Study of price variation among the different brands of anti-tubercular drugs available in India

Background: India is one of the largest Tuberculosis (TB) burden countries in the world. Although Revised National Tuberculosis Control Programme provides free cost of therapy, sometimes patient get treated by private practioners. This can sometimes lead to irregular course of treatment due to decreased patient compliance. This in turn may lead to multi drug resistance among TB bacilli. One of the reasons for decreased patient compliance is cost of therapy. The present study was undertaken to evaluate the cost of therapy of various anti-TB drugs and their combinations available in India.Methods: The maximum and minimum cost in rupees (INR) of all anti-TB drugs manufactured by various pharmaceutical companies was noted. The cost of 10 tablets/capsules or their fixed dose combinations (FDCs) was calculated. The cost ratio and percentage price variation were calculated for each brand and compared.Results: Percentage variation in cost of oral anti-TB drugs marketed in India was highest in ethambutol 400mg (474.51), cycloserine 250mg (384.61), ethambutol 800mg (321.84) and rifampin 450mg (258.45). The lowest percentage cost variation was seen with pyrazinamide 225mg (10.04), ethambutol 1000mg (18.82) and rifampin 100mg (22.78). Among the FDCs lowest percentage cost variation seen with rifampin 150mg +isoniazid 75mg+pyrazinamide 400mg (0.16) and highest percentage cost variation is seen with rifampin 450mg+isoniazid 300mg+pyrazinamide 750mg+ethambutol 800mg (232.73).Conclusions: There is a significant variation in the cost of different brands of oral anti-TB drugs and their FDCs available in India. The National Pharmaceutical Pricing Authority (NPPA) should take more proactive steps for bringing down the prices of first line anti-TB drugs and the clinicians prescribing them should be aware of the price variation among the various brands of anti-TB drugs available in India

Thought control study of medical students in Shimoga Institute of Medical Sciences (SIMS)

Background: Thought is a mental process which occurs in the Neo-cortex of the Brain [Cerebral cortices] based on the background knowledge, perception of the event or the action and understanding influenced by the individual traits or personality. Individual thoughts differ from person to person, time to time, and the events in life. Mainly thought is interpreted or understood based on the behaviour or when the person explains about it. Thought process in the brain can be acknowledged by an individual to have acceptable behavioural norms in the society, but cannot be explained by patients with disorder of thought processes. The behaviour of these individuals is acknowledged as the thought of the individual. Abnormal thought process occurs in psychiatric conditions like Psychosis, Anxiety disorder, Post traumatic disorder, mood disorders in varied manners. It also has implications or influences of the hormonal status and age of the person. In this study we are evaluating the thought control in the teenagers.Methods: the study was carried out in the medical students of SIMS-Shimoga. It is a questionnaire based study using a thought control questionnaire (TCQ).Results: The results were studied in five domains namely Distraction, Social, Worrying, Punishment and Re-appraisal, were found to vary within the acceptable limits and comparable with earlier studies.Conclusion: The findings in this study reflect the positive approach, handling of the unwanted and distracting thoughts in the teenagers.

Evaluation of cost effectiveness and efficacy of commonly used different antacid gel preparations

Background: Gastroesophageal reflux disease (GERD) is a common clinical condition in Indian population. Antacids, which are available as over the counter (OTC) are the commonly prescribed drugs for treatment of GERD. Antacids manufactured and marketed by various multinational and local companies are available in the market. There is need for evaluating the cost effectiveness and efficacy of these antacids as a matter of public concern. Hence the present study was conducted to evaluate the cost effectiveness and efficacy of the commonly prescribed antacid gel preparations.Methods: Seven different gel formulations of antacids manufactured by different companies were evaluated. Cost effectiveness was done by calculating the cost per ml of antacid and also by palatability test. Efficacy was evaluated based on acid neutralizing capacity (ANC) of antacid preparations.Results: The highest cost was 0.305 Rs. per ml and lowest was 0.135 Rs per ml. Palatability score was high at 26.80 and low at 23.85. The antacid with lowest ANC was 20.5 mEq and the highest was 26.5 mEq.Conclusion: Cost effectiveness studies are beneficial in improving the prescribing pattern. It will be a benefit for both doctor as well as patient

Smart Metro - Rail System

Railway transport system has proved to be a very sturdy and convenient mode of transport over the centuries. It still serves as the economic and most efficient means of mass transport in many countries. It is a widespread practice even today that most operations are manually carried out, leading to several dangerous accidents and mismanagement of the system. When it comes to the matter of scores of lives, error margin is of utmost importance to ensure an efficient and safe mode of travel. There is an utter need for a system that provides automation of the critical systems that play a pivotal role in the smooth functioning. The focus remains on certain key functions including locomotion, data logging for position, speed and health of he locomotive. This can increase the safety levels, while also reducing the time for relief in-case of unfortunate emergencies

A study on cutaneous adverse drug reactions at district Mc. Gann teaching hospital, Shimoga institute of medical sciences, Shivamogga, Karnataka, India

Background: Adverse drug reactions very often manifest in the form of cutaneous reactions. Majority of new drugs are developed by western countries and releases the drug worldwide after testing on small number of patients. Safety profile of such drugs may not be relevant in our country due to varied factors. Pharmacovigilance in the form of post-marketing surveillance helps to establish the accurate safety profile of drugs. The objective of this study was to study the various cutaneous adverse drug reactions (CADRs), frequency, type, severity and preventability of CADRs and to evaluate the drugs causing the CADRs.Methods: A total of 52 patients were recruited for this study which was conducted in the dermatology OPD department from November 2015 to April 2016, demographic details, causality, severity, preventability were analysed by using standard scales.Results: 52 patients with CADRs were included in the study during the 6 months study period. Results were presented in the form of number and percentage. Most common age group with CADRs was 40- 60 years; the most common suspected drug group causing CADRs was antimicrobials 46.15%. According to Naranjos scale 67.30% of CADRs were probably caused by drugs. Schumoch and Thornton scale showed that 63.46% of CADRs in the study were definitely preventable.Conclusions: Wide variety of drugs causes CADRs. Awareness among clinicians is required for active reporting of CADRs. Patients need to be educated for the cautious use of drugs causing ADRs to prevent the same

A study on prescription analysis and utilization of antibiotics in geriatric in-patients admitted in Shimoga institute of medical sciences tertiary care hospital, Shimoga, Karnataka, India

Background: Geriatrics is concerned with population aged 60 and above. Elderly suffer from various problems of the old age and hence prone to suffer from various adverse effects due to multiple drug use. In this regard rational use of drugs assumes importance. Hence the present study was conducted to study the rationality of prescriptions and utilization of antibiotics in the geriatric age group.Methods: 126 inpatient prescriptions were chosen and analysed for their rationality according to WHO core drug use indicators. The prescriptions were chosen randomly during the months of July to November 2013 from inpatients at district Mcgann teaching hospital. Descriptive statistics were used to analyse data.Results: 97% of total drugs prescribed were from essential drug list (EDL). Cephalosporins were the most commonly prescribed group of antibiotics. Respiratory diseases were the maximum cause of admission to the hospital followed by cardiovascular diseases. Prescription by brand name was 57.93% while generic drug prescription was 40.65% of total drugs prescribed. 7.81% of total drugs were prescribed as fixed drug combination average of 6.25 drugs were prescribed per person and 1.39% of prescriptions were illegible.Conclusions: Most of drugs prescribed were from WHO model list of essential drugs which conforms to WHO rational drug use. Also prescription by generic name has to be emphasized to promote rationality of prescriptions. Antibiotic prescriptions should be preceded by microbiological testing wherever indicated and illegible prescriptions should be prevented at all costs. Adherence to guidelines regarding drug use in the elderly can help in rational drug use in elderly

Effect of Conventional and Microwave Tissue Processing Technique on DNA Integrity: A Comparative Molecular Analysis

BACKGROUND: Methods of diagnostic molecular biology are routinely applied on formalin-fixed, paraffin-embedded tissues processed via conventional method. Recently, there has been a growing interest to use microwave technology in histopathology laboratories to overcome the deficiencies of the conventional processing method. Thefore, this study was aimed to compare and analyze the quality and quantity of DNA obtained from tissues processed by conventional and microwave tissue processing techniques and to further ascertain the applicability of the latter for PCR (polymerase chain reaction based research).METHODS: Thirty fresh tissues of oral squamous cell carcinoma (OSCC) were included, and each sample was cut into two equivalent halves. One tissue half was processed by conventional manual method whereas the other half was processed using a domestic microwave oven. DNA was obtained from all the tissues which were then subjected to Polymerase chain reaction (PCR) to evaluate GAPDH (Glyceraldehyde-3-phosphate dehydrogenase) gene expression.RESULTS: The results revealed better DNA yield from microwave processed tissue while the quality of the DNA was alike from both the techniques.CONCLUSION: On the basis of the results obtained, it can be concluded that DNA produced by microwave processed tissues was similar to that obtained by conventional processing technique in terms of quantity and quality. Thus, microwave processed tissue samples can be successfully used for further molecular studies and researches

Percutaneous Closure of an Aortic Pseudoaneurysm Due to Saphenous Vein Graft Dehiscence With an Amplatzer Vascular Plug

Tàpies Puig, Antoni; Garcés, Jordi; Sòria, EnricPla general de l'entrada a l'espai de reflexió on s'aprecia el fons un díptic de 3 per 5 metres amb la silueta campana

Development and Validation of Risk Prediction Models for Cardiovascular Events in Black Adults: The Jackson Heart Study Cohort

Cardiovascular risk assessment is a fundamental component of prevention of cardiovascular disease (CVD). However, commonly used prediction models have been formulated in primarily or exclusively white populations. Whether risk assessment in black adults is dissimilar to that in white adults is uncertain

Mechanical Circulatory Support as a Bridge to Transplant or for Destination Therapy

Mechanical circulatory support (MCS) frequently is used to treat medically refractory end-stage heart failure. Initially designed to be a bridge to transplantation, MCS also has proven itself as a durable therapy for patients who are not transplant candidates. As outcomes for patients with MCS have improved, research interest in device development has flourished, with many new device types under investigation. In addition to improvement of MCS devices, investigational work continues to achieve appropriate patient selection and complication management