Observational study of drug use pattern in indoor patients suffering from major depression admitted in psychiatry department of tertiary care teaching hospital

Background: Mental illness is associated with high levels of health service utilization and associated costs. India is among one of the countries with the highest number of people suffering from depression. The data on antidepressant drug utilization in India is sparse. Hence, we planned to analyse the drug use pattern in patients of major depression as per the WHO recommended indicators of drug use.Methods: This prospective observational study was done to analyze the prescription pattern of hospital psychiatrist in indoor major depression patients. All the patients admitted in psychiatry indoor patient department (I. P. D.) of Dr. D. Y. Patil Hospital, Navi Mumbai were included.Results: Data of 97 patients was analysed. 55.67% of the cases were from the age group 31-50 years. Total number of antidepressants prescribed was 102(36.82%). Out of antidepressant agents, Selective Serotonin Reuptake Inhibitors (SSRIs) were the most commonly prescribed drugs 70 (68.62%). The most commonly prescribed antidepressant was Sertraline in 35 (34.3%).Conclusions: The findings of our study were similar to those of other studies conducted to evaluate the use of antidepressants

Oral antifungal: the safety and efficacy of oral itraconazole in dermatophytosis

Background: The systemic antifungals like Griseofulvin, Itraconazole, Terbinafine, Ketoconazole and Fluconazole are widely used for superficial fungal infection. Hepatotoxicity with oral antifungals is well established fact. The rate of transient asymptomatic changes in liver function tests accounts for about 0.5 - 10% of all patients treated with systemic antifungals. Clinical hepatic toxicity is seen less frequently. The aim of this study is to evaluate the effect of oral Itraconazole on hepatic function and it’s efficacy in patients with extensive dermatophytosis.Methods: The total of 524 patients with extensive dermatophytosis were included in our study which was conducted in a tertiary care hospital in Navi Mumbai.Results: Itraconazole, a systemic antifungal agent is efficiently used in treatment of superficial and deep mycoses. It inhibits fungal cytochrome P450 dependent enzyme and thus impaires conversion of lanosterol to ergosterol. Adverse reactions to itraconazole includes drug reactions, gastrointestinal upset, headache, dizziness, thrombocytopenia, gynecomastia, reversible edema of extremities and metabolic side effects like hypokalemia, and hypertriglyceridemia. The level of hepatic transaminases increases in about 1%-5% of patients who have received continuous therapy with systemic itraconazole. Clinical hepatitis rarely occurs in patients and, recovery generally ensues with the cessation of medication.Conclusions: The baseline and post treatment liver function test is important to monitor if patient is on higher dose and longer duration of itraconazole therapy. The screening for high risk patients like poor liver function test, history of alcoholism, history of liver disease should be taken before stating the therapy

Ayurveda View on Disease Progression w.s.r. to Concept of Shatkriyakala: A Review

Ayurveda aims to keep healthy people healthy and helps in the treatment of sick people's diseases. Ayurveda recommended a variety of treatments for balancing Dosha, Dhatu and Mala. Ayurveda portrayed various modalities of sickness determination and Kriyakala is one such methodology which assists or determines different phases of disease progression. The Kriyakala idea encourages specific treatment based on the stage of disease progression. The suitable measures can be taken to address the equilibriums of Doshas based on the specific phases of illness. Ayurveda looked into the idea of Shatkriyakala as a "six stages of disease progression" that can be used to evaluate the disease's pathogenesis in different stages. These six stages are Sanchaya, Prakopa, Prasara, Sthanasamshraya, Vyaktavastha and Bhedavastha. This article discussed six phases of Shatkriyakala, its significance in disease determination and their treatment

Role of conventional oral antidiabetic drugs in management of type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is caused by insulin resistance and characterized by progressive pancreatic β-cell dysfunction. Recent innovative treatment approaches target the multiple pathophysiological defects present in type 2 diabetes. The targets for glycemic control as set by the American Diabetes Association (HbA1C<7%) and the American Association of Clinical Endocrinologists (HbA1C<6.5%) sometimes appear daunting and unattainable. It is therefore of the utmost importance to have an excellent understanding of the mechanism of action of these drugs in order to optimize patient therapy. Here, we present a corresponding discussion of all the available oral antidiabetic drugs according to the different classes, their mechanisms of action and pharmacological profiles

A PROSPECTIVE AND OBSERVATIONAL STUDY TO ANALYZE THE ASSOCIATION OF LIPID PROFILE ABNORMALITY WITH DISEASE SEVERITY IN SEBORRHEIC DERMATITIS PATIENTS

Objective: The aim of the study was to evaluate the association of lipid profile abnormality and eborrheic dermatitis by analyzing the lipid profile; and to evaluate the association of lipid profile abnormality and severity of seborrheic dermatitis. Methods: This prospective and observational study was conducted in the department of dermatology in Dr. D.Y. Patil University and Hospital, School of Medicine, Navi Mumbai. The diagnosed cases of Seborrheic Dermatitis were subjected to lipid profile examination. The demographic and disease profile was then compared among the patients with normal and abnormal lipid profile. Results: A total of 30 seborrheic dermatitis patients were analyzed. Eighteen (60%) of the study participants were males. Serum triglyceride, LDL/ HDL ratio, and cholesterol total/HDL ratio were found to be significantly associated with disease severity. Conclusion: The study suggests a significant role of monitoring serum profile in the patients of seborrheic dermatitis

Role of insulin in management of type 2 diabetes mellitus

The prevalence of type 2 diabetes mellitus and its resultant morbidity and mortality is rapidly increasing. An important factor in reducing the microvascular complications of diabetes is strict glycemic control. Most patients require additional insulin therapy in spite of regularly taking oral anti-diabetic drugs. Though classically used later in the natural course of the disease, newer treatment guidelines suggest early initiation of insulin analogues. The discovery of insulin has been hailed as one of the most dramatic events in the history of diabetes, improving the life-span of most diabetics. Replacement insulin therapy should mimic physiological insulin release patterns. Modern insulin and its analogues have been developed to serve as an ideal replacement therapy. There are various insulin preparations available in the market and each of them has their own advantages and disadvantages. The modern insulin’s have been developed to overcome certain side effects of the older preparations. A range of insulin products are under development that aim to increase absorption prolong action and provide alternative delivery methods. Greater patient adherence is important since most patients are reticent about insulin therapy.  This review describes the role of insulin in the management of type 2 diabetes mellitus