Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2022.11.2.53.57
Dr Rajbala, Sonali Beniwal, Mamta Khandelwal, T Mirthun Thomas
Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value > 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value >0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile.
{"title":"Comparison of intracuff alkalinized 2% lignocaine versus dexamethasone for attenuation of post operative laryngotracheal morbidity: a randomized comparative study","authors":"Dr Rajbala, Sonali Beniwal, Mamta Khandelwal, T Mirthun Thomas","doi":"10.18231/j.joapr.2022.11.2.53.57","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.53.57","url":null,"abstract":"Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value > 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value >0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255027","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2022.11.2.32.39
Amanjot Kaur, Amandeep Singh, Amit Varma
Background: A chronic, symmetrical & inflammatory disease, which affects small joints and later progresses to involve large joints. To promote remission and control further joint destruction, disease modifying ant rheumatic drugs are used. The role of low Vitamin D3 and High BMI have been found in pathogenesis of RA. Methodology: The study was designed by Department of pharmacology and patients were enrolled from department of medicine. This was an open label; prospective study. After obtaining, informed written consent, the subjects were randomized in three groups, Group 1-Methotrexate 7.5-15mg once a week, Group 2 - Hydroxychloroquine 200mg BD and Group 3-Methotrexate 7.5mg once a week Plus HCQ 200mg OD. The Vitamin D3 levels and Body mass index was assessed at first visit. The quality of life was assessed using DAS-28/CRP, RAPID-3 Score. Average cost-effective ratio was also calculated. The adverse effects were also assessed using WHO-UMC causality assessment. The statistical analysis of the data Graph pad insta version 3.1 was used, p-value <0.05 was considered statistically significant. Results: The mean changes in DAS28/CRP and RAPID-3 between baseline & 16 weeks was highly significant (p<0.0001) in all groups. Vitamin D3 levels at baseline was 19.14±0.42, 19.86±0.67 and 19.52±0.98 in all groups respectively. Conclusion: The vitamin D3 levels were in the lower limit and BMI was raised in almost all the patients at first visit. The efficacy of combination therapy is found to be better when given at initial stages of RA patients
{"title":"Assessing the impact of methotrexate, hydroxychloroquine, and their combination in rheumatoid arthritis: efficacy, safety, and cost analysis with vitamin D3 and BMI","authors":"Amanjot Kaur, Amandeep Singh, Amit Varma","doi":"10.18231/j.joapr.2022.11.2.32.39","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.32.39","url":null,"abstract":"Background: A chronic, symmetrical & inflammatory disease, which affects small joints and later progresses to involve large joints. To promote remission and control further joint destruction, disease modifying ant rheumatic drugs are used. The role of low Vitamin D3 and High BMI have been found in pathogenesis of RA. Methodology: The study was designed by Department of pharmacology and patients were enrolled from department of medicine. This was an open label; prospective study. After obtaining, informed written consent, the subjects were randomized in three groups, Group 1-Methotrexate 7.5-15mg once a week, Group 2 - Hydroxychloroquine 200mg BD and Group 3-Methotrexate 7.5mg once a week Plus HCQ 200mg OD. The Vitamin D3 levels and Body mass index was assessed at first visit. The quality of life was assessed using DAS-28/CRP, RAPID-3 Score. Average cost-effective ratio was also calculated. The adverse effects were also assessed using WHO-UMC causality assessment. The statistical analysis of the data Graph pad insta version 3.1 was used, p-value &lt;0.05 was considered statistically significant. Results: The mean changes in DAS28/CRP and RAPID-3 between baseline & 16 weeks was highly significant (p<0.0001) in all groups. Vitamin D3 levels at baseline was 19.14±0.42, 19.86±0.67 and 19.52±0.98 in all groups respectively. Conclusion: The vitamin D3 levels were in the lower limit and BMI was raised in almost all the patients at first visit. The efficacy of combination therapy is found to be better when given at initial stages of RA patients","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255154","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.58.64
Moinuddin Nadaf, Sharan S Patil, Raghavendra R Huchchannavar
Background: In a developing country like India the cost effectiveness of all polyethylene tibial components is a major boon, without compromising the functional outcome. In this study we have attempted to evaluate the functional outcome of all polyethylene tibial monoblock component in total knee arthroplasty. Methodology: The study was carried out on 86 patients who are operated for total knee arthroplasty with all polyethylene tibial monoblock component. Demographic, surgical and follow up data was collected from case sheets of patients and copied in Performa. The patients were called for five years follow up and examined in the outpatient department. Results: The mean age of study population was 62.8 years (range 50 – 72 years) with mean BMI of 27.6 kg/m2. Statistically significant improvement was seen in the range of movements in all the age groups. Both male and female patients had insignificant difference in knee scoring. Assessment of clinical functional abilities of knee scoring have observed to be higher in patients with lower BMI. Conclusion: Significant improvement in range of motion as well as knee score in all age range, emphasizes the fact that total knee arthroplasty with all polyethylene design in osteoarthritis is an excellent surgery to restore near normal life style.
{"title":"Functional assessment of all polyethylene tibial monoblock component in total knee arthroplasty","authors":"Moinuddin Nadaf, Sharan S Patil, Raghavendra R Huchchannavar","doi":"10.18231/j.joapr.2023.11.2.58.64","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.58.64","url":null,"abstract":"Background: In a developing country like India the cost effectiveness of all polyethylene tibial components is a major boon, without compromising the functional outcome. In this study we have attempted to evaluate the functional outcome of all polyethylene tibial monoblock component in total knee arthroplasty. Methodology: The study was carried out on 86 patients who are operated for total knee arthroplasty with all polyethylene tibial monoblock component. Demographic, surgical and follow up data was collected from case sheets of patients and copied in Performa. The patients were called for five years follow up and examined in the outpatient department. Results: The mean age of study population was 62.8 years (range 50 – 72 years) with mean BMI of 27.6 kg/m2. Statistically significant improvement was seen in the range of movements in all the age groups. Both male and female patients had insignificant difference in knee scoring. Assessment of clinical functional abilities of knee scoring have observed to be higher in patients with lower BMI. Conclusion: Significant improvement in range of motion as well as knee score in all age range, emphasizes the fact that total knee arthroplasty with all polyethylene design in osteoarthritis is an excellent surgery to restore near normal life style.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255026","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}
Pub Date : 2023-03-31DOI: 10.18231/j.joapr.2023.11.1.26.32
B. M. Panda, Mishra Lopamudra, S. Dalai, S. Padhi
As SARS-CoV-2 has rapidly spread all over the world, it is evident that patient’s gender, age, and comorbidity might render these patients more vulnerable to either increased mortality or increased risk of infection. In the first wave of pandemic, percentage of infection was 5% in May 2020, which rose to 23% in August. Towards the end of the year, it was around 1.8%. In second wave, infection gradually increases to 3.4% in the later part of March 2021, reaching maximum of 31% in April. of the recorded positive cases, infection rate in male population was comparatively higher them the female. In September 2020 where the rate of infection was highest in the first wave the male infectivity rate is 16% compared to 7.13% in females. In April 2021, male infection rate was at 21% compared to 9.7% in the female population. The positivity rate in male population was at 3.7% in third wave of infection. During this period the positivity rate in female population was at 1.87%. Our study shows the positivity rare was maximum in the age group of 18-29(25.5%) followed by 30-39(23.5%) and 40-49(17.2%) in 2020. Similar trend was observed in the year 2021 where the infection rate was 24.2%,23.6%,18.46% in the age group of 18-29,30-39 and 40-49 respectively. However, in 2022 maximum infection was recorded in the age group of 18-29 at around 29%, followed by age group of 30-39(20.9%) and 6-17(15%).
{"title":"Comparison of COVID19(SARS-COV-2) infection, based on gender, age group and sequential waves by RT-PCR analysis among the population of western districts of Odisha","authors":"B. M. Panda, Mishra Lopamudra, S. Dalai, S. Padhi","doi":"10.18231/j.joapr.2023.11.1.26.32","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.26.32","url":null,"abstract":"As SARS-CoV-2 has rapidly spread all over the world, it is evident that patient’s gender, age, and comorbidity might render these patients more vulnerable to either increased mortality or increased risk of infection. In the first wave of pandemic, percentage of infection was 5% in May 2020, which rose to 23% in August. Towards the end of the year, it was around 1.8%. In second wave, infection gradually increases to 3.4% in the later part of March 2021, reaching maximum of 31% in April. of the recorded positive cases, infection rate in male population was comparatively higher them the female. In September 2020 where the rate of infection was highest in the first wave the male infectivity rate is 16% compared to 7.13% in females. In April 2021, male infection rate was at 21% compared to 9.7% in the female population. The positivity rate in male population was at 3.7% in third wave of infection. During this period the positivity rate in female population was at 1.87%. Our study shows the positivity rare was maximum in the age group of 18-29(25.5%) followed by 30-39(23.5%) and 40-49(17.2%) in 2020. Similar trend was observed in the year 2021 where the infection rate was 24.2%,23.6%,18.46% in the age group of 18-29,30-39 and 40-49 respectively. However, in 2022 maximum infection was recorded in the age group of 18-29 at around 29%, followed by age group of 30-39(20.9%) and 6-17(15%).","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77356007","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}
Pub Date : 2023-03-31DOI: 10.18231/j.joapr.2023.11.1.41.46
K. Chauhan, P. N, Ks Rao, Anupama Nagar
Objectives: Spinal anaesthesia is the most preferred method of anaesthesia for a caesarean section. The frequent complication of the subarachnoid block is hypotension. This study aimed to find out the association of pre-operative heart rate with post-spinal hypotension. Materials and Methods: A total of 100 pregnant patients, ASA physical status І and ІІ, aged between 20-35 years, undergoing elective caesarean section, under spinal anaesthesia. The patient’s baseline heart rate, Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure, and SPO2 were noted. Incidence of hypotension and mephentermine requirement following spinal anaesthesia noted. Results: Fifty-seven out of 100 patients developed hypotension (57.0%) of whom 48 were in the subgroup with HR >90bpm (67.0%) and 09 patients were in the group with HR < 90bpm (31.0%). The baseline heart rate was statistically significant with a p-value of 0.001. The average dose of mephentermine required to correct hypotension was 9.47±4.8 mg. Conclusion: Baseline heart rate is a promising predictor of postspinal hypotension in obstetric patients undergoing elective caesarean section.
{"title":"Prediction of postspinal hypotension in elective caesarean section: An observational study","authors":"K. Chauhan, P. N, Ks Rao, Anupama Nagar","doi":"10.18231/j.joapr.2023.11.1.41.46","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.41.46","url":null,"abstract":"Objectives: Spinal anaesthesia is the most preferred method of anaesthesia for a caesarean section. The frequent complication of the subarachnoid block is hypotension. This study aimed to find out the association of pre-operative heart rate with post-spinal hypotension. Materials and Methods: A total of 100 pregnant patients, ASA physical status І and ІІ, aged between 20-35 years, undergoing elective caesarean section, under spinal anaesthesia. The patient’s baseline heart rate, Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure, and SPO2 were noted. Incidence of hypotension and mephentermine requirement following spinal anaesthesia noted. Results: Fifty-seven out of 100 patients developed hypotension (57.0%) of whom 48 were in the subgroup with HR >90bpm (67.0%) and 09 patients were in the group with HR < 90bpm (31.0%). The baseline heart rate was statistically significant with a p-value of 0.001. The average dose of mephentermine required to correct hypotension was 9.47±4.8 mg. Conclusion: Baseline heart rate is a promising predictor of postspinal hypotension in obstetric patients undergoing elective caesarean section.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90201437","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}
Pub Date : 2023-03-31DOI: 10.18231/j.joapr.2023.11.1.33.40
Karthik Kateel, I. Verma, Manbhavan Mahajan
Objective: Laryngoscopy and intubation produce sympathoadrenal response posing risk especially in cardiac patients due to arrhythmias, myocardial ischemia increasing morbidity and mortality. Our aim is to compare lidocaine, fentanyl and dexmedetomidine in attenuation of this response in cardiac surgery patients. Material and Methods: Ninety patients were allocated into 3 groups of 30 participants each. Group A obtained 1µg/kg Dexmedetomidine for 10 minutes before laryngoscopy. Group B 1.5mg/kg of Lidocaine and Group C 2µg/kg Fentanyl 90 seconds before intubation. Hemodynamic parameters like Heart rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Rate Pressure Product (RPP) were noted before intubation and 1,3,5,10 and 15 minutes after intubation. Statistical analysis was done using Epi info version 7.2.1.0 statistical software (Chi square test, ANOVA test). Results: Dexmedetomidine had significant reduction in SBP at 1st (p-value=0.003), 5th, 10th and 15th (p-value<0.001) minute and in DBP at 3rd, 5th, 10th and 15th (p-value< 0.001). MAP was significantly reduced with dexmedetomidine at 1st, 3rd, 5th, 10th and 15th minute (p-value0.05). Conclusion: Dexmedetomidine 1µg/kg given as 10 min infusion before laryngoscopy was more effective than fentanyl and lidocaine in blunting hemodynamic response to laryngoscopy and intubation in cardiac surgery patients. However due to significant hypotension associated with dexmedetomidine, it has to be used with caution in these patients.
目的:喉镜检查和插管可产生交感肾上腺反应，尤其对心律失常、心肌缺血的心脏病患者有增加发病率和死亡率的危险。我们的目的是比较利多卡因、芬太尼和右美托咪定对心脏手术患者这种反应的衰减。材料与方法:90例患者分为3组，每组30人。A组喉镜检查前给予右美托咪定1µg/kg，持续10分钟。B组插管前90秒给予利多卡因1.5mg/kg, C组给予芬太尼2µg/kg。分别于插管前及插管后1、3、5、10、15分钟记录心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率压积(RPP)等血流动力学参数。采用Epi info version 7.2.1.0统计软件进行统计分析(卡方检验、方差分析)。结果:右美托咪定在第1、第5、第10、第15期的收缩压均有显著降低(p值=0.003)。结论:右旋美托咪定在喉镜检查前10 min输注1µg/kg比芬太尼和利多卡因更能有效地减弱心脏手术患者喉镜检查和插管后的血流动力学反应。然而，由于右美托咪定与明显的低血压相关，在这些患者中必须谨慎使用。
{"title":"Comparison of dexmedetomidine, lidocaine and fentanyl in attenuation of haemodynamic response to laryngoscopy and intubation in cardiac surgery patients","authors":"Karthik Kateel, I. Verma, Manbhavan Mahajan","doi":"10.18231/j.joapr.2023.11.1.33.40","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.33.40","url":null,"abstract":"Objective: Laryngoscopy and intubation produce sympathoadrenal response posing risk especially in cardiac patients due to arrhythmias, myocardial ischemia increasing morbidity and mortality. Our aim is to compare lidocaine, fentanyl and dexmedetomidine in attenuation of this response in cardiac surgery patients. Material and Methods: Ninety patients were allocated into 3 groups of 30 participants each. Group A obtained 1µg/kg Dexmedetomidine for 10 minutes before laryngoscopy. Group B 1.5mg/kg of Lidocaine and Group C 2µg/kg Fentanyl 90 seconds before intubation. Hemodynamic parameters like Heart rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Rate Pressure Product (RPP) were noted before intubation and 1,3,5,10 and 15 minutes after intubation. Statistical analysis was done using Epi info version 7.2.1.0 statistical software (Chi square test, ANOVA test). Results: Dexmedetomidine had significant reduction in SBP at 1st (p-value=0.003), 5th, 10th and 15th (p-value<0.001) minute and in DBP at 3rd, 5th, 10th and 15th (p-value< 0.001). MAP was significantly reduced with dexmedetomidine at 1st, 3rd, 5th, 10th and 15th minute (p-value</ = 0.001) and RPP at 1st (p-value=0.040), 3rd (p-value=0.001), 5th (p-value=0.001), 10th (p-value<0.001) and 15th(p-value=0.002) minute. Dexmedetomidine had higher fall in HR at 1st, 3rd, 5th, 10th mins which was not statistically significant(p-value>0.05). Conclusion: Dexmedetomidine 1µg/kg given as 10 min infusion before laryngoscopy was more effective than fentanyl and lidocaine in blunting hemodynamic response to laryngoscopy and intubation in cardiac surgery patients. However due to significant hypotension associated with dexmedetomidine, it has to be used with caution in these patients.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73114775","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}
Pub Date : 2023-03-31DOI: 10.18231/j.joapr.2023.11.1.9.14
Sridhara S, R. S., N. P, Gayatri Jayan, K. Gangadhara
Background: Mucormycosis is an opportunistic systemic fungal infection which is debilitating caused by order Mucorales. The standard management of mucormycosis consists of aggressive debridement of the infected tissue and parenteral anti-fungal therapy with Amphotericin B. Liposomal amphotericin B is a “true” liposomal formulation of amphotericin B with greatly reduced nephrotoxicity and minimal infusion-related toxicity. Very minimal data is available on the usefulness of combining different antifungal agents for an effective outcome. Our study was undertaken at a time when there was a huge turnover of mucormycosis cases during Covid 19 pandemic with resultant shortage of important resources including liposomal amphotericin B. In effect, combination of liposomal amphotericin B with posaconzole gave a promising outcome. Objectives: To study the efficacy of combination therapy of liposomal amphotericin B and posaconazole in the treatment of mucormycosis. Methodology: It is a prospective study of 43 patients with mucormycosis who received combination therapy based on their disease severity. Results: In our study, 16 (37%) were considered as patients with mild disease, 18 (41.8%) were considered as patients with moderate disease and 9 patients (20.9%) were considered as severe. 20 (58%) patients out of 34 patients with mild to moderate disease showed improvement after combination therapy. Conclusion: A significant percentage of patients in our study showed improvement with combination therapy of liposomal amphotericin B and posaconazole in terms of survival and disease recurrence.
{"title":"Efficacy of combination therapy of amphotericin and posaconazole in treatment of mucormycosis","authors":"Sridhara S, R. S., N. P, Gayatri Jayan, K. Gangadhara","doi":"10.18231/j.joapr.2023.11.1.9.14","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.9.14","url":null,"abstract":"Background: Mucormycosis is an opportunistic systemic fungal infection which is debilitating caused by order Mucorales. The standard management of mucormycosis consists of aggressive debridement of the infected tissue and parenteral anti-fungal therapy with Amphotericin B. Liposomal amphotericin B is a “true” liposomal formulation of amphotericin B with greatly reduced nephrotoxicity and minimal infusion-related toxicity. Very minimal data is available on the usefulness of combining different antifungal agents for an effective outcome. Our study was undertaken at a time when there was a huge turnover of mucormycosis cases during Covid 19 pandemic with resultant shortage of important resources including liposomal amphotericin B. In effect, combination of liposomal amphotericin B with posaconzole gave a promising outcome. Objectives: To study the efficacy of combination therapy of liposomal amphotericin B and posaconazole in the treatment of mucormycosis. Methodology: It is a prospective study of 43 patients with mucormycosis who received combination therapy based on their disease severity. Results: In our study, 16 (37%) were considered as patients with mild disease, 18 (41.8%) were considered as patients with moderate disease and 9 patients (20.9%) were considered as severe. 20 (58%) patients out of 34 patients with mild to moderate disease showed improvement after combination therapy. Conclusion: A significant percentage of patients in our study showed improvement with combination therapy of liposomal amphotericin B and posaconazole in terms of survival and disease recurrence.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74224327","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}
Pub Date : 2023-03-31DOI: 10.18231/j.joapr.2023.11.1.20.25
Pradnya Deolekar, K. Dongerkery, Jyoti P. Sonawane, Pramila Yadav, A. Naseem
Introduction: Proton pump inhibitors (PPIs) effectively suppress acid secretion and play an important role a lot of gastrointestinal disorders. PPIs are generally used long term by the patients. This can cause an increase in patient cost and subsequent decrease in adherence to the prescription. Hence, this study was done to assess the cost variation of PPIs. Methods: The cost of different brands of commonly used PPIs (10 capsules/tablets for oral drugs and one ampoule/vial for injectable drugs) was tabulated by referring to the “Monthly Index of Medical Specialties” October – December 2021, and 1mg online pharmacy. The cost ratio and percentage cost variation for various brands of a particular strength and dosage form was calculated and compared. Cost ratio >2 and cost variation >100% was considered significant. Results: The results showed a huge variation in costs of different brands with the highest being Rabeprazole 20mg (Cost ratio-16.4, Percentage cost variation-1540%) in oral formulation and Rabeprazole 20mg (11.9, 1090%) in the injectable formulation. Among oral drugs, Omeprazole 40mg has the lowest cost ratio and percentage cost variation (1.60, 60.34%) and Pantoprazole 40mg (1.51, 51.16%) in case of injectable formulations. Conclusion: There is a wide variation in the prices of PPIs available in the market. Huge demand for the commonly orally prescribed drugs like Omeprazole 20mg and Pantoprazole 40mg could be the reason for the high cost. Among injectable preparations, Pantoprazole 40mg is the most commonly prescribed but it has an acceptable cost ratio which is a positive sign.
{"title":"Pharmacoeconomic analysis of oral and injectable proton pump inhibitors available in India","authors":"Pradnya Deolekar, K. Dongerkery, Jyoti P. Sonawane, Pramila Yadav, A. Naseem","doi":"10.18231/j.joapr.2023.11.1.20.25","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.20.25","url":null,"abstract":"Introduction: Proton pump inhibitors (PPIs) effectively suppress acid secretion and play an important role a lot of gastrointestinal disorders. PPIs are generally used long term by the patients. This can cause an increase in patient cost and subsequent decrease in adherence to the prescription. Hence, this study was done to assess the cost variation of PPIs. Methods: The cost of different brands of commonly used PPIs (10 capsules/tablets for oral drugs and one ampoule/vial for injectable drugs) was tabulated by referring to the “Monthly Index of Medical Specialties” October – December 2021, and 1mg online pharmacy. The cost ratio and percentage cost variation for various brands of a particular strength and dosage form was calculated and compared. Cost ratio >2 and cost variation >100% was considered significant. Results: The results showed a huge variation in costs of different brands with the highest being Rabeprazole 20mg (Cost ratio-16.4, Percentage cost variation-1540%) in oral formulation and Rabeprazole 20mg (11.9, 1090%) in the injectable formulation. Among oral drugs, Omeprazole 40mg has the lowest cost ratio and percentage cost variation (1.60, 60.34%) and Pantoprazole 40mg (1.51, 51.16%) in case of injectable formulations. Conclusion: There is a wide variation in the prices of PPIs available in the market. Huge demand for the commonly orally prescribed drugs like Omeprazole 20mg and Pantoprazole 40mg could be the reason for the high cost. Among injectable preparations, Pantoprazole 40mg is the most commonly prescribed but it has an acceptable cost ratio which is a positive sign.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73733645","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}
Background: General anaesthesia (GA) includes intubation a necessary step to provide adequate ventilation in patients under anaesthesia along with protection of airway from regurgitation and aspiration. Postoperative sore throat (POST), hoarseness of voice, cough are common sequelae. The present study compares the efficiency of preoperative nebulization of lignocaine hydrochloride and magnesium sulphate for reducing the incidence of POST in patients under GA. Methods: The study conducted in GMC Kota and attached hospitals on 100 patients of surgery duration one hour to three hours. Patients were randomly allocated in two groups Lignocaine group and Magnesium group. Results: The majority of patients belonged to the age between 40 and 70 years. There was no significant difference in the mean pulse rate, SBP, mean SpO2. Comparison of sore throat in both the groups at rest, just after extubation, 2 hours, 8 hours, 24 hours and 48 hours showed incidence more common in lignocaine group than magnesium group but no significant difference (P>0.05). Hoarsness after extubation reduced within 24 hours in Magnesium group in comparison to Lignocaine group where it persists till 48 hrs. Conclusion: Incidence of sore throat, hoarseness of voice and cough was more common in lignocaine group and more in female patients. Both drugs can be used for prevention of postoperative sore throat, but magnesium sulphate has better results.
{"title":"Comparative study of magnesium sulphate nebulization and lignocaine nebulization in prevention of postoperative sore throat (POST)","authors":"Gopal Sharma, Kumar Asnani, Sanjay Kalani, Mohit Kumar","doi":"10.18231/j.joapr.2023.11.1.1.8","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.1.8","url":null,"abstract":"Background: General anaesthesia (GA) includes intubation a necessary step to provide adequate ventilation in patients under anaesthesia along with protection of airway from regurgitation and aspiration. Postoperative sore throat (POST), hoarseness of voice, cough are common sequelae. The present study compares the efficiency of preoperative nebulization of lignocaine hydrochloride and magnesium sulphate for reducing the incidence of POST in patients under GA. Methods: The study conducted in GMC Kota and attached hospitals on 100 patients of surgery duration one hour to three hours. Patients were randomly allocated in two groups Lignocaine group and Magnesium group. Results: The majority of patients belonged to the age between 40 and 70 years. There was no significant difference in the mean pulse rate, SBP, mean SpO2. Comparison of sore throat in both the groups at rest, just after extubation, 2 hours, 8 hours, 24 hours and 48 hours showed incidence more common in lignocaine group than magnesium group but no significant difference (P>0.05). Hoarsness after extubation reduced within 24 hours in Magnesium group in comparison to Lignocaine group where it persists till 48 hrs. Conclusion: Incidence of sore throat, hoarseness of voice and cough was more common in lignocaine group and more in female patients. Both drugs can be used for prevention of postoperative sore throat, but magnesium sulphate has better results.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135897845","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}
Pub Date : 2023-03-31DOI: 10.18231/j.joapr.2023.11.1.15.19
Sampat Rathod, Chetali Das, Trishala Jain
Background: Spinal anesthesia is a widely used technique for lower abdomen and lower limb surgeries. We used opioids as an adjuvant to attain a dense block and increase the duration of surgery. The purpose of the study is to compare the anesthetic and analgesic effects of intrathecal isobaric 0.5% ropivacaine-fentanyl versus isobaric 0.5% levobupivacaine-fentanyl in patients undergoing lower limb surgeries. Material and methods: This prospective randomized double-blind interventional study was carried out in ASA I and II, aged 18 to 60 years. Injection Isobaric ropivacaine (0.5%) 2.5 ml with injection fentanyl 0.5 ml (25 μg) intrathecally in group A (n=30) and Inj. Isobaric levobupivacaine isobaric (0.5%) 2.5 ml with injection fentanyl 0.5 ml (25 μg) intrathecally in group B (n=30) was used. The sealed envelope method was used for group allocation. Results: Both groups' demographic and hemodynamic data were comparable. There was a faster onset of sensory and motor block in the levobupivacaine group than in the ropivacaine group with fentanyl, and the result was statistically significant. (P value <0.001). Two-segment regression mean time was statistically significant between groups (P value > 0.008). Sensory and motor block durations were shorter in the ropivacaine than in the levobupivacaine with the fentanyl group. There is a statistically significant difference between the two groups' time to first-dose rescue analgesia. Conclusion: We deduce in our study that using intrathecal 2.5 ml of 0.5% ropivacaine with 0.5ml fentanyl (25 micrograms) helps in early ambulation and can be used in day-care lower limb surgeries when compared with levobupivacaine.
背景:脊髓麻醉是一种广泛应用于下腹和下肢手术的技术。我们使用阿片类药物作为辅助剂以达到致密阻滞并延长手术时间。本研究的目的是比较0.5%罗哌卡因-芬太尼与0.5%左布比卡因-芬太尼在下肢手术患者鞘内的麻醉和镇痛效果。材料和方法:本前瞻性随机双盲介入研究在ASA I和II中进行，年龄为18 ~ 60岁。A组(30例)鞘内注射异重罗哌卡因(0.5%)2.5 ml，同时注射芬太尼0.5 ml (25 μg)。B组(n=30)采用等重左布比卡因(0.5%)2.5 ml加芬太尼0.5 ml (25 μg)鞘内注射。采用密封包络法进行分组。结果:两组的人口学和血流动力学数据具有可比性。左布比卡因组感觉和运动阻滞的起效比罗哌卡因加芬太尼组快，结果有统计学意义。(P值0.008)。罗哌卡因组感觉和运动阻滞持续时间短于左旋布比卡因与芬太尼组。两组患者到第一次抢救镇痛的时间比较，差异有统计学意义。结论:我们在本研究中推断，与左旋布比卡因相比，鞘内使用2.5 ml 0.5%罗哌卡因与0.5ml芬太尼(25微克)有助于早期下床，可用于日间护理下肢手术。
{"title":"Comparison of anesthetic and analgesic effect of isobaric 0.5% ropivacaine versus levobupivacaine with fentanyl as adjuvant in lower limb surgeries under spinal anesthesia- a randomized double-blind, interventional study","authors":"Sampat Rathod, Chetali Das, Trishala Jain","doi":"10.18231/j.joapr.2023.11.1.15.19","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.1.15.19","url":null,"abstract":"Background: Spinal anesthesia is a widely used technique for lower abdomen and lower limb surgeries. We used opioids as an adjuvant to attain a dense block and increase the duration of surgery. The purpose of the study is to compare the anesthetic and analgesic effects of intrathecal isobaric 0.5% ropivacaine-fentanyl versus isobaric 0.5% levobupivacaine-fentanyl in patients undergoing lower limb surgeries. Material and methods: This prospective randomized double-blind interventional study was carried out in ASA I and II, aged 18 to 60 years. Injection Isobaric ropivacaine (0.5%) 2.5 ml with injection fentanyl 0.5 ml (25 μg) intrathecally in group A (n=30) and Inj. Isobaric levobupivacaine isobaric (0.5%) 2.5 ml with injection fentanyl 0.5 ml (25 μg) intrathecally in group B (n=30) was used. The sealed envelope method was used for group allocation. Results: Both groups' demographic and hemodynamic data were comparable. There was a faster onset of sensory and motor block in the levobupivacaine group than in the ropivacaine group with fentanyl, and the result was statistically significant. (P value <0.001). Two-segment regression mean time was statistically significant between groups (P value > 0.008). Sensory and motor block durations were shorter in the ropivacaine than in the levobupivacaine with the fentanyl group. There is a statistically significant difference between the two groups' time to first-dose rescue analgesia. Conclusion: We deduce in our study that using intrathecal 2.5 ml of 0.5% ropivacaine with 0.5ml fentanyl (25 micrograms) helps in early ambulation and can be used in day-care lower limb surgeries when compared with levobupivacaine.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74779897","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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