%, 76%, 72% patients showed reduction in the ST segment in the Streptokinase, Tenecteplase and Reteplase group, respectively (p-value=0.79). A total of nine, five and eight deaths were seen in the streptokinase, tenecteplase and reteplase group, respectively within a span 30 days (p-value=0.52). Conclusion: Streptokinase, tenecteplase and reteplase were equally efficacious for thrombolysis in terms of thrombus resolution and preventing mortality, when started early