A. Bhattacharya, Shelka Dua, Anuj Chawla, Deepanjan Dey
Gastroesophageal reflux disease (GERD) is usually caused by dysfunction of the lower oesophageal sphincter (LES). However, abnormal patterns of oesophageal motility, such as ineffective oesophageal motility (IEM) or absent peristalsis, leading to impaired oesophageal clearance may also cause or aggravate GERD, leading to refractoriness to treatment. The objective of this study was to analyse oesophageal topographic metrics in patients presenting with symptoms of GERD, refractory to treatment. A retrospective analysis of 30 patients who presented with refractory heartburn/regurgitation of 06 months–03 years duration was done. pH metry (DeMeester score) was analysed. Sixteen channel high-resolution manometry (HRM) was used to study the oesophageal motility. Basal LES pressure (BLESP), integrated relaxation pressure (IRP) and 5 mL water swallows were assessed to determine the type of oesophageal peristalsis based on Chicago Classification version 4.0. The Statistical Package for the Social Sciences version 20 was used to analyse the data. Descriptive statistics such as percentage, mean, and standard deviation were reported. Karl-Pearson’s correlation was used to determine the correlation between age, BLESP and IRP. On analysis of 30 patients, 14 (46.66%) patients were found to have normal LES pressure and normal peristaltic wave, 07 (23.33%) patients showed hypotensive LES with normal peristaltic wave, and 09 (30%) were found to have IEM. About one-third of patients in our study showed IEM. HRM must be considered in patients with GERD, especially those who are refractory to treatment.
胃食管反流病（GERD）通常是由下食管括约肌（LES）功能障碍引起的。然而，食道运动异常模式，如食道无效运动（IEM）或蠕动缺失，导致食道清除功能受损，也可能引起或加重胃食管反流病，导致治疗无效。本研究的目的是分析有胃食管反流症状且难治的患者的食管地形测量指标。研究人员对 30 名病程在 06 个月至 03 年的难治性烧心/反胃患者进行了回顾性分析。使用十六通道高分辨率测压法（HRM）研究食道运动。根据芝加哥分类法 4.0 版评估了基础 LES 压力（BLESP）、综合松弛压力（IRP）和 5 mL 吞水量，以确定食管蠕动的类型。数据分析使用的是社会科学统计软件包 20 版。报告了百分比、平均值和标准差等描述性统计数据。对 30 名患者进行分析后发现，14 名（46.66%）患者的 LES 压力正常且蠕动波正常，07 名（23.33%）患者的 LES 血压过低且蠕动波正常，09 名（30%）患者患有 IEM。胃食管反流病患者，尤其是那些难治性胃食管反流病患者，必须考虑使用 HRM。
{"title":"Oesophageal pressure topographic metrics in refractory gastroesophageal reflux disease: An Indian perspective","authors":"A. Bhattacharya, Shelka Dua, Anuj Chawla, Deepanjan Dey","doi":"10.25259/ijpp_31_2024","DOIUrl":"https://doi.org/10.25259/ijpp_31_2024","url":null,"abstract":"\u0000\u0000Gastroesophageal reflux disease (GERD) is usually caused by dysfunction of the lower oesophageal sphincter (LES). However, abnormal patterns of oesophageal motility, such as ineffective oesophageal motility (IEM) or absent peristalsis, leading to impaired oesophageal clearance may also cause or aggravate GERD, leading to refractoriness to treatment. The objective of this study was to analyse oesophageal topographic metrics in patients presenting with symptoms of GERD, refractory to treatment.\u0000\u0000\u0000\u0000A retrospective analysis of 30 patients who presented with refractory heartburn/regurgitation of 06 months–03 years duration was done. pH metry (DeMeester score) was analysed. Sixteen channel high-resolution manometry (HRM) was used to study the oesophageal motility. Basal LES pressure (BLESP), integrated relaxation pressure (IRP) and 5 mL water swallows were assessed to determine the type of oesophageal peristalsis based on Chicago Classification version 4.0. The Statistical Package for the Social Sciences version 20 was used to analyse the data. Descriptive statistics such as percentage, mean, and standard deviation were reported. Karl-Pearson’s correlation was used to determine the correlation between age, BLESP and IRP.\u0000\u0000\u0000\u0000On analysis of 30 patients, 14 (46.66%) patients were found to have normal LES pressure and normal peristaltic wave, 07 (23.33%) patients showed hypotensive LES with normal peristaltic wave, and 09 (30%) were found to have IEM.\u0000\u0000\u0000\u0000About one-third of patients in our study showed IEM. HRM must be considered in patients with GERD, especially those who are refractory to treatment.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. A. Solomon, S. K. Bharathi, R. Vijayaraghavan, Madhan Krishnan
This study aimed to see whether a stress reduction programme based on mindfulness could reduce stress in substance-dependence patients. A randomised control design was used. At the addiction centre, 100 drug addicts were receiving treatment. Using a simple random sampling method, samples are split into 50 experimental drug abuse patient groups and 50 control drug abuse patient groups. Perceived stress scale (PSS) is used to assess the pre-test stress used to analyse the results. The mindfulness-based stress reduction (MBSR) program spanned 8 weeks and catered to a maximum of 25 participants. Each day, two sessions lasting 1 h each were conducted. At the end of the programme, the PSS would be completed once more to assess post-test perceived stress levels and compare them to the outcomes. The mean values for the control pre-test, experimental pre-test, control post-test and experimental post-test are 36.9, 36.0, 33.4 and 18.9, respectively. A two-way repeated-measures analysis of variance revealed significant differences among the groups (control and experimental), the tests (pre-test and post-test) and the interaction between the group and test (P < 0.001, < 0.001 and < 0.001, respectively). The control group’s pre-test and post-test did not demonstrate significance (P = 0.265). Conversely, the experimental group exhibited a significant decrease in PSS Score from the pre-test to the post-test (P < 0.001). This shows that the intervention is beneficial in decreasing the PSS score of the participants. Individuals receiving treatment at the addiction facility may discover that MBSR proves to be an efficient approach for alleviating stress.
{"title":"A randomised controlled trial of mindfulness-based stress reduction programme for substance abuse patients in deaddiction centre","authors":"D. A. Solomon, S. K. Bharathi, R. Vijayaraghavan, Madhan Krishnan","doi":"10.25259/ijpp_373_2022","DOIUrl":"https://doi.org/10.25259/ijpp_373_2022","url":null,"abstract":"\u0000\u0000This study aimed to see whether a stress reduction programme based on mindfulness could reduce stress in substance-dependence patients. A randomised control design was used.\u0000\u0000\u0000\u0000At the addiction centre, 100 drug addicts were receiving treatment. Using a simple random sampling method, samples are split into 50 experimental drug abuse patient groups and 50 control drug abuse patient groups. Perceived stress scale (PSS) is used to assess the pre-test stress used to analyse the results. The mindfulness-based stress reduction (MBSR) program spanned 8 weeks and catered to a maximum of 25 participants. Each day, two sessions lasting 1 h each were conducted. At the end of the programme, the PSS would be completed once more to assess post-test perceived stress levels and compare them to the outcomes.\u0000\u0000\u0000\u0000The mean values for the control pre-test, experimental pre-test, control post-test and experimental post-test are 36.9, 36.0, 33.4 and 18.9, respectively. A two-way repeated-measures analysis of variance revealed significant differences among the groups (control and experimental), the tests (pre-test and post-test) and the interaction between the group and test (P < 0.001, < 0.001 and < 0.001, respectively). The control group’s pre-test and post-test did not demonstrate significance (P = 0.265). Conversely, the experimental group exhibited a significant decrease in PSS Score from the pre-test to the post-test (P < 0.001). This shows that the intervention is beneficial in decreasing the PSS score of the participants.\u0000\u0000\u0000\u0000Individuals receiving treatment at the addiction facility may discover that MBSR proves to be an efficient approach for alleviating stress.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neetha Shastry, N. Ullal, A. Thattil, D. S. Maitreyee, Shwetha Ranjeet Bangera, L. Mahmood
Medical education in India has shifted to a learner-centric approach, with early clinical exposure (ECE) mandated for 1st-year medical students. Implementing ECE in a clinical setting is challenging, leading to the adoption of simulation-based ECE (SB-ECE). However, faculty perceptions of integrating simulation with ECE, especially for 1st-year undergraduates, remain understudied. This study aimed to explore faculty perceptions of the feasibility, advantages and challenges of using simulations in ECE, providing valuable insights for future studies. We conducted a qualitative study with intentional sampling according to predefined criteria. We interviewed 12 faculty members at a medical teaching institution using a topic guide. Thematic analysis was then performed on the data collected from the 12 interviews to identify the key themes and patterns. Most of the faculty interviewed considered the use of simulation in ECE as an excellent adjunct to teaching in a clinical setting. However, the faculty also noted a few challenges, such as fidelity, time constraints and the ratio of students to faculty members, in implementing SB-ECE. Faculty members recognised the integration of simulation into ECE as a highly effective tool for enhancing the learning of basic sciences and fostering attitudes, ethics and professionalism in medical education, with the main challenge being the logistical demand for implementing simulation-based sessions.
{"title":"Faculty perceptions of the efficacy, benefits and challenges of simulation-based early clinical exposure for medical students in India: A qualitative study","authors":"Neetha Shastry, N. Ullal, A. Thattil, D. S. Maitreyee, Shwetha Ranjeet Bangera, L. Mahmood","doi":"10.25259/ijpp_537_2023","DOIUrl":"https://doi.org/10.25259/ijpp_537_2023","url":null,"abstract":"\u0000\u0000Medical education in India has shifted to a learner-centric approach, with early clinical exposure (ECE) mandated for 1st-year medical students. Implementing ECE in a clinical setting is challenging, leading to the adoption of simulation-based ECE (SB-ECE). However, faculty perceptions of integrating simulation with ECE, especially for 1st-year undergraduates, remain understudied. This study aimed to explore faculty perceptions of the feasibility, advantages and challenges of using simulations in ECE, providing valuable insights for future studies.\u0000\u0000\u0000\u0000We conducted a qualitative study with intentional sampling according to predefined criteria. We interviewed 12 faculty members at a medical teaching institution using a topic guide. Thematic analysis was then performed on the data collected from the 12 interviews to identify the key themes and patterns.\u0000\u0000\u0000\u0000Most of the faculty interviewed considered the use of simulation in ECE as an excellent adjunct to teaching in a clinical setting. However, the faculty also noted a few challenges, such as fidelity, time constraints and the ratio of students to faculty members, in implementing SB-ECE.\u0000\u0000\u0000\u0000Faculty members recognised the integration of simulation into ECE as a highly effective tool for enhancing the learning of basic sciences and fostering attitudes, ethics and professionalism in medical education, with the main challenge being the logistical demand for implementing simulation-based sessions.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Erratum: Breath characteristics in four volitional yoga breathing practices","authors":"Kumari Prasoon, S. Sharma, Shirley Telles","doi":"10.25259/ijpp_169_2024","DOIUrl":"https://doi.org/10.25259/ijpp_169_2024","url":null,"abstract":"","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deep brain stimulation affects the pathophysiology of various motor disorders including essential tremor, Parkinson’s disease (PD) and dystonia. The motor deficits from PD have been explained by the firing rate and pattern models. However, due to the variability between patients’ electrophysiology, the pathophysiology for PD is difficult to sparse apart. Neither model can fully explain the spectrum of patient presentations. The localisation and stimulation of various structures including the subthalamic nucleus, globus pallidus internus and ventral intermediate nucleus lead to different effects on the patient’s motor symptoms. This group of targeted structures affects the models of PD in distinct ways. This review aims to explain the models of PD and the effects of stimulation in each structure.
{"title":"Deep brain stimulation for the heterogeneous pathophysiology of Parkinson’s disease","authors":"Rajiv Dharnipragada","doi":"10.25259/ijpp_48_2023","DOIUrl":"https://doi.org/10.25259/ijpp_48_2023","url":null,"abstract":"Deep brain stimulation affects the pathophysiology of various motor disorders including essential tremor, Parkinson’s disease (PD) and dystonia. The motor deficits from PD have been explained by the firing rate and pattern models. However, due to the variability between patients’ electrophysiology, the pathophysiology for PD is difficult to sparse apart. Neither model can fully explain the spectrum of patient presentations. The localisation and stimulation of various structures including the subthalamic nucleus, globus pallidus internus and ventral intermediate nucleus lead to different effects on the patient’s motor symptoms. This group of targeted structures affects the models of PD in distinct ways. This review aims to explain the models of PD and the effects of stimulation in each structure.","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bhawana Thapa, S. S. Bhandari, Sanjay Kumar, N. B. Laskar, Saumen Gupta
Given the rising concern over depression and anxiety among adolescents, this study aims to investigate their potential impact on respiratory health by comparing pulmonary function test (PFT) parameters between healthy adolescents and those with either depression or anxiety or those exhibiting symptoms of both depression and anxiety. In this cross-sectional study, a random sample of school-going adolescents aged 13–18 years from various schools in Sikkim, both males and females, were selected. Depression and anxiety were assessed using the Revised Children’s Anxiety and Depression Scale-25, and pulmonary function was measured using a computerised spirometer-Spirolab III. The recorded variables included forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), FEV1/FVC ratio, peak expiratory flow rate (PEFR) and forced expiratory flow at 25–75% (FEF 25–75%). Significant differences emerged in FVC (P = 0.034), PEFR (P = 0.013) and FEF 25–75% (P = 0.023) between healthy and depressed adolescents aged 13–18 years. Similarly, a significant difference was observed in PEFR (P = 0.022) and FEF 25–75% (P = 0.002) between healthy adolescents and those with symptoms of both depression and anxiety. These differences were more pronounced among students in higher grades. Furthermore, significant differences in PEFR (P = 0.015) and FEF 25–75% (P ≤ 0.001) were found while comparing healthy males and males with symptoms of both depression and anxiety. However, no such disparities were seen in girls. There was no significant difference in any of the parameters when compared between the healthy group and those with anxiety. Depressed adolescents exhibited significantly reduced FVC, PEFR and FEF 25–75% compared to their healthy counterparts, despite being otherwise healthy. This negative association was more pronounced in the higher age group. However, anxious adolescents did not show any significant difference in PFT compared to healthy peers.
{"title":"Comparative analysis of pulmonary function in school-going adolescents: Examining the impact of depression and anxiety","authors":"Bhawana Thapa, S. S. Bhandari, Sanjay Kumar, N. B. Laskar, Saumen Gupta","doi":"10.25259/ijpp_572_2023","DOIUrl":"https://doi.org/10.25259/ijpp_572_2023","url":null,"abstract":"\u0000\u0000Given the rising concern over depression and anxiety among adolescents, this study aims to investigate their potential impact on respiratory health by comparing pulmonary function test (PFT) parameters between healthy adolescents and those with either depression or anxiety or those exhibiting symptoms of both depression and anxiety.\u0000\u0000\u0000\u0000In this cross-sectional study, a random sample of school-going adolescents aged 13–18 years from various schools in Sikkim, both males and females, were selected. Depression and anxiety were assessed using the Revised Children’s Anxiety and Depression Scale-25, and pulmonary function was measured using a computerised spirometer-Spirolab III. The recorded variables included forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), FEV1/FVC ratio, peak expiratory flow rate (PEFR) and forced expiratory flow at 25–75% (FEF 25–75%).\u0000\u0000\u0000\u0000Significant differences emerged in FVC (P = 0.034), PEFR (P = 0.013) and FEF 25–75% (P = 0.023) between healthy and depressed adolescents aged 13–18 years. Similarly, a significant difference was observed in PEFR (P = 0.022) and FEF 25–75% (P = 0.002) between healthy adolescents and those with symptoms of both depression and anxiety. These differences were more pronounced among students in higher grades. Furthermore, significant differences in PEFR (P = 0.015) and FEF 25–75% (P ≤ 0.001) were found while comparing healthy males and males with symptoms of both depression and anxiety. However, no such disparities were seen in girls. There was no significant difference in any of the parameters when compared between the healthy group and those with anxiety.\u0000\u0000\u0000\u0000Depressed adolescents exhibited significantly reduced FVC, PEFR and FEF 25–75% compared to their healthy counterparts, despite being otherwise healthy. This negative association was more pronounced in the higher age group. However, anxious adolescents did not show any significant difference in PFT compared to healthy peers.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141369526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vishwa Karanth, Thirumal Yerragunta, Nishanth Sampath, V. Yerramneni, Ramanadha Reddy Kanala, E. P. Kumar, Anand Govindaraj
The objective of this study was to evaluate the utility of facial motor-evoked potentials (FMEPs) as a significant part of multimodal intraoperative neurophysiological monitoring (IONM) for preserving facial nerve (FN) function in vestibular schwannoma surgery guiding the resection, and predicting outcome. This prospective observational study included 35 cases of vestibular schwannomas operated under multimodal IONM using free-running electromyography (EMG), triggered EMG (with both monopolar probe and suction stimulator), FMEPs, electroencephalography and its spectral derivatives and train-of-four testing. Direct stimulation using a monopolar probe helped in the identification of FN and guiding tumour resection. The suction stimulator probe was used for quasi-continuous stimulus delivery and FN mapping. FMEPs helped in the assessment of the integrity of FN. In 14 cases, there was a single instance, and in 11 cases, there was more than one instance of a significant drop in FMEPs. Sixteen cases had >50% fall in FMEPs during surgery. In 28 cases, the proximal stimulation threshold for FN was ≤0.1 mA at the end of the tumour resection. At the end of the first week following surgery, only 42.9% of the cases had good functional preservation (House–Brackmann [HB] Grade I or II) of FN, which increased to 78.8% at the end of one year. The remaining 21.2% had HB Grade III weakness. Percentage drop in FMEP amplitude and final FMEP amplitude correlated significantly (P < 0.01) with the post-operative HB Grade at 1st week, 3, 6 and 12 months following surgery. FMEPs, as a significant component of multimodal IONM, provide a real-time assessment of FN function during surgery, facilitate safe maximal resection, predict immediate post-operative FN outcomes, and improve long-term FN function by minimising the cumulative insult inflicted on the FN during surgery.
{"title":"Multimodal intraoperative neurophysiological monitoring with special emphasis on facial MEPs for facial nerve preservation in vestibular schwannoma surgeries: Surgical nuances and outcome predictability","authors":"Vishwa Karanth, Thirumal Yerragunta, Nishanth Sampath, V. Yerramneni, Ramanadha Reddy Kanala, E. P. Kumar, Anand Govindaraj","doi":"10.25259/ijpp_77_2024","DOIUrl":"https://doi.org/10.25259/ijpp_77_2024","url":null,"abstract":"\u0000\u0000The objective of this study was to evaluate the utility of facial motor-evoked potentials (FMEPs) as a significant part of multimodal intraoperative neurophysiological monitoring (IONM) for preserving facial nerve (FN) function in vestibular schwannoma surgery guiding the resection, and predicting outcome.\u0000\u0000\u0000\u0000This prospective observational study included 35 cases of vestibular schwannomas operated under multimodal IONM using free-running electromyography (EMG), triggered EMG (with both monopolar probe and suction stimulator), FMEPs, electroencephalography and its spectral derivatives and train-of-four testing. Direct stimulation using a monopolar probe helped in the identification of FN and guiding tumour resection. The suction stimulator probe was used for quasi-continuous stimulus delivery and FN mapping. FMEPs helped in the assessment of the integrity of FN.\u0000\u0000\u0000\u0000In 14 cases, there was a single instance, and in 11 cases, there was more than one instance of a significant drop in FMEPs. Sixteen cases had >50% fall in FMEPs during surgery. In 28 cases, the proximal stimulation threshold for FN was ≤0.1 mA at the end of the tumour resection. At the end of the first week following surgery, only 42.9% of the cases had good functional preservation (House–Brackmann [HB] Grade I or II) of FN, which increased to 78.8% at the end of one year. The remaining 21.2% had HB Grade III weakness. Percentage drop in FMEP amplitude and final FMEP amplitude correlated significantly (P < 0.01) with the post-operative HB Grade at 1st week, 3, 6 and 12 months following surgery.\u0000\u0000\u0000\u0000FMEPs, as a significant component of multimodal IONM, provide a real-time assessment of FN function during surgery, facilitate safe maximal resection, predict immediate post-operative FN outcomes, and improve long-term FN function by minimising the cumulative insult inflicted on the FN during surgery.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141370188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Souvik Majumder, Sayan Chattaraj, Sabyasachi Roy, Subhadip Saha
Hypercalcaemia is a relatively less common yet life-threatening electrolyte disorder and is caused by parathyroid-dependent and independent factors. This case report describes an elderly lady, a known patient of stable hypothyroidism, hypertension, type 2 diabetes mellitus and non-oliguric chronic kidney disease-IV who presented with complaints of gradually worsening drowsiness. Investigations revealed a hypercalcemic crisis; all other contributory investigations were unremarkable. She was put on intravenous saline rehydration, furosemide, pamidronate, and calcitonin. However, due to new-onset haemodynamic instability, cardiomyopathy, and worsening renal parameters, haemodialysis was initiated to reduce the serum calcium levels rapidly. The patient remained asymptomatic after that, and her renal parameters improved to near baseline levels, though cardiac function improvement was not obtained at the end of one month. History elicited from the patient after her neurological improvement revealed that failing to interpret the prescription of three orthopaedics she had visited lately, she followed all simultaneously and had thus consumed toxic levels of calcium and Vitamin D. Medication reconciliatory measures such as e-prescribing, computerised drug dispensing system, automated patient drug dispensing boxes and ‘brown-bagging’ all ongoing medications during the physician visits would ensure reduction in medication errors, thus avoiding adverse events, reducing uncalled for mortalities and morbidities and healthcare cost.
{"title":"Medication reconciliation to minimise medication errors: Iatrogenic hypercalcaemia as a case report","authors":"Souvik Majumder, Sayan Chattaraj, Sabyasachi Roy, Subhadip Saha","doi":"10.25259/ijpp_375_2023","DOIUrl":"https://doi.org/10.25259/ijpp_375_2023","url":null,"abstract":"Hypercalcaemia is a relatively less common yet life-threatening electrolyte disorder and is caused by parathyroid-dependent and independent factors. This case report describes an elderly lady, a known patient of stable hypothyroidism, hypertension, type 2 diabetes mellitus and non-oliguric chronic kidney disease-IV who presented with complaints of gradually worsening drowsiness. Investigations revealed a hypercalcemic crisis; all other contributory investigations were unremarkable. She was put on intravenous saline rehydration, furosemide, pamidronate, and calcitonin. However, due to new-onset haemodynamic instability, cardiomyopathy, and worsening renal parameters, haemodialysis was initiated to reduce the serum calcium levels rapidly. The patient remained asymptomatic after that, and her renal parameters improved to near baseline levels, though cardiac function improvement was not obtained at the end of one month. History elicited from the patient after her neurological improvement revealed that failing to interpret the prescription of three orthopaedics she had visited lately, she followed all simultaneously and had thus consumed toxic levels of calcium and Vitamin D. Medication reconciliatory measures such as e-prescribing, computerised drug dispensing system, automated patient drug dispensing boxes and ‘brown-bagging’ all ongoing medications during the physician visits would ensure reduction in medication errors, thus avoiding adverse events, reducing uncalled for mortalities and morbidities and healthcare cost.","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141370491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Yogisparan, P. Arun, S. Vijayabaskaran, Vidhya Sairam, K. Deepalakshmi, S. Mukundan, P. Thirumal, R. Vasanthi, L. Venkatakrishnan
The prevalence of dysphagia is 16–22%. Achalasia is characterised by impaired relaxation of the lower oesophageal sphincter (LES) and absent oesophageal peristalsis. Minimally invasive procedures, endoscopic pneumatic balloon dilatation (PD) and peroral endoscopic myotomy (POEM) are treatments of choice. We aimed to assess the manometric profile of patients presented with dysphagia and pre- and post-LES pressure and integrated relaxation pressure (IRP) of patients who underwent PD and POEM. One hundred and twenty-nine patients presented with dysphagia underwent high resolution oesophageal manometry (HREM). Manometric parameters: IRP, LES and pattern of motility were noted. According to Chicago classification 4.0, those who are diagnosed with achalasia underwent PD (17) and POEM (15). Statistical analysis was performed using the Statistical Package for the Social Sciences version 28. Pre- and post-procedure values (IRP and basal LES) were compared using the Wilcoxon signed-rank test. Out of 129 patients with dysphagia, 57 had increased IRP and 75 had simultaneous motility. The mean LES pressure and IRP were found to be 28 ± 19.82 and 17 ± 14.04 mmHg, respectively. On analysis, of patients who underwent procedures PD (17) and POEM (15), a statistically significant decrease in IRP was observed in patients with post POEM compared to post PD status (P = 0.005 and 0.017, respectively). Reduced basal LES pressure was observed in patients with post-POEM status compared to post-PD status, which was not statistically significant. About 44% of patients presented with dysphagia were diagnosed with achalasia cardia. POEM procedure was found to be more effective compared to pneumatic dilatation.
{"title":"Manometric profile of patients presented with dysphagia – A hospital-based descriptive study","authors":"P. Yogisparan, P. Arun, S. Vijayabaskaran, Vidhya Sairam, K. Deepalakshmi, S. Mukundan, P. Thirumal, R. Vasanthi, L. Venkatakrishnan","doi":"10.25259/ijpp_9_2024","DOIUrl":"https://doi.org/10.25259/ijpp_9_2024","url":null,"abstract":"\u0000\u0000The prevalence of dysphagia is 16–22%. Achalasia is characterised by impaired relaxation of the lower oesophageal sphincter (LES) and absent oesophageal peristalsis. Minimally invasive procedures, endoscopic pneumatic balloon dilatation (PD) and peroral endoscopic myotomy (POEM) are treatments of choice. We aimed to assess the manometric profile of patients presented with dysphagia and pre- and post-LES pressure and integrated relaxation pressure (IRP) of patients who underwent PD and POEM.\u0000\u0000\u0000\u0000One hundred and twenty-nine patients presented with dysphagia underwent high resolution oesophageal manometry (HREM). Manometric parameters: IRP, LES and pattern of motility were noted. According to Chicago classification 4.0, those who are diagnosed with achalasia underwent PD (17) and POEM (15). Statistical analysis was performed using the Statistical Package for the Social Sciences version 28. Pre- and post-procedure values (IRP and basal LES) were compared using the Wilcoxon signed-rank test.\u0000\u0000\u0000\u0000Out of 129 patients with dysphagia, 57 had increased IRP and 75 had simultaneous motility. The mean LES pressure and IRP were found to be 28 ± 19.82 and 17 ± 14.04 mmHg, respectively. On analysis, of patients who underwent procedures PD (17) and POEM (15), a statistically significant decrease in IRP was observed in patients with post POEM compared to post PD status (P = 0.005 and 0.017, respectively). Reduced basal LES pressure was observed in patients with post-POEM status compared to post-PD status, which was not statistically significant.\u0000\u0000\u0000\u0000About 44% of patients presented with dysphagia were diagnosed with achalasia cardia. POEM procedure was found to be more effective compared to pneumatic dilatation.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141375056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Both conventional and newer antiepileptic drugs (AEDs) are being used as initial monotherapy in epileptic patients. However, differences in their quality of life (QoL) scores have not been researched considerably. The objective of this study was to determine the overall QoL employing the QoL in Epilepsy Inventory (QOLIE-31) questionnaire This prospective comparative research was conducted on 126 patients with epilepsy. Two equal groups, A and B, consisting of 63 patients each, were allocated conventional and newer AEDs, respectively. The allotment of the AED was as per the decision of the treating physician based on patient and drug characteristics. QoL was assessed at 0 and 12 weeks using questionnaire QOLIE-31. The QoL showed significant improvement with newer AEDs, while conventional AEDs worsened it. The subscales of QOLIE-31 showing the statistical difference in the mean percentage change were worry related to seizure, energy/fatigue, cognitive function, and medication effects. QoL did show a statistically significant difference in young and more educated patients. The patients who had generalised tonic-clonic seizures (GTCS) demonstrated a better QoL than patients with partial seizures, as per the questionnaire. The findings of our study suggest that QoL is better with newer AEDs. There seemed to be no effect of gender, age, or education on QoL; however, subjects with GTCS displayed a better QoL. Therefore, newer AEDs can be helpful in improving QoL in epileptic patients. Newer Antiepileptics as monotherapy may offer a better quality of life to epileptic patients.
传统和新型抗癫痫药物（AEDs）都被用作癫痫患者的初始单一疗法。然而，关于他们的生活质量（QoL）评分差异的研究并不多。这项前瞻性比较研究针对 126 名癫痫患者进行。A 组和 B 组各由 63 名患者组成，两组人数相等，分别分配到传统和新型 AEDs。AED的分配由主治医生根据患者和药物特征决定。QoL在0周和12周时使用QOLIE-31问卷进行评估。QOLIE-31的子量表在平均百分比变化上显示出统计学差异的是与癫痫发作有关的担忧、能量/疲劳、认知功能和药物效应。年轻和受教育程度较高的患者在 QoL 方面确实存在显著的统计学差异。根据问卷调查，全身强直-阵挛发作（GTCS）患者的 QoL 优于部分性发作患者。性别、年龄或教育程度似乎对 QoL 没有影响，但 GTCS 患者的 QoL 更好。因此，新型 AEDs 有助于改善癫痫患者的 QoL。新型抗癫痫药物作为单一疗法可提高癫痫患者的生活质量。
{"title":"Comparing the quality of life of patients with epilepsy receiving conventional and newer antiepileptics in a tertiary care hospital, Northern India","authors":"Meenu Thomas, D. K. Badyal, J. Pandian","doi":"10.25259/ijpp_479_2023","DOIUrl":"https://doi.org/10.25259/ijpp_479_2023","url":null,"abstract":"\u0000\u0000Both conventional and newer antiepileptic drugs (AEDs) are being used as initial monotherapy in epileptic patients. However, differences in their quality of life (QoL) scores have not been researched considerably. The objective of this study was to determine the overall QoL employing the QoL in Epilepsy Inventory (QOLIE-31) questionnaire\u0000\u0000\u0000\u0000This prospective comparative research was conducted on 126 patients with epilepsy. Two equal groups, A and B, consisting of 63 patients each, were allocated conventional and newer AEDs, respectively. The allotment of the AED was as per the decision of the treating physician based on patient and drug characteristics. QoL was assessed at 0 and 12 weeks using questionnaire QOLIE-31.\u0000\u0000\u0000\u0000The QoL showed significant improvement with newer AEDs, while conventional AEDs worsened it. The subscales of QOLIE-31 showing the statistical difference in the mean percentage change were worry related to seizure, energy/fatigue, cognitive function, and medication effects. QoL did show a statistically significant difference in young and more educated patients. The patients who had generalised tonic-clonic seizures (GTCS) demonstrated a better QoL than patients with partial seizures, as per the questionnaire.\u0000\u0000\u0000\u0000The findings of our study suggest that QoL is better with newer AEDs. There seemed to be no effect of gender, age, or education on QoL; however, subjects with GTCS displayed a better QoL. Therefore, newer AEDs can be helpful in improving QoL in epileptic patients. Newer Antiepileptics as monotherapy may offer a better quality of life to epileptic patients.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141374209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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