A comparative study of effect on reducing pain, inflammation and side effect of combination of enzymes (bacterial proteases, papain, bromelain, vitamin C and rutin) versus conventional non-steroidal anti-inflammatory drugs (diclofenac) in patients of closed fracture lower end radius coming at orthopaedic department of a tertiary care hospital

Background: Diclofenac and oral systemic enzymes both are commonly used for control of pain and inflammation in fracture lower end radius as well as other such conditions. Some studies have shown that combination of enzymes like bacterial proteases, papain, bromelain, vitamin C and rutin can reduce pain and Inflammation which is comparable to diclofenac but it still not definite.Methods: Total 50 patients with closed fracture lower end radius were enrolled and randomly divided in to two groups. Group-1 with 25 patients received oral diclofenac and group-2 with 25 patients received oral preparation which contains combination of enzymes bacterial proteases, papain, bromelain, vittamin C and rutin. Effect of drug was assessed by improvement in wrist function which was evaluated by patient rated wrist evolution (PRWE) and reduction in oedema on day 1, day 3 and day 5. Both the groups were compared by unpaired Z test.Results: Mean reduction in PRWE score was 132.08±5.01 in Group 1 and 104.4±11.78 in group 2. Mean of percentage reduction of oedema for group 1 was 8.22 while for group 2 it was 17.8. Both were statistically significant (p<0.05). Total 5 patients out of 25 complained of gastritis in group 1 patients while there was no side effect reported in group 2 patients.Conclusions: Diclofenac was better in reducing pain, while combination of enzymes used in the study was better in reducing oedema. Combination of the enzymes used in this study is safer than diclofenac in cases of the closed fracture lower end radius

Pharmacovigilance study of angiotensin-converting enzyme inhibitors in patients visiting Department of Medicine of a Tertiary Care Hospital, Surendranagar, Gujarat

Background: The objective of this study was to evaluate incidence, patterns, and severity of angiotensin-converting enzyme inhibitor (ACEI) induced adverse drug reactions (ADR).Methods: A total of 500 hypertensive patients taking ACEI was enrolled in the study by taking an informed consent. Reporting of all ACEI-induced ADRs was done by filling CDSCO ADR form. All ADR reports were evaluated according to WHO-UMC causality assessment scale.Results: A total of 53 ADRs (31 males and 22 females) was observed in 500 hypertensive patients taking ACEI. Of 53 ADRs, 22 (41.51%) were mild, 28 (52.83%) were moderate, and only 3 (5.66%) were classified as severe. 7 ADRs (13.21%) were classified as certain, 30 ADRs (56.60%) were in probable category, 8 (15.09%) were in possible category, 4 (7.55%) in unlikely category, 3 (5.66%) in conditional category (unclassified), and 1 ADR was in unassessable (unclassifiable) category. Among 53 ADRs, 24 (4.80%) patients developed dry cough, 8 (1.60%) hypotension, 2 (0.40%) headache, 2 (0.40%) dizziness, 3 (0.60%) nausea/bowel upset, 3 (0.60%) rashes, 2 (0.40%) developed angioedema, 3 (0.60%) dysgeusia, hyperkalemia, acute renal failure, proteinuria are rare.Conclusions: Incidence of ADRs by ACEIs is 10.60% with cough as the most common ADR followed by hypotension. As enalapril is most frequently used ACEI, ADRs due to enalapril are more common

Subsurface signatures and timing of extreme wave events along the Southeast Indian coast

Written history's limitation becomes apparent when attempting to document the predecessors of extreme coastal events in the Indian Ocean, from 550-700 years in Thailand and 1000 years in Indonesia. Detailed ground-penetrating radar (GPR) surveys in Mahabalipuram, southeast India, complemented with sedimentological analyses, magnetic susceptibility measurements, and optical dating provide strong evidence of extreme wave events during the past 3700 years. The diagnostic event signatures include the extent and elevation of the deposits, as well as morphologic similarity of buried erosional scarps to those reported in northern Sumatra region. Optical ages immediately overlying the imaged discontinuities that coincides with high concentration of heavy minerals date the erosional events to 340 ± 35, 350 ± 20, 490 ± 30, 880 ± 40, 1080 ± 60, 1175 ± 188, 2193 ± 266, 2235 ± 881, 2489 ± 293, 2450 ± 130, 2585 ± 609, 3710 ± 200 years ago. These evidences are crucial in reconstructing paleo extreme wave events and will pave the way for regional correlation of erosional horizons along the northern margin of Indian Ocean

A comparative study of effect on reducing pain, inflammation and side effect of combination of enzymes (bacterial proteases, papain, bromelain, vitamin C and rutin) versus conventional non-steroidal anti-inflammatory drugs (diclofenac) in patients of closed fracture lower end radius coming at orthopaedic department of a tertiary care hospital

Background: Diclofenac and oral systemic enzymes both are commonly used for control of pain and inflammation in fracture lower end radius as well as other such conditions. Some studies have shown that combination of enzymes like bacterial proteases, papain, bromelain, vitamin C and rutin can reduce pain and Inflammation which is comparable to diclofenac but it still not definite.Methods: Total 50 patients with closed fracture lower end radius were enrolled and randomly divided in to two groups. Group-1 with 25 patients received oral diclofenac and group-2 with 25 patients received oral preparation which contains combination of enzymes bacterial proteases, papain, bromelain, vittamin C and rutin. Effect of drug was assessed by improvement in wrist function which was evaluated by patient rated wrist evolution (PRWE) and reduction in oedema on day 1, day 3 and day 5. Both the groups were compared by unpaired Z test.Results: Mean reduction in PRWE score was 132.08±5.01 in Group 1 and 104.4±11.78 in group 2. Mean of percentage reduction of oedema for group 1 was 8.22 while for group 2 it was 17.8. Both were statistically significant (p&lt;0.05). Total 5 patients out of 25 complained of gastritis in group 1 patients while there was no side effect reported in group 2 patients.Conclusions: Diclofenac was better in reducing pain, while combination of enzymes used in the study was better in reducing oedema. Combination of the enzymes used in this study is safer than diclofenac in cases of the closed fracture lower end radius