A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Indurkar, M.
- Hiatus Hernia : An Uncommon Presentation of Chest Discomfort
Authors
1 Dept. of Medicine, Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa MP, IN
Source
The Indian Practitioner, Vol 67, No 10 (2014), Pagination: 636-638Abstract
Chest discomfort is a worrisome symptom for both patients and physicians and presents a diagnostic challenge with a long list of differential diagnosis. Chest discomfort due to gastrointestinal causes includes oesophagitis, GORD, gastritis, oesophageal spasms, and rarely pancreatitis, cholecystitis and peptic ulcer disease. Here we present an uncommon cause of chest pain: hiatus hernia (HH). HH can be life threatening, if not diagnosed and treated early.Keywords
Chest Discomfort, CT Scan, Barium Swallow, Hiatus Hernia
- Medi Quiz
Authors
1 Department of Medicine, Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa, MP, IN
Source
The Indian Practitioner, Vol 67, No 9 (2014), Pagination: 564-565Abstract
No Abstract.- Chorea: A Rare Presentation of Vivax Malaria
Authors
1 HOD Dept. of Medicine, SSMC, Rewa M.P, IN
Source
The Indian Practitioner, Vol 68, No 4 (2015), Pagination: 43-44Abstract
Malaria is now being reported with unusual manifestations because of increasing resistance, indiscriminate use of antimalarial drugs and development of immunity. Chorea is one of the rare complication of falciparum malaria. In this case, a 28 year old male presented with fever, splenomegaly and with choreiform movement. Peripheral smear was positive for vivax malaria.- A Comparative Study of Clinical Scoring System of Cerebrovascular Accident with CT Scan
Authors
1 Department of Medicine, SS Medical College and SGMH, Rewa (MP), IN
Source
The Indian Practitioner, Vol 68, No 8 (2015), Pagination: 23-30Abstract
OBJECTIVE: Stroke is the second most common cause of death and major cause of disability worldwide. Low and middle income countries account for 85.5% of total stroke deaths worldwide and the number of disability-adjusted life years in these countries is seven times that in high income countries.CT scan is a safe and non-invasive procedure for differentiating between cerebral infarction and haemorrhage. However, in India and other developing countries the availability of CT scan facilities in rural and peripheral centres is low but cost of scanning precludes its routine usage by the poorer society. So this study aims at differentiating ischaemic and haemorrhagic strokes at bedside by using clinical scoring systems and to compare the accuracy of clinical scoring with the CT scan findings.
METHODS: This was a prospective clinical study on 100 patients who presented to the hospital within 72 hours of onset of symptoms of stroke. Siriraj and Allen stroke score were calculated using various parameters, subsequently all of these patients underwent CT scan of brain and accuracy of clinical scoring system with the CT scan was compared.
RESULTS: Most number of affected patients belonged to the age-group 61-70 with a male preponderance. 66% of the stroke cases were ischaemic, most common presenting symptom was hemiplegia followed by altered sensorium. Midline shift in CT scan was seen more in haemorrhagic stroke patients. On comparison of Siriraj score with CT scan findings correct correlation was seen in 82% of cases while Allen score showed correct correlation only in 67% of cases so the diagnosis of stroke subtype was best predicated by Siriraj score as compared to Allen score.
CONCLUSION: Present study shows that Siriraj score had good sensitivity and positive predictive value for ischaemic stroke (91.93% and 90.47%) while for haemorrhagic stroke sensitivity and positive predictive value was less (80.6% and 83.33%). Allen's score also showed good sensitivity and positive predictive value (96.2% and 91.22%) for ischaemic stroke however for haemorrhagic stroke it had poor sensitivity and positive predictive value (75% and 88.23%). So overall Siriraj score is a better tool for bedside early clinical diagnosis of stroke and to start anti-ischaemic therapy where immediate CT scan facilities are not available but these scores cannot be used for deciding thrombolysis using recombinant tissue plasminogen activators (r-tPA) which requires exclusion of haemorrhage by CT scan.
Keywords
Infarction, Haemorrhage, Cerebrovascular Accident, CT Scan, Siriraj Score, Allen Score.- A Prospective Study of Adverse Drug Reactions Monitoring in a Tertiary Care Hospital, Rewa (MP)
Authors
1 Department of Pharmacology, S.S. Medical College, Rewa, (MP), IN
2 Department of Medicine, S.S. Medical College, Rewa, (MP), IN
Source
The Indian Practitioner, Vol 69, No 11 (2016), Pagination: 11-15Abstract
Aims and Objectives: The aim of study is to determine the pattern of suspected ADRs reported in ICU and ward admitted patients in a tertiary care hospital.
Material and methods: Study was conducted in the department of Pharmacology and department of Medicine, SS Medical College and SGM Hospital, Rewa, MP, during October 2014 to September 2015. Total 130 cases were enrolled in study that presented with suspected ADRs during study period, after taking written informed consent. Clinical evaluation and scrutiny of data was done to assess pattern, extent and duration of the suspected adverse drug reactions, affected organ system and involvement of therapeutic drugs classes as a part of the drug reaction.
Results: The result of this study showed that maximum (25%) patients belonged to the 18-25 years of age group, of these 55% was males and 45% were females. Mean (± SD) age of these patients was 34.84 ± 20.99 years. Among the reported suspected ADRs; maximum (26%) were skin rashes, followed by pruritus (15%), nausea, vomiting and rigor each occur 7%; Fever 6%, Apnea, oral ulcers and headache 3%. The most commonly affected organ system was skin and mucous membrane (44%), followed by central nervous system (11%), gastrointestinal system (10%), respiratory system (7%), and cardiovascular system (5%) in decreasing order. Of these; majority of suspected ADRs were associated with use of antimicrobials (68%), followed by NSAIDs (9%); Hematinics (5%); Antihypertensive, Antianginal, Antiepileptics, Hypoglycemis, Corticosteroids and Ionotrops (2%).
Conclusions: The Hospital-based monitoring of suspected ADRs is convenient but it is under reported and the limitation of these studies is that they do not yield the exact incidence of suspected ADRs associated with particular drug use.
Keywords
Drugs, Adverse Drug Reaction, Morbidity, Organ System.References
- RabburRSM, Emmerton L. An introduction to adverse drug reporting system in different countries. Int J Pharm Prac 2005; 13(1):91-100.
- Onder G, Pedone C, Landi F, Cesari M, Della VC and Bernabei R. Adverse Drug Reactions as Cause of Hospital Admissions Results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am GeriatrSoc 2002; 50(12):1962-1968.
- Lazarou J, Pomeranz BH and Corey PN. Incidence of Adverse Drug Reactions in Hospitalized Patients.A Meta-analysis of Prospective Studies. Journal of American medical Association 1998; 279(15):1200-1205.
- Hakkarainen KM, Hedna K, Petzold M, Hagg S. Percentage of patients with preventable adverse drug reactions and preventability of adverse drug reactionsA meta-analysis. PLOS ONE 2012;7 (3): 104-109.
- Alomar M J. Factors affecting the development of adverse drug reactions. Saudi Pharmaceutical Journal 2014;22:83-94.
- Vallano A, Cereza G, Arnau J M. Obstacles and solutions for spontaneous reporting of adverse drug reactions in the hospital. Br J Clin Pharmacol. Dec 2005; 60 (6):653-658.
- Gupta R, Sheik A, Strachan D, Anderson HR. Increasing hospital admission for systemic allergies disorders in England: analysis of national admission data. Br Med J 2003;327(7424):1142-1143.
- Chawla S, Kalra BS, Dharmshaktu P, Sahni P. Adverse drug reaction monitoring in a tertiary care teaching hospital. J Pharmacol Pharmacother 2011;2(3):196-198.
- Arulmani R, Rajendran SD, Suresh B. Adverse drug reaction monitoring in a secondary care hospital in South India. Br J Clin Pharmacol 2007;65(2):210-216.
- Murphy BM and FrigoLC.Development, Implementation and Results of a Successful Multidisciplinary Adverse Drug Reaction Reporting Program in a University Teaching Hospital 1993; 28: 1199-1204.
- Jose J, Rao PG. Pattern of adverse drug reaction notified by spontaneous reporting in an Indian tertiary care teaching hospital. Pharmacol Res 2006;54:226-233.
- Glassen DC, Pestotnik SL, Evans RS, Burke JP. Computerized surveillance of adverse drug events in hospital patients. JAMA 1991;266:2847-2851.
- Prosser TR, Kamysz PL. Multidisciplinary adverse drug reaction surveillance programme. Am J Hosp Pharm 1990;47:1334-1339.
- Wester K, Jonnson AK, Spigset O, Druid H, Hagg S. Incidence of fatal adverse drug reactions: a population based study. Br. J. Clin. Pharmacol 2007;65(4):573-579.
- Gor AP, Desai SV. Adverse drug reactions (ADR) in the inpatients of medicine department of a rural tertiary care teaching hospital and influence of pharmacovigilance in reporting ADR. Indian J. Pharmacol. 2008;40(1):37-40.
- Vora MB, Trivedi HR, Shah BK, Tripathi CB. Adverse drug reaction in inpatient of internal medicine wards at a tertiary care hospital: a prospective cohort study. J Pharmacol Pharmacother 2011;2(1):21-25.
- Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA. The nature of adverse events in hospitalized patients. N Engl J Med 1991;324(6):377-384.
- Bilateral Basal Ganglia Calcification:Uncommon Manifestation in Hypoparathyroidism
Authors
1 Department of Medicine, Shyam Shah Medical College, Rewa, Madhya Pradesh, IN
Source
The Indian Practitioner, Vol 69, No 12 (2016), Pagination: 37-38Abstract
Hypoparathyroidism is far less common than hyperparathyroidism. Although as many as one-half of patients in an ICU setting are reported to have hypocalcemia (<8.5mg/dl), most do not have a reduction in ionized calcium. Since adequate treatment of hypoparathyroidism may lead to marked clinical improvement, serum concentration of calcium, phosphorus, and parathyroid hormone (PTH) is suggested to be determined in all individuals with calcification of the basal ganglia to rule out hypoparathyroidism.References
- Kumar, Abbas, Fausto, Aster. Robbins and Cotran Pathologic Basis of Disease, Eighth Edition January 2009;1129.
- Kasper,Fausi,Hauser,Longo,Jameson,Loscalzo.Harrison ´s Principles Of Internal Medicine. 19th Edition; 315.
- Kasper, Fausi, Hauser, Longo, Jameson, Loscalzo. Harrison´S Principles Of Internal Medicine. 19th Edition; 2482
- Kumar, Abbas, Fausto, Aster. Robbins and Cotran Pathologic Basis of Disease, Eighth Edition January 2009;1130
- Cutaneous Adverse Drug Reaction (CADR): An Overview
Authors
1 Department of Pharmacology, S.S. Medical College, Rewa, (MP) – 486001, IN
2 Department of Physiology, S.S. Medical College, Rewa, (MP) – 486001, IN
3 Department of Anatomy, Sukh Sagar. Medical College & Hospital, Jabalpur, MP, IN
4 Department of Medicine, S.S. Medical College, Rewa, (MP) – 486001, IN
5 Department of Ayurveda Rewa, (MP) – 486001, IN
Source
The Indian Practitioner, Vol 70, No 1 (2017), Pagination: 11-15Abstract
Aims and Objectives: Aim of this prospective, hospital based study is to determine the pattern of cutaneous adverse drug reactions (ADR). Material and methods: The study was conducted in the department of Pharmacology and department of Medicine, at SS Medical College and associated SGM Hospital, Rewa, MP from Oct 2014 to Sept 2015; total 130 cases were enrolled with suspected ADRs. Results: In this study maximum (25%) patients belonged to 18-25 years of age group. Mean (± SD) age of these patients was 34.84 ± 20.99 years. The skin and mucous membrane are most commonly (52.29%) affected organ system with suspected ADRs followed by central nervous system (9.19%) and gastrointestinal system (8.62%). Among the cutaneous ADRs; 51.64% were skin rashes followed by 29.67% pruritus, 5.49% oral ulcers, 3.29% Stevens-Johnson syndrome (SJS), 2.19% bullous eruption, 2.19% lips swelling, 2.19% toxic epidermal necrolysis (TEN), 1.09% oral candidiasis, 1.09% red man syndrome and 1.09% hair changes. Of these ADRs; 82.41%were associated with use of antimicrobials followed by 14.28% NSAIDs. Amongst AMAs 20.97% ADRs were associated with fluoroquinolones, 18.68% with cephalosporin, 10.98% with penicillin and 5.49% with sulphonamide. Conclusions: In this study, skin and mucous membrane is most commonly (52.29%) affected organ system; skin rashes and pruritus are the most common cutaneous ADRs and majority of cases were associated with use of fluoroquinolones and cephalosporins AMAs.Keywords
Cutaneous Adverse Drug Reactions (CADR), Exanthematous Drug Eruptions, Antimicrobial Agents (AMAs), Fluoroquinolones.References
- Edward IR, Aronson JK. Adverse drug reaction: definition, diagnosis and management. Lancet 2000; 356 (9237): 1255-1259.
- Rabbur RSM, Emmerton L. An introduction to adverse drug reporting system in different countries. Int J Pharm Prac 2005; 13 (1): 91-100.
- Rao PGM, Archana B, Jose J. Implementation and result of adverse drug reaction reporting program at an Indian teaching hospital. Indian J Pharmacol2006; 38 (4): 293-4.
- Brown SD and Landry FJ. Recognizing Reporting and Reducing Adverse Drug Reactions. Southern Medical Journal 2001; 94: 370-372.
- Padmaja U, Adhikari P, Pereira P. A prospective analysis of adverse drug reaction in a south Indian hospital. Online J Health Allied Sci. 2009; 8 (3): 12.
- David WB, Nathan S, David JC. Elisabeth B, Nan L, Laura A and Petersen. The Cost of Adverse Drug Events in Hospitalized Patients. Journal of American Medical Association. 1997; 277 (4): 307-311.
- Bordet S, Gautier H, Lelouet B and Dupuis J. Caron. Analysis of the Direct Cost of Adverse Drug Reaction in Hospitalised Patients. European Journal of Clinical Pharmacology 2001; 56: 935-39.
- Arulmani R, Rajendran SD, Suresh B. Adverse drug reaction monitoring in a secondary care hospital in South India. Br J Clin Pharmacol 2007; 65 (2): 210-216.
- Murphy BM, Frigo LC. Development, implementation and results of a successful multidisciplinary adverse drug reactions reporting program in a university teaching hospital. Hosp Pharm 1993; 28: 1199-1204.
- Jose J, Rao PG. Pattern of adverse drug reaction notified by spontaneous reporting in a Indian tertiary care teaching hospital. Pharmacol Res 2006; 54: 226-233.
- Glassen DC, Pestotnik SL, Evans RS, Burke JP. Computerized surveillance of adverse drug events in hospital patients. JAMA 1991; 266: 2847-2851.
- Prosser TR, Kamysz PL. Multidisciplinary adverse drug reaction surveillance programme. Am J Hosp Pharm 1990; 47: 1334-1339.
- Surajit Nayak and Basanti Acharjya. Adverse cutaneous drug reaction. Indian J Dermatol. 2008; 53 (1): 2–8.
- DeShazo RD, Kemp SF. Allergic reactions to drugs and biologic agents. JAMA. 1997; 278: 1895–906.
- 3. Anderson JA, Adkinson NF. Allergic reactions to drugs and biologic agents. JAMA. 1987; 258: 2891–9.
- Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. N Engl J Med 1994; 331: 1272-1285.
- Sharma VK, Sethuraman G. Adverse cutaneous reactions to drugs: An overview. J Postgrad Med 1996; 42: 15-22.
- Gupta R, Sheik A, Strachan D, Anderson HR. Increasing hospital admission for systemic allergies disorders in England: analysis of national admission data. Br Med J 2003; 327 (7424): 1142-1143.
- Chawla S, Kalra BS, Dharmshaktu P, Sahni P. Adverse drug reaction monitoring in a tertiary care teaching hospital. J Pharmacol Pharmacother 2011; 2 (3): 196-198.
- Gruchalla R. Understanding drug allergies. J Allergy Clin Immunol. 2000; 105: 637–44.
- Chatterjee S, Ghosh AP, Barbhuiya J, Dey SK. Adverse cutaneous drug reactions: A one year survey at a dermatology outpatient clinic of a tertiary care hospital. Indian J Pharmacol. 2006; 38: 429–31.
- Stern RS, Wintroub BU. Cutaneous reactions to drugs. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick’s Dermatology in general medicine. 5th ed. McGraw-Hill: New York; 1999. pp. 1634–42.
- Sullivan JR, Shear NH. Drug eruptions and other adverse drug effects in aged skin. Clin Geriatr Med. 2002; 18: 21–42.
- Kauppinen K, Stubb S. Drug eruptions: Causative agents and clinical types. Acta Derm Venereol. 1984; 64: 320–4.
- Pudukadan D, Thappa DM. Adverse cutaneous drug reactions: Clinical pattern and causative agents in a tertiary care center in South India. Indian J Dermatol Venereol Leprol. 2004; 70: 20–4.
- Ajayi FO, Sun H, Perry J. Adverse drug reactions: A review of relevant factors. J Clin Pharmacol. 2000; 40: 1093–101.
- Wester K, Jonnson AK, Spigset O, Druid H, Hagg S. Incidence of fatal adverse drug reactions: a population based study. Br. J. Clin. Pharmacol 2007; 65 (4): 573-579.
- Gor AP, Desai SV. Adverse drug reactions (ADR) in the inpatients of medicine department of a rural tertiary care teaching hospital and influence of pharmacovigilance in reporting ADR. Indian J. Pharmacol. 2008; 40 (1): 37-40.
- Vora MB, Trivedi HR, Shah BK, Tripathi CB. Adverse drug reaction in inpatient of internal medicine wards at a tertiary care hospital: a prospective cohort study. J Pharmacol Pharmacother 2011; 2 (1): 21-25.
- Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA. The nature of adverse events in hospitalized patients. N Engl J Med 1991; 324 (6):377-384.
- V K Sharma, G Sethuraman, B Kumar. Cutaneous adverse drug reactions: clinical pattern and causative agents--a 6 year series from Chandigarh, India. Journal of Postgraduate Medicine 2001; 47 (2): 95-99
- F. Fiszenson-Albala, V. Auzerie,E. Mahe, R. Farinotti,C. Durand-Stocco, B. Crickx, V. Descamps. A 6-month prospective survey of cutaneous drug reactions in a hospital setting. British Journal of Dermatology 2003; 149, (5): 1018–1022