Asian Journal of Pharmaceutical and Clinical Research

EFFECT OF ADDITION OF DEXAMETHASONE TO ROPIVACAINE ON POST-OPERATIVE ANALGESIA IN ULTRASOUND-GUIDED TRANSVERSE ABDOMINIS PLANE BLOCK FOR ANTERIOR ABDOMINAL WALL HERNIA REPAIR

POOJA GARHWAL — 2024-04-07

Objective: The objective of the present study was to evaluate the adjuvant effect of dexamethasone to Ropivacaine in ultrasound-guided transverse abdominal plan block for anterior abdominal wall hernia repair.

Methods: A single-blind randomized control trial was conducted by selecting patients undergoing anterior abdominal wall hernia and dividing them into two groups with Group A: received a total of 50 mL of 0.2% Ropivacaine (48 mL) with normal saline (2 mL) and Group B received a total 50 mL of 0.2% Ropivacaine (48 mL) with 8 mg dexamethasone (2 mL). Outcome was assessed on the basis of visual analog scale (VAS), the requirement of rescue analgesia, and adverse events.

Results: Twenty-seven patients were recruited in each group, Group A and Group B had an average pain-free interval of 11.85±2.82 and 8.07±2.51, respectively (p<0.001). Mean VAS was lower in Group B at the end of 2 h (p<0.05). Both the groups had similar side effects with no significant difference. Total analgesia dose required in Groups B and A was 75 and 96 mg, respectively (p<0.001).

Conclusion: A combination of 0.2% Ropivacaine (48 mL) with 8 mg dexamethasone (2 mL) significantly reduces the VAS in post-operative pain along with reduced quantity and frequency of rescue analgesia.

A STUDY ON INDICATIONS, MODE OF HYSTERECTOMY AND HISTOPATHOLOGICAL ANALYSIS OF HYSTERECTOMY SPECIMENS

LAKSHMI PRIYANKA K — 2024-04-07

Objectives: To study the age distribution, indications, modes of hysterectomy, concurrent surgery done along with hysterectomy, and histopathological analysis of hysterectomized specimens.

Methods: This study was conducted in the Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, a tertiary teaching hospital at Medchal. Medical records of 240 cases of hysterectomy performed from January 2015 to December 2021 were retrieved from the Medical Record Department. The age distribution, indications of hysterectomy, mode of hysterectomy, concurrent oophorectomy, and histopathological reports of hysterectomy specimens were analyzed in this study.

Results: Out of the total 240 hysterectomies, 51.25% were in the age group of 40–49 years, followed by the age group of 50–59 years, i.e., 19.5%. Common indications for hysterectomy were AUB (36.25%), fibroids (34.58%), and UV prolapse (29.16%). Abdominal hysterectomy (62.5%) was performed more commonly than vaginal hysterectomy (29.16%). Histopathological analysis showed the most common pathologies as atrophic endometrium, leiomyoma in the myometrium, and inflammation in the cervix. Concurrent bilateral oophorectomy was done in 51.66%, unilateral oophorectomy was done in 10%, and ovaries were conserved in 38.33%.

Conclusion: Hysterectomy is a common major gynecological surgery performed, most commonly in the perimenopausal age group. Although there is an increased trend toward the laparoscopic route, the abdominal route is still the preferred route. Leiomyoma is the most common pathology found in hysterectomized specimens. AUB being the most common indication for hysterectomy, there should be increased use of medical management, and patients should be counseled for conservative management in order to prevent increased surgical interventions.

PREVALENCE OF FLUOROQUINOLONES RESISTANCE AMONG ESBL-PRODUCING ESCHERICHIA COLI ISOLATED FROM URINE SAMPLES

Ranjan Kumar Sharma — 2024-04-07

Objectives: Resistance among uropathogens has emerged as a growing concern necessitating re-evaluation of the efficacy of recommended empiric antimicrobial regimens. Misuse and overuse of various antibacterial agents in hospitals are a key cause of the emergence of anti-microbial resistance.

The study aimed to identify the prevalence of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli from urine specimens and to know the prevalence of Fluoroquinolone resistance among ESBL-producing E. coli isolates.

Methods: The study was conducted on 500 E. coli isolates from urine samples received in the Department of Microbiology, MMIMSR, Mullana, Ambala. The organism isolation and identification were done as per the standard procedures and antibiotic sensitivity testing was done following Clinical Laboratory Standard Institute (CLSI) guidelines. All the strains were screened out for ESBL production as per CLSI guidelines. Ciprofloxacin, Norfloxacin, and Ofloxacin discs were used for the detection of fluoroquinolone resistance.

Results: Out of the total 500 E. Coli isolates from urine samples received in our laboratory, 69% were found to be ESBL producers.

Conclusion: We found a high level of quinolone resistance among ESBL-producing E. coli strains isolated from patients with urinary tract infections. Because of the widespread use of fluoroquinolones in our country, there is a need for sensitive antibiotic stewardship. Further research is needed to ascertain the gravity of quinolone resistance and to swiftly act against its spread among other nosocomial pathogens.

ANALGESIC ACTIVITY OF ETHANOLIC EXTRACT OF PORTIERIA HORNEMANNII (LYNGBYE) P. C. SILVA IN MANDAPAM, RAMANADHAPURAM, TAMIL NADU, INDIA

ATHI LAKSHMI S — 2024-04-07

Objective: The present study intends to detect the analgesic activity of the ethanolic extract of Portieria hornemannii collected from Mandapam, Ramanathapuram district, Tamil Nadu, India.

Methods: Diclofenac sodium (100 mg/kg) was the standard. The analgesic activity of P. hornemannii was predicted on intact rats by tail flick latency in the Tail Immersion Method. The various concentrations of the ethanolic extracts were used as 200 mg/kg and 400 mg/kg, considering the body weight of mice. The control group received a typical saline solution.

Results: The present study shows that the doses (200 mg/kg and 400 mg/kg body weight of mice) of the ethanolic extracts of P. hornemannii have brought out the analgesic activity.

Conclusion: The conclusion of the study is that the ethanolic extracts of P. hornemannii Silva at 400 mg/kg showed more effect than the 200 mg/kg ethanolic extract.

A CORRELATION STUDY OF BLOOD HBA1C WITH FASTING AND POSTPRANDIAL BLOOD GLUCOSE

PANKAJ KUMAR — 2024-04-07

Objectives: This study aimed to evaluate the correlation between raised blood sugar and glycated hemoglobin (HbA1c), a gold standard test for the assessment of glycemic control. Serial monitoring of HbA1C in diabetes mellitus helps in the prevention of microvascular and macrovascular complications.

Methods: We retrospectively reviewed the laboratory reports of 397 patients who visited the hospital for various reasons. There were 195 males and 202 females in the study group. We evaluated the correlation between HbA1c and two indicators of glycemic control: fasting blood glucose (FBG) and postprandial blood glucose (PPBG).

Results: Both FBG and PPBG showed a significant positive correlation with HbA1c. However, PPBG had a stronger correlation with HbA1c than FBG. The Spearman’s correlation coefficient (r) was 0.610 (p<0.05) for FBG and HbA1c and 0.683 (p<0.05) for PPBG and HbA1c.

Conclusions: PPBG was a better predictor of HbA1c than FBG. PPBG may be an alternative marker of HbA1c for the management and monitoring of diabetes mellitus.

COMPARISON OF ANTI-PROTEINURIC EFFECTS OF AMLODIPINE AND CILNIDIPINE AS AN ADD-ON DRUG TO BASELINE MEDICATION IN HYPERTENSIVE CHRONIC KIDNEY DISEASE PATIENTS

JESMI JAMES — 2024-04-07

Objectives: The objectives of the study were to compare the anti-proteinuric effects of amlodipine and cilnidipine in individuals with Chronic Kidney Disease (CKD) on baseline medication.

Methods: This was a prospective observational study carried out in the Department of Nephrology at Government T.D. Medical College, Alappuzha spanning a duration of 1 year from January 2016 to December 2016. The study encompassed a total of 90 hypertensive CKD patients-45 were administered amlodipine and the remaining 45 were given cilnidipine in conjunction with their existing baseline medications. The inclusion criteria consisted of hypertensive CKD patients aged between 18 and 80 years possessing a Glomerular Filtration Rate (GFR) between 30 and 60 mL/min and exhibiting blood pressure readings surpassing 140/90 mmHg despite receiving a loop diuretic (Tab. Frusemide 80 mg BD), an α-blocker (Tab. Prazosin 10 mg BD) and a β-blocker (Tab. Metoprolol 50 mg BD) for a minimum duration of one month. The key parameters that were monitored were sitting systolic and diastolic blood pressure readings and proteinuria which was evaluated by determining the Urine Protein Creatinine (UPC) ratio using untimed random urine samples. The GFR was calculated utilizing the Cockcroft-Gault formula.

Results: The number of patients who improved to stage 3A CKD from stage 3B CKD were more with cilnidipine which indicates its reno-protective action. Amlodipine was seen to have no effect on UPC ratio whereas cilnidipine decreased UPC ratio significantly.

Conclusion: Unlike amlodipine, cilnidipine exhibits marked reduction in proteinuria and improved GFR thereby preventing progression of hypertensive CKD patients to end stage renal failure.

EFFECTIVENESS OF DOUBLE-GLOVING METHOD ON PREVENTION OF SURGICAL GLOVE PERFORATIONS AND BLOOD CONTAMINATION: A PROSPECTIVE STUDY

Divyang H Chavda — 2024-04-07

Objectives: To evaluate efficacy of double gloving to provide mechanical barrier against communicable diseases and also to evaluate different parameters affecting glove perforation rate.

Methods: This prospective study was performed in department of General Surgery at tertiary care teaching hospital of Gujarat. This study involved a group of surgeons and operation theatre nursing staff. Randomization of the participants was done with the closed envelope method in two groups: single gloving and double gloving. Glove perforation rate and hand contamination rate was calculated and compared between both the groups. Participants of double gloving groups were also asked for discomfort using double gloves and compromised tactile sensations.

Results: There was no statistically significant difference in the glove perforation rate between single gloves and double outer gloves. (p=0.55) But, the glove perforation rate was significantly low in double inner gloves than single gloves. (p=0.004) The hand contamination rate was significantly lower amongst perforated double gloves than perforated single gloves. (p=0.00001) Awareness of glove perforation was absent in majority of the participants in both the groups. All the participants in the double gloving group were comfortable with using double gloves and their tactile sensations were not compromised.

Conclusion: This study concluded that double gloving efficiently prevented hand contaminations during a surgery. There was no significant difference noted in glove perforation rates in both single and double gloving groups. Double gloving is recommended for the surgeons and nursing staff to protect them from blood borne infections and eliminate the chances of surgical site infections in the patients.

Haemodynamic responses to intubation, extubation and post‐operative analgesia after intravenous lignocaine in laparoscopic cholecystectomy surgeries: a randomized control study

srikanth gujja — 2024-04-07

Objectives: To evaluate the effect of intravenous lignocaine on haemodynamic responses to intubation, extubation and post‐operative analgesia in laparoscopic cholecystectomy surgeries.

Methods: This prospective, randomized, double blinded study was conducted in patients for elective laparoscopic cholecystectomy surgery in tertiary care hospital of Tamil Nadu. Group A (n=60) received 0.9% normal saline for perioperative intravenous infusion and Group B (n=60) received preservative free lignocaine 2% (20mg/ml) as intravenous infusion Hemodynamic responses were recorded to intubation, extubation and post‐operative analgesia in both groups. VAS scores and pain free period were also compared.

Results: Pulse rate (PR) and mean arterial pressure (MAP) were significantly increased in both the groups during laryngoscopy and intubation, though the rise of both in lignocaine group was significantly less than normal saline group. (p<0.0001) Similarly, both PR and MAP were significantly increased during extubation in both the groups. (p<0.0001) However, the rise of both the parameters in lignocaine group was significantly less as compared to normal saline group. (p<0.0001) VAS scores in immediate post operative period were better in lignocaine group than normal saline group. The mean pain free period was less than an hour in normal saline group, while it was approximately 4 hours in lignocaine group. (p<0.0001)

Conclusions: This study concluded that i.v infusion of lignocaine had significantly increased the pain free period post operatively. So those who are not affordable for epidural block, lignocaine i.v infusion is better alternative for post operative analgesia.

ETHNOPHARMACOLOGICAL INVESTIGATION OF PLEUROTUS OSTREATUS FOR ANTI-OXIDATIVE AND ANTI-INFLAMMATORY ACTIVITY IN EXPERIMENTAL ANIMALS

LAKKARAJU CHANDANA — 2024-04-07

Objective: This particular study was aimed to evaluate the anti-oxidant effect of Pleurotus ostreatus using the in vitro method and also against inflammation.

Methods: A methanolic extract of P. ostreatus (MEPO) was prepared by the cold maceration technique. Different tests. In vitro anti-oxidant activity was investigated using the 1,1-diphenyl-1-picryl hydrazyl (DPPH) method. Wistar rats were chosen for the study; animals weighing 150–200 g were divided into six groups of six each (n=6). Control animals were grouped as I, group II was administered with approximately 100 μL of 1% suspension of carrageenan in saline and injected into the plantar surface of the right hind paw, group III, IV, V, and VI were given with carrageenan, followed by diclofenac sodium (150 mg/kg body weight, p.o.) and MEPO at the dose of 200, 400, and 800 mg/kg orally for 21 days. The paw volume and percentage of inhibition of the paw were measured in all animals.

Results: The IC50 values of the test extract in the DPPH free radical scavenging assay were found to be 44.02±0.09 as compared with the standard drug 35.01±0.12, which was considered significant (***p<0.001). The test extract at the dose of 400 and 800 mg/kg significantly decreased (**p<0.001) the paw volume thereby, the inflammation, the % percentage of inhibition in paw volume was compared to the positive control in the carrageenan-induced paw edema.

Conclusion: The study explored a potential source for anti-oxidants in the MEPO, which also seems to be effective in chemical-induced inflammation.

A RETROSPECTIVE STUDY ON SEVERITY AND ASSESSMENT OF MEDICATION ERRORS IN A TERTIARY CARE TEACHING HOSPITAL

UMAMAHESWARA RAO K — 2024-04-07

Objectives: This study mainly aims to assess the severity and occurrence of medication errors (MEs) in a Tertiary Care Teaching Hospital and suggest solutions for reducing MEs.

Methods: It is a retrospective study of patients receiving medication during treatment. The techniques used during this study to identify MEs are direct observation of patients, daily review of medication charts by clinical pharmacists, daily audit of prescriptions, and using medication administration records.

Results: The study revealed that the majority of MEs fall under the age groups of 51–60 (45), 41–50 (40), 61–70 (31), 31–40 (19), 21–30 (17), 71–80 (16), 81–90(7), 11–20(6), 1–10(3), and 91–100 (1), respectively. Among 185 patients, males were 100 and females were 85, indicating that MEs occurred more in males than females, and the personnel involved in MEs were more nurses than physicians.

Conclusion: By assessing the severity and occurrence of MEs, we identified the most common risk factors for the occurrence of MEs. The study concludes that educating nurses, implementing an evidence-based treatment strategy, and fostering communication and collaboration among hospital pharmacists, doctors, and nurses can help to decrease the occurrence of MEs.

EFFECT OF BETEL NUTS AND TOBACCO DERIVATIVES ON ANTIOXIDANTS AND MICRONUTRIENTS IN ORAL SUBMUCOUS FIBROSIS AND ORAL CANCER PATIENTS IN GUJARAT POPULATION

MONIKA PATEL — 2024-04-07

Objective: In our previous study, we have find the significance of biochemical markers between precancerous and cancerous subject with normal healthy individuals in Gujarat population, taking into consideration the severity of biochemical markers in cancerous condition. We felt that other than comparison, effect of betel nuts and tobacco derivatives on antioxidants and micronutrients has required further evaluation to develop a better understanding. The objective of the present study is to measure the interdependence of antioxidants and micronutrients in oral submucous fibrosis and oral cancer patients and find its significance.

Method: In this study, a total of 150 patients in which 50 diagnosed PMD patients and 50 diagnosed oral cancer patients with 50 healthy non-tobacco consuming were selected as a control group. Five to seven milliliters of venous blood was collected under aseptic precautions with patients consent. All the parameters were analyzed by standard methods using fully auto-analyzed with a ready-to-use kit.

Result: This research was conducted on 150 patients, out of which 50 diagnosed potential malignant disorder patients and 50 oral squamous cell carcinoma patients matched with 50 healthy control individuals. Average age of patients with PMD and OSCC was 55.6±9.74-and that of control group was 35.83±8.90 years. Student t-test showed that there was a significant difference between the two groups with regard to age. Of the 100 patients with PMD, 72 (72% of total) were men and 28 (28% of total) were women. Among the individuals in the control group (n=50), 35 persons (70% of total) were men and 15 (30% of total) were women. Chi-square test showed that there was no significant difference between the two groups in terms of sex (p=0.891). The copper levels of PMD and OSCC, respectively, were 153.57±7.68 and 164.43±15.75. The value was statistically compared with OSCC which had significantly higher levels than healthy control (102.53±22.1). The iron levels of PMD and OSCC, respectively, were 77.62±15.27 and 50.04±19.97. The value was statistically compared with OSCC which had significantly lower levels than (138.4±13.2) healthy control. The Vitamin C levels of PMD and OSCC, respectively, are 0.55±0.10 and 0.44±0.9. The value was statistically compared to the OSCC which had significantly lower than 1.09±0.17 control. The Vitamin E levels of PMD and OSCC, respectively, 1.18±0.16 and 0.8±0.12 values were statistically compared the OSCC which had significantly lower levels than (1.39±3.64) healthy control.

Conclusion: In our finding, Vitamin C showed positive correlation with serum iron and serum copper with malignant disorders. Trace elements and antioxidants exhibited interdependence in both physiologic and pathologic states such as oral cancer.

EVALUATING THE BLOOD-SPARING EFFICACY AND SAFETY OF TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY

Ramya R — 2024-04-07

Objectives: Tranexamic acid (TXA) is an antifibrinolytic agent that effectively reduces bleeding both during and after surgery. The purpose of our study was to assess the effectiveness and safety of TXA use in reducing blood loss in uncomplicated primary total knee arthroplasty (TKA) without complications.

Methods: This is a prospective, open-label, comparative study that includes patients who are undergoing unilateral primary TKA. The patients were divided into two groups: Group I, which is a control group, did not receive any doses of TXA, and Group II received three doses of intravenous TXA: 15 mg/kg TXA was administered 30 min before incision, followed by post-operative doses of 10 mg/kg TXA at 3 and 6 h. The primary objectives of the study were to measure the total blood loss (TBL) and Hemoglobin (Hb) drop, which were calculated preoperatively and on the third post-operative day. The secondary objectives were to determine transfusion rates, incidences of symptomatic deep vein thrombosis, and thromboembolic events (TE).

Results: In this study, a total of 57 patients underwent unilateral TKA. The TBL in Group I was 861.67±167.65 mL, compared to 780.05±158.05 mL in Group II (p<0.001). The study also found that the Hb drop was significantly lower (2.78±0.36 vs. 2.3±0.37) with IV TXA. Furthermore, neither group required transfusions, nor were any thromboembolic complications noted for up to 6 months post-operation.

Conclusion: Our study supports the use of TXA in TKA, as it effectively reduces perioperative blood loss, decreases the need for blood transfusions, and does not increase the risk of TE.

SIMULTANEOUS METHOD DEVELOPMENT AND VALIDATION OF COMBINED DOSAGE FORM DAPAGLIFLOZIN AND VILDAGLIPTIN IN BULK AND COMBINED TABLET DOSAGE FORM BY UV SPECTROPHOTOMETER

BHAVYA SRI K — 2024-04-07

Objectives: In the present work on the determination of dapagliflozin and vildagliptin in tablet dosage form, a simple, rapid, inexpensive, accurate, and precise stability-indicating ultraviolet (UV) method was established. For the measurement of vildagliptin and dapagliflozin in tablet dosage form.

Methods: A UV-visible spectrophotometric technique was done. Double-distilled water was used as the dapagliflozin’s diluent. Vildagliptin’s diluent was 0.1 N NaOH. The diluent used in the dosage form that contains both vildagliptin and dapagliflozin was 0.1 N NaOH. This approach was verified for linearity, accuracy, precision, QL, and detection limit (DL).

Results: For the dosages of dapagliflozin and vildagliptin (0.16:1.6–2.2:22 μg/mL), linearity were seen. Vildagliptin and dapagliflozin were found to have QLs of 3.7432 μg/mL and 1.2860 μg/mL, respectively. Vildagliptin and dapagliflozin were found to have DLs of 1.2352 and 0.4244, respectively. The developed method for estimating the dosage of dapagliflozin and vildagliptin in tablet form was proven to be accurate, exact, and quick. Under identical circumstances, the medication was stressed by hydrolysis, oxidation, photolysis, and thermal deterioration. The UV-visible system was used to analyze the stress sample.

Conclusion: The proposed method was found to be simple, precise, accurate, and reproducible and can be used for routine analysis of dapagliflozin and vildagliptin in bulk and tablet dosage forms.

A DIRECT BONDING TECHNIQUE VERSUS AN INDIRECT BONDING TECHNIQUE - AN IN VIVO ANALYSIS

ANANYA BHARGAVA — 2024-04-07

Objectives: The objectives of this study were to compare the clinical performance of an indirect versus a direct bonding technique in a split mouth study design and to develop a reproducible and cost efficient technique for indirect bonding for clinical use.

Methods: This comparative study was conducted on Twelve patients (212 teeth; 106 each in direct and indirect group) who reported to the Department of Dentistry at Ruxmaniben deepchand gardi medical college, Ujjain, Madhya Pradesh. Transbond XT (3M Unitek) adhesive and primer were used to bond the brackets onto the teeth in both the direct and indirect bonding groups using split mouth study design. Transfer trays constructed using Thermal glue matrix applied through hot glue gun for indirect bonding. The clinical performance was assessed for 6 months.

Results: In the 1st month was a failure of one lower 2nd premolar bracket from the indirect bonding group (p=1.00). There on in the subsequent months there were no failures for 6 months. The study showed no statistically significant differences in clinical performance in both group (p=NS).

Conclusion: The failure rates for both the indirect and direct bonding techniques in this study were the same. Statistically, there was no significant difference between the two groups. The indirect bonding technique used in this study was found to be an effective and efficient means of bonding orthodontic brackets. Transbond XT and thermal glue matrix found to be suitable choice for use in indirect bonding technique for clinical use.

DEVELOPMENT AND OPTIMIZATION OF RAFT-FORMING FORMULATION OF H2BLOCKERS

MANSI MANOJ BHOSALE — 2024-04-07

Objective: The present research work is focused to develop in situ raft gel of Nizatidine. sodium alginate (SA) is one of the critical components for the development in situ raft system.

Methods: The formulation was prepared using polymers such as SA and gellan gum. The formulations were subjected to evaluation characteristics such as pH, in vitro gelling capacity, viscosity, gel strength, and in vitro release studies.

Results: The pH of all the prepared batches was found in the range of 6.4–7.2 for S1–S9, and 6.3–7.2 for G1–G9. S1–S9 formulations showed viscosity in the range of 253.7–400.9 cps, and G1–G9 formulations showed viscosity in the range of 253.4–399.8 cps. Formulation S6 containing SA and G6 containing gellan gum gave the highest drug content of 99.58% and 99.5%, respectively. The highest gel strength 4.6 is exhibited by S6 and G6 formulations. Formulation S6 containing SA gave the highest drug release of 95.62% and also showed sustained and controlled release for up to 12 h.

Conclusion: Gastric raft formulation is a better choice for drugs such as Nizatidine which enhances the drug release for a prolonged time by remaining buoyant in the stomach for more than 12 h.

TO STUDY THE EFFECT OF TADALAFIL IN IMPROVING URODYNAMIC PARAMETERS IN SPINAL CORD INJURY PATIENTS: A RANDOMIZED CONTROLLED TRIAL

KARMENDRA SINGH KUSHWAHA — 2024-04-07

Objectives: The aim of the study was to compare the effect of single dose Tadalafil 20 mg 2 h after administration on Urodynamic study (UDS) parameters and comparison with calcium+vit-D3 (control) in spinal cord injury (SCI).

Methods: Sixty-six SCI individuals with lower urinary tract symptoms (LUTS) and upper motor neuron bladder were randomized into Tadalafil group (n=33) and calcium+vitD3 group (n=33). UDS was done and parameters (maximum detrusor filling pressure [MDFP], maximum bladder capacity, and bladder compliance) were recorded at baseline and 2 h after administration of respective drugs in both groups and comparison was done.

Results: Statistically significant improvement in mean MDFP from 24.42±6.75 to 21.12±5.72 cm H2O (p < 0.001), mean maximum bladder capacity from 263.94±108.48 to 287.67±112.71 mL (p<0.001), and mean bladder compliance from 11.07±4.31 to 13.94±5.13 mL/cm H2O (p<0.001) was observed in Tadalafil group whereas in calcium+vit-D3 group, no significant improvement was observed. When we compared difference of mean of MDFP, bladder capacity, and bladder compliance between Tadalafil and calcium+vitD3 group, significant improvement (p<0.001) in Tadalafil group was noted as compared to calcium+vitD3 group.

Conclusions: Single dose of oral Tadalafil 20 mg has shown significant improvement in MDFP, bladder capacity, and bladder compliance in SCI individuals with LUTS as compared to control.

A STUDY ON INTESTINAL OBSTRUCTION REGARDING ITS EPIDEMIOLOGY, ETIOLOGY AND MANAGEMENT IN A PERIPHERAL MEDICAL COLLEGE

MD AHMAD — 2024-04-07

Objectives: The intestinal obstruction is a widespread emergency problem in our surgical practice day by day. It is a significant cause of morbidity and mortality in our health system. It is caused by adhesions, hernias, malignancies, endometriosis, inflammatory bowel disease stenosis, intussusception, and others. Our research aims to identify the etiology, epidemiology, and clinical presentations of the pathology so that we can manage the disease as early as possible for better outcomes in our peripheral institution.

Methods: The study was performed on 100 cases of the age group 12–76 years admitted in the surgical ward of Midnapore Medical College and Hospital, Paschim Medinipur (W.B.) from December 2016 to June 2018. Cases of acute intestinal obstruction who underwent operation were included in our research to establish the pathology of intestinal obstruction.

Results: In our study, the incidence of acute intestinal obstruction is 1.6% of total surgical cases. Maximum patients (25%) were in the age group 51– 60 years. The most common cause of intestinal obstruction was obstructed/strangulated hernia (40%). The most common symptoms were pain abdomen (88%), abdominal distension (84%), and vomiting (78%). An X-ray revealed presence of air-fluid levels in 75% of patients. The overall mortality rate was 10%.

Conclusion: The morbidity and mortality of intestinal obstruction are dependent on early diagnosis, prompt resuscitation, and proper management. The critical determinants of the morbidity are age of the patient, duration of the disease, existing comorbidity, and delay in treatment. X-ray in erect view is an essential mode of diagnostic method and obstructed hernia is the most common etiology of obstruction in our research study.

RAPID ON-SITE EVALUATION AND MICRONUCLEUS SCORING IN BREAST LESIONS FINE NEEDLE ASPIRATION CYTOPATHOLOGY BY NEW IAC YOKOHAMA SYSTEM OF REPORTING

SAMRITI GOYAL — 2024-04-07

Objective: The objective of the study is to report all fine needle aspiration cytopathology (FNAC) cases of lump breast as per New Yokohama classification 2016, to highlight the importance of rapid onsite evaluation (ROSE) in breast cytology at the time of FNAC, and to assess the relationship between micronucleus (MN) scoring and various breast lesions in cytology.

Methods: The study was conducted on 70 patients with breast lumps in the Department of Pathology in Government Medical College, Patiala, and comprised evaluation of ROSE and MN scoring in breast FNAC by the use of New Yokohama system of reporting.

Results: On ROSE, 11 out of 70 patients were categorized under category I according to the Yokohama system of reporting and on the same sitting with repeat FNAC after performing the ROSE; nine cases were upgraded for cytological reporting and two remained in category I. According to as per the International Academy of Cytology (IAC) Yokohama system of reporting (2016) cases were categorized as category I – 2 (2.9%), category II – 46 (65.7%), category III – 7 (10.1%), category IV – 5 (7.1%), and category V – 10 (14.2%). In MN scoring, MN with the highest score of 14–17/1000 epithelial cells was in category V (malignant), and the lowest score was 0–1/1000 epithelial cells in category II (benign).

Conclusion: ROSE is an easy, safe, and cost-effective method. IAC Yokohama system for reporting (2016) provides a comprehensive way of categorizing various breast lesions on FNAC with clinical correlation. MN score is a good biomarker in differentiating benign, atypical, and malignant breast lesions.

METHOD DEVELOPMENT AND VALIDATION OF RAPID ISOCRATIC RP-HPLC METHOD FOR SIMULTANEOUS ESTIMATION OF PARACETAMOL, CAFFEINE, AND PROPYPHENAZONE IN PHARMACEUTICAL FORMULATION

SAYALI JADHAV — 2024-04-07

Objective: The objective is to develop a novel, rapid, simple, precise, accurate, and reproducible RP-HPLC method for simultaneous estimation of paracetamol, caffeine, and propyphenazone in bulk and a pharmaceutical dosage form.

Method: Optimized chromatographic conditions were used for isocratic elution with Shimadzu C18 (4.6×250 mm, 5 μm), methanol, and 20mM phosphate buffer (60:40, v/v, pH 2.5) as mobile phase, flow rate 1.2 mL/min, and UV detector at λ max 272 nm. The method was validated for specificity, precision, linearity, accuracy, robustness, and solution stability as per the International Council for Harmonization (ICH) guidelines.

Result: It was discovered that the retention time for paracetamol, caffeine, and propyphenazone was found to be 2.6 min, 3.0 min, and 7.5 min. The method proved to be rapid, simple, linear (R2>0.999), precise {relative standard deviation (RSD<2.0%)}, accurate (recovery 98–102%), sensitive, and robust.

Conclusion: The proposed novel isocratic RP-HPLC method was found to be rapid (short run time of 10 min), highly selective, accurate, and sensitive. The method has been successfully applied to the simultaneous analysis of paracetamol, caffeine, and propyphenazone in a pharmaceutical formulation.

TRADITIONAL VERSUS ONLINE TEACHING - A COMPARATIVE STUDY AMONG UNDERGRADUATE BDS STUDENTS

DEEPALAXMI S — 2024-04-07

Objectives: This study was conducted with a purpose to determine the perception of dental students toward traditional and online teaching methods.

Methods: A validated and structured questionnaire was prepared using Google Forms and the study link of the questionnaire was sent through WhatsApp to all the participants. The questionnaire consisted of two parts. The first part included the demographic information of the students. The second part constituted a pre-validated 16-item questionnaire on the perception of students on traditional and online teaching. The variables, such as interest, convenience, time, motivation, tiredness, distractions, satisfaction, retention, and understanding, were included. A 5-point Likert scale was used for collecting the responses. Descriptive statistics was used for the final analysis and were represented as percentages.

Results: Overall response rate was 98.2%. Female preponderance was more compared to male constituting 66%. Mobile (92.9%) was the gadget of preference followed by laptop (6.5%). Majority of students showed a negative inclination toward online teaching. They felt online teaching was less interesting, less motivating, with more distraction, low satisfaction, and lacked interaction. Meanwhile, they agreed that online teaching was more comfortable, cost-effective, and less time-consuming. Most of the students (63.1%) opted for a mixed method of teaching.

Conclusion: Both traditional and online methods have advantages and disadvantages at some levels. Mixed approach can be tried for better results.

ANALYSIS OF DRUG UTILIZATION PATTERN IN CHRONIC KIDNEY DISEASE PATIENTS IN A TERTIARY CARE HOSPITAL, SOUTH INDIA

SIYAMALA DEVI T — 2024-04-07

Objective: The objective of the study is to assess the drug utilization pattern of various drugs prescribed in chronic kidney disease (CKD) patients in a tertiary care hospital.

Methods: As a cross-sectional study 200 prescriptions were randomly selected from both the nephrology outpatient department and the inpatient ward. Patient demographics details, CKD staging, classes of drugs prescribed, and number of drugs prescribed were noted and data were analyzed with the World Health Organization core prescribing indicators.

Results: Incidence of CKD is more common in the age group of 40–50 years (45%) with male predominance (70%). Hypertension, diabetes, and anemia are the common comorbid conditions seen with CKD. Anti-hypertensives, anti-anemic drugs, calcium supplements, and anti-diabetic drugs are the commonly prescribed drugs in CKD. Number of prescription contains that generic names are near optimal and drugs from the National List of Essential Medicine are optimal. Majority of the prescriptions contain on average 5 drugs.

Conclusion: Diabetes and high blood pressure are the two most common causes of CKD with male dominance. Since polypharmacy is common in CKD patients , they should be monitored for drug – drug interaction and adverse drug reactions.

LUNG FUNCTION INDICES IN MALE WOODWORKERS AND HEALTHY WORKERS IN CENTRAL INDIA – A COMPARATIVE STUDY

PRAVIN SAINIKRAO GOWARDIPE — 2024-04-07

Objectives: The objectives of the study were comparison of lung function indices in woodworkers and age, height, and weight-matched healthy workers other than woodworkers and comparison of lung function indices among woodworkers about the duration of exposure.

Methods: A comparative study of spirometry was performed on 60 male woodworkers from the Lakadganj area of Nagpur city and 60 males of age, height, and weight-matched healthy workers other than woodworkers aged from 25 to 40 years. The study was performed in the laboratory of the Physiology Department, IGGMC Nagpur from January 2012 to September 2013. The Institute Ethics Committee approved the present study and it was completed in IGGMC Nagpur. Data collection from each individual was performed using a health history questionnaire, estimation of height (cm) with roll ruler wall mounted roll ruler wall mounted stature meter, weight (kg) with weight measuring device, and well-calibrated Spirometry device Physiopac Windows-based computerized Polygraph. Age, height, weight, body mass index, and lung function indices forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), forced expiratory flow25-75% (FEF25-75%), FEV1/FVC, and maximum voluntary ventilation (MVV) were included in the present study. Data analysis was performed using analysis of variance, unpaired t-test, and the Pearson correlation coefficient.

Results: Comparison of FVC, FEV1, peak expiratory flow rate, FEF25-75%, FEV1/FVC (p<0.001), and MVV (p<0.05) shows statistical significance between woodworkers and healthy workers. A negative correlation was found between FVC and all groups (Group A [−0.28], Group B [−0.33], and Group C [−0.46]). A negative correlation was found for FEV1 in Group A (−0.08), and Group B (−0.20). A positive correlation was found for FEV1 in Group C (0.14). FEF25-75% showed a negative correlation in Group I (−0.03), and Group III (−0.19).

Conclusion: FVC, FEV1, FEF25-75%, FEV1/FVC, and MVV decreased significantly in woodworkers as compared to age, height, and weight-matched healthy workers other than saw-mill workers. There was a significant decrease in FVC, FEV1, and FEF25-75% as the duration of exposure increased but had no significant effect on FEV1/FVC and MVV.

OPEN REDUCTION AND INTERNAL FIXATION WITH PLATING VERSUS EXTERNAL FIXATOR IN DISTAL END RADIUS FRACTURES: A COMPARATIVE STUDY

SATYANARAYANA Y — 2024-04-07

Objectives: The purpose of this study is to compare the external fixation and locking plate fixation of intraarticular fractures of the distal radius in terms of functional outcome and complications. The study aims to assess the patients for fracture union, wrist range of motion (ROM), grip strength, pain, and activity among the locking plate and external fixator group.

Methods: This study aimed to compare distal end radius external fixator to distal end radius plating regarding functional outcomes. This is an observational type of study where 40 patients were included in the study, among them, 20 were treated with external fixator/k wire and 20 with distal radius plate. The study was conducted in a tertiary care institute during the study period.

Results: The most patients were males >50 years of age, with injury caused by a fall on an outstretched hand. In the present study, we got excellent functional results according to the G and O’Brien system in 11 (55%) of patients treated with the plating group, good results in 5 (25%), fair results in 4 (20%), and poor (0%) in the plating.

Conclusion: Plating provides better functional outcomes, as assessed by Green and O’Brien’s score, as compared to external fixation. It allows for an early post-operative ROM exercises compared to an external fixator and better anatomical positioning of the fracture segments.

A A STUDY ON THE PREVALENCE OF OVERWEIGHT AND OBESITY AMONG WOMEN AGED 20 YEARS AND ABOVE IN RURAL FIELD PRACTICE AREA OF SIMS, HAPUR

R K SEHGAL — 2024-04-07

Objectives: The aim of the study was to assess the prevalence of overweight as well as obesity among women aged 20 years and above in a rural covered area of SIMS, Hapur, and to assess the risk factors for overweight and obesity in the above study population.

Methods: This research was carried out in the rural field practice area of SIMS, Hapur, spanning from July 2022 to July 2023. The study focused on women aged 20 years and older who were residents of the SIMS field practice area. The following criteria were used to select the study participants: Women who were pregnant at the time of the study, those who could not be reached after two home visits, individuals taking chronic medications that might lead to weight gain, and those who were uncooperative were excluded from the study.

Results: Out of the 500 participants in the study, 18.6% were categorized as underweight, 53.6% fell within the normal weight range, and 27.8% were considered overweight. Within the group of overweight individuals, a substantial 70.5% were classified as obese. The study revealed that the overall prevalence of overweight (defined as BMI>23) was 27.7%, while the prevalence of obesity (defined as BMI>25) stood at 19.8%. Furthermore, 29.9% of the women had a waist circumference exceeding 80 cm.

Conclusion: Based on the findings from our current research, it can be deduced that women with higher levels of education and socioeconomic status, a family history of excess weight, a higher number of pregnancies, a lack of physical activity, insufficient sleep, and poor dietary choices are more likely to be at risk of becoming overweight or obese. To prevent the rising prevalence of excess fat and obesity, it is imperative to implement lifestyle and dietary modifications.

PERINEAL PAIN AND DISCOMFORT: A STRANGE PHENOMENON FOLLOWING INTRAVENOUS DEXAMETHASONE

SINDHU CB — 2024-04-07

Objectives: The objectives of this study were to estimate the incidence of perineal discomfort, to assess the type of perineal discomfort, and to determine the time frame in which the discomfort started and persisted following IV administration of Dexamethasone in patients in the wards of a tertiary care teaching hospital.

Methods: This study was a descriptive cross-sectional study among 235 inpatients of a tertiary care hospital in Kerala receiving IV Dexamethasone. Study setting was in-patient wards of Government Medical College, Manjeri, Kerala. The study duration was 6 months from the date of IEC approval.

Results: Out of the 235 patients enrolled to the study, 126 (55.6%) were male and 109 (44.4%) were female. The mean age of the patients enrolled was 55.85±16.657. About 63 (26.8%) patients developed abnormal discomfort or symptoms following IV Dexamethasone injection. Patients presented the symptoms mainly over perineal area, perianal area, and lower abdomen. About 50 (79.4%) presented with symptoms in perineal area. All the 63 (100%) patients who experienced the symptoms had sudden and spontaneous onset of symptoms while administering the injection and the duration of the symptoms varied from few seconds to 5 min. There was no significant relationship between gender and dosage with appearance of symptoms.

Conclusion: In clinical practice, health-care professionals should be aware of such transient symptoms of perineal irritation and pruritus followed by IV Dexamethasone. Even though the exact mechanism is not known, this should be kept in mind and proper dilution and slow administration of the dexamethasone should be done to reduce such symptoms.

ADVERSE DRUG REACTIONS OF BACLOFEN, NALTREXONE, AND ACAMPROSATE IN PATIENTS HAVING ALCOHOL DEPENDENCE: A CROSS-SECTIONAL PHARMACOVIGILANCE STUDY

SUDHIR PANDURANG PANDHARE — 2024-04-07

Objectives: The research aims to investigate the prevalence and patterns of adverse drug reactions (ADRs), gauge the severity of these reactions, establish causality in ADR cases, and assess the preventability of such adverse reactions.

Methods: ADR information was gathered through personal interviews with patients or their relatives. Causality was assessed using the Naranjo algorithm, and a modified Hartwig and Siegel Severity Assessment Scale was used for estimating the severity of ADR. ADRs were grouped into various preventability categories based on the modified Schumock and Thornton criteria.

Results: The total number of patients evaluated in the baclofen, naltrexone, and acamprosate groups was 65, 28, and 42, respectively. The most commonly reported adverse events with baclofen were nausea (31.25%), followed by fatigue (18.75%) and headache (12.50%). The majority of patients receiving acamprosate reported nausea (57.14%), followed by diarrhea (28.57%). Patients receiving naltrexone most commonly reported nausea (35.71%), followed by abdominal pain (21.43%) and headache (14.28%).

Conclusion: This study shed light on the prevalence, severity, causality, and preventability of ADRs associated with anti-craving agents used to treat patients with alcohol withdrawal syndrome, providing valuable insights into the safety profiles of these medications.

BACTERIOLOGICAL PROFILE OF CLINICALLY SUSPECTED SEPTICEMIA AMONG NEONATES AND THE ANTIBIOTIC SUSCEPTIBILITY PATTERN OF THEIR ISOLATES: A CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL OF JHARKHAND

KUMAR VIMAL — 2024-04-07

Objectives: Neonatal septicemia is a generalized bacterial infection that occurs during the first 4 weeks of life and is one of the four primary causes of neonatal mortality and morbidity in India. This study aims to determine the bacteriological profile and antibiotic sensitivity patterns of isolates from blood cultures of suspected septicemic neonates in a tertiary care hospital.

Methods: Two hundred and twenty-eight blood samples were collected and processed from patients in accordance with standard protocol. The antibiotic susceptibility of the isolates was determined by the disk diffusion method according to Clinical and Laboratory Standards Institute recommendations.

Results: Blood culture results were positive in 44.7% of the patients. Late-onset sepsis was present in 53.92%, and early-onset sepsis was observed in 46.08% of the cases. The best overall sensitivity among Gram-negative isolates was to Amikacin, followed by Gentamycin and Meropenem. Gram-positive isolates had sensitivity to Chloramphenicol, tetracycline, Linezolid, Tetracycline, Vancomycin, and Piperacillin.

Conclusion: The most common causes of newborn sepsis in this study were Gram-negative organisms (Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii) and Gram-positive organisms (Staphylococcus aureus), the majority of which are antibiotic-resistant.

PREVALENCE OF ANEMIA AND ITS ASSOCIATION WITH BODY MASS INDEX AND PLASMA PROTEIN IN MEDICAL STUDENTS OF KOLHAN REGION OF JHARKHAND – A CROSSSECTIONAL STUDY

NEELAM CHOUDHARY — 2024-04-07

Objectives: Anemia is one of the major public health concerns affecting almost 30% of the global population. Past studies have indicated that anemia is linked to lower body mass index (BMI) and plasma protein levels. This study aims to determine the prevalence of anemia among medical students and also to investigate its association with BMI and plasma proteins.

Methods: A cross-sectional study of 177 medical and paramedical students aged 18–21 years was done at MGM Medical College in Jamshedpur from September 2018 to July 2019. A Transasia EM200 automated chemical analyzer was used to identify plasma protein using the biuret approach. HemoCOR-D (cyanmethemoglobin) was quantified by a colorimetric instrument. A colorimetric apparatus measured hemoglobin (Hb) with HemoCOR-D (cyanmethemoglobin).

Results: There are a total of 177 pupils. The study included 48% (n=85) females and 52% (n=92) males. Males had a mean age of 20.03± 0.99 years while females had a mean age of 20.16±0.937 years. Males had greater Hb levels and protein levels than females, with averages of 13.61 ± 1.43 and 7.77± 0.93, respectively. Males had a frequency of anemia of 15.4%, while females had a prevalence of 70.9%. The researchers discovered a statistically significant link between anemic and non-anemic girls’ plasma protein levels (p=0.07), protein intake and plasma protein (p=0.048), and BMI and Hb (p=0.022).

Conclusions: A significant association was found between daily protein intakes with plasma protein. The association between BMI and hemoglobin was also found significant.

A COMPARATIVE ANALYSIS OF THYROID CYTOLOGY CLASSIFICATION SYSTEMS: BETHESDA SYSTEM VERSUS FRCPATH, AUSTRALIAN, JAPANESE, AND ITALIAN APPROACHES IN THE INDIAN CONTEXT

PUJA SINGH — 2024-04-07

Objectives: There are many different popular coding systems in use across the world such as Bethesda, FRCPath (UK), the Australian reporting system, the Japanese Thyroid Reporting System, and the Italian classification system. By evaluating the strengths and weaknesses of each system concerning the Indian patient population and health-care infrastructure, this study aims to identify the most suitable approach for accurate thyroid cytology reporting and patient management in India.

Methods: A retrospective cohort study was conducted at a tertiary care center in central India following due ethical clearance. A total of 208 cases met the inclusion criteria of this study. The clinical records and the cytological records of these cases were independently analyzed and reclassified by a group of pathologists into all the above-stated thyroid coding systems. Data were collected and analyzed using Microsoft Excel 2016.

Results: Approximately 88.46% of the cases were women. Medial lobe was the most common site with prevalence of 80.29%. Colloid goiter is most common cytological diagnosis. Only for 11 cases, there was a difference in coding among these coding systems. Codes 1 and 2 are same in all the coding systems and the main difference identified for cases with Bethesda Codes 3 and 5.

Conclusion: The Bethesda coding is simple and reliable for coding thyroid FNAC as it has been reported over the period. The other coding systems can also be used but they will have their long learning curve. Furthermore, Bethesda is being used universally making the report understandable.

PREVALENCE OF SPONDYLOLISTHESIS IN PATIENTS OF CHRONIC LOW BACK PAIN

AMRITA PAREEK — 2024-04-07

Objective: The objective of the study is to assess the prevalence of spondylolisthesis in patients with chronic low back pain (CLBP).

Methods: This was a cross-sectional and observational study, conducted on patients of CLBP presented and evaluated with relevant radiological investigation in neurosurgery clinics in Rajasthan.

Results: The mean age of the study population was 46.62 years with female dominance (73.85%). 63.96% had moderate work followed by severe work 28.98%. The prevalence of spondylolisthesis was 16.61% (47).

Conclusion: The present study’s prevalence of lumbar spondylolisthesis was more prone in middle-aged females.

A CASE REPORT ON ANGIOMYXOMA OF VULVA - A RARE MESENCHYMAL TUMOR IN REPRODUCTIVE AGE GROUP WOMEN

ASHISHJOT KAUR — 2024-04-07

Aggressive angiomyxoma (AAM) is a mesenchymal tumor that arises from perineal or lower pelvic connective tissue. This tumor is locally aggressive. It has mostly been found in reproductive age group females. The correct diagnosis and follow-up of this tumor are very important, as it has similar presentation to many other vulvar masses and it tends to recur due to its locally aggressive nature. We report here a case of 40-year-old female P2L2, who presented with a soft, non-tender swelling on the left labia majora.

RARE CASE OF LIPEMIA RETINALIS IN A 24 DAY OLD INFANT

RAJEETA BASUR — 2024-04-07

We present a rare case of Lipemia Retinalis in a 24 day old Infant due Hyperlipoprotienimia type 1.

CONCURRENT OCCURRENCE OF PERIAMPULLARY DISTAL CHOLANGIOCARCINOMA AND MUCINOUS CYSTADENOCARCINOMA OF THE OVARY: A RARE CASE REPORT

BHAVYA KATARIA — 2024-04-07

In this case report, the clinical characteristics, diagnostic approach, and outcome of a patient with coexisting periampullary distal cholangiocarcinoma and mucinous cystadenocarcinoma of the ovary were described. This case underscores the importance of considering rare tumor combinations and highlights the diagnostic challenges and limited treatment options in such cases.