Knowledge, attitude and practice of preventing spread of COVID-19 amongst orthopaedic surgeons and residents in a tertiary care hospital in Navi-Mumbai

Background: With on-going coronavirus pandemic, there is high incidence of COVID-19 occupational risk exposure among health care professionals. The aim of this study was to assess the knowledge, attitude and practice (KAP) amongst orthopaedic surgeons and residents regarding prevention of spread of COVID-19 at a tertiary care hospital.Methods: A cross-sectional, observational, web-based questionnaire study was conducted at orthopaedic department of a tertiary care hospital in Navi Mumbai. The study included orthopaedic surgeons and residents of either sex. A predesigned KAP questionnaire was used to assess the knowledge, attitude and practice regarding prevention of spread of COVID-19. The web-based questionnaire was circulated to eligible participants and the responses obtained were analysed.Results: Overall, the knowledge regarding hand hygiene, mask etiquette and COVID-19 diagnoses was high. Majority participants knew the proper technique of personal protective equipment (PPE), but few 25% and 35% lacked correct technique for donning and doffing of PPE respectively. Majority participants knew the indications and pre/post-operative protocols for orthopaedic surgeries in COVID-19. Around 40% only knew the type of pressure system used in the COVID-19 operation theatre (OT). Majority felt that mask, hand hygiene and PPE were essential kit for prevention. In practice, majority participants were taking drug prophylaxis and were adequately practicing mask/hand hygiene.Conclusions: Overall, KAP regarding prevention of spread of COVID-19 among orthopaedicians were adequate. Further formal preventive education on COVID-19 and structured hands-on experience workshops are necessary to advance the proper techniques of PPE handling

Computer assisted learning vs. conventional teaching in experimental Pharmacology: perception of second year medical students

Background: The main pool of pharmacology practical teaching is formed by the use and demonstration of animal experiments. Animals have been used to demonstrate the effect of various drugs in experimental pharmacology classes, in the lab. The practical sessions in pharmacology training involving animal experiments are still taught by traditional teaching methods. Rapid development of information technology has led to newer trends in teaching and learning using Computer Assisted Learning (CAL). Keeping it in mind we decided to undertake this study to assess the perception of CAL in 2nd year MBBS students over conventional teaching in experimental pharmacology.Methods: This was an observational, questionnaire-based study. A total of hundred undergraduate MBBS (2nd year) students participated. Participants were first demonstrated an animal experiment by conventional teaching method followed by the same animal experiment demonstration on CAL. Students’ feedback was recorded on a questionnaire and analyzed.Results: The mean age of the participants was 19.88±1.28 years. The study overall observed that 62% preferred CAL to conventional (38%). Majority of the participants’ thought CAL (63%) helps to understand better over conventional (28%) and that CAL (63%) is time independent over conventional (28%). More than 85% felt that CAL was more explanatory and provided a better learning experience.Conclusions: Students preferred CAL to conventional teaching, in experimental pharmacology. It also provided insight on perception and experience of students towards CAL for experimental pharmacology. However, further studies are warranted to assess the knowledge, cognitive and psychomotor skills of students

An observational study to assess the drug prescription pattern and quality of life of acne vulgaris patients in a tertiary care center in India

Background: The study was conducted to assess the prescription pattern of acne vulgaris patients, and impact of anti-acne treatment on severity of acne and change in quality of life (QoL) in patients.Methods: A prospective observational study was conducted in dermatology OPD of a tertiary care hospital with 160 patients of acne vulgaris. All patients with acne vulgaris >18 years, of either sex were included while those with pre-existing other cutaneous or systemic diseases, pregnant and lactating females and not giving consent were excluded from the study. Prescriptions were analysed and patients were followed-up at 2 and 6 weeks for assessment of change in acne severity and QoL, determined by GAGS score and CADI difference score, respectively.Results: Mean age of patients was 20.7±2.5 years, with males and females constituting 62 (38.8%) and 98 (61.3%) patients, respectively. Acne was mild in 88 (55%), moderate in 51 (31.9%) and severe in 21 (13.1%) patients. A total of 537 drugs were prescribed to all patients, with an average of 3.36 drugs per prescription. Two, 3 and 4 drugs were prescribed in 2.5%, 59.4% and 38.1% patients, respectively. There was significant improvement in the GAGS score (p<0.001) and QoL (CADI score difference) (p<0.001) at 2 and 6 weeks follow-up compared to initial visit.Conclusions:Polypharmacy was a common practice in anti-acne treatment. However, it was associated with improvement in acne severity and QoL.

The effect of a polyherbal oral formulation in the management of essential hypertension: an open label, pilot clinical study

Background: Effective control of blood pressure in patients with hypertension decreases cardiovascular mortality. However, many hypertensives are unresponsive to standard antihypertensive treatment. Research has found anti-hypertensive potential in the Ayurvedic drugs Brahmi (Bacopa monnieri) and Shunthi (Zingiber officinale). Hence, a pilot study was conducted to evaluate the efficacy and safety of Capsule Artyl (the oral formulation of Brahmi and Shunthi) as a treatment option in hypertensive subjects.Methods: There were 30 hypertensive subjects attending out-patient departments of clinics in Maharashtra, India were enrolled in this four-week, open label, single arm study. All subjects received capsule Artyl (500mg) twice a day orally daily. The mean systolic (SBP) and diastolic blood pressure (DBP) on days 1 and 28 of the study were compared along with the mean arterial pressure (MAP).Results: The mean SBP was significantly lesser on day 28 (141.86±12.54mm Hg) as compared to the mean SBP recorded on day 1 (155.48±19.37mm Hg) (p0.05). There was a significant decrease in the mean value of MAP on day 28 (107.06±7.03mm Hg) as compared to that on day 1 (112.06±10.75mm Hg) (p<0.01).Conclusions: Capsule Artyl significantly decreased the BP in hypertensive patients, without any adverse effects. Controlled trials are needed to confirm the positive outcome of this promising herbal formulation in hypertensive patients

Role of Ayurveda based non-invasive intervention in management of ischemic heart disease patient of diabetes

Background: The aim of the study was to determine the effectiveness of IRP therapy in patients of myocardial ischemia attending Madhavbaug clinics in Vidarbha region, Maharashtra.Methods: This was a retrospective study conducted from June 2019 to December 2019, wherein we identified the data of patients suffering from IHD (positive for inducible ischemia from stress test) of either gender or any age, and who had attended the Out-patient departments (OPDs) of Madhavbaug clinics across India. The data of patients who had been administered IRP with minimum 7 sittings over a span of 12 weeks were considered for the study.Results: In the present study, medical records of 50 patients of IHD were analyzed.  At the end of IRP therapy there was statistically significant reduction in weight, BMI, SBP, and DBP. VO2 peak was improved at the end of therapy i.e. 26.51±5.93 ml/kg/min as compared to baseline i.e.; 15.62±5.36 ml/kg/min and the difference was highly statistically significant (p<0.001). DTS improved from -2.93±5.88 at baseline to 3.21±6.03 at week 12 of IRP therapy and the difference was highly statistically significant (p<0.0001).Conclusions: Findings of present study suggest that IRP can serve as effective therapeutic option for the management of myocardial ischemia

Efficacy of Ayurved based therapy on global longitudinal strain in ischemic heart disease: a retrospective analysis

Background: The current study aimed to investigate the efficacy of the Ischemia Reversal program (IRP) as an Ayurveda based therapy to standard anti-ischemic therapy in patients with ischemic heart disease (IHD). Methods: A retrospective, single centre, observational study was conducted from January 2022 to May 2023. A total of 39 patients diagnosed with ischemic heart disease and global longitudinal strain (GLS) &lt;15, regardless of underlying co-morbidities such as diabetes mellitus, hypertension, obesity, hyperlipidemia, low ejection fraction, history of myocardial infarction were included in this study. The primary endpoint was improvement in GLS from baseline to the 90-day follow-up in various different categories. Secondary endpoints were improvement in EF, abdominal girth, weight and reduction in dependency on allopathic medication from baseline to the 90-day follow-up. Results: The mean age of the study population was 59.23±9.01 years. Weight (day 1: 67.29±13.16 kg and day 90: 61.39±11.11 kg; p=0.00), body mass index (day 1: 25.75±4.03 and day 90: 23.79±3.50; p=0.00), abdominal girth (day 1: 95.31±10.75 cm and day 90: 85.67±17.02 cm p=0.00), EF (day 1: 40.74±10.30% and day 90: 53.91±11.87%; p=0.00), and GLS (day 1: -10.99±2.72 and day 90: -13.17±3.75; p=0.00) improved at the 90 day follow-up. Conclusions: The study showed notable improvements in weight, body mass index, abdominal girth, EF, and GLS after 90 days. These results suggest that IRP is beneficial treatment for IHD, but more extensive research is needed to confirm its effectiveness

Drug utilization study in ophthalmology in OPD patients at a tertiary care teaching hospital

Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs

Study of efficacy of ischemia reversal program (IRP) in ischemic heart disease (IHD) patients with VO2max and Duke’s treadmill score

Background: Number of people dying from IHD has increased from 0.61 million in 1990 to 1.13 million in 2010, which is a disturbing fact. According to report by World Health Organization, India would be spending a whopping 237 billion US dollars, owing to direct spending on health care and indirectly due to loss of productivity due to IHD. Ischemia Reversal Program (IRP) is a combination of Panchakarma and allied therapy. This study was conducted to evaluate the effect of IRP on VO2max, Duke’s treadmill score, systolic blood pressure (SBP), diastolic blood pressure (DBP), and dependency on conventional therapy in IHD patients.Methods: This observational study was conducted in January 2017, wherein the data of IHD patients (inducible ischemia on stress testing) who attended out-patient departments (OPDs) at Madhavbaug clinics in Maharashtra, India were identified. Data of patients who were administered IRP (60-75 minutes) with minimum 7 sittings over 90 days (±15 days) were considered. Variables were compared between day 1 and day 90 of the IRP.Results: Out of 38 enrolled patients, 25 were males while 13 females. There was significant improvement in Duke’s score with  subjects at moderate (50%) and high (31.6%) risk at baseline were significantly decreased to low (52.6%) and moderate (47.4%) after the 90th day of therapy.  IRP also showed significant improvement in VO2max by 9.11 (from 20.29±6.72 to 29.40±6.71; p<0.001), SBP by 5.78 (from 128.78±17.40 to 123±12.23, p<0.03), DBP by 4.76 (from 80.53±8.10 to 75.76±6.85, p<0.005). Dependency on concomitant medicines was reduced.Conclusions: IRP was effective in IHD; it had dual benefits, i.e. anti-ischemic effect, as well as reducing the dependency on allopathic medicines

TO STUDY EFFICACY OF COMPREHENSIVE DIABETES CARE (CDC) MANAGEMENT PROGRAM IN TYPE II DIABETIC OBESE PATIENTS: AN OBSERVATIONAL STUDY

Context: Diabetes mellitus (DM) contributes to a major chunk of morbidity, mortality, and healthcare cost on a global level. The prevalence of DM is rising alarmingly, worldwide and India. Comprehensive Diabetes Care (CDC) is a combination of Panchakarma and diet management.Aims: This study was conducted to evaluate the effect of CDC on Glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight, abdominal girth and dependency on conventional therapy in DM Patients.Setting and Design: This observational study was conducted in July 2017, wherein the data of obese Type II DM patients (HbA1c &gt;6.5%) who attended out-patient departments (OPDs) at Madhavbaug clinics in Maharashtra, India were identified.Materials and Methods: Data of patients who were administered CDC (60-75 minutes) with minimum 6 sittings over 90 days (± 15 days) were considered. Variables were compared between day 1 and day 90 of CDC.Results: Out of 27 patients, 22 were included for analysis, out of which 10 were males while 12 females. CDC showed significant improvement in HbA1c 1.1% (from 8.80 ± 0.93 to 6.98 ± 1.73; p&lt;0.001), BMI by 2.66 (from 33.79 ± 3.80 to 31.13 ± 3.91, p&lt; 0.001), weight by 6.56 kg (from 83.67 ± 11.28 to 77.11 ± 12.27, p&lt;0.001). Abdominal girth (from 104.34 ± 9.74 to 96.97 ± 11.93; p&lt;0.001), also showed significant reduction. Dependency on concomitant medicines was reduced, with the number of patients on no concomitant medicines increasing from 27% to 41%.Conclusion: Comprehensive Diabetes Care Management Program found to be efficacious; by reducing HbA1c, as well as reducing dependency on allopathic medications

Stem Cell Therapy in Motor Neuron Disease

Motor neuron disease (MND) is an insidious, fatal disorder that progresses with the selective loss of anterior horn cells of the spinal column. Over 150 years since it was first described, various therapeutic approaches have been tested in the quest of a cure but with little success. Current standard therapy only improves lifespan by a few months; palliative care is the only option available for patients. Stem cell therapy is a potent approach for the treatment of this devastating disease. A multitude of vitalizing effects, both paracrine and somatic, a robust safety profile, as well as ease of availability make a strong case for using these cells for therapeutic purposes. Coupled with rigorous rehabilitation, this powerful treatment modality has been shown to slow disease progression, improve quality of life, and increase survival, along with being well tolerated by amyotrophic lateral sclerosis (ALS)/MND patients. Compelling preclinical as well as clinical evidence abounds that stem cells hold great potential as a therapy for ALS/MND. Although not a definitive solution yet, stem cells have been verified to have slowed and/or halted disease progression in a subset of ALS/MND patients