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Narayanan, Varsha
- Efficacy of Acotiamide in PDS Type Functional Dyspepsia Symptoms with and without PPI and Laxative Co-Therapy
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Authors
Affiliations
1 DGM Medical Services, Lupin Ltd, IN
2 Medical Services, Lupin Ltd, IN
3 VP Medical Services, Lupin Ltd, IN
1 DGM Medical Services, Lupin Ltd, IN
2 Medical Services, Lupin Ltd, IN
3 VP Medical Services, Lupin Ltd, IN
Source
The Indian Practitioner, Vol 71, No 6 (2018), Pagination: 19-23Abstract
Background: Functional Dyspepsia (FD) is a common condition presenting at the clinic of a gastroenterologist. Though the Post-prandial Distress Syndrome (PDS) type is more commonly seen in clinical practice, often the symptoms overlap with Epigastric pain or burning and sometimes even with other gastro-intestinal symptoms like constipation. Acotiamide, approved specially for meal related FD symptoms, exerts its gastro- kinetic effect by enhancing the action of acetylcholine. Evidence of its efficacy and safety are available from various randomized clinical trials. However, real-world data from its regular in-clinic use especially in patients presenting with overlapping symptoms and being prescribed other concomitant therapies, is lacking.
Methodology: Data, evaluated from 314 patients through questionnaires to record patient’s perception of improvement in the presenting symptoms, as well as tolerance to treatment with acotiamide 100 mg thrice daily, across gastroenterology clinics in India, was analyzed.
Results: The responder rate for treatment with acotiamide in the groups receiving only acotiamide and in those also receiving Proton Pump Inhibitor (PPI) and laxatives as concomitant therapy, for each of functional dyspepsia symptoms of post prandial fullness, upper abdominal bloating and early satiety was 72.5% and 86.5%, 68.8% and 80.2%, and, 80% and 74.1% respectively. No significant difference was seen in the number of patients achieving complete relief or significant improvement from both post prandial fullness and early satiety at final follow up between the two groups. A significant difference was seen in the number of patients who ‘significantly improved’ from epigastric bloating in the group co-prescribed a PPI or a laxative with acotiamide versus the group which was only given acotiamide. Overall a low treatment discontinuation rate of 1.3% was observed.
Conclusion: This real-world study suggests that use of acotiamide is associated with improvement of mealrelated (PDS) FD symptoms with good safety profile, in patients also receiving a PPI or a laxative for other overlapping symptoms with PDS.
Keywords
Rome IV Criteria, Functional Dyspepsia, Gastric Emptying, Constipation, PPI, Acotiamide, Prokinetic, Laxative, Post Prandial Fullness, Abdominal Bloating, Early Satiety, Epigastric Pain.
References
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- Tack J et al. Long-term safety and efficacy of Acotiamide in functional dyspepsia (postprandial distress syndrome)results from the European phase 3 open-label safety trial. NeurogastroenterolMotil. 2018 Jan 8. doi: 10.1111/nmo.13284. [Epub ahead of print]
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- Narayanan V et al. Real World Efficacy and Tolerability of Acotiamide, in Relieving Meal- related Symptoms of Functional Dyspepsia. J Gastrointest Dig Syst 2018, 8:1
- Matsueda K, Hongo M, Tack J, Saito Y, Kato H.A placebocontrolled trial of Acotiamide for meal-related symptoms of functional dyspepsia. Gut 2012. 61. 821-8. 10.1136/ gutjnl-2011-301454
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- COVID-19 Indian Perspectives and Challenges: The TIP Approach
Abstract Views :258 |
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Authors
Affiliations
1 Health and Pharmaceutical Consultant, Dr Varsha’s Health Solutions, Andheri West, Mumbai, IN
1 Health and Pharmaceutical Consultant, Dr Varsha’s Health Solutions, Andheri West, Mumbai, IN
Source
The Indian Practitioner, Vol 73, No 4 (2020), Pagination: 7-10Abstract
No Abstract.Keywords
No Keywords.References
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- COVID Vaccines in India – A Medical Milestone: Current and Future Prospects
Abstract Views :166 |
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Authors
Affiliations
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Mumbai, IN
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 1 (2021), Pagination: 7-11Abstract
At the start of 2021, two COVID vaccines have received approval for emergency use in India. The review of study data available on the safety and efficacy of these vaccines, and understanding their technological development along with rational of their approval, can help in achievement of a more effective vaccination drive. It is important at this stage that apprehensions and concerns on these vaccines are addressed scientifically in a balanced manner to improve vaccination coverage and success. A peek into what the near future holds also points towards India emerging as an effective global player in vaccines.Keywords
COVID, Vaccine, Adenoviral Vector, Inactivated, Immunogenicity, Safety.References
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- Key Learnings from the COVID Resurge – Putting Healthcare First and Ramping Up Resources: Recommended Action Points to Handle Such Pandemics in Future
Abstract Views :294 |
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Authors
Affiliations
1 Consultant, Community Health Care, Bhopal, IN
2 Health and Pharmaceutical Consultant, Dr Varsha’s Health Solutions, Andheri West, Mumbai, IN
1 Consultant, Community Health Care, Bhopal, IN
2 Health and Pharmaceutical Consultant, Dr Varsha’s Health Solutions, Andheri West, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 6 (2021), Pagination: 7-10Abstract
The second wave of the COVID pandemic has had a sudden and severe impact on India. This grueling period was associated with the shortage of healthcare resources like hospital beds, oxygen supply, and medicines along with overburdening of health workers, and a very high toll of community suffering and loss. A combination of highly infective viral variant strains with the backdrop of premature complacency, removal of restrictions and abandonment of COVID appropriate behaviour may be responsible factors in hindsight. However, important learnings and action points acquired from the COVID resurge, can be valuable to avert such situations in future. These include focusing on maximizing population vaccination; continuing enforcement of safety norms with the graded lifting of restrictions; using data tools and medical research for prediction, analysis and timely decisions; ramping up healthcare resources and production of medicines, lifesaving equipment and vaccines; and having regulations and mechanisms in place to tackle misuse and illegal activities. Above all selflessness and unity at the level of the administration, community and individual are the needs of the hour in such a challenging situation.Keywords
COVID, second wave, healthcare, learnings, pandemicReferences
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- COVID Second Wave in India – Revisiting the TIP Approach
Abstract Views :96 |
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Authors
Affiliations
1 Dr Varsha’s Health Solutions, Andheri West, Mumbai, IN
1 Dr Varsha’s Health Solutions, Andheri West, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 4 (2021), Pagination: 7-9Abstract
The resurgence of COVID as a second wave of rising cases has been seen in many parts of India. Presentation with a typical non-specific symptoms, delay in test positivity and diagnosis, infections more among younger people, and a fast-paced growth in daily cases have been the trends so far. Variant strains are also emerging as a cause for concern. The importance of TIP – Testing, Isolation and Prevention still hold as the three corner-stones of management. This can enable effective home isolation and treatment, identifying high risk cases for hospitalization, and prevent overburdening of healthcare resources. The two major pillars of prevention are wearing of masks in public, and further ramping up vaccination to include younger age-groups as well.Keywords
COVID Second Wave, Resurge, Home Isolation, Masks, Variants.References
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- Narayanan V. The Mask Dilemma: Unmasking the Myths and Facts. International Journal of Community Medicine and Public Health. January 2021;8(1):1-5.
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- Strengthening the Base of Healthcare with Focus on Family Physicians
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Authors
Affiliations
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Andheri (West), Mumbai, India., IN
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Andheri (West), Mumbai, India., IN
Source
The Indian Practitioner, Vol 75, No 4 (2022), Pagination: 7-10Abstract
India has a wide range of healthcare providers and systems. The base is formed by general practitioners from both allopathic and alternate systems of medicine. However, the concept of the family physician is yet to find firm roots both at the academic and scientific, as well as the community level. A family physician has a holistic approach and has to engage with all members and age-groups in a family. He/she has to take care of physical health, mental health, and be abreast of social, occupational and economic factors, along with lifestyle, and nutrition. In addition, accessibility, patient comfort, dissemination of information and guidance, along with closer monitoring defines the family physician as compared to a general physician. The pandemic brought forth the importance of the family physician and how they can improve patient outcomes and reduce the load on healthcare infrastructure. It is pertinent in a country like India to formalize the family physician through academic training and qualification, financial and career growth opportunities, exposure in research as well as policy making, and establishing a healthcare structure and referral system with family physicians as its foundation.
Keywords
Family physician, holistic health, healthcare structure, health Infrastructure, general practitionerFull Text
References
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- COVID Vaccination for Children in India: A Step Towards Better Health, Wellbeing and Development
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Authors
Affiliations
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Mumbai, IN
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 12 (2021), Pagination: 7-10Abstract
As on December 2021, COVID vaccination for children is yet to commence in India, a country that has been a global leader in vaccinating the adult population. Two indigenous vaccines have already been approved for children 12 years and above by the Drug Controller General of India (DCGI), with vaccination set to commence for children aged 15 years and above in January 2022. Children are being considered as low risk and low priority for vaccination, as in them, COVID is commonly mild, and complications, rare. However, the impact of the evolving SARS-CoV-2 mutants on children cannot be fully predicted, and some children have comorbidities and immune deficiencies putting them at higher risk. Moreover, children not being vaccinated has contributed significantly to parental anxiety and reluctance in sending them to school, and also the schools continuing hybrid teaching and not being able to start physical and interactive activities that can improve children’s holistic health, wellbeing and development. As globally across several countries, children are now being vaccinated, this is being expected from India too. Vaccination of children may not only enhance protection against severe COVID and unpredictable variants, but can help the children return to a more wholesome school life and childhood.Keywords
Vaccination, COVID, children, school, developmentReferences
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- The New Medical Education Curriculum in India: A Great Initiative with Scope for Further Enhancement
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PDF Views:90
Authors
Affiliations
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Andheri (West), Mumbai, India., IN
1 Consultant Family Medicine and Holistic Health, Dr Varsha’s Health Solutions, Andheri (West), Mumbai, India., IN
Source
The Indian Practitioner, Vol 75, No 6 (2022), Pagination: 6-8Abstract
Medical education in India that includes MBBS and specialty post-graduation programmes are intense, thorough and well acclaimed. The new medical education curriculum introduced by the National Medical Commission in 2019 is all set to be uniformly implemented. It is a welcome move in the direction of competencies-based assessment, as well as enhancing soft skills and integrated learning. It is also important for medical students to learn other aspects and skills that are highly important in shaping their career, practice, and life after their education is completed. These include business, finance and administrative skills and knowledge, medicolegal aspects, interacting with and tackling different kinds of patients, understanding the scope and benefits of general practice, family medicine and holistic healthcare, making informed career choices, and selfcare that involves coping skills, building resilience, managing stress, and maintaining one’s own physical and mental health.
Keywords
MBBS, NMC, new medical education curriculum, CBME, holisticFull Text
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- Suicide Prevention : Need for a Multi-Sectorial and Integrated Effort
Abstract Views :105 |
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Authors
Affiliations
1 Community Health Care, Bhopal, IN
2 Dr. Varsha’s Health Solutions, Andheri West, Mumbai, IN
1 Community Health Care, Bhopal, IN
2 Dr. Varsha’s Health Solutions, Andheri West, Mumbai, IN
Source
The Indian Practitioner, Vol 75, No 9 (2022), Pagination: 7-10Abstract
Suicide is one of the most concerning incidents that not only has a severe socioeconomic, emotional, and psychological impact on the family but also has adverse effects on the community and overall development of the country. Statistics show that India has an alarmingly high rate of suicide, with a significant proportion being among the youth. Mental health is an important aspect that needs more robust addressing and awareness in society. A multi-sectorial and integrated approach involving governmental and non-governmental health, administrative and social services, as well as mental health experts is required, along with a National Suicide Prevention Policy, as a comprehensive guiding document.Keywords
Suicide, Prevention, Mental Health, Public Health, Psychology.References
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