International Journal of Cardiovascular and Cerebrovascular Disease, 2016
The US FDA in 2012 released a safety announcement of risk of cognitive impairment with statin use... more The US FDA in 2012 released a safety announcement of risk of cognitive impairment with statin use. However, because this probable adverse event is conflicting with findings of several studies that demonstrate a potential benefit on cognition with the use of statins, we thought to do further analysis to clear the confusion. Reports of statin-associated cognitive impairment were found principally in few observational studies (e.g., case reports/series) and occasionally in few randomised trials. On the contrary, in the majority of observational studies and randomized controlled clinical trials, statins were found to have either a no effects or rather beneficial effect on cognition. However, should it happens, switching from lipophilic to hydrophilic statins such as Rosuvastatin may resolve this issue of cognitive impairment. Therefore, in spite of some concerns of cognitive impairment with statins, the current evidences do not favour the changing practice with respect to statin use, though one needs to be vigilant and address efficiently if it occurs at all.
International Journal of Basic & Clinical Pharmacology, 2019
Background: LSCS is a routine obstetric procedure performed under general anesthesia (GA) or regi... more Background: LSCS is a routine obstetric procedure performed under general anesthesia (GA) or regional anesthesia (RA). Choice of anesthesia depends on factors like gestational age, parity, co-morbidities, urgency of situation, etc. Both GA and RA involve the use of various medications which may influence maternal and neonatal outcome. As there are few studies comparing maternal and fetal outcome in RA and GA for LSCS in Indian population, the present study was taken up. Objectives of the study was to compare the maternal and neonatal outcome after RA and GA for LSCS.Methods: 60 subjects with indications for LSCS were assigned non-randomly into two groups, 30 for GA and 30 for RA, at the discretion of anesthesiologist. The demographic, anthropometric and clinical data was recorded for all subjects. The maternal outcome after RA and GA for LSCS was assessed by parameters like maternal blood loss, postoperative pain, postoperative nausea and vomiting, maternal satisfaction and neonatal...
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Calcium channel blockers (CCB) like amlodipine, S (-) amlodipine and cilnidipine, etc.... more BACKGROUND Calcium channel blockers (CCB) like amlodipine, S (-) amlodipine and cilnidipine, etc. have established place in the treatment of hypertension (HTN). As perceived by most of the physicians, they have comparative antihypertensive efficacy. However, available evidences suggest varied differences in incidence of pedal oedema. Aim-This survey was planned to understand real-world clinical practice pattern of Indian physicians for usage of various antihypertensive agents with emphasis on CCBs and whether differential incidence of oedema with CCBs is encountered in their clinical practice. MATERIALS AND METHODS Survey questionnaire consisting of 10 questions about preferred antihypertensive choice for different subsets of patients with HTN and efficacy and safety of S (-) amlodipine was prepared and validated in small group of physicians. Overall, 494 general physicians and cardiologists practising in India were approached for seeking their opinion on usage of various CCBs. Statistical Analysis-Data were expressed in percentage. Design-Prospective, cross sectional, questionnaire-based survey. RESULTS Amongst various anti-hypertensive agents, majority of the physicians preferred CCB as their initial drug of choice for patients with HTN (53.8%), HTN with CKD (41.1%), elderly (55.3%), and young (30.8%) patients. Though amlodipine was preferred by 75.7% physicians, pedal oedema was observed in >10% patients by 40.5% physicians. Most of the physicians rated S (-) amlodipine to have better efficacy (79.4%) and safety profile (88.3%) with decreased incidence of pedal oedema than racemic Amlodipine. CONCLUSION Available evidences suggest comparative efficacy of S (-) amlodipine and racemic amlodipine with varied differences in incidence of pedal oedema. However, our survey suggests better efficacy and safety of S (-) amlodipine over racemic amlodipine as opined by most of the physicians of India. The survey findings need to be further evaluated in randomised clinical trials.
International Journal of Research in Medical Sciences, 2017
Background: Recently, management of type 2 diabetes mellitus (T2DM) has changed with advent of no... more Background: Recently, management of type 2 diabetes mellitus (T2DM) has changed with advent of novel agents like DPP4i, SGLT2i and GLP-1 agonist. Of these, DPP4i have emerged as promising agents as monotherapy and as an add-on to metformin for improved glycaemic control. This survey was planned to explore current prescribing trends of physicians of India for the management of T2DM.Methods: This was a prospective, cross sectional, questionnaire-based survey of physicians and endocrinologist across different geographic areas in India. A survey questionnaire consisting of 10 questions related to management of T2DM in real-world clinical settings was prepared, validated in a small group of physicians and then administered to physicians and endocrinologists.Results: Responses from 502 physicians were received. About 60% physicians prefer DPP4i as first add-on to metformin followed by sulfonylurea (SU) (30%). Amongst DPP4i, vildagliptin and sitagliptin were preferred by 48% and 28% physi...
International Journal of Basic and Clinical Pharmacology, 2016
Background: Educational interventions targeting undergraduate medical students provide a great op... more Background: Educational interventions targeting undergraduate medical students provide a great opportunity to strengthen the efforts to promote rational prescribing and to decrease antimicrobial resistance. A better understanding of knowledge and beliefs of students about issues of antimicrobial use and resistance, and analysing the improvement after educational session, can assist in devising an effectively tailored educational intervention. The objective of this study was to comparison of knowledge and attitude about antimicrobial prescribing and awareness about resistance amongst medical, dental and nursing undergraduates before and after an educational session on antimicrobial use and resistance. Methods: A pre-validated questionnaire on knowledge and attitude about antimicrobial use and resistance was distributed to second year medical (80), dental (61) and nursing (37) students before and after an educational session. Results obtained were compared within and between the groups by using paired t-test and one-way ANOVA respectively. P-value<0.05 was considered to be statistically significant. Results: All groups showed statistically significant improvement in knowledge and attitude scores following the session on antimicrobial use and resistance (P<0.001). Post-session attitude scores of medical students were better than that of dental and was statistically significant (P=0.006). The pre-session evaluation showed that medical students had better knowledge and attitude about antimicrobial use and resistance as compared to dental (P<0.001) and nursing students(P<0.001). Conclusions: Significant improvement in attitude and basic knowledge following an educational session about antimicrobial prescribing and awareness about antimicrobial resistance in undergraduate students suggest establishment of special course on rational prescription of antimicrobials in undergraduate curriculum.
International Journal of Basic & Clinical Pharmacology, 2017
Background: Teratogenicity is a major cause of abortion, still birth and can result in longterm d... more Background: Teratogenicity is a major cause of abortion, still birth and can result in longterm disability with a significant impact on individuals, families, societies and healthcare systems. Drugs being one of the causes of teratogenicity, creating awareness among medical students, the future prescribing physicians, the rate of teratogenicity can be decreased. The objective was to compare the attitude and knowledge about teratogenicity among the medical undergraduates before and after an educational session on teratogenicity.Methods: A pre-validated semi structured questionnaire on attitude and knowledge about teratogenicity was distributed to 2nd year medical students (147) before and after teratogenicity educational session. Results obtained were compared within the group. Paired t test was used for within the group comparison. P-Value <0.05 was considered to be statistically significant.Results: Improvement in knowledge showed statistically significant improvement following ...
International Journal of Cardiovascular and Cerebrovascular Disease, 2016
The US FDA in 2012 released a safety announcement of risk of cognitive impairment with statin use... more The US FDA in 2012 released a safety announcement of risk of cognitive impairment with statin use. However, because this probable adverse event is conflicting with findings of several studies that demonstrate a potential benefit on cognition with the use of statins, we thought to do further analysis to clear the confusion. Reports of statin-associated cognitive impairment were found principally in few observational studies (e.g., case reports/series) and occasionally in few randomised trials. On the contrary, in the majority of observational studies and randomized controlled clinical trials, statins were found to have either a no effects or rather beneficial effect on cognition. However, should it happens, switching from lipophilic to hydrophilic statins such as Rosuvastatin may resolve this issue of cognitive impairment. Therefore, in spite of some concerns of cognitive impairment with statins, the current evidences do not favour the changing practice with respect to statin use, though one needs to be vigilant and address efficiently if it occurs at all.
International Journal of Basic & Clinical Pharmacology, 2019
Background: LSCS is a routine obstetric procedure performed under general anesthesia (GA) or regi... more Background: LSCS is a routine obstetric procedure performed under general anesthesia (GA) or regional anesthesia (RA). Choice of anesthesia depends on factors like gestational age, parity, co-morbidities, urgency of situation, etc. Both GA and RA involve the use of various medications which may influence maternal and neonatal outcome. As there are few studies comparing maternal and fetal outcome in RA and GA for LSCS in Indian population, the present study was taken up. Objectives of the study was to compare the maternal and neonatal outcome after RA and GA for LSCS.Methods: 60 subjects with indications for LSCS were assigned non-randomly into two groups, 30 for GA and 30 for RA, at the discretion of anesthesiologist. The demographic, anthropometric and clinical data was recorded for all subjects. The maternal outcome after RA and GA for LSCS was assessed by parameters like maternal blood loss, postoperative pain, postoperative nausea and vomiting, maternal satisfaction and neonatal...
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Calcium channel blockers (CCB) like amlodipine, S (-) amlodipine and cilnidipine, etc.... more BACKGROUND Calcium channel blockers (CCB) like amlodipine, S (-) amlodipine and cilnidipine, etc. have established place in the treatment of hypertension (HTN). As perceived by most of the physicians, they have comparative antihypertensive efficacy. However, available evidences suggest varied differences in incidence of pedal oedema. Aim-This survey was planned to understand real-world clinical practice pattern of Indian physicians for usage of various antihypertensive agents with emphasis on CCBs and whether differential incidence of oedema with CCBs is encountered in their clinical practice. MATERIALS AND METHODS Survey questionnaire consisting of 10 questions about preferred antihypertensive choice for different subsets of patients with HTN and efficacy and safety of S (-) amlodipine was prepared and validated in small group of physicians. Overall, 494 general physicians and cardiologists practising in India were approached for seeking their opinion on usage of various CCBs. Statistical Analysis-Data were expressed in percentage. Design-Prospective, cross sectional, questionnaire-based survey. RESULTS Amongst various anti-hypertensive agents, majority of the physicians preferred CCB as their initial drug of choice for patients with HTN (53.8%), HTN with CKD (41.1%), elderly (55.3%), and young (30.8%) patients. Though amlodipine was preferred by 75.7% physicians, pedal oedema was observed in >10% patients by 40.5% physicians. Most of the physicians rated S (-) amlodipine to have better efficacy (79.4%) and safety profile (88.3%) with decreased incidence of pedal oedema than racemic Amlodipine. CONCLUSION Available evidences suggest comparative efficacy of S (-) amlodipine and racemic amlodipine with varied differences in incidence of pedal oedema. However, our survey suggests better efficacy and safety of S (-) amlodipine over racemic amlodipine as opined by most of the physicians of India. The survey findings need to be further evaluated in randomised clinical trials.
International Journal of Research in Medical Sciences, 2017
Background: Recently, management of type 2 diabetes mellitus (T2DM) has changed with advent of no... more Background: Recently, management of type 2 diabetes mellitus (T2DM) has changed with advent of novel agents like DPP4i, SGLT2i and GLP-1 agonist. Of these, DPP4i have emerged as promising agents as monotherapy and as an add-on to metformin for improved glycaemic control. This survey was planned to explore current prescribing trends of physicians of India for the management of T2DM.Methods: This was a prospective, cross sectional, questionnaire-based survey of physicians and endocrinologist across different geographic areas in India. A survey questionnaire consisting of 10 questions related to management of T2DM in real-world clinical settings was prepared, validated in a small group of physicians and then administered to physicians and endocrinologists.Results: Responses from 502 physicians were received. About 60% physicians prefer DPP4i as first add-on to metformin followed by sulfonylurea (SU) (30%). Amongst DPP4i, vildagliptin and sitagliptin were preferred by 48% and 28% physi...
International Journal of Basic and Clinical Pharmacology, 2016
Background: Educational interventions targeting undergraduate medical students provide a great op... more Background: Educational interventions targeting undergraduate medical students provide a great opportunity to strengthen the efforts to promote rational prescribing and to decrease antimicrobial resistance. A better understanding of knowledge and beliefs of students about issues of antimicrobial use and resistance, and analysing the improvement after educational session, can assist in devising an effectively tailored educational intervention. The objective of this study was to comparison of knowledge and attitude about antimicrobial prescribing and awareness about resistance amongst medical, dental and nursing undergraduates before and after an educational session on antimicrobial use and resistance. Methods: A pre-validated questionnaire on knowledge and attitude about antimicrobial use and resistance was distributed to second year medical (80), dental (61) and nursing (37) students before and after an educational session. Results obtained were compared within and between the groups by using paired t-test and one-way ANOVA respectively. P-value<0.05 was considered to be statistically significant. Results: All groups showed statistically significant improvement in knowledge and attitude scores following the session on antimicrobial use and resistance (P<0.001). Post-session attitude scores of medical students were better than that of dental and was statistically significant (P=0.006). The pre-session evaluation showed that medical students had better knowledge and attitude about antimicrobial use and resistance as compared to dental (P<0.001) and nursing students(P<0.001). Conclusions: Significant improvement in attitude and basic knowledge following an educational session about antimicrobial prescribing and awareness about antimicrobial resistance in undergraduate students suggest establishment of special course on rational prescription of antimicrobials in undergraduate curriculum.
International Journal of Basic & Clinical Pharmacology, 2017
Background: Teratogenicity is a major cause of abortion, still birth and can result in longterm d... more Background: Teratogenicity is a major cause of abortion, still birth and can result in longterm disability with a significant impact on individuals, families, societies and healthcare systems. Drugs being one of the causes of teratogenicity, creating awareness among medical students, the future prescribing physicians, the rate of teratogenicity can be decreased. The objective was to compare the attitude and knowledge about teratogenicity among the medical undergraduates before and after an educational session on teratogenicity.Methods: A pre-validated semi structured questionnaire on attitude and knowledge about teratogenicity was distributed to 2nd year medical students (147) before and after teratogenicity educational session. Results obtained were compared within the group. Paired t test was used for within the group comparison. P-Value <0.05 was considered to be statistically significant.Results: Improvement in knowledge showed statistically significant improvement following ...
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