scholarly journals A Study of the Safety and Efficacy of Alternate Day vs. Daily Rosuvastatin Dosing in Hypercholesterolemia Patients at Tertiary Care Hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 33-37
Author(s):  
Rajesh Yadav ◽  
Gaurav Chhetri

Background: Many of the patients with coronary heart disease require lifelong statin administration. Patients usually discontinue the medicine either due to side effects like myalgia, hepatotoxicity or due to the cost of the medicine.  The aim of this study is to see the scope of adjustment of the regimen to alternate-day dosing as an option to be considered in patients for whom adverse effects or cost are issues. Materials and Methods: A comparative, prospective, parallel group and open study was performed on forty- two patients of both genders with dyslipidaemia within the age group of 30 to 60 years attending the out – patients department of Medicine of Nobel Medical College and Teaching Hospital from February 2020 to March 2020. Mean reductions in different lipid fractions in the two treatment groups over the eight-week study period was calculated and then compared. Frequencies of patients developing different side effects was also calculated and compared between the two groups. Results: Baseline characters of both the groups were well balanced. Low density lipoprorein-C was reduced by 33.8 % in once-daily group and 31.3 % in alternate-day group, respectively. Changes were also recorded for the other lipid parameters. Such changes were found to be of no significant difference when compared between the two groups (p>0.05). Conclusion: An alternate-day regimen of statin in patients of hyperlipidaemia showed similar effect on the lipid panel compared to daily regimen.

2019 ◽  
Vol 9 (2) ◽  
pp. 147-150
Author(s):  
Nadia Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Fahmida Islam ◽  
Shabnam Sarwar Sejooti

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology , Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal womenaged between 45-70 years were considered as case and another 50 regular menstruating premenopausal women aged between 30-40 years were selected as control. Results: The mean age of case and control groups was 50.5± 2.3 years and 36.5± 4.4 years respectively. In this study serum zinc levels in cases and controls were 71.54 ± 5.69 ìg /dl and 74.68 ± 5.453 ìg/dl respectively, and there was significant difference(p<0.01). Conclusion: Serum zinc level was significantly decreased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum zinc levels might be incorporated in every postmenopausal for possible prevention of complications. Birdem Med J 2019; 9(2): 147-150


2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
N Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Syed Md Tanjilul Haque ◽  
ANM Ashikur Rahman Khan ◽  
...  

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal women (Case) aged between 45-60 years were considered as case and another 50 regular menstruating premenopausal women(Control) aged between 30-40 years were selected as control. Results: The mean age of cases and control groups was 50.5±2.3 years and 36.5±4.4 years respectively. In this study we found Serum Copper levels in cases and controls were 115.36±8.836 µg /dl and 90.58 ±6.315 µg/dl respectively had (p< 0.01) significant difference. Conclusion: Serum Copper level was significantly increased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum Cu level might be incorporated in every postmenopausal woman for prevention of complications. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 110-113


Author(s):  
Rita D. ◽  
V. Haripriya

Background: Tocolytic agents are used to reduce preterm deliveries. Very few studies documenting the comparison of tocolytic agents viz. nifedipine, nitroglycerin dermal patches and isoxsuprine. Other drugs are not used due to their adverse effects. Objective was to study and compare the safety efficacy of nifedipine, nitroglycerin dermal patches and isoxsuprine as tocolytic agents in suppression of preterm labour 1 year study.Methods: This was a prospective case control study was conducted for a period of 1 year. Total 90 cases selected to study were randomly distribute in to three treatment groups viz. A, B, and C nifedipine, nitroglycerin and isoxsuprine respectively. Subjects in all three groups were evaluated for maternal pulse rate, palpitation uterine contractions and fetal heart rate in order to assess efficacy of each drug under investigation.Results: There was no statistically significant difference in age of woman’s in three different groups. Among (100%) subjects, majority of the cases i.e. (27.8%) primi gravida followed by multi (72.2%). Side effects of nifedipine was less when compared to nitroglycerine dermal patch and isoxsuprine i/v/o of headache (8.9%), nausea (1.1%), vomiting (1.1%), tachycardia (3.3%), palpitation (3.3%), hypotension (1.1%). side effects were statistically significant different between the treatment groups. There was no statistically significant difference with respect to APGAR score at 1 minute and 5 minutes.Conclusions: Oral nifedipine was found to be superior and efficacious as tocolytic agent as compared to transdermal nitroglycerin and intravenous isoxsuprine.


2019 ◽  
Vol 7 (2) ◽  
pp. 68-71
Author(s):  
Abhishek Karn ◽  
Subodh Kumar Yadav ◽  
Renu Yadav ◽  
Rakesh Kumar Adhikari

INTRODUCTION :- The well being of the fetus and hence the baby is influenced by a number of factors among which the length and diameter of umbilical cord is one important aspect. Studies have found association between gestational hypertension and the structure of umbilical cord. The objective of this study was to determine the effects of gestational hypertension on the length and diameter of umbilical cord.  MATERIAL AND METHODS :- A total of 70 umbilical cords with placenta were collected in Nobel Medical College and Teaching Hospital for comparison of umbilical cords length and diameter between normotensives and patients with gestational hypertension. Data were statistically analyzed.  RESULTS :- The difference in umbilical cords' diameter was statistically significant between normotensives and patients with gestational hypertension whereas the length of the umbilical cord had no statistically significant difference.  CONCLUSION :- We concluded that gestational hypertension affects the diameter of umbilical cord by decreasing it significantly which may affect normal fetal development.


2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.


2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Liaqat Jalal ◽  
Atta-ur-Rehman Khan ◽  
Muhammad Shaukat Farooq ◽  
Muhammad Tahir Nouman

Background: The outcome for this neurosurgical problem is still far from set target in many developing countries like Pakistan. Major proportion of cases presenting with EDH in hospital still has poor outcome. This poor outcome of EDH is attributed to many factors including weak health systems of most developing countries. Objective of study was to analyze factors influencing outcome among patients of head injury with an extradural hematoma before surgery admitted in neurosurgery department of Dera Ghazi Khan Medical College, Dera Ghazi Khan. Materials and Methods: This cross-sectional analytical study was conducted in neurosurgery department of Dera Ghazi Khan Medical College from January 2019 to December 2019 after ethical approval. All the patients with extradural hematoma of either gender admitted in the department during the study duration in which surgery was performed to evacuate extradural hematoma were included in the study. Data was collected by using preformed, pretested questionnaire. A vital signs and Glasgow coma scale record was maintained at thirty minutes interval. Computerized tomography was done in every patient. The EDH volume was calculated by using Peterson and Epperson equation a x b x c x 0.5. Data was entered and analyzed by using SPSS version 22. Chi square test was applied to observe any statistically significant difference between various strata if existed and p value <0.05 was taken as significant. Results: Total 237 patients with Extradural Hematoma (EDH) were admitted in neurosurgery department during the study period were included in study. More than half 136 (57.4%) patients were more or equal to the age of 18 years. Majority of the patients 218 (91.9%) in the study were male.  Major cause of extradural hematoma among patients in this study was road traffic accident 154 (64.9%). The outcome of EDH was found to be significantly (p <0.001) associated with age of patients. More than ninety percent of the patients who were directly admitted to tertiary care hospital has good outcome as compared to 109 (60.2%) patients which were referred and difference in outcome was statistically significant (p<0.001). The volume of EDH is not significantly associated with the outcome (p=0.090). The GSC score of the patients at the time of admission is significantly associated with the outcome (p<0.001). Study findings showed that GCS score of the patients at the time of surgery was also found to be significantly associated with outcome of EDH (p<0.001). Conclusion: There is a strong association of outcome in extradural hematoma with age, gender and GCS of the patient. In higher GCS the outcome was excellent but in low GCS the outcome was poor.


2019 ◽  
Vol 6 (2) ◽  
pp. 718
Author(s):  
Muhammad Hassan ◽  
Adarsh E. ◽  
Rajanish K. V.

Background: The aim of this study was to determine the clinical profile of neonates admitted with dehydration fever and ascertain the maternal and neonatal factors affecting it.Methods: A observational descriptive study was conducted at Rajarajeswari Medical College and hospital, population included neonates who were admitted in NICU with dehydration fever.Results: The study were conducted among 50 neonates admitted with dehydration fever. Majority of neonates (72%) were diagnosed with dehydration fever on day 3 of life. 84 % neonates were born to primiparous mothers. In the study there was significant difference in mean birth weight, weight at admission and percentage of weight loss between birth weight and weight at admission with respect to symptoms on presentation. Mean % of weight loss was 12.06 when dehydration fever was presented with fever, 11.29 when dehydration fever presented with decreased urine output, 18.44 when presented with both fever and decreased urine output and 12.73 when presented with jaundice these values were statistically significant.Conclusions: Dehydration fever occurs most commonly on day 3 or after, effective measures should be initiated for early diagnosis and prevention of complications like effective breast-feeding counselling, proper techniques, good latching and supplementation of artificial feeds if required and monitoring of daily weight and daily urine output.


2014 ◽  
Vol 4 (5) ◽  
pp. 428-432 ◽  
Author(s):  
LJ John ◽  
EM Esheiba ◽  
MAM Fathi ◽  
AK Agarwal ◽  
J Sreedharan ◽  
...  

BackgroundThe reduction of serum total cholesterol and LDL-cholesterol levels varies with different statins. The objective of the present study was to compare the efficacy of Simvastatin, Atorvastatin and Rosuvastatin in the treatment of newly diagnosed dyslipidemia.Material and Methods:A prospective, non-interventional 12-week study was conducted after approval from the Ethics Committee. A total of 70 patients with newly diagnosed dyslipidemia receiving 20mg of Simvastatin, Atorvastatin or Rosuvastatin were included. The primary efficacy measure was reduction of lipid levels from the initial baseline values at the end of 12 weeks with the respective Statins. Data was analyzed using descriptive statistics, Paired -t test, and analysis of variance (ANOVA).Results:Of total 70 patients, 14 patients received Simvastatin; 40 patients received Atorvastatin and 16 patients received Rosuvastatin. Demographic and baseline clinical characteristics were similar between the three groups. Significant reduction in lipid levels (total cholesterol, and LDL) was seen within the three treatment groups (p<0.01). However, statistically significant difference in the reduction lipid levels was not observed between the three groups.Conclusion:We found no significant difference in the reduction of lipid levels between Simvastatin, Atorvastatin or Rosuvastatin patients with newly diagnosed dyslipidemia.DOI: http://dx.doi.org/10.3126/nje.v4i5.12023 Nepal Journal of Epidemiology 2014; 4(5):428-32


2015 ◽  
Vol 9 (1) ◽  
pp. 110-116 ◽  
Author(s):  
Mallika Ghosh ◽  
Subhadip Choudhuri ◽  
Reena Ghosh Ray ◽  
Basudev Bhattacharya ◽  
Sujata Bhattacharya

Background:Chlamydia trachomatisis recognized as one of the most common sexually transmitted pathogen in the world. 50-80% of infected females are asymptomatic. These untreated women are at risk of developing chronic sequelae leading to tubal pathology causing infertility. Infertility is defined as 1 year of unprotected intercourse without pregnancy. It may be primary or secondary.Aim:To find out the association of genitalChlamydia trachomatisinfection with female infertility.Materials and Methodology:This case control study has been carried out in collaboration with R. G. Kar Medical College and Institute of Post Graduate Medical Education &amp; Research, India, between July 2012 and June 2013. 40 infertile and 40 pregnant women were enrolled by purposive sampling as per inclusion and exclusion criteria. ELISA test was performed to detect serum IgG and IgA antibody against recombinant analogs of MOMP and 3 different PCR assays were done targeting MOMP and rRNA DNA from DNA extracted from first void urine.Results:IgG seropositivity was significantly higher (15%vs0%,P=.0255) in cases than controls, though there was no significant difference in the proportion of IgA seropositivity among 2 groups (12.5%vs2.5%,P=0.2007). Out of 80 samples 2 samples showed the production of amplicons with R1 – R2 primers. Only 1 sample gave positive result with production of amplicons with all the 3 primers used (R1 – R2, CT0005 – CT06 and JM15 – JM16).Conclusion:PersistentC. trachomatisinfection must be recognized as a risk factor of infertility in this region of India. The low PCR positivity in FVU sample helps to conclude the diagnostic utility of serological tests in screening of infertile women.


Author(s):  
Dharmaraj B. ◽  
Abhijith L. M. ◽  
Jagadeesh K. ◽  
Basavaraj S.

Background: As per GOLD (Global initiative for chronic obstructive lung disease) guidelines bronchodilators are required for symptomatic treatment of chronic obstructive pulmonary disease (COPD) patients. Currently there is no evidence to say about the safety of fixed dose combinations used in COPD patients. Since the drugs are to be taken for longer period, it is essential to know the safety aspects of these drugs. Moreover we don’t have adequate studies and documentation to say that a particular drug combination is better and safer for COPD patients.Methods: Prospective, open labelled, randomized, comparative, interventional clinical study conducted by the Departments of Pharmacology and Pulmonary Medicine of Basaveshwara Medical College and Hospital, Chitradurga in 40 COPD patients.Results: The fixed dose combinations of drugs used in both the treatment groups i.e. salmeterol/fluticasone and tiotropium/formoterol were equally safer and well tolerated. Some side effects noticed during the course of treatment were statistically significant when compared between the 2 groups, however they were milder and predictable adverse drug reactions.Conclusions: Systemic and severe adverse drug reactions were not observed during 8 week treatment period and the local side effects observed were mild in both the treatment groups. Hence the fixed dose combinations of salmeterol or fluticasone and tiotropium or formoterol are found to be safer for maintenance therapy in COPD patients.


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