Hypolipidemic effect of sitagliptin, voglibose and glimepiride in combination with metformin in patients with type 2 diabetes mellitus at a tertiary care teaching hospital: a comparative study

Background: The prevalence of coronary artery disease has been increased in diabetic dyslipidemia; hence the present study would like to compare the dyslipidemic effects of Sitagliptin, Voglibose, and Glimepiride in combination with Metformin in type 2 diabetes mellitus patients.Methods: This study was a Prospective, Randomized Clinical trial conducted at SRM medical College Hospital and Research centre. Potheri, Kancheepuram District in diabetic outpatient department after obtaining approval from Institutional Ethics Committee. The patients receiving antidiabetic drugs were divided into three groups. Patients received Metformin with Sitagliptin were grouped as I, Metformin with Voglibose were named as Group II and Metformin with Glimepiride were marked as Group III. Based on the inclusion and exclusion criteria, in each group, 40 patients were assigned as per simple randomization method. The level of lipid profile and BMI was evaluated at the end of 6 months.Results: There was a significant reduction of Total Cholesterol (TC) in Group II and Group III (p value- <0.001, <0.006). Group I showed significant elevation of HDL-C level with the p value of <0.03. Group III showed significant reduction of Triglyceride (TG) level with the p value of <0.04, significant reduction of Low Density Lipoprotein Cholesterol (LDL-C) level with the p value of <0.02 and significant reduction in Very Low Density Lipoprotein Cholesterol (VLDL-C) level with the p value of <0.05. There was no significant reduction in Body Mass Index (BMI) among the groups. On multiple comparisons, Group III showed higher efficacy in reducing TC, TG, LDL-C and VLDL-C levels.Conclusions: The results of this study were analysed and it could be concluded as Metformin with Glimepiride combination (Group III) showed significant reduction of TC, TG, LDL-C and VLDL-C levels

In vitro evaluation of antibacterial activity in ethanolic extract of whole plant Sphaeranthus indicus Linn.

Background: Sphaeranthus indicus Linn is a widely used medicinal plant in Indian traditional system of medicine against human pathogens. Alarming bacterial resistance is urging scientist to search for newer anti-microbial substances from the medicinal plants. The objective of the study was to evaluate the antibacterial activity of ethanolic extract of the whole plant Sphaeranthus indicus Linn (Asteraceae).Methods: The antibacterial activity of ethanolic extract of whole plant of Sphaeranthus indicus Linn was done against Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and Staphylococcus aureus in Mueller Hinton Agar (MHA) and compared with ciprofloxacin as standard by disc diffusion method.Results: The study revealed that there was no zone of inhibition in doses of 100 mcg, 200 mcg and 300 mcg of ethanolic whole plant extract of Sphaeranthus indicus in MHA plates compared with ciprofloxacin 30 mcg.Conclusions: Ethanolic extract of Sphaeranthus indicus does not have antibacterial activity. Further studies are needed in different extracts and parts of the plant. Simultaneous studies can be done in different places to evaluate environmental factors and regional variations

Antifungal activity of ethanolic extract of Sphaeranthus indicus Linn. against Dermatophytes and Candida species

Background: Sphaeranthus indicus as an entire plant or the specific parts like roots, leaves, flowers are used for treating helminthiasis, jaundice, diabetes, dyspepsia, fever, cough, hernia, gastritis, hemorrhoids, migraine, leprosy and skin diseases. The objective of this study was to evaluate the antifungal activity of ethanolic extract of the whole plant Sphaeranthus indicus Linn. Methods: The antifungal activity of ethanolic extract of the whole plant Sphaeranthus indicus Linn was evaluated by incorporating the extract in Sabourauds dextrose agar. This property was studied in vitro using the ethanolic extract on Candida albicans, Microsporum gypseum, Trichophyton mentagrophytes and Epidermophyton floccosum by using Clotrimazole as standard drug.Results: This study revealed that the ethanolic extract of Sphaeranthus indicus is having good antifungal activity against Dermatophytes and Candida species. Conclusions: This study demonstrates the promising antifungal action of ethanolic extract of whole plant of Sphaeranthus indicus Linn. This feature can be exploited in the development of a newer antifungal agent from plant.

PRESCRIPTION PATTERN OF PROPHYLACTIC ANTIMICROBIAL AGENTS USED IN PREOPERATIVE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL

Objective: This study was designed to analyze the prescription pattern of prophylactic antimicrobial agents used in preoperative patients.Methods: A descriptive observational study was done at a tertiary care teaching hospital in Potheri from July to December 2013 after obtaining of Institutional Ethics Committee clearance.Results: Total 284 patients were included in this study, out of which 141(49.6%) were females and 143(50%) were males. In the department of general surgery, the very commonly used antimicrobial agents were cefotaxime (81%) followed by cefoperazone sodium (42%). In the orthopaedics department, the frequently used antimicrobial agents were cefoperazone and sulbactam (39%) followed by cefazolin (29%). Most commonly used antimicrobial agent was cefotaxime (100%) in gynaecology department.Conclusion: Antimicrobial prophylaxis is helpful in declining the frequency of post-operative infections. This study explained about the various antimicrobial agents used prior to surgeries. Practitioners must prescribe an antibiotic based on their hospital antibiotic policy

PATTERN OF ADVERSE DRUG REACTIONS IN A TERTIARY CARE TEACHING HOSPITAL: A CROSS-SECTIONAL STUDY

ABSTRACTObjective: The aim of this study was to carry out adverse drug reactions (ADRs) monitoring in various departments of a tertiary care teaching hospital.Methods: A cross-sectional study was conducted on ADRs reported in the hospital from December 2012 to May 2013 after obtaining InstitutionalEthics Committee approval.Results: A total of 40 ADRs were reported, 47.50% were males and 52.50% were females. The female adult population was 45%. The majority of ADRswere due to antimicrobial agents especially beta-lactam antibiotics (42.5%) followed by NSAIDs (7.50%). A maximum number of patients (75%)were reported with dermatological manifestations. The department of medicine reported the highest number of ADRs (37.5%). As per Naranjo'sprobability scale, 62.5% reports were assessed as probable. 62.5% reports were documented as mild according to Modified Hartwig's criteria forseverity assessment.Conclusion: This study was done to sensitize the practicing physicians on the importance of adverse drug monitoring and reporting.Keywords: Pharmacovigilance, Adverse drug reactions, Tertiary care teaching hospital, Antimicrobial agents

Prevalence of gestational diabetes mellitus and its maternal and fetal outcomes

We hereby report the results of a prospective cohort study where we compared the association of various demographic factors and gestational diabetes mellitus (GDM), determined the prevalence of GDM and its maternal and fetal outcomes

Recital Comparison of Bilingual Language Using Various Filters for Offline Handwritten Character

Optical Character Recognition (OCR) of multilingual document containing Offline Handwritten Character (OHC) in regional languages of India, it is necessary to identify different script forms before running an individual OCR of the scripts. In this paper, novel approaches for offline character recognition are written in south Indian languages such as Tamil and Kannada. Preprocessing is one of the most important phases in OCR development. It directly affects the efficiency of any OCR. In this process an extracting of basic constituent symbols of the script. Different methodologies which are growing rapidly in the area of character recognition is South Indian Languages. In this paper, it is mainly focused on the existing methodology used in different stages of OCR to recognize offline handwritten character of bilingual regional languages of South India such as Tamil and Kannada are reviewed, summarized and documented

Benign papillary cystadenofibroma of fallopian tube presenting as posterior fornix cyst: case report

Benign papillary cystadenofibroma of fallopian tube is very rare tumor of female genital tract. Usually asymptomatic and incidental finding. Worldwide literature only 18 cases were found. On account of its rarity and best of our knowledge, is the first case of benign papillary cystadenofiboma presented as posterior fornix cyst, so we are presenting this case. We report a rare case of benign papillary cystadenofibroma of fallopian tube in a 30-years old female P3L3 presenting with abdominal pain. On examination abdomen was soft, per vaginally mobile non-tender cystic mass of 5×4 cm was noted. Laparotomy was planned. Intraoperatively 5x4 cm cyst arising from serosal surface of left fallopian tube near fimbrial end noted with bilateral ovaries normal. Left fimbrial cystectomy with salpingectomy was done with sparing both ovaries. Histopathology suggestive of benign papillary cystadenofibroma of fallopian tube. Patient had uneventful recovery in follow up period. Benign papillary cystadenofibroma of fallopian tube is rare tumor found incidentally. Tumor seems to have benign course only cystectomy is required for treatment

Comparison of different brands of centrally acting skeletal muscle relaxants: a cost analysis study

Background: Skeletal muscle relaxants are structurally distinct drugs prescribed for reducing muscle spasms, pain, and hyperreflexia. Centrally acting skeletal muscle relaxants are manufactured by various pharmaceutical companies with variable price. The present study, aimed to analyze the cost variation of various brands of centrally acting skeletal muscle relaxants, so as to help the physician to choose the cost effective treatment.Methods: Current index of medical stores (CIMS) April 2018 and online literature were used as information guide to review the prices of drugs used in the treatment of musculo skeletal pain and spastic neurological disorders.Results: Among anti spasmodic group, thiocolchicoside 4 mg shows maximum price variation of 337.5%, whereas carisoprodol 350 mg shows the least variation of 0.1%. It is evident from antispastic group that baclofen 10 mg shows maximum price variation of 93.91% and 5 mg of Baclofen shows the least variation of 11.22%. It is observed that, among anti spastic group, a percentage prize variation of 93.91 for 10 mg and 11.22 for 5 mg baclofen. Largest % prize variation is seen in metaxalone + diclofenac sodium (400+50) mg as 525% and the least variation is observed in tolperisone+ paracetamol (150+325) mg as 3.88%.Conclusions: Centrally acting orally effective skeletal muscle relaxants are commonly prescribed for painful musculoskeletal and spastic neurological disorders. Physicians should give due importance for the cost of the drugs while selecting appropriate drug for musculo skeletal disorders

Knowledge, attitude and practices of antibiotic usage and resistance among the second year MBBS Students

Background: Social aspect of antibiotic management forms a significant way to overcome the rapidly intensifying problem of antibiotic resistance. Knowledge helps in spreading awareness and understanding while attitude and practices influences health related behaviour. Medical students should not only be made aware of the current emerging health issues but also be directed towards rational antibiotics prescribing behaviour as future medical practitioners. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices (KAP) related to antibiotic usage and resistance among second year (fourth semester) MBBS students.Methods: This was a cross-sectional, questionnaire based study conducted in department of pharmacology of a government medical college in Kerala, India. Questionnaire was distributed among a batch of 120 second year MBBS students after one of the pharmacology lecture session. Attitude and Practices related questions were assessed using Likert scale. Data was entered in excel and analysed using descriptive statistics of SPSS to generate frequency and percentage.Results: 91.6% (110) were considered valid for analysis. Mean age was 21±1 years. Students had fair knowledge regarding antibiotics usage and resistance with mean correct response 79.72±25.37%. Mean correct responses of attitude and practices related questions were found to be 55.95±25.63% and 64±13.79% respectively.Conclusions: Most of the students were aware of the antibiotic resistance and its consequences. However, their attitude and practices were found to be a matter of great concern. An educational intervention can be introduced to bring about behaviour changes regarding rational antibiotics prescribing among them